HomeMy Public PortalAbout5016 TEMPLE CITY BLVD_Electrical__ 0116 BA 11 EE ' APPLICATION FOR ELECTRIC PERMIT ' 1
DIVISION OF BUnDING AND SAFETY /
CalBb asLas gs]tt ADDRESS �D I�oZen
JOHN A LAMBIE,COUNTY ENGINEER
CASSATT D GRIFFIN. tUP'T DF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
PORrFEES
!NE
CROSS STzi
xure
OWNER
LIGHT OUTLETS MAIL 1
ECEPTACLES MAIL
WALL SWITCHES FEE CRY O�TOTAL OUTLETS a ELECTRICIAN
ELEC RANGES 2aADDRESS
ELEC HEATERS 2a
KW CITY OSTATE
FIXTURES 'aLICENSE NOMOTORS DISTRICT�I p IG DT Poe leerErnor
NUMB HORSEPOWER FEE
NEW MVD HP OVER INC EACH
e Lean t 2a WSPEIMON BD
2 ao
2 S 100
a fa Too
15 DO 2 a0
DO 200 S 00
MIHC
NO SIGNS NO TRANS
NO SIGNS NO LAMPS
FOR EACH PERMIT
WIRING 1 OO m
FIXTURES $1 00
SUPPLEMENTARY AMOVATS
TOTAL FEE DATE INSPECTOR S SIGNATURE
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ TRIS APPI I ION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO CO PLT CONDUR
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING WIRING
I HEREBY CERTIFY THAT 1 AN PROPERLY REGISTERED AMD/OR FIXTURES
LICENSED AS REQUIRED By 9 AAGEL65 COUNTY STATE
CALIFORNIA OR THAT I XE AL OWNER HE AB POWER
DESCRIBED REBID L
H[GNATURE UTILFTYCO NOTIFIED 14 3ja Is,
OF PERMITTE FINAL
JOHN A LAMBIE.COUNTY ENGINEERolc Y ATJON ARTHUR C.VER.CHIEF EUICT. INSPECTOR
CASH
I11C9 4 1 4L AUG 21 2 3.70 m