HomeMy Public PortalAbout5460 TEMPLE CITY BLVD_Electrical__ 76A663 CES06 10/1' APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES pB
RE55 /7L
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION gOD
LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
OUTLETS No EACH FeEOR
$ S FIRM NAME
RECEPT MAIL
LIGHT—_?— TOTAL
FIRST 20 26 ADDRESS
�Q OVER 20 CI Ty TEL NO
SWITCH` /.0 . 10 PLAN CHECK - -
LIGHTING' 1 FIRST 20 Zy \ APPLICANT
J} TOTAL
FIXADDRESS
TURES y� COVER 20 10
RESIDENTIAL APPLIANCES CITY TEL NO
PERMIT
RANGE_DRYER_WTR HTR_ APPLICANT F� NNYAMO
STA COOK-1315P _F A U _ ADDRESS O J
SPACE HTR AIR GOND CITY TEL NO
CLOTHES WASH DISHWASH_ REGE NUMBER CLASS—(:!!Q
FAN_OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT TME ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND HEATERS ETC HP KW KVA ELECTRICAL WIRING
SIZE 6 TYPE OVER TO
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 — 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
1 — 10 300 OESCRI PCD RES IUENTIAL PROPERTYPERMI
10 — 50 600 SIGNATURE,
Ca
SIGNATURE d'L rS4 �
� O
SO — 100 1000 DISTRICT NO PROCESSED BY
100 — 500 1300
2
SIGN GAS SIGN AND ONE CIRCUIT 600 APPROVALS DATE INSPECTDWS SKNATURE
TUBE OR
MARQUEE ADDITIONAL CIRCUITS 100 TEMP POWER POLE
SERVICE NOTOVER 600 VOLTS OR 200 AMP SOO UNDERSLAB WORK
SERVI CEOVER 600 VOLTS OR 200AMP 1000 ROUGH CONDUIT
TEMPSERVICE POLE @APPURTENANCES 600 WIRING
TEMP LIGHT OR RECEPT SYSTEM 9DO FIXTURES
1
POWER AUTHORIZED
UTILITY CO NOTIFIED
FINAL _
PERMIT FEE (SUB TOTAL) NOTES
PLAN CHECK FEE
PERMIT ISSUING FEE 300
TOTAL FEE
PLAN CHECK VALIDATION CK M o CASH PERMIT VALIDATION
CK M 0 cAl
8 6 3 V AlN 20 2 0 6.7 5 ,&W
SEE SACK OF APPLICATION FOR COMPLETE SCHEDULE
76A653 CEM II/'° APPLICATIO FORE CTRICAL PERMIT
COUNTY OF LOB ANGELES
DEPARTMENT OF COUNTY ENGINEER ABUILDING
BUIDDRESS Jr
BUILDING AND SAFETY DIVISION b
COLEMAN W JENKINS N RMT r LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS 3T
OUTLETS FE
jQ/P�� OWNER
RECEPTiIL 6 , S MAIL
LI GNT�� TOTAL FIRST 20 2! 5 o'a ADDRESS
OVER 20 L O CITY TEL NO
SWITCH - - IO 3 V PLAN CHECK
LIGHTING TOTAL FIRST 20 25 0,0 APPLICANT
TURES 10 -
OVER 20 ADDRESS
FI%
APPLIANCES CITY TEL NO
O_
RANGE DRYER PERMIT
_WT HTR APPLICANT eo
STA COOK_DISP 2F A U ADDRESS BKL.
SPACE HTR L. ;A IR CONO CITY && TEL NO
CLOTHEH S WASH ✓ DISHWASLICENSE NO a_S�g CLASS C-
FAN ✓QOTHER IDO 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
U AHO STATE THAT THE ABOVE I! CONNECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINAXCLS AND STAT! LAW! REGULATING
IND ,CATERS ETC HP KW MVA ELECTRICAL WIRING
SIZE & TYPE OVER TO
HEREBY CERTIFY THAT I AM Q9U.E C RIG AND E° AND/Olt
Q _ 1 100 LICENSED AS TTHATRIOUIRED BY LO!LEGAL
OW COUNTY AND STATE OF
ULI FOPMIA OR THAT AM THE LEGAL OWNER OF AND INTEND TO }
1 - 10 300 RESIDE IN TMC ABOVE DESCRIBED RESIDENTIAL PROPERTY d
O
10 - 50 500 SIGNATURE V
OF PERMITTEE
CC
SQ - 100 1000 OI f TAI CT NO CLASS f!D B O
100 - SOO 15M �� r T IIIILLL)
6
SIGN GAS SIGN AND ONE CIRCUIT 500 rE
N
TUBE OR ?
MARQUEE ADDITIONAL CIRCUITS IDD
SERVICENOTOVER600 VOLTS OR 200AMP SOO o-
ROVALS DAYS IxePECT0IPl SIGNATURE
S ERVI CE OVER 600 VOLTS OR 200 AM P 100°
OWER POLE
TEMPSERVICE POLE &APPURTENANCES SOO
AB WORK
TEMP LIGHT OR RECEPT SYSTEM SOD
ONDIUT .'7
S -L^UTHORIZEDLPPER
(SUB TOTAL) CO NOTIFIED 'tEE -` -� K
NG FEE 9;�eJOSEPH C ROO AN
O SUPERVISING ELE I L ENGINEER
PLAN CHECK VALIDATION CK M 0 c•ex P RMIT'YALIDATION CK M 0 CASH
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE �' _