HomeMy Public PortalAbout5470 TEMPLE CITY BLVD_Electrical__ tSAsasc- cr:wse 11175 APPLICATION FOR ELECTRICAL PERMIT
BUI�A.. ETYDIVI ION
FOR APPLICANT TO FILL Iry ��P./
New Residential Bldgs &Pools
EACH NO FEE Au DBDRESS>Sf/D air
1 &2 Finally Sq Ft S — $ LOCALITY7 Ai60V, G6 Ty
Multi family Sq Ft — NEAREST
Residential Swimming Pools CROSS ST
OWNER OR
FIRM NAME
Outlets Light,Switch& Receptacle MAIL T
DDRESS CT
First 20 A
Additional I CITY Tel No
PLAN CHECK
Lighting Fixtures APPLICANT
First 20 i ADDRESS
Additional CITY To' No
PERMIT C
Fixed Appliances Not Over 1 HP APPLICANT LaG
Range— Heater_ DW
Oven , Dryer W M ADDRESS
Top _ FAU W H CITY Tal No
Hood Fan LICENSE OR y
Disp A C REG NUMBER Class
weev • NHIS
Power Apparatus& Large Appliances S
TAT. TN.TS TN v„I• c E TOLC ATIOY
L COUNTY ORDINANCES ADD .TATE LAWS RSUDLATJND
Size&Type HP, KW KVA or KVAR ELECTRICAL
WIRING w
P a
U t0 1 Incl Y CERTIFY T I AR rP DIST.R.D AND/OR 2
Over 1 to 10 Ind DE HERESY
E DUIRSD BY LOS w D STAT. OF
Over 10 to 501nc1 o.,��e�o D L,A.
n..sa"`S o.D,r.e„TOFN T.I. A
Over 50 to 1 D Incl PERMiTCC
Over 1 D sIGNATU Re i ff
Services
DISTRICT NO "SED BY
/1
0 200 Amp Under 600 V < O Vy/
201 1000 Amp Under 600V APPROVALS DATE `1NSSIGTUBE
Over 1000 Amp or Over 600 V
TEMP POWER POLE
Temp Power Pole&Appurtenances UNDERSLAB WORK
Sign with One Branch Circuit ROUGH CONDUIT
Additional Sign Branch Circuits
(Other) WIRING
FIXTURES
POWER AUTHORIZED
PERMIT FEE (Sub Total) UTILITYCO NOTIFIED
PLAN CHECKING FEE (One Fourth Permit Fee) FINAL .7
PERMIT ISSUING FEE
TOTAL FEE IF/ NOTES
Zt p U
PLAN CHECK VALIDATION CK MO CASH PERMIT VAL ION K M o CASH
J
o 4,5r►ur 2 1 0 -12.00 •ss
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