HomeMy Public PortalAbout5503 TEMPLE CITY BLVD_Electrical__ DNS sA 12 Et APPLICATION FOR ELECTRIC PERMIT 1�
DIVISION OF BUILDING AND SAFETY
Dopartn' of county Engluesr
county of Lo$ Anq$1$$ BUILDING
_ WM J FOX COUNTY ENGIREER ADDR E63 ^
CASSATT O GRIFFIN SUP T OF BUILDING �7^
FOR APPLICANT TO FILL IN LOCALITY / L 1
PERMIT FEES NEARECROSSST
FEE
NUMBER EACH
LIGHT OUTLETS ! OWNER s
RECEPTACLES MAIL y r
ADDRESS [+
WALL SWITCHES
TOTAL OUTLETS BI At 7 CITY TEL O
ELEC RANGES 25 ELECTRICIAN CZ&V ^
ELEC HEATERS 25
—ADDRESS
NW EA -_
CITYTEL NO
FIXTURES B LICENSE NO2.
NUMBER OF LIGHT CIRCUITS DISTRICT NO 1GROLIP11 ZONE
READY foA INT P[cT IDP
U A 6A02
MOTORS ✓�
NUMGIR HORSEPOWER FEE INSPECTION RECOBD
NEW MVD HP OVER INC EACH
LESS S 25 _
_ 2 B 100 _
_ 3 IB IHO
_ tB SO 250 _
BO 200 500
M19
NO SIGNS NO TRANS
NO SIGNS NO LAMPS _
OR EACH PERMIT _
WIRING $100 G
FIXTURES $100 OO
SUPPLEMENTARY BO
2 APPROVALS
TOTAL FEE $ / VD DATE INSPECTOR S SIGNATURE
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION CONDUIT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY _
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING A •
ELECTRICAL WIRING
1 HEREBY CERTIFY THAT I AN PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF WER
CALIFORNIA OR THAT 1 AM THE LE6 OWNER OF THE ABOVE
DESCRIBED RESIDENTIA PE
UTILITY CO NOTI FI D
SIGNATURF
OF PERM IIT' FINAL
WILLIAM J FOX,COUNTY ENGINEER _ ._..VTW]k 8j 2 2 2.`�O
i1I1[� BY
EPUTY