HomeMy Public PortalAbout5738-5738 1/2-5740 TEMPLE CITY BLVD_Electrical__ 76Aa63C- C68,=/»I APPLICAT N FOR ELECTRICAL PERMIT
BUILDING,.AND FETY DIVISION
FOR APPLICANT TO FILL IN JOB
New Residential Bldgs.&Pools EACH NO. FEE ADDRESS �.
1'&2 Finaily Sq. Ft. $ — $ LOCALITY-1-2,01
Multi-family Sq. Ft. — NEAREST
Residential Swimming Pools CROSS ST.OWNER OR
FIRM NAME
Outlets: Light,Switch&Receptacle MAIL
First 20 ADDRESS
Additibnal CITY Tel. No.
PLAN CHECK
APPLICANT
Lighting Fixtures
First 20 ADDRESS
Additional CITY Tel.'No.
PERMIT
Fixed Appliances Not Over 1 HP APPLICANT
Range_ Heater_ D.W. _ ADDRESS.
Oven _ Dryer _ W.M. _ `...
Top _ FAU W.H. _ CITY Tqj. /
Hood Fan LICENSE-OR' r/
REG. NUMBER Class. G v
Disp. ._ A.C. v
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY 0
Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
I.IJ
Size&Type HP,KW,KVA,or KVAR ELECTRICAL WIRING,
Up to 1 Incl. I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR Z
Over 1 to 10 Incl. LICENSED AS REO UIR ED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
Over 10 to 50)nCl. DESCRIBED REBID P O Y.
Over 60 to 100 Incl. PER MITEE i�IAL
Over 100 SIGNATURE
DISTRICT NO. CESSED BY
Services �"��Q
0-200 Amp. Under 600 V
201 -1000 Amp.Under 600 V APPROVALS DATE INSPECTOR'S
SIGNATURE
Over 1000 Amp.or Over 600 V
TEMP.POWER POLE'
Temp.Power Pole&Appurtenances UNDERSLAB WORK
Sign with One Branch Circuit
Additional.Sign Branch Circuits ROUGH CONDUIT
(Other) WIRING
FIXTURES
]POWER AUTHORIZED
PERMIT FEE (Sub-Total) UTIL.IrTV CO,NOTIFI;E.D
PLAN CHECKING FEE (One-Fourth Permit Fee) FINAL
PERMIT ISSUING FEE
NOTES � -
TOTAL F,EE
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION SCK._ M.O. CASH
1 5 9 NNOV 16 2 0 —�. ®tet
jD.B.M.SA e25M METS
10�-47 1� 1��T,ry �p�� AiS I CATION FAIR
OEPARToaEW OF BUILDING AM MOM d'IIS�i.uY��Hi li Y"V
COUNTY OF LOS ANGELES �'��� 1 4
`y M. O IEF ENGINEER
Ea AD
E DISTRICT O. GROUP ZONE PERMIT NO.
RECEIVED BY READY FOR DATE ISSUED
®We N� TEL.NO. 4v�9 FIRST INSPECTION it G�oCOUNW
RI
Ms
Q � �a�. (/ n EXPIItBB C'Zr
APPLICANT FILL IN ]HEAVILY OUTLINED PORTION ONLY
JOBESCCRIPTION OF WORK ADDRESS/W o �p a oS°UNS efMBER OF OUTLETS ON CIRCUITS LOCALITY E ELOCATION BY ROOMSNEAREST /LIGHT OUTL6IS BW. PLU68 Fair C OSSc�A B C D E F G H mNAME I MAIL
ADDRESS 07 �PIr
bA CITY M d. TEL.NO.
1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ASA ® ANG9LE8 COUNTY CERTIFIC�Mao iCATiON..
tfzl AM I=-La"L.OWNER OF 7HR P PERTY DIBSCRIB®
�/ G R
I, e H ® OWNER.
COCTHONS
a
RAM 5Z
O
TOTAL ® O
NO. OF OUTLETS s �•� APPROVALS
NO. OF FIXTURES DATE INSPECTOR'S NAME
NO. OF MOTORS H.P. CONDUIT
NO. OF SIGNS TRANS. WIRING
99 s
NO. OF RANG OR HEATERS / $ S FIXTURES
MISCELLANEOU 8 POWER
PERMIT FEE $ y� UTILITYCO.NOTIFIED
TOTAL FEE m '7 'L� FINAL 1 / .r �-
D.S.S.SA 2SM SETS 10-47 411181 CATION TOR
InEPART14ENd' OF BUELMCY AND SAFETY � LY i'ED ��
• ) COUNTY OF LOS ANGELES
M J. C23CHIEF E EER
_Q NAME �' n ',� D18TRICT NO. GROUP ZONE PERMfT NO.
U ADDRESS ��� ��/ ® /
® 3 �/
o �y pgT6�S9
CITY / �ii,/ TEL.NO. 6a,-7
RECEIVED BY FIRSTINSPE FOR
(- U�
CERT O m EXPIRES
6 c
APPLICANT FILT N Afff.Y OUTLINED PORTION ONLY
DESCRIPTION OF WOVE: ADDRESS tai°4,f
NUMBER OF OUTLETS ON CIRCUITS LOCALITY �a
LOCATION BY ROOMS NEAREST
LIGHT OUTLETS ISW. PLUGJA
SS
CIRCUIT A B C D E F G NAMESl
ADDRESS 7(� C4 0,o ctTY ® TEL.No.
`' P GAN C8 LEGALNTY E�POSFSES R OF T7SL.EIFIABOVE.LOSELECTRICIAN.
AM TM s Erse OWNER OF PROPEJU Y DESCRIBED
OYB
OWNER.
ORRECHONS
_R4/•
P n �
V.
Vii-Rhe r�
Z
RED
f f °
OTA Tie
NO. OF OUTLETS APPROVALS
NO. OF FIXTURza DATE INSPEC'TOR'S NAME
NO. OF MOTORS H.P. CONDUIT
NO. OF SIGNS TRANS. WIRING S-NO. OF-RANCECr R HEATERFIXTURESMISCELLANEOU 'POWER
PERMIT FEE is .f/�� UTILITYco.NOTIFIED
TATAL Ems? a f ITINIaL 7 u
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