HomeMy Public PortalAbout5909 TEMPLE CITY BLVD_Electrical__ 76A663-CES06 4-68 MIPF
APPLICATION FOR, ELECTRI ALL PEI PER
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING T
S f
BUILDING AND SAFETY DIVISION ADORES
JOHN A. LAMSIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SupERINTjtNDsNT OF BUILDING LOCALITY 1.
RES NEAREST
FOR APPLICANT TO FILL IN CROSS S'T
O. AC FE
RECEPT. 1$ OWNER
MAIL
LIGHT TOTAL FIRST 20 .20 4w ADDRESS
OVER 20
SWITCH .10 )WCITY TEL. NO,
/ PLAN CHECK
LIGHTING )TO-JAL I FIRST "20 .20 APPLICANT
OVER .10
BUILDING
FE
0.'
FIXTURES ADDRESS
RANGE—DRYER—WTR.HTR.— CITY TEL. NQ /7
STA.COOK—DISP.—F.A.U.— CONTRACTOR
SPACE H'TR.—AIR COND.— ADDRESS
CLOTHES WASH.—DISHWASH—, CITY NO. 3 It.7-
FAN—OTHER 1.001 LICENSE NO. 71 5 ,1 CLASS.
MOTORS,TRANSFORMERS RATING
IND. HEATERS, ETC.. HP. KW. KVA. I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 13 CORRECT AND AGREE TO COMPLY
SIZE & IYPFOVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING.
0 - 1.001, 0,
1 HEREBY CERTIFY 'THAT I AM PROPERLY REGISTERED AND,/QR
v 1 - 10 3.00LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE or
— CALIFORNIA OR THAT I AMI THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN. THE ABO%E-DE CR IDENTIAL PROPERTY.
10 - so 5�00 C.2
SIGNATURE
so - 100 10.00 OF PERMITTE
100 - 500 .15.00DISTSI. T p Q
SIGN,GAS SIGN AND ONE CIRCUIT 3.00 An
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES:
SERVICE NOT OVER SOO VOLTS OR 200 AMP 2.00
SERVICE OVER 600 VOLTS OR 200 AMP 5.00
TEMP SERVICE:POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE
EMP. POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
WIRING
PERMIT FEE (SUB TOTAL) FIXTURES
PLAN CHECK FEE.(50% PERMIT FEE) POWER AUTHORIZED z
PERMIT ISSUING FEE 2.00 0 UTILITY CO.NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1'-Oc 0 FINAL
I
JOSEPH C- ;R00HAN
TOTAL FEE SUPERVISING ELEC AL ENGINEER.,
PLAN CHECK VALIDATION CK. M.O:. CASH PERMIT VALIDATION M.O.. CASH'
W9474% APR21 P D 4-00&
n
-E BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
DEPARTMENT OF BUILDING APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES ELECTRIC CTRIC
NAT RE F INSTALLATION D15TRICT-UM
�i �� ITjO.
WIRING FIXTURES SERVICE__ y / / `� '?Z
READY FOR RECEIVED Y DATE 1 SUE
RANGE NEATER I-I POWER FIRST yNSP TIO /y
SIGNS MISCELLANEOUS ///�� / 1 ��
APPLICANT FILL IN HEAVILY 0VTLl'NED PORTION QNLY
! .IOB �
q NAME ADDRESS
U
F ADDRESS LOCALITY
NEAREST
Ig CITY V&j AV40TEL. No CROSS ST. � �-
STATE COUNTY 0�{
N LICENSE No. REG. NO. iC/ d' NAMEMAIL C,
DESCRIPTION OF WORK 3 ADDRESS
NUMBER OF OUTLETS ON CIRCUITS 0 }
CITY TEL. NO.
LOCATION BY ROOMS
LIGHT OUTLETS $E PLUGSFIYT. C® S
CIRCUIT A I BICI D1 E F G I H
LIVING ROOM I I ( I I I I I I I
DINING ROOM I I I I I I I
BRKFST. RM. I I I I I I
BATH
ENT. HALL I I I I I I I
HALL No. I I
FRONT PORCH I I I I
OUTSIDE
KITCHEN
SERV. PCH. _z
BOBM. No. a
I _CLOSET O
NORM. No.
CLOSET I I I I I I
X10 �-a��f:•(�' �- .
I I
TOTAL I I I I I
NO. OF OUTLETS a APPROVALS
NO. OF FIXTURES $ DATE INSPECTOR'S NAME
NO OF MOTORS H. P. S CONDUIT
NO. OF SIGNS TRANS. S WIRING
NO. OF RANGES OR HEATERS & FIXTURES
MISCELLANEOUS # POWER �/,.•�)�.PERMIT FEE I6 ;L UTILITY CO. NOTIFIED �.qq? ��5. Y� LiJc %�4
TOTAL FEE !i L/ FINAL 1 �lrGt
0