HomeMy Public PortalAbout5913 TEMPLE CITY BLVD_Electrical__ DBB S-A 12-44
APPLICATION FOR PERMIT
(DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES ELECTRIC
W M. J. FOX CHIEF ENGINEER
Q NAME �;-b _ 'Ti'r. =BYRE-ADY
ONE PERMIT NO,
1U. ADDRESS CITY v�*Z -� � --I r�s� OR DATEISSUED
�/ �1 ) TEL.NO. CTION
W COUNTY
CERT.NO. / ` 13 EXPIRES
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
(DESCRIPTION OF PORK ADDRESS !' P S 0p�o
NUMBER OF OUTLETS ON CIRCUITS LOCALITY , / --1 1-E
LOCATION BY ROOMS
NEAREST
LIGHT OUTLETS SW. PLUGS F11[T CROSS ST.
CIRCUIT A B C D E F G H 0' NAME
z MAIL
o ) kms+ 3 ADDRESS
O
CITY TEL.NO.
I AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIF TS /O,F(QUA�J/pIFICATION..
ELECTRICIAN.
1 AM TM IEGAL I MINER OF TILE PROPERTY DESCRINED
ABOVB
OWNER.
CORRECTIONS
— Q
Z_
L7
O
TOTAL
NO. OF OUTLETS I $ APPROVALS
I NO. OF FIXTURES N� IB r' DATE INSPECTOR'S NAME
NO. OF MOTORS H.P. B CONDUIT
NO. OF SIGNS TRANS. B WIRING
NO. OF RANGES OR HEATERS FIXTURES
MISCELLANEOUS Si POWER
'r
PERMIT FEE �.�// UTILITY CO.NOTIFIED r •�_ y
\ TOTAL FEE _FINAL SSS r�• +'�-
u
78A889-CE808 8-89
I ,
APPLICATION FOR ELECTRICAL PERMJT
COUNTY OF LOS ANGELES ,O
DEPARTMENT OF COUNTY ENGINEER ADDRESS (. f
BUILDING AND SAFETY DIVISION
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY 7�
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NO. EACH FEE
c
RECEIPT._ $ $ OWNER
MAILp
LIGHT TOTAL FIRST 20 .20
ADDRESS S ]�
SWITCH OVER 20 10 CITY P TEL.NO. bff —3�o I
PLAN CHECK
LIGHTING TOTAL FIRST 20 1 ,20 APPLICANT
FIXTURES } OVER 20 ,70 ADDRESS
RANGE_DRYER_WTR. HTR. CITY TEL.NO.�^
STA. COOK_DISP._F.A.U. CONTRACTOR t
SPACE HTR. AIR COND. ADDRESS .S
CLOTHES WASH._DISHWASH. CITY W I If TEL.N0. 2':7.2
FAN_OTHER 1.00 LICENSE NO. '2 3 ,K CLASS.
MOTORS,TRANSFORMERS RATING 1 HEREBY ACKNOWLEDGE THAT IHAVE READ THIS APPLICATION
IND, HEATERS, ETC. HP. KW. KVA. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
- ELECTRICAL WIRING.
y
0 - I /.- 1.00 y 6 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OP
1 - 10 3.00 3 d� CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF, AND INTEND TO a
RESIDE IN, THE ABOVE DESCRIBEZRES ENTIAL PROPERTY. C
10 — 50 5.00 L
SIGNATURE pk
50 — 100 10DO OF PERMITTEE c
H
100 — 500 15.00 DIST�T NO. GROUP ZONE PROSES EO LL
SIGN GOR SIGN AND ONE CIRCUIT 3.00 t O Z
MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES:
SERVICE NOT OVER 600 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
TEMP. POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
WIRING
PERMIT FEE (SUB TOTAL) FIXTURES
PLAN CHECK FEE (50°/6 PERMIT FEE) POWER AUTHORIZED
PERMIT ISSUING FEE 2.00 Q O UTILITY CO.NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL
TOTAL FEE JOSEPH C. ROOHAN
4 SUPERVISING ELECTRI ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE