HomeMy Public PortalAbout5918 TEMPLE CITY BLVD_Electrical__ ,.VPLICATION FOR ELECTRICAL PERMIT
78A66SC- CBB fE�7
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4_4B.UILDI AND SAFEI VISION
FOR APPLICANT TO FILL IN ,IOFB
New Residential Bldgs.&Pools
EACH N0. FEE ADDRESS5938 Temple City M-W
1 &2 F.maily Sq. Ft. $ - $ LOCALITY Tp
Multi-family Sq.Ft. — NEAREST
Residential Swimming Pools CROSS ST.
OWNER OR
FIRM NAME City Mirror Sr Glass rn
Outlets: Light,Switch&Receptacle MAI L
First 20 ADDRESS
5918 Tpmple 014t B3-vd---
Additibnal CITYTj Tel. No.
PLAN C'H.E K
Lighting Fixtures APPLICANT
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 A 9/7'70 Tel.No. 28p_11260
Hood Fan LICENSE OR a
REG. NUMBER 227962 Class. C-.
Disp. A.C. .�
I HEREBY ACKNOWLEDGE THAT 1 HAVE RBFO THIS APPLICATION
g pp AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY Q
Power Apparatus&Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. IG
Size&Type HP, KW,.KVA,or KVAR LLI
Up to 1 Incl. 1.HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR y
Over 1 to 1' Incl. LICENSED AS REQUIRED BY LOS AN ELS .NT AND STATE OF
2—ton----- 0 CALIFORNIELI
ES
OR THAT 1 AM THE EGA'L OP THE ABOVE
Over 10 to 50 Incl. DESCRIBED RES ENT7AL PRO PERT
Over 50 to 100 Incl. PERMITEE
Over 100 SIGNATUR
Services
DISTRICT NO. RO. SSED Y
- �
0-200 Amp. Under 600 V i
I
201 -1000 Amp.Under 600 V APPROVALS DATE ECTOR'S
Over 1000 Amp.or Over 600 V SIGNATURE
TEMP.POWER POLE
Temp.Power Pole&Appurtenances UND.ERSLAB WORK
Sign with One Branch Circuit
Additional Sign Branch Circuits ROUGH CONDUIT
(Other) WIRING
I :# I
FIXTURES
]POWER AUTHORIZED'
PERMIT FEE (Sub-Total) UTILITY CO.NOTIFIED
PLAN CHECKING FEE '(One-Fourth Permit-Fee) FINALq-77�A_"�_
PERMIT ISSUING FEE NOTES
TOTAL FEE 9'e 90
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION Z=_� M.O. CASH
W. 9
}Ry 16
9.0 0 Aw