HomeMy Public PortalAbout5954, 5956, 5958 TEMPLE CITY BLVD_Electrical__ 'BA669 CE-60616/76) APPLICATION FOR ELECTRICAL PERMIT -
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN r C 1
New Residential Bldgs. ADDRESS&Pools EACH- NO. FEE ``V
1 &2-Family,Sq.Ft. $ .025 — $ LOCALITY
Multi-family Sq.Ft. .02 — NEAREST
25.00 CROSS ST. D � a Residential Swimming Pools OWNER OR A
FIRM NAME A . e L
Outlets:Rec _Light Sw. MAIL
First 20 •50 ADDRESS
Total No. Additional :30. CITY Tel.No.
PLAN CHECK
APPLICANT
Lighting Fixtures First 20 •50 ADDRESS
Additional .30
Total No. 'CITY Tel.No.
Fixed Appliances Not Over 1 HP PERMIT
Range_Heater_D.W._ APPLICANT
LL A 19 &iml
Oven_Dryer_W.M. ADDRESS
Top _FAU —W.H.— CITY L_ Tel.No.
Hood_Fan —Other LICENSE OR
Disp.._Room Air Cond.. 2.50 REG.NUMBER \ IJ Class.
I HEREBY ACKNOWLEDGE THAT I HAVE.READ THIS APPLICA-
Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO.
Size&Type HP;KW,KVA,or KVAR COMPLY WITH ALL COUNTY 'ORDINANCES AND STATE LAWS-
Size REGULATING ELECTRICAL WIRING..
Up to 1 Incl. 2.50
I.HEREBY CERTIFY THAT I•AM PRQMRLY EGISTE AND/OR
Over 1 to 10 Incl. 5.00 LICENSED AS REQU BY LOS ANG C NTY A STATE OF
Over 10 to 50 Incl. 12.50 CALIFORNIA
BED ORSID A I A RT LE O NER O E ABOVE.DESCQ
Over 50 to 100 Inc. 25.00
Over 100 40.00 PERM.ITEE
SIGNATURE
Services DISTRICT NO. 4:�ESSID BY ++
0-.200 Amp.Under 600 V 12.50
201.:1000 Amp,Under 600 V 25.00
Over 1000 Amp.or Over 600 V 5.0.00 Z
O
Temp.Power Pole&Appurtenances 10.00 Q
Sign with One Branch Circuit 10..00 olor o
Additional Sign Branch Circuits 2'00 INSPECTION
Misc. t 0.00 INFORMATION.Conduits&Conductors ON REVERSE s
Other(See Complete Fee Schedule) SIDE u
Z
5
PERMIT FEE (Sub-Total) D o o N ..M
PLAN CHECKING FEE (One-Fourth Permjt-Fee) �t o Z o Phu
o p s o ca
PERMIT ISSUING FEE $7:00 -40 -J u C'I
TOTAL FEE -1 C) o. O
0 N 3?
INSPECTION FINALED CH W
date:7 By '46— es
16A669 'i 806R �,�� APPLICATION. FOR ELECTRICAL PERMIT '•
==�COUNTY-OP LOS ANGELES
t^ DEPARTMENT OF COUNTY ENGINEER FADDRESSS
BUILDING AND SAFETY DIVISION L FOR'APPLICANTTO FILL IN /
New Residential Bldgs.&Pools EACH NO. FEE S .025 — $ .
1 &2•Family,Sq.Ft. OOR
Multi-family Sq.Ft. 02 — FIRM NAME
Residential Swimming Pools 25.00 MAIL
i� ADDRESS .. O
Outlets:Rec I-ighJ—Y–SW. ° CITY Te. o.
First 20 .50_ O0. PLAN CHECK
Total No.Z_ Additional 30 3 APPLICANT
ADDRESS
Lighting Fixtures First 20 .50 `® CITY Tel.No.
Additional .30 PERMIT
Total No. APPLICANT OE-LAff C Tie C_
Fixed Appliances Not Over 1 HP ADDRESSZ 6_ 'eH j5g7rgPL
Range_Heater_D.W._ CITY Ay fF 'TeI.No.2 gI`7
Oven_Dryer_W.M. LICENSE OR
Top —FAU —W.H. REG.NUMBER Class. �� n
Hood_Fan _Other- I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPUCATIOIJ AND STATE
Disp. _ Room Air Cond. 2.50 THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDIN-
ANCES AND STATE LAWS.REGULATING ELECTRICAL WIRING.
Power Apparatus&Large Appliances
Size&Type HP,KW,KVA,or KVAR I HEREBY CERTIFY THAT]AM PROPERLY REGISTERED AND/OR LICENSED AS
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM
Up to 1 Incl. 2.50 THE LEGAL OWNER OF THE ABOVE D5.00 RIBE.D RESIDENTIAL PROPERTY.
d
Over 1 to 101nc1. PERMITTEE �
ISC
Over 10 to 50 Incl. 12•.50 c
Over 50 to 100 Inc.
25.00 SIGNATURE.
Over 100 40.00 DISTRICT NO. PROC D BY ti
Services
0.200 Amp.Under 600 V 12.50 •3 37-
I CTOR'S
201.1000 Amp.Under 600 V 25.00 APPROVALS DATE GNATURE
Over 1000 Amp.or Over 600 V 50.00 TEMP.POWER POLE
UNDERSLAB WORK
10.00
Temp.Power Pole&Appurtenances •i
Sign with One.Branch Circuit 10.00 ROUGH CONDUIT
10
Additional Sign Branch Circuits 2.00 WIRING
140,
Misc.Conduits&Conductors 10.00 FIXTURES
Other(See Complete Fee Schedule. POWER AUTHORIZED
UTILITY CO.NOTIFIED
FINAL
PERMIT FEE (Sub-Total) NOTES
'PLAN CHECKING FEE (One-Fourth Permit Feel
PERMIT ISSUING FEE $7.00 b-1.
,TOTAL FEE
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
o�juL 25 2 U 9 0
SEE BACK OF APPLICATION FOR COMPLETE C E Z