HomeMy Public PortalAbout6017 1/2 TEMPLE CITY BLVD_Electrical__ TGAA668 DBS SA 6-49 ® APPLICATION FOR PERMIT
DEPARTDIIENT OF SUII.DING AND SAFETY ELECTRIC -
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COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER LL
FOR , PLICANT TO FILL
�INN,+�J DISTRICT NO. GROUP ZONE (PERMIT NO.
ELECTRICIAN /
Ad r r d, e RECEIV D BY READY FOR DATE ISSUED
ADDREl!SS, //4�® dl ` •c Le'=-[' Y' !/a FIRST 1 V �IN/SPECT ON
CITY U. �Ai� �$%�F TEL. NO h �� 'l V �I j� / •v
COUNTY LICENSE NO. .! . - EXPIRES����or l,!IO BUILDING s4
PERMIT FEES ADDRESS -31 v !/ 127 ��� �J
NUMBER OUTLETS EACH FEE LOCALITY v— `,'`�
LIGHTS Sc NEAREST ,
RECEPTACLES 5 a CROSS ST.
FIXTURES st ►4 OWNER b d /l v
WALL SWITCHES S ► A e+ MAIL r 6Ier
ELEC. RANGES 2S ADDRESS SS
n 19.
ELEC. HEATERS 25 a t+ CIT9:i ` i /e;�o TEL. NO.
NUMBER OFICI CIUITS INSTALLED: I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
LIGHTS RECEPTACLES AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
MOTORS AND STATE LAWS REGULATING ELECTRICAL WIRING.
NUMBER HORSEPOWERI CERTIFY THAT I POSSESS THE ABOVE VALID LOS
NEW MVD. HP OVER INC. EACH
FEE ANGELES COUNTY LICE Siix OR 1 AM THE LEGAL OWNER
e OF THE RESIDENTIAL ROPERTY ESCRIBED ABO-V
Ys 6 LESS $ .25
Va 2 .50 SIGNATURE OF
2 5 1.00 • PERMITTER �•
5 15 1.50 INSPECTION RECORD
15 50 2.50
50 200 5.00
200 500 10.00
Soo 1000 15.00 J
OVER 1000 I 20.00 Z
M.G. SET/FREQ. CHANGER-HP
WELDERS: AC-KVA rx
Q
GENERATORS - KW
TRANSFORMERS - KVA
TEMP. MOTORS (75% of oRic.)
MOVED MOTORS (75% OF ORIG.)
MISC.
SIGNS
TYPE NO. TRANS.
TYPE: NO. LAMPS APPROVALS
FOR EACH PERMIT: DATE INSPECTOR'S NAME
WIRINGCONDUIT
81.00
FIXTURES 81.00 WIRING r
( /
SUPPLEMENTARY FIXTURES
.g0
a POWER
TOTAL FEE a•� 1
8 � UTILITY CO. NOTIFIED
FINAL