HomeMy Public PortalAbout6163-6163 1/2 TEMPLE CITY BLVD_Electrical__ 76A669-CE80.6 468 APPLICATION FOR ELECTRICAL f ERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING te�rr}} —M
BUILDING AND SAFETY DIVISION ADDRESS Cpl � 3 /uYi /
JOHN A. LAMBIE. COUNTY,ENGINEER
COLEMAN"W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY ew,
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
.NO. AC FEE
RECEPT._ $ $ OWNER �. Le u we-
MAIL
LIGHT TOTALFIRST 20 .20 ADDRESS
SWITCH_ OVER 20 .10 CITY TEL. N.Q.
PLAN CHECK.
LIGHTING �TOTAL FIRST 20 .20 APPLICANT
FIXTURES OVER 20 .10 ADDRESS
RANGE_DRYER_WTR.HTR._. CITY TEL. NO.
STA.COOK_DISP._F.A.U._ CONTRACTOR D
SPACE HTR. AIR COND.'—
ADDRESS
OND: ADDRESS ;Z
CLOTHES WASH._DISHWASH._ CITYnrA C b1D VXW TEL.'NO�� <3L J
FAN—OTHER 1.00
LICENSE 1.10. / L9 �7 CLASS.^"'10
MOTORS,TRANSFORMERS .RATING
IND. HEATERS, ETC. HP. KW. KVA. i HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
SIZE & TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING'
0 - i 1.00
ELECTRICAL WIRING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
1' 10 3..00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND.INTEND TO
10 - 50 5.00 RESIDE ABOVE. PESCRIRED R.ESI NTIAI PROPERTY. C7
V
50 - 100 10.00 SIGNATU
OF PERMITT
100 - 500 15.00 (—
SIGN,GAS DISTft : G UP PR� ESSED BY w
TUBE, OR SIGN AND ONE CIRCUIT 3.00 5e .� Lj N
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
PERMIT FEE (SUB TOTAL) WIRING
FIXTURES
PLAN CHECK FEE (50% PERMIT FEE)
POWER AUTHORIZED
PERMIT ISSUING FEE 2.00 � UTILITY CO.NOTIFIED12
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL
TOTAL FEE QZ7 JOSEPH C. ROOHAN
SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION cK. M.O. CASH
cc
:E BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE __
COUNTY OF LOS ANGELES - APPLICATION FOR PERMIT
DEPARTMENT OF COUNTY ENGINEER , . % %I
DIVISION OF BUILDING& SAFETY ELECTRIC 1
WILLIAM J. FOB. COUNTY ENGII M
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP 4ONE PERMIT//NO.
L
ELECTRICIAN ./ 0 � � � 4-1
ADDRESS a7.c REEC IVED BY READY FOR DATE ISSUED
y' VIQ(lye�� FIRST INSPECTION //
CITY R TEL. NO �IY h�'- d
COUNTY LICENSE NO. ® EXPIRES � BUILDING C D C
PERMIT FEF ADDRESS
NUNMR EACH FEE LOCALITY
LIGHT OUTLETS & NEAREST
RECEPTACLES ROSS ST.
WALL SWITCHES OWNER
TOTAL OUTLETS SC $ /
MAIL (� (p (�f/{^/J
ELEC. RANGES 25 ADDRESS
ELEC. HEATERS 25
FIXTURES S CITY TEL. NO.
MISC. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
NUMBER OF LIGHT CIRCUITS APPLICATION AND STATE THAT THE ABOVE 18 CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING.
MOTORS 1 CERTIFY THAT I POSSE I AB VE VALID LOS
NUMBER HORSEPOWER FEE ANGELES COUNTY LICEN OR 1 AM LEGAL OWNER
NEW MVD. HP OVER INC. EACH OF THE RESIDENTIAL DES D ABOVE.
_ V2&LESS $ .25 SIGNATURE
V2 2 .50 PERM
2 s 1.00 II�iSPECTION RECORD
S 15 1.SO
1S SO 2.50
so 200 5.00 ✓�3 �/ �
200 500 10.00 (/_/���� CJ /J2161
soo loco 15.00I/I-rl e)/✓dF z
z
OVER 1000 20.00 ig
M.G. SET/FREQ. CHANGER-HP k;F,p V/I �. lx
WELDERS- AC-KVA 7` ����� �� S- O
GENERATORS-KW
TRANSFORMERS-KVA I
TEMP. MOTORS (75% of ORia.) n/
MOVED MOTORS (75% OF ORIG.) `` Id / /�,ll 6AI
MISC. /f �� dC Pl
SIGNS
NO. NO. TRANS. h y +� •�+APPR��AIiB�a�1/p [-T-�ID j., �,"
NO. NO. LAMPILI1J/�/� (D ✓ (/ O W
FOR EACH PERMIT: ATE INSPECTOR'S NAME
WIRING $1.00 CONDUIT .311x'1 • y.,
FIXTURES $1.00 WIRING r 1
SUPPLEMENTARY SO FIXTURES 4- cl
POWER
TOTAL FEE --UTILITY CO. NOTIFIED
INA •+ Vrl ... -•- .r
76A 603 Dss# EA. a-Ea J