HomeMy Public PortalAbout6225 TEMPLE CITY BLVD_Electrical__ 7En869-CE906 9-69 7
. " ,d APPLICATION FOR ELECTRI �EIT
fj F COUNTY OF LOS ANGELES
16, DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY67
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NO. EACH FEE
RECEIPT $ $ OWNER
MAIL
LIGHT TOT FIRST 20 0 ,20 ADDRESS ��
SWITCH _/� OVER 20 p2 10 CITY T L.NO.
PLAN CHECK
LIGHTING AL FIRST 20 ,20 APPLICANT
FIXTURES } I OVER 20 ,10 ADDRESS
RANGE DRYER WTR. HTR. CITY TEL.NO.
STA. COOK_DISP. F.A.U.
CONTRACT
SPACE HTR. AIR COND.. ADDRESS lO� 64--Q
CLOTHES WASH.� �DISHWASH. CITY TEL.NO. ^ AA
FAN OTHER a 1.00 / bc LICENSE N0. IrFcCLASS(fl
MOTORS,TRANSFORMERS RATING / 1 HEREBY ACKNOWLEDGE THAT I HAVE 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.
0 - 1 1.00 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATEOF
I - 10 3.00 CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF, AND INTEND TO a
RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. C
10 - 50 5.00 F C.
SIGNATURE pI
so — 100 1000 OF PERMITTEE (`
F
lOO — $OO iSAO DISTRICT NO.Q� GROUP ZO PRO SED BY LL
SIGNGOR SIGN AND ONE CIRCUIT 3.00 v'
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% PERMIT FEE) POWER AUTHORIZED
s
PERMIT ISSUING FEE 2.00 f O UTILITY CO.NOTIFIED J
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL
TOTAL FEEOv JOSEPH C. ROOHAN
SUPERVISING ELECT ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
2 9 9 Gkca DEEC 5 2 D 1 9.00-
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE