HomeMy Public PortalAbout6240 TEMPLE CITY BLVD_Electrical__ 76A°63-DE°°° ~°' APPLICATIONFFORJ�LECTI & PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVI910N ADDRESS D
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS, SUPERINTENDENT OP BUILOIND FLOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
No C
RECEPT
S OWNER
MAIL
LIGHT_ TOTAL FIRST 20 20 ADDRESS
SWITCH_ OVER 20 t0 CITY TEL NO
LIGHTING 1TOTAL FIRST 20 20 CONTRACTOR
FIXTURES 7( OVER 20 10 ADDRES
RANGE_DRYER—WTR HTR — CITYT EC 1V0
STA COOK_DISP F A U LICENSE NO
SPACE HTR _AIR COND I MMCeY ACKMOW L[D o[ HAT I HA E R[AD THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
CLOTHES WASH _DISHIWASH WITH ALL COUNTY ORDINANCES AMO STAT[ LAWS REOUTATING
ELECTRICAL WIRING
FAN_OTHER 1 00 I HERESY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
MOTORS TRANSFORMERS RATING LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIIDANIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO _
IND HEATERS ETC HP KW KVA RESIDE IM ApOVE D[SCRI R[51DENTIAL PROPERTY
SIZE & TYPE OVER TO SIGNATURE
OFIERMITTEE
0 — 1 1 00
I - 10 3 00 DIST T N R P NE P D
10 — so 6 00 Im
50 — 100 1000 NOTES
100 — 500 15 00 0.
SIGN GAS SIGN AND ONE CIRCUIT 3 00 \
TUBE OR
MARQUEE ADDITIONAL CIRCUITS 1 00
SERVICE NOT OVER 600 VOLTS OR 200 AMP j 2 00
-I
SERVICE OVEN 600 VOLTS OR 200 AMP 5 00
TEMP SERVICE POLE 8 APPURTENANCES 3 00
APPROVALS DATE INSPECTOR S SIGNATURE
TEMP POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
WIRING
ISSUING FEE
FIXTURES
SUPPLEMENTARY ISSUING FEE 1 00 t
POWER AUTHORIZED iJ
PERMIT FEE UTILITY CO NOTIFIED r
PLAN CHECK FEE (60% PERMIT FEE) FINAL
TOTAL FEE JOSEP ROOHAN
SUPERVISING ELEC CAL ENGINEER
PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION cK M 0 CASH
Vr'_,9 9 9 0� FAf14 A? D 4,90~ Q
ME BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE 44a-ml
DEPARTKM OF BUHDING AND SAFSPY APPIdCA740N FOR PTERMPt
COUNTY OF LOS ANGELES EI, ' IC 1
NAM j P ewltp
A - T72 mor7i �7 DISTRICT N0. GROUP I ZONE I PERMIT NO.
U ADDRREADY FOR
6SSf
CRY/J ,cy�. T�NOA/y T•/:l el / FIRST INSPECTION DAT/.II ISSUED
COUNTY
ApPLWANC FIIL IN IIEAVII Y 6dTLINED PdKnON ONLY
DESCRIPITON OF WORK ADDRESS X -?U -1. t A +n
NUMBER OF ORTTLSTB ON CIRCUITS LOCALITY l� L R t A �/ ?71
LOCATION BY ROOMS NEAREST
uOHT oIITL m SwPLuaB rl:r C
CIRCUIT// A B C D E P G H C NAM
CRY I
L7 h ll/ a 1 AY TNB LIGiAL POSSiYR80R OP TN[ ABOVE LDS
_ ANGD" COUNTY CmmFICATs of QUALIFICATION.
LAM TTtS 1,xaAl.oan i oP TTS PRDPlurrr DESCRIBED CORRECTIONS
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No OF OUTLETS p APPROVALS
NO OF FIXTURE[ / ll41d ) DATE INS R S NAME
E
OF MOTORS H P CONDUIT 1 OF SIONH TRANS [ WIRING OF RANOW ORiIlATERS— [ FIXTURES
S POWER
PERNIT I= / .gam UTILRYCO NOTIFIED
0 n 0
: . '::I; 1 1 1 I I 1 .�
wi 1 1 ' JI
L:.
OF
APPLWCW IL IN FIFAVELYOSU-1UNED PORMON ONLY
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1 MI I' • 1 I 1 ' If ; 2 a
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