HomeMy Public PortalAbout6242 TEMPLE CITY BLVD_Electrical__ 7RA663-CESOB 4.68 APPLICATION FOR ELECTRIC PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
JQ
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE COUNTY ENOINEEM
COLEMAN W. JENKINS, SUPRRINTLNGLNT Gr BUILDING LOCALITY
ANT TO FILL IN NEAREST
CROSS ST
F77
s OWNSMAIL
ST 20 20 ADDRESS _ER 20 10 CITY TELNO IFPLAN CHECK
ST 20 20 APPLICANT
FIXTURES / OVER 20 10 ADDRESS
RANGE-DRYER_WTR HTR CITY TEL NO
STA COOK_DISP _F A U _ CONTRAC rOR
SPACE HTR _AIR CONO ADDRESS D r _
CLOTHES WASH -DISHWASH CITY �rJ9£C NO
FAN-OTHER 11 00 LICENSE NO CLASS
MOTORS TRANSFORMERS RATING
IND HEATERS ETC HP KW KVA I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
SIZE & TYPE OVER TO AND STATE THAT THE ABOVE 12 CORRECT AND AGREE TO COMPLY
WIT N ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING
0 - I 1 00
1 HERESY CERTIFY THAT I AM PROPERLY REGISTERED AND"
I 10 3 00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF AND INTEND TO
10 SO , 6 00 RESIDE IN SOVE DESCRIPED IDENTIAL PROPERTY
SO - 10010 00 SIGNATUR 1
OF PERMITT O
U
GAS 100 - 500 IS 0
DISTRICT OIG R E
TIGN UBE OR SIGN AND ONE CIRCUIT 300 'Fl U
MARQUEE ADDITIONAL CIRCUITS 1 00 NOTES 1
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00
SERVICE ODEA 600 VOLTS OR 200 AMP S 00
TEMP SERVICE POLE h APPURTENANCES 3 00 APPROVALS DATE INSPECTGIS SIGNATURE
TEMP POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
PERMIT FEE (SUB TOTAL) WIRING
PLAN CHECK FEE (SO% PERMIT FEE) FIXTURES
POWER AUTHORIZED
PERMIT ISSUING FEE 2 00 Q ✓
UTILITY CO NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE.1 00 FINAL /
TOTAL FEE JOSEPA C ROOHAN
SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION 0
M D CASH
99910 MAY 14 2 D 4.09
EE HACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
7Sg663-CEB06 10/72 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER JOB 2¢ ��
BUILDING AND SAFETY DIVISION T , r /� M�-
LOCALITY FM 4, (..SIT
NEAREST
FOR APPLICANT TO FILL IN CROSS ST D'YI
OUTLETS NO EACH FEE
OWNER OR
F RM NAME L- Y N 7a 4EFT
RECEPT_ S
$
MAILLIGHT w��11
FIRST 20 L� �yy ADDRESS 2 4V /«F Ora LLL^O
CITY 7- TEL NO2� ®vV
SWITCH_ TOTAL
_ OVER 20 �S� y PLAN CHECK
GHTING TOTALO-D
LFIRST 20 0 y APPLICANT
FI%Il
/( ,� OVER 20 �, ADDRESS
TURES +1B
RESIDENTIAL APPLIANCES CITY }}�� TEL NOPERM IT
RANGE_DRYER_WTR HTR_ APPLICANT //JWZ :`
iG
STA COOK_DISP_F A U ' AGGRESS lV S. W ,41 �`
SPACE HTR AIR COND CITY TEL NO `
CLOTHES WASH DISHWASH REG NNUMBER CUSS
FAN_OTHER100 I HERESY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND HfA T[RS ETC HR KW RVA ELECTRICAL WIRING
SIZE & TYPE OYER TO
_ I HERESY CERTIFY THAT I AM PROPERLYlRLO A OR
0 — 1 100 LICENSED AS R[ )RED BY LOS ANGELES COUNTYNTYAND ST Oe
CALIFORNIA OR THAI I AM THE LEGAL OWNER OF THE SOVE
1 — 10 300 OESCPIf EO RESIDENTIAL PROPERTY
10 — 50 B00 PERMITEE
SIGNATURE CC
O
50 - 100 1000 DISTRICT NO PROCE EO BV
loo - 500 1500 IS: 0 B
SIGN GAS SIGN AND ONE CIRCUIT SOO APPROVALS DATE' INSPECTOR S SIGNATURE
TUBE OR
MARQUEE ADDITIONAL CIRCUITS TDO TEMP POWER POLE
SERVICENOT OVER 600 VOLTS OR 200AMP 300 UNOERSLAB WORK
SERVICEOVER600 VOLTS OR 200AMP 1000 ROUGH CONDUIT
TEMPSERVICE POLE &APPURTENANCES 500 WIRING X76
TEMP LIGHT OR RECEPT SYSTEM 300 FIXTURES
POWER AUTHORIZED
UTILITY CO NOTIFIED
FINAL G {-
PERMIT FEE (SUB TOTAL) NOTES SC//tV�C'E+
PLAN CHECK FEE '
PERMIT ISSUING FEE 0
TOTAL FEE
PLAN CHECK VALIDATION CR M 0 CASH PERMIT VALI TION EA u o CASH
SEE BACR OF APPLICATION FOR COMPLETE SCHEDULE 2 Z 4 nCEB 17 2 3 6,7 O ,L�