HomeMy Public PortalAbout6261 TEMPLE CITY BLVD_Electrical__ APPLICATION FOR ELECTRIC PERMIT 1
COUNTY OF LOB ANGELES
DEPARTMENT OF COUNTY ENGINEER gu1LOIN0 /
BUILDING AND SAFETY DIVISION ADDRESS V-4 1 7�
JOHN A LAMBIE. COUNTY ENGINEER
WILLIAMA JENSEN SUPTOPBUIWING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
PERMll, FSS CROSS ST
ITEM NuNBp1 EAcH FE¢ OWNER cll�-tl
OUTLETS • • MAILADDRESS e-
-LIGHTS MCEPT BW 10
LIGHTING FIXTURES 10 CITY
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STATE
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2— D 100
D— 1D 150
to— DO 250
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SERVICE 0-600V 100 J (%('J 3-1i-4a !,/'M !,o SPP A1,7P:F
SERVICE OVER 600V goo
MISC
WIRING PERMIT too QD
FIXTURE PERMIT 100
SUPPLEMENTARY PERMIT DO
TOTAL FEE t O
1 HEREBCIOI
Y AOWLEDOE THAT 1 NA" READ THIS AT.IGTIOM APPROVALS DATE IHSI•ECTORBnoNATUM
AND STATE THAT THE ABOVE W CORHECT AND AGKIL TO COMPLY
WITH ALL COUNTY ORDIMAM® AND •TATE LAWS REGULATING CONDUIT
ELECTI11CAL WIRING
1 HXRKIIY CERTIFY THAT 1 AM FROPERLY MOIBTEEED AND/OR WIRING
LICENSED AS REQUIRED BY LOB ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT i AM THE LEGAL OWNER OI THE ABOvE
DESQIBtD ROIDRRIAl POWER
SIGNATURE �' UTILITYCO NOTIFIED /I
OF PERMITTE
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