HomeMy Public PortalAbout6304 TEMPLE CITY BLVD_Electrical__ ' """"e N$R 10/" APPLICATION FOR ELECTRICAL PERMIT LI
` COUNTY OF LOS ANGELES
BUILDING AND SAFETY DIVISION
Mpg
•DEPARTMENT OF COUNTY ENGINEER ADDRESSG
FOR LICANTTO FILL IN LOCALITY
New Residential Bldgs 8 Po Is EACH NO FEE NEAREST ST
182 Fomily Scl Ft / �D E 025 — E WNERO
Multi Iamdy Sg F 02 — FIRM NAME �—
Residential Swimming Pools 2500 'AADRESS
Outlets Rec Llght_Sw CITY Tel No
First 20 50 PLAN CHECK
Total No Additional 30 APPLICANT
ADDRESS
Lighting Fixtures First 20 50 1 1 CITY Tel No
Total No Additional 30 PERMIT NAPPLICA57
Fixed Appliances Not Over 1 HP ADDRESS
Range—Heater—D W _ CITYTel No
Oven—Dryer_W M_ LICENSE OR 6`'
Top —FAU —WH — REG NUMBER Class
Hood_Fan _Other_ I HEREBY ACKNOVAEDGE THAT i HAVE READ THIS APRICATION AND STATE
Dnp _ Room Air Cord — 250 THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDIN
ANCES AND STATE lA WS REGIAATING ELECTRICAL WIRING
Power Apparatus d Large Appliances
Size&Type HP KW KVA or KVAR I HEREBY CERTIFY THAT I AM PROPEBY REGISTERED AND/OR LICENSED AS
Up to 1 Ind 2 50 REQ IRED y LOS AO RES E ABOVE TY ANDES ARTE LO F CALIFORNIA THAT I AM
Over 1 to 10 Incl 5 00THEi
PIOPEM
Over 10 to 50 Ind 1250 PERMITTEE C
Over 50 to 100 Inc 2500 SIGNATU
Over 1 DO 40 DO DIST Cr NO ROC ED B
Services S�� 1 2
0 200 Amp Under 600 V 1250
201
DATE SIP E
201 1000 Amp Under 600 V 2500
Over 1000 Amp or Over 6DO V 5000 TEMP POWER POLE
Temp Power Pole 8 Appurtenorces
1000 UNDERSLAB WORK
Sign with One Branch Circuit 1000 ROUGH CONDUIT
Additional Sign Branch Circuits 200 WIRING
Misc Conduits&Conductors 1000 FIXTURES
Other(See Complete Fee Schedule, POWER AUTHORIZED
UTILITY CO NOTIFIED
FINAL
PERMIT FEE (Sub Total) NOTES
PLAN CHECKING FEE One Fourth Permit Fee,
PERMIT ISSUING FEE $7 00 V7 p
TOTAL FEE .3 •70
PLAN CHECK VALIDATION CK M O CASH PERM VALIDATIONM O CASH
1 3 2 CK JUN 22 2 U 8.7 0 •so
SEE BACK OP APPLICATION FOR COMPLETE SCHEDULE