HomeMy Public PortalAbout6327 TEMPLE CITY BLVD_Electrical__ 76A663-CEB06 8
0-6APPLICATION FOR ELECTRICAL P IT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN JENKINS, SUKRINT[ND[NT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEARESTCRN
OSS ST 1lJ
ACIIF
RECEPT_ OWNER
MAIL
LIGHT__ TOTAL FIRST 20 20 ADDRESS
SWITCH_ __ OVER 20 10 CITU EL NO
PLAN CHECK
LIGHTING iTOTAL FIRST 20 20 APPLICANT
FIXTURES /! OVER 20 10 ADDRESS
RANGE_DRYER-WTR HTR _ CITY TEL NO
STA COOK_DISP F A U _ CO,JTRAC rOR
SPACE HTR _AIR GOND _ ADDRESS
CLOTHES WASH _DISHWASH CITY TEL NO
FAN-OTHER 1 00
LICENSE NO CLASS
MOTORSTRANSFORMERS RATING
IND HEATERS ETC HP KW KVA I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
SIZE Q TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING
0 1 1 00
I HEREBY CERTVY THAT I AM PROPERLY REGISTERED ANOMR
1 10 3 00 LICENSED AS REOUIRED BY LOS ANGELES COUNTY AND STATE Or
CALIFORNIA OR THAT I AM THE LEGAL OWNER Or AND INTEND TO
10 50 5 OD RESIDE IN THE ABO DESCRIFEO RESIDENTIAL PROPERTY 0
U
SIGNATURE
50 - 100 1000w
OF PERMITTED
100 - 500 15 001~
DIST CP ZONE BY w
TUBE OR SIGN AMD ONE CIRCUIT 3 00 y
MARQUE! AD0I TIONAL CIRCUITS 1 00 Z
NOTES
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00
SERVICE OVER 600 VOLTS OR 200 AMP S 00
TEMP SERVICE POLE 6 APPURTENANCES 3 00 APPROVALS DATE INSPECTOR B SIGNATURE
TEMP POWER POLE
UROUGHCONDUIT
ORK
UIT
PERMIT FEE (SUB TOTAL)
PLAN CHECK FEE (50% PERMIT FEE)
RI2EDPERMIT ISSUING FEE 200 OTIFIEDSUPPLEMENTARY PERMIT ISSUING FEE 100
TOTAL FEE JOSEPH C ROOHAN
SUPERVISING ELE CAL ENGINEER
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK M 0 CASH
LK, 0 2 6 0V PAY 29 2 0 4.00-
_. ��// _ 1
IEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE ✓ 11�
T6A.66S-CE606 B-62 APPLIC ION FOR ELECTRICAL PERMIT
COUNTY OF LOS GELEB
DEPARTMENT OF COUNTY ENGINEER BUILDINo
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE, COUNTY ENGINEER r
WILLIAM A JENSEN,SUP T OF BUILDING LOCALITY ✓
NEAREST y e J'77
FO A N N GR066 6'TRECEPT TOTAL NO [ACHOUTLETS FIRST 20 S206 OWNER
15TIF
LIGHT MAIL 71SWITCH OVER 2wooeefieLLIGHTING I TOTAL FIRRT 20 20 OITYf/ TEL NO Q-
FIXTURES I OVER
2 10 ELECTRICIAN
oY R 20
RANG[[ =0 DRYnm WTR MTM 1100 ADDRESS
map STA COOK
CITY TEL NO
OISHWASII AUTO WASH HTATE
CRACK HTRS STA APP Ill HJ MAX ) 50 LICENSE NO
MOTORS, ov[R NOT ov[R H F DISTRICJ�N G P PR
O 1 100
I 6 1 no INSPECTION RECORD
3. 6 200
a is 250
15 Do 700 T
a
50 foo Goo O
V
6101161 NO LAM 0
No urn
(FJ
SERVICE O 600V NOT OVOI 200A 100 W
6ERVICE O 600V OYu 200 A 200 0.
N
SERVICE OVER 600V Boo 2
MISC
PERMIT ISSUING FEE 2 00
SUPPLEMENTARY PERMIT ISSUING PEE 100
TOTAL FEE S
I H[RRSY ACKMOWL[DGX THAT I HAVE READ THIS APPLICATIONj��
LOANDSTAT[ THAT TH[ ABOV[ I[ CORR[CT AND AGR[[ TO COMPLY WITH Au COUNTY ORDINAMCq AND STAT[ uw6 =GU"TING[L[CTRICAL WIRING 1 MIDISBY C2RTIFY THAT 1 AM PROP(RLY IROISTO® ANO/ORLICOIRO A6 R[GUIRED BY 1.06 ANG[W COUNTY AMO STAT[ OF GYIORNIA OR THAT I AM TH[ L[GAL 0"" OF TM[ AROV[DE[CRIB[D R[[lD MIAL SIGNATURE TIFIED
OF PERMITTE
FINAL
IV VALIDA ARTHUR C VEIT
CR M GSH BUPERYIBING ELECTRICAL ENGINEER
L1oo 5 3 FEB 6 2 D 4.0 0~ p