HomeMy Public PortalAbout6403 TEMPLE CITY BLVD_Electrical__ 700603 03e eA n-OO APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFM
COUNTY OF LOS ANGELES ELECTRIC 1
WILLIAM J FOX CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO GROUP ZONE PERMIT NO
ELECTRICIAN Q
RECEIVED BY READY FOR DATE ISSUED
ADDRESS FIRST INSPECTION
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CITY L
NO �`- 3-
COUNTY LICENSE101PIRMBUILDING /1 L
PERMIT FEES
ADDRESS l
FEE LOCALITY L. I
NUMBER TACH -
LIGHT OUTLETS 12 NEAREST 1
CROSa ST L
RECEPTACLES
WALL SWITCHES OWNERRjC-+jf9RDS
TOTAL OUTLETS 6e • I I, MAILp
ELEC RANGES is ADDRESS II
CLEC HEATERS 25 CITY TEL NO
FIXTUR" 6 1 HERKOY ACNNOWLEDGE THAT 1 HAVE READ THIS
MISC APPLICATION AND STATE THAT THE ABOVE IB CORRECT
NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING
MOTORS I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOB
NUMBER HORSEPOWERANGELES COUNTY LICENSE OR I AM THE LEGAL OWNER
FEE OF THE RESIDENTIAL PROPERTY DESCRIBED A00V[
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is 50 2 50
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200 500 1000 J
500 1 loco 1 1500 Z
OVER 1000 20 DO l9
M G SET/FREQ CHANGER-HP O
WELDERS AC-"A
GENERATORS-XW
TRANSFORMERS-MVA
TEMP MOTORS 75 OF ORIG
MOVED MOTORS (]B of oRla
MISC
SIGNS
NO NO TRANS APPROVALS
NO LAM DATE INSPECTOR BNAME
FOR ACH PERMIT
CONDUIT
No $1 00
FIXTURES 1 00 0 WIRING
SUPPLEMENTARY a0 FIXTURES
�(1/ POWER
TOTAL FEE • r`�- UTILITYCO NOTIFIED
lo FINAL �� D—Sz �h✓
7GA663-CE006 /-SD APPLICATION FOR ELECTRICAL PERS
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
ILDING
BUILDING AND SAFETY DIVISION ADDRESS i%� G �r y
JOHN A LAMBIE COUNTY ENCIN"R
COLEMAN JERKINS, SUP6RINTRMDtNT QP BUILDING LOCALITY7;91Vfi-,r rcT
NEAREST
FOR APPLICANT TO FILL IN CROSS ST VA
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RECEPT_ 40 $ OWNERO/ �' M. Kos
LIGHT_ TOTAL FIRST 20 20 ADDRESS d//��� 4(
PLAN
SWITCH_ OVER 20 10 CITY LG `1'I f TEL NO G
PLAN CHECK
LIGHTING `TOTAL FIRST 20 20 APPLICANT
FIXTURES /( OVER 20 10 ADDRESS
RANGE_DRYER_WTR HTR CITY TEL NO
STA COOK_DISP __F A U , CONTRAC iOR
SPACE HTR _AIR COND _— ADDRESS
CLOTHES WASH _DISHWASH CITY TEL NO
FAN—OTHER 1 00
LICENSE NO CLASS
MOTORS TRANSFORMERS RATING
IND HEATERS ETC HP KW KVA I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
SIZE5 TYPE OVER TO AND STATE THAT THE ABOVE 13 CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING
0 - 1 1 001 1
HEREBY CERTIFY THAT I AM PROPERLY REGISTEREO AND/OR
I 10 3 00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO
10 SO S OD RESIDE IN THE ABOVE DESCPIPEO RESIDENTIAL PROPS TY
Y
IROUGH
NATURE fE_
SO - 100 1000 PERMITTEE loo - Soo 16 o IGN GAS 15 RICT P ZONE P TSUDE OR SIGN AND ONE CIRCUIT 3 00MARQUEE ADDITIONAL CIRCUITS 100OTES 6 0� ✓ � T ..'SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00 C� / o rSERVICE OV M 600 VOLTS OR 200 AMP 6 00TEMPSERVICE POLE dAPPURTENANCES 3 00 APPROVALS OATE IMSPlCTdi'6 SIYIMTUIE
EMP POWER POLENDERSLAB WORK CONDUITPERMIT FEE (SUB TOTAL) IRING
FIXTURES
PLAN CHECK FEE (30% PERMIT FEE) ,,RR,,,,��''77 POWER AUTHORIZED f�
PERMIT ISSUING FEE 200 VE/ UTILITY CO NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE I 00 FINAL H
TOTAL FEE JOSEPH C ROOHAN
SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK M o CASH PERMIT VALIDATION CK M Q c,.s
1cr- 0 s 1 9-� AM22 2 0 - 400— a
EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE