HomeMy Public PortalAbout6430 TEMPLE CITY BLVD_Electrical__ 005 GA APPLICATION FOR ELECTRIC PERMIT ],
Dee BA Ix DIVISION OF BUILDBIG AND SAFETY
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WM J FOX COUNTY ENGINEER ADDRESS
CASSATT O GRIFFIN SUP T OF BUILDING
FOR APPLICANT TO FILL IN LOCALITY,
MIT
PEBFEES NEAREST _
CROSS ST
NUMBER EACH FEE
LIGHT OUTLETS OWNER
RECEPTACLES MAIL
ADDRESS -
WALL SWITCHES
TOTAL OUTLETS CITY TEL VO
ELEC RANGES IIC ELECTRICIAN
ELEC HEATERS 25 ADDRES O
KW EA /, -Z 37 CITY TEL NO 7
FIXTURES 5 LICENSE NO
NUMBER OF LIGHT CIRCUITS DISTR,(T NO GROUP , Z HL.DY 109 INSPECT10M
NUMBER E 6JE
MOTORS o0
NUMBER HORSEPGWER FEE INSPECTION RECORD
NEW MVD HP OVKR INC EACH
e L"S f 25 _
2 EO "
2 S 100
S 15 1 50 _
_ 1S EO 250 _
DO 200 5 00
MISC
NO SIGNS NO TRANS
NO SIGNS NO LAMPS _
OR EACH PERMIT _
WIRING fi 00 0
FIXTURES f100 /o
SUPPLEMENTARY 50 T—'_
{/ APPROVALS
TOTAL FEE f J DATE 1 PEC OR S SIGNATURE
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CONDUIT
ANO STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING
ELECTRICAL WIRING
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF POWER
CALIFORNIA OR THAT 1 AM T LEGAL OWN OF T E ABOY
DESCRIBED RESIDENTIAL-PROP UTILITY CO NOTIFIED
SIGNATURE P�J FINAL
OF PERMITTEE
WILLIAM J FOX.COUNTY ENGINEER VALmATION 4;� 5 th
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DEPUTY�
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APPLICATION OR ELECTRICAL P"IT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION BUILDIADDREsAr ol
JOHN A LAMBIE COUNTY ENOINBER
COLEMAN JENKINS, SUPaRINTENDGNT OP BUILDING LOCALITY
FXTURES
PPLICANT TO FILL IN NEAREST
CROSS ST
NO C
S OWNERMAIL
FIRST 20 20 ADDRESS aOVER 20 10 CITY TEL NOPLAN CHECK
FIRST 20 20 APPLICANT
OVER 20 10 ADDRESS
RANGE_DRYER_WTR HTR _ CITY TEL NO
STA COOK__DISP _F A U COIJTRAC rOR
SPACE HTR _AIR COND _ ADDRESS
CLOTHES WASH _DISHWASH CITY NO
aZU
FAN—OTHER 1 00 LICENSE NO 62142CLASS
MOTORSTRANSFORMERS RATING
IND HEATERS ETC HP KW KVA I HEREBY ACKNOWLEDGE THAT I HAVE HEAD TNI9 APPLICATION
SIZE 6 TYPE OVER TO AND !TATE THAT THE AaOVE le CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING
0 - I 1 00
1 HERESY CERTIFY THAT I AM PROPERLY REGISTERED AMD/OR
1 10 3 00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER GI` ND INTEND TO
10 so S 00 RESIDE IN OVE DESCRIFED EVIDENTIAL PROPERTY O
U
SIGNATURE, R
SO - 100 10 00 OF PERMITTE C
100 - 500 15 00 U
OISTR�T G PSIGN GAS P E
TUBE OR SIGN AND ONE CIRCUIT 300 N
MARQUEE ADDITIONAL CIRCUITS 1 00
NOTES � o�6T 7 .AtT Sn F,-rW
SERVICE NOT OVER BOO VOLTS OR 200 AMP 2 00
SERVICE OVER 600 VOLTS OR 200 AMP 5 OO
TEMP SERVICE POLE 6 APPURTENAHCES 3 00 APPROVALS DATE INSPECTOR'!SIGNATURE
,ew"' o i 'RC1
cs ec."47 N d1! TEMP POWER POLE
Al. UNY UNDE RSLAB WORK
7 L•/ P�`/ ROUGH CONDUIT
PERMIT FEE (SUB TOTAL) WIRING
FIXTURES
PLAN CHECK FEE (501 PERMIT FEE)
POWER AUTHORIZED
PERMIT ISSUING FEE 200 v UTILITY CO NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1 00 FINAL
TOTwL FEEZolf' JOSEPH C ROOHAN
SUPERVISING ELEC AL ENGINEER
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK M o CASH
9 9 9 3 o NAY 14 2 D 4./00- a
£E BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1201120005
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID FEES PAID BUILDING ADDRESS
ON FILE 44**t MPLE CITY BL
IFEE DESCRIPTION QUANTITY UOM AMOUNT I TEMP CA 917801436 I
(ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET I
15383-013-017 IA1 PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 596 GRID J1 LOCALITY TEMPLE CITY C
1 101 ODTLETS-LOT SW RECP 2 00 OUT 3 90
TENANT TOTAL FEES 31 70 ISSUED ON PROCESSED BY PLAN BY
01/12/12 SR
OWNER TEL NO FINAL DATE FINAL Y CODE
GRBAVAC DRAM
16424 TEMPLE CITY BL
1TEMP 917801436 1DESCRIPTION OF WORK
I REPLACE 2 OUTLETS
APPLICANT TEL NO
INIXOS CONSTRUCTION INC (818) 845-0126- 1 [ 1
ISPECIAL CONDITIONS
I I
1 1 G
lCONTRACLOR '
TEL NO I 1APPROVAIS DATE INSPECTOR SIGNATURE 1
INIKO'S CONSTRUCTION INC (310) 365-5244- 1 1
13821 W CLARK LIC NO I IT04POPARY POWER POLE 1
IBURBANK, CA 91505 924392 1-
I
I IUNDERGROUND CONDUIT I
I
(ARCHITECT OR ENGINEER TEL NO IUFER GROUND I I
LIC NO ROUGH CONDUIT
1 ROUGH WIRING I I
I I
I 1 (MAIN WATER LINE I 1
I [PLASTIC YIN METAL YIN I
1 I
IDTxLITY COMPANY NOTIFIED(
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IREPORT ID DPR265 ROUTE TO SS0508
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