HomeMy Public PortalAbout6445 TEMPLE CITY BLVD_Electrical__ IF
TeAeeYC¢I•C 10171 APPLICATIOW FOR ELECTRICAL PERMIT �I
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER �pS0DRE55
BUILDING AND SAFETY DIVISION '
LOCALITY
NEAREST erns Vt.'
APPLICANT TO FILL IN CROSS ST
OUTLETS NO EACH F E OWNER OR
S $ FIRM NAME / /L
RECEPTMAIL
ADDRESS AA- ��
LIGHT__ TOTAL FIRST 20 y
CITY .9 yoa3 t. TEL NO
SWITCH_ OVER 20 10 PLAN CHECK
FIRST 20 1 APPLICANT
FI%TURES 10 DR / /�R
LIGHTING 1 TOTAL
I OVER 20 ADESS
RESIDENTIAL APPLIANCES CITY
PERMIT
RANOE_ORYER_WTR HTR— APPLICANT
STA COON_DISP _F A U — ADDRESS
SPACE HTR AIR GOND CITY TEL NO
REGcuo
CLOTHES WASH _DISHWASH _ NUMBEoq R CLASS
FAN OTHER 100 I H[R[SY ACKNOWLEOGE THAT I HAVE READ THIS APPLICATION
AND [TAT[ THAT THEADDV[ 18 CORRECT AND AGREE TO COMPLY
MOTOR[ TRANSFORMER[ RATING WITH ALL COUNTY ORDINANCE[ AND [TAT[ LAW[ REGULATING
IND HEATERS, ETC HP KW RVA [L[CTR ICAL WIRING
SIE[ ■ TYPE OVER TO
NSEDSA CERTIFY R THAT I M PROPER R[SI/T[R[O AMO/OR
0 - 1 100
LICENSED AS REQUIRED [ NO [ COUNTY N° STATE OF
CALIFORNIA OR THAI H [R TH[ OVE
1 - 10 300 0[SCRIS[0 R[IIO[M Y _ p
10 = SO DOD PERMITEE CJ
SIGNATURE o
60 - 100 1000 DISTRICT NO , PROCESSED BY
100 - 600 1e00 B i
SIGN, GAS SIGN AND ONE CIRCUIT 000 APPROVAL[ DAT[ INJI SIGIMIURS
TUBE, OR
MAROUEE ADDITIONAL CIRCUITS IAO TEMP POWER POLE
3ERVICENOTOVER BOO VOLTS OR 20OAMP 300 SU UNDERSLAB WORK
SERVICEOVER SOO VOLTS OR200AMP 1000 ROUGH CONDUIT
TeMPSERVICE,POLE, h APPURTENANCES 300 WIRING 't 7
TEMP LIGHT OR RECEPT SYSTEM 300 FIXTURES
POWER AUTHORIZED
UTILITY CO NOTIFIED
FINAL
PERMIT FEE (SUB TOTAL) NOTES lz
PLAN CHECK FEE
PERMIT ISSUING FE! 800
TOTAL FEE Q
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION cK M 0 CASH
5�FFR 10 9.0 0 A.%;
919 SACK OF APPLICATION FOR COMPLETE SCHEDULE / /T/
7M D"a a-® APPLICATION FOR PERMIT
DEPARTMENT OFNG AND SAFETY ELECTRIC i
COIINTY OFF LOS LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOR PLICANT TO FILL IN 018TRICT NO. GROUP ZONE PERMIT NO.
ELECTRICIAN
%o7 / '/'5; )-1- y
ADDRE88 ® REQ W FIR u1NeP[OTION Y FOR DAT[ t0
CITY TEL NO �O "1.56 1 ,�
COUNTY LIC[NEW NIL
O I— KXPIRE14 BUILDING /
PERI FEES ADDR[88 (O S I
NUMBER [AON FII LOCALITY _
LIGHT OUTLETS A17 NEAR®T
RECEPTACLES / CRO86 BT.
WALL SWITCH[B OWNER bu I
TOTAL OUTLETS 8C MAIL
ELEC RANGES IIO ADDRESS
[LLC HEATERS 78 Z CITY TEL NO.
rIXTUR® 8 I HEREBY ACKNCWLEDGE THAT 1 HAVE READ THIS
1SO _ APPLICATION AND STAT[ THAT THE ABOVE 18 CORRECT
NUMBER OF LIGHT CIRCUITS / �j AND AGR[[ TO COMPLY WITH ALL COUNTY OROINANCEB
NUMBER Or RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING.
MOTOR8 1 CERTIFY THAT I P088[B8 THE ABOVE VALID LOS
NUMBER IICRas EPOWER FEE ANGELES COUNTY LICENBFi CR 1 AM THE LEGAL OWNER
Nrw I MVC HPI own I IMC IIAUH OF THE RESIDENTIAL PROP DEBC IB[D ABOVE.
Va • 2 .28 SIGNATURE Oso ��
a B IOC INSPECTION RECORD
8 18 1 80
18 Go 5.80
80 a0O Sao
9O° am 1000 C TDT n L6>r Q
SDD 1000 1B 0D - Z
OVER IOM SO DO Al FIN RL-
a
me scT/rRM CHANGER-HP Q'
WELDERBI AC-KVA - Z VYL GU O
GENERATORS - Kw
TRANSFORMERS - KVA 1 +
TEMP MOTORS 78 or CRIB) A
M13VEP MOTORS (78 or oRICJ - 7.5� /• �l /1 rr ��
Him
81DN8 ,� ri' F,[3X � PctjF_n
NO NO TRANS
NO ND LAMPQ T7 AT F APPROVALS /Ll Bov i{/D
FOR EAC" PERMIT- DAT[ INSPEOTOR'B NAM[
WIRING $1013 Q Q CONDUIT --
FIXTURES 81 DO U WIRING
SUPPLEMENTARY FIXTURER - "f
g PDWER �
TOTAL FEE ■� UTILIT'Co NOTIFIED
rEL
76AO63 CEI06 "S APPLICATION FC;R ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS E
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS, SYPtRINTum"KIT CP BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
RECEPT
S OWNER
MAIL
LIGHT__ TOTALEFIRST
20 ADDRESS
SWITCH_ 10 CITY TEL NO
PLAN CHECK
LIGHTING TOTAL 20 APPLICANT
FI%TURES 10 ADDRESS
RANGE_DRYER-WTR HTR _ CITY TEL NO
STA COOK_DISP F A U _ CONTRACTOR
SPACE HTR _AIR COND ADDRESS
CLOTHES WASH _DISHWASH CITY L NO
FAN_OTHER 1 00 LICENSE NO CLAS$
MOTORS TRANSFORMERS RATING
IND HEATERS ETC HP KW KVA I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
SIZE 6 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 - I 1 00
I HERESY CERTIFY THAT I AM PROPERLY REGISTERED AMO/OR
1 10 3 00 LICENSED AS REOU IRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER Or AND INTENDTO
10 SO 3 00 RESIDE IM T V[ DESCPIIED RESIDENTIAL PROPEN
TY
U
SIGNATURE
SO - 100 1000 OF PERMITTEE
100 - 500 15 00 I~
DISSj21CT P Z P D w
TUIGN GAS BE OR SIGN AND ONE CIRCUIT 3 00 y
Z
MARQUEE ADDITIONAL CIRCUITS 1 00
NOTES
SERVICE NOT OVER 600 VOLTS OR 200 AMP 1 2 00
SERVICE OVER 600 VOLTS OR 200 AMP 3 00
TEMP SERVICE POLE 6 APPURTENANCES 3 00 APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
PERMIT FEE (SUB TOTAL) WIRING
FIXTURES
PLAN CHECK FEE (50% PERMIT FEE) POWER AUZED
PERMIT ISSUING FEE 200 UTI LITY COTHORI
NOT
FIE 7 ] 4
SUPPLEMENTARY PERMIT ISSUING FEE 100 §FINAL RA 4
TOTAL FEE JOSEPH C ROOHAN
SUPERVISING ELE AL ENGINEER
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK M D CASH
1 0 3 ' D 4 QG
EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE ��