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P64663 CE-806(11 /7B) APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES BUILDING•AND SAFETY '
FOR APPLICANT TO FILL.IN JOB r
EACH NO, FEE ADDRESS 'S6.O k &. i..TR.
New Residential Bldgs,&Pools •. , � o ,
1 &2-Family,Sq..Ft. X200 $ .025 — $ LOCALITY TEMPLE CITY _
Multi-family Sq.Ft.. •02 — NEAREST'
Residential Swimming.Pools , 25.00 CROSS ST.
.OWNER OR
FIRM.NAME ORIA'S.•CONSTRUCTION ,CO.
Outlets.Rec Light Sw.. MAIL •
First 20 •50. ADDRESS- •61 ,.LAS TU1tIaS �
-Total-No.- . - Additional .30 CITY ARCADIA Tel,.No..-.•. ...
PLAN CHECK
..APPLICANT
,
Lighting Fixtures First 20 .50 ADDRESS
Additional .30 -
Total No, CITY Tel.No.
Fixed Appliances Not Over 1 HP PERMIT
Range—Heater—'.D.W._ APPLICANT JERRY08 EIFCTRIC
Overt_Dryer_W.M. i' ADDRESS B01,159
Top —FAU _W.H._ CITYB ,DT^IIB'BARR. ` lel•:N�:9F?Z
Hocd_Fan _Other_ LICENSEOR• . '
Disp.._Room Air Cond.- — 2.50 REG..NUMBER 'C"1025(4 • •;Class;
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA-
Power Appafotus&Large Appliances TION AND STATE THAT THE ABOVE IS.CORRECT AND AGREE TO
COMPLY WITH',ALL.COUNTY',ORDINANCES AND.' STATE LAWS �
Size_&Type HP,KW,.KVA,or KVAR 2 30 REGULATING ELECTRICAL WIRING, -
Up to I'Itacl. 1 HEREBY CERTIFY.THAT I AM PROPERLYRE ERED AND/OR - (�
Over 1 to 10 Incl. 5.00` LICENSED AS REQUIRED.BY LOS.ANGEL -COU TY ND STATE OF pL
Over 1'D to 50'Incl. .12.5.0 CALIFORNIA OR THAT AM THE.LEGAL OW. R F THE ABQVE
Over 50 to 100 Inc.
25.00 6ESCRIBED'RES IDE DZ'y--PROPERTY.
40:00 PERMITEE , jL
-
' Over 100 Sir 11%,,
Services DISTRICT WW ;ti's,. P ES D BY
0-200 Amp..Under 600 V 12.50
201-1600 Amp.Under 600 V 25.00 `J '•V
Over 1000 Amp.or Over 600 V 50.00' Z'
C „
Temp.Power Pole&Appurtenances •10.00
Sign with One Branch Circuit 10..00
Additional Sign Branch Circuits '• 2'00 INSPECTION .
Misc.Conduits&Conductors INFORMATION u °6 S ,$,.A
io,00 ON REVERSE' : z ;:
Other(See Complete Fee Schedule)
SIDE z _ o 0 0 0 0 2
A.
s z a;,Qo
.r o n
PERMIT FEE •ISyb-Totall 80aoQ o �7,
PLAN CHECKING FEE. (One-FoUrth Permit Fee) p 0 9.2 5-' 9
PERMIT ISSUING FEE -$7,00 7 o 00
TOTAL FEE 87.00 FSS
INSPECTION FINALED �+ W
date: y ! g . BY c�4,A.oZ'11i�+�t°P'/�'�Pi
_'_ 6. ®s
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