HomeMy Public PortalAbout6323 AGNES AVE_Electrical__ 76AS63 DBS 5A 11-50 APPLICATION FOR PERMT
DEPARTMENT OFNG AND SAFETY ��
COUNTY OFF LOS LOS ANGELES
WILLIAM J FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN /�t DISTRICT NO. GROUP ZONE PERMIT NO.
ELECTRICIAN . LzC7'rC i'� � �
U� 4 RECEIV BY READY FOR DATE ISSUED
ADDRESS I �. '"" '`�s, FIRST INSPECTION
CITY y P,C,4 D f A . TEL NO J/�
COUNTY LICENSE NO 74V EXPIRES BUILDING in
ADDRESS .,,? p
PERMIT FEES
NUMBER EACH FEE LOCALITY 'l
LIGHT OUTLETS ! NEAREST / �q
RECEPTACLES CROSS ST I`y N 15; DatvI
WALL SWITCHES OWNER
TOTAL OUTLETS 5c $ _ MAIL
ELEC RANGES 25 ADDRESS
ELEC HEATERS 25 CITY TEL NO
FIXTURES 5 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
MISC APPLICATION AND STATE THAT THE ABOVE IS 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 i POSSESS THE ABOVE VALID LOB
NUMBER HORSEPO\VER FEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
NEW MVD HP OVER INC EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE
I/2 6 LESS $ 25 SIGNATURE OF
V2 2 50 PERMITTEE
2 5 1 00 INSPECTION RECORD
5 is 1 50
is 50 l 50 —
50 200 5 00 a
200 SOO 1000 J
500 1 1000 1500 Z
OVER 1000 2000
M O HET/FREQ CHANGER-HP _ m
WELDERS AC-KVA O
GENERATORS - KW
TRANSFORMERS - KVA
TEMP MOTORS (75% OF ORIG)
MOVED MOTORS (75% OF ORIG)
MISC
SIGNS
NO NO TRANS
APPROVALS
NO NO LAMPS
DATE INSPECTOR'B NAME
FOR EACH PERMIT /�/
WIRING $1 00 CONDUIT //l/� vYt,
FIXTURES $1 OO WIRING
SUPPLEMENTARY 50 FIXTURES
POWER
TOTAL FEE $ UTILITY CO NOTIFIED
FINAL �� VWVVv
COMPENSATION DECLARATION 810/81
CE e06G APPLICATION FOR ELECTRICAL PERMIT
-vd a certificate of consent to self insure CE os
orkers Compensation Insurance or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY
o (Sec 3800 Lab C)
Policy NoPC 3 5 3 6 Company FREMO NT FOR APPLICANT TO FILL IN JOB
❑ y, New Residential Bldgs & Pools ADDRESS 6323 N. Agnes
Certified copy is hereb furnished ' EACH NO FEE ,
Certified copy is filed with the county building inspection
1 & 2-Family Sq Ft $ — $ LOCALITiY Tem l e City
department kr Multi-family Sq Ft — NEAREST
CROSS ST
Date7/2 7 $7 Applicant pYRAMTTI RiTTT.1lRRs Residential Swimming Pools OWNER OR
° FIRM NAME
CERTIFICATE OF"EXEMPTION FROM WORKERS 6 MAIL
Outlets Rec Light Sw 7
COMPENSATION INSURANCE t ADDRESS6 3 2 3 N• A rie S
( Y
This section need not be completed if the work involved b the �n}First 20
R� CITY Tel No
permit Is for one hundred dollars ($100)or less) Total NoAdditional
I certify that in the performance of the work for which this permit PLAN CHECK APPLICANT PYRMIID
is issued I,shall not employ any person in any manner so as t0 R ^
become subject to the Workers Compensation Laws Lighting Fixtures First 20 v ADDRESS16332 F.- Ran Ri—rnridinn
' ` Total No _y„ Additional CITY ' Tel No
Date Applicant Covina 967 '13 4
Fixed Appliances Not Over 1 HP PERMIT �
NOTICE TO APPLICANT If after making this Certificate of APPLICANT PYRAMID BUILDERS
Exemption you should become subject to the Workers Compensation Range_ Heater_ DW _
provisions of the Labor Code you must forthwith comply with such Oven _ Dryer L W M ADDRESS
provisions or this permit shall be deemed revoked Top — FAU WH CITY i Tel No
LICENSED CONTRACTORS DECLARATION
Hood — Fan ��Other_ ,
I hereby affirm that I am licensed under provisions of Chapter 9 Disp — Room Air Cond LICENSE - Clas '`
(commencing with Section 7000) of Division 3 of the Business and , REG NUMBER
Professions Code and my license is in full force and effect ' Power Apparatus& Large Appliances DISTRICT NOKPR SED BY
' Size & Type HP KW KVA or KVAR 5 b
License Number ;407 400289 Lic Class� Up to 1 Incl " FINAL - (�
Contracts Y'RAMID BU II�DERfre 7 2 7 g 7 Over 1 to 10 Incl DATE �� JUDATION
0
Over 10 to 50 Incl FIN V
❑ I am exempt under Sec Over 50 to 100 Inc W
B&P C for this reason Over 100 1 �
Services Swbd MCC& Panelboards , Z
Date 0- 200 Amp Under 600 V
Signature 201 - 1000 Amp Under 600 V '
` Over 1000 Amp or Over 600 V y
Exemption for Reg Maint,Elect n
SINGLE FAMILY ' Temp Power Pole & Appurtenances
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit
I hereby affirm that I am exempt from the Contractors License Law
for the following reason(Section 7031 5 Business and Professions Additional Sign Branch Circuits
Code)
❑ Misc Conduits& Conductors' -9-7 6 2'4 A
I as owner of the property will do the work and the structure Other(See Complete Fee Schedule)
,is not intended or offered for sale (Section 7044 Business _ # o 0 0 0 0 2 }
and Professions Code) ,
CONSTRUCTION LENDING AGENCY e I -'-'5a25
' `
I hereby affirm that there is a construction lending agency for the
performance of the work for which this permit is issued(Sec 3097 PERMIT FEE (Sub-Total) + T 0 0 - 5a255
Civ C) ' ?"
r PLAN CHECKING FEE 0 U O 7 t 8 7
Lenders Name +
PERMIT ISSUING FEE (J
- , ,
r
'Lenders Address
I certify that I have read this application and state that the above TOTAL FEE
information is correct I agree to comply with all County ordinances ,
and State laws regulating Electrical wiring and hereby authorize
representatives of this County to enter upon the above-mentioned s F f
property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE
nature of Permi tee Date
i
,
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0207310010
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID FEE§ PAID BUILDING ADDRESS
ON FILE 6323 AGNES AV
FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917801402
ATS-MOIFINFORMATION NUMBER NEAREST CROSS STREET LONGDEN
5383-021-016 Al PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID Al LOCALITY TEMPLE CITY
HA FAU LESS 3HP 1 00 FAU 10 95
TENANT JB AC UNITS +3-10HP 1 00 AC 19 65 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON
TOTAL FEES 58 35 07/31/02 JK 01/27/03
OWNER TEL NO F AL DATE FINAL BY CODE
BRYAN & TANJA JOHNSON (626) 285-1969- 2 6
6323 AGNES AV
TEMP 917801402 FION OF WORK
NEW HVAC SYSTEM
APPLICANT TEL
JORDANAIR _ (626) 963-3313-
129 S HACIENDA SPECIAL CONDITIONS
GLENDORA �-
�y�q S L
CONTRACTOR TEL NOAPPROVALS DATE INSPECTOR S GNA UR
JORDANAIR (626) 963-3313- �� f�
129 S HACIENDA AVE LIC NO POLE
GLENDORA, CA 91741 5604290206 * \
UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER TEL NO p } LIFER GROUND
LIC Nq/ i t � � ROUGE CONDUIT
�L L - - - - �� - '- ��� _� �ROUGH N
� r,) r 'F�(�J (�� i� MAIN WATER LINE
PLASTIC Y/N METAL Y/N
UTILITY COMPANY NOTIFIED
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* ADDITIONAL DATA ON FILE
(REPORT ID DPR265 ROUTE TO BS0508
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