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Home My Public Portal About5307 BALDWIN AVE_Electrical__ (2) 76A663 CE 606R 10 77 -� r APPLICATION FOR ELECTRICAL PERMIT • COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEERJOB FADBUILDING AND SAFETY DIVISION SS ' 1 �!f/FOR APPLICANT TO FILL IN TY New Residential Bldgs &Pools EACH NO FEE CROSS ST ` NEAREST 1 &2 Family Sq Ft $ 025 — $ OWNER T Multi family Sq Ft 02 — OR FIRM NAME Residential Swimming Pools 2500 MAIL ADDRESS Outlets RecLight—(1—Sw Z CITY Tel No First 20 50 '7- V 0Q PLAN CHECK Total No Additional 30 APPLICANT ADDRESS Lighting Fixtures First 20 50 6 e CITY Tel No Additional 30 PERMIT Total No APPLICANT tl Fixed Appliances Not Over 1 HP ADDRESS Range—Heater D W CITY _jo L(j No r Oven_Dryer_W M— LICENSE OR Top —FAU L W H REG NUMBER Class n Hood—Fan Other— 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE Disp _ Room Air Cond 2 507 THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDIN ANCES AND STATE LAWS REGULATING ELECTRICAL WIRING Power Apparatus&Large Appliances Size&Type HP KW KVA or KVARHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REOUI RED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM >Q: Up to I Incl 2 50 THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY �O Over 1 to 10 Incl 500 v Over 10 to 50 Incl 12 50 PERMITTEE Over 50 to 100 Inc 2500 SIGNATURE Over 100 4000 DISTRICT NO PR E B d Services O Y >nJ c/) 0 200 Amp Under 600 V 1250 / INSPECTOR S 25 00 APPROVALS DATE SIGNATURE 201 1000 Amp Under 600 V i Over 1000 Amp or Over 600 V 5000 TEMP POWER POLE UNDERSLAB WORK Temp Power Pole&Appurtenarces 1000 ROUGH CONDUIT ' Sign with One Branch Circuit 1000 ��i Additional Sign Branch Circuits 2 00 WIRING 7f Misc Conduits&Conductors 1000 FIXTURES 71 Other(See Complete Fee Schedules POWER AUTHORIZED UTILITY CO NOTIFIED FINAL ,� ' �7\, / PERMIT FEE (Sub Totals NOTES I PLAN CHECKING FEE (One Fourth Permit Feel PERMIT ISSUING FEE $700 TOTAL FEE / /� nA C1 0 0 Np PLAN CHECK VALIDATION CK M OSHS 0 P l VALIDATION e CK M 0 CASH 1 0 —1 VT� o 0 IV�o 0 o Iv :i.- CH SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE rA I APPLICATION ® ® pw��p gya� g/�_ PERMIT 1 JOBS O"'19 Y LICATI®Y� FOR ELECTRIC 9 E■ \MIT e� DBS 5A 3 Sr DIVISION OF BUILDING AND SAFETY Deportment of County Engmeer County of Los Angeles rU'LD' NG T WM J FOX COUNTY ENGINEER DDRESS ICASSATTD GRIFFIN SUPTOFBUILDINGOCALITY CT FOR APPLICANT TO FILL IN NEAREST ` p� PERMT FEES CROSS ST D h I� NUMBER EACH FEE OWNER LIGHT OUTLETS ^'t MAIL �� Q / a-Al—D I A/ RECEPTACLES ADDRESS i,] ry�- WALL SWITCHES CITY ��EL NO -D Z TOTAL OUTLETS 5¢ $ V ELEC RANGES 25 ELECTRICIAN ELEC HEATERS 25 ADDRESS KW EA CITY TEL NO FIXTURES 1 1 5 LICENSE NO NUMBER OF LIGHT CIRCUITS DISTRICT NOI GR P I� I READY FOR INSPECTION NUMBER OF RECEPTACLE CIRCUITS MOTORS NUMBER HORSEPOWERFEE INSPECTION RECORD NEW MVD HP OVER INC EACH 1/�&LESS $ 25 +. 1/2 2 50 2 5 100 5 15 1 50 15 50 1 250 50 200 1 5 00 M1SC NO SIGNS NO TRANS NO SIGNS NO LAMPS FOR EACH PERMIT WIRING $1 00 FIXTURES $1 00 U SUPPLEMENTARY 50 APPROVALS TOTAL FEE $ DATE INSPECTOR S SIGNATURE IO ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CONDUIT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING ELECTRICAL WIRING �^ I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES 3-7 'J 7 i LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE POWER DESCRIBED RESIDENTIAL PROZERTY SIGNATURE UTILITY CO NOTIFIED —j OF PERMITTEE FINAL loll WILLIAM J FOX COUNTY ENGINEER VALIDATION A C VEIT CHIEF ELECT INSPECTOR t 0 6,0 9w sEP25 2 240 0 0 'Ayr WORKERS COMPENSATION DECLARATION 76A663 10/81 ereb)i a4rirm that I have a certificate of consent to self CE 806G APPLICATION FOR ELECTRICAL PERMIT ��sq ev or a certificate of Workers Compensation Insurance COUNTY OF LOS ANGELES BUILDING AND SAFETY r7 certified copy thereof (Sec 3800 Lob C ) Policy No Company FOR APPLICANT TO FILL IN r JOB ADDRESS Certified copy is hereby furnished New Residential Bldgs & Pools EACH NO FEE Certified copy is filed with the county building inspec 1 &2 Family Sq Ft $ $ LOCALITY �p tion department Multi family Sq Ft NEAREST CROSS ST Dote Applicant Residential Swimming Pools OWNER OR FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec-I(V Light--)—Sw 2 AMAIL DDRESS COMPENSATION INSURANCE First (This t be completed 20 ( is section neenopleted if the work involved b y Total No�_ Add Additional CITY � Tel No the permit is for one hundred dollars ($100)or less ) I certifythat in the performance of the work for which this PLAN CHECK P APPLICANT permit is issued I shall not employ any person in any manner so as to become subject to the Workers Compensation Laws Lighting Fixtures First 20 i ADDRESS Total No_ 2 Additional Date Applicant Fixed Appliances Not Over 1 HP PERMIT CITY Tel No NOTI E T APPLICANT If after making this Certi icate of APPLICANT Exemptionyou should become subject to the Workers Range_ Heater_D W L Compensation provisions of the Labor Code you must forth Oven _ Dryer — W M ADDRESS with comply with such provisions or this permit shall be Top FAU —W H CITY O� Tel No — T} deemed revoked Hood L Fan _ Other_ LICENSED CONTRACTORS DECLARATION 3 LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp Room Air Cond REG NUMBER Class (commencing with Section 7000) of Division 3 of the Business DISTRICT NO PRO E ED BY and Professions Code and my license is in full force and effect Power Apparatus& Large Appliances O 06 Q Size& Type HP KW KVA or KVAR L Q License Number v Lic Class"'/d Up to 1 Incl FINAL ^V Contractor ��irJ Over 1 to 10 Incl DATE VALI TION O ❑ Over 10 to 50 Incl FINAL vvv V I am exempt under Sec Over 50 to 100 Inc BY W d B&P C for this reason Over 100 D �J Services Swbd MCC& Panelboards ► 0 200 Amp Under 600 V Signature 201 1000 Amp Under 600 V Over 1000 Amp or Over 600 V #ZT M 6 g F] Exemption for Reg Maint Elect 1 Temp Power Pole & Appurtenances_ SINGLE FAMILY O 1 2 HOME OWNER BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor s License Additional Sign Branch Circuits Law for the following reason (Section 7031 5 Business and Professions Code) ❑ I as owner of the property will do the work and the Misc Conduits 8 Conductors structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)— , 7044 Business and Professions Code) A CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued PERMIT FEE (Sub Total) (Sec 3097 Civ C ) '` PLAN CHECKING FEE !V Lender s Name v PERMIT ISSUING FEE Lender s Address I certify that I have read this application and state that the TOTAL FEE ,3 .0 above information is correct I agree to comply with all County — ,ordinonces and State laws regulating Electrical wiring and ` // qq ? I hereby authorize representatives of this County to enter upon e �� / CCAS P yzl 2 6 the ab mentioned roperty for inspection purposes 'is- SEE REVERSE FOR EXPLANATORY LANGUAGE 1,o Signature of Permittee Date CQUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0906080008 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285 0488 EXT LEGAL ID FEES PAID BUILDING ADDRESS ITR 6755 LT 14 5307 BALDWIN AV IFEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917803264 (ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET OLIVE 16589 005 010 1A1 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID B4 LOCALITY TEMPLE CITY Cl IF1 120V 15/20A BR CKTS 2 00 BR 34 50 1 ITENANT IG1 OUTLETS LGT SW RECP 9 00 OUT 17 55 (ISSUED ON PROCESSED BY PLAN BY EXPIRES ON 1 IG2 LIGHTING FIXTURES 1 00 LGT 1 95 106/08/09 SR 12/05/09 1 1 1 TOTAL FEES 81 75 I 1 I OWNER TEL NO I FiADA' FI[N�ALy_BY CODE 1YANG CHENGFU (626) 347 3862 1 /ff�all �//ITU 15307 BALDWIN AV 1 ITEMP 917803264 1 IDESCR PTI N OF WORK 1 I 1 12 BRANCH CIRCUITS 9 OUTLETS AND 1 LIGHT FIXTURES (APPLICANT TEL NO 1 1 SAME AS OWNER i ISPECIAL CONDITIONS I I I I ICONTRACTOR TEL NO 1 1APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER I 1 LIC NO 1 ITEMPORARY POWER POLE I I I (UNDERGROUND CONDUIT 1 I 1 1ARCHITECT OR ENGINEER TEL NO 1 1UFER GROUND 1 I I 1 LIC NO IROUGH CONDUIT 1 1 IROUGH WIRING 1 / 1 IMAIN WATER LINE (PLASTIC Y/N METAL Y/N 1 1 (UTILITY COMPANY NOTIFIED( I I I I I I I I I I I I I I I I I I I I I I I I 1 I I I I I I I I I I I I I I I I I IREPORT ID DPR265 ROUTE TO BS0508 1 1 I I I I I I