HomeMy Public PortalAbout5435 BALDWIN AVE_Electrical__ (2) TF•�/��� c /Iryy
76A663CE806 9 67 APPLICATION - AL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING /
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE COUNTY ENGINEER ��,/
COLEMAN W JENKINS SUPERINTENDENT OF BUILDINGi-
RECEPT
LOCALITY /`�•
NEAREST
FOR APPLICANT TO FILL IN CROSS ST19,4
NO ACH FEE ,/
$ $ OWNE J /!
MAIL
LIGHT TOTAL FIRST'20 20 Q ADDRESS
SWITCH_ OVER 20 10 CITY TEL NO
LIGHTING TOTAL FIRST 20 20 O CONTRACTOR 7
FIXTURES OVER 20 10 ADDRESSA!Lj:
RANGE—DRYER—WTR HTR — CITY EL NOAelltg
STA COOK_DISP _F A U - � /G
LICENSE NO
SPACE HTR AIR COND IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
CLOTHES WASH -DISHWASH WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING
FANOTHER 1 00 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
MOTORS TRANSFORMERS RATING CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO
IND HEATERS ETC HP KW KVA RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL P OPERTY
SIZE & TYPE OVER TO SIGNATURE
0 - 1 1 00 OF PERMITTEE d
O
1 - 10 1 3 00 DISTRICT NO GROUP ZONE ROCESSED SY U
10 — 50 5 00 O
50 - 100 10 00 NOTES G
W
100 - 500 15 00 C"
N
SIGN GAS SIGN AND 05E CIRCUIT 3 00
TUBE OR
MARQUEE ADDITIONAL CIRCUITS 1 00
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00
SERVICE OVER 600 VOLTS OR 200 AMP 5 00
TEMP SERVICE POLE &APPURTENANCES 3 00
APPROVALS DATE INSPECTOR S SIGNATURE
TEMP POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
WIRING !/
ISSUING FEE 2 00 /
FIXTURES
SUPPLEMENTARY ISSUING FEE 1 00 POWER AUTHORIZED
PERMIT FEE UTILITY CO NOTIFIED S
PLAN CHECK FEE (507 PERMIT FEE) ]FINAL ` C/
TOTAL FEE
JOSEPA C ROOHAN
SUPERVISING ELE L ENGINEER
PLAN CHECK VALIDATION CK M o CASH PERMIT VALIDATION C CKM o CASH
Ip _ 496 c2l APR 8 2 D 2 60-
u
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
76A663 DBS SA 3 sO APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
WILLIAM J FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRNO GRROOUP ZONE PERMIT NO
14)
ELECTRICIAN '
If
RECEIVED BY READY FOR DATE ISSUED
ADDRESS (J !p r � FIRHT, INwPECT10N
CITY TEL.NO
COUNTY LICENSE NO �G Z-- EXPIRES BUILDING /�
PERMIT FEES ADDRESS
NUMBER EACH FEE LOCALITY
LIGHT OUTLETS NEAREST
i
RECEPTACLES CROBB ST
WALL SWITCHES OWNER ; I
TOTAL OUTLETS Sc `B 3-S MAIL
ELEC RANGES 85 ADDRESS
ELEC HEATERS 25 CITY TEL NO
FIXTURES B Z Q
I 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 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOB
NUMBER HORSEPOWERFEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
NEw Mvo HP OVER INC EACH OF THE RE8IDENTIAPERT X DESCRIBED ABOVE
V & LESS 16 25 SIGNATURE OF
I/2 2 SO PERMITTEE C\
2 5 1 00 INSPECTION RECORD
5 15 1 50 /
15 50 250.
50 200 6 00f�j
9 �
200 500 10 00 Q200 500 10 00 a��2 uli
500 1000 15 DO '' ---
OVER 1000 2000
M G SET/FREQ CHANGER HP
WELDERS AC KVA
GENERATORS KW
TRANSFORMERS KVA
TEMP MOTORS (75% of DRIO)
MOVED MOTORS (75% OF ORIS)
MIBC
SIGNS
NO NO TRANS
APPROVALS
NO N0 LAMPS ,
,J DATE INSPECTOR'S NAME
FOR EACH PERMIT
WIRING $1 00 Jf ()d CONDUIT
FIXTURES $1013 �f � 60 WIRING
FIXTURES
SUPPLEMENTARY 50
,�. POWER 71,
TOTAL FEE # UTILITY CO NOTIFIED
FINAL
WORKERS COMPENSATION DECLARATION CE 806G (2 80) APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm'that I have a certificate of consent to self y COUNTY OF LOS ANGELES �� BUILDING AND SAFETY
insure or a certificate of Workers Compensation Insurance or
a certified copy thereofy(Sec 3800 Lab C)
FOR APPLICANT TO FILL IN SOB
Policy No Company EACH NO FEE ADDRESS
New Residential Bldgs &Pools
Certified copy is hereby furnished 1 &2 Family Scl Ft " $ — $ LOCALITY pr
r Multi family Scl Ft — NEAREST
ElCertifiedicopy is filed with the county building inspection _ CROSS ST 041al
department Residential Swimming Pools OWNER OR
"`ry FIRM NAME m
Date Applicant Outlets Rec_Light_Sw ADDRESS m
t First 20 p�
CERTIFICATE OF EXEMPTION FROM WORKERS Total No Additional CITY 6 � Tel No o 2�yo!5 7 }
�rCOMPENSATION INSURANCE
y PLAN CHECK
APPLICANT _t+ e
(This section need not be completed,if the work involved Lighting Fixtures First 20 ' U
by the permit is for one hundred dollars ($100) or less) ADDRESS
Total No Additional
I certify that in the performance of the work for which this Tel No
Fixed Appliances Not Over 1 HP - CITY t
permit is issued I shall not employ any person in any manner PERMIT i W
so as to become subject to the Workers Compensation Laws Range_ Heater_D W APPLICANT (� �� f.CJ d
i Oven _ Dryer_W M /
_ ADDRESS91'
Cn
Dat e, Applicant Q1;6a "s" Top _ FAU _W H _ a
Hood _ Fan _Other_ y CITYrz57w,,�6� Tel Noa85 ,
NOTICE TO APPLICANT If after making this Certificate of Disp _ Room Air Cond_ LICENSE OR
Exemption you should become subject to the Workers REG NUMBER I Class i f
Compensation'provisions of the Labor Code you must forth Power Apparatus& Large Appliances DISTRICT NO PR CES D BY
with comply with such provisions or this permit shall be Size&Type HP or`KW KVA KVAR
deemed revoked t
Up to 1 Incl FINAL
f c
LICENSED CONTRACTORS DECLARATION ' Over 1 to 10 Incl DATE (p VALIDATION
Over 10 to 50 Incl
I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc FINAL
9 (commencing with Section 7000) of Division 3 of the BusiOv r 1 p )
ness and Professions Code and my license is in full force and � j .
effect Services 1�
Cp �� 0 200 Amp Under 6 V
35679112i
License Number 35 'Lic Class 201 1000 Amp Under 600 V
Contractor Date —�S d'z- Over 1000 Amp or Over 600tV
� f _
HOME OWNER BUILDER DECLARATION Temp Power Pole&Appurtenances
I hereby affirm that I am exempt from the Contractors Sign with One Branch Circuit
License Law for the following reason (Section 7031 5 Busi Additional Sign Branch Circuits 2 3 2 a 3 A
ness and Professions Code) I
Misc Conduits&Conductors
El I as owner of the property will do the workland the Other (See Complete Fee Schedule)— # 0 0 0 0 0 2
structure is not intended or offered for sale (Section' 2'o,° 2 3 5 0
' 7044 Business and Professions Code)
CONSTRUCTION LENDING AGENCY ° ° ° 2 3 5 0 Cl)
I hereby"affirm that there is a construction lending agency-
for
gency for the'performance of the work for which this ,permit is PERMIT FEE (Sub Total) d 3 1 '6-82
issued (Sec'3097 Civ C)
Lender s Name PLAN CHECKING FEE (One Fourth Permit Fee)
� S
Lender s Address PERMIT ISSUING FEE "
1
I certify that I have read this application and state that the TOTAL FEE I 1
above information is correct I agree to comply with all County
ordinances and State laws regulating Electrical wiring and
hereby au rize representatives of this County to enter upon
the at ntioned property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE
,
Signature of Permittee Date _
i
x� t
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1402100019
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285 0488 EXT
LEGAL ID FEES PAID BUILDING ADDRESS
ON FILE _ 5435 BALDWIN AV
_ _(FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917802625
(ASSESSOR INFORMATION NUMBER I i 1 NEAREST CROSS STREET OLIVE
18588 019 023 IA1 PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 597 GRID B4 LOCALITY TEMPLE CITY CAI
I 1G1 OUTLETS LGT SW RECP 5 00 OUT 10 00 1
TENANT 1H2 RES GREG DISP LT 3HP 1 00 DIS 11 00 JISSUED ON PROCESSED BY PLAN BY
IH3 RES DISHWASHR LT 3HP 1 00 DIS 11 00 102/10/14 SR
I IH4 RES RANGE HDS LT 3HP 1 00 HOD 11 00 I 1
(OWNER TEL NO 1H5 RES WASH MACH LT 3HP 1 00 WAS 11 00 IFINAI DATE FINAL BY CODE 1
IYANG CHRIS (626) 378 6222 IH7 RES EXHAUST FANS 1 00 EX 11 00
16289 BION AVENUE 1
TOTAL FEES 92 80
1SAN GABRIEL CA 91775 I IITESCRIPTIO OF WORK 1
I I 15 OUTLETS GARBAGE DISPOSAL DISHWASHER RANGE HOOD WASHING(
I _I 1MACHINE AND EXHAUST FAN 1
1APPLICANT TEL NO 1 I I
ISUN MAN YAT (626) 354 3886 1 1 1
1937 S RAMONA STREET 1 (SPECIAL CONDITIONS 1
1SAN GABRIEL CA 91776 I 1 1
I I I ) I
1CONTRACTOR TEL NO (APPROVALS DATE INSPECTOR SIGNATURE
IMAN YAT SUN (626) 780 8728 1 1 1
1937 S RAMONA STREET LIC NO ITEMPORARY POWER POLE
ISAN GABRIEL CA 91776 689505 1 1 1 I 1
1 1UNDERGROUND CONDUIT
I I I
1ARCHITECT OR ENGINEER TEL NO 1 1UFER GROUND
I I I
1 LIC NO 1 IROUGH CONDUIT I I I
I I I
1 I IROUGH WIRING1 I 1
i
1 1 (MAIN WATER LINE I I
I I (PLASTIC Y/N METAL Y/N I I 1
(UTILITY COMPANY NOTIFIEDI I I
I 1 I I I I
I I I I I I
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I IREPORT ID DPR265 ROUTE TO BS0508 1 1 I 1
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