HomeMy Public PortalAbout4880 ARDSLEY DR_Electrical__ 76A663-CES06 3-69
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APPLICATION FOR ELECTRICAL PERMIT
DEPARTMENT OF COUNTY ENGINEER BUILDING (p �y
BUILDING AND SAFETY DIVISION ADDRESS a t l f�s
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NO. EACH FEE
$ $ OWNER /" T/4
RECEIPT.- MAIL J
LIGHT TOTAL FIRST 20 .20 ADDRESS 4
SWITCH OVER 20 10 C-!TY 7TEL.NO.
PLAN CHECK
LIGHTING TOTAL I FIRST 20 .201 APPLICANT
FIXTURES } OVER 20 .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 r2p TEL.N0.
FAN_OTHER ` 1.00 / � CLASS. ^,Ju
MOTORS,TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
IND. HEATERS, ETC. HP. KW. KVA. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING.
0 - 1 1'00 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND TATEOF }
1 - 10 3.00 CALIFORNIA OR THAT I AM HE EGAL OWNER OF, AND N END TO >
RESIDE IN, THE ABOVE DE R O RESIDENTIAL PROPE T . O
10 - 50 5.00 V
SIGNATURE
50 100 10.00 OF PERMITTEE O
100 - '5500 1'55.00 DISTRICT NO. GROZ U! ZONE PR ?ED X-1 U
^/7� ' 615
SIGN,GAS SIGN AND ONE CIRCUIT 3.00 � N
TUBE, OR ,7O Z
MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES: 7/4
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
PERMIT FEE (SUB TOTAL) FIXTURES
POWER AUTHORIZED
PLAN CHECK FEE (50% PERMIT FEE)
PERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED gg
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL
TOTAL FEE JOSEPH C..ROOHAN
SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION {K, M.O. DASH
.0ONSI Ar 6 7 8 2 SEP 1-5-- 2 D 5.00-
SEE
EE BACK OF APPLICATION FOR COMPLETF FEE SCHEOI/L.E / /A�
COITNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 9901270022
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
TR: 14647 LT: 41 4880 ARDSLEY 'DR
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803801
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: TEMPLE CITY BLVD.
8590-016-005 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A5 LOCALITY: TEMPLE CITY
G1 OUTLETS-LGT,SW,RECP 24.00 OUT 44.40
TENANT: G2 LIGHTING FIXTURES 5.00 LGT 9.75 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
H7 RES EXHAUST FANS 1.00 EX 10.80 01/27/99 UT 01/27/00
LA 100 AMP PANELS, MCC 1.00 PAN 38.85
OWNER: TEL. NO: TOTAL FEES 131.55 FINAL DATE FINAL BY: DE:
LEE; BORNE (626) 285-3326-
4880 ARDSLEY DR - ,
TEMP 917803801 DES RIPTION OF WORK
ELECTRICAL FOR ADDITION AND RELOCATE SERVICE PANEL
APPLICANT: TEL. NO:
;LAI (626) 442-6718-
3535 TEMPLE CITY SPECIAL CONDITIONS:
.ROSEMEAD, CA
CONTRACTOR: TEL. N0:
® �� APPROVALS DATE INSPECTOR SIGNATURE
HONG A MIU (626) 281-3881- Q�
1715 SIERRA VISTA AVE. LIC. NO TEMPORARY PO ER POLE
ALHAMBRA, CA 91801 755456 B
UNDERGROUND CONDUIT i
ARCHITECT OR GINEER: T L. NO: UFER GROUND
LIC. N0: / 1111111 ROUGH CONDUIT
I L ,
ROUGH WIRING
Iu U DD L�C V v v V �1 LI UK2 MAIN WATER LINE
LJ= PLASTIC Y/N METAL Y/N
UTILITY COMP NY NOTIFIED
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REPORT ID: DPR265 ROUTE TO: BS0508