HomeMy Public PortalAbout4922 ARDSLEY DR_Electrical__ _ 76A663-CTE B.Oy..1-68 APPUCAMN FOR ELEC TR -M & E M I�
COUNTY OF LOS.ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING ;2,
BUILDING AND SAFETY DIVISION � ADDRESS �^
JOHN A: LAMBIE. COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY 7 e
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
NO. EACH FEE
$ $ OWNER /2
J. —�
MAIL
LIGHT6TOTALFIRST 20 .20 D ADDRESS /H
SWITCH / OVER 20 .10 CITY TEL. NO.
PLAN CHECK
LIGHTING TOTAL FI-RST 20 -20j APPLICANT
Id
FIXTURES a OVER 20 .10 ADDRESS
" RANGEDRYER—WTR.HTR._ CITY TEL. NO.
L, STA.COOK_DISP. F.A.U._ CONTRACTOR l
.,
SPACE HTR. AADDRESS '
IR COND. rQ /RDx.
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CLOTHES WASH._DISHWASH._ CITY iC/,7W �'/LI NO. r '
` FANOTHER 1.00 LICENSE NO. �. ,� - (CS CLASS.
I,�t}MOTORS,TRANSFORMERS RATING
IND. HEATERS, ETC. HP. KW. KVA. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION '
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., ?i
- 0 _ - 1 1.00
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
g LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
} i - 10 3.00 CAL IFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO d
10 - 50 5.00 RESIDE IN, THE ABOVE DES CRIRED RE IDE NTIAL PROPERTY. O
SO — 100 10.00 SIGNATURE VOF PERMITTEE ad
100 — 500 15.00
DIST T GROZ PRO ESSE BY V
SIGN,GAS SIGN AND ONE CIRCUIT 3.00 BJ
TUBE, OR O.
MARQUEE ADDITIONAL CIRCUITS 1.00 } N
f,NOTES: Z
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 .�..
I�t
SERVICE OVER 600 VOLTS OR 200 AMP 5.00
n' TEMP SERVICE, POLE, & APPURTENANCES 3.00 Sn-. APPROVALS DATE INSPECTOR'S SIGNATURE
i
TEMP. POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT !/ Ay
j
PERMIT FEE (SUB TOTAL) WIRING
FIXTURES
PLAN CHECK FEE (50% PERMIT FEE)
POWER AUTHORIZED
PERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL
TOTAL FEE JOSEPH C. ROOHAN
_ SUPERVISING ELOCK
AL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATIONM.O. CASH
Leo 4 6 2 o'0 MAY g 2 0 8.40-
iEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
TV 0 F
76n.663-CE806 9-67 APP CAU ON FOR EIEC UCAL PERM0C
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEERBUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY
FGLOTHES
- s�.= NEAREST
FOR APPLICANT TO FILL IN CROSS ST. 2NO. EACH FEE
PT. $ $ OWNERMAILT TOTAL FIRST 20 .20 ADD ESSCH_ OVER 20 .10 CITEL. NO.
TING 1 TOTAL FIRST 20 .20 CONTR TOR ,.e.URES T OVER 20 .10 ADDR SSJ 7U rE—DRYER_WTR.HTR._ CIT /, yzjr. ELl7 g.COOK_DISP. F.A.U._ LICENSENO.E HTR. AIR COND.� I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
ANDSTATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
HES WAS H. DISHWAS H._ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING.
FAN-OTHER / 1.00 I HEREBY CERTIFY THAT I AM PROP RLY REGISTERED AND/OR
LICENSED AS REQUIRED Y LOS ANG COUNTY AND STATE OF
MOTORS,TRANSFORMERS RATING CALIFORNIA OR THAT I T LEGL NER 0 , AND INTEND TO
IND. HEATERS, ETC. HP. KW. KVA. RESIDE IN, THE. A V D ScR BE REST TIAL PROPERTY.
SIZE & TYPE OVER TO SIGNATURE
0 - 1 1.00 OF PERMITTEE d
1 - 10 3.00 DISTRICT NO.1 GROUP" KE PIRQL.ESED BY
U
10 - 50 5.00 ��
O
50 - 100 10.00 NOTES:
W
100 - 500 15.00SIGN,GAS
O.
N
4
+ TUBE, OR SIGN AND ONE CIRCUIT 3.00
" 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
,•.UNOERSLAB WORK
z� a^ ROUGH CONDUIT
WIRING
ISSUING FEE 2.00 `
ti. FIXTURES
SUPPLEMENTARY ISSUING FEE 1.00 ,u POWER AUTHORIZED
PERMIT FEE '.UTILITYCO.NOTIFIED
PLAN CHECK FEE (50% PERMIT FEE) +-FINAL
TOTAL FEE JOSEPH C. ROOHAN
- „i ;;,:,::;�-t - `_v,,•„_M_.,«'• - - _ SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION 0
M.O. CASH
0.5 1 3 4\cao X20 2 D 2.00—
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
• DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1104060006
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID BUILDING ADDRESS: 1
ITR: 14647 LT: 45 I 1 4922 ARDSLEY DR 1
I IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT: 1 TEMP CA 917803803 I.
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: TEMPLE CITY 1
18590-016-009 IA1 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: A5 LOCALITY: TEMPLE CITY, Cl
I IG1 OUTLETS-LGT,SW,RECP 90.00 OUT 133.00 I
(TENANT: IG2 LIGHTING FIXTURES 25.00 LGT 45.70 (ISSUED ON: PROCESSED BY: PLAN BY: 1
I IRA FAD LESS 3HP 2.00 FAU 21.80 104/06/11 SR
IH2 RES GRBG DISP LT 3HP 1.00 DIS 10.90 I
(OWNER: TEL. NO: IH3 RES DISHWASHR LT 3HP 1.00 DIS 10.90 IFZNAL DATE FIIJAL BY: CODE: 1
ICHUI, VINCENT (626) 285-1112- IH4 RES RANGE HDS LT 3HP 1.00 HOO 10.90 1le/1_
1106 ALABAMA ST. IHS RES WASH MACH LT 3HP 1.00 WAS 10.90 1 -j
ISAN GABRIEL CA 91776 IJB AC UNITS +3-10HP 1.00 AC 19.70 ID SCRIPTION OF WORK I
I ILB 200 AMP PANELS, MCC 1.00 PAN 38.80 (ELECTRICAL FOR ADDITION, REMODEL, HVAC SYSTEM AND UPGRADE 1
I. TOTAL FEES 330.40 ISERVICE PANEL 200 AMP
(APPLICANT: TEL. NO:
IVINCENT CHUI CONSULTING (626) 285-1112-
1106 ALABAMA ST. I ISPECIAL CONDITIONS: 1
ISAN GABRIEL CA 91776 I I I
I I I I
I I I
(CONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE I
IQUALITY RESTORATION AND REHAB. (626) 215-7318- I. I I
12213 FALLING LEAF AVE. LIC. NO ITEMPORARY POWER POLE I I
IROSEMEAD, CA 91770 656275 B I I
I I' (UNDERGROUND CONDUIT 1 I -
t I I I I I
(ARCHITECT OR ENGINEER: TEL. NO: IUFER GROUND I I I
I I._- 11 I
I LIC. NO: (ROUGH CONDUIT I ' I
I I IROUGH WIRING
I
I IMAIN WATER LINE I I
IPLASTIC Y/N METAL Y/N I
(UTILITY COMPANY NOTIFIED( I
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I IREPORT ID: DPR265 ROUTE TO: BS0508 I
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