HomeMy Public PortalAbout9431 BLACKLEY ST_Electrical__ . '� 'APPLICATION PE MI� IJ
( 76-11!, 806 1470
I� COUNTY OF LOS ANGELES
I DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADORESS
41
JOHN A LAMBIE, COUNTY ENGINEER
COLEMAN W JENKINS, SUPERINTENDENT OF BUILDING LOCALI /J
NEAREST C
FOR APPLICANT TO FILL IN CROSS ST
OUTLETS NO EACH FEE
$ $ OWNER
RECEPT_ MAIL
LIGHT TOTAL
FIRST 20 20 ADDRESS
OVER 20 Y TEL NO
SWITCH_ 10 PLAN CHEC
LIGHTING TOTAL FIRST 20 20 APPLICANT
FIXTURES
OVER 20 10 ADDRESS
APPLIANCES CITY TEL NO
PERMIT /
RANGE DRYER_WTR HTR APPLICAN C- ,
STA COOK DISP F A U -a
ADORES
SPACE HTR AIR CON TEL N
CLOTHES WASH DISHWASH LICENSE CLASS
FAN OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND HEATERS, ETC HP KW KVA ELECTRICAL WIRING
SIZE & TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANDAYP
0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY ANO STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
1 - 1O 300 RESIDE IN, THE ABOVE PESCRIP RESIDENTIAL PROPERTY
,,,///�, //A
SIGNATURE �j f� ,� / 0
10 - 50 500 OF PERMITTE���..,.,,,,,,!!( (('Z�(j _ �` UO
50 - 100 1000
DISTRIC NO CLASS -TOU I Zr PR CE$,S ED BY OC
100 - 500 1500 Z u
U
SIGN, GASSIGN AND NE CIRCUI 300 NOTES UJ
CL
TUBE, OR ( Z
MARQUEE AD TIO CI)RCU S 100 if
SERVIC j VE 0=ILLT R 0
APPROVALS DATE INSPECTOR'S SIGNATURE
S RVIC VER 600 OR200AMP 500
TEMP POWER POLE
TEMP SERVICE,POLE, &APPURTENANCES 300
UNDERSLAB WORK
TEMP LIGHT OR RECEPT SYSTEM 300
ROUGH CONDIUT
WIRING
PERMIT FEE (SUB TOTAL) FIXTURES
POWER AUTHORIZED
PLAN CHECK FEE (50% PERMIT FEE)
UTILITY CO NOTIFIED
PERMIT ISSUING FEE
FINAL 77i
SUPPLEMENTARY PERMIT ISSUING FEE 100
J SEPH C ROOHAN
TOTAL FEE SUPERVISIN E ENGINEEP
PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION CK M 0 CASH
LACo fi Q G6 9-,. mAy 15 2 D .0 0- V
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
76AG63 SA Sm 0 -7 67 67 •••-f.1 � APPUC MON FOR PEHLl�Ytii
aD�AI3�'A'IOU OF OF-LOS
DI1vG LE SAFETS�_ � f �i�� `'� I�:
C®[7ioi'd'x OF�.OS ANGELES
WM J. FO` y�CHIEF ENGINEER W
_Q NAME f +2/ !�" DISTRICT NO. GROUP ZONE PERMIT NO.
U ADDRESS / " C -`t �',., .d'
NU CITY L t. ' TEL NO �J RECEIVED BY FIRST INSPECTION'READY FOR DATE I SUED
A COUNTY f -i �f
-LICENSE NO Jr EXPIRES
APPLICANT FILL IN HEAWII.Y OIJ LINE® POII'TION ONLY
r 4a
JOB
(DESCRIPTION OF WOR ADDRESS
NUMBER OF OUTLETS ON CIRCUITS " � J �f/
LOCALITY /L._
LOCATION BY ROOMS NEAREST
LIGHT OUTLETS SW PLUGS FIXT CROSS ST
CIRCUIT A B C D E F G H W NAME,, �G�D et �'i t ✓1�,�- .Q +`
III
MAIL
a. 3 -ADDRESS
O CITYQ��y-1�L t l e�J C� tom.?EL: NO.14-f,
1 AM THE LEGAL POSSESSOO OF THE ABOVE
ANGELES COUNTY CERTIFICATE OF QUALIFICATION.
ELECTRICIAN.
I AM THE LEGAL.OWNER OF THE PROPERTY DESCRIBED
ev 4 -OWNER.
CO V..a�ONS
w
y"
Q
U
_ a
0
OTAL /
NO. OF OUTLETS $ APPROVALS
NO OF FIXTURES $ DATE INSPECTOR'S NAME
NO. OF MOTORS H P. $ CONDUIT
NO OF SIGNS TRANS E WIRING
NO OF RANGES OR HEATERS ffi FIXTURES
MISCELLANEOUS ffi POWER
PERMIT FEE $ UTILITYCO NOTIFIED (f
AL FEE V FINAL
Y-
t
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1007260036
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
ILEGAL ID I FEES PAID BUILDING ADDRESS I
ON FILE I 9431 BLACKLEY ST
IFEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917803141
(ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET I
18590-003-048 IA1 PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 596 GRID J4 LOCALITY TEMPLE CITY, Cl
I ILA 100 AMP PANELS, MCC 1 00 PAN 38 80 1
ITENANT I TOTAL FEES 66 60 (ISSUED ON PROCESSED BY PLAN BY I
107/26/10 SR
I I I I
OWNER TEL NO I FI`y�/y�' ATE FI BY CODE
1PHAM, DORIS (626) 379-8797- I I y/
19431 BLACKLEY ST I ]� -/
ITEMP 917803141 I IDS TION OF WORK I
I I IREPLACE ELECTRICAL MAIN PANEL 100 AMP 1
1APPLICANT TEL NO I I I
ISAME AS OWNER
I I I S'�P11ECiI-AL CONDITIONS 1
(CONTRACTOR TEL NO 1 IAPPPOVALS DATE INSPECTOR SIGNATURE I
ISAME AS OWNER - 1 I I
I LIC NO 1 ITEMPORARY POWER POLE I I I
I I I I
I I (UNDERGROUND CONDUIT 1
I I I I I I
(ARCHITECT OR ENGINEER TEL NO I IUFERUFER GROUND 7s �/ 1
I LIC NO I IROUGH CONDUIT I �!
I I IROUGH WIRING I 1
I I I I I I
I IMAIN WATER LINE i
iPLASTIC YIN METAL YIN
` t - UTILITY COMPANY NOTIFIED / _l-'61I
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