HomeMy Public PortalAbout9532 BLACKLEY ST_Electrical__ 76A663A-CE806A 4/72 APPLICATION FOR ELECTRICAL PERMIT . •-
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEERBUILDING /) Q
BUILDING AND SAFETY DIVISION ADORE
SS 7 [�
LOCALITY
NEAREST ep ,
FOR APPLICANT TO FILL IN CROSS ST p/e r n Q
OUTLETS NO EACH FEE OWNER `O /s // vs
S $
RECEPT MAIL
FIRST 20 ADDRESS
LIGHT TOTAL '
CITY rn e ; EL NO
SWITCH OVER 20 '
PLAN CHECK _
LIGHTING FIRST 20 APPLICANT
TOTAL OVER 20 ADDRESS
FIXTURES
RESIDENTIAL APPLIANCES CITY TEL NO
PERMIT L
RANGE DRYER WTR HTR. APPLICANT S
STA COOK DISP F.A U ADDRESSa!u.
SPACE HTR AIR COND - -�
CITY /em Ci TEL NOp'7 'p(
CLOTHES WASH. DISHWASH LICENSE NO. CLASS.
FAN OTHER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AN STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING W ITH 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 AND/OR
0 - 1 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO �
1 - 10 RESIDE N, THE ABOVE DE SCR D RESIDENTIAL PRO RTY N
Z
SIGNATURE
10 - 50 OF PERMITTEE
50 - 100
DISTRICT NO CLASS ZONE ROL S BY
100 - 500 0_• d0
SIGN, GAS SIGN AND ONE CIRCUIT NOTES:
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS -
SERVICENOTOVER600VOLTS OR200AMP /
APPROVALS DATE INSPECTOR'S SIGNATURE
SERVI CEOVER 600 VOLTS OR 200 AMP
TEMP POWER POLE
TEMP SERVICE,POLE, &APPURTENANCES
UNDERSLAB WORK
TEMP LIGHT OR RECEPT, SYSTEM
ROUGH CONDIUT
WIRING
FIXTURES
POWER AUTHORIZED
PERMIT FEE (SUB TOTAL)
UTILITY CO NOTIFIED �)
PLAN CHECK FEE
PERMIT ISSUING FEE FINAL -�-3z)A! ��j���.
TOTAL FEE �O
PLAN CHECK VALIDATION CK M 0 CASH PERMIT V IDATIONOKMO CASH
$-9�7�r t►s 26,_ 2 n .1 ,0.5 O-A2`8
76A863 . PERMIT
pRMIT
9-SS 77
P®LICATIO � FOR ELECTRIC
_.DIVISION OF BUILDING AND SAFETY
Deportment of County, Engineer
County of Loa Angeles BUILDING
WM.J. FOX, COUNTY'ENGINEER ADDRESS
CASSATT D. GRIFFIN. SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
PERMIT FEES cRoss sr
J`
NU-
MBER-EACH FEE OWNER
LIGHT OUTLETS &
RECEPTACLES MAIL�� ADDRESS
WALL SWITCHES 7 //
TOTAL OUTLETS Q CITY TEL -
ELEC RANGES 25 ELECTRICIAN
_ELEC HEATERS 25 a5 ADDRESS 5O �vl.lCi
KW EA CITYTEL. N S4
FIXTURES - 5 LICENSE NO.
larcgsaa
NUMBER OF LIGHT CIRCUITS - DISTRIC O. I GR9. LP&E I READY FOR INSPECTION
NUMBER OF RECEPTACLE CIRCUITS O"LVL,
MOTORS .
NUMBER HORSEPOWER FEE INSPECTION RECORD
NEW MVD. HP OVER INC EACH
1 I/2 a LESS $ 25 a7
1/Z 2 so
2 5, 1 00
5 15 1 50
15 50 250
50 200 Soo
MISC.
NO SIGNS NO.TRANS.
NO SIGNS NO LAMPS,
FOR EACH PERMIT '
WIRING $1 00 A b
FIXTURES $1 00- r 0
SUPPLEMENTARY 50 APPROVALS
TOTAL FEE I g407
I 0 DATE INSPECTOR'S SIGNATURE
I HEREBY ACKNOWLEDGE THAT 1 .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 Ste, ,J
ELECTRICAL WIRING,
1HEREBY CERTIFY THAT 1 AM PROPERLYREGISTEREDAND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY ND STATE OF
CALIFORNIA OR THAT 1 THE LEGAL O NE F THE ABOVE POWER
DESCRIBED RESIDENTIA TY.� -
SIGNATURE UTILITY CO NOTIFIED
OF PERM ITT FINAL V
WILLIAM J. FOX. COUNTY'ENGIN ER VALIDATION A. C.VEIT,CHIEF ELECT. INSPECTOR
1AC,05027U 114AY15 24.QC� Lr)
• COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS - - EL 0508 1208270030
BUILDING AND SAFETY / LAND_ DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT -
ILEGAL ID I FEES PAID 1, BUILDING ADDRESS
ITR 14572 LT 63 1 1 9532 BLACKLEY ST I
1 IFEE DESCRIPTION QUANTITY UOM AMOUNT I TEMP CA 917803142 1
IASSESSOR INFORMATION NUMBER - I NEAREST CROSS STREET 1
18590-007-028 1A1 PERMIT ISSUANCE FEE 27 80 I THOMAS-PAGE 596 GRID J4 LOCALITY TEMPLE CITY CAI
I IG1 OUTLETS-LGT,SW,RECP 10 00 OUT 20 00 I I
ITENANT IG2 LIGHTING FIXTURES 3 00 LGT 6 00 (ISSUED ON PROCESSED BY PLAN BY.
1 IH2 RES GRBG DISP LT 3HP' 1 00 DIS 11 00 106/27/12 SR '
TOTAL'FEES 64 80 I I
TOWNER TEL NO FINAL DA e i�j q BY '�lI^ CODE =
DYNES DENNIS H,YVONNE M (62T 286-2811- 6®pQ{/1 06n (Lv`�
19532 BLACKLEY ST I
ITEMP 917803142 I (DESCRIPTION OF WORK 1
(OUTLETS, NEW LIGHTING FOR KITCHEN REMODEL I
(APPLICANT TEL NO
IKITCHEN MEDIC (909) 578-6745- 1 -
1672 16TH STREET I ISPECIAL CONDITIONS 1
(UPLAND, CA I I
ICONTRACTOR. TEL NO 1 (APPROVALS DATE INSPECTOR SIGNATURE I
IKITCHEN MEDIC (909) 578-6745- 1
1672 16TH STREET LIC NO 1 ITEMPORARY POWER POLE 1 I
(UPLAND, CA 826849 1 1
I I (UNDERGROUND CONDUIT I I 1
(ARCHITECT OR ENGINEER TEL NO I IUFER GROUND I
LIC NO IROUGH CONDUIT I I
IROUGH WIRING �Z I
I - IMAIN WATER LINE I
I 1PLASTIC YIN METAL YIN I
I I (UTILITY COMPANY NOTIFIEDI I I
I I I I I I
I I I I I I
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I IREPORT ID: DPR265 ROUTE TO BS0508 I I I
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