HomeMy Public PortalAbout9064 BROADWAY_Electrical__ COUNTY OF LOB ANGELES APPLICATION FOR PERMIT
Department F of CountBUILDING
Engineer
DIVISION OF BUILDING & SAFETY
WILLIAM J. FOX, County Engineer
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO.
ELECTRICIAN /'.Ay- 6. -
ADDRESS Qr Imes f� � .F�i/g�'P'/ RECEIVED BY READY FOR DATE 1 9UE
_ (/+ FIRST INSPECTION 1 '^
CITY �� /� Xf- TEL NO. J
' / (/ EXPIRES BUILDING / 'J
COUNTY LICENSE NO. Y (O �7
PERMIT FEES ADDRESS t
FEE
NUMBER EACH LOCALITY
NEAREST
: 'LIGHT OUTLETS
CROSS ST. i/w tJ
RECEPTACLES �
WALL SWITCHES ? t OWNER;lY -7/Cc-AG✓�C.��A,I}rl..�/' j��
TOTAL OUTLETS SC B l AMAIL
DDRESS
ELEC. RANGES 251
ELEC. HEATERS 24 CITY
FIXTURES 5 L�
1 '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 1 POSSESS THE ABOVE VALID LOP
NuHgeRHORSEPOWER FEE ANGELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER
NEw MVR. HP GVER EACH OF THE RESIDENTIAL PROPERTY DESCRIBED
ABOVE.
I/2 s LESS § .25 SIGNATURE OFQ/ .d✓/�f/
I/ 2 .50 PERMITTE�/{{{{���� --_
2 s 1.00 INSPECI70N RECORD
_ 5 Is 1.50
is s0 2.50
_ 50 200 5.00
zoo BDO 10.00 J
s00 1000 15.00 Q
— Z
OVER 1000 20.00
M.G. HET/FRED. CHANGER-HP
WELDERS: AC-KVA D
GENERATORS - KW
TRANSFORMERS - KVA
TEMP. MOTORS (75q DF ORIG.)
MGVED-MCT-0RS (75% vF 0.10.)
MISC. —
SIGNS c
NO. NO.TRANS. APPROVALS
NO. NO. LAMPS
FOR EACH PERMIT: DATE INSPECTOR'S NAME
WIRING §1.00 �^1 CONDUIT
FIXTURES _ §1,00 _L— WIRING
SUPPLEMENTARY .50 FIXTURES
POWER _
TOTAL FEE H / ` t� UTILITY CO. NOTIFIED
G+ FINAL,
TGA5g3 DBS#5A 4-52
76A663 0.s SA 11-So APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES ((v"
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO.
ELECTRICIAN �-3 �~
RECEIVED BY READY FOR DATE ISSUED)
ADDRESS FIRST INSPECTION
CITY TEL. NO. NG A AA /
COUNTY LICENSE NO. EXPIRES BUDREISG A 0 L
PERMIT FEES T / m
FEE /�////Ai3n J'.O� �
NUMBER EACH LOCALITY
LIGHT OUTLETS Z' NEAREST
CRU S96T.
RECEPTACLES
WALL SWITCHES 4r OWNER
I,? TOTAL OUTLETS /h 50 5 MAIL I1
CJ ELEC. RANGES 25 -ADDRESS
/�1X a
ELEC. HEATERS 25 y
CITY J 6�t TEL.
t/ - r
FIXTURES s I HEREBY ACKNOWLEOGE 'THAT I 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 I CERTIFY THAT I POSSESS THE ABOVE VALID LOS
NNMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
NEW MVO. NP DYER INC. EACH OF THE RESIDENTIAL PROPER" DESCRIBED ABOVE.
Vis LESS $ .25 SIGNATURE OF A44 �/ 1
_ I/s 2 .50 PERMITTEE •( 1. A +A-.+
2 5 1.00 INSPECTION (RECORD
_ s is 1.50 _
15 50 2.50
_ SD 200 5.00 _
200 5013 10.00 J
_ 500 Z 1000 15.00 a
OVER IOOp 20.00 IS
M.G. SET/FRED. CHANGER-HP rx
WELDERS: AC-KVA O
GENERATORS - KW
TRANSFORMERS - KVA
TEMP. MOTORS (75% of oRio.)
MOVED MOTORS (75% OF owlc.)
MISC.
SIGNS
NO. NO.TRANS. APPROVALS
NO. NO. LAMPS
FOR EACH PERMIT: DATE INSPECTOR'S NAME
WIRING $1.00 CONDUIT
FIXTURES $1.00 WIRING �/ ., ► /- 7�.7
SUPPLEMENTARY .50 FIXTURES
POWER
TOTAL FEE $ 6O UTILITYCO. NOTIFIED /
FINAL �� l/1oln_
11"EWaPLE CkTV
APPLICATION FOR ELECTRICAL PERMIT 'Q
COUNTY OF LOS ANGELES - - - -
DEPARTMENT OF COUNTY ENGINEER FADDRESS106a
NG
BUILDING AND SAFETY DIVISION JOHN A.LAMBIE. COUNTY ENGINEERWILLIAM A.JENSEN. SUPT OF BUILDING TY /FOR APPLICANT TO FILL IN TST.
PERMIT FEES OWNER
[Tam NUMBER EACH FEE MAIL //
OUTLET $ $ LJ`
ADDRESS 'r
LIGHT$ RECEPT. 6W. .10- '
—�� CITY TEL.NO.
LIGHTING FIXTURES .10
ELEC. RANGE$ CLO. DRYERS ELECTRIC AN
WATER HEATERS .50 ADDRESS
ELEC.SPACE HTRS. DISHWASHERS CITY
TEL.NO.
GARBAGE DISPOSERS AUTO.. STATE
WASHERS STA. COOKING UNITS .25 LICENSE NO.
MOTORS: OVER INC. H.P. DIy4,ZE21Cz OU E E�$ED
0 — I/2 .25
i, — 2 .50 INSPECTION hEtORD
2 — 5 1.00 d
5 — Is 1.50 0
15 — 50 2.50 C
O
SO — 200 5.00 U
SIGNS:
NO TRANS. W
a
NO. LAMPS Z
SERVICE 0.500V 1.00
SERVICE OVER BOOV 5.00
MISC.
WIRING PERMIT 1.00
FIXTURE PERMIT 1.00
SUPPLEMENTARY PERMIT .50
TOTAL FEE s'-'3 o
1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVA D E INSPE OR'SSIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY II
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT L,I S AH �'`v ew �.L . G/
ELECTRICAL WIRING. WIRING " Y
1 HEREBY CERTIFY THAT 1 AM PROPERLY REOIST O ANO/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY A STATE OF FIXTURES
CALIFORNIA OR THAT I A HE LEGAL OWNER OF HE BOVE
DESCRIBED OR
PERTY. POWER A
SIGNATURE L- UTILITY CO. NOTIFIED
PERMI / AV
OF TTE
FINA =/ �Fti�/ r.Qo�LL-^..�
ALIDATION ARTHUR C.VEIT,
C MO CASH SUPERVISING ELECTRICAL ENGINEER
f;L(�9 7 5 9 JUL 2 U3.0 0 `�
WOthat I hveacertificate
COMPENSATION DECLARATION 76A663 DPW„2-9„ . APPLICATION FOR ELECTRICAL PERMIT d
64863
I her4by affirm that I have a certificate of consent to sell insure,
or a Certificate of Worker's Compensation Insurance, or a'certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV.
copy thereof(Sec.3800 Lab.,C.)
Policy No. Company FOR APPLICANT TO FILL IN JOB Q �O�O�H �S
4DDRESS OG
CertifieCco is hereb furnished. NO. EACH FEE
PY Y Naw Resitlential Bltlgs.8 Pools
❑ _ $ $ LOCALITY C G C O
derartm copy is filed with the county building inspection i ul i--Family, .q.Ft FL
department. Multi-(omit S Ft. — NEAREST
Y g� CROSS ST.S(�(,
Residential Swimming Pools ASSESSOR O,pe � µ.�
Date Applicant } MAP BOOK ppG PARCEV!J[� r
CERTIFICATE OF EXEMPTION FROM WORKERS' �/ OWNER OR _
Outlets:RCC. Light Sw. FIRM NAME
COMPENSATION INSURANCE 0?&0 � d NIL1 /. /V /9
First 20 MAIL
(This section need not be completed if the work Involved by the Total No. Additional AOORES6�6 Wyd Ave.
permit is for one hundred dollars(6100)or less.)
I certify that in the performance of the work for which this permit CITY M/4 L C t CR Tel.
is issued, I shall not employ any person in any manner so as to PLAN CHECK
l
become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANT HZI'< pn ,,/ R,4AJ1ji L.
Total No. Additional
.[ ADDRESS
Date J Applicant /-><LR/tRxi �{<lprl/RGZ )/ �� �j ?d GN'� Uf•
�11ZL APPLIANC S NOT OVER 3 HP.
NOTICE , y APPLICANT: a after making this Certificate of CITY L e , Tel.No. 3o9-9yJ'L..
Exemption, you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP.
provisions of the Labor Code, you must forthwith comply with such PERMIT S A.s V
provisions or this permit shall be deemed revoked.
Power Apparatus 8 Large Appliances APPLICANT
LICENSED CONTRACTORS DECLARATION Size 8 Type HP,KW.KVA,or KVAR ADDRESS
I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 70 Incl.
(commencing with Section 7000)of Division 3 of the Business and CITY T.I.No.
Professions Cade,and my license is in full force and effect. Over 10 to 50 Ind. �•-- �l }
Over 50 f0 100 IOCI. CESE 08
RIEG NNU B44ER J� Z o Class. d
License Number Lic.Class
S/Y l d S Over 100 DISTRICT NO. PROCESSED BY Q
� yf
Services,Swbd.,MCC 8 Panelboards ,DO
Contractor �7G'\�p' mI�SZDate S`3—�G 0-399 Amp.Under 600 V FINAL Q
GATE
I am exempt under Sec. 400-1000 Amp.Under 600 V ` V
VALIDATION
Over 1000 Amp.or Over 600 VF
B.BP.C,for this r¢daOn jFINAL
fMPLd /�E c BRANCH CIRCUIT FEES BY (n
Dat 154,or 204,120V.Lighting Branch
ch Cir. Z
�� � 1 To 10 Branch Circuits
S'anat IrP .
i 11 To 40 Branch Circuits
❑ 41 Or More Branch Circuits
Exemption for Reg. Maint.Elect. 1SA,20A,208V To 277V Lighting Sr.Cimuits 2
SINGLE FAMILY Temp.Power Pole&AppurtenancesAGCT.J.
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit
I hereby affirm that I am exempt from the Contractor's License Law 7-+,iry� �L.r1Fl
for the following reason (Section 7031.5. Business and Professions Additional Sign Branch Circuits 3303 _ 4 00
Code):
1 ITEMS ,r�e
F11,as owner of the property,will do the work and the structure Misc.Conduits 8 Conductors
r TOTAL 154t ®4J
is not intended ooffered for sale (Section 7044, Business Other(See Complete Fee Schedule)_ D
and Professions Code). NECK 54..00
CONSTRUCTION LENDING AGENCY CHANGE .00
I hereby affirm that there Is a construction lending agency for the
performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total)
Civ. C.) 0000-0001 5/ 3/96
PLAN CHECKING FEE
Lender's Name 6202 1 AM10:20
PERMIT ISSUING FEE
Lender's Address
1 certify that I have read this application and Under penalty of purjury state TOTAL FEE O�
that the above information is correct. I agree to comply with all County
ordinances and State laws regulating Electrical wiring,and hereby authorize
representatives of this County to enter upon the above-mentioned property
for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
�CLltOrnas S-3 E
SIGNATURE OF PERMITTEE DATE
Ja
NORXERS'COMPENSATIONDECLARATION 7o-wwDPW vs7 APPLICATION FOR ELECTRICAL PERMIT O
flirm.1hat I have a certificate of consent to self CE_
emc
re, or
'a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS
or a certifievy'copy thereof (Sec. 3800, Lab. C.)
Policy No. Company FOR APPLICANT TO FILL IN JOB p
Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS 701'10'r M6,1YOailfy
�Certified copy is iiled'with the county building inspec- 18 2-Family, Sq. Ft. $ — $ LOCALITY'�,S?Y,%= C/�y
tion department. Mufti-family Sq. Ft. — NEAREST
CROSS ST. SUL _,f,0,1,p U'Ge
Residential Swimming Pools WNERORDD
Date Applicant //��'' q
FIRM N ME /C D�tJzO/� pQ
lr
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Recl�Light�Sw�__ MAIL p
COMPENSATION INSURANCE ADDRESS /,06 O d4J -
(This section need not be completed If the work involved by First 20 CITY r'—
the permit is for one hundred dollars ($100)or less.)
Total No. Additional tc(l2rte C!/Y Tel. No. f ^' yy-
certify that in :he s PLAN CHECK
performance of the work For which this -
permit is issued, shall not employ any person in any manner APPLICANT
so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS
G i fe _yp e Additional
Date / _/_V V Applicoma Total pli___e.—_ CITY Tel. No.
NOTICE TO APPLICANT: If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT
Exemption, you should become subject to the Workers' Range— Heater—D.W. _ APPLICATION
Compensation provisions of the Labor Code, you must forth- Oven — Dryer _W.M.— ADDRESS
with comply with such provisions or this permit shall be Top — FAU —W.H, —
deemed revoked. CITY Tel. No.
LICENSED CONTRACTORS DECLARATION Hood — Fan —Other_
. Disp. — Room Air Cond. LICENSE OR
MM
BER Class.
(commencing with Section 7000)of Division 3 of the Business Power Apparatus & Large Appliances DISTRICT NO. PROCESS BY Y
and Professions Code,and my license is in full force and effect. (/ d
Size & Type HP, KW, KVA, or KVAR ( a 0
License Number Lic. Class U,
Up to I Incl. FINAL
Contractor Date Over 1 to 10 Ind. DATE r Zo y C ypLl A ION 0
❑ Over 10 to 50 Incl. FINAL c/
1 am exempt under Sec. Over 50 to 100 Inc. By U
W
B.&P.C. for this reason Over 100 CL
Date: Services, SwI d., MCC& Panelboards Z
0- 200 Amp. Under 600 V —
Signature 201 - 1000 Amp. Under 600 V
OOver 1000 Amp. or Over 600 V
Exemption for Reg. Maint. Elect.
SINGLE.FAMILY
HOME OWNER-BUILDER DECLARATION Temp. Power Pole 8 Appurtenances (]5 7.2 A
I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit e • e,e • 2
Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits
Professions Code): I :e - 35.50
1, as owner of the property, will do the work and the Misc. Conduits &Conductors
structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ D •,e e 3a5,0'
A
Business and Professions Code).
CONSTRUCTION LENDING AGENCY 09. 01 8 8
1 hereby affirm that there is a construction lending agency for
the performance of the work for which this permit is issued PERMIT FEE (Sub-Total)
(Sec. 3097, Civ. C.).
PLAN CHECKING FEE
Lender's Name
- PERMIT ISSUING FEE
Lender's Address
I certify that I have read this application and state that the TOTAL FEE `,
above information is correct. I agree to comply with all County
ordinances and State laws regulating Electrical wiring, and
hereby authorize representatives of this County to enter upon
the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
aS. r,640�— 9-1-dif-
Signature of Permittee Date Os
WORKER'S
haveCOMPENSATIONcertificate
DECLARATION 76A663 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I have a certificate of consent to self insure,
or a certificate of Worker's Compensation Insurance, or a Certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV.
copy thereof(Sec.3800 Lab.C.)
Policy No. Company FOR APPLICANT TO FILL IN JOB
ADDRESS
Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH' FEE
❑ _ $ $ LOCALITY
Certified copy is filed with the county building inspection 1 ul i--Family,Sq.Ft. NEAREST
department. Multi-family Sq.Ft. CROSS ST.
Residential Swimming Pools ASSESSOR
Dale Applicant MAPROOK I PAGE PARCEL
CERTIFICATE OF EXEMPTION FROM WORKERS' ..� f% OWNER OR
ODtlelS:RBC._Light Sw._ FIRM NAME
I' COMPENSATION INSURANCE First 20
(This section need not be completed If the work involved by the MAIL
Total No. Additional ADDRESS
permit is for one hundred dollars($100)or less.)
.l certify that in the performance of the work for which this permit CITY Tel.No.
is issued, I shall not employ any person in any manner so as to PLAN CHECK
become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANT
Total No. Additional
' ADDRESS
Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP.
NOTICE TO APPLICANT: If, after making this Certificate of CITY Tel.No.
Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP.
provisions of the Labor Code, you must forthwith comply with such PERMIT
provisions or This permit shall be deemed revoked.
Power Apparatus&Large Appliances APPLICANT
LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS
' I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Ind. 1'
(commencing with Section 7000) of Division 3 of the Business and CITY Tel.No. d
Professions Code,and my license IS in full force and effect. Over 10 to 50 Inc. LICENSE OR O
Over 50 to 100 Inc. REG.NUMBER Clas. 0
Over 100 DISTRICT NO. PROCESSED BY Ill
License Number Lie.Class J_
A, Services,Swbd.,MCC&Panelbcards
Contractor Date 0-399 Amp.Under 600 V FINAL
I E
T1 I am exempt under Sec. 400-1000 Amp. Under 600 V
VALIDATION Q
Over 1000 Amp.or Over 600 V FINAL Ct
B.&P.C.for this reasonBRANCH CIRCUIT FEES ev - CL
CL
Date: 15A,or 20A, 120V,Lighting or Recept. 2
1 To 10 Branch Circuits W
Signature 11 To 40 Branch Circuits ~
❑ 41 Or More Branch Circuits -
,Exemption for Reg.Main.Elect. 15A,20A,208V To 277V Lighting Br.Circuits
SINGLE FAMILY Temp.Power Pole It Appurtenances Fqe�!sM
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit c
I hereby affirm that I am exempt from the Contractor's License Law y�y
for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits @ilLw� itd
Code): !
I, as owner of the property,will do the work and the structure Misc.Conduits&Conductors
is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule)_ D _ till 54
and Professions Code),
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the
performance of the work for which this permit is issued Sec. 3097, PERMIT FEE L"
p ( (Sub-Total)
Civ. C.)
PLAN CHECKING FEE
Lender's Name Lrzf srf AU
PERMIT ISSUING FEE VNL MI1!
Lender's Address TOTAL FEE
I certify that I have read this application and under penalty of purjury state
that the above information is correct. I agree to comply with all County
ordinances and State laws regulating Electrical wiring,and hereby authorize
representatives of this County to enter upon the above-mentioned property
for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
SIGNATURE OF PERMITTEE DATE
COUNTY OF LOS ANGELES TEMPLE CITY N 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1311060048
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: FEES PAID BUILDING ADDRESS:
ITR: 11218 LT: 2 BL: H 9064 BROADWAY
I (FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:1 TEMP CA 917802313
(ASSESSOR INFORMATION NUNIBER INEAREST CROSS STREET:
15388-002-002 JAI PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY CAI
G1 OUTLETS-LGT,SW,RECP 3.00 OUT 6.00
TENANT: IG2 LIGHTING FIXTURES 2.00 LOT 4.00 (ISSUED ON: PROCESSED BY: PLAN BY:
1 TOTAL FEES 37.80 111/06/13 SR 1
TOWNER: TEL. NO: IF NAL DATE FINAL BY: CODE:
ICHUN CHINGBROAD MA I��� f� `J}/J11/6 T
9069 BROADWAY � 1 � /(. ..
(TEMP 917802313 E CRIPTION OF WORK
_ 13 OUTLETS AND 2 LIGHT FIXTURES 1
IAPPLI CAN T: TEL. NO: T
IHOA NGUYEN (714) 337-9238-
113882 SUMMERWOOD PL (SPECIAL CONDITIONS:
(GARDEN GROVE 92844 T
I
(CONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE T
LANDING CONSTRUCTION GROUP (714) 337-9238- T
13882 S[.uE RWOOD PLACE LIC. NO ITEMPORARY POWER POLE
(GARDEN GROVE, CA 92844 963678
UNDERGROUND CONDUIT
� I �
1ARCHITECT OR ENGINEER: TEL. NO: 1 1OFER GROUND
1 LIC. NO: 1 1ROUGH CONDUIT 1 1
ROOGH WIRING
(MAIN WATER LINE
1PLASTIC YIN METAL YIN
i IUTIL'CTY COMPANY NOTIFIEDI
1 I I I I I
I I I I I I
1
I I I I
I /
IREPORT ID: DPR266 ROUTE T0: BS0508 I I I I
COUNTY OF IAS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS -EL 0508 1112220008
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: . FEES PAID
BUILDING ADDRESS:
ITR: 11218 LT: 2 BL: B 1 9064 BROADWAY
I IEEE DESCRIPTION: QUANTITY: DOM: AMOUNT: i TEMP CA 917802313
(ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET:
15388-002-002 IP2 PC RES PV110KW 153.90 THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY, Cl
I IA1 PERMIT ISSUANCE FEE 27.80
TENANT: IP3 INVRTR RES PV<10KW 27.90 (ISSUED ON: PROCESSED BY: PLAN BY:
I TOTAL FEES 209.60 101/05/12 SR
OWNER: TEL. N0: FINAL DATE FINAL-PY: CODE:
1ABBOTT LONNIE - ^ y/7
9069 BROADWAY
TEMP 917802313 D SCRI PTION OF WORK
R00E-MOUNTED SOLAR PANELS (PV)
(APPLICANT: TEL. NO:
HOGE, JEANINE (818) 782-0700-
115500 ERWIN ST #1121 ISPECIAL CONDITIONS:
(VAN NUYS, CA 91411
r
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
RONCO ELECTRIC (818) 782-0700-
15500 ERWIN ST #1121 LIC. NO ITEMPORARY POWER POLE
(VAN NUYS, CA 91411 611593010 1 I
I (UNDERGROUND CONDUIT
I � I
(ARCHITECT OR ENGINEER: TEL. NO: IUFER GROUND
LIC. NO: TROUGH CONDUIT
I - k
TROUGH WIRING \
I I (MAIN WATER LINE
PLASTIC Y/N METAL Y/N
I I
I I TUT IL ITY COMPANY NOTIFIED( I11
I
I I
IREPORIID: DPR265 ROUTE 1'0: BS0508