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Home My Public Portal About9123 BROADWAY_Electrical__ 76A663-'CE806 3-69 APPLICATION FOR ELECTRICAL PERMIT COUNTY O.F LOS ANGELES DEPARTMENT OF COUNTY ENGINEER 6UILOINc BUILDING AND SAFETY DIVISION 1 gODRE55 9123 E. Broadway JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. '� NO. EACH FEE s $ OWNER Luthern Church RECEIPT3 MAIL ame as a ol/e. LIGHT TOTAL FIRST 20 I - ADDRESS �//�� J(} CITY TEL.NO. SW ITCH�v_ /S•V OVER 20 .JJ10 PLAN CHECK II o LIGHTINGTOTAL - FIRST 20 ayy DO APPLICANT FIXTURES '}-3 OVER 20 10 .10 1 00 ADDRESS RANGE_DRYER WTR. HTR. 11 l CITY TEL.NO. STA. COOK_DISP.yLF.A.U. f CONTRACTOR Calectric Co. SPACE HTR._AIR COND. ADDRESS 624 Wo. Akele Dr. CLOTHES WASH._OIS1H,W-A.SH.� CITY Glendora, TEL ND. - t+ FAN�OTHER k-J R -/%H d -S 1.00 v LICENSE NO. 258436 CLASS. C-lo JJJ HEREBY ACKNOWLEDGE THAT I HAVE.READ THIS APPLICATION MOTORS,TRANSFORMERS RATING IND. HEATERS, ETC. HP. KW'. KVA. ANO(STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY SIZE'$ TYPE OVER TO WITH ALL COUNTY ORDINANCES ANO STATELAWS REGULATING ELECTRICAL WIRING. D - 1 1.00 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR ' 1 -10ENSEO AS PEgUINE. BY 5 ANGELES COUNTY AND STATEOF a w 1 - 10 l 3.00 0� CALIFORNIA OR THAT AM H LEGAL O E OF. AND INTEND TO O RESIDE IN, THE ABOVE OE CPI ED RE51 AL PROPERTY. V 10 - 50 5.00 SIGNATURE 50 - 100 1000 OF PERMITTEE V 100 - 500 15.00DISTR�T o. 1 c ouv zoNE� P o l BY 6 SIGN,GAS SIGN AND ONE CIRCUIT 0 �/ 0! / 57N TUBE, OR ? MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES: �L( SERVICE NOT OVER 600 VOLTS OR 200 AMP 3.00 SERVICE OVER 600 VOLTS OR 200 AMP 7,00 TEMP SERVICE, POLE, &APPURTENANCES S-00 APPROVALS DATE INSPECToas SIGNATURE TEMP. POWER POLE UNDERSLAB WORK ROUGH CONDUIT 9 WIRING PERMIT FEE (SUB TOTAL) FIXTURES IZED PLAN CHECK FEE (60% PERMIT FEE) POWER AUTHOR PERMIT ISSUING FEE .00 2 100 UTILITY CO.NOTIFIED SUPPLEMENTARY PERMIT ISSUING FEE 1.00 J FINAL TOTAL FEE ,�v-�•-.. JOSEPH C. ROOHAN W SUPERVISING ELECT L ENGINEER PLAN CHECK VALIDATION CK M.O. CASH PERMIT VALIDATION cK. M.o. CASH SIGa ?"51 . MAY,22 2 D 3600 -�i. v.) SEE BACK OF APPLICATION FOR COMPLETE.FEE SCHEDULE '-"" 1 764663-DE806 9-67 APPLICATION. FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES r DEPARTMENT OF COUNTY ENGINEER BUILDING 91 BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE. COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. NO. EACH. FEE 5 S OWNER RECEPT._ LIGHT TOTALEFIRST .20 (_((ADDRESS SWITCH J_ .10 CITY TEL-. NO. LIGHTING TOTAL .20 .2 Lj CONTRACTOR e.FIXTURES �� .10 ADDRESS p RANGE_DRYER—WTR.HTR._ CITY J TEL. STA.COOK_DISP._F.A.U._ LICENSE NO. ZZ -2 (cU SPACE HTR. AIR GOND. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY N CLOTHES WASH._DISHWASH._ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. FAN—OTHER 1.00 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF MOTORS,TRANSFORMERS RATING CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO IND. HEATERS, ETC. HP. IB KW. KVA. RESIDE IN, THE ADO V DESCRED ESIDENTIAL PROPERTY. SIZE & TYPE OVER TO SIGNATURE O - 1 1.00 OF PERMITTEE S O 1 - to 3.00 DISTRICT NO. GROUP ZONE P CESSED BY U 10 - 50 5.00 (s J G / � '� O G 50 - 100 10.00 NOTES: - W 100 - 500 15.00 S N SIGN,GAS SIGN AND ONE CIRCUIT 3.00 TUBE. OR MARQUEE gODI TI ONAL 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 UNDERSLAS WORK ROUGH CONDUIT p ISSUING FEE 2.00 _ L7[� WIRING FIXTURES SUPPLEMENTARY ISSUING FEE 1.00 POWER AUTHORIZED ^ ... PERMIT FEE UTILI TYOO.NOTIFIED PLAN CHECK FEE (507. PERMIT FEE) FINAL .,♦ TOTAL FEE S 6a JOSEPH C. ROOHAN - - SUPERVISING ELE [CAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK M.O. CASH ... l.AL;O 6 2 9 52 SEP 6 2 D 3.60- EE .60- cmEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE • Dv.Sr 2SM SET. 7-97 APPUCATION FOR PEIlNR DEPART OFLOS G AND SAFETY COU ELECTRIC- COUNTY OF ANGELES _ ,P COUM. J. FOX, LOS NIEF ENGINEER G NAME 0 C I< V/ B i 0, X_ 1=17 11) D DISTRICT NO. GROUP I ZONE PERMIT NO. ADDRESS�///_57.1 //-A A' Ll D,4LiL. IVF � 17 CD 2 U CITY ( 4 N P A C IY& TEL.NO. / �I ?{nJ RECEIVED BY READY FOR DATE ISSUED EI ; FIRST I NSPECTION J .COUNT... 37/4 TE EI CERT.NO. 1 G Q TJ Cl EXPIRES F� APPLICANNT FILL IN HEAVILY OUTLINED PORTION ONLY JOB DESCRIPTION OF WORK ADDRESS 44F7 Y5 NUMBER OF OUTLETS ON CIRCUITS _LOCALITY LOCATION BY ROOMS NEAREST L16HT OUTLETS ISW.f PLUGS Fll[T CROSS 8T. CIRCUIT A B C D E F G H M NAME / rte/i,�'il•G'.n-'An/ �. 7 ; MAIL ADDRESS O CITY TEL.NO. 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERFI/FIICATE.OFF'QUALIFICATION./ l ELECTRICIAN. 1 AM THE LECA"OWNER OF THE PROPERTY DESCRIBED ABOVE OWNER. CORRECTIONS ' J Q • Z D R ' O f TOTAL NO. OF OUTLETS I.girl /^ �'� APPROVALS I NO. OF FIXTURES �J 2 $ �_ �^ 1 DATE INSPECTOR'S NAME NO. OF MOTORS H.P. $ CONDUIT NO. OF SIGNS TRANS. $ WIRING > u-GR/i�S NO. OF RANGES OR HEATERS $ FIXTURES MISCELLANEOUS �j $ POWER PERMIT FEE UTILITYCO.NOTIFIED TO AL FEE i�,/'r�� 8 / Q 1FINAL APPLICATION FOR EICTRIC PERMIT g. COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER6u1Lo1NG �y SS / 2Z3 BUILDING AND SAFETY DIVISION ADDRE JOHN,A. LAMBIE. COUNTY ENGINEER11 _ // WILLIAM A.JENSEN,SUP�TOF BUILDING LOCALITY F_IAP(_I.r(.� CITY FOR APPLICANT TO FILL IN NEAREST k O � PERMIT FEES CROSS ST. s� I( 'U OWNER _117•f�I'..k'-,/}f,7 CnQ,('.N ITEM. NU MBER EACH FEE _ MAIL l LIGHTS TS. RECEPT. SW. Z/ d/f' Y .10 $2.i ADDRESS �' L; E. ,h1:A")Q.I.0}j.'•/ LIGHTING FIXTURES l7v 10 10 LJ CITY ... Q.IL TEL.NO.Y / / p ELEG RANGES CLO.DRYERS ELECTRICIAN W. — e - I C G . WATER HEATERS A ADDRESS 2-42-4 WR/ Yt�6L�A1 X11 / !@� A ELEC.SPACE HTR9. DISHWASHERS CITY .�; / TEL. NO.CLI,-J lI GARBAGE DISPOSERS AUTO.- STATE - WASHERS STA.COOKING UNITS .25 UCENS5 NO. 1 /J MOTORS: Ove. INC. H.P., TRIO+T NO. GU UP Z E PR CESSEDBY 9z— 2- .50 D INSPECTION RECORD 2— 5 1 1.00 t N 5— 75 1.50 ycnnea-S-�7. Cei a c. IS— 50 2.50 N J— r 50-200 5.00 uC, .ir 'mm' c°- I SIGNS: NO.TRANS. ,.J I NO.LAMPS _ •�'/r�/ SERVICE 0-600V I 1.00 SERVICE OVER 600V 5.00 V " MISC. =h) I +h P_t-D ll.fi N WIRINGPERMIT 1.00 Oo FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT - .50 TOTAL FEE S rt 13 T 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY / WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING 1 CONDUIT / ELECTRICAL WIRING. 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR WIRING LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY.q POWER SIGNATURE /�/� //J UTILITYCO.NOT]FIED OF PERM ITTEE d FINAL ®. ,VAPDATION A rJ veli. CK MO CASH / SU ER ING ELECTRICAL ENGINEER 7041 MY i- 2 2 0 3735 �✓%l�sz�iaih�/ L 7GA663-CE80610/72AI'�I.IV R E"ICAL PERMIT DIY COUNTY OFF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER gpDRE55 Z a....J BUILDING AND SAFETY DIVISION ✓ �' Os7 0/ d LOCALITY t�iHr A P C� NEAREST FOR,APPLICANT TO FILL IN CROSS ST. OUTLETS NO. EACH FEE OWN NAME G` S IS / / J t FiRECEP MAIL LIGHT .,_1 - ADDRESS / h� �Oq pQ A�✓� LIGHT_/1(1\ TOTAL FIRST 20 25 .} OVER 20 CITY M.�File C J TEL. NO. SWITCH_ .10 PLAN CHECK LIGHTING FIRST 20 25 APPLICANT TOTAL OVER 20 ADDRESS FI%TURES .10 RESIDENTIAL APPLIANCES - CITY TEL. NO. PERRANGE_ORYER_WTR. HTR._ APPLIICANT STA. COOKDISP. F.A.U._ AOORE5537�1 us cd' eL, SPACE HTR. AIR COND. CITY C e-E. Q2 TEL. NO. ZS-0-t12_& CLOTHESWASH. 01 SHWASH._ LICE SE OR - ��Jj REG. NUMBER L p CLASS.e C FAN_OTHER L00 IIEHEBY 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' EATERS. ETC. HP. KW. EVA. ELECTRICAL WIRING. SIZE 8 TYPE OVER TO IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR O - 1 100 LICE NSEO AS REQUIRED BY LOS ANGELES CO NTT ANO STATE OF CP LIFORWA OR THAI I AM TH LEG 4L Of THE ABOVE Y A 1 - 1D 3.00 O OESCRIf EO RE51 IPL PROP T n- O 3 PERMITEE 10 - 50 5.00 SIGNATURE W 14 d O 50 - 100 1000 DISTRICT NO. PROCES ED BY H /{ W 100 - 500 15.00 }.r vCIE.j V Z_ SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTO SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 TEMP. POWER POLE SERVICENOTOVER 600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK SERVICE OVER 600 VOLTS OR 200AMP 10.00 ROUGH CONDUIT TEMPSERVICE,POLE, &APPURTENANCES 5.00 WIRING TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL 41- -7L 'rlvT PERMIT FEE (SUB TOTAL) NOTES: PLAN CHECK FEE PERMIT ISSUING FEE 3.00 TOTAL FEE n PLAN CHECK VALIDATION CK. M.G. CASH PERMIT VALIDATION cK. M.O. CASH 4 6.7 VXAPR 10 2 U 9.0 0 egg SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 7-also? 5---A E E ® APPLICATION FOR PERMIT , -• DEPARTMENT OF BUILDING AND SAFETY ' COUNTY OF LOS ANGELES ; WILLIAM J. ,FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTR C� GROUP ZO. E PF�F21 lJf ;NO.3 LEA =1 fre-2810 I (� _ ELECTRICIAN IC REC VED BY ' READY FOR DAT ISSU D ADDRESS CALIF. FIRSTI P N CITY ,I TEL. NO. �,iTI COUNTY LICENSE NO. G EXPIRES ��(J `� - BUILDING ADDRESS 11n 41�f Broadway way PERNRT FEES FEE / i NUMBER OUTLETS EACH _ LOCALITY Temple City . Calif LIGHTS 5c I$ NEAREST enc inn to CROSS ST. RECEPTACLES 5 22 1 UREB 5 OWNER First Lutheran Chureh WALL SWITCHES 5 AMAIL DDRESS 174!sBroadway ELEC. RANGES 25 ELEC. HEATERS 25 CITY Temple City TEL. N0.At- 4-2698 MISC. 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS NUMBER OF CIRCUITS INSTALLED: /� / APPLICATION AND STATE THAT THE ABOVE l5 CORRECT LIGHTS / RECEPTACLES 2 � AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES MOTORS J,' '/ AND STATE LAWS REGULATING ELECTRICAL WIRING. NOm-eR HORSEPOWER • I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS FEE ANGELES COUNTY LICENSE, OR I AM THE NEW MVO. HP OVEF INC. EACH LEGAL OWNER ,,{J//w/EsC R,BE ��L SI THE RESIDEN L PROPE DCG' i D AB_ Ov6 1 -LE-- $ .25 TOr'�(yw y 2 .60 SIGNATURE OF A ' 5 1.00 PERMITTEE 2 s IS 1.50 INSPECTION RECORD 16 50 2.50 SO 200 5.00 200 500 10.00 J 500 1000 15.oo Q OVER 1000 1 20.00 Z M.G. SET/FREQ. CHANGER-HP - WELDERS: AC-KVA O GENERATORS -'KW TRANSFORMERS - KVA =y TEMP. MOTORS (75% OF ORIG.)" MOVED MOTORS 75% OFRIG.) MISC. SIGNS TYPE: NO. TRANS. TYPE: NO. LAMP6 APPROVALS DATE INSPECTOR'S NAME FOR EACH PERMIT: WIRING $1.00 V/) CONDUIT ` w9 I ti I1— FIXTURES $1.00 i WIRING SUPPLEMENTARY .50 FIXTURES POWER q TOTAL FEE - . $ Ir7 UTILITY CO. NOTIFIED FINAL /C!� , - DBS.SA Y-B6 APPLICATION FOR ELECTRIC PERMIT �. DBssA DIVISION OF BUILDING AND SAFETY' Deportment of County Engineer County of Los Angolos BUILDING /��; fl WM.J. FOX. COUNTY ENGINEER ADDRESS '9ynD'-vOw a CASSATT D. GRIFFIN. SUPT OF BUILDING Tc LOCALITY / G PERMIT FEES T TO FILL IN NEAREST c C 1 Gl CROSS ST. L CJY- N"BER EACH FEE l'••Yet .,v ��jj J, ��yJ LIGHTOUTLETS OWNER I r#1r0- 1' &4'JPA /9 RECEPTACLES a MAIL �- ' WALL SWITCHES ADDRESS / TOTAL OUTLETS 7 s CITY -( TEL. NO. ELEC. RANGES 25 ELECTRICIAN >• A-.SPie- _ELEC. HEATERS 25 ADDRESS KW EA CITY La.`' A �f TEL.N FIXTURES �- � 5 If L7 LICENSE NO. NUMBER OF LIGHT CIRCUITS DISTRICT NO. I GROUP ZONE I READY FOR INSPECTION NUMBER OF RECEPTACLE CIRCUITS �/ MOTORS NUMBER HORSEPOWERFEE INSPECTION RECORD NEW MVD. HP OVER INC. EACH 2OAT ObQ. LISOd Q1 I�a LESS $ .25 -'I.. 1 2 .50 G:w�' 2 -5 1.00 _ 5 IS 1.50 15 50 2.50dCOMPLY _200 -5.00 MISC. NO.SIGNS NO.TRANS. NO.SIGNS NO. LAMPSFOR EACH PERMIT, WIRING 51.00OFIXTURES 51.00 SUPPLEMENTARY .50APPROVALS TOTAL FEE II DATE INSPCCTOR'S SIGNATURE I HEREBY ACKNOWLEDGE THAT-I HAVE READ TNIATION CONDUITAND STATE THAT THE ABOVE IS CORRECT AND AGRMPLYWITH ALL COUNTY ORDINANCES AND STATE LAWATING WIRINGELECTRICAL WIRING. ,1 HEREBY CERTIFY THAT i AM PROPERLY REGISD/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY E OFCALIFORNIA OR THAT I AM THE LEGA OWNER BOVE POWER _DESCRIBED RESIDENTIAA RO - Y.SIGNATURE -"/ UTILITY CO.NOTIFIEDOF PERM ITTE_ -227" 6Z FINAL U' YJ 'e WILLIAM J. FOX. COUNTY ENGINEER VALIDATION A.C.VEIT.CHIEF ELECT. INSPECTOR LIG 4 3 3 6- MAR 21 2 7.3 0 9SAEB3 D.SSA 11-49 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES �m WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRICIAN W. J. Giles S 8' Z /&/ A, �Q � ADDRESS 2714 No. Tyler Ave, RECEIVED By FIRST INSPECTION �y]DY FOR DATENiSUED CITY �1 Monte to TEL. NO. ✓ • -.C- r/ COUNTY LICENSE No. 657 EXPIRES 6/30/52 BUILDING PERMIT FEES ADDRESEI Ast Broadwav NUMBER OUTLETS EACH FEE LOCALITY Temple City LIGHT Sc $ NEARBEST. Rosemead Blvd CROSET 19 RECEPTACLES 5 LI FIXTURES 5 OWNER FLutheran Church 5 WAIL SWITCHES 5 MAIL ELEC. RANGES 25 ADDRESS Same ELEC...HEATERS 25CITY Temple C1tY TEL. No. AT 66282 bell ell oilt] P L L. I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS NUMBER OF CIRCUITS INSTALLED: TOTA L1 APPLICATION AND STATE THAT THE ABOVE IS CORRECT LIGHTS 3 RECEPTACLES AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES MOTORS AND STATE LAWB REGULATING ELECTRICAL WIRING. NUMBER HORSEPOWERFEE I CERTIFY THAT I POSSESS THE ABOVE VALID LOB NEw MVD. I HPI OVER I.C. EACH ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER ✓2 s LES. $ .25 125 OF THE RESIDENTIAL PROPE S RIBED ABOVE. �/2 2 .50 SIONATURE OF 2 5 1.00 PERMITTEE s 1s 1050 INSPEC ON RECORD 5 so 2.50 _ so 200 5.100 200 Boo 10.001 500 1 1000 15.00 J OVER 1000 20.00 Z M.G. SET/FRED. CHANGER-HP CI WELDERS: AC-KVA IL' O GENERATORS - KW _ TRANSFORMERS - KVA TEMP. MOTORS (75% DE Ri..) _ MOVED MOTORS (75% .1 DRl..) "-- MISC. _ SIGNS TYPE: NO.TRANS. TYPE: NO. LAMPS APPROVALS FOR EACH PERMIT: DATE INSPECTOR'S NAME WIRING $1.100 1.100 CONDUIT n FIXTURES $1.00 �.n— WIRING SUPPLEMENTARY .50 FIXTURES _ POWER TOTAL FEE $ 3.65 UTI LITY C O.N OTI FI ED ' F• t'l1 RKERS.GOIv1,,e 8 ciION DECLARATION ]6.4663 ID/Bt APPLICATION PP IC p TION �I( OR E EC 1 RIC p L PERMIT ti,hare.' offirmthbPP,E�ve 8 certificate of consent to self CE.BIMG i'Y r IL 'b P9 1 ICI IL Y'( �9 Ir Y'IET/C G 7� insure, ar a certificate a Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec. 3800, Lab. C) XWW86204199 Ohio Casualty Policy No. 'C�mpany FOR APPLICANT TO FILL IN JOB 9123 E. BROADWAY Certified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE ADDRESS ❑ Certified copy is filed with I • county bZId mspec- 1 8 2-Fomily, Sq. FI. $ = $ LOCALITY TEMPLE CITY tion department 7q Multi-family Sq. Ft. NEAREST x// Residential Swimming Pools CROSS ST. Date Applic t OWNER OR FIRST LUTHERAN FIRM NAME CERTIFICATE OF EXEM FROM WO RS' Outlets: Rec_1 FIRM Sw.S�_ MAIL COMPENSATION INSURANCE . ']5 �0 15 00 ADDRESS 9123 E. BROADWAY ( P T First 20 TEMPLE CIT This section nerd not ha completed if the work involved h Total No. 1 "t Additional . 50 1 4 5 7 2 U 0 CITY ,Y Tel. No. the permit is for one hundred dollars ($100) or less.) I certifythat in.the performance of the work for which this PLAN CHECK P APPLICANT Permit is issued, I sholl not employ any person in any manner ']5 Z U ]-5 U U so as to become subject to the Workers'Compensation Laws, Lighting Fixtures First 20 ADDRESS Total No. Additional . 50 164 82 00 Date Applicant 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. APPLICANT Compensation provisions of the Labor Code, you must forth- Oven _ Dryer — W.M._ ADDRESS 10777 Monte Vista. with comply with such provisions or this permit shall be Top FAU —W.H. — UNIAKIU deemed revoked. Hood Fan _Other_ CITY Tel. No.59 – 765 LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed.under provisions of Chapter 9 Disp. _ Room Air Cond. REG, NUMBER Class. (commencing with Section 7000) of Division 3 of the Business DISTRICT NO. PROCESS per.' and Professions Code,and my license is in full force and effect. Power Apparatus 8 Large Appliances /,� Size 8 Type HP, KW, KVA, or KVAR' t U U License Number 448663 tic Class C10 [ E Up to I to 1. _ 00 00 FINAL D ,Z� Clamage Electrbc 5/01/87 Over 1 to tO Incl. VALID TION Contractor ate Over 10 to 50 Incl. ❑ FINAL �J - Ed a am exempt under Sec Over 50 to l00 Inc. BY d' B.BP.C. f this reason Over 100 Z Date: Services, Swbd., MCC 8 Ponelboords 15 1 15 U U D 26954'A 0 -200 Amp. Under 600 V Signory 201 - 1000 Amp. Under 600V #�e•o,a e e 2 ❑ Over 1000 Amp. or Oyei 600 V n •( e 3 1 4_10DExemptio f Reg. Maint. Elect. SINGLE FAMILY Temp. Power Pole 8 Appurtenances ? • 3.1 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 0502.t87 1 4,0 O I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits Low for the following reason (Section 7031.5, Business and Professions Code): ❑ I, as owner of the property, will do the work and the Misc. Conduits 8 Conductors structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ D 7044, Business 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 PERMIT FEE (Sub-Total) 303 50 (Sec. 3097, Ci, C.). PLAN CHECKING FEE10 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 Electricol wiring, and , 7Signatune by authorize representatives of this County to enter upon �. mentioned prorinspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE of e i tee �D to Wm that I have a certificate DECLARATION 76-663. IDIBI APPLICATION FOR ELECTRICAL PERMIT {� I hereby affirm that I have a certificate of consent to self insure, CE-806G LJ or.a certificate of Workers'.Compensation Insurance, or a certified. COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec.3800.Lab.C.) Policy No. - Company r ,FOR APPLICANT TO FILL IN, JOB Certified copy is hereby furnished EACH. NO. FEE. ADDRESS f . .. New Residential Bldgs.&Pools - 1 & 2-Family,Sq.Ft. $ — $ LOCALITY_ L eL P Certified copy is" filed with'the county building inspection: NEAREST department. - .. , Multi-family Sq.Ft. ' Residential Swimming Pools OCROSS - Date - Applicant Residential WNEOR, FIRMNAME CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL //��,, es�� •COMPENSATION INSURANCE Outlets:Rae Light — Sw. _ ADDRESS-"9 1L " -(rte Zoe p V (This section need not be completed If the work involvedtby the First 20 permit is for one hundred dollars ($100)or less.) Total No: Additional CITY Tel.No. I certify that in the performance of the work for which this permit ti •; APPLICANT TYTK is issued,.) shall not,employ any person in any manner.so as to _ become subject to the Workers'Cc a sation Laws• Lighting Fixtures First 20 'ADDRESS AAL& Total No.' Additional Date Appl!ca CITY - Tel.No. NOTICE TO PPLICANT: If, after maV• g his Certificate of Fixed Appliances Not Over 1 HP PERMIT Exemption,you should become subject to the Workers'Compensation _ Range_ Heater_ D.W. -PPLIC✓`NT '. S provisions of the Labor Code, you must forthwith comply with such Oven Dryer _ W.M._ - ADDRESS'N / L D 6' provisions or this permit shall be-deemed revoked. . Top ._'FAU W.H. , LICENSED CONTRACTORS DECCARATION. Hood Fan Other_ 'CITS I 4=L51 Tel.Noe 1 herebyaffirm that I am licensed under provisions of Chapter 9 LICENSE OR Diep. — Room Air Cond. -- REG,NUMBER Class. -/Q (commencing with Section 7000) of Division 3'of the Business and. Professions Code,and my license is in full force and effect. Power Apparatus& Large Appliances DISTRICT NO. n PROCESSED BY / /�y Size& Type HP,KW,KVA,-or KVAR �•. License Numb r4101- E Lic.Class ll Up to 1 Incl: " ' - FINAL A - U �'11 �q � Over 1 to 10 Ind. -. DATE. I"1 Q Contractor Date 1 6 VALIDATION 0 ❑ 'Over 10 to SO Incl. FINAL I am ex pt under Sec. Over 50 to 100 Inc. BY W .G&P.C..for this reason Over-100 Services,Swbd:;MCC& Panelboards N Date: _ 0-200 Amp.Under 600 VZ-00 Signature - 201 - 1000 Amp.Under 600-V • . - - -- ❑ Over 1000 Amp.or Over 600 V Exemption for Reg.Maint.Elect. SINGLE-FAMILY' Temp.Power Pole& Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit t 1 ` I hereby affirm that I am exempt from the Contractor's License law Y ALC.T.s ' for the following reason( ction 7031.5, Business and Professions Additional Sign Branch Circuits.' _ ___ Code): JJI-/ J1.0', ❑ I,as own/ody/Irth p will do the work and the structure Misc.Conduits B Conductors - 1 ITEMS. Eht• is not int�nd{d r .`red for sale (Section 7044, Business Other.(See Complete Fee Schedule) D - AAA TOTAL 31 - 00 and Prof ssion Code). - - CONSTRUCTION LENDING AGENCY - - CHECK I hereby affirm thfat e e a construction lending agency for the CHANGE _ ,r.!(1 performance of the o q0 EX this permit is issued'ISec.3097, PERMIT FEE -- - (Sub-Total) Civ.C.). PLAN CHECKING.FEE. Lender's Name - Q[(Q(I-I I[:[li 9,11/91PERMIT ISSUING FEE- - �� Cr_r Lender's Address Oi-' 1 Ar1iQ:4J I certify that I have read this application and-state that the above TOTAL FEE _.. _. . .. informati n is•correct. I agree lo'comply with all County ordinances - - ani) Sta laws regulating Electrical wiring, and hereby authorize ' represe atives of this Collmty to enter upon the above-mentioned prop r for inspe ion (poses. - _. SEE REVERSE:FOR EXPLANATORY LANGUAGE ml I D ate WORKERS'COh1PEN5ATION DECLARATION 76A66 CE-806G 12 601 APPLICATIONFOR ELECTRICAL PERMIT r l hereby affirm that 1 have ajcerGficate of consent to self COUNTY OF LOS ANGELES C' BUILDING AND SAFETY insure, or a certificate Of Workers'Compensation Insurance,or a certified copy thereof(Sec: 3800, Lab.C.) -�p51J U n I, i FOR APPLICANT TO FILL IN JOB Policy No.LL c te� enySt . Paul Fire & ), EACH NO. FEE ADDRESS 77 'P New Residential Bldgs.&Pools ❑ Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ — S LOCALITYTemP le Cites,Ca. Mufti-family Sq. mi CROSSST gay _Pa-111LLCLAR- Rosemea Certified copy is filed with [ o ty buildin nspec[ion ResMulti-family -famiential Swimming Pools depart nt. OWNER ORCirst ILuthern Church Sc a ( FIRM NAMP - Dat Applican Outlets: Rea_Light_Sw._ - ADDRESS 9123 E. Braodwa First 20 CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional: CIT Tel No. COMPENSATION INSURANCE Yfem le city- t PLAN CHECK d (This sectionneed not be completed if the work involved APPLICANT 0 by the permit is for one hundred dollars ($100) or less.) Lighting Fixtures First o ADDRESS U Total No. Additional cc I certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY ?el No. permit is issued, 1 shall not emplov any person in any manner PERMIT so as to become subject to the Workers' Compensation Laws. Range_ Heater_D.W. APPLICAf Olaf sten Ind. Electric U Oven _ Dryer_W.M._ ADDRESS 5005 E. S auson AV. Dale Applicant Top _ FAU _W.H.. Hood — Fan _Other_. ]CITY L.A.90040 Tel No7735005 NOTICE TO APPLICANT: If, after making this Certificate of LICENSE OR o n Disp. _ Room Air Cond,_ REG.NUMBER?28: 370 Class C10 / Exemption,. you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth- Power Apparatus&Large Appliances DISTRICT NO. PROCESS D BY with comply with such provisions or this permit shall be deemed revoked. - Size&Type HP, KW, KVA,or KVAR d (i Up to 1 Incl. FINAL U Over 1 to 10 Incl. I DATE G�: Q2 VALIDATION LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl. / C/ I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL 9 (commencing with Section 7000) of Division 3 of the Busi- Over 100 BY r� ness and Pro fessions.Code, and my license is in full force and vV effect. Services n 0-200 Amp. Under 600 V License Number2'1Q�27a2 Lie.Class 17,10 201-1000 Amp.Under 600 V Contract3aaeks ten Inc}3�, trial EllCCT1C Over 1000 Amp.or Over 600 V HOME OWNER-BUILDER DECLARATION Temp. Power Pole&Appurtenances ' Sign with One Branch Circuit 1 hereby affirm that ! am e from the Contractor's Additional Sign Branch Circuits b 36 A License Law for the following reason (Section 7031.5, Busi- ness and Professions Code): Misc.Conduits&Conductors L as owner of the property, will do the work and,the Other ISee Complete Fee Schedule)— 2_e a 2 'S O structure is not intended or offered for sale (Section . 7044,Business and Professions Code). CONSTRUCTION LENDING AGENCY 'a e e 2 3.5 0 csi I hereby affirm that there is a construction lending agency ' for the performance of the'work for which this permit is PERMIT FEE (Sub Total) ,Q•9.2 O—8 2 issued (See. 3097,Civ.C.). - ' Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) Lender's Address PERMIT ISSUING FEE 1 certify that 1 have'read this application and state that the TOTAL FEE above information is correct. I agree to comply with all County ordina9 and State laws regulating Electrical wiring, and 'here If au horize are of this County to enter Upon theg 6v m boned property f r inspection urp ses. , / SEEREVERSEFOR EXPLANATORY LANGUAGE 7 i nature of Fermi[[ Date ,. • WORKERS'IhaveCOMPENSATION e of consent to 76-869 ,D;a, ,.APPLICATION FOR ELECTRICAL PERMIT {� P hereby affirm that I have a certificate of consent fo self insure, CE-806G LJ ore certificate of Workers' Compensation Insurance,-gr a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec.3800.Lab.C.). Policy No. 'Company`' FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished. EACH NO. FEE ADDRESS /rV �❑f .- New Residential Bldgs. 8 Pools �- - �11 8 2-Family,Sq.Ft. $ _ $ LOCALITY i L1' Certified copy Is Filed with the'bounty bwldmg Inspection NEAREST • department. Multi-family Sq.Ft. _ '.Date Applicant •` Reakle0tl21 Swimming PODS '44 - OWNER OR • ,.< OutlafS:•R¢C Light�� Sw.1 FIRM NAME 'CERTIFICATE OF''EXEMPTION FROM WORKERS' - MAIL /- COMPENSATION INSURANCE ab0• " BBQ ADDRESS /' This section nee&not.be completed if the work involved by the First 20 ( - .CITY -permit is for one hundred dollars ($100)or less.) Total No. Additional ,. PLAN IF I certify:that in thwid.rformance of'the Work for which this permit APPLICANT CHECK is issued,'Ishall.not employ zny-person in:any manner so as to - r� dO• - become sub) ct to the Workers'Compen 'on ws Lighting Fixtures First 20 ' 7 ADDRESS - /e �. Additional d' O `aF � - Total No.�e CITY Tel.No. f .. Dat — Applicant' - - Fixed-Appliances Not Over 1 HP PERMIT / C�— NOTICE• TO APPLICANT: h, atter making this Certifi ate of APPLICANT Exemption,you should become subject to the Workers'Compensation , Range_ Heater_ D.W. _, _ •• provisions of the Labor Code,you must forthwith comply with such Oven _ Dryer W.M.— ADDRESS r .,provisions or this permit shall be deemed revoked. _ Top — FAU WH., - .�•�_ 4�S CITY TeI�No. S2�d LICENSED CONTRACTORS DECLARATION Hood _— Fan Other_ (, I hereby affirm.that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. LICENS OR' OF (commencing with Section 7000) of Division 3 of the Business and REG.NUMBER S 'Class Professions Professions Code,and my,l* en�isn full force and effect. Power Apparatus 8 Large Appliances -, DISTRICT NO. �i PROCE D `✓3 / 7 �"/''�� Size 8 Type HP,KW,KVA,or KVAR ®�/ p License Number Lic.Class J Up to 1 Incl. FINAL U / .. r9s'(Date x'79 L S Over 1 to 10 Incl. y . DATE: ' ��LI �� VALIDATION 0 - Contracto r. %r.I Over 10 to 50 Incl. /i 6l 'p _ ❑ I,am exempt,under Sec. Over 50 to 100Inc. - gy FINAL - W Over 100 n' 8.8 P.C. for this reason N • rvice C P r s D "- Z ate' n 0 Amp.//f�{� er 600 Signature 201'- 1�rnp.Under 600 V -- Amp. - - ❑ Over 1000 Ap.or Over 600 V Exemption for Reg.Mamt. Elect. 2 •• SINGLE FAMILY Temp.Power Pole 8 Appurtenances ACCT.v HOME OWNER-BUILDER DECLARATION ' ' Sign with One Branch Circuit I hereby affirm that )am exempt from the Contractor's License Law Additional Sign Branch Circuits 3003. _ 310.10 for the following reason fSection 7031.5,Business and Professions i ITEMS Code): - ❑ Misc:Conduits s Conductors TOTAL 31D_ 10 1,as owner of the property,will do the work and the structure is not,intended or offered.for sale.(Section'7044, Business : Other(See Complete Fee Schedule) CHECK- - 310.10 and Professions Code). ' - ' CHANGE` .00 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 (Sub-Total) - . �(�-•0�1 10/25/95Civ.C.). .app PLAN'CHECKING FEE -' - 2996. -1 • AM9:13 Lender's Name PERMIT ISSUING FEE - - -.27 .. - Lender's Address certify that I have read this application and state that the above - TOTAL FEE information is correct.1 agree to comply with all County ordinances - and State laws regulating Electrical wiring, and hereby authorize • , _ ... . repre atives of ih' County to enter upon the above-mentioned pro r fo a (o� poses. "C• T �SEE REVERSE FOR EXPLANATORY LANGUAGE ignature of-Permiffetr Date ,