HomeMy Public PortalAbout9336 BROADWAY_Electrical__ DDEPARTMENT OF• BUH.DING AND SAFEPY APPLICATION FOR PERMIT
r COUNTY OF LOS ANGELES ELECTRIC
WM. J. FOX CHIEF ENGINEER
NAME f 4 DISTRICT NO. GROUP ZONE PERMIT NO.
V ADDRESS , O' SS
E p RECEIVED BY READY FOR _DATE ISSUED
r CITY �j� TEL.NO. P-JG�d9 FIRST INSPECTION /`
j COUNTY
N CERT.NO. EXPIRES
' - /" �-
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY - J
DESCRIPTION OF WORK ADDRESS G/ fIYOHd tt1C�Y
NUMBER OF OUTLETS ON CIRCUITS LOCALITY
LOCATION BY ROOMS NEAREST
LIGHT OUTLETS Sw-i- if
CROSS ST.
CIRCUIT A B C D Em NAME. d 1'
Z MAIL
.= ADDRESS
°
cln TEL.No.
1 AM THE LEGAL POSSESSOR OF THE ABOVE LOB
ANGELES COUNTY CERTIFIC T OF.GI)/�LIFICATION...
V ELECTRICIAN.
/ 1 AM THE LEGAL'OWNER OF-THE PROPERTY DESCRIBED
/ Y ABOVE ....
y - OWNER.
CORRECTIONS
A.0 i
a
z
c�
0
TOTAL
NO. OF OUTLETS A $ 3 .Tl� APPROVALS
NO. OF FIXTURES /.� $ I DATE INSPECTOR'S NAME
NO. OF MOTORS H.P. $ CONDUIT .�
NO. OF SIGNS TRANS. ` � $ WIRING X66 sx7 ei;_ v
NO. OF RANGES O EATER y $ �Q FIXTURES
MISCELLANEOUS ? $ POWER
6
PERMIT FEE J $ ?--.:1-771 UTILITY CO.NOTIFIED
TOTAL FEE FINAL
DEPARTMENT OF RUILDMG AND SAFETY APPLICATION'FOR PERMIT
.COUNTY OF LOS ANGELES' ELEC'T'RIC
WM. J. FOX CHIEF ENGINEER
f Q NAME �,'�, .4 dtJ/'9�/p6 ,✓,,,t=CTIDISTRICTNO. GROUP ZONE PERMIT NO.
1�1-- ADDRESS LO\ Cs(JC SS•" Ed
^� / Z7376
UW CITY n5� PJ..0 TEL.NO. RECEIVED BY
READY FOR E ISSUED
FIRST INSPECTION SAT
J COUNTY 9aa /, EXPIRES j,� /
W CERT.NO. 1
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY 93
DESCRIPTION OF WORK AooREss '.I�'v,�l /� 6TAw2
NUMBER OF OUTLETS ON CIRCUITS LOCALITY
LOCATION BY ROOMS NEAREST
LIGHT OUTLETS SW. PLUGS ",IT CROSS ST.
CIRCUIT A B C D E F G H N NAME J_lel w
Z IMAIL
ADDRESS
O
CITY TEL.NO. '
1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE-OF QUALIFICATION..
ELE=RICIAN
. =
CTRI .
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE
OWNER.
CORRECTIONS
J
Q
Z_
L9
TOTAL
NO. OF OUTLETS ,2 $ /O APPROVALS
NO. OF FIXTURES $ DATE INSPECTOR'S NAME
NO. OF MOTORS H.P. $ CONDUIT
NO. OF SIGNS TRANS. - $ WIRING
NO. OF RANGES OR HEATERSn S FIXTURES
MISCELLANEOUS �)•�//,O- S POWER
PERMIT FEE / / O $ / G UTILITYCO.NOTIFIED S` r � V 901
TOTAL FEE SWo I FINAL
/ N / .
76A663-CE806 12-65 APPLICATION FOR, ELECTRI AL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY.EN GI N EER BUILDING -33/ �O:PZ
�BUILDING,AND.SAFETY DIVISION ADDRESS (ooJOHN A. LAMBIE•.COUNTY ENGINEERCOLEMAN W. JENKINS, SUPERINTENDEN TOF BUtLDING, LOCALITYNEARESTFOR APPLICANT TO FILL IN CROSS STRECEPT, 1 TOTAL NO. IEACH FEyJyUTLETS FI� 20 $ ZO� OWNERJ ,. 1�+ ADD'L 10 AD LE58 'CCWIT
—� OVER 20FIRST 20 .20 CITY L � NO ADD'L .10CONTRAC OR
OVER 20RANGES .DRYERS. WTR.HTRS, 1.00 ADDRESSGARB.DISP. STA.'COOKCITY
DISHWASH. AUTO.-WASHSTATE
SPACE HTRS. STA. APPL. .50 LICENSE NO.
MoioRs: ovER \ NorovER n.P. 'DISTTf�0.. G$ E PRO 9'S D BY
O 1 _ 1'.Oo / �j
-1- 3 - 1.501 - INSPECTION RECORD' a
O3 8 2.00 -
S - 15 2.501 - O
H
IS 50 1 3.00 W
50 100 5.00 0
Z
SIGNS: 'NO.TRANS-
NO. LAMPS
SERVICE 0.60OV.NOT OVER 200A 1.001
SERVICE 0.60OV-OVER 200 A. 2.00��
SERVICE OVER 600V 5.00 - -
OTHER (SEE COMPLETE FEE SCHEDULE)
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 .APPROVALS DATE. INSPECTOR'S SIGNATURE
TOTAL FEE $
1 HEREBY,ACKNOWLEDGE THAT IHAVE READ THIS APPLICATION UNDERSLAB WORK
/61
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY- ROUGH CONDUIT /
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING y'
ELECTRICAL WIRING. - WIRING
I HEREBY CERTIFY THAT 1 AM PROPERLY REGIFIXTURES. _
LICENSED AS REQUIRED BY LOS ANGELES"COUNTWAND ATE:OF" - -- - -
'CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AN INTEND POWER
RESIDE IN.THE.ABOVE OESCRIBEO REBI DEN PRO TY. //
SIGNATU
T ,L!/ UTILITY CO.NOTIFI�ESD"Y /�i /FP. /.J J/ r
OF
FINAL
VALIDAT� JOSEPH C. ROOHAN
CK MO' CASH SUPERVISING ELECTRICAL ENGINEER
Q
LilL41-96:' AL'S17` 2 DD 5.60"'
APPLICATION FOR ELECTRIC PERMIT" �.
De5.5A 355��
DIVISION OF BUILDING AND SAFETY
�Doportment of County Engineer - -
County of Los Angelos •BU I LOING 3 L
WM.J. FOX. COUNTY ENGINEER ADDRESS J fo -
CASSATT D. GRIFFIN..SUF'T OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
PERMIT FEES CROSS ST. dl �v-
NUMBER EACH- FEE
. OWNER _
LI
.LIGHT OUTLETS
RECEPTACLES MAIL
ADDRESS
WALLSWITCHES ,
TOTAL OUTLETS I Y' SR CITY TEL O.
ELECT RANGES 25. ELECTRICIAN S
_ELEC. HEATERS 25 ADDRE
KW EA CITYTEL.NO.
FIXTURES 5 _ LICENSE NO. �/ S
NUMBER OF LIGHT CIRCUITS lwmm
.DISTRICT NO. GROUP ZONE,II READY FOR INSPECTION
NUMBER OF. RECEPTACLE CIRCUITS I � I l _
MOTORS / /9999
NUMBER HORSEPOWER FEE INSPECTION RECORD
NEW .MVD. HP ' OVER INC. EACH
V3 Bi LESS S .25 _
112 2 .50
2 5 .1.00.
_ 5 15 1.50
15 50' 2150
50 200 5.00
MISC.
NO. SIGNS NO.TRANS. - ,
NO.SIGNS NO.LAMPS I.
FOR.EACH PERMIT:
WIRING S1.00 �
FIXTURES . .31.00
SUPPLEMENTARY -.50 APPROVALS
_ TOTAL FEE Ig Y�7_ DATE I NSPECTOR'S SIGNATURE
1 HERESY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATIONS CONDUIT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLYWITH ..
ELECTRICAL
ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELEC
' TRICAL WIRING. _ WIRING
_
I HEREBY CERTIFY THAT-1 AM PROPERLY -REGISTERED AND/OR FIXTURES - - -
LICENSED AS REOUIRED,BY.LOS ANGELES COUNTY AND STATE.OF
CALIFORNIA OR .THAT I. AM THE LEGAL OWNER OF THE 'ABOVE POWER
DESCRIBED RESIDENTIAERT --
SIGNATURE UTILITY CO. NOTIFIED A /1
OF PERMITT C I . FINAL'. 't 0. 4 SS /
WILLIAM J. FOX, COUNTY ENGINEER VALIDATION A. C. VEIT.CHIEF ELECT. INSPECTOR
ACo7 0 0 7'S AUG23 2 2.7 5 In
o
ixGi��no'�Y•L
WORKERS' COMPENSATION DECLARATION z6oW DPW 3/87 APPLICATION FOR ELECTRICAL PERMIT O
Thereby"affine that have a certificate o4 consent fo self CE.Boza
insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS
or a certified copy thereof (Sec. 3800, Lab, C.)
Policy No. - Company FOR APPLICANT TO FILL IN JOB -
❑Certified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE ADDRESS Fj
$ _ $ LOCALITY
tion department. Multi-family$q. 7=
Certified copy i�:..fWd ^h the county building inspec- 18 2-Family, Sq. Ft. _
EAH. CNEO
SRESTi. eS A/.l.
r Residential Swimming Pools OWNER OR
Date Applicant FIRM NAME 6n. Q (J S h L"JU h
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec—Light_Sw.— MAIL
COMPENSATION INSURANCE First 20 ADDRESS U w i4
(This section need not be completed if the work involved by Total No. Additional CITY 6` Tel. No.' _1 3SQ
the permit is for one hundred dollars ($100)or less.) � PLAN CHECK
I certify that in the performance of the work for which this APPLICANT
permit is issued, I shall not employ any person in any manner
so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS
n Additional.
Z/� (J �US�711Qf' Total No. CITY Tel. No.
Date Applicant
NOTICE/TOAPPLICANT: 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. - Hood — Fan —Other_ CITY Tel. No.
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 Power Apparatus 8 Large Appliances DISTRICT NO. P CE ED BY, Y
and Professions Code,and my license is in full force and effect. p 13-
Size8 Type HP, KW, KVA, or KVAR UU 0,
License Number Lic. Class-
- Up to 1 Incl. FINAL V
Contractor Date Over 1 to 10 Ind. DATE Id VALIDATION 0
❑ Over 10 to 50 Incl. U _ F_
FINAL L)
I am exempt under Sec. Over 50 to 100 Inc. By IFIV W
B.BP.C. for this reason Over 100 - D.
Services, Swbd., MCC 8 Ponelboards - Z
Date: z
. 0-200 Amp. Under 600 V
Signature 201 - 1000 Amp. Under 600 V
Q _. Over 1000 Amp. or Over 600 V
Exemption for Reg. Moint. Elect.
SINGLE FAMILY
HOME OWNER-BUILDER DECLARATION Temp. Power Pole 8 Appurtenance
Sign with One Branch I hereby affirm that I am exemphrancCircuit
from the Contractor's License Additional Si
Low for the following reason (Section 7031.5, Business and ,gn ranchBranch Circuits
Professions Code):
�I, as owner of the property, will o the work and the Misc. Conduits 8 Conductors c 0 4 9, 0 A
Other (SClete Fee Schedule)_ ,
structure f # • • e e • 2 not intended or offered for sale(Section
eeomp
n 7044,
Business and Professions Code). I�
CONSTRUCTION LENDING AGENCY - ',:( e e 255,10
1 hereby affirm that there is a construction lending agency for - e • e '� S'rj
the performance of the work for which this permit is Issued' PERMIT FEE (Sub-Total) - t
(Sec. 3097, Civ. C.). 0 8.1.9'-8 8
PLAN CHECKING FEE
Lender's Name PERMIT ISSUING FEE Q
Lender's Address - -
I certify that t 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 represents es of I is County to enter upon
the above-mention prop r for i peclion purposes. -
SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature at Permits e ( Date Os
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0201220019
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 _
PHONE: (626)-285-0488 EXT: -. .
LEGA S PAID BUILDING ADDRESS:
ON FILE - 9336 BROADWAY
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802403
ASSESSOR INFORMATION NUMBER: - . NEAREST CROSS STREET: ENCINITA/CLOVERLY -
8588-030-042 - Al PERMITISSUANCEFEE 27.75 THOMAS PAGE: 596 -_ GRID: J4: LOCALITY: TEMPLE:CITY' ,
G1 OUTLETS-LGT,SW,RECP 21'.00 OUT 40.35 -
TENANT: - LB 200 AMP PANELS, MCC. 1.00 PAN 38.85 ISSUED PROCESSED BY: PLA B S ON:
TOTAL FEES 106.95 01/22/02 JK 07/21/02-
OWNER: TEL. NO: FINAL DATK FINAL BY: CODE:
LASALA; OSCAR (626) 287-1827-
9336 BROADWAY
TEMP 917802403 DESCRIPTION " . .,:
LIF, .iii - ELECTRICAL FOR ADDITION, UPGRADE ELECTRICAL PANEL
APPLICANT: TEL. NO: -
SAME AS OWNER - - -
_ - SPECIAL CONDITIONS: .
CONTRACTOR: TEL. NO:
SAME AS OWNER APPROVALS DATE INSPECTOR SIGNATURE
- �_
LIC. NO •� TEMPORARY POWER .POLE _
-
�% UNDERGROUND CONDUIT -
K.w , Y, t
ARCHITECTOR R: TEL. 0: / ; i �� A_ t�.'� R GROUND .
LIC. NO �) _ _j: ROUGH CONDUIT
ROUGH WIRING
{/L
MAIN WATER LINE _
PLASTIC Y/N METAL Y/N -
>.-. UTILITY COMPANY NOTI
i
REPORTI ID !DPR265 ROUTE TO:.BS0508
- -
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0610270010
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-04BB ERT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
ON FILE - 9336 BROADWAY
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802403
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: ALESANDRO
8588-030-042 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY, C
G1 OUTLETS-LGT,SW,RECP 3.00 OUT 5.85
TENANT: G2 LIGHTING FIXTURES 2.00 LGT 3.90 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
TOTAL FEES 37.50 10/27/06 SK 04/25/07
OWNER: TEL. N0: FINAL DATE BY:OWNER:, LOURDES (626( 590-3603- O`` (((
9336 BROADWAY
TEMP 917802403 DESCRIPTION OF WORK
2 OUTLETS, 1 SWITCH, 2 LIGHT FIXTURES
APPLICANT: TEL. NO:
SAME AS OWNER -
SPECIAL CONDITIONS:
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER -
LIC. NO TEMPORARY POWER POLE
UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER: TEL. NO: UFER GROUND
LIC. NO: ROU3H CONDUIT
ROUGH WIRING
MAIN WATER LINE
PLASTIC Y/N METAL Y/N
UTILITY COMPANY NOTIFIED
REPORT ID: DPR265 ROUTE TO: SS0508