The URL can be used to link to this page

Home My Public Portal About9723 BROADWAY_Electrical__ 'sAE" DBS.SA APPLICATION FOR ELECTRIC PERMIT 9.55 DIVISION OF BUILDING AND SAFETY ' Deportment of County Engineer 2 _ I County of Los Angolas BUILDADDRESS WM.J. FOX, COUNTY ENGINEER CASSATT D. GRIFFIN. SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST PERMIT FEES CROSS ST. i NUMBER EACH FEE /Yi�ZTNI/�!L��i/ OWNER LIGHT OUTLETSMAIL / RECEPTACLES ADDRESS/� ` 0 WALL SWITCHES TOTAL OUTLETS 5¢ S �U CITY �!?1.- TEL. NO. ELEC. RANGES 25 ELECTRICIAN jZr ELEC. HEATERS 25 ADDR S � � p KW EA CITY 9�OL- TEL. N U- FIXTURES 5 LICENSE NO. NUMBER OF LIGHT CIRCUITS - DISTRICT-NO. I GROUP I ZONE )II READY FOR INSPECTION NUMBER OF RECEPTACLE CIRCUITS MOTORSY rvumRER HORSEPOWER FEE '. INSPECTION RECORD NEW V. HP OVER INC EACH �11ll�.� �ye uh Sa�Y• _ I/2&LEss S .25 I/2 2 .50 - 2 5 1.00 -- 5 IS 1.50 I5 50 2.50 50 200 5.00 MISC. '' L /5-7 NO.SIGNS NO.TRANS. NO.SIGNS NO. LAMPS FOR EACH PERMIT: WIRING $1.001 FIXTURES 51.00 SUPPLEMENTARY .50 APPROVALS _ TOTAL FEE S /D DATE INSPECTORS 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 ELECTRICAL WIRING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE POWER /. DESCRIBED RESIDENTIA PROPERTY. SIGNATURE UTILITY CO.NOTIFIED / II - OFPERM ITTEE A FINAL I��tO AU Ql✓ 1. N WILLIAM J. FOX, COUNTY ENGINEER VALIDATION A. C.VEIT.CHIEF ELECT. INSPECTOR LkC03.6 3 1 N RAR 1 2 1 .10 ID o 'BA 85 OB£-SA APPLICATION FOR ELECTRIC PERMIT 3-55 DIVISION OF BUILDING AND SAFETY / Depmuiment of County Engineer 0 No =t\ County of Los Angeles SULWM.J. FOX. COUNTY ENGINEERCASSATT D. GRIFFIN. SUPT OF BUILDING FOR APPLICANT TO FILL IN NEAREST PERMIT FEES CROSS ST. NUJMJBER EACH FEE OWNER LIGHT OUTLETS / MAIL RECEPTACLES a ADDRESS J WALLSWITCHES TOTAL OUTLETS _ St $ CITY TEL. NO. ELEC.RANGES Q- 25ELECTRICIAN _ELEC. HEATERS 25 jr U - ADDRESS / KW EA _ CITY •� �� FIXTURES 5 / LICENSE NO./t"1 Jr.�// NUMBER OF LIGHT CIRCUITS DISTRICT NO. I GRQJJP I ZOO N� I READY FOR INSPECTION NUMBER OF RECEPTACLE CIRCUITS I✓,•�J Z rp/i� MOTORS NUMBER I HORSEPOWER FEE INSPECTION RECORD N£W MVD. HP OVER INC. EACH 19�J lF T• � '�� / I/2&LESS $ .25 U On /2 2 .50 2 5 00 5 IS 50 5 50 2.50 S0 200 5.00 MISC. NO.SIGNS NO.TRANS. NO.SIGNS NO.LAMPS FOR EACH PERMIT: WIRING $1.00 Q FIXTURES SLOO V O SUPPLEMENTARY .50 '] /> APPROVALS TOTAL FEE - $ / 7Y/� DATE INSPECTORS SIGNATURE I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS A PLICATION CONDUIT A AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING I2 •[•rP CMS �� ELECTRICAL WIRING. - 1 HEREBY CERTIFY THAT i AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY .AND STATE OF / CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE POWER f .n /� j DESCRIBED REST OENTI A PR RTY. UTILITY CO. NOTIFIED ,I-t13� u I1f IPAata cam_;, SIGNATURE }t OF PERMITTEE FINAL N lu.GA.✓ L V WILLIAM J. FOX, COUNTY ENGINEER VALIDATION A. C.VEIT,CHIEF ELECT. INSPECTOR j �4 4 3 4 MAR 2 6 2 7.9 5 Bt o APPLICATION FOR ELECTRIC PERMIT �. COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER eu1LDINc'� Q BUILDING AND SAFETY DIVISION ADDRESS L.3 , 5HOA OLuA-t' JOHN A. LAMBIE. COUNTY ENGmEER �y� /'� WILLIAM A.JENSEN.SUPT of BUILDING LOCALITY ✓r! L - 1, / z4 FOR APPLICANT TO FILL IN NEAREST G. L L,'CJ PEPMT FEES ITEM NUMBER EACH FEE OWNER we S OUTLETSS $ MAIL �a ADDRESS LIGHTS ' RE.EPI'. SW.I .10 LIGHTING FIXTURES ( 10 / '.f CITY TEL.NO. ELEC.RANGES CLO.DRYERS ELECTRICIAN WATER HEATERS .50 ADDRESS L I O ELEC.SPACE HTRS. D15HWASHERS CITY C TEL. NO. GARBAGE DISPOSERS AUTO.- STATE / O WASHERS STA.COOKING UNITS .25 LICENSE NO. MOTORS: OVER INC. H.P. DISTRICT NO. ✓ OUP ZO alp' P ED BY — .50 INSPECTION &CORD z- 5 1.00 5— 15 50 2 15— 50 2.50 50-200 5.00 SIGNS: NO.TRANS. NO.LAMPS SERVICE 0-500V 1.00 SERVICE OVER 500V 5.00 MISC. WIRINGPERMIT I 1.00 (�Q FIXTURE PERMIT J 1.00 �d SUPPLEMENTARY PERMIT .50 TOTAL FEE S �j 1 HEREBY ACKNOWLEDGE THAT I 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 CONDUIT ELECTRICAL WIRING. WIRING ��i��/T ✓NGY/ /A✓f 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED pNDIOR LICENSED AS REQUIRED BY LOS ANGELES CODNTY ANO STATE OF FIXTURES � CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROP POWER t�— SIGNATURE UTILITY CO.NOTIFIED t OF PERMITTE _ FINAL %J./ I�f➢. S///1LO� ®r ......��ATION ARTHUR C.VEIT. GK Mo CASH SUPERVISING ELECTRICAL ENGINEER 2 9 7 0 JUN '2 2 D 2 .8 0 WORKER'haveCOMPENSATION DECLARATION 20-0019DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT LI 0-001 IfI have a certificate of consent to self insure, f Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT, OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof Seo.380 L C.) Policy N II on, pany OnM FOR APPLICANT TO FILL IN JOB ADDRESS ❑ Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE LOCALITY' _ ® 1 &2-Family,Sq.Ft. $ S Certified Copy Is fl atl Wlth the COU ty building epeCliOn CROSS �epar�,e�rl��n Multi-family Sq.Ft. CRo6S ST. ' Date ;Applic Residential Swimming Pools ASSESSOR PAGE PARCEL CERTIFICATE OF EXEMPTION FROM W KERS' OWNER OR '/ COMPENSATION INSURANCE Outlets:Rec._Light Sw. FIRM NAME I First 20 MAIL Total No. Additional (This section need not be completed if the work involved by the ADDRESS permit is for one hundred dollars(5700)or less.) 1 certify that in the performance of the work for which this permit CITrTViel.No. 5 is issued, I shall not employ any person in any manner so as to PIAN CHECK become subject to the Workers' Compensation Laws. Lighting Fixtures First 20 APPLICANT Total No. Additional ADDRESS Date Applicant RESIDENTIAL APPLIANC S FT TER 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 Cade, you must forthwith comply with such - PERMIT miil provisions or this permit shall be deemed revoked. Power Apparatus It Large Appliances APPLICANT LICENSED CONTRACTORS DECLARATION Size&T�e'�KW, KVq �� ` ADDRESS 1 hereby affirm That am licensed under provisions of Chapter 9 Ove rt I. (commencing with Section 7000) of Division 3 of the Business and CITY eM T.I.No.r;99(lo"51 • Professions Code,and my license is in full force and effect. Over 10 to'50 Incl. LICENSE OR Over 50 to 100 Ind. REG.NUMBER � Cla i O r`! 3 C��R �— �100 DISTRICT NO. PA CESSED BY License Numbe Lic.Clas 1 �� In J� � U n 'n^ /Services,Swbd.,MCC&Panelboards r/ I&F--li cc Contracto Date 0-399 Amp.Under 600 V DATE qq l ❑ X400-1000 Amp.Under 600 V -LI— (J am exempt under Sec. I LL VALIDATION LL �....,,Over 1000 Amp.or Over 600 V FINAL 11 B.&P.C.for this reason BRANCH CIRCUIT FEES BY fn Date: 15A.or 2-120 apt. Z Signature 1,T� nch Circ its c, cults' El41 Or MoreBranch Circuits Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits 2 SINGLE HOME OWNER BUILDERIDECLARATION LY Temp.Power Pole&Appurtenances AGGT.s I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit 46°717 for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits 3303 Code): �t 1 ITEMS F-1 1, as owner of the property,will do the work and the structure Misc.Conduits&Conductors TOTAL ITAL m is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) 70 and Professions Code). . D CHECK 4'6.7!01 CONSTRUCTION LENDING AGENCY CHANGE .GQ 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-L0001 5/ 7196 PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE 626.5 1 AMII.41 Lender's Address �f 1 certify that 1 have read this application and under penalty of purjury state TOTAL FEE L� 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 ounty to enter upon the above-mentioned property for ins(lectian purpos SEE REVERSE FOR E%PLANATORV LANGUAGE SIGNATURE OF PE MI SDA// WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) Ireby affirm that I have a certificate of consent to self insure, 76A663 APPLICATION FOR ELECTRICAL PERMIT t certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. y thereof(Sec. 3800 Lab. C.) cy No. Company FOR APPLICANT TO FILL IN JODRE55 Certified copy is hereby furnished. New Residential Bldgs, &Pools NO, EACH FEE LOCALITY d - . — S Certified fil copy is ed with the county building inspection 1 &2-Family.Sq.FtIS department. Multi-family Sq. FL NEARESTCROSS ST. - . Applicant Residential Swimming Pools I ASSESSOR MAP BOOK I PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rea_Light_Sw. OWNER OR COMPENSATION INSURANCE FIRM NAME s section need not be completed if the work involved by the First 20 MAIL nit is for one hundred dollars (S100)or less.) Total No.. Additional ADDRESS Idly that in the performance of the work for which this permit CITY Tel.No. sued, I shall not employ any person in any manner so as to )me subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ) PLAN CHECK APPLICANT Total No. Additional ADDRESS Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP. iICE TO APPLICANT: it, after making this Certificate of CITY Tel.No. notion,you should become subject to the Workers' Compensation OTHER APPLIANCES NOT OVER 3 HP. isions of the Labor Code, you must forthwith Comply with such °PERMIT isions or this permit shall be deemed revoked Power Apparatus&Large Appliances APPLICANT LICENSED CONTRACTORS DECLARATION Size 8 Type HP,KW,KVfjF}or�(K�,I.AR ADDRESS reby affirm that 1 am licensed under provisions of Chapter 9 Over 3 t6901nc1. - } lmencing with Section 7000) of Division 3 of the Business and CITY Tel.No. > essions Code, and my license is in full force and effect. Over 10 to 50 Ind. CL Over 50 to 100 Incl. 1 LICENSE OR Class. O REG.NUMBER (� Over 100 DISTRICT NO. PROCESSED BY W ase Number Lia Class � � J Services,Swbd., MCC&Panelbearas - — L :-actor Date 0 399 Amp.Under 600 V FATE �/ I >_ I am exempt under Sea 400-1000 Amp,Under 600 V l VALIDATION Q Over 1000 Amp.or Over 600 V BAP.C.for this reason FI AL O BRANCH CIRCUIT FEES d Date: 15A,or 20A.120V,Lighting or Recap!. r 2 1 To 10 Branch Circuits UJ Signature 11 To 40 Brandt Circui's F 41 Or More Branch Circuits Exemption for Reg.Main!.Elect. 15A.20A.208V To 2TIV Lighting Br.Circuits SINGLE FAMILY Temp.Power Pala&Appurtenances _ HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit r' ( ` soy affirm that I am exempt from the Contractor's License Law g ne following reason (Section 7031.5, Business and Professions Adtlitional Sign Branch Circuits 'It - I f ici :. I. as owner of the property, will do the work and the structure Misc.Concurs&Conductors _ Is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) 'JY - r and Professions Code). CONSTRUCTION LENDING AGENCY f: coy affirm that there is a construction lending agency for the I.P;v4,r rtmance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total) PLAN CHECKING FEE er's Name r 1_ PERMIT ISSUING FEE er's Address ify that I have read this applicafion and under penalty of purjury state TOTAL FEE :he above information is correct. I agree to comply with all County antes and State laws regulating Electrical wiring.and hereby authorize sentatives of this County to enter upon the above-mentioned property spection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE TURE OF PERMITTEE DATE COUNTY OF LOS ANGELES TEMPLE CITY 4 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1203290032 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91760 PHONE: (626) 285-0488 EXT: (LEGAL ID: 1 FEES PAID BUILDING ADDRESS: ON FILE 1 9723 BROADWAY FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: j TEMP CA 917803213 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 18588-010-025 IA1 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY, Cl IG1 OUTLETS-LGT,SW,RECP 24.00 OUT 44.40 TENANT: IG2 LIGHTING FIXTURES 16.00 LOT 36.00 (ISSUED ON: PROCESSED BY: PLAN BY: IH2 RES GREG DISK LT 3HP 1.00 DIS 11.00 103/29/12 SR IH3 RES DISHWASHR LT 3HP 1.00 DIS 11.00 TOWNER: TEL. NO: IH4 RES RANGE RDS LT 39P 1.00 HOD 11.00 1FI}9AL DATE FINAL BY: CODE: IWONDERFUL INVESTMENT INC. (626) 512-5863- TOTAL FEES 141.20 1 J� 77 W. LAS TUNAS DR. -1 ARCADIA, CA 91007 1DESCRIPTION OF WORK (ELECTRICAL FOR KITCHEN, TWO BATHROOMS REMODFL INSTALL RECESSI 1LIGHTS IN FAMILY/LIVING ROOM APPLICANT: TEL. NO: SAME AS OWNER - SPECIAL CONDITIONS: ICONTRACTOR: TEL, NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - LIC. 140 TEMPORARY POWER POLE UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: 1UFER GROUND LIC_ NO: j .1ROUGH CONDUIT IROUGH WIRING 111 MAIN WATER LINE (PLASTIC Y/N METAL Y/N JUTILITY COMPANY NOTIFIEDI 111 I I II I I I I 11 I I I I I 11 I 11 I I TI I 111 111 1111 I 111 I 111 T 11 I 11 I I 1REPORT ID: DPR265 ROUTE TO: HS OS OB I I I I I I I I I I