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Home My Public Portal About9822 BROADWAY_Electrical__ TEMPLE CITY °E°°°'°'° APPLICATION FOR ELECTRIC PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS /d (Grtr JOHN A..LAMBIE, COUNTY ENGINEER WILLIAM.A.JENSEN.SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST PERMIT FEES CROSS ST. �Oell ll ITEM NUMBER EACH FEE OWNER OUTLETS: $ $ MAILADDRESS LIGHTS RE<EPT. SW. .10 ''7��nn !!��k/� // LIGHTING FIXTURES 10 CITY 1G, I�IY TEL.NO.�jlb _ ELEC.RANGES CLO.DRYERS r/ ELECTRICIAN WATER HEATERS .50 J ADDRESS ELEC.SPACE HTRS. DISHWASHERS CITY TEL, NO. GARBAGEDISPOSERS AUTO.- STATE WASHERS STA.COOKING UNITS .25 LICENSE NO. MOTORS: OVER I.C. H.P. DISTJ�ICTNO. G SOUP I 29 E CESSED BY � AV// � 1/2— 2 .50 INSPECTION RECORD 2— 5 1.00 5— 15 1.50 15— 50 2.50 50—200 5.00 SIGNS: NO.TRANS.. NO.LAMPS SERVICE 0-600V 1.00 / SERVICE OVER 600V 5.00 ' MI50. WIRING PERMIT 1.00 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERM IT .50 TOTAL FEE Is 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 ^„e- _41 /,oWITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT ' •N41} ELECTRICAL WIRING. P 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR WIRING LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF TME ABOVE ` DESCRIBED RESIDENTIAL PROPER Y.I�7'. /�///{/✓� �� //�J POWER SIGNATURE Rl L2/Lr • �iGc.c UTILITY CO.NOTIFIED QVV vif •vn.�/� OF PERMITTE FINAL ®. VALIDATI _) ARTHUR C.VETT, V Mo Asx SUPERVISING ELECTRICAL ENGINEER _ LAIC B o a o—� NOV -18 2 D 2.5 p a v✓LCfM� BA DeYSA A 9-55 APPLICATION FOR ELECTRIC PERMIT �. t DIVISION OF BUILDING AND SAFETY Deportment of County Engineer County of Los Angelca BUILDINGA��✓9y _ WM.J. FOX. COUNTY ENGINEER 'ADDRESS CASSATT O. GRIFFIN. SUPT OF BULLDINC LOCALITY 7-6MPLE G i//TY FOR APPLICANT TO FILL IN NEAREST �"oLDE�✓ W PERMIT FEES CROSS ST. F� NUMSER EACH FEE OWNER A— I& ULLE� LIGHT OUTLETS RECEPTACLES MAIL ADDRESS ��Z�-- E. oA l�G✓A7° WALL SWITCHES TOTAL OUTLETS CITY TEMPLE r TEL. NO. ELEC. RANGES 25 ELECTRICIAN O/.��/✓E� ELEC. HEATERS .25 ADDRESS KW EA CITY TEL. NO. FIXTURES 5LICENSE NO. NUMBER OF LIGHT CIRCUITS DISTRICT NO. I GROUP I ZI READY FOR INSPECTION NUMBER OF RECEPTACLE CIRCUITS 1.' MOTORS �°O NUMBER HORSEPOWER FEE INSPECTION RECORD NEW MVD. HP OVER INC. EACH 11/2&LESS S .25 _ 2 .50 2 5 1.00 S 15 1.50 15 50 2.50 50 200 5.00 MISC. .L~ 5riav/I ci` NO.SIGNS NO.TRANS. NO.SIGNS NO.LAMPS FOR EACH PERMIT, WIRING SLOG / •�� - FIXTURES S1.00 SUPPLEMENTARY .50 � APPROVALS OA TOTAL FEE S .7.5� DATE INSPECTOR'S SIGNATURE I HEREBY ACKNOWLEDGE'THAT 114AVE.READ THIS APPLICATION CONDUIT 1 AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING M IS I55 I n - ELECTRICAL WIRING. IHEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REOUMED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE POWER 1 DESCRIBED RESIDENTIp PROPERTY. a I n I SIGNATURE /l. ' I// / UTILITY CO.NOTIFIED 1 IsIsJ _ /� ■ s...� OF PERMITTEE lJ��LtWW/��CCC FINAL �� 1J�iLM.✓-�-.-� �" WILLIAM J. FOX,COUNTY ENGINEER VALIDATION A. C.VEIT. CHIEF ELECT. INSPECTOR iCo8941c- OCT 13 2 2.75 � G WORKERS' COMPENSATION DECLARATION ]0-Wt4DPW 3,9) APPLICATION FOR ELECTRICAL PERMIT O eAaas :reby affirm that I have a certificate of consent to self ce-gpyD re, or a certificate of Workeri Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS rtified copy/thereof'(�j$�ec. 3800, ab. C.)t.w •s' k) , N �UCompany_ � y `DN / FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH fNO. FEE ADDRESS '(8 / Z (�I�� /•� Certified copy is filed with the county building inspec- 18.2-Family, Sq. Ft. $ $ LOCALITY 7 �mPLtion department. Multi-family Sq. Ft. NEARESTCROSS5TDateApplicant ) Residential Swimming Pools OWNER ORFIRM NAMECERTIFICATE OF EXEMPTION M RKERS' MAIL Outlets: Rec light $w._COMPENSATION INSU ANCE First 20 � ADDRESS (This section need not be completed if the work involved by Total No. CITY Tel. No. the permit is for one hundred dollars ($100)or less.) Additional y a , PLAN CHECK certify that in the performance of the work for which this APPLICANT permit is issued, shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS Additional Total No. CITY Tel. No. Date Applicant �r I NOTICE Fixed Appliances Not Over 1 HP PERMIT APPLICANT: If, offer making this Certificate of APPLICATION Q 1) C_ �L�S jJ K/ Exemption,n, you should become subject to the Workers' Range— Heater—D.W. — �a �y� Compensolion provisions of the Labor Code, you must forth- Oven — Dryer W.M._ O ADDRESS 07 p J tr QPMD)tib• with comply with such provisions or this permit shall be Top — FAU -�-W.H. — deemed revoked. Hood — Fan —Other— CITY GL(=WC> 9t2J, Tel. No.'3 YF1 LICENSED CONTRACTORS DECLARATION Dis _ Room Air Cond. _ UEG OR I hereby affirm that I am licensed under provisions of Chapter 9 p REG. NUMBER 7762 Class. C�C) (commencing with Section 7000)of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NO. PROSSED BY >_ and Professions Code,and my license is in full force and effect. D- 1, Size 8 Type HP, KW, KVA, or KVAR ��my�{n,l 0 License Number. ' 97 n 77 L1 2. Lic. Class e)L-U U Up to 1 Incl. FINAL ,� �V� S USS o�' Over 1 to 10 Ind. O DATE -�'� ( VALIDATION Contractor Date J r1.. U ❑ Over 10 to 50 Incl. FINAL p F I am exempt under Sec. Over 50 to 100 Inc. By L wiN-ir,� U lL 8.8P.C. for this reason Over 100 d Dote: Services, Swbd., MCC 8 Ponelboards D U) 0 -200 Am . n er 600 VJ . �� t7 Signature 2011 - Amp. Under 600 ❑ Exemption for Reg. Moint. Elect. Over 1000 Amp. or Over 600 V 7 SINGLE FAMILY Temp. Power Pole 8 Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit Ht_r_ T hereby affirm that exempt from the Contractor's License Law for the following r reason (Section 7031.5, Business and Additional Sign Branch Circuits Professions Code): _ ❑ I, aowner of the property, will o the work and the Misc. Conduits 8 Conductors c f structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)— I)�f AL dti? . 30 Business and Professions Code). D (',4�i_t� y,5,�_',I] CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for CHANGE XF1 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 4697 1 fihliLl=llJ 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 t ve-mention proper y for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signal of PSmt ee Date It 44CE 0RKERS'.COMPENSATION DECLARATION 80 ,e,R, - APPLICATION FOR .ELECTRICAL PERMIT • {� I hereby ajirm that I have a.certificate of consent to self insure,. CE806G • �J dl a corhhcate of Workers' Compensation Insurance,,ora certified COUNTY. OF LOS ANGELES. BUILDING AND SAFETY - copy repQr/ugr�,I6`. @9i C.) •Policy i L3,,,)%rriPanY FOR APPLICANT TO FILL IN JOB � �CertiLetl copy is hereby furnished. - New Residential.Bltlgs.8Pools r -, EACH- NO. FEE ADDRESS , c;']ilx r $ _ $ 'LOCALITY' -t Cettjye filed with the county building inspection 1 & 2-Family;Sq. Ft. — d a t nt. - 4 Multi-family Sq.Ft. NEAREST�,. -.. - ROSS , Residential Swimming tPools N RST. Dae APPlicant ;' , "'-CERTIFICATE OF EXEMPTION FROM'WORKERS � k FIRM NA E Outlets Light Sw. MAIL•- '.•' COMPENSATION INSURANCE„'- + J ADDRESS This section need not be.completed'if the work Involved''-b the First 20' .,( Y - _ CITY..- Tel,No Ipermit Is for dne,hundretl dollars($100)or less.)- - - Total No. Additional' 1'certif -that in me. erformance.of the:work-for whichrthi5 permit - PLAN CHECK Y P P APPLICANT Is.issued, I shallot'employ anyperson-in any jmanner,so as to •y become subject to the Workers'Compensation Laws _ .t Lighting Fixtures First 20 - ADDRESS A'- ' Additional ' ' 'Total No. CITY' �' �Tel'No: Date• - Applicant Fixed APPliances Not Over 1'HP NOTICE- TO APPLICANT.,;If, after makin -this Certificate of` FADDRESS i l 9' ems' Exemption,you.should become'sublect,to the Workers;Compensation .� _ _Range_ Heater_ D.W.provisions,of. Labor Code,.you must forthwith comply'with'.such Oven.— Dryer _ W.M. _ - �,,N �� ' .' ,provisions or this'permit,shall be deemed revoked. Top -,— FAU W.H. _- '• , /, a+ ,.7��'sZci�( Tel.N91.11-.(_//.Jr LICENSED CONTRACTORS DECLARATION Hood,— 'Fan ' Other= I hereby affirm that I am licensed under provisions of.Chapter 9 LICENSE OR - - Disp.^—Room Air Conti. _ ' Class. p (commencing.with Section'7000) of in 3 of.the Business and 'REG.NUMBER/-�;T- �� -� Professions Code,and my license is in full force and,effect' DISTRICT NO Power Apparatus& Large'Appliances y Size&Type HP,KW,KVA,or KVAR. f v License Number z�.� , 2 CLa.Class Up to 1 Incl. FINAL 0 Date7 1 Over 1 to 10 Incl -/ `�� VALIDATION O Contracts - Over 10 to 50 Incl. F- Is' F- _ am exempt under Seo: -- Over 50 to 100 Inc. BY - .: .. . -.-_. LU B.&P.C..for4his reason Over 100 .� _, Services, Swbd.,MCC 8 Panelboards ;D '._ Z Date: - 0-200 Amp.Under 600 V - Signature 201 - 1000 Amp.Under 600 V - _ - Over 1000 Amp. or Over.600 V 1 ❑ Exemption for Reg.Maint.Elect ANT, a SINGLE FAMILY Temp..Power Pole& Appurtenances: HOME OWNER-BUILDER DECLARATIONSign with One Branch Circuit _ 32.51 3 I hereby affirm that I am exempt from the Contractor's License Law - - ,; for the following reason(Section,7031.5,Business and Professions 'Additional Sign Branch Circuits - '•- - • - I 1 TENS - Code); e _ . lg�. ;_F"� -❑' as owner.of the property,will do the work and the structure Misc.Conduits & Conductors - - U.�,7 is not intended or offered for sale (Section 7044, Business Other (See Complete Fee Schedule) +, �• E'-�'v 32.5(1 - and Professions Code). D (-i�1}fy�7F •�)� CONSTRUCTION LENDING AGENCY: 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 -;' 'ISub-Totaq` •" ' - -1i-(i{�(�Il-1k �',r �7��4' CFCiv.C.1. , ,. AN 11'24. PLAN CHECKING FEE - "ehour's Name' _ PERMIT ISSUING FEE nder's Address ertity that have read this application and state that the above .TOTAL.FEE'_ a - rmatlon is come99L I agree to comply with all County ordinances - .State laws ting Electrical wiring, and hereby .authorize sentatives of� I County to enter upon the above mentioned rtyforep ti pur os SEE REVERSE FOR EXPLANATORY LANGUAGE' Ire Petpiittee / p WORKERS'mthathavea COMPENSATION DECLARATION 78-883 ,D,B, APPLICATION FOR ELECTRICAL PERMIT I�2j\� I hereby affirm that I have a certificate of consent to self insure, CE-806G `/ 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 FOR APPLICANT TO FILL IN JOB ❑ Certified copy is hereby furnished. New Residential Bldgs.& Pods EACH NO. FEE ADDRESS ❑ Certified copy is filed with the county building inspection 1 & 2-Family,Sq.Ft $ — $ LOCALITY department. Multi-family Sq.FL — NEAREST CROSS ST Residential Swimming Pools OWNER OR Date Applicant FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets.Ree—Light Sw. MAIL COMPENSATION INSURANCE ADDRESS (This section need not be completed if the work imolved by the First 20 CITY Tel.No. permit is for one hundred dollars($100)or less.) Total No. Additional I certify that in the performance of the work for which this permit PLAN CHECK APPLICANT 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 . . Additional Total No. CITY Tel No. Date Applicant Fixed Appliances Not Over 1 HP NOTICE TO APPLICANT: If. after making this Certificate of PERMIT Exemption,you should become subject to the Workers'Compensation Range_ Heater_ DW, _ APPLICANT provisions of the Labor Code. you must forthwith comply with such Oven _ Dryer _ W.M. _ ADDRESS provisions or this permit shall be deemed revoked. Top — FAU _ W.H. CITY Tel.No. LICENSED.CONTRACTORS DECLARATION Hood — Fan Other_ I hereby affirm that I am licensed under provisions of Chapter 9LICENSE OR DisP Room Air Cond. (c .ommencing with Section 70001 of Division 3 of the Business and . Professions Code,and my licenfull f d REG.NUMBER Class >wse is in full force and effect. Power Apparatus& Large Appliances DISTRICT NO. PROCESSED BY O ,,.� Size& Type HP,KW.KVA,or KVAR W License Number - Lie. Class Up to 1 Incl. FINAL J Over 1 to 10 Incl. DATE U_ Contractor Date I ( VALIDATION >_Over 10 to 50 Incl. FINAL C= ❑ I am exempt under Sec. Over 50 to 100 Inc. BY Q Over 100 ly BAP.G.for this reason O Services,Swbd..MCC & Panelboards ► CL Date: 0- 200 Amp.Under 600 V 2 W 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 I hereby affirm that I am exempt from the Contractor's License Law for the following reason(Section 7031.5, Business and Professions Additional Sign Branch Circuits Code): ❑ Misc.Conduits&Conductors 1,as owner intended the property.will do the work and 4, structure Other (See Complete Fee Schedule) is not essior offered for sale (Section 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(Sec.3097, PERMIT FEE (Sub-Total) Cm.O). PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address I cerfdy that I have read this application and state that the some TOTAL FEE - information is comect. I agree to comply with all County ordinances and State laws regulating Electrical wring, 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 # 0506 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0609150002 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 13805 LT: 29 9822 BROADWAY FEE DESCRIPTION:. QUANTITY: DOM: AMOUNT: TEMP CA 917802633 \ ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: BALDWIN to �- T 8588-016-004 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID.' A3:" LOCALITY:' TEMPLE`CITY, C GS OUTLETS-LGT,SW,RECP 20.00 OUT 39.00 " TENANT: G2 LIGHTING FIXTURES 20.00 LGT 39.00 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: TOTAL FEES 105.75 09/15/06 JK 03/14/07 OWNER: TEL. NO: FINAL DA HY: CODE: BECKWITH CHARLES E;JOANNE R (626) 287-2820- 9822 BROADWAY TEMP 917802633 DESCRIPTION OF WORK ELECTRICAL FOR ADDITION APPLICANT: TEL. N0: WENDY WILSON 6 ASSOC. (626) 484-2161- 708 W. SIERRA MADRE SPECIAL CONDITIONS: SIERRA MADRE 91024 - CONTRACTOR: TEL. NO i APPROVALS DATE INSPECTOR SIGNATURE CHARLES MYRICK - (818) 371-3610- 1312 HIGHLAND AVE LIC. NO �.. �` ( ., TEMPORARY POWER POLE DUARTE, CA 91010 849976 B - UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: 'TEL. NO: OPER GROUND CALCIVIC ENGINEERING (818) 790-0473- 4929 RUPORT LN. LIC. NO: ROUGH CONDUIT LA CANADA FLINTRIDGE, CA NONE ROUGH WIRING MAIN WATER LINE PLASTIC YIN METAL YIN UTILITY COMPANY NOTIFIED REPORT ID: DPR265 ROUTE TO: SS0508 -