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DEPSARTME4NT OF BUILDING AND SAFETY APPLICATION FOR PEIihIIT
COUNTY OF LOS ANGELES �I���� �� hi
W J. FOX CHIEF ENGINEER 9H��
Q NAME Y DISTRICT NO. GROUP ZONE PERMIT NO.
ADDRESS ZY� • �
F' RECEIVED BY READY FOR DATE.ISSUE
W CITY TEL.NO. /-01 FI RST INSPECTION
J COUNTY I /
N CERT.NO. Q EXPIRES f
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
JOB
DESCRIPTION OF WORK A DRESS .,gso 9 ,
NUMBER OF OUTLETS ON CIRCUITSLOCALITY
LOCATION BY ROOMS F NEAREST 1
LIGHT OUTLETS JEW. PLUGS IFIXT CROSS ST.
CIRCUIT A/ B C D E F GG/ - H I N NAMEw MAIL
/
ADDRESS
O
CITY TEL.no.
1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTAFIGATF. OF QUALIFICATION-.
_Y\-/'/fU/J/zY1'C�/lr.-il'O�'yE1LE/-CTRI•LI��AN.
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE
OWNER.
CORRECTIONS
J
Z
Z
LI
E
O
TOTAL
NO. OF OUTLETS 3 s 2 APPROVALS
3 NO. OF FIXTURES S DATE INSPECTOR'S NAME
NO. OF MOTORS FI.P. $ CONDUIT
p p f
NO. OF SIGNS TRANS. 9i WIRING ` G ��� ✓U IJ/ C
NO. OF RANSESENSIr4NEATERS 3 FIXTURES
MISCELLANEOUS S POWER
PERMIT FEF. $ ( I <� UTILITY CO.NOTIFIED
TOTAL FEE _a_��4. FINAL
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0602210011
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
TR: 13805 LT: 41 9938 BROADWAY
FEE DESCRIPTION: QUANTITY: DOM: AMOUNT: TEMP CA 917802618
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: BALDWIN
8588-016-016 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY, C
G1 OUTLETS-LGT,SW,RECP 16.00 OUT 31.20
TENANT: 02 LIGHTING FIXTURES 9.00 LGT 17.55 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
H1 RES ELEC OVEN LT 3HP 1.00 OVE 10.95 02/21/06 JK 00/20/06
H2 RES GREG DISP LT 3HP 1.00 DIS 10.95
OWNER: TEL. NO: H3 RES DISHWASHR LT 3HP 1.00 DIS 10.95 FINAL DATE FINAL BY: CODE:
SCHUYLER JOHN;MARGARET TRS - R4 RES RANGE BOB LT 3HP 1.00 ROO 10.95
9938 BROADWAY LB 200 AMP PANELS, MCC 1.00 PAN 3B.05v-
TEMP 917802618 TOTAL FEES 159.15 DESCRIPTION OF WORK
ELECTRICAL FOR KITCHEN REMODEL AND UPGRADE SERVICE TO 200
AMP
APPLICANT: TEL. NO:
HEILEIN (909) 599-9545-
5139 VALLEY CENTER SPECIAL CONDITIONS:
COVINA, CA 91724
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
DEAN'S HOME REPAIR (626) 523-5422-
5139 VALLEY CENTRAL AVE LIC. NO TEMPORARY POWER POLE
COVINA, CA 91724 808571 B
UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER: TEL. NO: UFER GROUND
LIC. NO: ROUGH CONDUIT 6- G (,
ROUGH WIRING
MAIN WATER LINE -
PLASTIC YIN METAL YIN
UTILITY COMPANY NOTIFIED
REPORT ID: DPR265 ROUTE TO: BS0508
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1306200020
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: FEES PAIDBUILDING ADDRESS:
ITR: 13805 LT: 41 II9938 BROADWAY
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: I TEM? CA 91.9802618 1
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: BALDWIN
18588-016-016 JAI PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY CAI
I IG1 OUTLETS-LGT,SW,RECP 3.00 OUT 6.00 1
1 TENANT: IHA FAD LESS 3HP 1.00 FAT 11.00 ISSUED ON: PROCESSED BY: PLAN BY:
J0 AC UNITS +3-10HP 1.00 AC 19.70 106/20/13 SA
I TOTAL FEES 64.50 1
1OWNER: TEL. NO: (FINAL JDATE FIDIAL BY: CODE:
1JOHN;MARGARET TRS (626) 286-2269-
9936 BROADWAY
9938 BROADWAY
(TEMP 917802618 J IDnSCRIP1'ION OF WORK 4 -
1 113 OUTLETS, A/C AND FAU 1
JAPPLICANT: TEL. NO: 1
IWUKMIR, NICK (626) 442-2148-
111500 RAMONA BLVD 1 (SPECIAL CONDITIONS:
JEL MONTE CA 91731
(CONTRACTOR: TEL. NO: AWL DATE I I INSPEC OR SIGN TURE
JAMES WUKMIR CO., INC- (626) 442-2148-
111500 RAMONA BLVD LIC. NO (TEMPORARY POWER POLE
IEL MONTE CA 91731 285626 III
UNDERGROUND CONDUIT
(ARCHITECT OR ENGINEER: IEL. NO: DFEFIGROUND
I - II I 1111 I Illi
LIC. N0: I ROUGH CONDUIT
IROUGY. WIRING TF
MAIN WATER LINE
(PLASTIC YIN METAL YIN
1
' UTIDITY COMPANY NOTIFIEDI I
I I 11 11 I I
I I I I I
I I I 11 I I
I I I 1111 I I
II 11 I 11 I �
I III I (III I I
I I I I I I
I- ADDITIONAL DATA ON FILE
J IREPORT ID: DPR265 ROUTE TO: BS0508
I I I I I I