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Home My Public Portal About9969 BROADWAY_Electrical__ 76A64-CE0061/70 APPLICATION FOR LECTR & PERMIT �J COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE. COUNTY ENGINEER LOCALITY COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING -S FOR APPLICANT TO FILL IN CROSS ST. OUTLETS NO. EACH FEE $ 5 OWNER 71 RECEPT._ MAIL S FIRST 20 20 ADDRESS LIGHT TOTAL SWITCH_ OVER 20 .10 CITY TEL. NO. PLAN CHECK LIGHTOTAL TING FIRST 20 20 APPLICANT FIX .10 OVER 20 ADDRESS TURES APPLIANCES Clry TEL. No, RANGE_pRYER_WTR. HTR. PERMIT _ APPLICANT( H�y n STA. COOK-X—DISP._F.A.U._ ADDRESS Y,, % d C o /V z /l SPACE HTR. AIR CONO. CITY TEL. NO. H9 J/ CLOTHES WASH._01 SHWASH. LICENSE NO.x 2 ( CLASS FAN IXOTHER 1.00 L�V HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW. KYA, ELECTRICAL WIRING. SIZE 6 TYPE OVER TO 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED ANO/OR 0 - 1 100 LICENSEDAS REQUIRED BY LCS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO 1 - 10 3.00 RESIDE IN, THE ABOVE DRESID TI13- A Pg OPERTY. } SIGNATURE 10 - 50 5.00 OF PERMITTEE 0LA 50 - 100 1000 p DISTRICT NO. C4ESCRIRED P 20NE P ESS EO Y O 100 - 500 1500 SIGN, GASW SIGN AND ONE CIRCUIT GOO NOTES: � TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 SERVICENOTOVER600 VOLTSOR 200AMP 2.00 APPROVALS DATE INSPECTOR'S SIGNATURE SERVICE OVER 600 VOLTS OR200AMP 5.00 TEMP.POWER POLE TEM P SERVI CE,POLE, &APPU RTENANCES 300 UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM 3.00 ROUGH CONDIUT WIRING PERMIT FEE (SUB TOTAL) FIXTURES POWER AUTHORIZED PLAN CHECK FEE (50% PERMIT FEE) UTILITY CO. NOTIFIED PERMIT ISSUING FEE S90 SUPPLEMENTARY PERMIT ISSUING FEE 100 FINAL Fy 7i JOSEPH C. ROOHAN TOTAL FEE O-[J SUPERVISING ELECTRICAL ENGINEER, PLAN CHECK VALIDATION CK. M.D. CASH PERMIT VALIDATION cK. m.o. usH Ih� 9345' MAR 23 2D 6.00- Q �l SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE �7W63-C EdT6 1/q0 n APPLICATION FOR ELECTRICAL ERMIT �J COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER n elss y ✓ /� BUILDING AND SAFETY DIVISION G •. L-,; JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING FOR APPLICANT TO FILL IN NEAREST CROSS ST. .(.Cy OUTLETS NO. EACHI FEE S S OWNER Cr L' (/ i✓��/ RECEPT._ MAIL n r LIGHT_ TOTAL FIRST 20 20 ADDRESS SWITCH OVER 20 ip CITY TEL. NO. PLAN CHECK LIIGHTING FIRST 20 20 APPLICANT FXTURES TOTAL .f0 OVER 20 ADDRESS APPLIANCES CITY TEL. NO. PERMIT RAN GE_DRV ER_WTR, HTR._ APPLICANT IJ J- STA. COOKOISP.`F.A.U._ } , ADDRESS F SPACE HTR. AIR CONO. CITY L II TEL. NO, YU Wa7 CLOTHES WASH._DI SHWASH._ LICENSE N V CLASS'6 FAN_OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY MOTORS. TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 - / 100 LICENSED AS REO UIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTENO TO 1 - ,0 3,00 RESIDE IN. THE ABOVE DES CR IFED RESIDENTIAL PROPERTY, r a 10 - 50 6.00 SIGNATURE OF PERMITTEE $0'- 100 10.00 yr DIST RT CDT NO 1A55 ROLA ZONE p OCE55E _ Y 100 - 500 16.00 , LelG SIGN, GASW SIGN AND ONE CIRCUIT 3.00 NOTES: d TUBE, OR Z MARQUEE Ap01 TIO NAL CIRCUITS 1.00 a SERVICENOTOVER 600 VOLTS OR 200AMP 200 . �1 OV L r APPROVALS ATE INSPECTOR'S SIGNATURE SERVICEOVER 600 VOLTS OR 200AMP 500 TEMP.POWER POLE TEMP SERVICE,POLE, &APPURTENANCES 3.00 UNOERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM 3.00 ROUGH CONDIUT WIRING PERMIT FEE (SUB TO FIXTURES POWER AUTHORIZED PLAN CHECK FEE (50% PERMIT FEE) UTILITY CO. NOTIFIED PERMIT ISSUING FEE 2.00 FINAL SUPPLEMENTARY PERMIT ISSUING FEE 1.00 JOSEPH C. ROOHAN TOTAL FEE L SUPERVISING ELECTRI&ENGINEER. "PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION cK: M.0. CASH I nr_ 5 0 2 5 2 D 4.00 ' SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE �•`, 76AE_63 `FB°G '°" APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER LOB S�OF�DwRY BUILDING AND SAFETY DIVISION AODRESS LOCALITY .M FOR APPLICANT TO FILL IN NEAREST T. OUT N0. EACX FEE OWNER OR / FIRM NAME q �.0 �•`p-Ly RECEPT.L� $ S ) ADDRESS 1 C MAIL LIGHT TOTAL FIRST 20 .2S Ll'! CITY .p Q,.� 1 TEL. NO. SWITCH OVER 20 PLAN CHECK LIGHTING FIRST 20 25 L, APPLICANT TOTAL < FI%TURES f0 / OVER 20 ADDRESS RESIDENTIAL APPLIANCES CITY TEL NO. PERMIT RANGEDRYER_WTR. HTR._ APPLICANT STA. COOKOISP. F.A.U.- ADDRESS SPACE HTR. AIR CONO. CITY TEL. NO. LICENSE OR CLOTHES WASH._DiSHWASH. REG. NUMBER CLASS. FAN OTHER 1.00 n ANO XEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION Y STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS. TRANSFORMERS RATING WITALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. 512E 5 TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR O - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ,C CALIFORNIA OR THAI I AM THE LEGAL OWNER OF THE ABOVE Y -1 - 10 3.00 a DESCRILEO RESIDENTIAL PROPERTY. d 111YYY O PERMITEEU 10 - 50 500 SIGNATUR` K O 50 — 100 1000c~i DISTRICT N0. 'SED,BY ... 100 — 500 SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTOR'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 TEMP. POWER POLE SERVICENOTOVER600VOLTSOR200AMP 3.00 UNDERSLAB WORK SERVI DROVER 600 VOLTS OR 200AMP 10.00 ROUGH CONDUIT TEMPSERVICE, POLE, &APPURTENANCES SOO WIRING N.`CA� TEMP LIGHT OR RECEPT. SYSTEM 3.00 FI%TURES POWER AUTHORIZED UTILITY CO. NOTIFIED ri FINAL I PERMIT FEE FEE (SUB TOTAL) NOTES: PLAN CHECK FEE PERMIT ISSUING FEE 3.00 Q TOTAL FEE PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIONM.O. CASH X'AA43 cK. 5 9 2 0 JJJN 5 2 U L 5.�- 5 e SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE_ 76AG63-`EB06 '0"4 APPLICATION EL CTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER JOB V BUILDING-AND SAFETY DIVISION ADDaess Q LOCALITY'_�_j'Mpr FOR APPLICANT TO FILL IN NEAREST q CROSS ST. ` OUTLETS NO. EACH FEEOWNER OR �Q •� $ S FIRM NAME RECEPT._ MAIL LIGHT_ TOTAL FIRST 20 25 ADDRESSGR( 3L1IW V OVER 20 CITY _ ` C EL, NO. SWITCH_ .10 PLAN CHECK LIGHTING FIRST 20 25 APPLICANT TOTAL FIXTURES OVER 20 .10 ADDRESS RESIDENTIAL AP .LIANCES CITY TEL. NO. PERMIT RANGE_ORV ER_WTR, HTR._ APPLICANT STA, COOK_DISP._F,A.U._ ADDRESS SPACE HTR. AIR COND. CITY TEL. NO. CLOTHES WASH. zff!!�OI SHWAS H._ LICENSE OR REG. NUMBER CLASS. FAN_OTHER 1,001 J I HEREBY 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, ETC, HP. KW, KVA. ELECTRICAL WIRING. SIZE B TYPE OVER TO HEREBY CERTIFY THAT AM PROPERLY REGISTERED ANO/OR ' O - 1 100 LICENSED A9 REQUIRED BY L09 ANGELES COUNTY AND STATE OF > CALIFORNIA OR THAI AM TXE LEGAL OWNE OF THE ABOVE a 1 - 10 3.00 OESCFIOED RE9IDENTIAL PROPERTY. U 10 - 60 8.00 PERMITEE OC SIGNATURE CD 50 - 100 10.00 W DISTRICT NO. ED BY a N 100 - 600 10.005 p U 1 'SIZ SIGN, GAB SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTOR'SONATURE TUBE, OR MARQUEE A001 TION AL CIRCUITS 100 TEMP. POWER POLE SERVICENOTOVER600 VOLTS OR 200AMP 300 UNDERSLAB WORK SERVICEOVER600VOLTSOR200AMP 10.00 ROUGH CONDUIT TEMPSERVICE,POLE, &APPURTENANCES 5.00 WIRING TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED �J FINAL PERMIT FEE (SUB TOTAL) NOTES: PLAN CHECK FEE PERMIT ISSUING FEE 3.00 0 J . TOTAL FEE UU PLAN CHECK VALIDATION CK. M.o. CASH PERMIT VALIDATIONcK. M.O. CASH & 8 9�JUL 28 2 0 5.0 0 A SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 76A663-C ES666,0/74 APPLICATION FOR lkTRICAZ PERMIT • / COUNTY OF LOS ANGELES i DEPARTMENT OF COUNTY ENGINEER ADDRESS AND SAFETY DIVISION LOCAL! Y J FOR APPLICANT TO FILL IN NEAREST CROSS ST. OUTLETS N0, EACH FEE OWNER OR //�� r FIRM NAM l.( RECEPT.! 5 S MAIL Lf t�) A rv-"l -al- _ LIGHT I TOTAL FIRST 20 ADDRESS CITY 0. SWITCH OVER 20 jJ0 PLAN CHECK LIGHTING I FIRST 20 it APPLICANT F %TURES TOTAL .10 Jy V OVER 20 ADDRESS RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT RANGEDRYER__WTR. HTR._ APp LI CANJt4�111 Po STA. COOKOISP. F.A.U._ ADDRESS SPACE HTR. AIR CORD. CITYA EL. NO. CLOTHES WASH._DISHWAS H.__ LICENSE 0 CLASS REG. NUMBER FAN_OTHER 1.00 1 nEHEBY AC%NOW LEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE I$ CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC, HP. KW. KVA. ELECTRICAL WIRING. - SIZE IN TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 — 1 1.00 V V LICENSED AS REOUIRED BY LOS ARE COUNTY AND STATE OF Y [A LIFOPNIq Oq THAI AM THE LEGAL OWNER OF THE ABOVE d 1 — 10 3.00 DESCRIPED RESIDE TIAL PROPERTY. U 10 — 50 5D0 PERMITEEJ/ _O-Jf-1 SIGNATURE CD 50 — 100 10.00 W DISTRICT NO. _ R1 SSEO Elly 6. 100 — 500 19.00 SIGN, GAS SIGN ANO ONE CIRCUIT 5.00 APPROVALS DATE INSPEC 'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 TEMP. POWER POLE SERVICENOTOVER600VOLTSOR200AMP 3.00 UNDERSLAB WORK SERVI CEOVER 600 VOLTS OR 200 AMP 10.00 ROUGH CONDUIT 4 TEMP SERVICE,POLE, &APPURTENANCES 5.00 WIRING TEMP LIGHT OR RECEPT. SYSTEM 3.00 1 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL PERMIT FEE (SUB TOTAL) NOTES: / PLAN CHECK FEE PERMIT ISSUING FEE 3.00 TOTAL FEE PLAN CHECK VALIDATION M.D. CASH PERMIT VALIDATION cn. M.D. CASH iolC' . 17 2 0 7.60 SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE WOthatI haveCOMPENSATION DECLARATION 76G63 DPW(1291) APPLICATION FOR ELECTRICAL PERMIT 0-001 I heFeby affirm that I have a certificate of consent to self insure, or a certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec. 3800 Lab.C.) � Policy No. CompanycWrg r tj �^ FOR APPLICANT TO FILL IN JOB ❑ � ADDRESS Certified copy is hereby furnishetl, New Residential Bldgs.8 Pools NO. EACH FEE = s $ LOCALITY Certified co is filed with the count building inspection 1 &i--Family,Sq.Ft. PY Y 9 P Ae ^ department. i Multi-family Sq. Fl, NEAREST cRo55 ST Date Applicant� LResidential Swimming Pools MRPE900K �+ �V PAGE �� PARCEL Q0� OWNER OR CERTIFICATE OF EXEMPTION FROM WORKERS' � ry COMPENSATION INSURANCE Outlets:Rea Light Sw. ' O a FIRM NAME MAIL (This section need not be completed First 20 the work involved by the �� ADDRESS permit is for one hundred dollars(6100)or less.) Total No. Additional Ii e>WaAi I certify that in the performance of the work for which this permit CITY!-I �x TeL No. Is issued, I Shall not employ any person in any manner s0 as to PLAN CHECK become subject to the Workers' Compensation Laws. Lighting Fixtures First 20APPLICANT Total No. Additional r y� �.�� ADDRESS Date Applicant SIDENTIAL APPLIANCES O OVEP 3 FP. .35 NOTICE TO APPLICANT: If, after making this Certificate of CITY T.I.No. Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code, you must forthwith comply with such PERMIT l .— provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances APPLICANT K LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR o ADDRESS I hereby affirm that I am licensed under provisions of Chapter 9 �Q or (commencing with Section 7000) of Division 3 of the Business and Over 310 101nc1. CITY Tel.No, _ z Professions Code,and my license is in full farce and effect. Over 10 to 50 Ind. >. LICENSE OR Class. d Over 5010 100 Incl. REG.NUMBER Over 100 DISTRICT NO. SSED BY O License Number yPf� Lic.Class� I� V �n r Services,Swbd., MCC&Panelboards �//� O ContractorOt� l ✓fA+R� Date N I-9r,� 0-399 Amp, Under 600 V DATE F ❑ am exempt under Sec. 400-1000 Amp.Under 600 V - � VALIDATION LU 1000 Amp.Of Over 600 V FINAL d BAP.C.for this reasonBY W BRANCH CIRCUIT FEES Date: 15A,or 20A, 120V.Lighting or Recept Z 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits Exemption for Reg.Maim.Elect. 15A,20A,208V To 277V Lighting Br.Circuits '? SINGLE FAMILY Temp.Power Pole&Appurtenances d T a HOME OWNER-BUILDER DECLARATION t '' I hereby affirm that Sign with One Branch Circuit .J`I am exempt from the Contractor's License Law � 7 for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits ' Code): _ -1 I L1`. ❑ I,as owner of the property, will do the work and the structure Miss.Conduits&Conductors .0 r. t' -F —L 1=7 is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule)_ I and Professions Code). ' y_HE1 CONSTRUCTION LENDING AGENCY E%3AN7C ,ilii 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.) y PLAN CHECKING FEE - QI�I_IJ"JiJl1771171�7i Lender's Name PERMIT ISSUING FEE Lender's Address I certify that 1 have read this application and under penalty of perjury state TOTAL FEE 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 County to enter upon the above-mentioned property for ins purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE L SIG ATUR OF PERP EE DATE if WORKER'S I have COMPENSATIONcertificate DECLARATION 20.0019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT IJ 6-001 hereby affirm that have a certificate of consent to self insure, I r a certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec. 3800 Lab.C.) ' Policy Nb /� �3 V m /� Copany, f 47K di L 0Zi/ FOR APPLICANT TO FILL IN JOB ADDRESS ( (•/ Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE — $ $ LOCALITY •L Certified Co Is filed with the count building inspection 1 ul i--Family,Sq.Ft. PY Y 9 P NEAREST „5 department �/ Multi-family Sq.FL CHOSS ST. �-- Date _0L-1`5_ A Applicant ilii OZL�-> Residential Swimming Pools ASSESSOR PP - MAP BOOK PAGE PAflCEI CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Ree._Light_Sw. Fol RM NAME n r 9 COMPENSATION INSURANCE 7 M afQe First 20 MAIL (This section need not be completed if the work involved by the Total No. Additional ADDRESS /ZC- $7 permit is for one hundred dollars(5100)or less.) I certify that in the performance of*the work for which this permit CITY - Tel.No. Is issued, I Shall not employ any person in any manner 50 as t0 PLAN CHECK become subject to the Workers' Compensation Laws. Lighting Fixtures First 20 APPLICANT Total No. Additional ADDRESS Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: It, 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 Code, you must forthwith comply with such PERMIT provisions or this permit shall be deemed revoked. L Power Apparatus&Large Appliances APPLICANT LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS I hereby affirm that I am licensed under provisions of Chapter 9Over 3 to 101nc1 (commencing with Section 7000) of Division 3 of the Business and . CITY ��• Tel. Professions Code, and my license is in full force and effect. Over 10 to 50 Ind. LICENSE R Aa. - Class. % 0' L� Over 50 to 100 Incl. REG.NUMBER d License Number ��/ / Lia Class Over 100 DISTRICT NO. ^ P SED eV J s 0 �.-• - �/ r Services,Swbd,MOP Panelboards 'i 4, ��(.L,(L[ry r FINAL 0-399 P4m .UndAr 600 V EL 0 COOIraCtOr Date DATE n i F ❑ 400-1000 Amp.Under 600 V / �'] VALIDATION 0 am exempt under Sec. Over 1000 Amp.or Over 600 V FINAL _ W B.8 P.0.for this reason BRANCH CIRCUIT FEES BY A'-f'7" a R U) vb: eF Date: 15A,or 20A,120V,Lighting or Recept. Z 1 To 10 Branch Circuits -- - _J l— Signature 11 To 40 Branch Circuits '' _-Psp y ❑ 41 Or More Branch Circuits j j tTy c��' -'. = o Exemption for Reg.Maint. Elect. 15A.20A,208V To 277V Lighting Br.Circuits SINGLE FAMILY Temp. Power Pole&Appurtenances zs ii`-v ,{;:crf0 HOME OWNER-BUILDER DECLARATION itn with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law Sig ;_F,:'1j. -`Ir for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits -,- Code). I, as owner of the property, will do the work and the structure Misc.Conduits&Conductors _ P P Y. 00110-00,01: ..j is not intended or offered for sale (Section 7044. Business Other(See Complete Fee Schedule) " 7-.1 and Professions Code). Oi, S' AN r„=�i L.-.- 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) 41 Civ.C.) 15, PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address I certify that I have read this application and under penalty of purjury state TOTAL FEE 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 County to enter upon the above-mentioned property for inspec' R purpos SEE REVERSE FOR EXPLANATORY LANGUAGE - DATE sIGA R PERM E DATE COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0007180003 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 13805 LT: 1 9969 BROADWAY FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802635 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: BALDWIN 8588-015-001 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT,SW,RECP 17.00 OUT 33.15 TENANT: G2 LIGHTING FIXTURES 7.00 LGT 13.65 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: H1 RES ELEC OVEN LT 3HP 1.00 OVE 10.95 07/18/00 UT 01/15/01 H2 RES GRBG 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: MAICHROWIC2 VINCENT H;DEBORAH L - H4 RES RANGE HDS LT 3HP 1.00 HOO 10.95 9969 BROADWAY LN OTHER PNL 0-399 AMPS 1.00 PAN 38.85 TEMP 917802635 TOTAL FEES 157.20 DESCRIPTI N OF WORK ELECTRICAL FOR KITCHEN REMODEL APPLICANT: TEL. NO: TOM O'LEARY CONX. - 5823 AGNES _ _ SPECIAL CONDITIONS: TEMPLE CITY, CA - - CONTRACTOR: TEL. N0: '� EL�$ C�\. �� rjAPPROVALS DATE INSPECTOR SIGNATURE TOM O'LEARY CONSTRUCTION (818) 287-0927- a r 5823 AGNES AVENUE LIC. NO y _i✓'� '� TEMPORARY POWER POLE TEMPLE CITY, CA 91780 489354 B-1 / f- UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: �� UFER GROUND LIC. NO: /' _ y 11171 i ROUGH CONDUIT ROUGH WIRING -� d MAIN WATER LINE `> � 1 PLASTIC Y/N METAL Y/N ��- -- - - - - - - 1 UTILITY COMPANY NOTIFIED V6\C — — REPORT ID: DPR265 ROUTE TO: BS0508