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Home My Public Portal About5620 CAMBURY AVE_Electrical__ 76A663 SEb{16 11/,70 APPLICATION FOR ELECTRICAL fERAAIT COUNTY OF LOS ANGELES fi, ,.DEPARTMENT OF COUNTY ENGINEER BUILDING ' BUILDING AND SAFETY DIVISION ADDRESS S6 D 1j COLEMAN W. JENKINS, SUPERINTEDENT"OF BUILDING LOCALITY N NEAREST FOR APPLICANT TO FILL IN CROSS ST. OUTLETS NO. EACH FEE OWNER RECEP $ T. $ MAIL ' 11 ADDRESS IG LHTFIRST 20 25 1 TOTAL JV CITY TEL. Y SWITCHOVER 20 JO PLAN CHECK ' LIGHTING FIRST 20 ZS FIXTURES � .10 APPLICANT _ TOTAL OVER 20 ADDRESS �� - - APPLIANCES CITY TEL. NO, PERMIT RANGEORYERWTR. HTR._ APPLICANT STA. COOKOISP. F.A.U._ ADDRESS - SPACE HTR. AIR GOND. CITY TEL. NO. CLOTHES WASH. DISHWASH. LICENSE NO. CLASS. FAN_OTHER 1T0 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 & TT PE OVER TO HEREBY CERTIFY THAT CAM PROPERLY REGISTERED AND/OR O — I L00 LILE LASED AS REQUIRED BY. LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF, AND INTEND TO r 1 — 10 300 RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. D_ O 10 - 50 500 SIGNATURE V OF PERMITTEE _ Cd SO - 100 1000 DISTRICT NOLASS. ZONE P C SSO Y O 100 - 500 15.00 V SIGN, GAS SIGN AND ONE CIRCUIT 5,00 - NOTES: Z TUBE, OR — MARQUEE ADDITIONAL CIRCUITS 100 ,., SERVI CENOT OVER 600 VOLTS OR 200 AMP 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE S ERVICE OV ER 600 VOLTS OR 200 AMP I0,00 - TEMP. POWER POLE TEMP.SERVI CE,POL E, &APPURTENANCES 5.00 UNOERSLAB'WORK TEMP LIGHT OR RECEPT, SYSTEM 3.00 _ ROUGH CONDWT V WIRING FIXTURES - - POWER AUTHORIZED PERMIT FEE (SUB TOTAL) - - UTI LITV CO. NOTIFIED PLAN CHECK FEE a FINAL //ShJ /�LC./,Y/ i PERMIT ISSUING FEE 3.00 �J JOSEPH C. ROO N TOTAL FEE � AJ :D SUPERVISING ELE AI AL ENGINEE P. PLAN CHECK VALIDATION CK. M.D. CASH PERMIT VALIDATION cK M.O. ; "CASH 'u•' l 04 n 1 ,6 N FEB 1 2 '0 7.50- 1. SEE .50- SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 76Afi63C- C6806 5/75 AY Pte' CATION FOR ELL TRICAL PERM I BUILD( AND SAFET (VISION FOR APPLICANT TO FILL IN JOB New Residential Bldgs. & Pools EACH NO. FEE ADDRESS Q U 1 &2 Finaily Sq. Ft. S _ $ LOCALITY G74/ Multi-family Sq. Ft. — NEAREST Residential Swimming Pools CROSS ST. OWNER OR FIRM NAME L Outlets: Light, Switch& Receptacle MAIL First 20 ADDR Additihnal CITY Tel. No. PLAN CHECK IF Lighting Fixtures APPLICANT First 20 ADDRESS Additional CITY Tet. No. PERMIT Fixed Appliances Not Over 1 HP APPLICANT ).... Range_ Heater— D.W. '� ADDRE (/ Oven Dryer W.M. Top FAU W.H. CITY Tel. No Hood Fan _ _ LICENSE OR +� Disp. A.C. REG. NUMBER 1,S �Q Class.I "I"Bly ACH"OAL-C BE THAT I HAVE READ TH15 APPLICATION G-- U C Power Apparatus& Large Appliances AGE STATE T..T THE ABOVE IS CORRECT AND �G.EG TO CG.P11 RGH—CES ARG STATE LAWS REGULATING Size&Type HP, KW, KVA,or KVAR ELECTRICAL WRING' w UP to i Incl. d /' I "EIEBYCCATIFITHATIROIG"Ll AIG.ETEIREQNoIGR z Over 1 to 10 Incl. 'C. AS REQUIRED COAL Over 10 to 501ncl. ESCRIBED RCSCALIFORNIA OR1THAT RERT Rom Over 50 to 100 Incl. PERmITEE Over lOO SIGNATURE Services DISTRICT NO. OC SSED B 0-200 Amp. Under 600 V ~c o 201 -1000 Amp. Under 600 V APPROVALS DATE IN CTOR'S Over 1000 Amp. or Over 600 V SIGNATURE TEMP. POWER POLE Temp. Power Pole& Appurtenances UNOERSLAB WORK Sign with One Branch Circuit 0,10 ROUGH CONDUIT f Additional Sign Branch Circuits ILLU (Other) WIRING F /� FIXTURES V P OWER AUTHORIZED PERM IT FEE (Sub-Totall UTILITY CO.NOTIFIED PLAN CHECKING FEE (One-Fourth Permit Fee) FINAL PERMIT ISSUING FEE S V " TOTALFEE -L NOTES PLAN CHECK VALIDATION CK, M.O. CASH PERMIT VALIDATION CK.- M.O. CASH 744SEP 12 2 U 13.50 € 7GA963-CE80C 3-69 C APPLICATION FOR ELECTRICAL PEROT '"COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING I4 BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEARESTCROSS ST. y� NO. EACH FEE RECEIPT. /7 $ $ OWNER MAIL ,� �Gfsc[ CA�7/1 FIRST 20 .20 ADDRESS LIGHT �)��)� TOTAL - SWITCH—d— OVER 20 ,10 CITY TEI.NO. L//2�G-g PLAN CHECK LIGHTING TOTAL FIRST 20 .20 APPLICANT cz FIXTURES / } III OVER 20 ,10 ADDRESS RANGE_DRYER_WTR. HTR. CITY TEL. NO. STA. COOK_DISP. F.A.U. CONTRACTOR SPACE HTR AIR CONO. ADDRESS Al CLOTHES WASH. DISHWASH. CITY _ TizNO. ' '*k. , FAN—OTHER 1.00 LICENSE Nit3 7 CLASS. MOTORS,TRANSFORMERS RATING IHEREBY ACKCONLFDGE THAT 1 HAVE READ THIS APPLICATION IND. HEATERS, ETC. HP. KW. KVA. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. D — 1 1.00 I HEREBY CERTIFY THATMPROPERLY REGISTERED ANO/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATEOF 1 — 10 3.00 CALIFORNIA OR THAT T AM THE LEGAL OWNER OF, AND INTEND TO 4 RESIDE IN. THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. O 10 - 50 5.00 U SIGNATURE SO - 100 10110 OF PERMITTEE/-e--A O h 100 - 500 15.00 DISTRICT No. GNo p E PROC E V W SIGN,GAS SIGN AND ONE CIRCUIT 3.00 Z N TUBE, OR Z MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES: SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 SERVICE OVER 600 VOLTS OR 200 AMP 5.00 TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTORS SIGNATURE TEMP. POWER POLE UNDERSLAB WORK ROUGH CONDUIT WIRING e PERMIT FEE. (SUB TOTAL) FIXTURES POWER AUTHORIZED I PLAN CHECK FEE (50% PERMIT FEES PERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED ' 1 A nLL� SUPPLEMENTARY PERMIT ISSUING FEE 1.00 A-1/ FINAL i Y . o/ / Y TOTAL FEE JOSEPH C. ROOHAN SUPERVISING ELECTRICAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION cK. M.O. CASH 2 2 6 3`-� OOT 1 6 2 0 2.6 0.C' SEE BACK OF APPLICATION FOR COMPLETE FEE cCHEDULE , I6A663-,E0061-68 APPLICAT16N FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT,OF.COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADORES' D - JOHN A. LAMBIE. COUNTY ENGINEER y� COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY c. NEAREST FOR APPLICANT TO FILL IN CROSS ST. NO. ACH FEE ). RECEPT,( S S OWNER LIG,T_f Q TOTAL FIRST 20 2-0 .20 aQ .ADDRESS � //�� Q SWITCHzj- �_J.L52 OVER 20 .10 Q CITY TEL. NO..2 0 PLAN CHECK LIGHTING TO'TnAL FIRST 20 .20 Q APPLICANT ♦ - FIXTURES OVER 20 .10 ADDRESS RANGE-/-DRYER—WTR.HTR.— CITY TEL. NO. STA.COO K-LOIS P. F.A.U.— CONTRAC,FOR SPACE HTRi.—AIR CONO. ADDRESS co &A M Ai .A CLOTHES•WASH.�DISHWASH.� CITY r EL. NO,Ac FAN-4-OTHER— 1 .00 LICENSE IJO. CLASS. `, MOTORS.TRANSFORMERS RATING IND. HEATERS, ETC. HP. KW. KVA. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION SIZE & TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL W IR ING. HEREBY CE PT IFY THAT AM PROPERLY REGISTERED AND/OP I - IO 3.00 LICENSED AS flD DY LOS ANGELES COUNTY AND STATE OF THATI CALIFORNIA OR THAT AM THE LEGAL OWNER OF, AND INTEND T. 0- 10 $O 5.001 RESIDE IN, THE ABOVE OESC.R IFED RESIDENTIAL PROPERTY. O 50 - 100 10.00 SIGNATURE + _ V OF PERMITTEE C - 100 - 500 15.00 DISTRICT NO. GFjQLIP Z E SSED BY 0 TUBE.GAS OR SIGN AND ONE CIRCUIT 3.00 0 1 a MARQUEE pp01T"IIAL CIRN ITS I.00 NOTES:. Z SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 21 DO SERVICE OVER 600 VOLTS OR 200 AMP S.00 TEMP SERVICE, POLE, & APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP. POWER POLE UNDE RSLAB WORK ROUGH CONDUIT WIRING PERMIT FEE ISUB TOTAL) .. l FIXTURES PLAN CHECK FEE (50: PERMIT FEE) POWER AUTHORIZED I PERMIT ISSUING FEE 2,00 111- Q UT I L I TY CO.NOTI F I ED SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL II TOTAL FEEJOSEPH C. ROOHAN SUPERVISING ELE L ENGINEER PLAN CHECK VALIDATION CK. M.ODATION; CASH PERMIT VALICK. M.O. CASH • L&O4 4 4.6'C" APR 26 2 D 1 7.60 "a {EE BACK OF\APPLICATION FOR COMPLETE FEE SCHEDULE ^ / Y WORKERS' COMPENSATION DECLARATION 16 to/Bt I hereby affirm that I have a certificate of consent to self CE-BpG APPLICATION mSLICpTION FOR ELECTRICAL ECTRICpL ®ER IW insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY 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 Certified copy is filed with the county building inspec- 18 2-Family, Sq. Ft. $ — $ LOCALITY tion department. Multi-family Sq. Ft. — "NEAREST Residential Swimming Pools - CROSS ST. Date Applicant OWNER OR FIRM NAME ei CERTIFICATE OF EXEMPTIONFROMWORKERS' Outlets: Re< Light_Sw. MAILADDRESS COMPENSATION INSURANCE First v. t (This section need not be completed if the work involved by Total NaAdditional CITY �� 0' Tel, fes? 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 an rson in ny manner sous to become subject to the Wo sono Laws. Lighting Fixtures First 20 - ADDRESS - Total Na. Additional CITY Tel. No. Date Applica Fixed Appliances Not Over 1 HP PERMIT NOTICETOT: If, after moking this Certificate of APPLICANT .TCS Exemption, you should become subject to the Workers' Range_ Heater—D.W. — 7 Compensation provisions-of the Labor Code, you must forth- Oven _ Dryer _ W.M.— ADDRESS �i. - with comply with such.provisions or this permit shall be Top — FAU —W.H. — deemed revoked. CI45;f�l �, - Tel. LICENSED'CONTRACTORS DECLARATION Hood _ Fan _Other— , M I hereby affirm that I am licensed under provisions of Chapter 9 Disp. Room Air Cond. REG. NUMBER LICENSE � � Class Z_`(3 (commencing with Section 7000) of Division 3 of the Business DISTRICT NO. PR 5 BY and Professions Code, and my license is in full force and effect. 'f Power Apparatus 8-Large Appliances y ��,.� Size Type HP, KW, Ind. or VAR' .� O License Number Z+Q Lic. Class ^ Up to 1 Incl. N FINAL / ,� _ Over 1 to 10 Incl. DATE / VALIDATION Q Contractor L Dote Over 10 to 5Qlncl. CCCJJJ _ V ❑ ,. _ _-_ FINAL ' _ _—_-___. 1 am exempt under Sec. Over 50 to 100 Inc.. BY ru B.BP.C. for this reason Over 100 N Services, Swbd., MCC 8 Punelboards Z Date: 0 _200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V ' El - Over 1000 Amp. or Over 600 V Exemption for Reg. Maint..Elect. •moi 1 .6 3, 1 A SINGLE FAMILY Temp. Power Pole 8 Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits Q to a 1'•4,5 O Law for the fallowing reason (Section 7031.5, Business and Professions Code); x • ••• 1 4,50 r I, as owner of the Misc. Conduits 8 Conductors property, will do the work and the D structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)— O �O 2—83 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 PERMIT FEE -(Sub-Total) -. (Sec. 3097, Civ. C.). PLAN CHECKING FEE _ Lender's Name PERMIT ISSUING FEE Lender's Address I certify that I have read this application and state that the TOTAL FEE Ales above information is correct. I agree to comply with all County - ordinances and.State laws re luting Electrical wining, and hereby ut rize repres at ��1 is County to enter upon - the o entione f 'Fspec n purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE _ s ^� n re of Permittee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1204250067 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: (LEGAL ID: FEES PAID BUILDING ADDRESS: ITR: 15159 IT: 13 5620 CAMBURY AV (FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( TEMP CA 917802601 (ASSESSOR INFORMATION NUMBER I INEAREST CROSS STREET: OLIVE 18588-014-016 1A1 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY, Cl G1 OUTLETS-LGT,SW,RECP 8.00 OUT 16.00 TENANT: IG2 LIGHTING FIXTURES 5.00 LGT 10.00 (ISSUED ON: PROCESSED BY: PLAN BY: IH2 RES GREG DIST LT 3HP 1.00 DIS 11.00 104/25/12 SR I _1113 RES DISHWASHR LT 3HP 1.00 DIS 11.00 OWNER: TEL. NO: IH5 RES WASH MACH LT 3HP 1.00 WAS 11.00 1:F-SA =DATE ` FINAL Y: CODE: (TEMPLE CITY CHURCH OF THE NAZARENE - TOTAL FEES 86.80 f1 1 15620 CAMEURY AV SA L ITEMP 917802601 1 IDESCRIPTION OF WORK 1 (ELECTRICAL FOR KITCHEN AND BATHROOM REMODEL TAPPET CANT: TEL. NO: 1KO, DAVID (626) 672-8768- 1 ISPECIAL CONDITIONS: I I 111 1111 CONTRACTOR: TEL. N0: (APPROVALS DATE INSPECTOR SIGNATURE I,IING LING KO (626) 622-8768- 1 15559 EARLY ST LIC. NOiTEMPORARY POWER POLE AN USGABRIEL, CA 91776 671176-B * UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: IUFER GROUND LIC. NO: - - - IROUGH CONDUIT -- - - --- - ROUGH WIRING 1 MAIN WATER LINE PLASTIC YIN METAL YIN 1UTILITY COMPANY NOTIFIED I 1111 1111 1111 1111 I 111 II I 1111 11111 I 11111 I I 1111 1 I 11 I I I * ADDITIONAL DATA ON FILE I III I I I REPORT ID: DPR265 ROUTE TO: BS0508 I I 11 I I I