HomeMy Public PortalAbout5032 CAMELLIA AVE_Electrical__ APPLICATION FOR ELECTRICAL PERMIT
BUILDING D SAFETY DI IQN
FOR APPLICANT TO RILL IN JOB
New Residential Bldgs.&Pools
'Z-'2
EACH NO. FEE ADDRESS
1 &2 Finally Sq. Ft $ — $ LOCALITY
Multi-family Sq. Ft — NEAREST
Residential Swimming Pools CROSS ST.14
OWNER OA
FIRM NAME
Outlet.: Light,Switch&Receptacle O MAIL
First 20 ADDRESS
Additional CITY Tel. No.
PLAN CHECK
Lighting Fixtures APPLICANT
First 20 ADDRESS
Additional
CITY Tel. No.
PERIT
Fixed Appliances Not Over 1 HP APPLICANT
Ranger Heater_ D.W. ADDRESS
Oven Dryer W.M.
Top FAU W.H. CITY Tel. No.
Hood Fen LICENSEOR Clete CD
Disp. A.C.
I H.R.1Y ACKIOML.D.. THAT I HAV. R.AD THIS APPLICATION CD
_
AND ■TAT. THAT TH. A101K IS CORR.CT AND A.R.. TO COMPLY V
Power Apl5eratus& Large Appliances WITH ALL COUNTY ORD INAX C.
AND ■TAT. LAW R.GULATIIG LJ
Size&Type HP, KW, KVA,or KVAR .L.CTRICAL WIRING. d
Up to 1 Incl. I H.R.1Y C.RTIPY THAT 1 AM ►ROP.RLY R.GIIIT.R.D AND/OR
Over 1 to 10 Incl. UC.N1.0 A• R10 UIR.D ■Y LO■ ANOW-8 COUNT`/ AID /TAT. OF
CAU ..NIA OR THAT 1 AM TH. L.GAL OWNKR OF TH. A10V.
Over 10 to 50 Incl. D..CR11.D R.11D.NTIAL PROP.RTY.
Over 10 to 100 Incl. SIGNATURE /����
Over 100 EIONATU RE
sees
Services DISTRICT O. ED BY
0-200 Amp. Under 600 V
201 -1000 Amp. Under 600 V APPROVALS DATEIN
Over 1000 Amp.or Over 600 V SI NATURE
TEMP. POWER POLE
Temp. POwer Pole&Appurtenances UNDERSLAB WORK
Slgn with One Brandi Circuit ROUGH CONDUIT
Additional Sign Branch Circuits
(Other) WIRING
FIXTURES
POWER AUTHORIZED
PERMIT FEE (Sub-Total) UTILITY CO.NOTIFIED
PLAN CHECKING FEE (One-Fourth Permit Fee) FINAL
PERMIT ISSUING FEE
NOTES
ITOTALFEE
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIONCK. M.O. CASH
l -
253 NOV 12 6.10 &
L 0 `
&zt
7LAee15cEeoe „i�Q APPLICATION FO AL PERAT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
COLEMAN W. JENKI u Nr u LOCALITY
NEAREST
FOR APPLICANT TO FILL-IN CROSS ST.
04TLETS Fe
QQ_ OWNER
RECEPT. s MAIL
FIRS �O
LIGHT ADDRESS
CITY �✓ TEL. N0.
T Z
SWITCH OVER 20 Ip
PLAN CHECK
l FIRST lkv APPLICANT
LIGHTING Il TOTAL
OVER 26ADDRESS
FIXTURES I0
APPLIANCES
CITY TEL. NO.
RANGE DRYER_WTR. HTR. PERMITAPPLICANT dr
STA. COOK DISP.r_F.A.U. ADDRESS
SPACE HTR, AIR GOND. CITY EL.
CLOTHES WASH.'_/—DISHWASH. LICENSE N0. CLASS.
FAN OTHER ,.00 @ IHEREBY ACKNOWLEDGE THAT I HAV[ READ THIS APPLICATION
AND STAT[ THAT THE ABOVE Il CORRECT AND AGREE TO COMPLY
MOTORS, TRAMSFORMERS PLATING WITH ALL COUNTY o'I1DINANCES AND STAT[ LAWS REGULATING
IND. HEATERS, ETC. HP. KW. KVA. E.LE CTRICAL WIRING.
SIZE, TYhI, OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 — I I m LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA ON THAT I AM TH[ LEGAL OW ER OF, AND INTEND TO
1 — 1G app RESIDE IN, TH[ ABOVB D IEED SI [RTY. 0
SIGNATURE V
10 — BO 6.00 OF PERMITTE oC
60 — 100 10.00 0
D L/TRICT NO. 0.A1f PRO ED BY
100 - 600 15.00 -5 p /
o.
8IGN, GAS SIGN AND ONE CIRCUIT 6A0 NOTES: Z
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS ,•00
SERVICENOT OVER 600VOLTS OR200AMP, 3.00
APPROVALS DAT[ DISPEL 'S 4NIW7UI!
SERVICE OVER 600 VOLTS OR 200 AMP 10.00
TEMP.POWER POLE
TEMP SERVICE,POLE, IN APPURTENANCES 6.00
UNDERSLAB WORK
TEMP LIGHT OR RECEPT. SYSTEM 3.00
ROUGH CONDIUT
WIRING
FIXTUR
POWER AUTHORS ED
PERMIT FEE (SUB TOTAL)
UTILITY CO. NOTIFIED LU
PLAN CHECK FEE
FINAL j
PERMIT ISSUING FEE 3no
JOSEPH C. AN .
TOTAL FEE Q SUPERVISING E7Elp CAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATI M.o. CA IH
4611. M 2 2D
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
7&, -CE.°° ,,,7D APPLICATION FOR ELECTRICA PERMIT IJ
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
13UILDING AND SAFETY DIVISION ADDRESS JAII
COLEMAN W. JENKINS u N or u LOCALITY
NEAREST
FOR APPLICANT TO FILL Ito CROSS ST.
OUTLETS NO. EACHI FIVE
OWNER
RECEPT. S_ MAIL �
LIGHT TOTAL
FIRST 20 ADDRESS
CITY TEL. N
SWITCH OVER 20 .10 '
PLAN ECK
FIRST 20 25APPLICANT
LIGHTING Il TOTAL
OVER 20 ADDRESS
FIXTURES .10
CITY TEL. N0.
APPLIANCES
PERMIT
RANGE ` DRYER_WTR. HTR. APPLICANT
STA. COOK DISP. F.A.U. ADDRESS
SPACE HTR. AIR COND. CITY TEL. NO
CLOTHES WASH. /~DISHWASH. LICENSE NO. CLASS
FAN OTHER 1.00 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AN STATE THAT THE ABOVE 13 CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STAT[ LAWS REGULATING
IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING.
SIZE k TYPE OVER TO
I HEREBY CERTIFY THAT I AM PR OPER LY REGISTERED AND/OR
0 - 1 IAO LICENSED Al REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
1 - 10 3.0101
OO
RESIDE IN, THE ABOVE 0[S CR ID D R[fl NTnIAL PROPERTY.
SIGNATURE / qf�� ) O
10 - 50 6.00 OF PERMITTEE r 1, 1 ,/ l �
50 - 100 IOAO 0
DISTRI CT HO ASS iONE Y 0
100 - 500 Ieoo
oe ( CIL
SIGN, GAS SIGN AND ONE CIRCUIT 5.00 NOTES: Z
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS IAO
SERVI CENOTOVER 600 VOLTS OR 200 AMP DAO OD
APPROVALS DATE U7SP[CTOR'1 SIGNATURE
SERVICE OVER 600 VOLTS OR20D MP t0A0
TEMP.POWER POLE
TEMPSERVICE,POLE, &APPURTENANCES 6.00
UNDERSLAB WORK
TEMP LIGHT OR RECEPT. SYSTEM 3.00
ROUGH CONDIUT
WIRING
FIXTUR y
POWER AUTHORIZED- ! C�
PERMIT FEE (SUB TOTAL)
UTILITY CO. NOTIFIED 1
PLAN CHECK FEE /
3 Q FINAL `
PERMIT ISSUING FEE DAO JOSEPH C RO HAN
TOTAL FEE OO SUPERVISINpg ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDAT CK. M.O. CASH
LAGo 4 6 9 0-2 2 D 6.0 0-
SEE SACK OF APPLICATION FOR COMPLETE SCHEDULE
7GA663 SA 25M SETS 7-48 APPLICATION FOR PERMIT
t DEPARTMENT OF BUILDING AND SAFE'L'Y ELECTRIC �
COUNTY OF LOS ANGELES
WM. J. FOX. CHIEF ENGINEER
Q NAME DISTRICT NO. GROUP I ZONE PERMIT NO.
U ADDRESS
1- RECEIVED BY READY FOR DATE ISSUED
UU CITY TEL.NO. FIRST INSPECTION
J COUNTY
W LICENSE NO. EXPIRES
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
JOS
DESCRIPTION OF WORK ADDRESS v
NUMBER OF OUTLETS ON CIRCUITS LOCALITY
LOCATION BY ROOMS
NEAREST
LIGHT OUTLETS JSW. PLUGS FIXT CROSS ST.
CIRCUIT A B C D E F G H NAME
Z MAIL
3 ADDRESS
O
CITY TEL.NO.
1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CEIFI�TE OF QUAL 151CA N.. -
ll`�yy,, �((TT ffffff
ELECTRICIAN.
1 AM THE"GAL OWNER OF THE PROPERTY DESCRIBED
ABOVE
OWNER.
CORRECTIONS
a
z
0
0
TOTAL
NO. OF OUTLETS $ APPROVALS
NO. OF FIXTURES F 10 $ DATE INSPECTOR'S NAME
NO. OF MOTORS H.P. $ CONDUIT
NO. OF SIGNS TRANS. $ WIRING
NO. OF RKNGFS OR HEATERS $ FIXTURES
EPIERMIrT
LAN S $ POWER
FEE ffi UTILITY CO.NOTIFIED
FEE FINAL
COUNTY OF LOS ANGELES TEMPLE CITY 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TURAS ` EL D508 9704030003
BUILDING AND SAFETY'/' LAND DEVELOPMENT TEMPLE CITY CA
PRONE: (818) 205-0488 EXT:
LEGAL ID: FEES PAID BUILDING
TR: 1467 LT: 75 5032 CAMELLIA AV:
6-
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803853
ASSESSOR IN NEAREST CROSS STREET:
8589-017-022 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID; A4 LOCALITY: TEMPLE CITY
E1 TEMP SERV POWER POLE 1.00 TMP 43.50
TOTAL FEES 71.25ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES .,
04/03/97 TC 04/03/98OWNER- TEL. NO: FIRAL DATE. BY CODE:
SKIMMER WILLIAM R;LILLIAN A -
5032 CAMELLIA AV
TEMP 917803853 DESCRIPTION OF WORK
TEMPORARY POWER POLE FOR CONSTRUCTION SITE
APPLICANT: TEL. NO-
PERFORMANCE POWER SYSTEMS (9D9) 923-6133-
SPECIXE. CONDITIONS: .
CONTRACTOR- TEL. NO: APPROVALS DATE INSPECTOR, SIGNATURE
PERFORMANCE POWER STYSTEMS (909) 923-6133- -
1326 E FRANCIS LIC. NO '- TEN RA POWER POLE
ONTARIO 91761 693087CIO =
s`•
ARMTECT OR ENGINEER: TEL. NO: UFER GROUND
LIC.- NO: r, —
MAIN WATER
_ PLASTIC Y/N - METAL Y/N
UTILLTY
1
REPORT ID: DPR265 ROUTE TO: BS0508