HomeMy Public PortalAbout5728 CAMELLIA AVE_Electrical__ COUNTY OF LOS AROELEI APPLICATION FOR PERJM
Deparhm'F � ELECTRIC 1
DIVISION OF BUILDING ac SAFL�Y
WILLIAM J. FOX, Oausb Envinow
FOR ASCANT TO FILL I DIRTRICT ROUP ZONE P[RMrr NO.
ELECTRICIAN
MM;WY READY FOR DATE ISSUED
ADDR FIRST INsP[OTION
CITY TIL No.
COU LICKKXIIJ NEL EXPIRES ■UILDING y
PERBM FEES ADDRQ !J
FQ
NUMBER U *^
CH LrAI STY C
LIGHT OUTLETS NEAREST
R[O[PTACLES
WALL SWITCH= OWNER
TOTAL OUTLETS 1513 MAIL
[LEO. RANSEI SS ADDR
[LED. HEATLRS Sib CITY TLL. MC.
FIXTUR[s 6
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS
MIEO. APPLICATIONAND STATE THAT THE ASOV[ 18 CORRECT
NUMBER OF LIGHT OIROUITE AND AGREE TC COMPLY WITH ALL COUNTY ORDINANCES
NUMS[R OF R[D[PTACL[ CIRCUITS AND STATIK LAWS REGULATING EL[OTRIOAL WIRIN0.
MOTORS 1 CERTIFY THAT I POAIStss THE ASOVE VALID LOs
Mums" HDRS[POWFR FEE ANGELEN COUNTY UO[NM OR 1 AM THE LEGAL OWNER
NEW MVE). HP ev[r I IME). LAMM OF THE 1![SIDENTIAL PROF[ RISED ASOVE.
ya • L[M as EIONATlJltK r-
ya >i BO FERN
2 s 1.00 INSPECTION RECORD
6 is 1.50
1s so 2.50
60 IIVID 5.00
ZOO 1600 1C.O0 J
BOO 1000 111.00
Z
OVER IOM so.00 0
M.O. NL`T/FREQ,NET/FRCHANGER-HP
WELD[RSt AO-K`/A Q
GENERATOR! - KW
TRANSFORMERS - KVA
TEMP. MCTORG (76 OF E)III1111.)
MOVED MOTORS X76 or DRISJ
BIONS
NO. NO.TRANS. APPROV
AM
NO. N D. LAJ4 FV
FOR EACH PERMITS D INSP[OT171l7 NAME
WIRING 01.00 O CONDUIT
FiXTi1R[S 151.00 WIRIN0 d
• F IX�I l RLS
[
POWER
TOTAL FEE 15 / y UTIuTY 00.NOTIFIED
( FINAL ' /b
TUM DM*6A 4-62
DD 5-A 12-43 25M APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES ELECTRIC
WM. J. FOX CHIEF ENGINEER
Q NAME DISTRICT NO. GROUP ZONE PERMIT NO.
ADDRESS
RECEIVED BY READY FOR DATE ISSUED
W CITY TEL.NO. FIRST INSPECTION
-1 COUNTY
W CERT.NO. EXPIRES
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
JOB
DESCRIPTION OF WORK ADDRESS
NUMBER OF OUTLETS ON CIRCUITS LOCALITY _
LOCATION BY ROOMS _ -
NEAREST
LIGHT OUTLETS I SW.11 UGS IFIXT CROSS ST.
CIRCUIT A B C D E F G I H K _NAME
Z MAIL
3 ADDRESS
O
CITY TEL.NO.
1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE OF QUALIFICATION..
ELECTRICIAN.
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE
OWNER.
CORRECTIONS
J
Z
R
O
TOTAL
NO. OF OUTLETS ,j $ APPROVALS
NO. OF FIXTURES $ DATE INSPECTOR'S NAME
NO. OF MOTORS H.P. $ CONDUIT
NO. OF SIGNS TRANS. $ WIRING
NO. OF RANGES OR HEATERS $ FIXTURES
MISCELLANEOUS $ POWER
PERMIT FEE $ UTILITY CO.NOTIFIED
TOTAL FEE s FINAL
0
Vffirm that
COMPENSATION DECLARATION 2o-oolvDPW 3 e7 APPLICATION FOR ELECTRiCAE PERMIT
I hereby affirm that I have a cert4ficate of consent to self CE�
Insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS
or a certified copy thereof (Sec. 3900, Lab. C.)
Polity No Company FOR APPIJUNT TO FILLL LN JOB iJ I
❑Certified copy Is hereby famished. New Residential Bldgs. & Pools FSI NO. FEE ADDRESS i
❑Certlfled copy is filed-with the county building inspec- 1 &2-FamIly, Sq. Ft. $ — $ LOCALITY
tion deportment. Multi-family Sq. Ft. — NEAREST
CROSS ST.
Residential Swimming Pools
Date Applicant IRM NAME
CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL
COMFirst PENSATION INSURANCE Outlets: RsLlght Sw.�_ ADDRESS r
f
(This section need not b.complota+d if tie work Imrohr.d by Total No. Additional
CITY onal Tel. No.
► '
the,pe+rmM Is for ore hundred dollars ($100)or lass.) PLAN dHEd
I certify that In the performance of the work for which this APPUCAN.
permit Is Issued, I shall not employ any Person In any manner Lighting Fixtures First 20 ADDRESS
so as to become subject to the Workers Compensation Laws.
Total No. Additional CITY Tel. No.
Date Applicant Fixed Appliances Not Over 1 HP PERMIT
NOTICE TO APPLICANT: If, after making this Certificate of
Exemption, you should become subject to the Workers' Range— Heater—D.W. — APPLICATKJN
Compensation provisions of the Labor Code, you must forth- Oven — Dryer —W.M.— ADDRESS
with comply with such provisloni or this permit shall be Top — FAU —W.H. —
deemed revoked. Hood — CITY Tel. No.
LICENSED CONTRACTORS DECLARATION Other— LKB14 f ORDlsp. _ RRoom Air Cond. REG NUMBER Chas.
I hereby affirm that I am licensed under prwlalons of Chapter 9
(commenting with Section 7000)of Division 3 of the Business power Apparatus& Large Appliances DISTRICT NO. BY d
and Profeuions Code,and my Ilcerne is In full force and effect.
Size 8 Type HP, KW, KVA, or KVAR O
License Number Lit. Class Up to 1 Incl. FINAL U
Over 1 to 10 Incl. DAT VALIDATION CE
Contractor fkre Over 1Q to 50 Incl. FINAL ~
❑ I am exempt under Sec. Over 50 to 100 Inc. BY W
B.BP.C. for this reason Over 100 n
Services, Swbd-, MCC& Ponelboards , Z
Date: Z
0-200 Amp. Under 600 V
Signature 201 - 1000 Amp. Under 600 V
F-1Over 1000 Amp. or Over 600 V a
Exemption for Req. Malnt. Elect. .�f.t
SINGLE FAMILY 7-7
Temp. Power Pole &Appurtenances 3}I r •L
HOME OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's Ucense Sign with One Branch Circuit 1 ITEs
Low for the following reason (Sectlon 7031.5, Business and Additional Sign Branch Clrcults
Professions Code): . . TENIAL =s
Misc. Conduits&Conductors CASH
I, as owner of the property, will do the work and the Other structure Is not intended or offered for sale(Section IOMerSee Complete( Pets Fee Schedule�_ 1313Buslneu and Professions Code).
CONSTRUCTION LENDING AGENCY
I hereby affirm that there Is a construction lending agency for �'1 �13� i
the performance of the work for whlcfr this permit Is Issued PERMIT FEE (Sub-Total)
(Sec. 3097, Ov. C.). 57
PLAN CHECKING FEE 1934 1 AM ¢'
Lenders Name
PERMLT ISSUING FSE
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
�hobove-m�fled property for Inspectlon purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
r
AfgrKftre of Perml Date ms
_ — COUNTY OF LOB ANGII.EB TEMPLE CITY f 0508 rLZ=ICAL PERMIT
DEPARTMENT OF PUBLIC AORIB 9701 LAB TURAB EL 050E 0609270003
BU=ING AND SKYWY / LAND DIVE MUTT TEMPLM CITY CA 91780
PHONEt (626) 285-0488 RZTi
LNGAL IDi FEES PAID BUILDING ADn—ASi
TRs 6561 LTi 548 5728 CAKELLIA AV
PRE DESCkIPTION. QU3XT t UOK: AMOUNT. TEMP CA 917602501
ASSESSOR INPORMITIOY SER: XIU R38T CROSS STR=i
8567-022-022 Al PERMIT ISSUANCE PEE 27.75 THOYMB PAGE. 597 OR_IDi A3 LOCALITYs TRMPLE CITY, C
G1 OLTPLYPB-L?P,BA,RNCP 7.00 OUT 13.65
TENT. G2 LIGLHTING FIXTURES 6.00 LM 11.70 ISSUED OR: PROCYBBED BYt PLAY BY: aPIRYB OYt
B:7 REB YXEAIIST FAYB 1.00 II 10.95 09/27/06 ox 03/26/07
TOTAL FIEB 64.05
ov3m, TEL. NO1 DATE )I7LAL BS: CODE.
ffiKAIWSON, DAVID (626) 309-1301-
5728 CAMELLIA AV
TEMP 917802501 DCSC3LIPTIOM OF 11'ORL
XIdt=CIL FOR BATHROCIN REMODEL
APPLICANTa TEL. NO:
DWE (562) 945-2083-
0407 XNRAXADA SPECIAL CO®ITIONS:
WHITTIER CA 90605
COYTRACTORi TIL. NO APPROVALS DATE IYSP*C OR 8I®TQRA
D i T GM3n9 AL CONTRACTING (562) 945-2083-
8407 XVEA1&DA LIC. MO TEMPORARY POWER POLE
WHITTIER, CA 90605 423766 B +
UNDXRGROIDID CONDUIT
ARCHITECT OR ENGIYEMRi TML. NOt UFR GROPED
LIC. NO, ROUGH CA®UIR
ROUGH AIRING
tlC,4 Co 1
MAIM MATER LINY
PLXS IC Y/M MRTAI, Y/N
UTILITY COIPANY NOTIFIED
+ ADDITIOYAL DAT1 ON FILE
REPORT IDi DPR765 ROUTS TO: BS0508
h
r COUNTY OF LOB ANGNLYB TZKPLH CITY - # 0508 RId9=ICAL PERMIT
D=PARTKINT OF PUBLIC WORIB 9701 LAB TUYAB NL 0508 0701040035
BUILD DIG AND BAlYTY / LARD DYVYLOPMYNT TYMPLA CITY CA 91780
PHONE: (676) 185-0488 IIT
LEGAL IDi FNNB P]LID BUILDING ADDR=88i
TRi 6561 LTA 548 5718 CANNA AV
P=R DNBCYIPT'IONi QUANTITY: DOK. AMOUNT: TR" CA 917807501
ASBRBBOR INFORMATION NUMBER: NEAREST CROSS BTR=: LAB TOYAH
8587-011-077 Al PERMIT ISSUANCY FXR 77.75 TE011W PAGRs 597 GBIID: A3 LOCILITT: TDD7LE CITY, C
67 LIGETI19G FIX711R98 1.00 LGfT 1.95
TENANT _ LA 100 AMP PAR'NLB, MCC 1.00 PAN 38.85 ISSURD ONi PROCNBBND BT. PLAN BTI BXPIRNB Oixi
TOTAL 7=3L8 68.55 01/04/07 JL 07/03/07
OMNNR: TEL. NO: FIXAL FIXAT BT: CODR�
HBIN FUH-LIY (676) 864-8653-
5778 C7MILLIA AV _
TXMP 917807501 DkSCRIPTION OF WOR=
YLY=CAL PANEL UPGRADI 100 AMP L 1 LIGET
APPLICANT: TEL. NO:
CAL PROPNBBIOIELL lljt 'QTCAL INC. .(676) 915-1768-
71160 LTCCKSNG ST. SPICIAL CONDITIOWS.
WALNUT, CA 917E9
CONTRACTOR: TEL. NOS APPROVALS DATE IYBPS=R SI®SURE
CAL PROPRBBIONAL pT•BqTRTCAL NYC. (676) 915-1768-
71160 LYCOMIYG STRICT LIC. YO T314PORART POWER POLY
WALNUT, 0 91709 675019010
UNDNRQROUND COYDUIT
ARCHITzer OR YNGIYYBI TEL. NO UFYR QROUSD
LIC. 1110: ROUGH CONDUIT
. ROUIE WIRING
MASH WATYR LINL
PLASTIC T/N METAL T/N
UTILITY COMPANY NOTIFIED
1
REPORT ID: DPR.265 R.OUTR TO, 880508