HomeMy Public PortalAbout5733 CAMELLIA AVE_Electrical__ 4 COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Departmentof County Engines
'ELECTRIC 1
DNISION OFFBIIII.I)INDING & SAFETY '
WILLIAM J. FOX, Wuaty Enalmou
FOR APPLICANT TO FILL IN DISTRICIT NO. OR13UP I ZONE PERMIT NO.
ELECTRICIAN
[ SY READY FAR DATE ISU[D
ADDRESS 4FIRST INSPLUTION
TILL. 1
CITY TL. NO. -�"� I S,
DO I [NSIt No. IRIe ■UILDINa
EEA
PE 3M FS %DRiss
NUM E
R AD H FEE
LJSCAL MY
LIGHT OU-rL[TS M[��ir L I J ec G?4
REDIPTAOL37
WALL SWITOHEN el GWNER-ea15
F�
TOTAL OUTL[T7! 00 MAIL pp
ELIC. RANGED 2A ADDR[ss ICI J NO Cj}M lE L-L I A
[LEC. HEATERS 916 GIT' TL- Nd
FIXTURE7t 6 �+
1 HERESY AOKNOWLIDO[ THAT 1 HAV[ READ THIS
APPLICATION AND STAT[ THAT THE ASOVI 10 CCRRIOT
NUMBER OF LIGHT CIROUITE AND ADRKK TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE OIRCUITI AND STATE LAWS RIDULATING <L[OTRIOAL WIRINS.
MOTDRH 1 O[RTIFY THAT 1 rOs&jCBs TH[ ABOVE VALID LO■
Numman HDRSIPOW[nFE[ ANSEL[1 COUNTY LICENSE. OR TG
I A64 HK LEGAL OWNER
NEW Mw. HP 13V[11 IND. CMN QF T141E RKWD[NTI P ESCRIB ABOVE.
yx >Z .50 PKRMrTIT -
9 S 1.00 INSPECTION RF=RD
■ is 1.60
1 1s 50 9.513
so 2,00 5.00 a'
950 Sao 10.00 J
50C 1000 15.00 Q
OVER IMOD 2 0.00 O
M.D. KKT/F'RM4, CHANGER-Hr
WELD[RBI AC- VA I+PL« i�0.� '� •� O
K
GCN[RATORE - KW
' TRANEFORM[RB - KVA
` TEMP. MOTOR■ 75 Dr DRIB.)
MOVED MOTOR■ 176 OF DRI■
I
SIGNS
NO. NO.TRANS. APPROVALS
NAM[
FOR EACH P[RMITI DA INSP[OTDR'S
WIRING 41.00 CONDUIT _
1 FIXTURES 7.00 WIRIN
U"LEMKKTAKY -Sq FIXTUR3b
POWER
TOTAL FEK UTILITY CO.NOTIFttD -7
FINAL
kk TEAU3 DBS$ 5A 443
COUNTYOF LOS ANGELES - APPLICATION FOO PF.RMT
D>PI�'� OF c°� >Na>� ELECTRIC 1
DIVISION OF BUILDING 6 SAFETY
WILLIAM 1. FO=. COUNT! mmuu H
FOR APPLICANT TO FILL IN D �10. GROUP ZONE I•ERMJT NO.
ELECTRICIAN L— —Z:: �—I Z
716,5f
ADDRISS R ST INS FOR D m r FIFtlT li�F[CT10N
CITY TIL NO.
c;OUKTY UggKox NO. SUM.DINGPERM -3,3ME L L/ 4FEWDRE"
NUMIEIR wymi FE[ M P 1 T
LIGHT OUTLKr8 "AR"T
R[CETTACL[>i go"VT
WALL SWITCHES OWN /J C/v D G
TOTAL OUTL[TB 5c
PAIL
[LEC. RANGES 15 ADDREW
"C. HEATERS 15
rY TIKLI NO
F Q[TU RES e
1 HEREBY ACKNOWLEDGE THAT I HAV[ READ THIS
APPLICATION AND STATE THAT THE ADOVE IS CORRECT
NUMS[R OF LIGHT CIRCUIl7
AND AGREE TO COMPLY WITH ALL COUNTY ORDINAN
NUMBER OFRC9931TAC-LJK OftClJrrf AND STATE LAWS REGULATING ELECTRICAL WIRING.
` MOTORS 1 CERTIFY THAT I POCCISS THE AIOV[ VALID LOS
NUIOJ31 HORSEPOWER FEE ANGELES COUNTY LICEMS[, OR 1 AM THE LEGAL OWNER
Naw Mw. HP oYvt I INC. uoa OF THE RESIDENTIAL FVLCMERTY.13CAEOVJ1.
•LCss 25
- SIGNATURE OF
va ! .50 PERM
1 S 1.00 --1IASP=ON D
RECO
5
Is 1.50 � �
111 50 P.60 2
SO 200 5.00
200 500 10.00
500 1000 15.00 Q
Z
OVER 1000 20.00 3
M.G. GET/FREQ. CHANGER-HP IC
O
WK D[Rfi AC-KVA
GENERATOR➢ -KW
TRANSFORMERS-KVA
TEMP. MOTORS 75of olua.
MOVED/M RS 715oil or a
MISC.
IGNS
No. NO. TRANS. APPROVALS
N
DATE INSPECTOR'S NAME
FOR EACH PERMIT
WIRING q 1 O0 CONDUIT
FIXTUR[8 $1.00 WIRING
• P ENTARY tso FIXTURES
POWER
TOTAL FEE • UTILITY CO. NOTIFIED
76A 643 13110111 aA. A-N&
76Ae63"sot P& 'APPLICATI• FOR EL [CAL PERMIT
COUNTY OF LOS ANG8Z J WILDING AND SAFETY
POR APPir_ TO FILL W }QB ir'•Ar� tl '
New Resldentlal Bldgs.$Pools EACH NO. N
FEE /
1 &2-family,Sq. Ft. L — LOCALITY
Multi-family So. Ft..�— r ��U K
Residential Swimming PoolsOWNE]R OR1
NAW
Outlets.Rv _Light_5w. T_ IL
First 20 DDRE55
Total No. Additional CFYCC}H� CC el. No.
NICAN��TK
Lighting Fixtures First 2Q ADDRESS
fatal No, Additional
CiT1' Tel. No.
Fixed Appl lances Not Over 1 HP.
RagPPL1CANfge—Heater—D.W._
Over1_Dryer_W.M.— I ADDRESS 15Ve
Top —FAU _W.H., C Tel. No� 'S
Hood_Fon —Other LICENSE OR
Disp.—Room Air Cond. REG.NUMBER a�� Claas-C`
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPDCA-
Powar Apparatus S Large Appltarc8s TION -AT THE ppAEE TO
TD STAq T1
WITH ALL COUNTY ORDEI INA NGS AND STATWt1EC7 AND EAWSSize Type HP, KW, KVA,or 1CVgR REGLA.ATING E3-JECTRIC,L WIRING.
Up to T Ind. I HEREBY CERTIFY THAT I AMPRCIPERLY RrGISTEREDAND/{qR
Over 1 to I� Irxi. WCENSED AS REMIRED BY LOS ANGELES COLJNT AND STATE OF
Over 10 to 50 Incl- CALIFQRN T IAM THE ER OF THE WVE
DESCRIB RSID PROPERTY.
Ovar 50to 100 Inc.
Over 100 ?6WEE
SIGNATURE
Sorvices TRICT NO. DBY
0-200 Amp.Under 400 V U p
201-100d-Arpp. Under 600 V D
Over 1000 Amp.or&ver 600 V
Temp. Power Role&Appurtenances Wry 7�
Sign with One Branch Circuit
Addltlonbl Sign Branch Glrcuits INSP
Misr,CQndv1ts&Conductors INFOW" ION
Other Co plate Fee Sch ON AWE ;E.5 5 1.3 A
EiC ILSIDE # 000002
- 2 0 f 0) 6100
PERMIT FEE iSub-Totall o;0 0 1 &006
PLAN CHECKING FEE (Oh e-Fourth Permit Feel
PERMIT ISSUING FEE
TOTAL FES >
INSPECTION FINALED,
date: ����T / By �-
WORKER'S COMPENSATION DECLARATION 2MO19 DPW(12.131) APPLICATION FOR ELECTRICAL PERMIT
I hergby aftLrm that I have a certificate of consent to Sall Insure,
or"a certificate of Worker's Compensation Insuranoe, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV.
copy thereof(Seo. 3800 Lab.C.)
Policy No. Company FOR APPUCAW fro P111 DI uo0 3�
Awe
❑ NO. EACH FEE LOCALFFY
Certtfled copy Is hereby fumiehed. N
1 S 2 Ferrilfy,3q.R 1�
Certified copy Is flied with the county building Inspection � i , i NEAREST
depart—t. Multi--fa my Sq.Ft cocas ST. Lt LJ
Data Applicant Reeldw,tiaal Swlmminp Pooh PraE O P OQ
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Roo.—Light Sw. �N E Q� Z
COMPENSATION INSURANCE Fl-rut
20 MA
(This section need not be completed H the work Involved by the Appq�g 472 �v Or
permit Is for one hundred dollars(9100)or less.) Total No. Additional
I certify that In the performance of the work for which this permit CITY Teo Ho
Is Issued, I shall not employ any person In any manner so as to PLAN CHECK
become subject to the Workers'Compensation Laws. U4htLng Fixtures First 20 APPLICANT
Total No. Additional ADDRESS
Date Appllcant RESIDENTIAL APPLIANCES NOT OVER 3 HP.
NOTICE TO APPLICANT: If, after making this Certificate of GrTy T■l-Ha
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
provisions or this permit shall be deemed revoked. Power Apparatus✓4 Large Appliances
APPLICANT
LICENSED CONTRACTORS DECLARATION Slzs S Type HP,KW,KVA,or KVAR ADDRESS
I hereby affirm that I am licensed under provisions of Chapter 8 Over 3 to 10 Ind.
(commencing with Section 7000) of Division 3 of the Business and CITY Tet Na
Profession*Code, and my license Is In full force and effect Over 10 to 60 Ind. LYCFlNBE OR Class. d
Over 60 to 100 Ind. REQ.NUMBER
Over 100 Df8TRICT NO. BY (�
License Number Llo.Close
Servloee,Swbd.,MCC S PenNboards
Contra" Date 0-399 Amp.Under 600 V FAQ
❑ 1 am exempt under Sec. 400-1000 Amp.Under 600 V ~ G VALIDATKON
Over 1000 Amp.or Over 800 V _ d
B.SP.C.for this reason BRANCH CIRCUIT FEES BY (1)
Date: 16A,or 20A, 120V,Ughtfn9 or ReoepL
Z
1 To 10 Branch Clrcufts
81gnawre 11 To 40 Branch CtrcuGs
41 I
ElExemption for Reg.Malrrt Elect. 1SA,20A,206V To V7V More ChaAa ACCT
SINGLE FAMILY Temp,Paver Pcle 8 ■i
HOME OWNER BUILDER DECLARATION glgn with One Branch C#routt zV 7■
I hereby affirm that I am exempt from the Contractor's Ucenas Law
for the following reason (Section 7031.6, Business and Professions Additional Sign Branch Circuits iTEMS
I
Coda): 1,
ITEMS
k7
TOT& 209 -25
C'
I, as owner of the property,will do the work anon
d the structure Miao.Conduits d Conductors TOT& 209 —25
Is not Intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) , NECK M9.219
and Professions Code).
.00
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. 3087, PERMIT FEE (Sub-Total
Cly. C.) 000 fyyy�—"1 yryyi 711v7/1.8/96
PLAN CHECKING FEE 76 1 PM 5;728
Lenders Name
PEAMIf ISSUING FEE �
Lenders Address /j q
I oertffy that I have read this appllcatfon and under penalty of purJury state TOTAL FEE t/
Cnai the above Information Is oorreoL I agree to comply with all County
ordinanon and State Is"regulating Eleotical wiring,and heroby euthortze
ropreeentaifvee of this County to enter upon the above-mentioned property
for I W SEE REVERSE FOR B(PL kMTORY L-ANQUAGE
La3NATL*W-OF DA
COUNTY OF LOS ANGELES TEMPLE CITY 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0293010010
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
•
FEES PAID BUILDING ADDRESS:
TR: 6361LT: 554 5M CAMELLIA AV
FEE DESCRIPTION: QUANTITY: UOK: AMOUNT: TEMP C� 917802502
N EAI EST CROSS STREET: LAS -TUNAS
8587-017-007 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: Al LOCALITY: TEMPLE CITY
G1 OUTLETS-LGT9W RECP 3.00 OUT 5.85
G2 LIGHTING Flii:UtES 2.00 LGT 3.90ISSUED . PROCESSED BY: PLAN BY: EXPIRES .
TOTAL FEES 37.50 03/01/02JK 08/28/02
06MER: TEL. NO: FINAL DATE FINAL BY:
GARCIA• JESUS (626) 286-6914- 7(f„DZCME.
5733 CAMELLIA AVE
TEMPLE CITY 91780
ELECTRICAL FOR PATIO
APPLICANT: TEL. NO:
SAME AS OWNER -
SPECIAL CONDITIONS:
ES Co \
S /� tOVALS DATE INSPECTOR SI
SAME AS ouwER - � - o ry
LIC. NO // - \
z TEMPORARY POWER POLE
ARCHITECT OR ENGINEER: . \ UFER GROUND
LIC. NO: r 111111
MAIN WATER
P U[B' L0 VY0 ILOF'a'F/\\`,2 PLASTIC Y/N METAL Y/N
UrTITT77WANY NOTIFIED
\\ �Service Thit
i
REPORT ID: DPR265 ROUTE TO: BS050B