HomeMy Public PortalAbout6145 CAMELLIA AVE_Electrical__ COUNTY OF LOS ANGEL98 "PLICATION FOR PERMIT
DMSION OF BIIII-DING & SAFETY
WILLIAM I FOX. Gmrty Emelvow ELECTRIC 1
FOR APPLICANT TO FILL IN DISTRI13T NO. GROUP ZONE PCRmrT NO.
ELECTRICIAN a a s
R[C[IV[D MY READY FOR DA INO
ADDREZS/ O — — I�-'} rIR91T Nsr[DTIOH
IT1
CY TZL. N • _' `
COUNTY LID NS[ N0. rV101) EXPIRES G�.S �D�S
ILDIH. 9
O
MI � - / 0
PERT FEES (' /�� F'9
Ft[
NUMBER EACH LOCALITY o 0
LIGHT OUTLETS! N[AR[ST It
' ,y,v
R[O[PTACLM C O o
WALL BWITIIH[E OWNER
TOTAL OUTL[TB Ea MAIL
[LIC. RAMBES 25 ADDRESS
[L[0. HEATZRG 28 CITY TEL.. NO.
FIXTURES 6
1 HERESY ACKNOWLEDGE THAT 1 HAV[ READ THI 1
MIBO. APPLICATION AND STATIE THAT THE ABOVE IS DORR[OT
HUMBER or LIGHT OIRCUITB AND AORI[ TD COMPLY WITH ALL OOUNTY ORDINANCES
NUMBER OF REDEPTA13LIE CIRCUITIR AND STATi LAWN REOULATINO [LZCTRIDAL WIRING.
MOTORS •1 CERTIFY THAT 1 PONDS TH[ ASOVE VALID L00
Humm 1 HCRSPOW[R r[[ ANOELEI COUNTY LIC[NS[, OR 1 Ala T14[ LEGAL OWNER
Nirw MVD. HP Dvcw IND. uaN OF THE REWDENTIIAAL PROPERTY DEWORII`SED ASOV[.
L .50 ■IO [NATUROF
2
2 Jp P[RMITTR
2 s 1.0113 INSPECTION RECORD
■ is 1.90
in so JIRD
so ZOO 5.DO
200 9m 1 D.DO J
Bao 1Dao 1111,00 a
Z
CV[R I COO 20.00 E3
MA. STT OHANOER-Hr m
W[LD[RSI AO-KVA O
MENERATDRS - KW
NSFORM[RS - KVA
TEMP. MOTORS (75or DRIM.)
MOVED MOTORS 715Or Dglma
M 1246
SIGNS
NO. NO.TRANS.
APPROVALS
Na
FOR EACH P[RMITY DAT[ IN EOTOR'S NAM[
WIRING 1.00 CONDUIT �� Z
FIXTURM :1.0113 WIRIHO
IKJPPLKMKKTAFtY SO r IXTU RVN
POWER
=AL FSE s O UTILITY Oa NOTIFIED �` 1
FINAL r `
7&A"M D=#&A w
WORKER s'coMPENSATIONDECLARATION E83
CE-608G (2-80) APPLICATION FOR ELECTRICAL PERMIT
E�
I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY
Injure, or a certificate of Workers'Compensation Insurance,or
a certified copy thereof(Sbc. 3800,Lab.C.)
FOR APPLICANT TO FILL IN JOB Ile
Policy No. Company EACH NO. FEE ADDRESS
New Residential Bldgs.&Pools
❑ Certified copy Is hereby furnished. 1 &2-Famlly,Sq. Ft. $ — $ LOCALITY
❑ Multi-femlly Sq. Ft.
Certifib ed copy filed with the county building Inspectiorr Residential Swimming Pool! CROSS T
department. OWNER OR S
FIRM NAME '�L
Date Applicant Outletr. Recaight Sw.� !� MAIL
ADDRESS
int 20
CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. 1_2_3 Additional CITY Tel No.
COMPENSATION INSURANCE PLAN CHECK
(This section need not be. feted if the wort Iavohed i--0 APPLICANT
by the permit it for one hundred doRm ($100) or leu.) L1Qhting Fixtures ddiirst io 0 `� ADDRESS
Additional �
' ` Total No. L U
I certify that Iq the performance of the work for which this CITY Tel No.
permit is Issued, I&hull not employ any person in any manner Fixed Appliances Not Over 1 HP P RMIT
w as to'become subject to the Work ' Compensation ws. Range_ Heeter D.W. CANT IF-41F-C77s a
_ Oven _ Dryer W.M. ADDRESS f Z
Applicant Top _ FAU W.H.
Date ,�� _
Hood Fen _Other— CITY �t el No
NOTICE TO APPLICANT: I iter -
ki
mang this Certificate of Dlsp. ,� Room Air Cond. LICENSE
Exemption, you should be me subject to the Workers' REG NUMBER Cler
Compensation proylsions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO. PR CED BY
with comply with such provfi�loru or this permit shaD be
deemed revoked Size&Type HP,KW, KVA,or KVA O
Up to 1 Incl. Z��
Over 1 to 10 Incl. ATEL /
LICENSED CONTRACTORS DECLARATION Over VALIDATION
Over 10 to 60 I nc I.
I hereby affirm that I am licensed under provislons of Chapter Over 60 to 100 Inc. FINAL '
9 (commencing with Section 7000) of Division 3 of-the Buri- Over 100 BY
nese and Profealon&.Coda, and my license is in full force and
effect. / Services
License Number 7L�� Lic.Class G--/19 1-200 Amp. Under 800 V.
II t / 201-1000 Amp. Under 600 V V
Contractor/. .1 A112 � Date—1�z Over 1000 Amp.or Over 600 V
HOME OWNER-BUILDER DECLARATION Tamp.Power Pole&Appurtenances
I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit
License Law foc the following reason (Section 7031.5, Busl- Additional Sign Branch Circuit
nese and Professions Code): J�2 9. A
Misc.ConduRs&Conductors
El I, u owner of the property, will do the work and the Other (See Complete Fee Schedule)—
structure is not intended or offered for sale (S&ction } 0 0 0 o o 2
7044, Business and Professions Code).
CONSTRUCTION LENDING AGENCY 2 -.- 4290
I hereby affirm that there is a construction lending agency
for the performance of the work for which this permit Is PERMIT FEE (Sub-Total) o 0 0 (1 2 9 0
Issued(Sec. 3097,Civ.C.).
Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee)
Lender's Address PERMIT ISSUING FEE
I certify that I have read thlz appllation and state that the TOTAL FEE
above Information is correct.I agree to comply with all County
ordinances and State raves regulating Electrical wiring, and
hereby authorise representatives of this County to enter upon
the boyo- Honed properly pectlon purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE
tore of Permittee Data
COUNTY OF LOS ANGELES TEMPLE CITY 0508ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9071 'LAS TUBAS EL 0508 9711170044.
BUILDING AND SAFETY / LAND' DEVELOPMENT TEMPLE CITY CA
i PHONE: (818) 285-0488 EXT:
TR: 19338 LT: 5 BL: .DO1 145 CAMELLIA AV
AN
FEE DESCRIPTION: QUTITY: IDM: AMOUNT: EMP CA 917801734
NEAREST CROSS STREET: GARIBALDI
5385^Q15.004 Al PERMIT, ISSUANCE FEE 27.75 THOMAS PAGE:-596 GRID: J2 LOCAL#TY: TEMPLE CITY
LA 100 AMP PANELS, MCC 1.00.PAN .38'.a5
TOTAL' FEES -66.60 -
11/17/97 UT 11/17/98
TEL No F-I RAi DATE FIKkL BY: E:
MEISEL MARVIN (415) 322-;81$- ti-� A
1 BA$SETT LN„ 'V
DESCRIPTIUN QF
NEW 100 AMP SERVICE UPGRADAPPLICANT: TELE
TOM CLEMENTI ELECTRICAL (626) 444-7336
CONTRA OR: TEL. WF7 6F� E TINS`PECT�T�T�E
THOMAS MICHAEL CLEMENTI (626) 4447:7336-
10915 E. WILDFLOWER RD. -LIC. NO
TEMPLE CITY, CA 91780 571426 UNDERGROUNDYARCHITECT OR ENGINEER: TEL. NO: �
` .
:LIC. NO: ROUGH�XDNDUIT
PUBUCWORKS PLASTIC Y/N METAL Y/N
co
�� .
�c
REPORT ID: DPR265 ROUrt TO: BSO508
j