HomeMy Public PortalAbout9420 CAMINO REAL AVE_Electrical__ 7"".JD"M 11-49 -APPLICATION
FOR riaa.L*J.L a
DEPARTMENT OF Htriz.DnNG AND SAFETYELECTRIC � i
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENBINEER
FOR APPLICANT TO FILL IN DIQTRT
RICT NO. GROUP ZONE PEM NO.
Az
ELECTRICIAN
R [IV[D sY READY FOR DAT[ ls3Utn
ADDRESS FIRST INSPEUTION15,
CITY TEL NO
O EXPIRES SUILDINBOOU TY O[Ns .
7PE33M FEES
ADDR[I
D I`
NUMS[R OUTU1Ts EACH
rim LOCALITY
LIBHT SoGROSS ST.NEAREST
R[D[PTACLIS 6 �
FIXTURES s OWNER
WALL BWITDHq s MAIL
ADDRESS
ELKO. RANBq is
[I1C. HEATERS 1i OITY TEL. Na
I H[RKWY ADKHOWLMOX THAT I HAV[ READ THIN
NUMs[I! OF OIROUITS INSTALLIDI A0PLIMATION AND STAT'[ THAT THE ASOVX IS DORKEDT
TOTAI
AND ABRE[ TO COMPLY WITH ALL OOUNTY ORDINANCES
MOTORB AND STAT[ LAWS RESULATINB ELEOTRIOAI WIRINB.
Nuw9[R HORSEPOWERI OETIFY THAT I PONS® THE ABOVE VALID LOS
F[[ R N[w MV0. HP OVER Iwo. r.^a1 AHBELKIN OOUNTY LICENSE, OR I AM THE LYA
BL DWRNE
OF THE RESIDQITIAL PROP DESURI L
ASDV
Vn a Lx" .215
2 .SC ■IBNATURE OF
s S 1.00 P[RMI
s is ' 1.50 INSPECTION RECORD
115 so SLOO
SD sw B.DO
sup sop 10.00 a
15 DO i OW 15-00 WO-T- A
OVER 111010 10.00 - y
M.B. airr/mEqL m4AHBER-HP !2
WELDERSIA13-KVA
❑
B[NERATORS - KW
TRAHSFURM[RE - KVA
TEMP. MOTOR■ 70 or ORI■
MOVED MOTORS 70 of OPU
MIECL
BISNB
TYP[l NO.TRANS.
TYl*KiAPPROVALS
FOR EACH PKRMIT1 TE INupLOT 3RIN HAM[
WIRINB 1.Dp OONDUIT
FIXTURES1111.0113 WIRINB
.50 FIXTURES
, ��'j - 7 W
POER
TOTAL F�ar� / * &0 UTILITY 00.NOTIFIED
�� ��d FINAL
,•.A�WM D..,A „-,• APPLICATION FOR PEHNT
-dDEPAHTMENT OF sIITI.DING AND sAFf,''Y ELECTRIC i
COUNTY OF LOS ANGELES
WILLIAM J. F'OX, CHIEF EMOINrER
FOR APPLICANT TO FILL IN DIETRI13T NO. GROUP ZO E Pwj;tm T NO.
ELECTRICIAN
RECEIVED R R DAT[ ISSUED
ADDR93 M FIRST INSPECTION r —
J1 /
CITY / T[L.N0.
OPUKTY LIDKNEK- NO, 110�12IR[S ■UILDINd
P� FEES ADDRGRM OZO
rim LOCALITY
MUM6[R OLITL[TS [ADH
L I O HT 50 N EAS![ST
DRUM ST.
REDEPTA13LES E
FIXTURE S IIWNER
WALL SWIT13HXM 6 MAIL
ADDRESS
RANOEM as
[LEO. HEATERS T6 CITY TEL Na
1 HERESY ADKNQWLEDOE THAT I HAV[ READ THIS
MUMMER OF OIROUITE INSTAL L r^1
TOTA, APPLICATION AND STAT[ THAT THE AMOV[ 1% CORRECT
AND AOR[[ TO COMPLY W" ALL.OOUNT`1 OR0II4AN01Ctf
MOTORB AND STAT[ LAWM RKBULATINO [LCOTRICAL WIRING.
Numb" H0RS[POYII[Ill I OplTIFY THAT I PD1MOS TME ADOV[ VALID LOU
F[[
Nrw MVD. HP GV" IND. [I�II1♦ AMOELYA COUNTY UDEME1i, OR I AM THE LEMAL gWNER
Y. OF THE RESIDENTIAL PROPERTY PEMORINED ASOVL
a LC.. .9M
i .60 MISNATURI OF
TTirr
Ts S 1.00 Pt RMI
M 1■ 1.50 INSPECTION RECORD
is 60 f.60
60 200 S.DO
TOO 600 10.00
600 1 000 1 6.017
OVER 1060 20.00
MA. ■6T FR OHAHM[R-HP O_
W[LDERM1 AO-KVA R
O
O[N[RATCR! - KW
TRAMMrORMKFtM - KVA
T11MP. MOTORS—(75% ar oRlo
OV[D MdTORI (76 Dr o,u■
M 1013.
SIGNS
TYPEI NO.TRANM.
APPROVALS
FOR EACH P[RMITI DATE I NAM[
W1RIM0 1= a OONDUI
FDLTuRES 1,® WIRING
F CITU RIS
POWER
TOTAL FKK • UTIOO.NOTIFIED
FINAL /
fin tat II COMPENSATION DECLAA/1TIto GE-&06 10,81 APPLICATION FOR ELECTRICAL PERMIT
Ihere�y efftrm,� I have e ante of cortaerrt to self Imre, �-80�
or aof Workers' Corn Pensatbn.lnauranoe. or a certified- COUNTY OF LOS ANGELES BUILDING AND SAFETY u
COPY=(Sec. 3800,Lab. C.)
pb(icy 140' Company FOR APPL.K"J,Pfr TO FRl..Qi ADORE� —26F-1Cerltw copy Is hereby fumlahed New Realdential Bldga& Pools EACH NO. FEE /
ent — LOCALITY
ALI
❑ Certified copy Is fIW with the county bu9d[ng kw)aotion 1 & 2-Farrd � 3 LOCALIfy,Sq.Ft _
NEAREST
departrnMufti-family Sq.Ft CAoss ST.
Date ApPlicent Reeldentfal Swlmminq Pools pyyfENp.E
p Oq
CERTIFICATE OF EXEMPTION FROM WORKERS' Outief�Reo Llpht ' Q
S,OMPENSIU ON INSURANCE T` Sw. ';Z_ S
FI3M
(ThFs Nation need not be completed G the work hrwo by the Total No. A,nay Fhat 20
permit Is for ori hu ndred dol hs re(S 100) or Iwa) �L Addttionai �Y
orTk No.
I certlfy that In the perforrnence of the work for whJch this permit { APLAN
IC��
b fasued, I shall nxrt employ any person In any manner 8o ae to
become sub}ect to the Workers'Compeneatbn Laws LlghtIng Flxturea Ftret 20 ADDRESS
Total No. Addltlonal CITY Tel.No.
Date Appihcant Fbced Appllarc Not Over 1 HP PEFJ4T
NOTICE TO APPLICANT: If, after making thls Certfficate of
Exemption,you&hound become sub}ect to the Workers'Cbmpeneafion Range— Heater D.W. APPUGANT
provWorhe of the Labor Code, you muet 1ofUl comOy with such Oven _ Dryer _ W.M.� ADDRESS
isi
provons or this permit ahall be deemed revoked. Top — FAU W,FL
CITY Tel.Na
LICENSED CONTRACTORS DECLARATION Fhootl — Fen Othes'— AP
�
I hereby affirtn that I am 5ceneed under provision of Chapter 9 Dlsp Rocrn Alr Cond. FCBMJ p Clea
OR
(commerx�n with Section 7000) of DMalon 3 of the &minees and
Professions Code,and my lkxK a 1:8 In full force and effectPcMer Apparatus& ��A � T
PROCTM)
Stze& Type HP,KW,K\O,or KVAR R
Llcerrae Number Lc.Claw Up to 1 Ind. FINAL
Over 1 to 10 Ind. DATE Q �/ AUDATIoN n'
Contractor Date Over 10 to 60 Ind. FINAL1
❑ I am exempt under Sec. Over 60 to 100 Inc. BY
BAP.C.for this reason Over 100 VV U)
Services,Swbd.,MCC& Panelboarda ,
Dele. 0-200 Amp.Under 600 V
S{gnature 201 - 1000 Amp.Under 600 V
Over 1000 Amp.or Over 800 V
F-1Exemptionfor Req.Malrtt EVect
SINGLE FAMILY Temp. Powor Pole& Appurtene�
HOME OWNER-BUILDER DECLARATION Sign with One Branch Clrautt tCT■T
for tide fo owlnrereaso(3 7exenrpt 031 6,the gr anLlc� Law d P esabr" Addnlonal Sign Branch C rafts 3317 3°.00I
Code): _
Mleo.Cordttts& conductorrs 1 ITEMS
❑ 488 owner of the property,will do the work and the structure Other (See CornpletA Fee Schedule) —
Is not Intended or offered for eale (Section 7044, Buefrssa , TOTAL 38 .00
and Professions Code).
CHECK 38.00
CONSTRUCTION LEND040 AGENCY { .CIO
I hereby affirm that there Is a construction lording agency for the
performance of the work for which thio permit♦8 lamed(Sea 3007, PERMIT FEE (Sub-Total)
Civ. C.).
PLAN CHECKINQ FEE I OXO —"l w7�/ �
11$/
LerxWs Name PERMIT ISSUING FEE I 18PA 1 AM 3%21
Lender's Address
I certify that I hae read this application and abate that the above TOTAL FES
Zm
Information Ia correct. I agree to comip4y with all County ordkar
and State Uwe regufattn Eleatrlml wiring, and hereby autt"t o
repreaentatfvee of this County to ember upon the above-mentioned
property for hnapection purposes. SEE REVIERSE FOR EXPLANATORY I'ANGUADE
Signature of tttee 44 G—�L_/� O
C0UMT7 OF LOS ANGELES TEMPLE CIT7 0508 E E P
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS 180023
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA
PHONE: (818) 285-0488 EXT:
ON FILE CAMINO REAL AE
FEE DESCRIPTION: QLVU(TITY: UOM: AMOUNT: S�►R 1-08774 -f
ASSESSOR I NEAREST CROSS STREET:
5382-010-027 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J1 LOCALITY: TEMPLE CITY
G1 OUT4ETS-LGTSW RECP 9.00 OUT 17.55
G2 LIGHTING FliHAES 2.00 LGT 3:90 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
TOTAL FEES 49.20 09/19/96 TC 09/18/97
OWNER: TEL. NO: PINAL DATE FINAL BY-
CLU(X GERALD -L-MARGARET A (818) 445-2695-. Z�
9420 CAMINO RikL AV
ARCD 910077711 DESCRIPTION OF WPM
ELECTRICAL FOR NEW BEDROOM ADDITI .
APPLICANT: TEL. NO:
TOM OILEARY CONSTRUCTION (818) 287-0927-
4856 ARDSLEY. " SPECIAL COltD!TIOWS:
TEMPLE CITY, CA ^ � � C C
TOM OCONSTRUCTION (818) 287-0927
ARDSLE �p
4856 ARDSLEY DRIVE LIG. NO �/yiTEKPOIRARY POWER POLE
TEMPLE CITY, CA 91780 489334 B-1 .
ARCHITECT OR ENGINEER: TEL. NO: UFER LIMD
LIC. NO: ti
RIOUGH WIRING
PUBLIC WORKS MAIN I�TER LINE Falb
PLASTIC Y/N METAL Y/N
�Jco UTILITY MWANT NUII�ILU
Ell
�j. ❑ o
r
C'
5E?rV.
ICe-
REPORT ID: DPR265 ROUTE TO: BSO5O8