HomeMy Public PortalAbout4949 CLOVERLY AVE_Electrical__ 76A663 CE 6068 10/77 APPLICATION FOR ELECTRICAL PERMI
COUNTY OF LOS ANGELES
DEPARTMENTIOF COUNTY ENGINEER JOB
BUILDING AND SAFETY DIVISION ADDRESS y �u
FOR APPLICANT TO FILL IN LOCALITY AA
/1
New Residential Bldgs &Pools EACH NO FEE CNEAREST
ROSS ST SWC ,, 2
1 &2 Family Sq Ft $ 025 — $ OWNER OR ��++
Multi family Sq Ft 02 — FIRM NAME SLA �( {
Residential Swimming Pools 2500 MAIL
r
ADDRESS 6Yr
Outlets RecLight_y__Sw 50 CITY v Tel No
First 20 / PLAN CHECA
Total No�— Additional 30 APPLICANT
ADDRESS
Lighting Fixtures First 20 -,50 q cqz�,CITY Tel No
Additional 30 PERMIT
Total No APPLICANT r+
Fixed Appliances Not Over 1 HP ADDRESS$;�&rr,
Range_Heater—D W CITY, / Tel No f/
Oven —Dryer—W M_ LICENSE OR
Top —FAU —W H REG NUMBER Class
Hood_Fan _Other- I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
Disp _ Room Air Cond 250 THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDIN
ANCES AND STATE LAWS REGULATING ELECTRICAL WIRING
Power Apparatus&Large Appliances
Size&Type HP KW KVA or KVAR I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFOR IA OR THAT I AM
Up 10 1 Ind 2 50 THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL P ERTY �O
Over 1 to 10 Incl 500 v
Over 10 to 50 In1 2 50 PERMITTEE i
Over 50 to 100 Inc 2500 SIGNATURE t
Over 100 4000d NP PROC BY d
Services
0 200 Amp Under 600 V 12 50 INSPECTOR
201 1000 Amp Under 600 V
2500 APPROVALS DATE SIGNATUR
Over 1000 Amp or Over 600 V 5000 TEMP POWER POLE
UNDERSLAB WORK
Temp Power Pole&Appurtenorces 1000
Sign with One Branch Circuit 1000 ROUGH CONDUIT �7(
2 00WIRING
U
Additional Sign Branch Circuits
Misc Conduits&Conductors 1000 FIXTURES
Other(See Complete Fee Schedules POWER AUTHORIZED
UTILITY CO NOTIFIED
FINAL
PERMIT FEE y (Sub Total) NOTES
PLAN CHECKING FEE (One Fourth Permit Feel
0 0 0 0 0
PERMIT ISSUING FEE $700
[ o o
TOTAL FEE ,h 0 0
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK 0 ARC? a CCASH
041 '6=80
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
� d
76A663-CE806 9-64 APPLICATION FOR EL CTRI I L PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS 9 Cloverl
JOHN A LAMBIE COUNTY ENGINEER City COLEMAN W JENKINS SUPT OF BUILDING LOCALITY Temple Cit
NEAREST
FOR APPLICANT TO FILL IN CROSS ST Lower Azusa
FRECEPT 2 TOTAL IN EACH FEEOUTLETS FIRST 20 $ $ / O WNER Palmer
GHT V MAILi A00'L ADDRESS4949 CloverlWITCH 1 OVER 20 10
TOTAL CITYTem le City TEL NO
LIGHTING FIRST 20 20
FIXTURES F ADD'L OVER 2O 10 ELECTRICIAN & Son
RANGES CLO DRYERS WTR HTRS 1 00 ADDRESS , O O 1V• Grandview) Ave•
GARB DISP STA COOK CITYS San Gabriel TEL No 280-2007
DISHWASH AUTO WASH STATE
SPACE HTRS STA APP I'/.H P MAX) S0 LICENSE NO 137567 7 C—10
MOTORS OVER NOT OVER H P DIS��RICT p G jQ-UP ONE PR CE ED BY
0 1 +oo i D -/- -
1 3 150 INSPECTION RECORD
3 S 200
O
S 15 250 V
is 50 300 Of
O
H
5o foo 500 U
W
SIGNS NO TRANS d
NO LAMPS N
Z
SERVICE O 600V NOT OVER 200A foo
SERVICE O 600V OVER 200 A 200
SERVICE OVER 600V Soo
MISC
PERMIT ISSUING FEE 200
SUP LEMEN TABY PERMIT ISSUING FEE 1 00 1 0
FEE_ Z 6S 1 6
I HEREB ACKNOWLEDGE AVE READ THIS APPLICATION APPROVALS DATE INSPECTOR 8 SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING WIRING &Y qtr.9
r
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY L05 ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE AB!ZIBED RESIDENTIAL ��ERTY POWER
SIGNATURE UTILITY CO NOTIFIED A __ L
_—.LA
OF PERMITTEE111/991" � �l
FINAL
ccl
IDATICIN SUPERVISING EECTRICAL ENGINEER
MO CASH
, AC0,1 8 1 3,G MAY 19 2 D 1.60-
- 4
l
76A663-CE806 8/63 APPLICATION FOR ELECTRICAt PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS LL9 9 Cloverl
JOHN A. LAMBIE, COUNTY ENGINEER /v
WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY Temple City
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
RECEPT. TOTAL NO. EACH FEE
LIGHT OUTLETS FIRST 20 16 s,20 $ 20 MAIL Palmer
ADD'L ADDRESS
SWITCH. L l`� OVER 20
.10
TOTAL CITY TEL. NO.
LIGHTING FIRST 20 20 60
FIXTURES 3 ! ADD'L10 ELECTRICIAN R L Conlee Son
OVER 2O
RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS 1030 N. Grandview -Ave.
GARB.DISP. STA.COOK CITY San Gabriel TEL.NO.280-200
DISHWASH. AUTO.-WASH. STATE
SPACE HTRS. STA.APP.ly ��s H.P.MAX.) .50 LICENSE NO. Z 6 C-10
MOTORS: OVER NOT OVER H.P. DISTRICTr. I GR E P B
O 1 1.00
1 3 1,50 INSPECTION R C RD
3 8 2.00 }
CL
8 15 2.50
15 50 3.00
50 100 5.00 O
_ W
SIGNS: NO.TRANS N
NO.LAMPS
Z
SERVICE 0.600V-NOT OVER 200A 111.00 1 O0
SERVICE 0-60OV-OVER 200 A. 2.00
SERVICE OVER 600V 5.00
MISC.
PERMIT ISSUING FEE 2.00 2 00
SUPPLEMENTABY PERMIT ISSUING FEE 1.00
TOTAL FEE a h 80
1HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING;
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDEN OPERTY POWER
SIGNATURE UTILITY CO.NOTIFIED
OF PERMITTEE
FINAL
IDATION ARTHUR C. VEIT
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
I
TEMPLE CITY
ISAE3CE806460 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE, COUNTY ENGINEER
WILLIAM A JENSEN SUPTOF BUILDING LOCALITY
Try
NEAREST
FOR APPLICANT TO FILL IN ' "OS,sT
PERMIT FEES
OWNER IRA
I T E M NUMBER EACH FEE MAIL l
FLIGHTS7s
s s ADDRESS
OUTLETS—
SW 10 11
LIGHTING FIXTURES 10 CITY E NO g
ELEC RANGES CLO DRYERS ELECTRICIAN
WATER HEATERS 50 ADDRESS
ELEC SPACE HTRS DISHWASHERS CITY TEL NO
GARBAGE DISPOSERS AUTO- STATE
WASHERS STA COOKING UNITS 25 LICENSE NO
MOTORS OVER INC H P DISTRICT G Z NE ED
O — 1/2 25 r
V2 — 2 50 INSPECTION RECORD
z — 5100 7 a
s — 15 Iso O
U
1s — so 250 l ��(r �O
50 200 500U,4/G[ I ,-e '%OV
LU
SIGNS NO TRANS r _
NO LAMPS 'F� -
in
SERVICE O 600V
too v /
SERVICE OVER 600V Boo
MISC
WIRING PERMIT // 100 r / a yam/ R
FIXTURE PERMIT 1 00
SUPPLEMENTARY PERMIT so
TOTAL FEE S
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR SSIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY '
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT ! (!
ELECTRICAL WIRING WIRING
1 HEREBY CERTIFY THAT i AM PROPERLY REGISTERED AND/0-
LI CENSED
ND/ORLICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AM T E LEGAL OW THE ABOVE
DESCRIBED RESIDE
O lTY POWER
SIGNATURE UTILITY CO NOTIFIED !!
OF PERMITTE .t n
FINAL v 'r/�
VALIDATIO AR HUk C VEIT
CK Mo cases SUPERVISING ELECTRICAL ENGINEER
'L�Cn 2 1 5 SCP 7 2 D 2 .0 0
76A66C-CE. '006 5-61 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS /ANGELES
DEPARMENT OF COUNTY ENGINEERBUILDING
BUILDING AND SAFETY DIVISION ADDRESS fid.
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A.JENSEN, SUPT of BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
PERMIT FEES OWNER f.'l"
1 T E M NUMBE EACH FEE MAIL
OUTLETS: $ S ADDRESS
LIGHTS 'i RECEPT.. SW. •1O CITY TEL. NO.
LIGHTING FIXTURES ,10
ELEC. RANGES CLO. DRYERS ELECTRICIAN A
WATER HEATERS .50 ADDRESS 1
ELEC.SPACE HTRS. DISHWASHERS
CITY ;' TEL NO.
GARBAGE DISPOSERS AUTO.- .STATE
WASHERS STA.COOKING UNITS ,25 LICENSE NO.
MOTORS: OVER INC. H.P. DISTRICT NO. GR Z NE P D B
O— 1/z 2 5 �� i
1/2- 2 .50 INS ECTION RECORD
\-7-
2— 5 1.00 d
--- O
5— 15 1.50 U
9x
15— 50 2.50 O
50— 200 5,00 W
NO TRANS. 0.
SIGNS: N
NO.LAMPS Z
SERVICE 0-600V 1.00
SERVICE OVER 600V 5.00
misc.
WIRING PERMIT 1.00 C
FIXTURE PERMIT 1.00
SUPPLEMENTARY PERMIT .50
TOTAL FEE $
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING J
1HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REOU I RED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. POWER
SIGNATURE UTILITY CO.NOTIFIED :..i t
OF PERMITTEE t
FINAL
VALIDATIPN---� ARTHUR C. VETT
CK mo cnsH SUPERVISING ELECTRICAL ENGINEER
-WORKERSCOMP�NSATLON#DECLARATION 200019 DPW(12 91) APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm tMl tt I have a certificate of consent to self Insure 76A663
or a certificate of Worker s Compensation Insurance or a certified COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV
copy thereof(Sec 3800 Lab C) - - -
4.
��
Policy No Company r FOR APPLICANT TO FILL IN JOB
ADDRESS
` Certified copy is hereby furnished New Residential Bldgs &Pools NO EACH FEE
❑ ' F _ $ $ LOCALITY
Certified co Is filed with the count building inspection 1 &2 Family Sq Ft
'copy y g p NEAREST
department Multi family Sq Ft — CROSS ST
Date Applicant Residential Swimming Pools ASSESSOR
MAP BOOK 1 PAGE PARCEL
CERTIFICATE OF EXEMPTION FROM WORKERSOutlets Rec � �G OWNER OR b4✓t t
_ COMPENSATION INSURANCE Light First 20 FIRM NAME V i
� O � O MAIL
(This section need not be completed If the work Involved by the Total No Additional ADDRESS 9 No CLPLIZ✓L
permit is for-one Hundred dollars($100)or less)
I certify that in the performance of the work for which'this permit CITY G , To No 7• y
Is issued I shall not'employ any person'm any manner so as to PLAN CHECK
become subject to the Workers Compensation Laws Lighting Fixtures First 20 APPLICANT
Total No Additional
" ADDRESS
Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP
NOTICE TO APPLICANT If after making this Certificate of CITY Tel No ,
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 PERMIT
provisions or this permit shall be deemed revoked
Power Apparatus&Large Appliances APPLICANT
LICENSED CONTRACTORS DECLARATION Size&Type HP KW KVA,or KVAR ADDRESS
I hereby affirm that'l am licensed under provisions of Chapter 9 Over 3 to 10 Incl
(commencing with Section 7000) of Division 3 of the Business and CITY Tel No
Professions Code and my license is In full force and effect Over 10 to 50 Incl >_
Over 50 t0 100 Incl LICENSE Class
REG NUMBER Q.
License Number LIC Class Over 100 DISTRICT NO p P SED BY O
Serrviicee,spSw d ~C&Par�Ib�coaards ��d ��iC� 0
FINAL
Contractor Date Amp Un e�r 60Q Vf�1R?� DATE O
t 4 0 1000 Amp Under 600 V V
I am exempt under Sec VALIDATION LU
Over 1000 Amp or Over 600 V FINAL fl
B&P C for this reason BRANCH CIRCUIT FEES BY U)
Date 15A or 20A 120V Lighting or Recept z
1 To 10 Branch Circuits
Signature 11 To 40 Branch Circuits
El 41 Or More Branch Circuits
Exemption for Reg Mamt Elect 15A 20A 208V To 277V Lighting Br Circuits
SINGLE FAMILY Temp Power Pole&Appurtenances
HOME OWNER BUILDER DECLARATIONSign with One Branch Circuit i"T.;:
I hereby affirm that I am exempt from the Contractors License Law
for the following reason (Section 7031 5 Business and Professions Additional Sign Branch Circuits 20"
Code) t�
I as owner of the property will do thework and the structure Mlsc Conduits&Conductors 7
Is not Intended or offered for sale (Section 7044 Business Other(See Complete Fee Schedule) I!I f�rL 6�-r
and Professions Code)
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the `-HANGS
performance of the,work for which this permit is Issued (Sec 3097 PERMIT FEE (Sub Total)
CIV C)
PLAN CHECKING FEE 1-2 Fj(!:-•,SEI f i ,'i _
Lender's Name
PERMIT ISSUING FEE p �� y�4r124r14, 1 t11` r�er_
Lender s Address
I certify that I have read this application and under penalty of purjury state TOTAL FEE >�
that the 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 the above mentioned property
for Ins n purposes SEE REVERSE FOR EXPLANATORY LANGUAGE
SI AT RE OF PERMI DATE
WORKERS'COMPENSATION DECLARATION CE 8069 (2 80) APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that P have a certificate of consent to self - COUNTY OF LOS ANGELES � T-, � BUILDING AND SAFETY
insure, or a certificate of Workers'Compensation Insurance,or
tifwd,cppy t er ofc 3800, La
1LC•�` r FOR APPLICANT TO FILL IN JOB
P y No Co pany ADDRESS
- New Residential Bldgs &Pools EACH NO FEE
Certified copy is hereby furnished 1 &2-Family,Sq Ft $ $ ' LOCALITY ;
Multi family Sq Ft
Certified co — NEAREST
py is filed with the county building inspection CROSS ST
Residential Swimming Pools
department � � OWNER OR
FIRM NAME
Date Applicant Outlets Rec Light Sw MAIL
First 20 ADDRESS
CERTIFICATE OF EXEMPTION FROM WORKERS' Total No Additional CI ) Te
COMPENSATION INSURANCE &px IL
PLAN CHECK
APPLICANT � 0
(This section need not be completed if the work involved U
by the permit is for one hundred dollars ($100) or less) Lighting Fixtures First 20 ADDRESS
Total No Additional Ii O
1 certify that in the,performance of the work for which this Fixed Appliances Not Over 1 HP CITY , 'Tel No U
1 W
permit is issued, I shall not employ any person in any manner PERMIT r
so as to become subject to the Workers"Com pensation Laws Range_ Heater_D W APPLICAN LU
Oven _ Dryer_W M _ ADDRESS N
Z
Dat `[Applicant f Top _ FAU„_W H
_ Hood _ Fan _Other_ CITY Tel N
NOTICE TO APPLICANT If, after making this Certificate of Disp _ Room Air Cond_ LICENSE OR
Exemption, you should become subject to' the Workers' REG NUMBER A MClass
Compensation provisions of the Labor Code, you must forth Power Apparatus& Large Appliances DISTRICT NO PROCES ED BY
with comply with such provisions or this permit shall be '
deemed revoked Size&Type HP,KW, KVA,or KVAR
Up to 1 Incl
' _ FINAL
Over 1 to 10 Incl DATE
LICENSED CONTRACTORS DECLARATIONOver 10 to 50 Incl VALIDATION
FINAL
I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc ! )
9 (commencing with Section 7000) of Division 3 of the Busi Over 100 BY
ness and Professions Code, and my license,is in full force and r f k
effect Services
0 200 Amp Under 600 V S
License
201 1000 Amp Under 600 V I
ContractN e Lic Class ate ' Over 1000 Amp or Over 600 V
HOME OWNER BUILDER DECLARATION Temp Power Pole&Appurtenances
Sign with One Branch Circuit
I hereby affirm that I am exempt from the Contractor's additional Sign Branch Circuits ✓
License Law for the following reason (Section 7031 5, Busi -
ness and Professions Code)
Misc Conduits&Conductors O'0 O A
❑ I, as owner of the property, will do the work and the Other�(See Complete Fee Schedule)—
structure is not intended or offered for sale (Section _ #lo oto o 'a 2
7044, Business and Professions Code)
CONSTRUCTION LENDING AGENCY / 2 0'0 3 2,0 0
1 hereby affirm that there is a construction lending agency 1
for the performance of the work for which this permit is PERMIT FEE (Sub Total) .ls 0'o yo 3 2 0 Q
issued(Sec 3097,Civ C) _
Lender's-Name PLAN CHECKING FEE (One Fourth Permit Fee) 016'2 2'-8 1'
Lender's'Address PERMIT ISSUING FEE
I certify that I have read this application and state that the TOTAL FEE i Jill
above information is correct I agree to comply with a111County 1 1
ordinances and State laws regulating Electrical wiring, and
h y authorize representatives of this County to enter upon
t e ab menti a operty for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE '
V
re of Perini + Date
,J
J ` COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0807260017
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID FEES PAID I BUILDING ADDRESS 7
ITR 11454 LT 14 4949 CLOVERLY AV
FEE DESCRIPTION QUANTITY DOM AMOUNT TEMP CA 917803811
ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET LOWER AZUSA
8590-022-005 IA1 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID J5 LOCALITY TEMPLE CITY, Cl
I ILB 200 AMP PANELS, MCC 1 00 PAN 38 85 e I
ITENANT ITOTAL FEES 66 60 JISSUED ON PROCESSED BY PLAN BY EXPIRES ON
107/28/08 SR 01/24/09
OWNER TEL NO VAL ATE FIN CODE
INEVAREZ RUBEN (626) 287-3974— 1
4949 CLOVERLY AV
(TEMP 917803811 SCRI TION OF WORK
ELECTRICAL PANEL UPGRADE TO 200 AMP
APPLICANT TEL NO
ISAME AS OWNER —
ISPE(.IAL CONDITIONS
(CONTRACTOR TEL NO � I /
_ � + (APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER —
LIC NO (TEMPORARY POWER POLE
� I �
(UNDERGROUND CONDUIT
(ARCHITECT OR ENGINEER TEL NO IUFER GROUND
LIC NOI ROU,
GH CONDUIT
ROUGH WIRING
IMAIN WATER LINE
IPLASTIC Y/N METAL Y/N
UTILITY COMPANY NOTIFIED(
,� REPORT ID DPR265 ROUTE TO BS0508
a
�s COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0809160034
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID FEES PAID BUILDING ADDRESS
ITR 11454 LT 14 I 4949 CLOVERLY AV
I IFEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917803811
ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET
18590-022-005 IA1 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID JS LOCALITY TEMPLE CITY Cl
I IG1 OUTLETS-LGT SW,RECP 1 00 OUT 1 95 I
TENANT JHA FAD LESS 3HP 1 00 FAU 10 95 JISSUED ON PROCESSED BY PLAN BY EXPIRES ON
IJB AC UNITS +3-10HP 1 00 AC 19 65 109/16/08 SR 03/15/09
TOTAL FEES 60 30
OWNER TEL NO IFI4AL DAIE FI BY CODE I
INEVAREZ RUBEN (626) 287-3974-
I4949 CLOVERLY AV
TEMP 917803811 IDE RIPTI N OF WORK
ELECTRICAL FOR HVAC
APPLICANT TEL NO
IPELL AIR & HEATING, INC (866) 646-8499- 1
11495 W 9TH ST 201 ISPECIAL CONDITIONS
UPLAND, CA 91786
CONTRACTOR TEL NO JAPPROVALS DATE INSPECTOR SIGNATURE
IPELL AIR AND HEATING INC (866) 646-8499- I
11495 N 9TH ST #201 LIC NO ITEMPORARY POWER POLE I I
UPLAND, CA 91786 848196
I (UNDERGROUND CONDUIT
I I �
ARCHITECT OR ENGINEER TEL NO , IUFER GROUND
I
LIC NO TROUGH CONDUIT
ROUGH WIRING 17
IMAIN WATER LINE
' (PLASTIC YIN METAL YIN
(UTILITY COMPANY NOTIFIEDI I
I I I I I I
1
I I I I I
I I I I I I
I I I I I I
I I I I I I
I I I I I I
t
I I I I I I
I IREPORT ID DPR265 ROUTE TO BS0508
I I I I I I
i