HomeMy Public PortalAbout5021 CLOVERLY AVE_Electrical__ 76A666-CE606 4-60 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, SUP•TOF BUILDING LOCALITY
FOR APPLICANT TO FILL IN CROSSSST. o - `J
PERMIT FEES
OWNER r=teL 6. C9RA
ITEM INUMBER EACH FEE MAIL
/''�
OUTLETS: $ $ ADDRESS S C>:V �• lam- ("`�S"
LIGHTS RECEPT. SW. .10
LIGHTING FIXTURES 10 CITY TEL.NO. 4 -fO S�
ELEC. RANGES CLO. DRYERS ELECTRICIAN
W A T E R H E A T E R S .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 NO. GEMUP Z NP ESSSE DBY
0 — /z // Z- .25 t•/
i
+i2 - 2 ,50 _ INSPECTION RE ORD
2 5 1.00
CL
5 — 15 1.50 O
U
15 — 50 2.50 O
50 — 200 5.00 U
NO TRANS. UJ
SIGNS: CL
NO. LAMPS Z
SERVICE O.600V 1.00
SERVICE OVER 600V 5.00
MISC.
WIRING PERMIT 1,00
FIXTURE PERMIT 1.00
SUPPLEMENTARY PERMIT .50
TOTAL FEE S
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT
ELECTRICAL WIRING. WIRING
IHEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR T M LEGAL O NER�1� THE ABOVE
DESCRIBED RESID NTIAL PR Y. / POWER
SIGNATURE fl.. !! UTILITY CO. NOTIFIED
OF PERMIT'
FINAL
VALIDAT!Q ARTHUR C.VEIT.
CK I /CAS SUPERVISING ELECTRICAL ENGINEER
OB S-A 12-43 "M a , APPLICATION FOR PERM
DEPA RVMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES ELECTRIC
WM J FOX. CHIEF ENGINEER
FCIR
/ DISTRICT NO. GROUP ZONE /PERMIT NO.
ESS .1 / /
TEL NO
]RECEIVED BY READY FOR D ATE ISSUED
FIRST INSPECTION NO ' EXPIRES APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLYJOB
I 'DESCRIP'T`ION OF WORIZ ADDRESS [l LSINUMBER OF OUTLETS ON CIRCUITS LOCALITY LOCATION BY ROOMS NEAREST
LIGHT OUTLETS SW PLUGS FIXT CROSS ST A B C D E F G H m NAME
p Z MAIL
,= ADDRESS.
O
CITY TEL NO
1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGKLES COUNTY CERTIFIC E Qu CA ION.
r
ELECTRICIAN
I AM THE&Z.GAL OWNER OF THE PROPF,RTY DESCRIBED
ABOVE
��y.�ag�� OWNER
3 COlO.l�E TIONS
I
.✓ts` �Gw�^ j F.-C 1T7 WthQga W
O
O
TOTAL C
NO OF OUTLETS $ Y APPROVALS
rNOF FIXTURES $ DATE INSPECTOR'S NAME
F MOTORS HP $ CONDUIT ,4'31F SIGNS TRANS $ WIRING Il—F RANGES OR HEATERS 1 FIXTURES
MISCELLANEOUS $ POWER
PERMIT FEE $ 7 UTILITY CO NOTIFIED
TOTAL FEE FtNA
CITY O _ -T MP/Lc (_I-rY LJ
� 76A663-CES0611/70 APPLICATION FOR ELECTRICAL PERMIT
COUNTY,OF LOS ANGELES
DEPAOTMENT OF COUNTY ENGINEER BUILDING (..O VES, Lir,
BUILDING AND SAFETY DIVISION ADDRESS Q 2
JOHN A LAMBIE, COUNTY ENGINEER LOCALITY
COLEMAN W JENKINS SUPERINTENDENT OF BUILDING
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
OUTLETS NO EACH FEE
� OWNER C(G L^
RECEPT! / $ A- MAIL
DDRESS
CITY
LIGHT TOTAL FIRST 20 [
CITY TEL NO
SWITCH Lj) OVER 20 10 PLAN CHECK
APPLICANT
FIXTURES
LIGHTING 1 FIRST 20 t ZS
J} TOTAL
FIXTURES + I
OVER 20 10ADDRESS
APPLIANCES CITY TEL NO
PERMIT
RANGE DRYER_WTR HTR APPLICANT Z_ L - lC
STA COOK DISP F A U ADDRESS
a -
SPACE HTR AIR COND CITYMr)!�: TEL NO _3c)
CLOTHES WASH DISHWASH LICENSE NO b --Z> CLASS G/
FAN OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND HEATERS, ETC HP KW KVA ELECTRICAL WIRING
SIZE & TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 - 1 100 LICENSED AS RED IRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
1 - 10 300 RESIDE IN THE ABO DESCRIPED RESIDENTIAL PROPERTY
SIGNATURE C
10 - 50 500 OF PERMITTEE
V
50 — 100 l000 oG
DISTRICTNO CLASS GROUP IZONE_/ PROCESSED BY O
100 — 500 15oo �� "
w
SIGN, GAS SIGN AND ONE CIRCUIT 300 NOTES a
TUBE, OR N
MARQUEE ADDITIONAL CIRCUITS 100 ?
SERVI CENOTOVER 600 VOLTS OR 200 AMP 200
APPROVALS DATE INSPECTOR'S SIGNATURE
SERVI CEOVER 600 VOLTS OR 200 AMP 500
TEMP POWER POLE
TEMP SERVICE,POLE, &APPURTENANCES 300
UNDERSLAB WORK
TEMP LIGHT OR RECEPT SYSTEM 300 "
ROUGH CONDIUT
WIRING XI
PERMIT FEE (SUB TOTAL) FIXTURES
POWER AUTHORIZED
PLAN CHECK FEE (50% PERMIT FEE)
UTILITY CO NOTIFIED
PERMIT ISSUING FEE 900
FINAL .1-SUPPLEMENTARY PERMIT ISSUING FEE 100
JOS PH C ROOHAN
TOTAL FEE 7 S^ SUPERVISING E AL ENGINEEP
L
PLAN CHECK VALIDATION CK M o CASH PERMIT VALIDATION C ,M o CASH
4 �,;� cCT 28 2 a 5, 5—
E BACK OF APPLICATION FOR COMPLETE SCHEDULE
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1405280018
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
(LEGAL ID FEES PAID BUILDING ADDRESS
ITR 13329 LT 41 UN 002 5021 CLOVERLY AV
IFEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917803813
ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET LA ROSA
18590-022-025 IA1 PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 596 GRID J5 LOCALITY TEMPLE CITY CAI
IF1 120V, 15/20A BR CKTS 20 00 BR 317 90 1
ITENANT IRA FAU LESS 3HP 1 00 FAU 11 00 (ISSUED ON PROCESSED BY PLAN BY
IH2 RES GRBG DISP LT 3HP 1 00 DIS 11 00 105/28/14 SR 1
IH3 RES DISHWASHR LT 3HP 1 00 DIS 11 00 I 1
(OWNER TEL NO IH4 RES RANGE HDS LT 3HP 1 00 HOO 11 00 IFINAL DATE FIN BY CODE 1
ICHEN, HENRY J (818) 286-3236- IH5 RES WASH MACH LT 3HP 1 00 WAS 11 00 1 1
15021 CLOVERLY AV IH7 RES EXHAUST FANS 3 00 EX 33 00 1
ITEMP 917803813 IJB AC UNITS +3-10HP 1 00 AC 19 70 IDE'SCRIPTIOlq OF WORK I
ILE 200 AMP PANELS, MCC 1 00 PAN 38 90 120 BRANCH CIRCUITS FAU/AC UNITS, GARBAGE DISPOSAL, DISHWASHI
I TOTAL FEES 492 30 1ER, RANGE HOOD, WASHING MACHINE, EXHAUST FANS AND UPGRADE
(APPLICANT TEL NO 1 ISERVICE PANEL TO 200 AMP
ICHEN, HENRY J (626) 864-7919-
15021 CLOVERLY AVE 1 ISPECIAL CONDITIONS
ITEMPLE CITY CA 91780 1
(CONTRACTOR TEL NO 1 (APPROVALS DATE INSPECTOR SIGNATURE
IEVERGREEN CONSTRUCTION AND REMODELI (213) 505-3293- 1 1
13 SAGE CANYON ROAD LIC NO I ITEMPORARY POWER POLE I I
IPOMONA CA 91766 946278 1 1 I I 1
I 1 (UNDERGROUND CONDUIT
(ARCHITECT OR ENGINEER TEL NO 1 IUFER GROUND I I I
I LIC NO 1 IROUGH COND T 1 1 1
IROUGH WIRING I 1 1
IMAIN WATER LINE 1 1
IPLASTIC Y/N METAL Y/N 1 1
(UTILITY COMPANY NOTIFIED( 1 1
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