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HomeMy Public PortalAbout5335 CLOVERLY AVE_Electrical__ DBS S-A 12-4444 Q r APPUCATION FOR PER= DEPARTMENT OF BUILDING Arty s ' ' r�11�iJL/��j�TRI�j� COUNTY OF LOS ANGELES , W J FOX CHIEF ENGINEER a NAME �� oder6` DISTRICT IVO. GROUP ZONE PERMIT NO. ADDRESS CITY TEL NO �� f� RECEIVED BY READY FOR FIRST INSPECTIONDATE ISSUED J COUNTY R J .��� 'F—-.a- _ 41 CERT NO EXPIRES �^�C, APPLICANT.' FILL IN HEAVILY OU'T'LINED PORTION ONLY DESCRIPTION OF WORK ADDRESS d Y Y NUMBER OF OUTLETS ON CIRCUITS LOCALITY LOCATION BY ROOMS NEAREST LIGHT OUTLETS ISW PLUGSFIXT CROSS ST CIRCUIT A' B I C I D I E F G H W NAME a+ Z MAIL 3 ADDRESS O CITY TEL NO 1 AM THE LEGAL, POSSESSOR Oc THE ABOVE LOS ANGELES COUNTY CERTIFICATE O QUALIFICATION. - ELECTRICIAN iI AM THIS LEGAL OWNER OF THS PROPERTY DESCRIBED ABOVE i OWNER CORRECTIONS Al. r Cs.X71 S i' V t n ft, M A A r — _.i Z 2 0 OTA NO OF OUTLETS ffi APPROVALS +:�m NO OF FIXTURES ffi i /DAT/E/// INSPECTOR'S 7dAME' NO OF MOTORS H P $ CONDUIT "4}�{, �nlq{ NO OF SIGNS TRANS $ WIRING NO OF RANGES OR HEATERS $ FIXTURES MISCELLANEOUS $ POWER /I //4 PERMIT FEE 11; 0 UTILITYCO NOTIFIED -G� Q q G,0,,� V TOTAL FEE FINA I 76A663-CE806 9-64 APPLICA ION FOR ELECTRI AL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING 9� BUILDING AND SAFETY DIVISION ADDRESS �J JOHN A LAMBIE COUNTY ENGINEER 4 COLEMAN W JENKINS SUP T OF BUILDING LOCALITY NEAREST OR APPLICANT TO FILL IN CROSS ST RECEPT TOTAL NO EACH FEE OUTLETS FIRST 20 �y('1 $ 20 $ X OWNER LIGHT Q I -•O av MAIL swl7cH ADD'L o`� 10 ADDRESS OVER 20 �( / d TOTAL r-i CITY L NO LIGHTING F)RST 20j t © 20 �Q FIXTURES } / C� — I O=D DR 20 10 ELECTRICIAN RANGES CLO DRYERS WTR HTRS 1 00 ADDRESS V GARB DISP STA COOK CITY TEL DISHWAS14 AUTO WASH $TATE pC(} / GO LICENSE NO SPACE HTRS STA APP ('/.H9MAX ) Y 50 MOTORS OVER NOT OVER H P DISTRICT N G P ZONE P O D B O 1 too 1 3 1 So INSPECTION REO D s B 200 O 8 Is 250 V 15 50 300 w O H 50 100 500 V w SIGNS NO TRANS a NO LAMPS H Z SERVICE O 600V NOT OVER 200A 100 0 0 SERVICE O 600V OVER 200 A 200 SERVICE OVER 600V 500 MISC PERMIT ISSUING FEE 200 d SUPPLEMENTA13Y PERMIT ISSUING FEE 100 TOTAL FEE 0 LBY ACKNOWLEDGE THAT I HAVE READ THIS APPL CATION APPROVAL$ DATE INSPECTOR 6 SIGNATURE TE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT / A LL COUNTY ORDINANCES AND STATE LAWS REGULATING CAL WIRING WIRING EBY CERTIFY THAT I AMPROPERLY REGISTERED AND/OR FIXTURESD AS REQUIRED BY LOS ANGELES COUNTY AND STATE OFNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TOIN THE ABOVE DESCRIBED SIO TIAL PROPERTY POWERURE l UTILITY CO NOTIFIED MITTEE FINAL ,/, /�"�.�/!►'I VA IDATION JOSEPH C ROOHAN CK MO CASH SUPERVISING ELECTRICAL ENGINEER L�'Co 3 6 9 0`0 JUL 15 2 0 1 4.7 O N n' WORKERS COMPENSATION DECLARATION -663 10/81 CE-806G APPLICATION FOR ELECTRICAL PERMIT {� LI - I hereby affirm that I have a certificate of consent to self insure or a certificate of Workers Compensation Insurance or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy tpereof(Sec 3800 Lab C) Policy No r Company FOR APPLICANT TO FILL IN JOB ❑ Certified copy is herebyfurnished EACH NO FEE ADDRESS New Residential Bldgs & Pools ❑ 1 & 2-Family,Sq Ft $ _ $ LOCALITY Certified copy is Bled with the county building inspection IV department Multi-family Sq Ft NEAREST CROSS ST Date Applicant Residential Swimming Pools OWNER OR { FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec4 Li ht Sw ADDRESS MAIL L/ - COMPENSATION INSURANCE g 3 C �–�V (This section need not be completed If the work Involved by the F rst 20 d r 1 permit Is for one hundred dollars ($100) or less) Total No Additional CITY CM �Z L Tel No PLAN CHECK I certify that In the performance of the work for which this permit a APPLICANT issued I shall not employ any person in any manner so as to b come subject to the Workers Compensation Laws Lighting Fixtures First 20 ADDRESS Additional Tel No ional �' Total No D e �� Applicant Fixed Appliances Not Over 1 HP PERMIT NO ICE TO AP (CANT If after making this Certificate of APPLICANT Exemption you should become subject to the Workers Compensation Range_ Heater_ D W provisions of the Labor Code you must forthwith comply with such Oven _ Dryer _ W M _ ADDRESS JTV provisions or this permit shall be deemed revoked Top — FAU W H - _ CITY Tel No LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other_ OR I hereby affirm that I am licensed under provisions of Chapter 9 LICENSE Disp B Room Air Cond REG NUMBER Class (commencing with Section 7000) of Division 3 of the Business and Professions Code and my license is in full force and effect Power Apparatus& Large Appliances DISTRICT NO OPROC S D BY d Size& Type HP KW KVA or KVAR � 0 License Number Lic Class Up to 1 Incl FINAL U VALIDATION Over 1 to 10 Incl DATE O Contractor Date v Over 10 to 50 Incl FINAL 1❑ I am exempt under Sec Over 50 to 100 Inc BY U W B&P C for this reasoZ n Over 100 Y D.. Services,Swbd MCC & Panelboards ® Z Date 0-200 Amp Under 600 V Signature 201 - 1000 Amp Under 600 V ❑ Over 1000 Amp or Over 600 V Exemption for Reg Maint Elect SINGLE FAMILY Temp Power Pole& Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ` 307 22.90 1 hereby affirm that I am exempt from the Contractors License Law Additional Sign Branch Circuits 1 ITEM for the following reason(Section 7031 5 Business and Professions Code) TOTAL 22. 90 ❑ Misc Conduits& Conductors I,as owner of the property,will do the work and the structure �!'���/ �� is not intended or offered for sale (Section 7044 Business Other(See Complete Fee Schedule) _ ® K 22.90 and Professions Code) CHANGE .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 3097 PERMIT FEE. (Sub-Total) 0�-00ri1 5l11/9(1 Civ C) - 041 1 AM 8:23 PLAN CHECKING FEE Lenders Name J PERMIT ISSUING FEE Lenders Address j I certify that I have read this application and state that the above TOTAL FEE 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 inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Per dtee Date -- COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0209230012 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT LEGAL ID F5ES PAID BUILDING ADDRESS ON FILE 5335 CLOVERLY AV FEE DESCRIPTION: QUANTITY UOM AMOUNT TEMP CA 917803106 ASSESSOR R A NEAREST CROSS STREET OLIVE 8590-004-009 Al PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID J4 LOCALITY TEMPLE CITY F1 120V, 15/20A BR CKTS 1 00 BR 17 25 TENANT JB AC UNITS +3-10HP 1 00 AC 19 65 ISSUED ON PROCESSED BY PLAN BY EXPIRES TOTAL FEES 64 65 09/23/02 JK 03/22/03 OWNER TEL NO FINAL DATE FINAL BY CODE CHIN,ELAIN (626) 281-9222- , 5335 CLOVERLY AV TEMP 917803106 DESCRIPTION OF WORK CIRCUIT FOR PANELS ON AND A/C UNIT APPLICANT ECONO AIR (800) 503-2666- 3366 LA PALMA AVE SPECIAL CONDITIONS ANAHEIM 92806 CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE ECONO AIR (800) 503-2666- �� �� TEMPORARY POWER0 3366 E LA PALMA AVENUE LIC NO ANAHEIM CA 92806 445220HIC \ \ UNDERGROUND CONDUIT CH N TEL 1 UER ON � ROUGH CONDUIT LIC No � � ROUGH WIRING — _ MAIN WATER LINE PLASTIC Y/N METAL Y/N ,�- ------- -- -- --- —----- --J UTILITY COMPANY NOTIFIE � ��Pswcs * ADDITIONAL DATA ON FILE REPORT ID DPR265 ROUTE TO BS0508