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Home My Public Portal About5423 CLOVERLY AVE_Electrical__ • 16A663 088 5A 7-31 APPLICATION FOR PERMIT DEPARTMENT OFNG AND SAFETY � � �� COUNTY OFF LOS LO$ ANGELES Raiff WILLIAM J FOX, CHIEF ENGINEER FOR APPLICANT TO FILL INDISTRIC � /cf2. NO GROUP ZONE PERMIT NO. 00, ELECTRICIAN n RECEIVEb Y READY 'FAO/R DATE ISSUED - ADDRESS O � FIRST �y$O W . TION CITYI-Z TL. ENO �ry COUNTY LICENSE NO t/ �L— EXPIRES BUILDING air PERMIT FEES ADDRESS �(i6� 44gM1.a( FEE NUMBER EACH LOCALITY s� _ LIGHT OUTLETS NEAREST RECEPTACLES CROSS ST 'o Zod WALL SWITCHES ��f / OWNER 1 b TOTAL OUTLETS Sc $ _ / MAIL ELEC RANGES ADDRESS ELEC HEATERS 25 'CITY TEL NO FIXTURES L s 9 4 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS MISC APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS tz _ AND STATE LAWS REGULATING ELECTRICAL WIRING MOTORS I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWERFEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER NEW MVD HP OVER INC EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE Vy a LE55 $ 25 _ SIGNATURE OE'� PERMITTE I/2 2 50 - 2 5 1 DO j- -S'-jZINSPECTION RECORD 5 15 1 so - 15 5O 2 50 50 200 Soo 200 50O 1D Oo J 500 1000 IS 00 Z OVER 1000 2000 M G SET/FRE4 CHANGER-HP WELDERS AC-KVA D GENERATORS - KW TRANSFORMERS - KVA _ TEMP MOTORS (75% Or ORIG) MOVED MOTORS (75% OF ORIG) MISC SIGNS NO N0 TRANS APPROVALS NO NO LAMPS I FOR EACH PERMIT DATE INSPECTOR'S NAME WIRING $100 (j CONDUIT FIXTURES $1 0O Q Q WIRING SUPPLEMENTARY 50 r— FIXTURES ✓\ Owe f�_r'� FPI OWER TOTAL FEE CJ UTILITY CO NOTIFIED rr FINAL o WORKER S COMPENSATION DECLARATION 20 DPW(12 91) APPLICATION FOR ELECTRICAL PERMIT 76A663 I hereby affirm that I have a certificate of consent to self Insure 76A663 or a certificate of Worker s Compensation Insurance or a certified COUNTY OF LOS ANGELE;- DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV copy thereof(Sec 3800 Lab C) hh Policy No Company FOR APPLICANT TO FILL IN' JOB ADDRESS Certified copy is hereby furnished New Residential Bldgs &Pools NO , EACH FEE LOCALITY El — Certified copy is fled with the county budding inspection &2 Family Sq Ft $ $SpeCtlOn NEAREST department Multifamily Sq Ft CROSS ST Jr Date Applicant MAP Residential Swimming Pools ASSESSORBOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec LPL Light Sw )NV�0 NER OR RM NAME COMPENSATION INSURANCE First 2 0 MAIL (This section need not be completed if the work Involved by the Total No Additional ADDRESS r permit is for one hundred dollars($100)or less) I certify that in the performance of the work for which this permit CITY Tel o S l7 Is issued I shall not employ any person in any manner so as to PLAN CHECK become subject to the Workers Compens'aking Laws Lighting Fixtures First 20 APPLICANT Total No Additional I ADDRESS V Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP NOTIC APPLICANT If after this Certificate of CITY Tel No Exemption,you should become subfe to the Workers Compensation OTHER APPLIANCES NOT OVER 3 HP provisions of the Labor Code you ust forthwith comply with such P RMIT p p y provisions or this permit shall be deemed revoked Power Apparatus&Large Appliances PLICANT LICENSED CONTRACTORS DECLARATION Size&Type HP KW KVA or KVAR ADDRESS hereby affirm that I 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 LICENSE OR -7 } Over 50 to 100 Incl REG NUMBER Class��} Q / ? /O Over 100 DISTRICT NO PRPCESSED BY License Number A7 J Lic Class Services Swbd -MCC&Panelboards 1= Contractor 0 399 Amp Under 600 V FINAL 0 DATE F 400 1000 Amp Under 600 V '�l y`� i J VALIDATION W I am a mpt under Sec Over 1000 Amp or Over 600 V FINAL d B&P C for this reason BRANCH CIRCUIT FEES BY co 6�y_ z Date 15A or 20A 120V Lighting or Recept �C(}y — 1 To 10 Branch Circuits 'j j03 53.30 Signature 11 To 40 Branch Circuits MS ❑ 41 Or More Branch Circuits 1 ITEMS 1T 0-53 Exemption r Reg Mamt Elect 15A 20A 208V To 277V Lighting Br Circuits SINGLE FAMILY Temp Power Pole&Appurtenances rC HOME OWNER BUILDER DECLARATION Sign with One Branch Circuit Cflt�uuwwL�ttGE °00 I hereby affirm that I am exempt from the Contractor s License Law for the following reason (Section 7031 5 Business and Professions Additional Sign Branch Circuits Code) 0000-0001 9/12/95 1 as owner of the property ro ert Misc Conduits&Conductors well do the work and the structure Is not intended oroffered for sale (Section 7044 Business Other(See Complete Fee Schedule) 2255 1 AMI r11:37 and Professions Code) 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) Civ C) PLAN CHECKING FEE Lender s Name PERMIT ISSUING FEE 30 - Lender s Address I certify that I have read this application and under penalty of purfury 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 representatIV this County to enter upon the above mentioned property for Ins on p rposes SEE REVERSE FOR EXPLANATORY LANGUAGE �SIGNATU OF PERMITTEE DATE COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0503090010 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT. LEGAL ID FEES PAID BUILDING ADDRESS ON FILE 5423 CLOVERLY AV FEE DESCRIPTION QUANTITY. UOM: AMOUNT TEMP CA 917803108 ASSESSOR INFORMATION NEAREST CROSS STREET OLIVE 8588-028-019 Al PERMIT ISSUANCE FEE - 27 75 THOMAS PAGE 596 GRID J4 LOCALITY. TEMPLE CITY, C HA FAU LESS 3HP 1 00 FAU 10 95 JB AC UNITS +3-10HP 1 00 AC 19 65 P BY PLAN BY EXPIRES ON LB 200 AMP PANELS, MCC 1 00 PAN 38 85 03/09/05 JK 09/05/05 TOTAL FEES 97 20 OWNER: TEL N0. FINAL DATE FINAL BY CODE LEE KYU-CHUNG,YOUNG JA (626) 445-6205 5423 CLOVERLY AV 2 TEMP 917803108 DESCRIPTION ELECTRICAL FOR HVAC SYSTEM AND UPGRADE SERVICE TO 200 AMPS APPLICANT TEL NO JAMES TSAI (626) 483-2857- 79 W MAGNA VISTA SPECIAL CONDITIONS ARCADIA, CA 91007 CONTRACTOR T L 0 APPROVALS INSPECTOR SIGNATURE JAMES TSAI CONSTRUCTION, INC (626) 445-8786- 79 W MAGNA VISTA LIC NO TEMPORARY POWER POLE ARCADIA, CA 91007 701042 B UNDERGROUND CONDUIT ARCHITECT OR ENGINEER --- TEL. NO UFER GROUND LIC NO ROUGH CONDUIT ROUGH WIRING RAIN WATER LINE PLASTIC YIN METAL YIN * ADDITIONAL DATA ON FILE REPORT ID DPR265 ROUTE TO: SS0508