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Home My Public Portal About5720 CLOVERLY AVE_Electrical__ 76A66S`-CE80'6 A`8 .APPLICATION FOR ELECTRICAL PERMIT &U NTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING 7 1 BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE. COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. NO. EACH FEE RECEPT.� $ $ OWNER MAIL LIGHT—TAOTAL FIRST 20 .20 Q ADDRESS' SWITCH!—/ OVER 20 .10 CITY TEL. NO. PLAN CHECK LIGHTING TOTAL FIRST 20 .20 aZ� APPLICANT FIXTURES �� OVER 20 .10 ADDRESS RANGEDRYER—WTR.HTR.— CITY TEL. NO. �y STA.COOK DISP. F.A.U.— 'CONTRACTOR 41Gi SPACE HTR. AIR COND.—ADDRESS .'S CLOTHES WASH._DISHWASH._ CITY ';.d TEL. NO. FANOTHER 1.00 J�—� LICENSE IJOr CLASS. MOTORS,TRANSFORMERS RATING IND. HEATERS, ETC. HP. KW. KVA. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. O - 1 1.00 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR • 1 - 10 3.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO O. 10 - 50 5.00 RESIDE IN, THE ABOVE OEESCRIPED RESIDENTIAL PROPERTY. O SIGNATURE 5.1- V 50 - 100 10.00 OF PERMITTEE -- C, ed 100 - 500 15.00 0 DI STI I T O. GR P zpvP L) TUBE,GOR SIGN AND ONE CIRCUIT 3.00 --> A. _ uj MARQUEE ADDITIONAL CIRCUITS 1.00N NOTES: Z SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 SERVICE OVER 600 VOLTS OR 200 AMP 5.00 TEMP SERVICE, POLE, & APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP. POWER POLE UNDERSLAB WORK ROUGH CONDUIT PERMIT FEE (SUB TOTAL) WIRING FIXTURES PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED PERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL TOTAL FEE Lfo JOSEPH C. ROOHAN SUPERVISING ELECTRICAL ENGINEER. PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIONCK. M.O. CASH IEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE 7GA663 099 SA 7-51 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY ' COUNTY OF LOS ANGELES ELECTRIC I WILLIAM J. FOX, CHIEF ENGINEER r FOR APPLICANT TO FILL IN DISTR157_bLG— GROUP ZONE PE MPT;O. ELECTRICIA RECE VED BY READY FOR DA-7-It IB ED ADDRESS /0-17 /f1 FIRST INSPECTION r CITY EL. NO COUNTY LICENSE NO262 EXPIRES BUILDING PERMIT FEES ADDRESS V NUMBER EACH FEE LOCALITY LIGHT OUTLETS NEAREST CROSS ST RECEPTACLES r WALL SWITCHES OWNER '�Q� ///��_c��I� TOTAL OUTLETS 5C AMAIL DDRESS �//� TTS � 1' ,/ ELEC RANGES 29 ELEC HEATERS 25 CITY TEL. NO ��QQ FIXTURES B / -33-T/ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS MIBC APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITB AND STATE LAWS REGULATING ELECTRICAL WIRING MOTORS 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWERFEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER NEW MVD HP OVER INC EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. V2 6 LESS III 25 SIGNATURE Orgy/ *�... I/2 2 5D PERMITTEE —— 2 5 1 00 INSPECTION RECORD 5 is 1 50 is Bo 250 50 200 Soo 200 500 1000 J 500 l000 1500 Z OVER 1000 29300 p M 0 HET/FREQ CHANGER-HP R' WELDERS. AC-KVA O GENERATORS - KW TRANSFORMERS - KVA TEMP MOTORB-(7S% OF-ORIB) MOVED MOTORS (75% OF ORIG) Mlsc 4WP*RVE ,44-MAF7'ArL.Oo SIGNS No .-FRAN9 APPROVALS NO NO LAMPS DATE INSPECTOR'S NAME FOR EACH PERMIT WIRING $1 00 09 CONDUM FIXTURES $100 WIRING SUPPLEMENTARY 5o FIXTURES POWER TOTAL FEE UTILITY CO.NOTIFIED „ �J FINAL ��v 2� os s b I-0-4128M t I ; APPLICA'r N FOR. DEPARTMENT OF BUILDING AND SAFETY] COUNTY OF LOS ANGELES ELECTRIC WM J FO CHIEF ENGINEER a NAME 9-o DISTRICT O., GROUP ZONE, PERMIT NO. U ADDRESS � yCITY N RE YED BIL READY FOR DATE ISSUED d� FIRST INSPECTIONijCERT NO EXPIRES �7 APPLICANT FIff, IN HEAVILY OUTLINED PORTION ONLY JOB DESCRIPTION OF WORK ADDRESS NUMBER OF OUTLETS ON CIRCUITS LOCALITY LOCATION BY ROOMS NEAREST LIGHT OUTLETS SW PLUGS FMT CROSS ST CIRCUIT A B C D E F G H W NAME x MAIL ADDRESS O CI TEL.NO. I AM THE &&GAL FOSS SOR OF THE ABO LOS ANGELES COUNTY CERT T $ UALIFI CIAN 1 AM THE LEGAL:O OF THE PROPERTY DESCRIBED ABOVE OWNER CORRECNONS a z c� a 0 TOTAL NO OF OUTLETS s$ APPROVALS NO OF FIXTURES DATE INSPECTOR'S NAME, NO OF MOTORS` H P, CONDUIT NO OF SIGNS TRANS. WIRING NO OF RANGES Q&NNERS E FIXTURES MISCELLANEOUS POWER PERMIT FEE ffi 1 UTILITYCO NOTIFIED /lop TOTALFEE ' F1 / �� ✓ F '- / �I WORKER'S COMPENSATION DECLARATION 20-0019 DPW 9/89 I APPLICATION FOR ELECTRICAL PERMIT 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 ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec.3800 Lab. C.) r Policy No. Company FOR APPLICANT TO FILL IN JOB i ADDRESS Certified copy is hereby furnished. New Residential Bldgs.&Pools EACH NO. FEE ❑ $ _ $ LOCALITY Certified co Is filed with the count building inspection 1&2-Family,Sq.Ft. PY Y 9 P NEAREST J f\ department. Multi-family Sq.Ft. CROSS ST. [� (J Date Applicant Residential Swimming Pools ASSESSOR ( MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' — OWNER OR C COMPENSATION INSURANCE Outlets:Rec._LightSW. FIRM NAMERa_ [,� w First 20 MAIL (This section need not be completed if the work involved by the _� »�1 permit is for one hundred dollars($100)or less.) Total No. Additional ADDRESS 2-� ,—K I certify that in the performance of the work for which this permit CITY _ , Tel.No. is issued, I shall not employ any person in 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 15 OR 20A,120V BRANCH CIRCUITS NOTICE TO APPLICANT: If, after making this Certificate of CITY Tel.No. Exemption,you should become subject to the Workers'Compensation 1 TO 10 INCLUSIVE EACH provisions of the Labor Code, you must forthwith comply with such 11 TO 40 INCLUSIVE EACH PERMIT P Y P Y APPLICANT provisions or this permit shall be deemed revoked. 41 OR MORE BRANCH CIRCUITS EACH LICENSED CONTRACTORS DECLARATION ADDRESS Cl/ v' d I hereby affirm that I am licensed under provisions of Chapter 9 15 OR 20A,208V TO 277V LIGHTING EACH (commencing with Section 7000) of Division 3 of the Business and CITY .'� No2� Professions Code,and my license is in full force and effect. RESIDENTIAL APPLIANCES UP TO 3HP LICENSE OR Power Apparatus&Large Appliances REG.NUMBER Class. 0 License Number Lic.Class Size&Type HP,KW,KVA,or KVAR DISTRICT NO. / P PRMLI�i Y Up to 3 Incl. v fr Ui d Over 3 to 10 Incl. FINAL Contractor Date DATE U) ❑ Over 10 to 50 Incl. I am exempt under Sec. Over 50 to 100 In . �(�G G VALIDATION Over 100 FINAL B.&P.C.for this reason BY Services,Swbd.,MC�C* Pan�l,booa�rd� Date: 0-200 Amp.Under 600 V O 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 I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit W _ for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits - Code): - I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors p ;.r.s.0 is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) , �5li' -` and Professions Code). : ` IM t 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 G PERMIT ISSUING FEE o�7 lo Lender's Address I certify that I have read this application and state that the above TOTAL FEE 3 information is correct. I agree to comply with all County ordinances and State laws regulating ectr' at wiring, and hereby authorize representatives of this unty enter upon the above-mentioned property for insp on rpo s. SEE REVERSE FOR EXPLANATORY LANGUAGE ,-K--7,9'2--- SIGNATURE OF AP R AGENT DATE l` Y COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0002150030 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 6561 LT: 700 UN: .002 5720 CLOVERLY AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP'CA 917802551 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LIVE OAK 8587-011-023 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT,SW,RECP 26.00 OUT 47.10 TENANT: G2 LIGHTING FIXTURES 18.00 LGT 35.10 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: TOTAL FEES 109.95 06/05/00 UT 12/02/00 OWNER: TEL. NO: E FINA4 BY: lC DF� KEELIN BERNARD;SHERRIE A TRS (818) 287-8504 y 5720 CLOVERLY AV TEMP 917802551 DESCR[PT OF WOR ELECTRICAL FOR ADDITION APPLICANT: TEL. NO: DREAM HOME CONS. - SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE DREAM HOME CONSTRUCTION (626) 285-4421- 6323 85-4421 6323 LIVIA AVE. LIC. NO �' �',. TEMPORARY POWER POLE TEMPLE CITY, CA 91780 7448546 * �� UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. N0: �; r _ '' -,,r �ti UFER GROUND LIC.-NO-' ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED * ADDITIONAL DATA ON FILE REPORT ID: DPR265 ROUTE TO: BS0508