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Home My Public Portal About6028 CLOVERLY AVE_Electrical__ 76ABBS CESOG 12 BB APPLICATION FOR ELECTRIC PERMIT � 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS /, v JOHN A LAMBIE.COUNTY ENGINEER CASSATT D GRIFFIN,SUPT OF BUILDING LOCALITY FOR APPLICANT TO FIL`L IN CROSS ST PERMIT FEES OWNER I T E M NUMBERI EACH FEE OUTLET $ -S MAIL LIGHTS RECEPT SW 10 ADDRESS LIGHTING FIXTURES 10 i CITY TEL NO ELEC RANGES CLO DRYERS ELECTRICIAN T WATER HEATERS 50 ADDRESS 45 72i 'dMr ELEC SPACE HTRS DISHWASHERS ,1 CITY TEL NO ; GARBAGE DISPOSERS AUTO I STATE }moi O WASHERS STA COOKING UNITS 25 LICENSE NO eJ /7.J MOTORS OVER INC H P "DISTRICT NOGROUP ZO E P ESSED,BY 0— 1/2 25 1/2- 2 5o INSPECTION RECORD 2— 5 100 5— 15 150 is— 50 2 50 50—200 Boo SIGNS NO TRANS NO LAMPS SERVICE 0-600V 1 00 SERVICE OVER 600V Boo MISC WIRING PERMIT 1 00 FIXTURE PERMIT 1 00 SUPPLEMENTARY PERMIT 50 TOTAL FEE APPROVALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS 4PLICATION DAT/E'� INSPECTOR S SIGNATURE D ANSTATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING WIRING I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR ) II p v r� p - LICENSED AS REQUIRED BY LOS ANGELES C NTY AND STATE OF FIXTURES .../moi" 7 ( �wl.�(� CALIFORNIA OR T 1 AM THE LEG L O ER OF THE ABOVE • V n DESCRIBED RESID TI L P OPERTY POWER SIGNATURE UTILITY CO NOTIFIED �aapp"...,�'gj� II��,,..�•�qq�.gyyyA. � OF PERMITTE FINAL !�`f� If��Il�bdlrf ®� VAPDATION SUPETHUR C RVISING ELECTRICAL ENGINEER CK MO CASH 114 51 3 9 1 IPPR 21 2 A 2M •4 COUNTY OF LOS ANGELES APPLICATION FOR PERMIT DEPARTMENT OF COUNTY ENGINEER E L E DIVISION OF WELDING & SAFETY WILLIAM J. FOX, COUNTY ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRICIAN CORRIN L ADDRESS •1IS RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION / CITY TELL 4L��4 /� 1. - /- J COUNTY LICENSE tU32 EXPIRES BUILDING �Q 1/ 7 J PEMT FEES ADDRESS FEE NUM13ERI EACH LOCALITY LIGHT OUTLETS NEAREST RECEPTACLES ` CROSS ST WALL SWITCHES OWNER TOTAL OUTLETS 5c $ MAIL ELEC. RANGES 25 ADDRESS ELEC. HEATERS 25 FIXTURES 5 CITY TEL. NO. MISC. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS NUMBER OF LIGHT CIRCUITS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT 1 POSSESS TH VE LID LOS NumBER HORSEPOWER FEE ANGELES COUNTY LICENSE, O AM THE AL OWNER NEW V OVER INC. EACH Pe THE RESIDENTIAL PROP RIB OVE. I/2&LESS $ .25 SIGNATURE OF I/2 2 .50 PERMITTE z 5 1.00 5 15 1.50 INSPECTION RECORD 15 50 2.50 50 200 5.00 200 5o0 10.00 J 500 1000 15.00 Q OVER 1000 20.00 z M.G. SET/FREQ. CHANGER-HP WELDERS. AC-KVA 0 GENERATORS.-KW TRANSFORMERS-KVA TEMP. MOTORS (75% OF ORIG.) MOVED MOTORS (75% OF ORIG.) MISC. SIGNS NO. NO. TRANS. NO. NO. LAMPS APPROVALS FOR EACH PERMIT: DATE INSPECTOR'S NAME WIRING $1.00 CONDUIT Z "I;, 7^ FIXTURES $1.00 WIRING / SUPPLEMENTARY .50 FIXTURES Z' 2 /jJr Jl POWER TOTAL FEE $ UTILITY CO. NOTIFIED y�7• ??/'', I FINAL 76A 663 OBS BA. 4-52 1 WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) 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.) FOR APPLICANT TO FILL IN l PJOB Policy No. Company ADDRESS O�L v... Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE $ $ LOCALITY ❑ Certified copy is filed with the county building inspection 1 &2-Family,Sq.Ft. NEAREST department. Multi-family Sq.Ft. CROSS ST. Date Applicant Residential Swimming Pools ASSESSOR MAP PAGE IPARCEL CERTIFICATE OF EXEMPTION FROM WORKERSOutlets:Rec._Light Sw. p I� OI P.M NAME COMPENSATION INSURANCE NER OR First 20 ,d 0 �• d This section need not be completed if the work involved by the MAIL permit is for one hundred dollars($100)or less.) Total No. Additional ADDRESS I certify that in the performance of the work for which this permit CITYTe 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 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 HERMIT Power Apparatus&Large Appliances APPLICANT provisions or this permit shall be deemed revoked.' y p LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS I 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 Over 50 to 100 Incl. REG.NUMBER Class. a Over 100 DISTRICT NO. ^ PROCES OU License Number Lic.Class Services,Swbd.,MCC&PanelboardsCc Contractor Date 0-399 Amp.Under 600 V L 0 DATE ❑ 400-1000 Amp, Under 600 V I am exempt under Sec. VALIDATION V Over 1000 Amp.or Over 600 V FINAL 13-LU B.&P.C.for this reason BRANCH CIRCUIT FEES Rv / (n Date: 15A,or 20A,120V,Lighting or Recept. v Z_ 1 To 10 Branch Circuits q Signature 9 11 To 40 Branch Circuits F-141 Or More Branch Circuits Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits i SINGLE FAMILY Temp Power Pole&Appurtenances Ci HOME OWNER-BUILDER DECLARATION h`- g Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law a y i for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits Code): ,-TF1'-1 ❑ Misc.Conduits&Conductors I, as owner of the property,will do the work and the structure �� ,.`L� ti�� is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) and Professions Code). L,°r{ S i CONSTRUCTION LENDING AGENCY 'CHANGE 1 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.) Ei' _..i PLAN CHECKING FEE 00 10110 'I`' L!:' .I`}`4 Lender's Name -e752 f• �01 0 PERMIT ISSUING FEE 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 inspection purpos SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE OF PE ITTEE DATE WORKERS'COMPENSATION DECLARATION CE 806G (2-80) APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELESl �� BUILDING AND SAFETY insure, or a certificate of Workers'Compensation Insurance,or a cert' 'ed co Yhere f(Sec. 3800, Lab.C.) � �-->�v •�j_�„/ FOR APPLICANT TO FILL IN JOB Policy No. Company EACH NO. FEE ADDRESS ❑ New Residential Bldgs.&Pools Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ $ LOCALITY ' Multi-family Sq. Ft. NEAREST Certified copy is filed with the county building inspection CROSS ST / Residential Swimming Pools y1�, department. P RM NAME /Nd�rI/�� C WNEROR � Ip Date Applicant �` " Outlets: Rec._Light Sw. ADDRESS ��BK First 20 CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITYTel No. COMPENSATION INSURANCE PLAN CHECK d (This section need not be completed if the work involved APPLICANT `� G „t� 0 by the permit is for one hundred dollars ($100) or less.) Lighting Fixtures First 20 ADDRESS 5—?' L) Total No Additional X . " I certify that in the performance of the work for which this CIT Tel No. 0 permit is issued, I shall not employ any person in any manner Fixed Appliances Not Over 1 HP ��a PERMIT so as to become subject to the Workers' Compensation Laws. Range_.Heater_D.W. APPLICANT W Oven _ Dryer_W.M. ADDRESS �� d � Date Applicant Top FAU _W.H.. ��/�/� Hood Fan _Other_ CITf7 66 Tel No. NOTICE TO APPLICANT: If, after making this Certificate of Disp. — Room Air Cond.— LICENSE OR ifq o ^ /��aj® Exemption, you should become subject to/ the Workers' REG. NUMBER aC o -Class l.� z9 Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO. PROCESS D VY with comply with such provisions or this permit shall be _ deemed revoked. Size&Type HP,KW, KVA,or KVAR v Up to 1 Incl. o FINA '� LICENSED CONTRACTORS DECLARATION � Over 1 to 10 Incl. DA VALIDATION Over 10 to 50 Incl. I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. I FINA. BY 9 (commencing with Section 7000) of Division 3 of the Busi- Over 100 ness and Professions.Code, and my license is in full force and effect. Services yC—.1 0-200 Amp. Under 600 V License Number Lic.Class G/ 201-1000 Amp. Under 600 V Contractor_ Date 7 3 Q/ Over 1000 Amp.or Over 600 V HOME OWNER-BUILDER DECLARATION Temp.Power Pole&Appurtenances I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits ness and Professions Code): Misc.Conduits&Conductors MI, as owner of the property, will do the work and the Other (See Complete Fee Schedule)— O 3 IL 6A structure is not intended or offered for sale (Section 7044, Business and Professions Code). #,o o 0 o o 2 CONSTRUCTION LENDING AGENCY 2 0.0 24,50 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is PERMIT FEE (Sub-Total) ? -0 0 0 2[j 5 0,55issued (Sec. 3097,Civ.C.). Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) 03, 1 5-81 Lender's Address PERMIT ISSUING FEE I certify that I have read this application and state that the TOTAL FEE 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 inspection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date. COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC'WORKS 9701 LAS TUNAS EL 0508 0105140022 BUILDING AND SAFETY`! LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL D: FEES PAID BUILDING ADDRESS: TR: 6561 LT: 304 6028 CLOVERLY AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802025 ASSESSOR IH FORMATION NUMBER: NEAREST CROSS STREET: LAS TUNAS 5385-007-019 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT,SW,RECP 4.00 OUT 7.80 TENANT: G2 LIGHTING FIXTURES 2.00 LGT 3.90 ISSUED ON: PROCESSED BY: PLA BY: EXPIRES ON: TOTAL FEES 39,45 05/14/01 UT 11/10/01 OWNER: TEL. NO: FINAL DATE FINAL BY: CODE: TRUONG, THOMAS (626) 675-9189- - l�l�� 6028 CLOVERLY AV � p 0�po TEMP 917802025 DESCRIPTION OF WORK 0.� 5-9 p ELECTRICAL PERMIT FOR FOR WORKSHOP APPLICANT: TEL. NO: SAME AS OWNS SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - LIC. NO TEMPORARY POWER POLE p'p UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: UFER GROUND ti LIC. N0: _ _. - -- ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED REPORT ID: DPR265 ROUTE TO: BS0508