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Home My Public Portal About6217 CLOVERLY AVE_Electrical__ 76AS63 DBS SA 11-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES ELECaCTRIC 1 WILLIAM J FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO GROUP ZONE PERMIT NO ELECTRICIAN R FWaltonREADY FOR ADDRESS 5134 N. Acacia St. RECEIVED BY FIRST INSPECTION DATE ISSUED CITY SanGab• TEL NO AT 68583 & 7-1l COUNTY LICENSE NO 1104 EXPIRES ABUILDING DDRESS 6217 Cloverly Ave. PERMIT FEES MBEACH FEE LOCALITY Temple City NUMBER LIGHT OUTLETS iQ, NEAREST RECEPTACLES 24 CROSS ST WALL SWITCHES 109 2 90 OWNER Meeker TOTAL OUTLETS 58 5C $ MAIL ELEC RANGES 25 ADDRESS ' ELEC HEATERS 1 25 25 FIXTURES 15 5 75CITY TEL NO 1 HEREBY ACKNOWLEDGE THAT 1 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 - AND STATE LAWS REGULATING ELECTRICAL WIRING `- MOTORS I CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. NEW MVD HP OVER INC EACH 1/2 a LESS $ 25 25 SIGNATURE OF i/2 2 50 PERMITTEE 2 5 1 00 INSPECTION RECORD 5 15 1 50 15 50 2 50 50 1 200 5 00 200 Soo 10 00 J 500 1 1000 15 00 Z 1---::#-OVER 1000 20 00 V' M G SET/FREQ CHANGER-HP 0 WELDERS AC-KVA GENERATORS-KW TRANSFORMERS-KVA TEMP MOTORS (75%OF ORIG ) MOVED MOTORS (75%OF ORIG ) MISC SIGNS NO NO TRANS APPROVALS IND NO LAMPS DATE INSPECTOR'S NAME FOR EACH PERMIT / Av 1 q ! V / % 4> G WIRING $1 00 1 loo V CONDUIT FIXTURES $1 00 1 00 WIRING SUPPLEMENTARY 50 FIXTURES 'U ` 6115 POWER ' TOTAL FEE $ UTILITY CO NOTIFIED h ► ) / A. ® FINAL v WORKERS'COMPENSATION DECLARATION `f CEA� '310/81 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of tdnsent to ;elf , insure, or a certificate of Workers' Compensation Insura , COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec 3800, Lab C ) Policy No Company FOR APPLICANT TO FILL IN JOB ADDRESS Certified copy is hereby fu s ed New Residential Bldgs & Pools EACH NO FEE i ❑ Certified copy is f with the county building inspec- 1 & 2-Family, Sq Ft $ — $ LOCALITY 6 tion departm Multi-family Scl Ft — 'NEAREST CROSS ST Residential Swimming Pools OWNER OR Date Applicant FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec Light Sw_ MAIL COMPENSATION INSURANCE ADDRESS p�- (This section need not be completed if the work involved by First 20 Total No Addtional CITY. GZ Tel No i the permit is For one hundred dollars ($100)or less ) t PIAN CHECK I certify that in the performance of the work for which this APPLICANT permit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws Lighting Fixtures First 20 ADDRESS Total No Additional Dat Applicant CITY Tel No NOTICE LIC If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT Exemption, you should become subject to the Workers' Range_ Heater—D W — APPLICANT Compensation provisions of the Labor Code, you must forth- Oven _ Dryer — W M — ADDRESS with comply with such provisions or this permit shall be Top _ FAU —W H — deemed revoked CITY — Tel Noe _G� LICENSED CONTRACTORS DECLARATION Hood _ Fan _Other— Disp _ Room Air Cond LICENSE OR 2 Class l I hereby affirm that I am licensed under provisions of Chapter 9 REG NUMBERo.0 F1 Z C (commencing with Section 7000) of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO FIR BY and Professions Code, and my license is in full force and effect ��^^ O. � Size'&Type P, KW, KVA, or KVAR License NumbeiC (�Lic Class l`� /^tt to 1 Inc, L A FINAL, f � b4e4 1 to 10 Incl cJl7 i VALIDATION Contra cT 4 Date / Over 10 to 50 Incl V ❑ FINAL I am exempt under Sec Over 50 to 100 Inc BY _d B &P C for this reason Over 100 t/f Date Services, Swbd , MCC& Panelboards ► // 1 (% 0 -200 Amp Under 600 V o•� Q Signature 201 - 1000 Amp Under 600 V ❑ Over 1000 Amp or Over 600 V Exemption for Reg Maint Elect SINGLE FAMILY Temp Power Pole &Appurtenances z-'3 5 9 6 A HOME OWNER-BUILDER DECL ATION Sign with One Branch Circuit I hereby affirm that I am exempt from t o Contractor's License # 0 0 o o o 2 Law for the following reason (Sects 7031 5, Business and Additional Sign Branch Circuitst '� U Professions Code) a'8,$ ❑ I, as owner of the prop y, will do the work and the Misc Conduits&Conductors 0820-8 4 structure is not intend d or offered for sale (Section Other (See Complete Fee Schedule)_ 110111.7044, Business and P ofessions Code) CONSTRU ION LENDING AGENCY I hereby affirm that t ere is a construction lending agency for the performance o the work for which this permit is issued PERMIT FEE (Sub-Total) 6l7 (Sec 3097, Civ ) PLAN CHECKING FEE Lender's No e PERMIT ISSUING FEE C� Lender's ddress I certif that I have read this application and state that the TOTAL FEE 36 S" abov information is correct I agree to comply with al,County ord�ances and State jaws regulating Electrical wiring, and hereby authorize representatives of this County to enter upon the a ve-mentio property for inspection purposes �v � SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Xrmllee ' Dalie COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1205210050 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT LEGAL ID FEES PAID BUILDING ADDRESS ITR 17179 LT 17 6217 CLOVERLY AV IFEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917801602 (ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET WENDON 1 15385-010-017 1A1 PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 596 GRID J2 LOCALITY TEMPLE CITY, Cl I IG1 OUTLETS-LGT,SW,RECP 5 00 OUT 10 00 1 TENANT IG2 LIGHTING FIXTURES 1 00 LGT 2 00 JISSUED ON PROCESSED BY PLAN BY I I IH2 RES GRBG DISP LT 3HP 1 00 DIS 11 00 105/21/12 SR I I TOTAL FEES 50 80 1 1 OWNER TEL NO IF AL DATE FINAL BY CODE ILEE, HUANLING (626) 456-0716- 1 19615 GARIABALDI AVE v ITEMP 917801602 IDESCRIPTION OF WORK 1 15 OUTLETS, 1 LIGHT FIXTUREAND GARBAGE DISPOSAL APPLICANT TEL NO SAME AS OWNER - I ISPECIAL CONDITIONS 1 I I I I I I I I I I I I ICONTRACTOR TEL NO I (APPROVALS DATE INSPECTOR SIGNATURE ISAME AS OWNER - , I I LIC NO I ITEMPORARY POWER POLE I I I I I I 1-1 I I (UNDERGROUND CONDUIT I I I I I I 11 1 (ARCHITECT OR ENGINEER TEL NO IUFER ,ROUND I I I LIC NO I IROUGH CONDUIT I I I I I I I RGUGrI WIRING 1 1 IMAIN WATER LINE I I I IPLASTIC YIN METAL YIN I I I I I I I I I I (UTILITY COMPANY NOTIFIEDI I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I i I I I I I I I I I I I I I I I I I I IREPORT ID DPR265 ROUTE TO BS0508 I I I I I I