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HomeMy Public PortalAbout6220 CLOVERLY AVE_Electrical__ 76A663-CE806 10/72 APPLICA _..__ F ; �E ECTRI z PERMIT / r COUNTY OF LOS ANGELES /� DEPARTMENT OF COUNTY ENGINEER JOBADDRESS �� �cl141J2 BUILDING"AND SAFETY DIVISION. , LOCALITY L-,e V NEAREST FOR APPLICANT TO FILL IN CROSS ST OUTLETS NO EACH FEE OWNER OR `, pt�� _ $ $ FIRM NAME RECEPT{U:LI- 7AIL /� ADDRESS FIRST 20 LIGHT 5L TOTAL •� 25 G" OVER 20 t-- I CITYaM (. TEL NO SWITCH `7 10 V PLAN CHECK LIGHTING FIRST 20 25 •�! F� APPLICANT OVER 20 ADDRESS �Ll FIXTURES f0 RESIDENTIAL APPLIANCES ' CITY TEL NO PERMIT RANGE DRYEP_WTR HTR APPLICANT STA COOK DISP F A U - ADDRESS SPACE HTR AIR COND.� CITYdw TEL NO CLOTHES WASH DISHWASH. ` LICENSE OR CLASS REG NUMBER FAN OTHER 100DO I HEREBI ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND HEATERS, ETC HP KW KVA ELECTRICAL WIRING I SIZE IN TYPE OVER • TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR O - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF- CAL I FORNI A F:CALIFORNIA OR TH I'+AM THE LEGAL OWNER OF THE ABOVE } 1 - 10 300 DESCRY ED RESI N IAL P OPERTY O PERMITEE V 10 - 50 500 SIGNATURE r pC O 50 - 100 1000 DISTRICT N0. PROCE ED BY ' W III- 100 - 500 15 00 N Z SIGN, GAS SIGN AND ONE CIRCUIT, 500 APPROVALS DATE INSPECTO SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 TEMP POWER POLE SERVICENOTOV0600VOLTS0R200AMP 300 UNDERSLAB WORK 1- , SERVI CEOVER 600 VOLTS OR 200AMP 1000 ROUGH CONDUIT TEMP SERVI CE, POLE, &APPURTENANCES 500 WIRING TEMP LIGHT OR RECEPT SYSTEM 300 FIXTURES oo POWER AUTHORIZED 6'7 /gypp Af UTILITY CO. NOTIFIED • FINALNt. ty PERMIT FEE (SUB TOTAL) NOTES PLAN CHECK FEE Q PERMIT ISSUING FEE 300 ' IF TOTAL FEE PLAN CHECK VALIDATION CK M 0 CA PERMIT VALIDATION CK M 0 CASH 1 � 6 31 j,"' PR 17 2 D' 1 0_. Jc ayo SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE _ ' 76A663C- CE8068 12/75 APPLICATION FOR ELECTRICAL PERMIT yG �' LBUI:LDII'LAND SAFETY DIV N FOR APPLICANT TO FILL IN ,JOB FResidential,Bldgs.& Pools EACH NO FEE ADDRESS G Finaily Sq Ft $ $ _ LOCALITY ' family Sq Ft. — NEAREST CROSS ST ntial Swimming Pools OWNER OR FIRM NAME Light, Switch & Receptacle MAIL0 ADDRESS - , / �/ional CITY Tel NA — 6� Y LjPLAN CHECK APPLICANT Fixtures 0 ADDRESS ional CITY Tel No PERMIT Fixed Appliances Not Over 1 HP APPLICANT Range Heater_ D W ADDRESS Oven Dryer W M Top FAU W H. CITY Tel No Hood Fan LICENSE O off.. Disp A.0 REG NUMBER Class V 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY O Power Apparatus& Large Appliances I WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING V Size&Type HP, KW, KVA,or KVAR ELECTRICAL WIRING W Up to 1 Incl. I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR N Over 1 to 10 Incl LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR T I A THE LEGAL OW E OF TME ABOVE Over 10 to 50 Incl DESCRIBED OR E RT Over 50 to 100 Incl PERMITEE ` Over 100 SIGNATURE DISTRICT NO OCE ED BY Services 0-200 Amp. Under 600 V 201 - 1000 Amp Under 600 V APPROVALS DATE IN CT Over 1000 Amp or Over 600 V SIGNATUURREE TEMP POWER POLE Temp. Power Pole&Appurtenances UNDERSLAB WORK Sign with One Branch Circuit Additional Sign Branch Circuits ROUGH CONDUIT (Other) WIRING FIXTURES POWER AUTHORIZED PERMIT FEE (Sub-Total) UTILITY CO NOTIFIED i PLAN CHECKING FEE (One-Fourth Permit Fee) f FINAL PERMIT ISSUING FEE d NOTES TOTAL FEE PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION CK M 0 CAS 3-816rMAY 19 2 '0 9.00 ♦�a ; 02 `� 76A66i!'CE-806(6/78) APPLICATION FOR ELECTRICAL PERMIT . COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN. JOB ADDRESS New Residential Bldgs &Pools' EACH NO FEE 1 &2-Family,Sq Ft $ 025 — $ LOCALITY Multi-family Sq Ft 02 — NEAREST JF Residential Swimming Pools 25 00 CROSSST FIRM NAM Outlets Rec ZLight Sw MAIL First,20 50 7 ADDRESS Total No Additional 30 CITY Tel No PLAN CHECK APPLICANT Lighting Fixtures First 20 50 ADDRESS Additional 30 Total No CITY Tel No . Fixed Appliances Not Over 1 HP PERMIT APPLICANT Range_Heater_D W _ Oven_Dryer_W M— ADDRESS Top _FAU — W H CITY Tel No Hood=Fan _Other_- LICENSE OR Disp —Room Air Cond 2 50 REG NUMBER Class I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO Size&Type HP, KW, KVA,or KVAR COMPL-Y WITH ALL COUNTY ORDINANCES AND STATE LAWS 2 50 REGULATING ELECTRICAL WIRING Up to 1 Incl I HEREBY CERTIFY\THAT I AM PROPERLY REGISTERED AND/OR � Over 1 to 10 Incl 5 00 LICENSED AS REQUIRED BY-LOS ANGELES COUNTY AND STATE OF Over l_O to 50 1nc1 1 2 50 CALIFORNIA-OR THATI WAM;THE'LEGAL'�OWN ,EROFr THE ABOVE Over 50 to 100 Inc 25 00 DESCRIBED RESIDE PROPERTY 40 00 PERMITEE Over 100 SIGNATURE r Services DISTRICT NO ]PROCESSED BY 0-200 Amp Under 600 V 12 50 201-1000 Amp Under 600 V 25 00 Over 1000 Amp or Over 600 V 5000 Z Temp Power Pole&Appurtenances 1000 G Sign with One Branch Circuit 1000 J Additional Sign Branch Circuits -200 INSPECTION > INFORMATION Misc Conduits&Conductors 1000 ON REVERSE s Other(See Complete Fee Schedule) SIDE u Z ;9456.2A • d # 0000'o2 PERMIT FEE (Sub-Total) Z 2 0 0'0 8.00 PLAN CHECKING FEE (One Fourth Permit Fee) O Qo 0 0 o a Q Q PERMIT ISSUING FEE $7 00 7 J _. 06,23-79 TOTAL FEE > r INSPECTIOONJFINALED W date '77j� ..+ca�/ By IL �- - ------ os'---— 76A663 DBS SA 11-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES L �T R T G 1 WILLIAM J. FOX, CHIEF ENGINEER i g FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMIT NO. ELECTRICIAN R. F. Walton RECEIVED BY READY FOR DATE ISSUED ADDRESS 5134 N. Acacia St. FIRST INSPECTION CITY San Gab* TEL No AT 68583 lb^l / COUNTY LICENSE NO 1104 EXPIRES BUILDING PERMIT FEES ADDRESS 6220 C1oVer1 NUMBER EACH FEE LOCALITY Temple Cit ' LIGHT OUTLETS 14 NEAREST RECEPTACLES 23 CROSS ST. , WALL SWITCHES 19 OWNER Meeker , TOTAL OUTLETS 6 Sc $ 2 80 MAIL ' ELEC. RANGES 25 ADDRESS ELEC. HEATERS 25 25 CITY TEL. NO. FIXTURES 14 5 70 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 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER NurneER HORS iPOW ER FEE NEW MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE- 7 A / I/z 6 LESS $ 25 SIGNATURE OF —\,/ � •1/z 2 .50F7�1 . PERMITTEE �L 2 s 1.00 INSPECTION RECORD 5 15 1 50 Is s0 2.50 50 200 5.00 ' 200 Boo 10 00 ,J soo 1000 1s 00 4—rC`I /��1 �C1 �✓/17�1d✓G-? , OVER 1000 20 00 ( (' M G SET%FREQ CHANGER-HP WELDERS: AC-KVA GENERATORS-KW TRANSFORMERS-KVA _ TEMP MOTORS (75%OF ORIG.) MOVED MOTORS (75%OF ORIG.) MISC. SIGNS NO. NO. TRANS. I APPROVALS NO NO LAMPS DATE /INSPECTOR'S NAME FOR EACH PERMIT M CONDUIT I IO^ 000 WIRING $1.00 1 FIXTURES $1 00 1 WIRING v SUPPLEMENTARY 50 I FIXTURES - 6 I w POWER TOTAL FEE $ UTILITY CO. NOTIFIED v ® I FINAL J WORKERS'COMPENSATION DECLARATION - ,o,a, APPLICATION FOR ELECTRICAL PERMIT I herb k affirrm tF(at I have a certificate of consent to self insure, CE-806G or a certificate ot.WorkersCompensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy therettt (Sec. 3800,Lab. C.) FOR APPLICANT TO FILL IN JOB Policy No. Company ADDRESS Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE 1 & 2-Family,Sq.Ft. S — $ LOCALITY x2 El Certified copy is filed with the county building inspection — NEAREST department. Multi-family Sq.Ft. CROSS ST Date Applicant Residential Swimming Pools OWNER OR FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL Outlets:Rec Light Sw. COMPENSATION INSURANCE � O � O ADDRESS This section need not be completed if the work involved First 20 ( b P Y the CITY permit is for one hundred dollars($100)or less.) Total No. Additional i[ 1 certifythat in the erfcrmance of the work for which this permit PLAN C EC< P P APPLICANT 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 Additional Total No. CITY Tel.No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of 'xW �• Lcc��ea!✓a v APPLICANT Exemption,you should become subject to the Workers'Compensation Range_ Heater_ D.W. S-c provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer _ W.M._ ADDRESS provisions or this permit shall be deemed revoked. Top — FAU _ W.H. CITY Tel.No. LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other_ I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. LICENSE OR (commencing with Section 7000) of Division 3 of the Business and REG.NUMBER Class. Professions Code,and my license is in full force and effect. Power Apparatus& Large Appliances DISTRICT NO PROCE BY d Size & Type HP,KW,KVA,or KVAR o 0 License Number Lic.Class Up to 1 Incl. FINAL U Over 1 to 10 Incl. DATE C)` / © VALIDATION 0 Contractor Date Over 10 to 50 Incl. ( 1 tJ E] FINAL I am exempt under Sec. Over 50 to 100 Inc. BY W Over 100 0- B.&P.C. for this reason fn 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 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): I,as owner of the property,will do the work and the structure Misc.Conduits & Conductors is not intended or offered for sale (Section 7044, Business Other (See Complete Fee Schedule) , 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 Lender's Address 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 repre ntatives of this County to enter upon the above-mentioned pro r y fo inspection purpogfs. SEE REVERSE FOR EXPLANATORY LANGUAGE a ur o Perm to Date I WORKERS COMPENSATION DECLARATION 200019 DPW 3/87 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self 'CE"� insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certified copy thereof (Sec 3800, Lab C ) Policy No Company FOR APPLICANT TO FILL IN JOB �t �C Certified copy is hereby furnished New Residential Bldgs & Pools EACH NO FEE ADDRESS ` oc (/L^ ✓ y ECertified copy is filed with the county building inspec- 1 & 2-Family, Sq Ft $ _ $ LOCALITY (� C G' tion department Multi-family Sq Ft NEAREST CROSS S Date Applicant Residential Swimming Pools 1 OWNER OR FIRM NAME ,ERTIF'(CATE OF EXEMPTION FROM WORKERS' Outlets Rec_I Light I Sw MAIL COMPENSATION INSURANCE ADDRE I/ First 20 (This section need not be completed if the work involved by Total No Additional CITY [_,b G lel the permit is for one hundred dollars ($100)or less ) PLAN 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 Lighting Fixtures First 20 ADDRESS so as to become subject to the Wo ers' mpensati Laws Additional \ Total No � CITY T I Dat Applica Fixed Appliances Not Over 1 HP PERMIT N TI O PP CANT If, after making this Certificate of APPLICATION Exemption, you should become subject to the Workers' Range— Heater—D W — 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 Hood — Fan —Other— CITY Tel No LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp — Room Air Cond — REG NUMBER Class (commencing with Section 7000)of Division 3 of the Business Power Apparatus & Large Appliances DISTRICT NO PROCES BY d and Professions Code,and my license is in full force and effect Size &Type HP, KW, KVA, or KVAR ( O License Number Lic Class Up to 1 Incl FINAL O Over 1 to 10 Incl DATE .� /Yl VA ATION Cc Contractor Date ' Over 10 to 50 Incl FI !/ O NAL F-1F_I am exempt under Sec Over 50 to 100 Inc gY U W B&P C for this reason Over 100 i1 Services, Swbd , MCC& Panelboards Z Date 0- 200 Amp Under 600 V J Signature 201 - 1000 Amp Under 600 V EJ Exemption for Reg Maint Elect Over 1000 Amp or Over 600 V 2 097.9 A SINGLE FAMILY Temp Power Pole&Appurtenances # o o e e o 2 HOME OWNER-BUILDER DECLARATION ircuit I hereby affirm that I am exempt from the Contractor's License Sign with One-Broach Circuits ' o - 1 S O O Law for the following reason (Section 7031 5, Business and Additional Sign Branch Circuits Professions Code) 0 0 owl 5,O O X0 1, as owner of the property, will do the work and the Misc Conduits&Conductors structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)— , l( Q24 -81B Business 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 PERMIT FEE (Sub-Total) (Sec 3097, Civ C ) PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address I certify that I have read this application and state that the TOTAL FEE above information is correct I agree to comply with oll,County ordinances and State jaws regulating Electrical wiring, and hereby authorize representatives of this County to enter upon t above entioned pr1ty for inspection urposes SEE REVERSE FOR EXPLANATORY LANGUAGE Os 5 nature of Permittee Dple 1 WORKERS' COMPENSATION DECLARATION 76A66310/81 APPLICATION FOR ELECTRICAL PERMIT I+'�e�efa • CE-806�ffirm that I'hove a certificate of consent to self CE-806G . rt irl5ure, Or a,�bertificaje'of Workers' Compensation Insurance, 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 ADDRESSD � Certified copy is hereby furnished New Residential Bldgs &•Pools EACH NO FEE 1 & 2-Family, 5 Ft $ — $ LOCALIT Certified copy is filed with the county building mspec- q tion department Multi-family Sq Ft — NEAREST !_ Residential Swimming Pools CROSS ST L- ��t,(� C OWNER OR Date Applicantr� .r FIRM NAME U , f CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec �^ Light�Sw AMAIL DDRESS COMPENSATION INSURANCE s section neenot be completed if the work involved b First 20 (Thiid p Y Total NoAdditional CITY Tel N n. the permit is for one hundred dollars ($100)or less.) -• + PLAN CHECK ' I certify that in the performance of the work for which this APPLICANT (1 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 fl ; � - CITY Tel No Date pplicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT If, after Aaking this Certificate of APPLICAN Exemption, you should become subject to the Workers' Range_ Heater_D W — 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 Hood Fan _ Other_ CITY Tel No LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp _ Room Air Cond REG NUMBER Class (commencing with Section 7000)of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO PROC SS BY and Professions Code,and my license is in full force ond,effect Size &Type HP, KW, KVA, or KVAR �. g 0 License Number Lic Class Up to 1 Incl FINAL //J V Over 1 to 10 Incl DATE ✓/ ✓f J 1119 Contractor Date // (/ VA ATION O ❑ Over 10 to 50 Iricl FIN I.- I am exempt under Sec Over 50 to 100 Inc BYOver 100 W B&P C for this reason N Services, Swbd , MCC& Ponelboards 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 Mamt Elect t SINGLE FAMILY Temp Power Pole &Appurtenances o o J a Q HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit o pp v I hereby affirm that I am exempt from the Contractor's License 'a J Law for the following reason (Section 7031 5, Business and Additional Sign Branch Circuits 0 Professions Code) - j, as owner of the property, will do the work and the Misc Conduits&Conductors structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)— 11011.7044, Business 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 PERMIT FEE .(Sub-Total) (Sec 3097, Civ C ) 'PLAN CHECKING FEE Lender's Name _ Lender's Address PERMIT ISSUING FEE z .O� I certify that I have read this application and state that the TOTAL FEE cJ 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 th a ove- entioned pro ty for inspection purposes � «n � SEE REVERSE FOR EXPLANATORY LANGUAGE t _ tur J`67 154r m A tee Tate - Y COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0604100007 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 ERT r LEGAL ID: FEES PAID BUILDING ADDRESS TR 17179 LT 22 6220 CLOVERLY AV FEE DESCRIPTION• QUANTITY. UOM AMOUNT TEMP CA 917801601 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET 5385-009-002 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE• 596 GRID J2 LOCALITY TEMPLE CITY, C HA FAU LESS 3HP 1 00 FAU 10.95 TENANT: JB AC UNITS +3-10HP 1 00 AC 19 65 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON: TOTAL FEES •58 35 04/10/06 JK 10/07/06 OWNER: TEL. NO: FINAL DATE FINAL BY: CODE CHASE HELEN L TR CHASE FAMILY TRUST (626) 286-6144- 6220 CLOVERLY AV TEMP 917801601 DtSCRIPTION OF WORK ELECTRICAL FOR AIR CONDITIONING AND HEATING SYSTEM APPLICANT: TEL NO: ZAMORA (818) 735-7876- 8319 VINEYARD AVE SPECIAL CONDITIONS: RANCHO CUCAMONGA CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE AMERICAN AIR CONDITIONING (800) 321-9494- 10716 GRAVILLEA LIC. NO TEMPORARY POWER POLE INGLEWOOD CA 433868C20 * UNDERGROUND CONDUIT ARCHITECT OR ENGINEER TEL NO 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