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HomeMy Public PortalAbout9861 ESTRELLA AVE_Building__ APPLIICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN (Prinl OI Ivor only) BDI LOINc�'T f �S�-.u� COUNTY OF LOS ANGELES A DDREss C UL DEPARTMENT OF COUNTY ENGINEER CITYJIPL� 'ZiP 2 - BUILDING AND SAFETY DIVISION SIZE OF SOT/, // NOWOONBLOTS •� ADDRESBUILDIN S, ��/ ` TRACTP BLOCK LOT NO. LOCALITY TEL. NEAREST ' OWNER ,e; ( �� 0.✓ i9// NO. _ CROSS ST. �. ZrASSESSOR ADDRESS �� f Oe. MAP BOOK PAGE PARCEL � J�[ DISTRICT GROUP TYPE FIRE OC SED BY CITY •/ L-''/ ZIP �O ^ CONST. ZONE L ARCHITECT O TEL. ClX ENGINEER LL,A� Lf1 C' /�P ND"ZA STATISTICAL CLASSIFICATION SEWER MAP ADDRESS ��7! ^L/R'�NLS/ G �! CLASS NO��-DWELL,UNITS SK�P CONTRACTOR�,'�J N k TEL 35V-7 USE ZONE MAP ADDRESS 3C/ ! // -D�11v T�K NO. CC�91��� LIC, -- JoSPECIAL CITY J /2L . CLASS - / CONDITIONS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO CONSTRUCTION LENDER/r, } NAME AND BRANCH `rz' BLDG.SETBACK FROM C %17 FRONT PROP.LINE OF � (STREET) L ADDRESS CITY HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING C SO. FT (6 NO. OF NO. OF CHECKFRONT PROP. LINE HIGH AY WIDTH SIZE FjO� STORIESa FAMILIES ONE L _ u + a DESCRIPTION OF WORK NEW El �� ' C/• BLDG.SETBACK FROM ' ? 1� cl ADD 1, SIDE PROP.LINEOF (STREET) ,�� ALTER O HIGHWAY + YARD o TOTAL SETBACK FROM TYPE OF EXISTING REPAIR SIDE PROP, LINE HIGHWAY WIDTH USE EMOL El + USE EXISTING BLDG. APPLICAN N !G Swr,NSQ TEL CORNER CORNER CUTOFF YES ❑ NO ❑ (PRINT) IN OPEN SPACE YES ❑ NO ❑ BY (SIGNATURE)0,ctaL �. (^ /(--1 /_ �+ A�/�^� IN COASTAL ZONECA TE 60RICAL EFEMPE ON❑ YES❑ NO ❑ %'ALUATION Y / Vl �/C�)d HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY IMPACT E%EM PTION DECLARATION SIGNED (GATE) WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE) HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE q / W BOF CODE M THE STATE DF CALIFORNIA IN RELATING TO y -/ WORKMEN'S COMPENSATION i ION INSURANCE. /. SIGNATUREOFOF PERMITTEE ADDRESS l / � L`/) 1A1,s,,�AFC�,_�/�o-JAff. Ala l— BY TEL / /-onl ,.f-e, NO3.OY^9DATE fl/ / A1AKE CIIECKS PAYABLIT 'I U' PEES FEE S HARVEY T. BRAN DT: COUNTY GI NEER 'PLAN CHECK VALIDATION O. CASH PERMIT VALIDATIONS CH. 'm.o. CASH 448�JAN 1423 D 7 .3.80 eat JV�� 6 3.6iJAN 30 1 D 1 23.001-56 76A638A CERS03 7/73 DEPARTMENT OF BUIr • AND SAFEIC'T p , +.PPLICATION FOR PEkMIT COUNTY OF L GELES 1 , WM. J. FOX. CHIEF ENGINEER UILDONG 1. FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY 4' NG a L /.�I• DISTRICT NO. I - PLANN(CK.NjO�.-^ - - --PERMIT NO. ADDRBUILD689 i�,Fina/ J .J,` laps F'Prp 7 }! 1 V � / � i LOCALITY /G' p-7 0 4e �4 tl RECEIJVED BY DATE OF APPL.^ DATEEIIS�SaUED NEAREST 'J � , '- /y-i7-so /I d� CROBB HT. Q V W + •/ IJ �w OWNER J. F, e kf b Cf d BUILDING — ZES 7TG-L/ !�" ADD RESB L L/ � � �9.J � /G `L' LJ7 MAIL s, �dw /.V Aj,4o //Q LOCALITY ��>i-`/1�)pI l �T 7 AAD RENSpA.- C/ (�/ /� iy y�/Q' CITY /! YL�'d/ 4"• NO.DO /ori Q�� NEAREST 'Rig L'1) . /ld TEL NEAREST T. L9 U (� IV FIRE ND.OF TYPE GROUP ARCHITECTOR / / ,TIJEOL. / / ZONE PLANS ENGINEER SLOG. iORD.NO., -ADDRESS / 1 / s� fiETSACKIINE 7 � F%" ffi/>V- SPL CONTRACTOR V• b/// NS�!'CI NOLDO (3gf G. BY PROVEp DATE , _ USE Q APPROVED ADORE H SQ- A.� A,,.. ZONE f,�I BY DATELAL i DESCRIPTION 717— / LOTNO. - BLOCK �� Z.00 -� CORRECTIONS TRACT /� /` 1 7— I - ' SIZE OF LOT S X I 7 NO.OF BLDSH. NOW ON LOT USEOF I NO.OF L... I NO,OF •EXISTING BLOW. FA. Ee ROO MB DESCRIPTION OF WORK NEW REPALTERATION ADDITION D T A AIR / MDVINO DEMOLI9H� � SIZE 6 T I O gI ROOMS STORIES D r WALLROOF /� n COVERING .CT/JI•r0 I COVERING COniPo I BUILT. NEW 'r]�fr �NQ •./TH J• c / /,„R , US"'NS L/ /./Y l7� 1/ e C7N �• Y/X so 00 /0", .O Gore rf / 7. s I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION:: LOCATION INSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS /OATS AND AND STATE LAWS.REGULAT.INO BUILDING CONSTRUCTION. FRAME:BRACINS, BC LTS STOP6, SIGNATURE2•'�-5� PERMITOF TE LATH, INT. /fi�A/In Ir AUTHORIZED AST ry LATH, EXT. VYI IN 96A.A-3 9-49� $ x OP.O.B �O PLASTER. INT. 2_0d FEE lJ / I_ uo VC PLASTER,EXT. VALUATION �/' f., ( 7 FINAL ILK 3-3a 557 a- COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION - FOR APPLICANT TO FILL IN 'BUILDING ADDRESS I hereby affirm that have a certificate of consent to self insure, BUILDINGAD RE8S or a Certificate of Workers'Compensation Insurance,or a certified �'6I y} copy thereof(Sea 3800,Lab.C.), CIT^ : ZIP LOCALITY Policy No.-Company Q P Y SIZE OF LO NO.OF BLDGS.NOW ON LOT ❑ Certified copy i3 hereby furnished. � NEAREST CROSS ST C ❑ Certified copy IS filed With the county building Inspection TRACT BLOCK LOT NO. 1 l a Jot ' department. USE ZONE MAP NO. � Date Applicant ASSESSOR MAP BOOK PAGE PARCEL- D I SPECIAL CONDITIONS ' 1A` CERTIFICATE EXEMPTION FROM WORKERS' OWNER TEL.NO. COMPENSATION INSURANCE Cc`}C, `_( �-5S WITHIN 11100 FT.OF SCHOOL? YES NOS//� (This section need not be completed if the permit is for one hundred AI)JgS/ I L. DISTRICT "GROUP TYPE CONST.' FIRE ZONE PROCESSED BV dollars($100)Or less.) CITY O .zIPG, o f..�r � / I Certify that in the pertormance of the work for which this(lermit ,�,,, } / I� �/ JV Q Is issued, I shell not employ any person in any ma of 83 t0 qR HI ECT R ENGINEER TEL.NO. become subject t0 Me Workers'C n tion w3. STATISTICAL CLAg191FIQATIQN APT CONDO Date�'^��Applicant DDRESS CLASS NO. � 1 DWELL UNITS NOTICE TO APPLICANT., If, after making thi ertificate 01 REQUIRED TOTAL SETBACK FROM EXIST Exemption, I CONTRAC/TOR 1 TEL.NO. p you should become subject t e Workers' Z SETBACK YARD HWY PROP LINE WIDTH Compensation provisions Of the Labor Code, you must forthwith V'" NXlSO� FRONT comply with such provisions or this permit shall be deemed revoked. %RRES, LIC. O. PL ((�� 'mil '!\ „i SIDE T LICENSED CONTRACTORS DECLARATION clTv I `ucl cu PL _ ao I hereby affirm that I am licensed under provisions of Chapter 9 c.�Tf I �" SEWER AP V (commencing with Section 7000)of Division.3 of the Business and SO.FT.SIZE NO.OF STORES NO.OF FAMILIES W/ v O Professions Code,"and my license is in full force and effect. NEW El BK (_ PG License Number T(J I y�7 LIC.Class DESCRIPTION OF WORK ADD ❑ VALu TION ,,,fi D Contractor.h .3(J DS,30 Data ?-.—'�a...z%C7 L` L�, F�u .20a�+ ALTER $ ©`^-' z ❑ I am exempt under Sec. REPAIR ❑ $ . B.BP.C.for this reason - DEMOL ❑ LDMA P/C# - Det USE OF EXISTING IDG. I �I t URM ❑ 1 `{, f Signature !/. APPLICA (PRINT) TEL.NO. LDMA Perm# y El 1. as owner of the property, my employees with wages as ZO ACCT.°t their sole compensation,will do the work and the structure is ADDRESS F -` 7 269.25not intended or offered for sale (Section 7044, Business and _ FINAL TE a Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE HAURDOUSMATERIAL - +I�•'� " ❑ 1, as owner of the property, am exclusive) contracting With OR A MIXTURE CONrAWING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN ! qj /'{-y Y g THE AMOUNTS SPEC.L'rIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY 7 ITL(tl'iL 26 T - 25 licensed contractors to construct the project.(Section 7044, ,p/1/ Business and Professions Code.) YES❑ No TOTAL 269.11 � WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING E e CONSTRUCTION LENDING AGENCY OCCUPANT REQUIREA PERMIT FORCONSTRUCTIION OR MODIFICATION FROM THESOUH I _Y ,HRNGE - ° COAST AIR QUALITY MANAGEMENT DISTRICT SCAOMD SEE PERMITTING CHECKLIST .1313 FOR GUIDELINES. m that there is a construction lending agency for YES El MOO / I the performance of the work for which this permit is issued(Sec. I hereby affirI HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD / 1'('I�j {�{ }� 3097,CIV.C.). PERMITTING CHECKLIST.I UNDERSTAND MV REQUIREMENTS UNDER THE LOS ANGELES / DLIV V��IQIJ 1 J'r1���L I �- GOUNTYC ETITLEY,CHAPTER 20s TIONS2.20.lWTHROUGH2.M.IQ ONCERNING /// a Lentlers Name HgZAR AU RIALS EPORT FOR OBTAINING A PERMIT FROM THE SCAOMD. CfOiJ 1 ''lA M'1'Iv=0 Lentlerss Addresavmm o I certify that I have read this application and state that the above P.C.FEE PERMIT FEE R information is correct. I agree to comply with all county Ce a ordinances and State laws elatinto building construction,and z"✓ a. hereb authorize repress tatives g of this County to enter upon ISSUANCEFEE the ve- en lone pro rty for inspection pu caes. /�Y/ U < -3 0-9�/' INVESTIGATION FEE TOTAL FEE m a ARuo,m> m . SEE REVERSE FOR EXPLANATORY LANGUAGE COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT - - DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD/ALT/REP •BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0110030064 - PHONE: (626) 285-0488 EXT: _ LEGAL D: NO. OF CONST NEW BUILDING ADD TR: .16712 LT: 8 SQ. FT STORIES TYPE OCCUP GROUP 9861 ESTRELLA AV STRUCTURE: 403 2 VN' R3 TEMP CA 917801417 ASSESSOR INFORMATION UMBER: GARAGE: NEAREST CROSS STREET: BALDWIN 5383-023-008 OTHER: THOMAS PAGE: 597 GRID: Al LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: USE ZONE: ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 03/15/02 JK 09/11/02 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE: CAMP RONALD J;KATHLEEN G (626) 286-1595- 1 - 75,300 ,yyam� 9861 ESTRELLA AV TEMP 917801417 FEES PAID DESCRIPTION ADD 302SF TO 1ST FLR(ENLARGE EXISTING BDRM, ADD DEN W/WETBAR FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ADD PWDR RM); ADD 101SF TO 2ND FLR(CONVERT EXISTING CLOSET APPLICANT: TEL. NO: 1 RON SEVERA (626) 573-4110- 111 PLANCHECK W/ENERGY 50000.00 VAL 745.83 1 1818 SAN GABRIEL BLV B1 PLANCHECK W/ENERGY 75300.00 VAL 243.63 SPECIAL CONDITIONS: SAN GABRIEL 91776 AA BLDG PERM I T,I SSUANCE�� 27.75 1 AC STRONG MOT-ION:R`SID,ELE:75300:00,VAL 7.53 82 PERMIT W/ENERGY 75300.00`VAL 1,164.08 CONTRACTOR.. TEL. NO:- TOTAL FEES2,188.82 APPROVALS DATE INSPECTOR SIGNATURE ROSEMEAD CONSTRUCTION (626) 573-4110- 1818 S. SAN GABRIEL BLVD. LIC. NO LOCATION AN SETBACKS SAN GABRIEL, CA 91776 221544/B SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. N0: FOUNDATION/TRENCH�FOR S NOT7, THOMAS (626) 403-0844- 1508 MISSION ST LIC. NO: 1111111 SLAB/UNDER FLOOR SO. PASADENA NONE j Ir RAISED FLOOR MING MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: LM �/I ����-,( nIK�( UND RERr LOOR INS LATS 3 01I PULS V��OLI lluU� ' TLE LEVEL FLOOR-AEATH 40. OF FAMILIES: DWELLING UNITS: APT/COND: STAT ASS: NO 21 �J pI I, �.EVEL- FLOG SHEATH SCHOOL WITHIN HAZARDOUS O 0 I, ROOFSHEATHING (� AIR QUALITY: - 1000 FEET MATERIALS _ NO NO. NO A �'� ®� FIRE DEPT. FRAME INSPECT REQUIRED TOTAL SETBACK FROM EX T V6�. O p< �✓/ BLDG DEPT. FRAME [NSP c7 SET BACK YARD: HWY: PROP LINE: WIDTH: ZC Service That AR PANELS FRONT PL- SIDE PL- INSULA ONlWEAT HER STRIP ' INTERIOR LATH/DRY leWALL O `Jl/ 7'0 3 li cl PAD ''// (p/Or f EXTERIOR LATH (�- _ LOT DRAINAGE 3 C �y Ye l�DT6 Zl9i�/OO v ( �: ��p /b SMOKE DETECTION DEVICES FIWDEPARTMENT APPROVAL t ADDITIONAL DATA ON FILE �ifl9Jo3, -.I�G3 REPORT ID: DPR261 ROUTE TO: BS0508 �V .voi CIO 'I �t/ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD/ALT/REP • BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BE 0508 0205130064 PHONE: (626) 285-0488 EXT: LEGAL NO. OF CONST NEW DI G ADDRESS: TR. 16712 LT: 8 SQ. FT STORIES TYPE OCCUP GROUP 9861 ESTRELLA AV STRUCTURE: 140 1 VN U1 TEMP CA 917801417 ASSESSOR INFORMATION NUMBER: GARAGE: NEAREST CROSS STREET: BALDWIN 5383-023-008 OTHER: THOMAS PAGE: 597 GRID: Al LOCALITY: TEMPLE CITY TENAT— EXIST BLDG UST— USE ONS ISSUED ON: PROCESSED BEXPIRES ON: EXIST OCC GRP: 05/30/02 JK 11/26/02 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE: CAMP RONALD J;KATHLEEN G (626) 286-1595- 1 4,000 9861 ESTRELLA AV TEMP 917801417 FEES PAID DESCRIPTION OF WORK ADD 4'X20' PATIO & 3'X20' TRELLIS ATTACHED TO ADDITION FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: CHANGE LOCATION OF FIREPLACE APPLICANT: L. 0: RON SEVERA (626) 573-4110- AA BLDG PERMIT ISSUANCE 27.75 1818 SAN GABRIEL BLV AC STRONG MOTION RESID 4000.00 VAL 0.50 SPECIAL CONDITIONS: SAN GABRIEL 91776 D2 PERMIT W/O EN-HC 4000.00 VAL 115.80 D7 ADDNL PLANCHECK FEE - 6.00 HOU 656.10 -- TOTAL FEES 800.15 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE ROSEMEAD CONSTRUCTION (626) 573-4110- 1818 S. SAN GABRIEL BLVD. LIC. NO �' � •��- - LOCATION AND SETBACKS SAN GABRIEL, CA 91776 221544/B * _ �'/ � � SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: - FOUNDATION/TRENCH FORMS NOTT, THOMAS (626) 403-0844- - _ 1 1508 MISSION ST LIC. NO: SLAB/UNDER FLOOR - - .- -.1 SO. PASADENA NONE I � RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PGE: FIRE ZONE: CMP: - - UNDERFLOOR INSULATION 3 01 IST LEVEL FLOOR SHEATH 0. OF FAMILIES: DWELL S: : STAT CLASS: NO 21 ZND LEVEL FLOOR SHEAfH— SCHOOL WITHIN HAZARDOUS ROOF SHEATHING AIR QUALITY: 1000 FEET MATERIALS _ NO NO NO FIRE DPT. FRAME SPECT REQUIRED0 'a�_�i�_', �' - BLDG DEPT. FRAME S SET BACK YARD: HWY: PROP LINE: WIDTH:'/r- FRONT Pl-- SHEAR PL- SHEARPANELS SIDE PL- - y N ON/ STRI IN RIO LATH/DRYWALL EXTERIOR LATH LOT DRAINAGE SMOKE 0 CES FI D PARTMEN ROYAL * ADO1T[ONAL DATA ON FILE REPORT ID: DPR261 ROUTE TO: BS0508 ]6A.563-CE80610/]Z� APPLICATION R ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER JOB BUILDING AND SAFETY DIVISION g0DRE55 G 60 LOCALITY M C1/1V FOR APPLICANT TO FILL IN NEARESTCROSS ST, j4✓ OUTLETS N0. EACH FEE OWNER OR /f A' r FIRM NAME (y"` /•✓ LA RECEPT.It S S ,� LIGHT TOTAL FIRST 20 .25 ADDRESS ��// V-q�{F� CITY '( TEL. N0, SWITCH)L — OVER 20 .10 PLAN CHECK LIGHTING 1 TOTAL FIRST 20 P5 r APPLICANT FIXTURES J} �l OVER 20 ADDRESS .10 RESIDENTIAL APPLIANCES CITY /I TEL, NO. RANGE DRYER / WTR. HTR._ PERIT APPLICANT STA. COOK DISP. F.A.U. A 0 0 RE55 .D•Qa /✓ SPACE HTR. I AIR COND. CITY / TEL. NO. CLOTHES WASH.�OISHWAS H._ LICENSE / T-t?- CLASS.0—/Q FAN OTHERL00 I HEHEBI' ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ANO STATE THAT THE ABOVE 15 CORRECT ANO AGREE TO COMPLY MOTORS, TRANSFORMERS RATINGWITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO HEREBY CERTIFY THAT AM PROPERLY REGISTERED AND/OR .O - I L00 LICENSED AS gEOUIgEO BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAI I AM THE LEGAL OWN*INSPECTVSSIGNATURE Y I - IO 3.00 OESCPIPEO RESIDENTIAL PROPERTY. C3 O PERMITEE 10 - 50 5.00 SIGNATURE50 - 700 1000DISTRICT NO. ,qRO SW100 - Soo 1500 O y$ 4'.• v SIGN. GAS SIGN.AND ONE CIRCUIT 5.00 APPROVALS DATE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 TEMP. POWER POLE SERVICENOTOVER600VOLTSOR200AMP 3.00 UNDERSLAB WORK SER'VICEOVER 600 VOLTS OR 200AMP 10.00 ROUGH CONDUIT TEMP SERVICE;POLE,'&APPURTENANCES 5.00 WIRING .J -7 -7 91 PmI6.�./ TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL PERMIT FEE (SUB TOTAL) NOTES: PLAN CHECK FEE PERMIT ISSUING FEE 3.00 TOTAL FEE PLAN CHECK VALIDATION CK. M.D. CASH PERMIT VALIDATION crc. M.O. CASH 9 �C FEB cd 2 1 X9.3 5 ®�F SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE //" I 76gss3 DBS sq 3-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES I • WILLIAM J. OX, CHIEF ENGINEER FOR LICANLL IN DISTRICT NO. GROUP ZONE PERMIT NO. I I / /,A/ /TE 2 ELECTRICIAN � RECEIVED BY READY FOR DATE ISSUED ADDRESS y/- FIRST INSPECTION CITU I TEL NO. D Y/ COUNTY LICENSE NO. zME EXPIRES '/` BUILDING PERMIT FEES ADDRESS NUMBER EACH FEE LOCALITY A LIGHT OUTLETS NEARESTROSS ST. RECEPTACLES WALL SWITCHES OWNER TOTAL OUTLETS Sc $ Z ® MAIL ELEC. RANGES 25 ADDRESS ELEC. HEATERS 25 CITY TEL. NO. FIXTURES / Z 5 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS M ISC. 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 1 OBSESS THE ABOVE VALID LOS NUMDER HORSEPOWER ANGELES COUNTY L NBE. OR 1 AM THE LEGAL OWNER FEE OF THE I CCU NTI PROPER ESCRIBED AB V . NEW MVO. P VER INC. EACH s LESS $ .25 SIGNATURE OF .5a PERMITTEE _ 2 5 1.00 INSPECTION RECORD _ 5 is 1.50 z.50 l2-- v 'SO OVi� R-oL//eYrv6 `4,eRrAO% so 200 5.00 1 —'I�5� (11n PkhT a✓r /) —� 200 Sao 10.00 //_eC('r Tia (, /S-Voh Q Soo 1000 ,S.OD C�7(Jt..f' 1- `r12 1A.1 f�y7 r// Z OVER 1000 M.G. SET/FREQ. CHANGER-HP l•,✓n�r"-me�qq ry��1� � T�!/ WELDERS: AC-KVA GENERATORS - KW n � e'�r� !)�C /F '//VCfJ`� TRANSFORMERS - KVA TEMP. MOTORS (75% DF DRI.-) �Z"�.f �� �//7Y' { Y X9 MOVED MOTORS (75% DF OR,..) �- A), T- �k lNlc:/?,e it MISC. SIGNS NO. NO.TRANB. APPROVALS NO. NO. LAMPS FOR EACH PERMIT: DATE INSPECTOR'S NAME WIRING $1.130I CONDUIT _ FIXTURES $1.00 WIRING SUPPLEMENTARY .50 FIXTURES 9-Y-.(-7 POWER TOTAL FEE $ UTILITY CO. NOTIFIED FINAL L�UJ 1