HomeMy Public PortalAbout5123 FARAGO AVE_Electrical__ 76A663 cE3069 64It I APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES A �J A
DEBPARTMENT OF COUNTY UILDING AND SAFETY DIVISION FNEAREST
RESS 3�/�3 A/?A&O
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUP T OF BUILDING ALITY
FOR APPLICANT TO FILL IN SS ST
RECEPT TOTAL NO EACH FEE p
OUTLETS FIRST 20 S $20 $ ( �_ OWNE
LIGHT
ADD L ADDRESS :5
SWITCH 3 OVER 20 10 ,�7 q
LIGHTING TOTAL FIRST 20� 20 4a CITY L.. 7- TEL NOZ-1/
FIXTURES } _ I ADD L
OVER 20 to ELECTRICIAN /cT
RANGES CLO DRYERS WTR HTRS too ADDRESS 3SZ! WOO
GARB DISP STA COOK / Q/ �^l
CITY EL NO (5 ((i J
D18HWASH AUTO WASH STATE
SPACE HTRS STA APP (/.HP MAX ) 50 LICENSE NO C O 1 9 73 0
MOTORS OVER NOT OVER HP DISTRICT NO ROUP ZONE PROCESSED BY
o t 3 too -z O 'o a
I s t 50 ///pA INSPECTION REE9,ORD,
S 8 1200, ;ill m -/ Co.
8 15 250 v U
15 so s oo O
so too Soo-
NO
oo ~
l2 C w
NO TRANS d
SIGNS NO LAMPS Le ^ 7 X In� Z
{ 1 Y
SERVICE O 600V NOT OVER 200A too L41,A
SERVICE O 600V OVER 200 A 200
SERVICE OVER 600V Soo
MISC _.. 0 0 10 —�9
U
PERMIT ISSUING FEE 200 Z
SUPPLEMENTA13Y PERMIT ISSUING FEE t 00
TOTAL FEE
1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR S SIGNATURE
AND STATE 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 I AM PROPERLY REGISTERED ANO/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF /7
CALIFORNIA OR THAT I AM THE LEGAL OWNER OFAND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY POWER
SIGNATUREUTILITY CO NOTIFIED
OF PERMITTEE
FINAL
VALMO JOS C ROOHAN
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
LlLo8 7 8 3-0 FEB 19 2- D 5 40N
04_5116-62A (215062A) August 4, 1959 Ghech No. �7j17
711A669 CE60612 BB APPLICATION FOR ELECTRIC PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS 5123 Fqrqj7n
JOHN A LAMBIE COUNTY ENGINEER
CASSATT D GRIFFIN SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
PERMIT FEES OWNER
1 T E M NUMBERI EACH FEE
OUTLET $ $ MAIL
LIGHTS RECEPT SW 10 ADDRESS 5123 Farago
LIGHTING FIXTURES 10 CITY G TEL NO
ELEC RANGES CLO DRYERS ELECTRICIAN D_J
WATER HEATERS 50 ADDRESS
ELEC SPACE HTRS DISHWASHERS
CITY S TEL NO Ly 9-21115
GARBAGE DISPOSERS AUTO
STATE
WASHERS STA COOKING UNITS 25 LICENSE NO
MOTORS OVER INC H P DISTRICT NO GROUP I Z NE I P OCESSE BY ,
0— 1/2 25 -'
1/2— 2 50 INSPECTION RECORD
2— 5 100
I i
5— 15 150Is— 50 250
l
50-200 500 a!
NO TRANS
SIGNS NO LAMPS / C 7Lm/`�
SERVICE O 600V 10-0
SERVICE OVER 600V 500
MISC
f
WIRING PERMIT 1 00 no
FIXTURE PERMIT 1 00 on
SUPPLEMENTARY PERMIT 50
TOTAL FEE $ zin APPROVALS
1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION DATE INSPECTOR S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT
ELECTRICAL WIRING WIRING
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA LOR THAT 1 A T E LEG OWNER OF THE ABOVE
DESCRIBED RDENTIAL OP TY POWER
SIGNATURE UTILITY CO NOTIFIEDOF PERM I ---
FINAL ✓Y1�
mm m
®° LIDATION ARTHUR C VETT
SUPERVISING ELECTRICAL ENGINEER
CK MO CASH
LAr0 2 3 8 6 SEP 8 2 A S6 ,)
WORKER S COMPENSATION DECLARATION 200019 DPW(12 91)
OR ELECTRICAL PERMIT u
I hereby affirm that I have a certificate of consent to self Insure 76A663 APPLICATION FOR
or a certificate of Worker s Compensation Insurance or a certified COUNTY OF LOS ANGELES t7EPTy OF PUBLIC WORKS BUILDING AND SAFETY DIV
copy thereof(Sec 3800 Lab C)
Policy No4t 7 Company /'^''�� FOR APPLICANT TO FILL IN JOB
"Ce�tlfled co is hereby furnished �'a2-� 93 NO EACH FEE ADDRESS
PY Y New Residential Bldgs &Pools 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
3 Residential Swimming Pools ASSESSOR
` I MAP BOOK PAGE PARCEL
CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec -Light Sw FlOWNER OR
RM NAME
COMPENSATION INSURANCE
(This section need not be completed if the work Involved by the First 20 MAIL C�
permit is for one hundred dollars($100)or less)
Total No Additional ADDRESS �J
I certify that in the performance of the work for which this permit CITY Tel
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 PLAN
APPLICANTK
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 PERMIT
provisions or this permit shall be deemed revoked
Power Apparatus&Large Appliances APPLICANT
LICENSED CONTRACTORS DECLARATION Size&Type HP KW KVA or KVAR ADDRESSg
1 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 Te o
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 a Class ] a
2 Over 100 DISTRICT NO P CESSED BY V 0
License Number ✓� Llc Class� � V
Services Swbd MCC&Pa elb ar
Contractor Date 0 3994Wnder 600 V FINAL 0
DATE J��
❑ I am 400 1000 Amp Under 600V /[
exempt under Sec VALIDATION V
Over 1000 Amp or Over 600 V W
B&P C for this reason FINAL W- co
BRANCH CIRCUIT FEES
Date 15A or 20A 120V Lighting or Recept Z
1 To 10 Branch Circuits
Signature 11 To 40 Branch Circuits
❑ 41 Or More Branch Circuits
Exemption for Reg Maint Elect 15A 20A 208V To 277V Lighting Br Circuits �wrF T
SINGLE FAMILY Temp Power Pole&Appurtenances r ~ �Ll ACCT.1r
HOME OWNER BUILDER DECLARATION t
I hereby affirm that I am exempt from the Contractors License Law Sign with One Branch Circuit L Za7
for the following reason (Section 7031 5 Business and Professions Additional Sign Branch Circuits G 7
Code) - ITEM'
❑ I as owner of the property will do the work and the structure Mlsc Conduits&Conductors _ TOTAL ® �
is not Intended or offered for sale (Section 7044 Business Other(See Complete Fee Schedule)
61
and Professions Code) ® CHECK frlab`_
CONSTRUCTION LENDING AGENCY CHANGE oGtr
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 amca-0001 / ���
Lender s Name 5939
PERMIT ISSUING FEE �� 1 tilt 1V
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 pection poses SEE REVERSE FOR EXPLANATORY LANGUAGE
6)-2 ��
SIGMATUREO ER ITTEE DATE
WORKERS COMPENSATION DECLARaTInN t CE806G (2 803" APPLICATION 1=0R ELECTRICAL PERMIT
Ikhe.eby affirm that I have a certificate of copse t to self COUNTY OF LOS ANGELES BUILDING AND SAFETY
insure or a certificate of Workers Compensation In ranee or �� /
a certified c t6,ereof(Sec 3800
\ FOR APPLICANT TO FILL IN JOB
New Residential Bldgs &Pools / "� J1
Policy C mpany ` EACH NO FEE ADDRESS / C/
®Cert�f�ed�opy�hereb"y�fdrnheYl 1 &2 Family Sq Ft $ — Is LOCALITY
Multi family Sq Ft + — NEAREST
Certified copy is filed with the county building inspection + CROSS ST
department Residential Swimming Pools + OWNER OR
y+ FIRM NAME
Date Applicant Outlets Rec^Light Sw s MAIL
First 20 ADDRESS
CERTIFICATE OF EXEMPTION FROM WORKERS Total No Additional CITY Tel N
COMPENSATION INSURANCE PLAN CHECK d
' I O
(This section need not be completed if the work involved APPLICANT U
Fixtures First 20hting
by the permit is for one hundred dollars ($100) or less) LigAdditional ADDRESS �
Total No O
1 certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No U
1permit is issued I shall not employ any person in any manner _ PERMIT
so as to become subject to the Workers Compensation Laws Range_ Heater_DW APPLICAN a
Oven _ Dryer_W M ADDRESSZ
Z
Date Applicant Top _ FAU _W H CITY ell -Tel
Hood _ Fan —Other
NOTICE TO APPLICANT If after making this Certificate of Disp _ Room Air Co__r�d__L O LICENSE OR ��
Exemption you should become subject to the Workers REG NUMBER Class
Compensation provisions of the Labor Code you must forth Power Apparatus& Large Appliances DISTRICT NO PROCMED
with comply with such provisions or this permit shall be
deemed revoked { Size&Type HP KW KVA or KVAR C 6 r/
Up to 1 Incl J U
Over 1 to 10 Incl FINF��,
DA
LICENSED CONTRACTORS DECLARATION T6� �� VALIDATION
Over 10 to 50 Incl �
I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc FINA `r
,
9 (commencing with Section 7000) of Division 3 of the Busi Over 100 BY
ness and Professions Code and my license is in full force and
effect / �� Services
License Numbe ` 6 Lic Class D 0 200 Amp Under 600 V
201 1000 Amp Under 600 V
Contractor Date Over 1000 Amp or Over 600 V
HOME OWNER BUILDER DECLA ATION Temp Power Pole& Appurtenances
I hereby affirm that I am exempt from the Contractors + Sign with One Branch Circuit ;2 45 3 1 A
License Law for the following reason (Section 7031 5 Busi Additional Sign Branch Circuits f1 o 0 o o o 2
ness and Professions Code) i
Misc Conduits& Conductors
❑ I as owner of the property will do the work and the 2 ° ° 2 9 0 0
iOther (See Complete Fee Schedule)—
structure is not intended or offered for sale (Section ° ° ° 2 9 0 0`c=
7044 Business and Professions Code)
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency 10 8 1 6—8 3
for the performance of the work for which this permit is PERMIT FEE (Sub Total) c
issued(Sec 3097 Civ C)
Lender s Name PLAN CHECKING FEE (One Fourth Permit Fee)
Lender s Address PERMIT ISSUING FEE
O Jf
I certify that I have read this application and state that the TOTAL FEE
abovei ormation is correct I agree to comply with all County
ordm ces and State 1 r 1 ing Electrical wain and
here author epre ative this County to ent +upo
the bove im �Jed perty inspectio purposes SEE REVERSE FOR EXPLANATORY LANGUAGE r
ig ature of Permittee Dat
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1201250019
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285 0488 EXT
LEGAL ID FEES PAID I BUILDING ADDRESS
ITR 11497 LT 8 BL A I 5123 FARAGO AV 1
I IFEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917803547
ASSESSOR INFORMATION NUMBER 1 1. _ NEAREST CROSS STREET
18574 008 019 JAI PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 597 GRID D4 LOCALITY TEMPLE CITY Cl
_IHA FAU LESS 3HP 1 00 FAU 10 90 I
TENANT IJB AC UNITS +3 10HP 1 00 AC 19 70 (ISSUED ON PROCESSED BY PLAN BY
TOTAL FEES 58 40 101/25/12 SR 1
OWNER TEL NO IFINAL_4ATE F AL Y CODE
ISOTER JANET B (626) 443 5974
15123 FARAGO AV I I�� �,� 1
ITEMP 917803547 I IDESCR PTION OF WORK 41
1 1 (INSTALLING NEW A/C HEAT SYSTEM + DUCTING 1
(APPLICANT TEL NO
I
1CONTRERAS CARRA (626) 286 3157 I
I
14931 N ENCINITA AVE I ISPECIAL CONDITIONS 1
ITEMPLE CITY CA 91780 1
I CONTRACTOR TEL NO u(/t It Q& wy _�r
(APPROVALS DATIJ INSPECTOR SIGNATURE I
ICONNOR AIR CONDITIONING AND REFRIG (626) 286 3157 1I
14931 NORTH ENCINITA LIC NO I ITEMPORARY POWER POLE I I
ITEMPLE CITY CA 91780 403735 C20 *I
1 IUND"RGROUND CONDUIT 1 1
(ARCHITECT OR ENGINEER TEL NO 1
IUFEF GROUND I I I
1 LIC NO 1 1ROUGH CONDUIT 1 I 1
1 1 IROUGH WIRING I I
1 ' IMAIN WATER LINE I
I I I
1 1 1PLASTIC YIN METAL YIN 1 1
I IUTILT_TY COMPANY NOTIFIEDI I
I
I I I 1
1 I I I I I
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1 I I I I I
I 1
1 I I I I
I I I I
I I I I I I
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ADDITIONAL DATA ON FILE
1
IREPORT ID DPR265 ROUTE TO BS0508
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