HomeMy Public PortalAbout4826 FIESTA AVE_Electrical__ 7 6A663
DBS SA 12 64 APPLICATION FOR ELECTRIC -PERMIT
DIVISION OF BUILDING AND SAFETY
Department of County Engmeer
County of Los Angeles BUILDING
WM J FOX COUNTY ENGINEER ADDRESS
CASSATT D GRIFFIN SUPT OF BUILDING lei
FOR APPLICANT TO FILL IN LOCALIT
PERMIT FEES NEAREST
FEE CROSS ST
NUMBER EACH
LIGHT OUTLETS OWNER 1
RECEPTACLES MAIL
ADDRESS
WALL SWITCHES !�
TOTAL OUTLETS 5t $ CITY TEL NO
ELEC RANGES 25 ELECTRICIAN t' I�
ELEC HEATERS 25 ADDRESS dd
KW EA CITY �TELN6W
FIXTURES 'T 5 LICENSE NO
' NUMBER OF LIGHT CIRCUITS
NUMBER OF RECEPTACLE CIRCUITS DISTRICT NO I GROUP ZONE I READY FOR INSPECTION
MOTORS
NUMBER HORSEPOWER FEE INSPECTION RECORD
NEW MVD HP OVER INC EACH
12&LESS S 25 ♦ 41�f►� `�a L
I/2 2 5 O
2 5 100 . ACS IZ3 C_� 1
t
_ 5 15 1 50 4 Y V._1 1 �A E4k L J.,44
15 50 2 50
50 200 500
� 6 v t -
MISC , 1
eS
L I �T L
n�a1 T/ �f, �U F�L�I-4CI'L.t.l �
Z C 1 p,r►- V
t. L �� L
NO SIGNS NO TRANS
NO SIGNS NO LAMPS
FOR EACH PERMIT
f
WIRING S100 / d ✓ �f�,�_
FIXTURES S1 00
SUPPLEMENTARY 50
PROVALS
TOTAL FEE S DATE INSPECTOR S SIGNATURE
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CONDUIT LN- 6z
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES STATE LAWS REGULATING WIRING
WS A
ELECTRICAL WIRING
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED OS ANGELES COUNTY AND STATE OF POWER
CALIFORNIA OR THAT THE LEGAL OW ER OF TH ABOVE
DESCRIBED RESIDEN OPERT UTILITY CO NOTIFIED II A
SIGNATU
OF PER TT FINAL
WILLIAM J FOX COUNTY ENGIN3 5 7 5° „ iI� TION 6 In
BY
® DEPUTY
oes sA li-as APPLICATION FOR P�,�r
DEPARTMENT OF BUILDING AND SAFL"1'Y
COUNTY OF LOS ANGELES *fIECTRIC
WM J FOX CHIEF ENGINEER
NAMECa� Py7C e�(7- , DIST:r GROUP ZONE �PERA'ITNO
ADDRESS //110 (/�G ? / �/
CITY g/py / TEL NO / -Y✓44.2 / �C YED BY READY FOR DA ISSU
) �7 _ FIRST INSPECTION
CERT NO ,3 / EXPIRES 5 1VAe I:r
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
DESCRIPTION OF WORK ADDRESSU-�a'/Ya � l
NUMBER OF OUTLETS ON CIRCUITS LOCALITY /r(� r
LOCATION BY ROOMS
NEAREST
LIGHT OUTLETS Isw PLUGS PIXT CROSS ST
CIRCUIT A B C D E F G H W NAME
Z MAIL
3 ADDRESS
O
CITY TEL NO
I AM THE LEGAL POSSESSOR Op,?THE ABOVE ,LOS
ANGKrp��Ew COUNTY CERT1Fl ATS O v/QUALIFICA fG i;'—
// ELECTRICIAN
I AM THE LEGAL OWNER�O_P'THB PROPERTY DESCRIBED
ABOVE ((//
OWNER
CORRECTIONS
-3
J
Q
Z_
C7
O
TOTAL 9 ,sl
ry
NO OF OUTLETS a $ D APPROVALS
NO OF FIXTURES $ DATE INSPECTOR S NAME
NO OF MOTORS H P $ CONDUIT
NO OF SIGNS TRANS $ WIRING
NO OF RANGES OR HEATERS $ FIXTURES
MISCELLANEOUS $ POWER
PERMIT FEE $ UTILITYCO NOTIFIED Z7 `I 1� i
TOTAL FE FINAL,
70A883 CE806 987 APPLICATION FOR ELECTRIC RIC PERMI tl 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS c�
JOHN A LAMBIE COUNTY ENGINEER
CASSATT D GRIFFIN SUP T OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
PERMIT FEES
I T E M NUM R EACH FEE OWNER
OUTLETS S S MAIL
LIGHTS RECEPT SW 10 ADDRESS
LIGHTING FIXTURES 10 V CITY TEL NO
ELEC RANGES CLO DRYERS ELE
WATER HEATERS 50
f
ELEC SPACE HTRS DISHWASHERS ADDRESS
GARBAGE DISPOSERS AUTO CITY TEL N O6
WASHERS STA COOKING UNITS 25 STATELICENSE NO
MOTORS OVER INC H P
DIS RIC NO GROUP ZONE READY FOR INSPECTION
O — 1/2 25_
1/2 — 2 50
INSPECTION RECORD
2 — 5 1100
5 — 15 150
15 — 50 250
so— 200 500
SIGNS NO TRANS
NO LAMPS
SERVICE O 600V too
SERVICE OVER 600V 500
MISC
WIRING PERMIT 100
FIXTURE PERMIT too
SUPPLEMENTARY PERMIT 50
TOTAL FEE $ APPROVALS
I TI
HEREBY ACKNOWLEDGE THAT I HAVE READ THIS A LIGAON DATE INSPECTOR SSIGNATURE
AND STATE THAT THE ABO S CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDI LASTATEWS REGULATING
ELECTRICAL WIRING WIRING Ltl
I HEREBY CERTIFY 1STERE A D/OR
LICENSED AS REOUIR AN ST E OF FIXTURES
CALIFORNIA OR THA MOF BO
DESCRIBED RESIDEN A PPOWER
SIGNATURE UTILITY CO NOTIFIED
OFPERMITTEE FINAL
ATION ARTHUR C VETT
K Ido CASH SUPERVISING ELECTRICAL ENGINEER �
Ois3% AAR24. 2 A 2.50 A
i
t
t
4
16A663 CESOE 10 80 APPLICATION FOR ELECTRI AL PERMIT 1'
COUNTY OF LOS ANGELES
DEPARMENT OF COUNTY ENGINEER BUILDING f
BUILDING AND SAFETY DIVISION ADDRESS f
JOHN A LAMBIE COUNTY ENGINEER
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
PERMIT FEES OWNER
1 T E M NUMBERI EACH FEE MAIL
OUTLETS ! $ 3 ADDRESS
LIGHTS RECEPT SW 10 CITY TE O
I
LIGHTING FIXTURES 10
ELEC RANGES CLO DRYERS ELECTRICIAN
r
WATER HEATERS SO ADDRES
ELEC SPACE HTRS DISHWASHERS ?
CITY TEL NO
GARBAGE DISPOSERS AUTO STA E
WASHERS STA COOKING UNITS 25 LICENSE NO �—
MOTORS OVER INC H P DIS
TRIC N G OU TE P D
0— 1/2 25
11/2- 2 50 I PECTIO R ORD
}
2— S 1 100 0.
O
5— 15 150 U
IS— 50 250 O
50— 200t-)G
W
d
SIGNS N
NO TRANS .
NO LAMPS 'Z
SERVICE O 600V too
SERVICE OVER 600V Soo
M ISC
WIRING PERMIT 100
FIXTURE PERMIT 100
SUPPLEMENTARY PERMIT 50
TOTAL FEE S Ud
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 WIRINGr
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR L s
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES fl t 1 A i
CALIFORNIA OR TH I AM THE LEGAL ��. F THE ROVE ( j
DESCRIBED RESIDE 1 L PROPERTY POWER
SIGNATURE UTILITY CO NOTIFI D I l� / !M AIA
OF PERMITTE t l I� fyl/'/A Wy�
FINAL 1 1
IDATION AR URIC VEITV
c Mo CASH SUP RVISING ELECTRICAL ENGINEER
D;'09656% JILL 62D 280 �"
B
DS
BS APPLICATION F®0 ■ E L E C T R I PERMIT
5A 3 55
A
DIVISION OF BUILDING AND SAFETY
Deportment of County Engmeer FaF
t County of Los Angeles BUILDING
WM J FOX COUNTY ENGINEER ADDRESS
CASSATT D GRIFFIN SUP T OF BUILDING 01,
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
PERMIT FEES CROSS ST
NUMBER EACH FEE
OWNER
LIGHT OUTLETS
MAIL
RECEPTACLES ADDRESS
WALL SWITCHES
TOTAL OUTLETS 5¢ $ CITY
ELEC RANGES 25
_ELEC HEATERS 25 ADDRESS
KW EA CITY
FIXTURES 5 LICENSE NO
NUMBER OF LIGHT CIRCUITS - DISTRICT NO GROUP ZONE READY FOR INSPECTION
NUMBER OF RECEPTACLE CIRCUITS
MOTORS
NUMBER HORSEPOWERFEE INSPECTION RECORD
NEW MVD HP OVER INC EACH
1/2&LESS $ 25
I/2 2 50
2 5 7001
5 15 1 50
15 50 2 50
50 200 500
MISC
NO SIGNS NO TRANS
NO SIGNS NO LAMPS
FOR EACH PERMIT '
WIRING $100
FIXTURES $1 00
SUPPLEMENTARY 50 APPROVALS
TOTAL FEE $ DATE INSPECTOR S SIGNATURE
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS PPLICATION CONDUIT
AND STATE THAT THE ABOVE IS C RRECT AND AGREE TO COMPLY I
WITH ALL' COUNTY ORDINANCE ND STATE LAWS REGULATING WIRING
ELECTRICAL WIRING
I HEREBY CERTIFY T"PROPERISTERED AN FIXTURES
LICENSED AS REQUIREY AND STA F
CALIFORNIA OR THAT OF THE VE OWER
DESCRIBED RESIDENTIA
SIGNATURE I
UTILITY CO NOTIFIED A
OF PERMITTEE
FINAL � I
WILLIAM J FOX COUNTY ENGINEER VALIDATION A C VEIT CHIEF ELECT INSPECTOR
t <
fi i0 s` o 3 TSAR 14 2 12- 5
a
_ I
6 �_
WORKER S COMPENSATION DECLARATION 720 6A663 DPW(12 91) APPLICATION FOR ELECTRICAL PERMIT ll
76A663
I Tiereby affirm that I have a certificate of consent to self Insure i
or a certificat6 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)
Policy NO Company FOR APPLICANT TO FILL IN JOB
ADDRESS
Certified copy is hereby furnished New Residential Bldgs &Pools NO EACH FEF
El _ $ $ 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 BOOK PAGE P(ARCCEL
CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec _Light Sw -FIIRMNAME
COMPENSATION INSURANCE
First MAIL
(This section need not be completed If the work involved by the Total No Additional ADDRESS
permit Is for one hundred dollars($100)or less) �jyn/
I certify that in the performance of the work for which this permit CITY Tel N I�6 ✓/! Le
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 PERMIT
provisions or this permit shall be deemed revoked Power Apparatus&Large Appliances APPLICANT
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
Over 50 to 100 Incl LICENSE OR Class >-
REG NUMBER d
Over 100 DISTRICT NO P�O�ESSED BY O
License Number Lic Class T e
Service/s�—Sw Panelboards ^ CS��G LlJz�`
/ ✓0 ender 600 V ` FINAL 7-- 0
Contractor Date DATE 0
❑ 400 1000 Amp Under 600 V '
I am exempt under Sec Over 1000 Amp or Over 600 V FINAL A-21 A AV LIDATION W
B&P C for this reasonBRANCH CIRCUIT FEES BY U)
Date 15A or 20A 120V Lighting or Recept Z
1 To 10 Branch Circuits Q►
Signature 11 To 40 Branch Circuits /
❑ 41 Or More Branch Circuits f 0
Exemption for Reg Maint Elect 15A 20A 208V To 277V Lighting Br Circuits r
SINGLE FAMILY Temp Power Pole&Appurtenances 7
HOME OWNER BUILDER DECLARATION Sign with One Branch Circuit ttt�T a
I hereby affirm that I am exempt from the Contractors License Law as
for the following reason (Section 7031 5 Business and Professions Additional Sign Branch Circuits 3303 65.60
�M
od JJ..77U
I as owner of the property will do the work and the structure Misc Conduits&Conductors I ITEMS
is not intended or offered for sale (Section 7044 Business Other(See Complete Fee Schedule) TuTAL 65 - 60
and Professions Code) CHECK 65060
CONSTRUCTION LENDING AGENCY rr��n��,,Ll�'��/--t nnn
I hereby affirm that there is a construction lending agency for the WltiNGE .00
performance of the work for which this permit is issued (Sec 3097 PERMIT FEE (Sub Total) �� T
Civ C)
PLAN CHECKING FEE 0000-SOI 3/2?/96
Lenders Name
PERMIT ISSUING FEE ,1 Q I PM 2:24
Lender s Address V
I certify that I have read this application and under penalty of purjury state TOTAL FEE �✓� Q
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 purposes SEE REVERSE FOR EXPLANATORY LANGUAGE
qI
P
r
�i NATURE O PERMITTEE DATE
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1402120039
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285 0488 EXT
ILEGAL ID FEES PAID I BUILDING ADDRESS
ITR 14647 LT 2 I 4826 FIESTA AV
I IFEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917803814 I
(ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET LOWER AZUSA I
18590 017 008 1A1 PERMIT ISSUANCE FEE 27 80 I THOMAS PAGE 597 GRID AS LOCALITY TEMPLE CITY I
I 1G1 OUTLETS LGT SW RECP 5 00 OUT 10 00 1 1
ITENANT 1G2 LIGHTING FIXTURES 2 00 LGT 4 00 11SSUED ON PROCESSED BY PLAN BY 1
1 1 TOTAL FEES 41 80 102/12/14 SR 1
10WNER TEL NO 1 IFINAL DATE FIN BY CODE 1
INGUO JOHN H (626) 292 7763 17 /f
14826 FIESTA AV 13 C I
ITEMP 917803814 1 Ig IPTION OF WORK 1
15 OUTLETS AND 2 LIGHT FIXTURES FOR BATHROOM REMODEL 1
(APPLICANT TEL NO 1 1
ISAME AS OWNER I
I I ISPECIAL CONDITIONS
I
I I
I
1 I I I
(CONTRACTOR TEL NO I (APPROVALS DATE INSPECTOR SIGNATURE
ISAME AS OWNER 1 I
I LIC NO 1 ITEMPORARY POWER POLE
I I I
I 1UNDERGROUND CONDUIT II
(ARCHITECT OR ENGINEER TEL NO 1 IUFER GROUND I I I
I I I
LIC NO IROUGH CONDUIT 1
1 TROUGH WIRING
1 I MAIN WATER LINE
PLASTIC YIN METAL YIN
I 1 (UTILITY COMPANY NOTIFIED(
I I I I I I
I I I I I I
1 I I I I I
I I I I I I
I I I I I I
I I I I I I
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1 IREPORT ID DPR265 ROUTE TO BS0508
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