HomeMy Public PortalAbout4927 FIESTA AVE_Electrical__ 78A883C .EVeB 12/75 APPLICATION FOR ELECTRICAL PERMIT
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BUILDDINING ND SAFETY D SION
FOR APPLICANT TO FILL IN JOB ��27 Fiesta r
New Residential Bldgs &Pools
EACH NO FEE ADDRESS
1 &2 Finaily Sq Ft $ — $ 1 LOCALITY Tem -Cy
Multi family Sq Ft I — I I NEARESCROSS ST
T
Residential Swimming Pools OWNER Thomas
NAME V a w.
Outlets Light Switch&Receptacle MAI L
First 20 ADDRESS P A
Additional CITY2em le City el No 296 0946
PLAN CHECK
APPLICANT
Lighting Fixtures
First 20 - ADDRESS
Additional
CITY Tel No
Fixed Appliances Not Over 1 HP APPLII'CTANT Valley Heat inj, Colpany
Range Heater_ D W n
ADDRESS 111 S San 1�3b lel1Vd
Oven Dryer W M
Top FAU WH CITYSan Gabriel Tel No 285 _816
Hood Fan / LICENSE OR 7899 C 20 �
Disp A C REG NUMBER Class U
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY Q
Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING l
Size&Type HP KW KVA or KVAR ELECTRICAL WIRINGLLJ
' U to 1 Incl vi
P 1 HEREBY CERTIFY THAT I AM PROPERLY REGI )ry ERED AND/OR Z
LICENSED AS REQUIRE ED �V LOS ANGE ES COV NTY,IAND STAT OF
Over 1 to 10 Incl r� t
CALIFORNIA OR THAT AM THE L�GAL OWNER OF THE' OVE
Over 10 to 50 Incl DESCRIBED RESIDJENTIAL PROPERRTT Yf
Over 50 to 100 Incl a PER MITEE
Over 100 SIGNATURE 'f
DISTRIC (� PR E Y
Services
0 200 Amp Under 600 V
74e� �rl/
201 1000 Amp Under 600 V APPROVALS DATE INSPECT S
SIGNATURE
Over 1000 Amp or Over 600 V
TEMP POWER POLE
Temp Power Pole&Appurtenances UNDERSLAB WORK
Sign with One Branch Circuit
Additional Sign Branch Circuits ROUGH CONDUIT
(Other) WIRING -
FIXTURES
u 0 0 0 0 r-
POWER AUTHORIZED
PERMIT FEE (Sub Total) UTILITYCO NOTIFIED
2010950
PLAN CHECKING FEE (One Fourth Permit Feel FINAL _—? ro =
PERMIT ISSUING FEE
NOTES 3 5—8
TOTAL FEE i
PLAN CHECK VALIDATIO CK MO CASH PERMIT VALIDATION CK MO CASH
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0806050024
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285 0488 EXT
ILEGAL ID FEES PAID BUILDING ADDRESS I
ITR 11454 LT 39 1 I 4927 FIESTA AV I
IFEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917803817 I
(ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET 1
18590 019 021 1A1 PERMIT ISSUANCE FEE 27 75 I THOMAS PAGE 597 GRID A5 LOCALITY TEMPLE CITY Cl
I ILB 200 AMP PANELS MCC 1 00 PAN 38 85 1
ITENANT I TOTAL FEES 66 60 11SSUED ON PROCESSED BY PLAN BY EXPIRES ON 1
I 106/05/08 SR 12/02/08 1
(OWNER TEL NO I FI(yP.T TE FIN CODE
IKUSAYNAGI MIYAKI 1 (��t E
14927 FIESTA AV (((JJJ
(TEMP 917803817 I (DESCRIPTION OF WORK 1
I (SERVICE UPGRADE 200 AMP 1
(APPLICANT TEL NO I 1 I
(COMMERCE ELECTRIC (323) 620 1252 1 1
15466 PUEBLO CT 1 (SPECIAL CONDITIONS 1
ICOMMERCE CA 90040 I 1
1 I `
I I
(CONTRACTOR TEL NO I (APPROVALS DATE INSPECTOR SIGNATURE 1
ICOMMERCE ELECTRIC (323) 620-1252 I
15466 PUEBLO CT LIC NO I ITEMPORARY POWER POLE I I 1
ICOMMERCE CA 90040 530723 C10 I I I I 1
I I (UNDERGROUND CONDUIT I I 1
IARCHITECT OR ENGINEER TEL NO I IUFER GROUND I I I
1 LIC NO I (ROUGH CONDUIT I 1 I
1
1 IROUCH WIRING I 1
/ I 1 IMAIN WATER LINE 1
IPLASTIC Y/N METAL Y/N I 1
I I (UTILITY COMPANY NOTIFIED( , 1
I I I I { I
I J I I I I I
I I I I I I
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1 (REPORT ID DPR265 ROUTE TO BS0508 1 1
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