HomeMy Public PortalAbout9019 GARIBALDI AVE_Electrical__ COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Department of CD Engineer ELECTRIC
DIVISION OF BUILDING & SAFETY
WILLIAM J. FOX, County Engineer
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMITANO.
ELECTRICIAN
REC I ED BY READY FOR DATE ISSUED
_ADDRESS `7 IV :: FIRST INSPECTION
CITY TEL. NO.
COUNTY LICENSE NO. EXPIRES BUILDING
ADDRESS
PERMIT FEES FEE -
NUMBER EACH LOCALITY
LIGHT OUTLETS NEAREST '�
CROSS BT. .f
RECEPTACLES
WALL SWITCHES ,,„„ WNER
ATOTAL OUTLETS 5C MAIL
ELEC. RANGES 25 ADDRESS
ELEC. HEATERS 25 / CITY ?sA' TEL. NO. - -
FIXTURES � 5 - 1 I 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 I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
NUMBER _ HORSEPOWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
NEw MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
I/2 6 LE88 $ .25 SIGNATURE OF
I/2 2 .50 PERMITTEE ---- —
2 5 1.00 INSPECTION RECORD f
5 15 1.50
15 50 2.50
50 200 5.00
200 500 10.00 J
_ 500 1000 15.00 a
Z
_ OVER 1000 20.00
M.G. SET/FREQ. CHANGER-HP it
WELDERS. AC-KVA O
GENERATORS - KW
TRANSFORMERS - KVA
TEMP. MOTORS (75% of ORIG.)
MOVED MOTORS (75% OF ORIG.)
MISC.
SIGNS
NO. NO.TRANS.
APPROVALS
NO. NO. LAMPS
DATE INSPECTOR'S NAME
FOR EACH PERMIT: --'—
WIRING $1,00 CONDUIT 1
FIXTURES $1.D0WIRING _-
1
SUPPLEMENTARY .50 FIXTURES
POWER
- r
TOTAL FEE 5 UTILITY CO.NOTIFIED
FINAL i^
16A663 DBS#5A 4-52 r
WDFIKERS'COMPENSATION DECLARATION 7aMM 10/91 APPLICATION FOR ELECTRICAL PERMIT
I'r,ereby afrtrn, tha{rtnav*[,■ d ca,eent to self Lrlerre,
or a owttffcats of W*xkeir Cort ��d.on Insurknce, or a certtfled COUNTY OF LOS ANGELES BUILDING AND SAFETY
copy thereof(Sea,3800,Lab. C.) t' r
PofbY Na Comperry
FOR AAPLYCJtlr TO w1 L#1 .TOB
❑ CW copy is hereby furnl*wl. New Ra*kmatiel Bldgs.&Poria EACH NO. FEE ADDRES
ert
❑ Cert1 led oopy le filed with the oamty building Lrlepeobm 1 &2-remly,So.Ft 3 = $
Multl-famQy Sq.Ft =,9T.
Date Applki�rlf a ResbentW Swimming Pooh OwTFA OR
F14A Nh E�J
CERTTElCATE OF EXEMPTION FROM YtK)R ERS' MA
COA�N3ATION INSURANCE Outlets Rao—Light Sw.—
A00RE88
Flret 20
(Thh Mction nerd rpt¢e completed C the work trwdved by th• Total No. Addftlarel CG'Y Tel.No.
perrntt b for one hundred0.
dorn J$100) or We&)
I carttfy #hat In the performance of tt1Q work fpr which this permitI PLAN C✓ECK
r +
APPLICANT
fe Issiu d, I ahall not empty afhy person In any manner so an b
become eubJed to the Wtxiaera'Compensation Laws. Lighting Fixtures Fl rat 20 ADDRESS
AddbDn
Total No. aJ CITY Tel.No.
Date Applicant Fixed Applanoes Not Over 1 HP PEF0 T
NOTICE TO APPLICANT: If, after maldrrp this C Moate of
F_xanlptbn,you should become subject to the Wprkws'Conlpernatton Rerlge— Heater— 0.W. APPLICANT
proyWons of the Lebdr Code, you must kxtwdth oompty with suoh Oven — Dryer— W.M.T ADDRESS
pro isioru or this permit shall be deemed rerdaed. Top — FAU W}i C7TY TOL No.
LICENSIO
ED-CONTRACTORS DECLARATION Hood — Fan Other—
ORI hereby afftrm that I -am Iberleed under provision of Chapter 9 DAw — Room LICENSE Cond. I
OABER
(oorrunenotrrp with Section 7000) d WWon 3 of the Bualneee and FAQ WTRICT
ssion
ProfeCode,and my fbenee is In full force and effect Power Apparatus& Large Appllsnces T
Size&Type HP,KW,KW,,or KVAR
Lberse Number,�J 4 S5r Lb.Clear Sr��
� up to , Ina. FINAL
C'ort7YWAe '9 1G Date —� Over 1 to 10 incl.• D'�`� ,�1
❑ Over 10 to 60 o-1d
I am exempt under Seo. Over 60 to 100 ho BY 1 f l
Bb P.C.for this reaeon T Over 100 Z
SaNtee,Swbd,MCC&Panelboenie
Data 0-200 Amp,Under 900 V 6LV
a 201 - 1000 Amp.Under 800 V
❑ Over 1000 Amp.or Over 800 V
Emnptbn for Req.Malnt Elect.
SINGLE FAMILY Temp.Power Pole& Appurtenances 2
HOME OWNER-BUILDER DECLARATION Sign with One Branch C§ait ACCT.-TL
I hereby affirm that I am exempt from the Contraatot's L oaree Lew es CUatte �,r
for the fabw�fng reason (Saoti n 7031.6,%eb&m and Profession 3307 45.00
Code):
❑ I,as owner d the property,will do the work end the structure Mhso.Condrltn&Conductors 1 I 1 u k7
Is not lntwxled or offered for sale (Section Tone, Busineas other(see Cornpiste Fee Sohedrie) — TOTAL 45.00
and Profesala,s Code).
DECK 45.00
CONSTRUCT}ON LEt` M0 AGENCY
F hereby affirm that dWe Is a construction lending agent' for the ■00
pert mwK)e d the work for whIch th}a permh Is Ieaied(Seo.3097, PERMrr FEE (Sub-Trial)
Cfv.C.).
L.erldWs Name-
PLAN CHECIgNG FES OOOa-(MI- 7f 5/90
PERMfr ISSUING FEE 1671 1 Ali 9:19
Lerlder'e Addn3ee
1 oerttfy that I have read this application and state that the above TOTAL FEE ,D
Informafton is occrect I agree to oompfy with all County ordLrguloas
and State Laws regutattng Electrioel wlrtrlg, and hereby authDrt a
represerrtattvee of this Canty bD enter upon the above-merrtloo d
SEE REVERSE FOR EXPLANATORY LANGUAGE
i
of Date
i,
COtNTY.OF LOS AHG=&.S TEMPLE CITY G 0508 EI CTRICAL PER?,=
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0804300011
,BUZIa2NG AHD SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 ETT:
LEGAL ID: FEFS PAID BUILDING ADDRESS:
TR: 5904 LT: 189 UN: .002 9019 GARIBALDI AV
FES DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801546
ASSESSOR INFORMATION NUMBER: NEAR CROSS STREET: ?4 DA
5384-006-030 AI PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H2 LO(LTSLITY: THMO?LE CITY, C
Gl OUTLETS-LOT,SW,RECP 30.00 OUT 52.50
TOUkTT: G2 LIGHTING FIXTURES 25.00 LOT 45.75 ISSUED ON: PROCESSED BY: PLAN BY: HZPIRE9 ON:
HA FAD LESS 3HP 1.00 FAD 10.95 04/30/08 SR 10/27/08
H1 R&S ELEC OVEN LT 3HP 1.00 OVE 10.95
OWNER: TEL. NO: H2 RFS GRBG DIST LT 3HP 1.00 DIS 10.95 F i l FINAL BY: CODE:
WANG, JANR9 Q (626) 215-9510- H3 R&9 DISHWIP,.9HR LT 3HP 1.00 DI9 10.95
9019 GAFIBALDI AV H4 RE8 RANGE HD8 LT 3HP 1.00 HOO 10.95
TEMP 917801546 H5 R&S WASH KkCH LT 3HP 1.00 WAS 10.95 DESCRIPTI N OF WORK
JB AC UNITS +3-10HP 1.00 AC 19.65 ELECTRICAL FOR ADDITION, RE24ODEL AND UPGRADE SERVICE PANEL
LB 200 AMO? PANELS, MCC 1.00 PAN 38.85 TO 200 AMP
APPLICANT: TEL. NO: TOTSL FEE`S 250.20
WIU (626) 524-3164-
4205 E. LIVE OAK AVE SPECIAL CONDITIONS:
ARCADIA, CA 91006
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
NA LU AND 9HENG WANG (626) 286-3328-
5012 XkLNUP GROVE AVE 4201 LIC. HO TE[ ARY POWER POLE
SAN GABRIEL, CA 91776 865781 B
UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER: TTS,. NO: UFER GROUND
SIU, JACK (626) 524-3164-
4205 E. LIVE OAK AVE. LSC. NO: ROUGH COSIDIITT
ARCADIA, CA 91006 021951
ROUGH WIRING
MASF WATER T.
PLA97IC Y/N METAL Y/N
U'ILITY COMPANY NOTTlrIED
REPORT ID: DPR265 ROUTE TO: B80508