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Home My Public Portal About9441 GARIBALDI AVE_Electrical__ TEMPLE CITY #5556fl 7eAee34cE/ae `7o APPLICATION FOR ELECTRICAL PERMIT GOUNTY OF LOB ANGELES DEPARTMENT OF COUNTY ENGINEER AUDORD N E G8 B BUILDING AND SAFETY DIVISION JOHN A. LAMBIE, COUNTY ENGINEER LOCALITY COLEMAN W. JKNKINS N NT OF BUILDING NEAREST FOR APPLICANT TO FILL IN CROSS ST. 011 lk -j OUTLETSK FEE OWNER R.Bezaire RECEPT.-6— MAIL FIRST 20 ADDRESS Same TOTAL CITY TEL. Not 5-4 65 SWITCH 11 OVER 20 .10 PLAN CHECK ACH LIGHTING FIRST 20 APPLICANT Il TOTAL ' FIXTURES OVER 20 •10 ADDRESS APPLIANCES CITY TEL. NO. PERMIT RANGE DRYER_WTR. HTR. APPLICANTMOrtS Electric STA. COOK DISP. F.A.U. ADDRF-SS9144 EjnNror SPACE HTR. 1 AIR COND. 1 1 00 CITY San Gabriel TEL. No. 87-5375- CLOTHES WASH. DISHWASH. LICENSE NO. 14684 CLASS. C.JO FAN OTHER 1.00 I HERESY ACKNOWLEDGE THAT I HAV[ READ THIS APPLICATION AND STAT[ THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS PLAT]Me WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. [W. KVA. ELECTRICAL WIRING. SIZE G TYPE OVER TO IH[R[SY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 — 1 1DO LICENSED Al REQUIRED BY LOS A [ COUNTY AND STAT[ OF CALIFORNIA Olt THAT I AM TH[ [/AL MIR OF D INT114D TO I — 10 SDp RESIDE IN, THE ASO RISED R[ L PROPERTY. SIGNATURE 10 - 60 Soo OF PERMITTEE 0 50 - 100 1x00 DIST RICT XO 1CLABS If ZONE F O By ad 100 - 800 1eDo arJ SIGN, GASNOTES; d SIQN AND ONE CIRCUIT SDO TUBE, OR MARQUEE ADDITIONAL CIRCUITS 11DO SERVICENOTOVER 600VOLTS OR200Amp 200 APPROVALS DAT[ IMECIOR'1 SIGNATURIE SERVICEOVER600VOLTS OR200AMP 5m TEMP.POWER POLE TEMP SERVICE,POLE, &APPURTENANCES &00 UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM 9.00 ROUGH CONDIUT WIRING FIXTURES PERMIT FEE (SUB TOTALS 4 UQ POWER AUTHORIZED PLAN CHECK FEE (60% PERMIT FEE) UTILITY CO. NOTIFIED PERMIT ISSUING FEE FINAL SUPPLEMENTARY PERMIT ISSUING FEE 1.00 /� JOS6P C. ROOHAN /�► TOTAL FEE vV SUPERVISING ELECTRICAL ENGINED— / PLAN CHECK VALIDATION l M.O. CASH PERMIT VALIDATION CK. M.D.96L-0 /[[ BACK OF APPLICATION FOR COMPLETE SCHEDULE Up *44�-&K [Wj 1 2 D 7.00— �p F 76A683-CE*OS 1'68 "T APPLICATION FOR ELERIC L PERMIT r COUNTY OF LOS ANGELES DEPARTMENT. OF COUNTY ENGINEER BUILDING BU4LDING AND S4FETY DIVISION ADDRESS JOHN A. LAMSIE, COUNTY ENGINEER COLQMAN W. JENICINS; SC1rIIKRINTNENDKNT OP BUIL.DINO LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. OWNER REC EP ECMAIL LIGHT. T TAL FIRST 20 JD .20 QQ ADDRESS SWITCHI _ OVER 20 .10 CITY TEL. NO. PLAN CHECK LIGHTING TOTAL FIRST 20 .20 APPLICANT FIXTURES OVER 20 .10 ADDRESS RANGE,LDRYkR-j–WTR.HTR.— CITY TEL. NO. STA.COOK_DISP.-/—F.A.U.— CONTRACTOR SPACE HTR AIR COND. ADDRESS CLOTHES WASH—DISHWASH— CITY TEL. NO. FAN_OTHER 1.00 LICENSE F40,.Z/oCLASS. MOTORS.TRANSFORMERS RATING G HERE AA - E 4T I HAVE READ THIS APPLICATION IND. REATERS, ETC. HP. KW. KVA. SIZE � TYPE OVER TO AND STATE THAT THE ABOVE CORRECT AND COMPLY WITH ALL COUNTY ORDI NA NCE LAWS B AND STATE LAW/ REGULATING ELS CTIR ICAL WIR IN S. 0 - 1 1.00 I HERESY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 1 - 10 3.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWM/R OF, AND INTEND TO 10 - 80 6.00 RES IDE IN, THE ADO VE DESCRIrED R[/IDENTIAL PROPERTY. 0 SIGNATURE V 80 - 100 10.00 OF PERMITTEE be 100 - 500 18.00 O DIST$f CT NO. GROUP E BION,GAB SIGN AND ONE CIRCUIT 3.00 :A l�3 1 TUBE, OR _ CL MARQUEE ADDITIONAL CIRCUITS 1.00s NO ES: _ r SERVICE NOT OVER 800 VOLTS OR 200 AMP 2.00 SERVICE OVER 600 VOLTS 0R 200 AMP 5.00 TEMP 8ERVICE, POLE, h APPURTENANCES 3.00 APPROVAL/ DATE INSPECTOR'S SIGNATURE TEMP. POWER POLE UNDERSLAB WORK ROUGH CONDUIT WIRING PERMIT FEE (SUB TOTAL) FIXTURES PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED PERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL TOTAL FEE J S H C. ROOHAN SUPERVISING ELE AL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH ,QOSEL ,0 4 6 2 22 MAT 10 2 D 1 8,00- SEE E BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE I C M" OF LOS'ANGELES TEMPLE GIT7 � 0508 Ii~ DEPARTMENT OF PUBLIC WORKS 9071 LAS TUN.&S E 05 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA' PHONE: (818) 285-0488 EXT: OIL FILE f isA�v- 5385-008,020 iAAR 14L-D 1%AV FEE DESCRIPTION: QUANTITY: UDl1: AMOUNT: _" .Al PERMIT ISSUANCE FEE 27.75THQ�AS P GRID: J2 LOCALITY: .TBPJ E CITY G1 OUTLETS-LGT RECD 17.Q0 Qlff 33_15 G2 LIGHTING F)kTL�ES 4.QQ0� Ll;t 7.80JSSUED ME IF : PLAN IA MORES EX FAITS LT 3HP 2. EX 30.90 /11/97 .- TC _ .-06/11/90-IRES . TOTAL FEES 99.60 OWNER: TEL. NO: FINAL 5XTV I WAL BY: SCH04VIMCK FEDOR A;CARQLYN A (818) X09-0320- ' 944 1 BAR I RAID I AV TEMP 917801648 DMIPTIOIN OF- ELECTRICAL -FOR ADDI IOM AND ,REMOOE ISTING BATHROOM APPLICANT: TEL. NO: SAME AS OWN ERSPECM CONDITIONS: SAME AS OWNER - TEL. NOi DAT Eun �O - LIC. NO TEMP�WY POWER POLE Cb� rl� UNDERMUM ; 0 / XRCHITECTOR ENGINEER: T EL. NO ✓sem LIC. NO: ; + EOP UBL IC_ WORKS PLASTIC Y/N MEITAL YEN- lz- /Vice REPORT ID: DPR265 ROUTE TO: RSD508 R COUNTY OF LOS ANGELES TEMPLE CITY 0508 ELECTRICAL PERMIT DEPARTHEa?r OF PUBLIC WORTS 9701 LAS TUNAS EL 0508 1210100015 BUILDING AND SAFETY / LAND DEVEIAPwE:NT 'ter•£ CITY CA 91780 PHONE: (626) 285-0488 ETT: LEGAL ID: FEES PAID BUILDING ADDRESS: ON FILE 9441 GARIBALDI AV FEE DESCRIPTION: QUANTITY: DOM: AMDUTPP: TEMP CA 917801648 - ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 5385-008-020 Al PERMIT ISSUANCE FEE 27.80 TRONAS PAGE: 596 GRID: J2 . LOCALITY: TE24PLE CITY CA Gl OUTLR"-L0T,SW,RECP 6.00 OUT 12.00 G2 LIGHTING FIZTUP-9S 4.00 LOT 8.00 ISSUED ON: PROCESSED BY: PLAN BY: TOTAL FEES 47.80 10/10/12 SR OWNER: TEL. NO: FINAL DINE FIS BY: CODE: KHA94410. DAQINRIBAL (626) 623-2731- L^ ''�1 / '�/�- 9441 G,ilRranr,nI AV IL►VL�11L �/ TFl� 917801648 IN&SCRIPTION OF WORK INSTALL FOUR RECESS LIGHTS IB THE FORMAL DIN NO ROOM CEILING TWO SWI1EIMS AND FOUR RECEPTICr.ita APPLICANT: TELT. NO: SAME AS OWNER SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER TIC. NO TE!{PORARY POWER POLE ULIDERGROUND CONDUIT ARCHITECT OR ENGI=: TEL. NO: IIFER GROUW LIC. NO: ROUGH CONDUIT ROUGH WIRING MAIN WATER T- PLASTIC Y/N ME-17LL Y/N UTILITY COMPANY NOTIFI= REPORT ID: DPR265 RDUTE TO: BS0508 1 WORKER'S COMPENSATION DECLARATION 7 °DPW(12-G1) -APPLICATION FOR -ELECTRICAL hereby affirm that l have n certificate of consent to self Insure, APPLIC ELECTRICAL PERMIT or g certlncate of Worker's Compensation Insurance, or a certlfled COUNTY OF LOS ANGELES ► DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec. 3800 Lab. C.) Pool Icy No. Comparry FOR APl-LJCAl1T TO FILL LN B . ❑ Certhled copy Is hereby fumished. New Reskdw tJa]Bldgs Q Pools NO. EACH FEE — s $ LLOCALITYEl Certtflad copy Is Mod with ttw county lou flmng Inspection 8 2 1 -Famlly,Sq.FIL NEAREST department- Mufti-fsmlfy Sq.PL CFbOgg ST. Dafs APPIca� Rseidentlal Swimming Pools Arm _ MAP BOOK PABE PAF�Cl3 CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec._Light 6w. OWNERE COMPENSAT)ON INSURANCE F1 rat 20 (This section need not be completed If the work Invotved by the Total No. Addrdonal ,' ADD_BS 111 C- permit is for one hundred dollars(=100)or Is".) I certify that In the performsnoe of the work for whlbh thls permit CITY t TSL No OLl Is Issued, I shall not employ any person In any manner so a's to PLAN CNS become subject to the Workers' Compensation Laws., Ughting Fbtiree First 20 AP PIJCANT Total No. Ackf dorsal ADDRESS Date ApplIoarrt RESIDENTAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: It, after making this Certlflcate of CITY T*L Na Exemption,you should become subject to the Workers'Compensaf]on OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code, you must forthwith comply with such ays PERMIT C�C7LUWC}L provisions or this permit shall be deemed revoked. Power Apperar"S LAppliances LICENSED CONTRACTORS DECLARATION Sire'S Type HP,KW,KVA,or KVAR ADDRESS I hereby affirm that I am licensed under pfovlslone of Chapter B Over 3 to 10 Ind. C (commencing with Section 70DO) of Dlvlelon 3 of the Business and , ` TOL No. Profasslons Code,and my license la In full force and effect. Over 10 to 50 Ind. uCENSE Ort r Over SO to 1010 Ind. R:Ea NUWBER License Number LJ~Clans Over 100 DOTIRCT NO. PFCCEB�BY S elQ Contractor Date P' DAT O ❑ I am gxempt under Seo 400-1000 Arnp.Under 900 V �' VAUDAWN LLI Over 1000 Amp.or Over 900 V FRA_ B.- P.C.for this reason BRANCH CIRCUIT FEES B Z Date: 15r,or 20A,.124V,Lighting or Recspt 1 To 10 Bran oh Clroufts SlgrAiture 11 To 40 Brarrh arcutts 41 Or ch 0rcults ElExemptionfor Reg.MainL Elect 15A,20A,2OW To 277V L Y:Inrcults CtrcuilB ' SINGLE FAMILY Temp,Power Pcle S Appurtenances LA �• s HOME oWNEP BUILDER DECLARATION ACCT■T Sign wfth One Branch Clrouh I hereby affirm that I am exempt from the Contractor's License Law Sig ��7�4r for the following reason (Section 70L31.5, Buslnesa and Professions Addit}onai Sign Branch Cirartta 33B363 Cods): 1 ITQ `' I, as owner of the property,will do the work and the structure Mlac.Condufts 8 Conducfons la not Intended or offered for sale (Section 7044, Buslnesa Other(See Complete Fee Schedule) TOTAL 63 -45 and Profeeslone Code). Poo. e y 63.45 CONBTAUCIION LENDING AGENCY ry la`�`dv .00 I hereby attlrm that there Is a constructlon lending agency for the LfEiT�L performanoe of the work for which thls permit Is Isaued (Sec. 3097, PERMrr FEE (Sub-Total) Ctv.C.) � PLAN CHECKING FEF 000MWI a1 71 7/93 Lenders Name PERMrr ISSUING FFA0617 1 Ai111�lCl Lenders Addrape P� ry TOTAL FEE I owtffy that I have read this appllcafion and under of u state that the above Infonmadon b corredL I agree to compty with a1 County ord3nancee and State laws regulating Electrical wiring,and hereby euthortzs repreeenfstives of this County Jo enter upon the above--mandoned property for lnpeeliT purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE -7 b MNA DA q'3 WOR>�I'SCOMPENSATIONDEa.�tA-nON 2o-Mg -o1) APPLICATION FOR ELECTRICAL PERMIT ^-I he[eb�•afilrm 7tSAEE3 that I have a certificate of consent to self Insure, � or a oertlficate of Worker's Compensation Insurance, or a certified G'.OUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. �ereof(Seo.3Q00 Lab.C.) _ _ 0, :0�!Y` n � FOR APPUCurr To FILL IN AADD4E88 ❑ CerttW copy Is hereby furnished. New Rest Woft Bldgs.S Pools NO. EACH FEE LOCALITY $O ❑ Ceried copy-Is Mad with thebuilding 1 d 2-Fmly,Sq.Ft bMuft> amRy Sq FL -- NEAREST C"ul OP0069 EFT.L Data Applloent Reeid Swimming Poole ASSE88OR MAP BOOK PAGE PAFlCEL CERTIFICATE OF EXEMPTION FROM WORKERS', Outlets:Roc.—Light Sw. COMPENSATION INSURANCE FfFtal--cw" , FbV(This section need not be completed If the work Involved by the Add ItLonal Lo A,D� perm Ft Is for one hundred dollars($100)oris...) Total No. Addtdonal I certify that In the performance of the work for which this permit CnY Is Issued, I shall not employ any person In any manner so as to PLAN CHECK become subject to thq Workers'Compensatign Laws. UghtJN Fbd— First 20 APPLIGA T Total No. Addrdonal ADDRESS Date "loar t NOTICE TO APPLICANT: If, after making this Certificate of RESIDENTIAL NOT HP. Crry Tel.No Exemption,you should beoDme subject to the Workers' Compensation OTHER provisions of the Labor Code, you must forthwith comply with such APS provlelona or this permft shall be deemed revoked. Power &Large Appliances � LICENSED CONTRACTORS DECLARATION Stn S Type HP,KW,KVA,or KVAR ADDRESS I hereby affirm that I am licensed under provlsloha of Chapter 8 Oyer 3 to 10 Ind. (commencing with Section 7000) of Division 3 of the Business and CffY T Professions Code,and my license Is In full force and effect Over 10 to 60 Ind. LJC� OR Over 50 to 100 Ind. REO.NLa1BEl C� d �fOver 100 DKM CT NO. tee P BY LkarNumber Lkaes.Cly (� 120 Services,8wbd.,MCC S Panelboarde -�a Corttrn[or 0-3W Amp.Under x300 V � ❑ I am exempt under Sec. 400-1000 Amp.Under 900 V (� VALDATION Over 1000 Amp.c Over 000 V LILI By ANAL a B.SP.C.for this reason BRANCH CIRCUIT FEES co Data: 16A,or 20A,12OV,LighUng or ReoepL Z 1 To 10 Branch C1raufte Slgrudure 11 To 40 Branch Ctou-b41�More T1 TT t�@i4a+pip ❑ Exemption for Reg.Maim Elect 1BA,20A,206V To 277VCucults SINGLE FAMILY Temp.Power Pole S Appurtenances r�t-Les�!�-t{// La p� HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit [WCK QJ■OL! 1 hereby affirm that I am exempt from the Contractor's License Law r nr1f{�1 for the following reason (Section 7031.6, Bualneea and Professions Adchkw i ftn Branch Cfrcutb � G ■LMJ Code): ❑ I,as owner of the property,will do the work and the structure Mho-Conduits d Conductors Is not Intended or offered for sale (Section 7044, Business Other(See Complate.Fee Schedule) , 0�—MOI 10/ 3/95 and Professlons Code). 97 1 AM10:09 CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the pirformance of the work for which this permit is leeued (Sea. 3087, PERMrr FEE (Sub-TotaD Ch.C.) PLAN CHECKING FEE Lenders Name / PERMrT ISSUING FEE Lenders Address j I oertIty that I have reed this appdoarion and under penalty of purlury state TOTAL FEE C� &w the above Information is correct- I agree to compty with all County orcIlruuicee and State laws rogulattng Elecbicel wiring,and hereby authortze of this County to enter upon the above-merrtfoned property }Of I Pu SEE REVERSE FOR EXPLANATORY LANGUAGE DATE