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Home My Public Portal About9544 1/2 GIDLEY ST_Electrical__ J TEMPLE CITY �A689-C[f0E 4$8 - APPLICATION FOR ELECTRICAL PERMIT H- COUNTY OF LOS ANGELES DEPARTMENT OR COUNTY ENGINEER BUILDING ]BUILDING AND SAFETY DIVISION ADDRESS 95441' E. Gidley JOHN A. LAMBIE, COUNTY ENGINEER COLaMAN W. JaNKIN8, SUP OF BUIL.DINO LOCALITYTemple City ST NEARE FOR APPLICANT TO FILL IN NO. EACH CROSS ST,Temple City Blvd. RgCEPT.— OWNER Mrs. Sama.rizch MAIL 4846 Kauffman LIGHT TOTAL FIRST 20 .20 ADDRESS OVER 20-- 10 CITY T.C. TEL. NO_ 286-73-22f SWITCHPLAN CHECK LI�,}ITING ITOTAL FIRST 20 .20 APPLICANT�ly(TURES OVER 20 .101 ADDRESS RANGE—DRYER—WT R.HTR.— CITY TEL. NO. STA.COOK.—DIS P. F.A.U._ CONTRACTOR Conlee & Son Electric SPADE HTR AIR COND. ADDRESS1030 . N. Grandview Ave. CLOTHES WASH._DISHWASH_ CIT1S.San Gabriel - TEL. NO. FAN—OCHER 1.00LICENSE No. 242432C CLASS. MOTORS,TRANSFORMERS RATING IND. HEATERS, ETC. HP. KW. KVA. I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ANDSTAT[ THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY SIZE & TYPE OVER TO WITH ALL COUNTY 0RDINANC ES AND STATE LAWS REGULATING 0 1 1.00 'ELECTRICAL WIRING. - - I HERESY CERTIFY THAT I AM, PROPERLY REGISTERED ANb/OR 1 - 10 3.00 3 00 LICENSED AS REQUIREBY LOS ANOU SELE5 CNTY AND STATE OF CALIFORNIE A OR THAT I AM THE LEO AL OWNER OF, AND INTEND TO 10 - 60 15.00 RES IDE IN, THE �pESCRll1lD RESIDENTIAL T.RTY, ^ EO - 100 10.00 SIGNATURE VU OF PERMITTEE 100 - E00 1E.0 DIS IC . G UP Z10 N E P w 3ION,GAS SIGN AND ONE CIRCUIT 3.00 O. TUBE, OR - C/1 'MARQUEE - ADDITIONAL CIRCUITS 1.00 NOTES-: SQtVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 sKRVICE OVER 600 VOLTS OTR ZOO AMP 15.00 TZNT fIRVIC✓E, POLE, &APPURTENA)CES 3.00 APPROVALS DAT[ INSPECTOR'S SIGNATURE TEMP. POWER POLE UNDERSLAB WORK P T NUMBER 0562 ROUGH CONDUIT PERMIT FEE (SUB TOTAL) WIRING FIXTURES PLAN CHECK FEE (150% PERMIT FEE) POWER AUTHORIZED PERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED SUPPLEMENTARY PERMIT ISSUING FEE 1.00 1 0 FINAL TOTAL FEE 4 0 JOSEPH C. ROOHAN SUPERVISING EL E CAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH_ PERMIT VALIDATION cK. M.O. CASH 683 "26 B 4PQ- 4 15ACX OF APPLICATION FON CONWL.[T[ FIM SCHEDULE TEMPLE CITY `I,oAbe9-cEeoe 1-ee APPLICATION FOR ELECTRICAL elT COUNTY OF LOS ANGELES fl DEPARTMENT OF COUN- Y ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS 4 JOHN A. LAMBIE. COUNTY ENGIN[eR COLEMAN W. JENKINS, SUPKRINTEUJDKNT01< BUILDING LOCALITYT ple City NEAREST FOR APPLICANT TO FILL IN CROSS ST. le City Blvd. OWNER Mrs. Samarizch RECEPT.�'� MAIL 4846 Kauffman LIGHT TOTAL FIRST 20 .20 ADDRESS SWITCHf OVER 20 -.10 CITY T.C. TEL. N0286-7124 PLAN CHECK LIGHTING �TOTALFIRST 20 .20 APPLICANT FfXTURE3 OVER 20 10 ADDRESS RANGE—DRY ER—WTR.HTR.— CITY TEL. NO. STA.COOK_DISP. F.A.U._ CONTRACTOR COnlee & Son Elect. SPACE HTR. AIR COND_ ADDRESS1030 N. GrandVieW O CLOTHES WASH. DISHWASH_ CIT TEL. NO. 280"200 7 FAN—OTHER 1.00 LICENSE NO. 242432 CLASS, C 10 MOTORS.TRANSFORMERS RATING IND. HEATERS, ETC. HP. KW. KVA. I HERESY ACKNOWLCDGE THAT I HAVE READ THIS APPLICATION SIZE h TYPE OVER TO - AND STATE THAT THE ABOVE ID CORRECT AND AGREE TO COMPLY 'WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. 0 - 1 1.00 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR Y - 10 3.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER Of,AND IN NO TO 10 - 80 5.00 RESIDE IN, THE A DESCRIKED RESIDE TIAL P ERT Y. 0 SIGNATURE ' IJ 80 - 100 10.00 'OF PERMITTEE GC 100 - 800 15.00 sloN,aAs DIS ICT O. G O�JP zpNE PROCESSEf�BY rj TUBE, A SIGN AND ONE CIRCUIT 3.00 a�'�� I�u MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES: _ SERVICE NOT OVER 600 VOLTS OR 200 AMP 12.00 2 0O SERVICE: OVER 600 VOLTS OR 200 AMP 5.00 Mw zL TEMP SERVICE, POLE, & APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP. POWER POLE UNDERSLAS WORK ROUGH CONDUIT PERMIT FSE (SUB TOTAL) WIRING FIXTURES AN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED PE-RMIT ISSUING FEE 2.00 2 00 UTILITY CO.NOTIFIED/ .I SUPPLEMENTARY PERMIT ISSUI NG FEEI 1.00FINAL TOTAL FEE 4 120 JOSEPH C. ROOHAN SUPERVISING ELECTRICAL ENGIN ER PLAN CHECK VALIDATION CK. M.G. CASH PERMIT VALIDATION CK. M.0. CASH Lir.{ 0 5 6 21-0- aY1 3 2 D 4.2 Q SEE BACK OF APPLICATION FOR COYPLCTE FEE SCHEDULE WORKERS'COMPENSATIONDECLARATION CE-80BG (2-80) APPLICATION FOR ELECTRICAL PERMIT I hereby ■form that I have ■.certificate of convent to self COUNTY OF LOS ANGLES BUILDINO'AND SAFETY I Insure, or ■ certificate of Workers'Compensation Insurance,or T-j a certified copy thereof(Sec.3800,Lab.C.) FOR APPLICANT TO FILL IN JOB Polley No. Company EACH NO. FEE ADDRESS KeW Raaldentlpl Bidgs.&Pools u Certlfled copy Is hereby furnished. 1 &2-Femlly,Sq. Ft. — i LOCALITY ❑ Certlhod copy is filed with the county build inspection Sq. Ft. �_ — _-� p ty ►nY pection Residential SWlmming Pools CROSS 9T department. OWNER OR FIRM NAME Date Applicant Outlets: Rec.____Light SW. MAIL ---71 rat 20 ADDRESS CERTIFICATE OF E?(EMPTION FROM WORKERS' Total No. Additional CITY Tal No. y COMPENSATION INSURANCE. PLAN CHECK S (This section need not be completed if the work btvoh►ed APPLJCANT by the permit Is for one hundred doI1Frs (=100) or lenLighting Fixtures First 20 ) ADDRE8b` Total No. Additional CCO I certify that in the performance of the work for which this CITY Tel No. permit Is Issued, I shall not employ Fixed Appliances Not Over 1 HP p y en y person In any manner PERMIT W so as to bacpme euboct to the Wdrken' Compensation Laws. Range_ Heater_D.W. _ PP ANT a Oven _Dryer_W.M.— ADDRESS Date Applicant Top _ FAU _W.H. Hood _ Fen _Other_ CITY T*I N NOTICE TO APPLICANT: If, after making this &rtiflcate of Dlsp. _ Room Air Condom LICENSE Exemption, you should become subje'ctt to the Workers' REG.NUMBER' Ira Compensation' provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO. PROCE8 BYE with comply with such providons or this permit shall be deemed revoked. Size&Type HP,KW,KVA,or KVA ^ s Up to 1 Incl. FIN L. Over 1 to 10 Incl.' DATE LICENSED CONTRACTORS DECLAMATION Over 10 to 60 Incl. VALIDATION I hereby afflim that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL 9 (commencing with Section 7000)of Division 3,of the Busi- Over 100 BY _ - nein and Profeodons.Cods, and my license is in full force and . . effect. i !l Services 673 q License NuCJ 0.2Amp.Under 600 V Llc.CLss00 • 201-1000 Amp. Under 600 V mb l& Contrs�lor Date_ " / Over 1000 Amp.or Over Q00 V ` yr HOME OWNER-BUFLDER DECLARATION Temp. Power Pole&Appurtenances I hereby affirm that I un exempt from. the Contractor's with One Branch Circuit ctor'e Addltionel Sign Branch Circuits License Law for the following feason (Section 7031.5, Buri- nese and Profesdom Code): 0 2 'A Mlic.Condults&Conductors I, as owner of the property, will do the work and the Other (See Complete Fee Schedule)— # o 0 0 0 0 2 structure is not,intended or offered for sale .(Section 704-4,Business and Professions Code). 2 ° 0 1200 CONSTRUCTION LENDING AGENCY I heteby affirm that there Is a construction lending agency ' for the performance of the.work for which this permit is PERMIT FEE (Sub-Totgl) .°,° P 1 2-00 is issued(Sec. 3097,Civ.C.). Lender'sNsrne PLAN CHECKING FEE (One-Fourth Permit Fee) 0 7.01.7 8 Lender's Address PERMIT ISSUING FEE I certify that I have read this application and state that the TOTAL FEE lox above information Is correct.I agree td comply with a4 County ordinances and State laws regiilating Electrical wiring, and hereby authorize representattvei of this-County to enter upon the ab o-m on roperty for action purposes. $EE'REVERSE FOR EXPLANATORY LANGUAGE I Sijnature o ttee Date '