HomeMy Public PortalAbout5117 GOLDEN WEST AVE_Electrical__ 76A663-CE606-10.56 APPLICATION FOR ELECTRIC PERMIT 1
BUILDING AND SAFETY DIVISION
Department of County Engineer BUILDING
County of Los Angeles ADDRESS,
JOHN A. LAMBIE, COUNTY ENGINEER
CASSATT D. GRIFFIN. SUPT OF BUILDING LOCALITY y
NEAREST
FOR APPLICANT TO FILL IN ROSS ST
PERMIT FEES
OWNER
LIGHTS RECEPTACLES SWITCHES MAIL
NUMBER I T E M EACH FEE
ADDRESS
TOTAL OUTLETS $ .10 $
ELEC. RANGES, WATER HEATERS, CITY TEL. NO.
CLOTHES DRYERS .50
ELEC. SPACE HEATERS, STAT-Y. COOK- ELECTRICIAN
1 +
I ING UNITS, GARBAGE DISPOSERS, ADDRESS„�
AUTO WASHERS. DISHWASHER .25
LIGHTING FIXTURES •10 CITYi1,�� O ,( TEL. NO. ' 7 / - ,
STATE r
MOTORS LICENSE NO.
_ HORSEPOWER
H.P. OVER INC. DISTRICT NO. GR_Up ZONE READY FOR INSPECTION
. .-� L
.25
71 '� - 2 .50 INSPECTION RECORD
2 5 1.00 /^ E�)
5 15 1.50 4
I S 50 2.50
50 200 5.00
MISC.
SIGNSI NO.TRANS
NO.LAMPS
SERVICE O-600V 1.00
SERVICE OVER 600V 5.00
WIRING PERMIT 1.00 r
FIXTURE PERMIT 1.00
SUPPLEMENTARY PERMIT .50 APPRO ALS
TOTAL FEE DATE IN CT R'S SIG ATU
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA ION
RE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT o
LDESCRIBED
COUNTY ORDINANCES AND STATE LAWS REGULATING `
L WIRING. WIRING O 1 4"-
IY.
Y CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
All
AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
A OR THAT 1 AM T LEGAL OW ER OF THE BOVE POWER
RE31DENTIA PROPE
RE - '... ,.- UTILITY CO. NOTIFIED /
MITTEE III
FINAL
JOHN A. LAMBIE. VALIDATION A HUR VETT, v
COUNTY ENGINEER; CK mo CASH SUPERVISING ELECTRICAL ENGINEER
02 0 6 3„ SEP 6 ? 1 .75
WORKEPS COMPENSATION°E "''°" � '°'a' APPLICATION FOR ELECTRICAL PERMIT
.t n,as I r,a e a d coneerrt to Ceti tr>srie
or�� of fie'Campeneauon Insurance,or a oertifted COUNTY OF LOS ANGELES BUILDING AND SAFETY
o; (S6o 3800,Lah Q)
7.38320,. 9- 'Fa-d Its.
. �,No- �� FI?R APQLx,Afyr rb Rua was.5L17C�il�V�3t
Ce-mm copy b hergby fur' a . New f3eaidenHaf Bides a Poole EACH NO: FEE
1 8 2-Fa�N,34 Ft. b — $ LQOAL, e
CitV
copy la ffW 'with ft county fx p �peciion —
damtriant A#O-fan n sq.FL - sT. Ta
Dat, ,,t 'BaP�I=.'CUBt(3D. Poo+e ow64Ea OR
F"A NAW F�IrI}c
r.EFrnFICATE Of'EXEMPT)ON FrtOM VVORKERS', C WB-ugu ,O S"'.12 r
CO#APENSAIQN INSURAT}CE.. i�ret 2Q. 'afk .
(TT*6totion need not be compWA4 Ir tt a work tmroK*d by th6 total No_� Addttlonal,. -`^- e ( Tel.No$1 _
,.per'fhR b for one t*j6dred dMLprz($-100)_{lam) ti' Ptrt gEGK
'I.oertffy that in the perfurmerCe of the.work,:}gr-whlc6 0*permk APftIGANT
As Iea*. I,eball-rip(brtploy.any Person Ih any manner,so as to,
beoo aub)ed to.the Vkelf re'Corrp9nsWJW Lewd. L rp Fbrturee tftrat 20 F ADDRESS L9'!60. 01±rg
T�,ry0. Addrtsa,al
Dedra Amt ��. QS.. Ie �_no a-a Tel.
W)tGE�,,TO' APPL'��t�ff''..tf, .O mMft bite 139rttflcata d FtxQd AppEarrcee Not Over 1 HP
' fF)ya{�,you houldbecorr>a eub}Qot talkie Vlbrkere'Compeneatbn � Healer_ DiN. A ai OJ,
,prq,rW&m-of the Labor Code,.'you must,fprttrvr(th gomPfywith auoli Oven.— Dryer _.WM. ADDRESS
pri}vVeiorrs or,tir}e pemllt Ciel!be,deemed revofced Top FAU' T Wkk CJTI,j ]le
UC LASED COK ACTORP DECLARATION . Hood Fan ';T, Other_ ` i•�'- `-�'-1 Tel Nc"14-�--1� .
t hereby ,df gp tt* f am Ilcertiped under provfalone of Crapter 8 Dye.,_ Fborn,Alr Coed -4 uCFM9E OR
1
(-dunenclrq,wfth Section 70 )qF 3 of the Bu -?o aft,
im
PJofaeebrre Code.and*I)cef le h tuJl#prce mid affectp�qPp�a t�'eodlea�ee. DaMicT r,o. Pflac� ar -
sbze a Type.HP,xw,Kl^or K\14R !
Llcorree Nurhbef; 4= uc.Cieae, R Up to-1 Incl � ���
f ii Over 1 to 10 IDOL
Corrliacto� a== arst Over 10 to 60 Jrrd,
FI
_I am e)pmpt under S00- Ove[60:#0 100-k
_ B. P.d.-for thb masa! Over i00. U)
Servbee,SwW,MCC a Parlelboefde Z
a DaW0-200 Arrp.Under 800 V -�
Sipna>ure 2q1 -10d0-Arnp.Undor 000 V
Oast 1-000 Arrro.or Over 800 V
Exe' on for Pm_�mnt.Qaot - 7 �V8 5 7 3 A
T Pcie Jt
SINGLE FAM�I' Power .. _ ,
emp1 APPIi � # o--o 0 0 0 2
HOME OWNER-BUILDER DECLARATION sign
I fwr aftlrrn that I aen pn a trout!the Centra s Lberse Lew wfffi One Branch Ctroutt
for the
AddBlonal S n Branch C1rou to
fdbvvh�reason(sed3on 703,.6,Suie(r*ee and Profeeeibne � l4 ' • '. . . � Q o
Code):
Moes.cot;dult a cbxdr,etora .1.0.0 ,
es oavner df the prbparty,wm do the worts and the s ochre other(see Complete Fee saradule) I 2- V4 t 5 7
Ye rlpt'lirtended or-offered for aale-(Seotion 7044, Bu*"as '
and Pr'ofegebrte Code)..
OONSTRUCTION LENDING ACIENCI
I heresy affirm that thefela a ooh&njc� Wdtrrp agwi y for the
Porbr—pe d th0 wb*for wbich bile permft Is leered(Sea,34GT; PERMfT FEE (Sub-Totaq ,
C1v,
PLAN CHECFCIW FFA
Lefgr'9 N4me r -
PERMfT.ISS UING FEE 1 O D
L�nder'e!address ,, .
-I cKtIty that I have read tib appli)a5m and-abate that the.al?we TOTAL FEE 6A , co •' J'
fr<focrrredbn is oorrecLl apme to.00mpty vft al 13ouhty ordnanbea
qfFNStEito Iewe raqul&no E1ect11oef wlrlrrp• and hereby authorize
of itde Camty to enter upon the.above-nwdDned
oto-y Toction wrp.— SEE REVERSE FOR EXPLANATORY LANGUAGE
srgiatrue of Perrmttee Dam
i COUNTY Of LOS ANGELES TEMPLE CITY 0 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL D508 0010270022
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-048$ EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS-
TR: 15683 LT: 11 5117 GOLDEN WEST AV
FEE DESCRIPTION: QUANTITY: UQI: AMOUNT: TEMP CA 917803941
ASSESSOR I ER: NEAREST CROSS STREET: LA ROSA
8589-010-011 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY
F1 120V, 15/20A BR CKTS 2.00 BR 34.50
HA FAU LESS 3HP 1.00 FAU 10.95ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES .
JB AC UNITS +3-10HP 1.00 AC 19.65 10/27/00 UT 04/26/01 .
TOTAL FEES 92.85
LAM• YVONNE (626) 285-2002- .
511'l GOLDEN WEST AV
TEMP 917803941 DESCRIPTION OF
ELECTRICAL FOR NEW HVAC SYSTEM
APPLICANT: TEL. NO:
IWAI COOLING AND HEATING (626) 932-1163-
826 BONITA ST. SPECIAL CONDillumb:
MONROVIA,CA 91016
NGELES C
CONTRACTOR: TEL. liU--- APPROVALS DATE INSPECTOR SIGNATURE---
S
IWAI COOLING AND HEATING (626) 932-1163- �� �T}►
826 BONITA ST LIC. NO TEMPORARY POWER POLE
MONROVIA CA 91016 778839 C20
ARCHITECT OR ENGINEER: TEL UFER GROUND
LIC. llllll
�� � ��C V 1� G�K PLASTIC Y/N METAL Y/N
Z9. ❑
a
.o4b/'c Eltact �,
Service Tha
REPORT ID: DPR265 ROUTE TO: BS0508
COUNTY OF LOS ANGELES TEMPLE CITY 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC STORKS 9701 LAS TUNAS EL 0508 1002170015
BUILDIM AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FES PAID BUILDING ADDRESS:
TR: 15683 LT: 11 5117 GOLDEN WF-ST AV
FEE D&SCRIPTION: QUANTITY: DOM: AM UNT: TEN4P CA 917803941
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET:
8589-0-10-011 AI PERMIT ISSUANCE FEE 27.75 THIONAS PAGE: 597 GRID: A4 LLSTY
OCA : TEMPLE CITY, C
GI OUTLETS-LGT,SW,RECP 9.00 OUT 17.55
TENANT: G2 LIGHTING FIXTURES 14.00 LOT 27.30 ISSDBD ON: PROCESSED BY: PLAN Y: EfPIR&S ON:
H2 RMS GRBG DISP LT 3HP 1.00 DIS 10.95 02/17/10 SR 02/17/11
H4 RES RANGE HDS LT 3HP 1.00 HOO 10.95
OWNER: TEL. NO: TOTAL FEES 94.50 FYULL DATE F BY: CODE:
YVON NE 4 BENJAMIN -
5117 GOLDEN WEST AV
TEMP 917803941 D ON OF FARO
R RCTRICAL FOR ZSTCHEN AND 2 BATF-RCOl S •REXODEL
APPLICANT: TEL. NO:
JAY MDTSOFI (818) 266-8978-
6037 SEPULVEN3A BLVD. SPECIAL CONDITIORS:
VAN NIIYS, CA 91411
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
PREFERRED HOME BUIWERS, INC. (818) 594-3500-
6271 VARIEI, AVE. UNIT C LIC. NO T24POR.ARY POWER POLE
WOODLAND 14TT.T-9 CA 91367 773147 B
UNDERGROUND COTE=
ARCHITECT OR EN57GI2EER: TEL. NO: UFRR GROUND
LIC. NO: ROUGE CCT41 T
ROUGH WIRING f�
FQITER LINE
PLASTIC Y/N }SAL Y/N
UTILITY COMPANY NOTIFIFII
REPORT ID: DPR265 ROUTE TO: BS0508