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Home My Public Portal About5612 GOLDEN WEST AVE_Electrical__ 76A663-CE80611/70 APPLICATION FOR ELECTRICAL ERMIT COUNTY OF LOS ANGELES _ DEPARTMENT,OF COUNTY ENGINEER FDDBUILDING LID I' S 601 �� BUILDING AND SAFETY DIVISION COLEMAN W. JENKINS' SUPERINTENDENT OF BUILDING TY. �t�.y" 'lc C/ TFOR APPLICANT TO FILL IN ST OUTLETS NO EACH FEE t ,. OWNER / G 'V O RECEPT MAI $ $ ADDRESS LIGHT TONAL FIRST 20 25 CITY _ TEL. NO - SWITCH OVER 20 10 PLAN CHECK LIGHTING TOTAL FIRST 20 25 APPLICANT FIXTURES OVER 20 IO ADDRESS APPLIANCES ,CITY TEL. NOPERIT RANGE DRYER WTR HTR. APPLICANT k5;1"I UdrQl••e STA COOK DI SP F A.U ADDRESS'2 7 3 1 u S 4_ aJ SPACE HTR AIR CON D Cl TY' Vj C ],�Q TEL NO Q-! t CLOTHES'WASH ' DISHWASH LICENSE NO. L 6 CLASS. 40 FAN OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT, AND AGREE•TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND HEATERS, ETC HP KW KVA ELECTRICAL WIRING , SIZE & .TYPE OVER TO ' I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR O - 1 / 100 CS b LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO 1 - 10 300' RESIDE IN, THE ABOVE DESCA D R NTIAL PROPERTY d• SIGNATURE V 10 - 50 500, OF PERMITTEp w 50 - 100 1000 DISTRICT NO ICLASSZONE PRO ES O100 - 500 1500 le D ( LU SIGN, GAS SIGN AND ONE CIRCUIT 500 NOTES: N TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 SERVICENOTOVER 600 VOLTS OR 200AMP 300 - 'APPROVALS DATE INSPECTOR'S SIGNATURE S ERVI CE OVER 600 VOLTS OR 200 AM P 1000 , TEMP POWER POLE - TEMPSERVICE, POLE, &APPURTENANCES 500 UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM 300 ROUGH CONDIUT WIRING FIXTURES POWER AUTHORIZED PERMIT FEE (SUB TOTAL) - ' UTILITY CO NOTIFIED - PLAN CHECK FEE Q FINAL PERMIT ISSUING FEE 300 ' JOS P C- ROO AN TOTAL F.EE Q 'SUPERVISING ELECT ICAL ENGINEER, •- PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION cKLIMO ' CASH U ;O,z 1 �.� 6 2 D� � 4.d ON SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE - 76A66-C4B06 4-68 APPLICATION FOR ELECTRICZPE�RfV11T COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING //�� BUILDING AND SAFETY DIVISION ADDRESS 5,(//2 G JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDINGLOCALITY NEAREST ylO-- FOR APPLICANT TO FILL IN CROSS ST NO. EACH FEE $ $ OWNER RECEPJJ��jj MAIL LIGHT_ TOTAL FIRST 20 20 CZ,) ADDRESS SWITCH _ OVER 20 ^ 10 CITY TEL. NO. T-��I ` PLAN CHECK LIGHTING 1 TOTAL FIRST 20 / 20 Cho APPLICANT FIXTURES Jj OVER 20 10 ADDRESS RANGE—DRYER_WTR HTR._ CITY TEL NO STA COOK:_DISP ��.A U I CONTRAC rOR e SPACE HTR. AIR COND. ADDRESS Q 3 1 CLOTHES WASH V DISHWASHA )L 1 C'ITY l .I TEL NO.''4`V /'2d`�/ FN_OTHER 00 �� LICENSE IJO• Z CLASS.(:::-/b7 LASS.�-/v MOTORS,TRANSFORMERS RATING - IND HEATERS, ETC HP KW KVA I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION SIZE & TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING 0 - 1 1 00 ELECTRICAL WIRING • • I HEREBY CERTIFY THAT I AM PROPERLY'REGISTERED AND/OR 1 - 10 3 00 LICENSED AS REOUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THA�B' AM THE LEGAL NER OF, AND INTEND TO 10 - 50 5 00 - RESIDE IN, THE VE OESf R I P•ED �ESIDE N7IAL PROPERTY O SIGNATURE ~ 1U 50 - 100 10 00 OF PERMITTEE C:) 100 - 500 15 00 U DISTRICT,• O GROUP q NE PROCESS D BY W SIGN GAS TUBE OR SIGN AND ONE CIRCUIT 3 00 �• D f� MARQUEE ADDITIONAL CIRCUITS 1 00 NOTES SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00 O SERVIC€ OVER 600 VOLTS OR 200 AMP 5 00 - TEMP SERVICE, POLE, & APPURTENANCES 3 00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP POWER POLE UNDERSLAB WORK •f/ ROUGH CONDUIT PERMIT FEE (SUB TOTAL) WIRING FIXTURES PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED - PERMIT ISSUING FEE 2 00 `� UTILITYCONOTIFIED - ola SUPPLEMENTARY PERMIT ISSUING FEE 1 00 FINAL - y `f fL q TOTAL FEE JOSEPH C. ROOHAN _ SUPERVISING ELECTRICAL ENGINEER PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATIONcK M 0 GASH 0 1. 5 3`0' Mffi 2 3 2 D 1 0 SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE WORKER S'COMPENSATION DECLARATION aI T CE-8Q6G (2-8Q) APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that.I have a certificate of consent to self COUNTY OF LOS ANGELES, BUILDING BUILDING AND SAFETY insure, or a certificate of Workers'Compensation Insurance,or / a certified copy thereof Sec 3800,Lab C.) J (J�. :4,n `7 d FOR APPLICANT TO FILL EACH N NO FEE AD Policy N 1 "`"��o an V 1 ADDRESS t (J ONew Residential Bldgs &Pools _ •� Certified copy is hereby furnished 1 &,2-Family,Sq Ft $ $ LOCALITY �! Multi-family Sq Ft — NEAREST Certifie copy is filed with the county building inspection CROSS ST 0& C de r e t .--; Residential Swimming Pools OWNER OR 7 nn ss�� FIRM.NAME Date Applicant Z Outlets Rec4ught�ySw MAIL r �"�"� First 20 CERTIFICATE OF EXEMPTION ROM WORKERS' Total No Additional CITY Tel No COMPENSATION INSURANCE } PLAN CHECK _ 9L (This section need not be completed if the work involved APPLICANT 0 by the permit is for one hundred dollars ($100) or less.) Lighting Fixtures First 20 ADDRESS 0 Total No _ Additional cr_ I certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No 0 permit is issued, I shall not employ any person in any manner PERMIT ' () so as'to become subject to the Workers' Compensation Laws Range_ Heater_D W. APPLICANT ()N\ 04A sx W Oven Dryer_W M ADDRESS % . Date Applicant Top _ FAU _W H Z Hood _ Fan _Other_ CITY Tel N 7 NOTICE TO APPLICANT If, after making this Certificate of Disp _ Room Air Cond.__1_ LICENSE OR Exemption, you should become subject to the Workers' REG NUMBER lass Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO PROCESSED-BY with comply with such provisions or this permit shall be Size&Type HP,KW, KVA,or KV AR deemed revoked ] U d Up to 1 Incl • FINAL � Over 1 to 10 Incl DATE / ' LICENSED CONTRACTORS DECLARATION VALIDATION Over 10 to 50 Incl I hereby affirm 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 ness and Professions Code, and my license is in full force and. effect 4 Services License2 Number�� (Ze Class 0-200 Amp. Under 600 V 201-1000 Amp Under 600 V Contractor Over 1000 Amp or Over.600 V t HOME OWNER-BUILDER DECLARATION Temp Power Pole&Appurtenances - I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit + License Law for the following reason (Section 7031 5, Busi- Additional Sign Branch Circuits- 1.3.A ness and Professions Code) Misc Conduits&Conductors # o 0 0 o 0 2 O I, as owner of the property,p p y, wdl do the sale nd the er (S Co pI Fee Schemed le)— structure is not intended or.offered for sale '(Section 2 0 o 3 Q TO 7044, Business and'Professions Code). rdVIA ' ° CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency LC,a �i '0'0` 0 7j 0.7,0'0 for the performance of the work.for which this permit is U6 PERMIT FEE (Sub-Total) 2�a0 t9. $-82 issued (Sec. 3097,Civ C) ' Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) Lender's Address PERMIT ISSUING FEE �d , I'certify that I have read this application and state that the TOTAL FEE �D above information is correct.I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize rapresQvAalives of this County to enter upon tA above-mentio d p perty inspection p ses SEE REVERSE FOR EXPLANATORY LANGUAGE -;nature of Permittee ate 3 ' COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0709210025 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT. LEGAL ID. FEES PAID BUILDING ADDRESS ITR 11131 LT 15 BL- 001 5612 GOLDEN WEST AV I I IFEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917802520 ASSESSOR INFORMATION NUMBER: I . NEAREST'CROSS'STREET. 18588-012-025 IA1 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE. 597 GRID A3 LOCALITY TEMPLE CITY, Cl IF2 208, 277V LGT BR CKT 1 00 BR 27 30 (TENANT I TOTAL FEES 55 05 (ISSUED ON: PROCESSED BY: PLAN BY EXPIRES ON. 1 1 109/21/07 SR 03/19/08 1 10WNER TEL NO I I A�L �`T FI Y CODE 1 IVAN ETTEN, GARY (626) 285-5996- 15612 GOLDEN WEST AV ITEMP 917802520 ID SCRIPTION OF WORK v1 I NEW-CIRCUIT 1 I I I I (APPLICANT TEL NO I I I IARGO (626) 332-8200- 1 I I 1662 SHOPPER LN #A 'I 1SPECIAL CONDITIONS 1 ICOVINA, CA 91723 1 1 I I I I I 1CONTRACTOR: TEL NO I 1APPROVALS DATE INSPECTOR SIGNATURE 1 1ARGO CONSTRUCTION SERV. (626) 332-8200- I 1 I 1662 SHOPPERS LANE #A LIC NO ITEMPORARY POWER POLE I I I 1COVINA, CA 91723 632879 I I I I I (UNDERGROUND CONDUIT I I I I I I I I I 1ARCHITECT OR ENGINEER TEL NO I IUFER GROUND I I I I I I I I I LIC NO I IROUGH CONDUIT I I I I I I I I I I I IROUGH WIRING 1 1 1 I I I I I I I I IMAIN WATER LINE I I I I I IPLASTIC YIN METAL YIN I I I I I I I I I (UTILITY COMPANY NOTIFIEDI I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I II I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 1REPORT ID. DPR265 ROUTE TO BS0508 I I I I 'F� •` � I I I I I