HomeMy Public PortalAbout6012 GOLDEN WEST AVE_Electrical__ ' 1
APPLICATION
■{q_p�p�app �g a PERMIT pp��/p�� .4
DBS-SA �I'-9tl B LICA 6 ION F®R IELEC a RIC 0 E IMIT is
DBS-SA 3.55
DIVISION-.OF BUILDING AND SAFETY
Deportment of County Engineer
County of Los Angeles BUILDING
WM.J. FOX, COUNTY ENGINEER ADDRESS Z�
` CASSATT D. GRIFFIN. SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
PERMIT FEES CROSS ST.
_
NU'MSER EACH FEE
LIGHT OUTLETS - OWNER
RECEPTACLES MAIL
_ADDRESS
WALL SWITCHES
TOTAL OUTLETS 5¢ $ CITY TEL. NO.
CLEC. RANGES 25 ELECTRICIAN
ELEC. HEATERS 25 ADDRESS
KW EA !J _CITY _ TEL. NO.
V
FIXTURES 5 LICENSE NO,
NUMBER OF LIGHT CIRCUITS - DISTRICT NO. GROUPI ZONE READY FOR INSPECTION
NUMBER OF RECEPTACLE CIRCUITS � I i I p�
MOTORS �L s[^+
NUMBER HORSEPOWER FEE INSPECTION RECORD
NEW MVD. HP OVER INC. EACH
1/2&LESS $ .25 _
1/z 2 .50
2 5 1.00
5 15 1.50
15 50 2.50
50 200 5.00
MISC.
04 U
NO.SIGNS .NO.-TRANS. -
NO.SIGNS NO, LAMPS
FOR EACH PERMIT:
WIRING $1.00 I 7 0
FIXTURES $1.00 O 6
SUPPLEMENTARY .50 APPROVALS
TOTAL FEE $ 4
4-3i DATE INSPECTOR'S
/SIGNATURE
HEREBY ACKNOWLEDGE THAT 1 HAVE-READ THIS APPLICATION CONDUIT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY .
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING
ELECTRICAL WIRING.
1HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE.OF
CALIFORNIA OR AT I AM THE LEGAL OW 1ER OF THE ABOVE _POWER
DESCRIBED R .. TIAL PRO R Y. _may UTILITY CO.NOTIFIED
SIGNATURE —
OFPERMITT, 'aFINAL
WILLIAM J. FOX, COUNTY ENGINEER VALIDATION A.C.VEIT.CHIEF ELECT. INSPECTOR
E� fl 4 9 6' JAN 4 - Z 2.40
w Y
WORKERS'GOMPENSAT(ON DECLARATION 76A663 to/st AP�L�C�'1TI®I� I�®R ELECTRICAL PERMIT
I here4ay affirm that I hav�a Oertficate of Consent to self insure, " CE-806G �+1
or a Certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SATIETY
zopy the ibf(Sec. 3800,Lab.C.)
Policy No. Company FOR APPLICANT TO FILL IN JOB r� �
❑ Certified co is hereby furnished. EACH NO. FEE ADDRESS o - CAI liL J
PY Y New Residential Bldgs.& Pools
ea
❑ • Certified copy is filed with the county building inspection 1 & 2-Family,Sq.Ft. $ $ LOCALITY
department. Multi-family Sq.Ft. NEAREST
CROSS ST.
Residential Swimming Pools OWNER OR
Date' Applicant FIRM NAME
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec Light Sw. - MAIL � ^
COMPENSATION INSURANCE ADDRESS AD Rrte@
1tJ9L -
(This section need not be completed if the work involved by the First 20 n
permit is for one hundred dollars ($100)or less.)
Total No. Additional CITY Tel.No. oC
I certify that in the performance of the work for.which this permit PLAN CHECK'
is issued, I shall not employ any person in any manner so as to APPLICANT
become s Nect to the Workers'Comp nsatio�n�L,agws. Lighting Fixtures First 20 ADDRESS
/C f f Total No. Additional CITY Tel.No.
Date Applicant VV
NOTICE O APPLICANT: If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT
Exemption,you should become subject to the Workers'Compensation Range_ Heater_ D.W. APPLICANT '
provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer W.M._ ADDRESS
provisions or this permit shall be deemed revoked. Top FAU W.H.
LICENSED CONTRACTORS DECLARATION Hood _ Fan Other_ CITY Tel.No.
I hereby affirm that I am licensed under provisions of Chapter 9 Disp. - Room Air Cond. LICENSE OR Class.
(commencing with Section 7000) of Division 3 of the Business and REG.NUMBER
Professions Code,and my license is in full force and effect. .DISTRICT NOESSED BY
Power Apparatus& Large Appliances D a
Size& Type HP, KW,KVA,or KVAR 0
License Number Lic.Class0
Up to 9 Incl FINAL
Over 1 to 10 Incl. DATE (�
Contractor Date VALIDATION 0
❑ Over 10 to 50 In . FINAL
I am exempt under Sec. Over 50 to 100 Inc. 8Y W
BAP.C.for this reason Over 100 d
Services, Swbd.,MCC& Panelboards ® Z
Date: 0- 200 Amp.Under 600 V
Signature 201 - 1000 Amp.Under 600 V V
❑ {'��
Exemption for Reg.Maint.Elect. Over 1000 Amp.or Over 600 V
SINGLE FAMILY Temp. Power Pole & Appurtenances l \ 2
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit « a
I hereby affirm that I am exempt from the Contractor's License Law ACCT.10
for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits
��
t� 25.50 am
Code:
I,as owner of the property,will do the work and the structure Misc. Conduits & Conductors' 1 ITEMS1�
is not intended or offered for sale (Section 7044, Business Other (See Complete Fee Schedule)
and Professions Code). / T�TAL 2:_a
CONSTRUCTION LENDING AGENCY CHECK 2Ju50
I hereby affirm that there is a construction lending agency for the CHANGE .011
performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total)
Civ. C.).
Lender's Name LJ .I
PLAN CHECKING FEE 0000-0013 1 7 9/21/189
Lender's Address
PERMIT ISSUING FEE ® 5829 . 1 AM 08925
5, .43t n
I certify that I have read this application and state that the above TOTAL FEE '
information is correct. I agree to comply with all County ordinances
and State laws regulating Electrical wiring, and hereby authorize
representatives of this County to enter upon the above-mentioned
prop`ty for inspection p�poce ,
SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Permittee Date
:DEfARTlVlENT-..OF ':BUILDING AND'SAFETY APPT.ICATION FOR PERMIT
COUNT .LF.Los AN GET ESS
NATI TE ,OF 'INSTALLATION DISTRICT Ho: CRo1 P,YPE PERMIT vo �
WIRING FIXTURES
E Y. .a
j) R AD FOR RECEIVED BY DATH ISSUED.
•RANG[ HEATER ''' 1 POWER: FIRST INSPECTION
�3`tel 07'- 4
1 alrtM@ MLSCFLLANEOC:S
AMAAN'i � LIN HE IL ' OU'1 D 01MO � ONL
} JOBJ� XJ�� k
Z Ir' * �1 1 ADDRE69` 1.� Ste/ * tr "•
U i ADDRESS ! ' `' LOCALITYA4
N.qAREST a
I Ct'fY ✓G'n � � � TEL Nof ! / ,.1(/,GR_OSe ST.
eT,i7n COUNTY.
w LICENSE No., -! 7S e� oaC !,1 i 2 NAME
-
DES &TION OFWOR_??•-eT i i MAIL
/ / 3 ADDRESS
R
NUMBER OOUTLETS ON CIRCUITS ! / O
LOCATION BY ROOMS :IT TEL No.
(.U1�{ZLI,l llf 1V 5
CIRCUrrA j B G ! rJ i S F G m
LiVI,%-G ROOM I 1
SRFST. RM. I I I
bATH
1 ENT. HALL
HALL NO
411 v� MA`Y •t ( � f...F 2n
OUTSIDE
t!lTCFIE V A 4 r 0a
SERV, PCH.
DATH �N sr�c•1•pst-• MAt.f� Y•
d r I f _CO%I7UIT
1 i _ WIRING
TOTAL - � _FIIfTtfR[S � •„.
NO. 0/ OUTER" G i S
k-7 ti!'DW[RGuTtLm CO. WKOTIrrR J ' /QI FIXTURtd1110. OI wOTORe N, i. • IrNAI Aft THt LR4AL O'+IIWHtC11 OI [ /J dKtf f
MO. OI •1M1i � T+A N•• ��( Cp1tMf7 ItSO1�TAAncoo +/�✓
t a s a40 two W .0 0 .
awmwr A- +-or w." a .es _ ♦w ,•• !dam I3:• I� a.Ae."e�"+-om
tclet F••
fs !.
:4!f y'>+''.r - -r alk'. �p• .
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS E!. 0508 0406030015
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
TR: 6561 LT: 85 6012 GOLDEN WEST AV
SEE DESCRIPTION: QUANTITY: UOM: AMOUNT. TEMP CA 9178017/8
ASSESSOR INFORMATION NUMBER: i NEAREST CROSS STREET: GARIBALDI
5385-027-018 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY, C
_ G1 OUTLETS—LGT,SW,RECP 79.00 OUT 118.65
TENANT.: G2 LIGHTING FIXTURES 25.00 LGT 45.75 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
,HA FAU LESS 3HP 1.00 FAU 10.95 06/03/04 VG 11/30/04
I, �J H7 RES EXHAUST FANS 3.00 EX 32.85
OWNER: TEL. NO: JB AC UNITS +3-10HP 1.00 AC 19.65 FINAL T ff
iit
i6O12
LI, JING HUA(LILY) (626) 353-0888— 'B 200 AMP PANELS, MCC 1.00 PAN 3,.85
GOLDEN WEST AV iTOTAL FEES 294.45
ITEMP 917801718 ! P ON OF WORK
FLEC RICAL FOR ADDITION
APPLICANT: TEL.
INFRA + ARCH DEVELOPMENT, INC. (626) 458-8111— i
11028 WESTMINSTER AVE I jSPECIAL CONDITIONS:
IALHAMBRA, CA 91803
CONTRACTOR: — — — _ -- TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
LI, JING HUA(LILY) (626) 353-0888-
6012 GOLDEN WEST AVE. LIC. NO I TEMPORARY POWER POLE
TEMPLE CITY, CA 91780 NONE
I I UNDERGROUND CONDUIT I
s _
ARCHITECT OR ENGINEER: � TEL. NO� UNEP GROUND j � --
IIN RA AND ARCH DEVELOPMENT, INC. (626) 458-8111— !
11028 WESTMINSTER AVE. LIC. NO-, i ROUGH CONDUIT
ALIHAMBRA, CA 91803 NONE
I
I iR0t1GF" WIRING —
!
iMAIN WATER LINE
PLASTIC Y/N METAL Y/N j
I UTILITY COMPANY ROT IFIED
I
.j
I-
i
REPORT ID: DPR265 ROUTE TO: BS0508
! ! I
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0406030012
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
TR: 6561 LT: 85 6012 GOLDEN WEST AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801718
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: GARIBALDI
5385-027-018 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY, C
B2 1 OR 2 FAMILY DWELL 639.00 SQ 67.10
TENANT: TOTAL FEES 94.85 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
06/03/04 VG 11/30/04
OWNER: TEL. NO: FINN D FINAL S : CODE:
LI, .LING HUA(LILY) (626) 353-0888-
6012 GOLDEN WEST AV
TEMP 917801718 ✓� :iPTION OF WORK
FEC, ICAL FOR NEW GUEST HOUSE
APPLICANT: TEL. NO:
INFRA ¢ ARCH DEVELOPMENT, INC. (626) 458-8111-
1028 WESTMINSTER AVE SPECIAL CONDITIONS:
ALHAMBRA, CA 91803
CGNTRRCTOR; TEL. NO: APPROVALS DATE INSPECTOR Sl nriU?
LI, jlNG HUA(LILY) (626) 353-0888-
6012 GOLDEN WEST AVE. LIC. NO TEMPORi?RY POWER POLE
TEMPLE CITY, CA 91780 NONE
UNDERGROUND CONDUIT'
ARCHITECT ORENGINEER: ^� TEL. NO: UPEr. GROUND
INFRA AND ARCH DEVELOPMENT, INC. (626) 458-8111-
I1028 WESTMINSTER AVE. LIC. NO: ( ROu'GH CONDUIT
{IALHAMBRA, CA 91803 NONE j
. ji uiimi wia<Iiev
MAID: WATER LINE
PLASTIC Y/N METAL Y/N
UTiLI Y COMPANY NOTIFIE I�
REPORT ID: DPR265 ROUTE TO: BS0508
COUNTY OF LOS ANF=ES_ -. TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1205240006
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID BUILDING ADDRESS:
ITR: 6561 LT: 85 - 1 6012 GOLDEN WEST AV
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( TEMP CA 917801718 I
(ASSESSOR INFORMATION NUMBER: 1 - I NEAREST CROSS STREET:
15385-027-018 IP2 PC RES PV<10KW 153.90 I THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY, Cl
I 1A1 PERMIT ISSUANCE FEE 27.80 1
(TENANT: IP3 INVRTR RES PV<10KW 27.90 (ISSUED ON: PROCESSED BY: PLAN BY: 1
I TOTAL FEES 209.60 107/12/12 SR 1
10WNER: TEL. NO: I FIN?.x -'T F FINAL BY: CODE:
ISZETO, ZUSELL (626) 592-0960- I 1
16012 GOLDEN WEST AV
TEMP 917801718 ,1Cii OF WORK
I I IRESIDENTIAL ROOF MOUNT OF 18 PV PANELS, 1 INVERTER, 20 A 1
I I IBREAKER 4.32 KW I
1APPLICANT: TEL. NO: I
IDUROCHER, NICOLE (909) 973-6299- I
12896 METROPOLITAN PL 1 (SPECIAL CONDITIONS: 1
POMONA I
I I I I
(CONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE 1
ISOLARCITY CORPORATION (650) 638-1028- 1
13055 CLEARVIEW WAY LIC. NO ITEMPORARY POWER POLEI I
2
ISAN MATEO, CA 9440888104BC10 *I 1 I
I I 1UNDERGROUND CONDUIT
I I I
1ARCHITECT OR ENGINEER: TEL. NO: IUFER GROUND I I
I
1 11 1
1 LIC. NO: 1 (ROUGH CONDUIT I I
1ROUGH WIRING
IMAIN I1 II
WATER LINE
JPLASTIC Y/N METAL Y/N
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
1* ADDITIONAL DATA ON FILE I
I I I I I I
I IREPORT ID: DPR265 ROUTE TO: BS0508
I I I I I I
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1211060009
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID I BUILDING ADDRESS: 1
ITR: 6561 LT: 85 I 1 6012 GOLDEN WEST AV 1
I IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT: 1 TEMP CA 917801718
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 1
15385-027-018 IP2 PC RES PV<10KW 153.90 THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY, Cl
IAl PERMIT ISSUANCE FEE 27.80
(TENANT: IP3 INVRTR RES PVc10KW 27.90 (ISSUED ON: PROCESSED BY: PLAN BY: 1
I I TOTAL FEES 209.60 111/28/12 SR 1
I I I I
(OWNER: TEL. NO: I IFINAL DATE FINAL BY: CODE: 1
ISZETO, ZUSELL (626) 592-0960- 1 1
16012 GOLDEN WEST AV I I
ITEMP 917801718 I IDESCRIPTION OF WORK I
IRESIDENTIAL ROOF MOUNT OF 6 PANELS TO EXISTING SOLAR FOR I
ITOTAL OF 5.52 KW I
(APPLICANT: TEL. NO: I i
IPEREZ, SHASTA (909) 973-8752- I I
12896 METROPOLITAN PL I - ISPECIAL CONDITIONS:
IPOMONA I I I
I I
CONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE
ISOLARCITY CORPORATION (650) 638-1028- 1 1
13055 CLEARVIEW WAY LIC. NO 1 ITEMPORARY POWER POLE I
ISAN MATEO, CA 94402 888104DC10 *I I
O
��� r� /16 )UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER: TEL. NO: i per— ED � IUFER GROUND
1 LIC. NO: I IROUGH CONDUIT I I I
TROUGH WIRING I I I
IMAIN WATER LINE
IPLASTIC Y/N METAL Y/N I
I I I I I I
(UTILITY COMPANY NOTIFIED( 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 I I I f
I I I I I
I I I I I I
I I I I I I
1* ADDITIONAL DATA ON FILE I I
I I I I I I
I i I I I I
IREPORT ID: DPR265 ROUTE TO: BS0508 I I I
I I I I I I
COUNTY OF LOS ANGELES TEMPLE CITY 0708 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0407190001
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONd : (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING DDRESS:
TR: 6561 LT: 85 6012 GOLDEN WEST AV
FEE DESCRIPTION: QUANTITY: UO2,17 AMOUNT: TEMP CA 917801718
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: GARIBALDI
5385-027-018 Al PERMIT ISSL..N;-E FEE 27.75 THOMAS PACs=: 597 GRID: A2 LOCALITY: TEMPLE CITY, C
_ E1 TEMP SERV POWER POLE 1.00 TMP 43.65
TENANT: TOTAL FEES 71.40 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
07/19/04 JK 1/15/05
OWNER: TEL. N0: FI L DA Tc FINAL CODE:
LI, JING HUA(LILY) (626) 353-0388-
6012 GOLDEN WEST AV G J
TEMP 917801718 ESCRIPTION OF WORK
TEMPORARY POWER POLE
APPLICANT: TEL. NO:
INFRA + ARCH DEVELOPMENT, INC. (626) 458-8111-
1028 WESTMINSTER AVE SPECIAL CON011'IUNS:
ALHAMBRA, CA 91803
CONTRACTOR: TcL. NO: APPROVALS DATE INSPECTOR SIGNATURE
LI, JING HUA(LILY) (626) 353-0888-
6012 GOLDEN WEST AVE. LIC. NO TEMPORARY —ER POLE
TEMPLE CITY, CA 91780 NONE
UNDERGROUMD CONDUIT
ARCHITECT OR ENGINEER. TFL. NO: UFER GRCsisd0 _
INFRA AND ARCH DEVELOPMENT INC. 1;62611 458-8111-
1028 WESTMINSTER AVE. LiC. NO:
ALHAMBRA, CA 91803 767:025
ROUGH
MAIN WATER—LINT--
PLASTIC
INEPLASTIC Y/;d METAL Y/N
UT I L T TY Gr-i�PANY NOT—IFI I ED Z ��
REPORT ID: DPR265 ROUTE TO: BS0508
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