HomeMy Public PortalAbout6406 GOLDEN WEST AVE_Electrical__ 7GA663-CE806 12-5B APPLICATION FOR ELECTRIC PERMIT 4
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS r '! �'•'i: r
JOHN A.LAMBIE,COUNTY ENGINEER _
CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
PERMIT FEES
OWNER
I T E M NUMBER EACH FEE
OUTLETS: g g MAIL
LIGHTS RECEPT. SW. - ,10 ADDRESS
LIGHTING FIXTURES _7I .10 CITY TEL.NO.
ELEC.RANGES CLO.DRYERS, ELECTRICIAN l
W A T E R HEATERSl .50 ADDRESS /
ELEC.SPACE HTRS. DISHWASHERS
CITY ;i r„ - -TEL.NO.
GARBAGE DISPOSERS AUTO.-
STATE
WASHERS STA.COOKING UNITS .25 LICENSE NO.
MOTORS: OVER INC. H.P. DISTRICT NO. GROUP ZONE PROCESSED BY
.25
1/2— 2 .50 INSPECTION RECORD
2— 5 1.00
5— 15 1.50
15— 50 2.50
50-200 5.00
SIGNS: NO.TRANS.
NO.LAMPS
SERVICE 0-600V 1.00-
SERVICE OVER 600V 5.00 y
s
misc.
1 -
WIRING PERMIT 1.00
FIXTURE PERMIT 1.00 1
SUPPLEMENTARY PERMIT .50 '7yI-
TAL FEE s
I
HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AAPPLICATioN APPRDATE OVALS INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT
ELECTRICAL WIRING.
WIRING
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. POWER
SIGNATURE r -r ` UTILITY CO.NOTIFIED
OF PERM ITTEE
FINAL
Or (l VALIDATION ARTHUR C. VEIT,
/l CK Mo CASH SUPERVISING ELECTRICAL ENGINEER
r1
--- - -- -
76A669-L1'.60610-69 APPLICATION FOR ELECTRIC PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER ADDREISS (�T(✓� VC���// jt fps
BUILDING AND SAFETY DIVISION
JOHN A. LAMBIE. COUNTY ENGINEERr�M
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY
PERMT FEES L''t/ �f�x
FOR APPLICANT TO FILL IN CNEAREST
ROSS ST. /`i 17—
OWNER / U tTIE
ITEM NUMBER I EACH FEE MAIL !/�.t/ B T�c'' 1�/ J
OUTLETS: $ $ ADDRESS (�f v(p Q c�L/-�G 1VL S`!
LIGHTS RECEPT. SW. .10 �1
LIGHTING FIXTURES 7 10 CITY -TE7,4L C/ TEL.NO.
ELEC.RANGES CLO.DRYERS ELECTRICIAN / �! �j'�+: j
WATER HEATERS .50 ADDRESS J�I�-vo 4 ,,1 O/..1-IN'A
ELEC.SPACE HTRS. DISHWASHERS CITY G/ l s-C d!7 TEL. NO.&I -01'�J
GARBAGE DISPOSERS AUTO.-
STATE '7 �j�j
WASHERS STA.COOKING UNITS .25 LICENSE NO. Lam.+ —
MOTORS: OVER INC. H.P. DISTRICT�O. GROlW I ZONE PR CESSED BY
O— 1/2 .25
1/2- 2 .50 INSPECTION RECORD
2— 5 1.00
5— 15 1.50
15— 50 2.50
50-200 1 1 5.00
SIGNS: NO.TRANS.
NO.LAMPS
SERVICE 0-600V 1.00
SERVICE OVER 600V 5.00
MISC.
WIRING PERMIT 1.00 (�
FIXTURE PERMIT 1.00 / 100
SUPPLEMENTARY PERMIT .50
TOTAL FEE 1-s1160
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT
ELECTRICAL WIRING.
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR WIRING
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AM HE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PPOPERTY. _ POWER
SIGNATURE � — UTILITY CO.NOTIFIED
OF PERMITTEE
FINAL
®P LIDATION ARTHUR C.VEIT,
C ctc, MO CASH SUPERVISING ELECTRICAL ENGINEER
L �a '7 2 3.0 C) M
7135 5-A 6-46 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY ���C���C
COUNTY OF LOS ANGELES
y1/M. J. FOX CHIEF ENGINEER
NAME DISTRICT NO. GROUP ZONE PERMIT NO.
U
ADDRESS
1 RECEIVED BY READY FOR DATE ISSUED
W CITY TEL.NO. FIRST INSPECTION
J COUNTY
W CERT.NO. EXPIRES
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
JOB
DESCRIPTION OF WORD _ADDRESS
NUMBER OF OUTLETS ON CIRCUITS LOCALITY f '�t
LOCATION BY ROOMS -
NEAREST
LIGHT OUTLETS lsw. PLUGS MeT CROSS ST. '
CIRCUIT A B C D E F G H X NAME e I •j-
Z MAIL 2-5 ,
3 ADDRESS
O
CITY G TEL.NO. 61,r494
1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE OF QUALIFICATION..
ELECTRICIAN.
1 AM THE"GAL OWNER OF THE PROPERTY DESCRIBED
ABOVE r
> f oc
OWNER.
CORRECTIONS
J
Q
Z_
E3
tY
O
TOTAL
NO. OF OUTLETS $ APPROVALS
NO. OF FIXTURES $ DATE INSPECTOR'S NAME
NO. OF MOTORS H.P. $ CONDUIT ` �1
NO. OF SIGNS TRANS. $ WIRING _ p 'f`'
NO. OFRANGESOR HEATERS $ FIXTURES I
MISCELLANEOUS $ POWER
PERMIT FEE $ UTILITY CO.NOTIFIED
TOTAL FEE FINAL
DBSDEPARTMENT OF BUILDING Alm SA TS' APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES ELECTRIC
WM. J. FOX CHIEF ENGINEER
d NAME DISTRICT NO. GROUP ZONE PERMIT NO.
U
ADDRESS
F RECEIVED BY READY FOR DATE ISSUED
W CITY TEL.NO. FIRST INSPECTION
,I COUNTY
W CERT.NO. EXPIRES
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
JOB
DESCRIPTION OF WORD ADDRESS
NUMBER OF OUTLETS ON CIRCUITS LOCALITY
LOCATION BY ROOMS
NEAREST
LIGHT OUTLETS SW. PLUGS IFIiT CROSS ST.
CIRCUIT A B C D I E F G lH Ix NAME
Z MAIL y
ADDRESS 1 1
O
CITY TEL.NO. 4
IAM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE OF QUALIFICATION..
ELECTRICIAN.
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE
y �7 OWNER.
CORRECTIONS
J
Q
Z_
2
IY
O
TOTAL LL__T
NO. OF OUTLETS $ APPROVALS
NO. OF FIXTURES $ DATE INSPECTOR'S NAME
NO. OF MOTORS H.P. $ CONDUIT
NO. OF SIGNS TRANS. $ WIRING
NO. OF RANGES OR HEATERS $ FIXTURES
MISCELLANEOUS $ POWER
PERMIT FEE $ UTILITY CO.NOTIFIED
TOTAL FEE FINAL —Z�-
KDN
2D-oo 19
y-)Imohat have a ENSATate of LARATI to 75AOM -91) APPLICATION FOR ELECTRICAL PERMIT
hereby rm that L have a oirtliloate of nt to self Insure, 7t3AaB3
ar a certlflc of Worker's Comp-en nsuranoe, or oertifled COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV.
copy thereof( 3800 Lab. C.)
Policy NO. .• POR APPL)CAN!TO I9L.L IN ADDFtE68 �s
❑ Certifled oopy eby tumlahed. New Reddontial B4i &&Pools NO. EACH FEE
LOCALIf1 s
❑ Certified Is sled the county bul}ding Inspectlon 1 &2 family,Sq.Ft
Mult1-farnliy Sq.PL — q-gge ST.
Date APplk�ent ReekienW 9wlmming Pooh ASSE68OR
YAP BOOK PAGE PAf1CB
CEFff1F1CATE OF EXEMPTION Outlets Roo._Light Sw. OWNER OR
COMPENSATION INSURAN � NAlAE
(This section nand riot be oomplatad IT the work In Fved by the Rret - ADDRESS
ti
permft la Tor one hundred dollars($In)or Isss.) Tote]No. AddlHonal
I certify that In the performance of the work for which this permit Cffl f Tk t
Is lsausd, I shall not employ any person In any manner to as to PLAN CHEkX
become subject to the Workers'Campensatlon Laws. Ughting Fbduree Rrat 20 APPUCANT
Total No. Add3tfonal ADDRESS
Date App 0card RESIDENTIAL APPLIANCES NOT OVER 3 HP.
NOTIC-E TO APPLICANT: If, after making this Certlfloate of CITY TeL No.
Exemp1don, you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP.
provlslons of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked. Power Apparatus&Imps Appllaraee
LICENSED CbNTRACTOR8 DE TION Size&Type HP,KW,KVA,or KVAR ADDRESS
I hereby affirm that I Am lloensed und6r I cf Chapter B Over 3 to 10 Ind.
{commencing Sectlorr 7000) of 1DIviel of the Buelness and CfTY Tat.No.
Profseelons d my Ilcenee Is I force and effect. Over 10 to 50 Ind.
Over 50 to 100 Ind. qEL � C� d
Over 100 D{STRICT NO. P BY 8
Lk»nse Number Lb.Class
Q
V R NAL
Contractor Date
❑ I pt under Sec. 400-1000 Amp.Under 900 V
VALIDATION LU
Over 1000 Amp.or Over 900 V FB�AL W
B.&P.C.for th BRANCH CIRCUIT FEES BY ,�/ co
15A,or 20A,12OV,Llghtfng or RecepL f- Z_
1 To 10 Branch Clroutts
ire 11 To 40 Branch C*cuN
41 Or More Branch CtwRs
❑ ptlon"tor Rep.Maim Elect 16A,2A 2091/To 277V Br.C=ft
SINGLE FAMILY Temp.Power Pols&Appurtenancee _. _ _ SPU A
HOME OWNER-BUILDER DECLARATION I rt 41 .r
I hereby afflhn that I am Sign with One Branch Ctrmft exempt from the Contractor's License Law _ `,.,f�1., 7 c
for the following reason (Seotion 7031.5, Buelne-" and Professions Addtional Slgn Branch Circutb , 303 6,x•4'i
Code): t ITEM ' -
fxl I,as owner of the property,will do the work and the structure Mbc.Conduftn&Conductors
7"
Is not Intended or offered for sale (Sactlon 704-4, Business Other(See Complete Fee Sohedule) �L''i 63 - 45
and Proteeslons Code). , CHECK OJ--— t�.1Fti5
L�
COtgSTRUCTION LENDING AGENCY r+i iAtlr1 .1313
1 hereby affirm that there Is a constructlon Iendh Cy for the �fTil�L
performan he work for whi�per@sued (Sec. 3087, PERMIT FEE (Sub-Tato
CIV.C.)
PLAN CHECKING FEE Q 1 1/131?4
Lender s Name PERMIT ISSUING FEE �rj 3471 1 PM12%IJ1
certftya I have reed this apoik�atfon end under penalty of purjury stole TOTAL FEE G3,
that ttie above Infomratlon is oorrect. I &g roe,to comply with all County
ordnancee and State laws repula N Elootrioel wiring,and hereby authbrtze
repreeenhdi,ss of this County to the above-merrtloned property
for Inspeotion pu SEE REVERSE FOR EXPLANATORY LANGUAGE
dt2P!!!-,/ 4//Y"
a*NA
!11,_ J .WORKERS`OOMPENSATK)N DECL.AA
""" � '0'81 APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that haw a owtffloate of consent to sett lineuir%
or a certifbate of Workers'.Compenaffiion Ineurence, or-a oertthed COUNTY OF 40S. ANQELFS, BUILDING AND SAFETY'
copy tf&edf(Seo, 3800,Lab.C.)
I'o8cy No G«r d FOR APPUCANT70 eru IN W Q b N- G D ' 4 k,.
. CerttW c pY.h hereby f,dnfefted. (i9W Residential Bldgs.aPbats EACH" . -NaEl FSE
I OGFfY
Certffled'Dopy la filed with the county buEdtrp ¢iepeotton 1 & 2-Fam0y,Sq.Ft _ tr£ARE$T
deparUr»rt( MDltl TnmRy Sq.FL CA099-ST,'
DE" Appk-it Reeldentfal Srvlmhdnp Pgoke O OTEA OFF
FFCH WA
'CERTIFICATE OF EXEMPT10k-frROM4VORKERS'-• perygbK RBeWh{-,Sw_ � '
COMPENSATION INSURANCE Flrit20. ` ADDRESS �,
Mile.MCtlon h-o'net t� gde�l compiIf the wgdr I&egtved 4Y the f CFrY 11*Mo.
permit In for 4m hundred dollern,($1M) or lees.) Trial r AJd
PLAN.1 0 tty that In the.pwVmance of the work for whloh thb permit SOK
Is Ipaued, 1 shall not emplgy eny. person In manner so as to
¢Qoome euH)ect to the"Wortcerp' Uphbnc Flxturat First 20 ;ADDRESS
Toted No.T CITY No,
Date ADp(bant F139ad Appilerroee Nbt Over 1+1P. .
140110f=',TQ APPLICANT: 11, after makfng this Carttficate of
EXmmJotlort,yriQ Ahodld beoorne t to the Vkfh—'CWVW—t;brr Fbater� D.W.
pr�pt the Labor Cpd -Y,w must.forthwftn conpty-With such Overt Dryers W.M._ ADOIRLSS a
V74"or thlQ pw7nk stiall,pe clow6d reVokpd TDP FAL. �. WR _
L�CEHs b CbNT13ACf0#i$�. GLARATIOtd-. Tkod — Fen t QW Cf1Y Tel.N.
I hereby affirm that.I Ar� lbarme. ur1der.pr6VWD .of s(rC,tiepter 8 OR _ Ctew
(oomirtend wt(h S9ctbn 7000) DMsion 3 of the Burasa and NP, — Roorrl Air Gond.
#Srolessione Code,and rr y liceoed I0 Irl"full f6rce'and affect: f +�6r/�PRelBhm LA7Q@ APPt NC
v
- SJze d lype HP,KW,I(Ns4 or K\b,R
Lloenae Nix w Lb.Class Up TO 1 Ind: . FINAL
43',W1 to 10 bd. DATE
Contractor IJata'
over to-10.60 In
�. I ant Axempt under Seo. QEer 60 to 100 Ino.
BAP.C.for ttils reason --O%w 100" V
Servbee,SWbd,MCC&-Paroboarde
138[te7: 0-200 Arrp.Under 600 v A 8,1 4,3 A
Signature 20.1 - 1000 Amp.Under 800 V
:.,'. C%W•1000 Amp.or Oyer 800 Y I #:o o s •,b
Examption f(?t Reg.Malnt,Elect.
SINGLE FAMILY Tentp.Power Pole d AppurU twx).ee I o"0 1,?O.O
I{
"E OWNQ:}-BUILDER DECL RATION %n wfth One Bram Clrorf(.I hereby affirm that 1 am exempt from the Con�otors License L,aw 00— 9.1 2.D 0�
for the folbwtw reason(Section 7031 4, Buetrtess ar)d prbfeeslcm -Gtr -
al 6 i$"7
1,as ownet d tyre Mparty,wff do the wodc aPid the sirtichrs Wleo Conduits& Gonduckors -
is not Intended or offered for &ale (Sectf)n.7044, 63fettess other(See Complete Foe Soheduie),
e{td Pro(esaSorb Code).
CONSTRUCTION-_ENDING AGENCY . � -
I hereby hM j,i that.there Is 8 cgtetr� lend!ng agency for the
pW fcrmance of t%w ark for whloh this perm tt Is Issued(Sea 3097, . .. PERMIT-FTE (Biro Total) -
ay. C:).
PLAN CHE(,KN),FEE Y
lBnders Nerve
etF3Mff ISSUING FEE•
Lerv)er's Address
I eertlfy that I have read thle eppfloatfon end state that the W-ye TOIL FEE
trtforftiE on Is carted. I agree.to comply wfth all County ordkwmnc a
and State fsws regulatfng EleaUioel hidrU Frrd hereby euthortre
of thb County to upon the above-mentionad
for SEE REVERSE PbR EXPLANATORY LANQ)IAd E
Signature d Permittee Date ,
+WORh<F--R'S COMPENSATION DECLARATION 20-0010 DPW(12-91)
I.Per.by afIrm that I have a cert1flcate of consent to self Insure, 7&A" APPLICATION FOR ELECTRICAL PERMIT u
or a certMtcate of 9;orker's Compensation Insurance, or a oertlfled COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV.
oopy thereof(Sec.3800 Lab.
{J
Pa No It I � �J I�AAPPLICANT TO I'41 IM ADDRESSJOB
J
FT Certified copy b hereby furrtlahed. New Real iwtUd Bldgs.&Pools NO. EACH FEE
— i.
Certlfled b filed with the cou building I 1 d 2 Tam Qy,Bq.R $ LOCALITY
QST
MUMamlly Sq.FT. CFIOB8 ST,
Date Apps Reelderttial Swimming Poole AggEggpA
MAP BOOK PAGE PAFT.g
FICATE OF EXEMPTION FROM WORKERS' OWNER OR
COMPINSATION INSURANCE Ovtletx 8w. FIRM
(This,seoUon need not be completed H the work Invotved by the Brat
permh Is f r one hundred dollars($100)or less.) Total No. Addltbnal AnoFaE38
I certify the the periormanoe oT th hlch this permit CITY �Ji- J TeL
Is Issued, I she of employ reon In any Manner so as to PIAN CHECK
become subject to t CompeneatlOR Laws. L4TdN Fixtures FIS 20 APPt)CANT
Total No. Additional ADDRESS
Date APPf,a t RESIDENTIAL APPLL4NGES NOT OVER 3 HP.
NOTI TO APPLICANT: IT, alter making this Certificate of CITY TeL Na
Exemption, you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. .
provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shell be deemed revoked.
Power Apparatus 8 Large Appliances APPLJr1,N r
LICENSED CONTRACTORS DECLARATION SlW
KW,KVA,or ICVAR ADDRESS .
I hereby affirm that I em licensed under provlslofrs of Chapter 9 p�3 to 1Q Ind
(commencing with Section 7000) of Division 3 of the Bualneas and C�
Professlona Cade, end my license Is In full force end affect. Over 10 to 60 Ina. a
}
over 60 m,00 Ina. " � 71ea
BY
Lover,00 DIHTRICT NO. Sicense Number Lk:.saes ~� p
y- Services,Swbd.,MCC✓4 Panelbosrda Da
Contract Date0-309 Amp.Under 600 V DA� q�}
❑ 1 am exempt under Sec. 400-10 00 Amp.Under 900 V Z-t- ` 1 VAUDATFOH
er V
Ov1000 Amp.or Over 000 V FINAL LU
BY o-
B.SP.C. BRANCH aRCUrr FEES � � (D
16A,or 20A,12OV,Lighting or ReoepL Z_
1 To 10 Branch arculte
t rlehae 11 To 40 Branoh Choufb
41 Or More Branch Clrartls
❑ Exsmptlon for Reg.Malnt.Elect T&A,MA,209V To 277V LVTting Br.ClIrcufin
SINGLE FAMILY Temp.Power Poo S Appurtenarwge �A7 ff
HOME OWNER BUILDER DECLARATION ugh whit One Branch arcuttL'T■T
I hereby efflrm th 1 am exempt from the Contractor's License Law
for the following re _ (Section 7031.6, Business and Professions AddTbonal 84gn Brunch Ctrcula 45.15
Code): T��r�
I, as owner of the props the work and the etructun
Woo.Condura S Conductors. 1 1 i Ct i
Is not Intended or }or Section 7044, Business Other(See Compote Fee Scheduo) , TfITAL515
and Prote ode).
ul 4`.15
CON UCT10N LENDING AGENCY ��1,tt��' r.
I hereby aNlrrh that th e a conetructlon lending a the tifti E •C(I
performance of the work for this perm ed (Sec. 3097, PERMrr FEE (Sub-Total)
CIV. C.)
PLAN CHECK]NGFEE -io1 1/11/94
LerKWa Name /
PERMrr ISSUING FEE �fO 342D 1 AM11:2
Lender's Address
I certify that I have read thb epplloetion and under penalty of pudurry stab TOTAL FEF
that the above Information Is correcL I agree to oompty with all Cmaty
ordlnancee and I lat! cal wiring,and hereby authorize
rep I upon the above-mentioned
for I pu / SEE REVERSE FOR EXPLANATORY LANGUAGE
TUBE OF PF3WTrEE a,
COUKTY OF LOS ANGELES TEMPLE CITY 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC YOR1C3 9701 LAS TUUAS EL 0508 0307030030
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (6261 285-0488 E)(T:
TR: 12368 LT: 1 6406 GOLDEN AlEST•AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUIT: TEMP CA 917801422
ASSESSOR INFORMATION NUM1BER: NEAREST CROSE STREET: LONGDEN
5383-020-001 Al PERMIT ISSUTANCE FEE 27.75 THOMAS PAGE: 597 GRID: Al LOCALITY: TEMPLE CITY
C2 :1 �15[20A
SHOT TLBk OTHR 1.00 SPA 54.45
F1 CICTS 6.00 BR 103.50 ISSM
PROCESSED BY: PLAN BY: EXPIRES ON:
Gl �IGHTIS-LGT SW
RECP 12..00 00 OUTLGT 60.60 23.40
07/03/03 . JK 12/30/03
OWN ER TEL. NO: H7 RES EXHAUST FANS 1.00 EX10.95
ABDOU NAM S•E11AD T (626) 443-8931- LA 100 AMP PANELS, NCC 1.00 PAN 38.85 - `1
6406 GOLDEN AkF AV TOTAL FEES 319.50
TEMP 917801422
ELECTRICAL FOR ADDITION, UPGRADE ELECTRICAL PANEL
APPLICANT: TEL. NO:
DAVID ESTRADA (800) 570-1818-
5500 SCHAEFER AVE fD SPECIAL CONDITIONS:
CHINO 91710CONTRACTOR: TEL. NO: APPROVAL$ DATE INSPECTOR SIGNATURE
-
DAVID ESTRADA CONSTRUCTION CO. (909) 613-5903- - r'
5500 SCHAEFER AVE LIC. NO - r
CHINO CA 91710 684942 =.
ARCHIT TEL. NO: UFER GROUND
LIC. NO: ROUGH WIRING� ROUGH CONDUIT
j-
- PLASTIC YIN METAL Y/N
UTILIT-Y COMPANY NOTIFIED
REPORT ID: DPR265 ROUTE TO: 850508
r