HomeMy Public PortalAbout5600 GRACEWOOD AVE_Electrical__ 76"003 C'-004141"" APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGEL BUILDINGS AND SAFETY
FOR APPUCANTTO FLLl IN. JQB ��
New Resldentlal Bldgs.&Pools EACH NO. FEE ADD
1 &2-Famlty,Sq. Ft. $ .025 — $ LOCALITY
Multi-family Sq. Ft. .02 — 1A tRResldentlal Swimming Pools25.00 ESTOWNFROR
Outlets Rec n " �Light�QLS'w.IY�� 50 Flrst 20 /yo 5 Total No.( Addttbnal 30 �,q �H Tel. Na.
PPNIEAN�TK
Lighting Fixtures First 20 •50 -Z ADDRESS
Additional 30
r Total No.� C1TY Tel. No.
Fixed Appl lances Not Over 1 HP PEPNT
RangeLHeater_Q.W. APPLICANT
Oven!Dryer_W.M— ADDRESS P
Top _FAU W.H. CIN LSA , OOZ%L . .Tel. No... 13
Hood—J— Fan L&Other_
E OR
Disp.�Room A I r C4nd. �� 2.50 RIEGrNUMBER Z,If C1 ass. 6—/0
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA
Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO
Sim&Ty HP, KW, KVA,or KVAR COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
2.50 �p REGULATING ELECTRICAL WIRING.
Up to 1 Ind. I HEREBY CERTIFY THAT I AM PROPERLY REGISTEREQ AND/OR
-IO?Ovef 1 to 10 Ind. 120 LICENSED AS REQIJIREB BY LOS ANGELES COUNTY AND STATE OF
ver 10 to 50 Ind. 12.50I RL
A OD Til LEGAOWNER OF THE ABOVE
Over 50 to 100 Inc, 25.00
BaY
Over 100 40.00 Ph1l EE
SIGNATURE
Se10ces DISTRICT NO. BY
0-200 Amp.Under 600 V 12.50 N �y
201-1000 Amp. Under 60Q V 25.00
Over 1000 Amp.or Over 600 V 50.00 43
Z
1 Temp. Power Pole&Appurtenances 10.00
Sign with One Brand,ClrcuN 10.00
Additional Sign Branch Circuits 2'D0 INSPECTION >
Misc.Conduits&Conductors 10.00 INFORMATION
ON ���
Other(See Complete Fee Schedule)=T SIDE $4 4 6 9 A
0 0 0 0 0 2
PERMIT FEE (Sub-Total) 2 - 93200
�
PLAN CHECKING FEE lOne•Fourth PermitFeel 9 3 2 0 C
PERMIT ISSUING FEE $7.00 G —7 9
TOTAL FEE 3�,/o >
INSPECTION FINALED
data: By
°`-'°°'°"" APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGBES BUILDING AND SAFETY
FOR ANT TO FILL IN [�$k C _`
Neft2i
ialBldgAs.8,'Pools EACH NO. FEE DD 1ly,Sq. Ft. $ .025 — $ LOCALITY
M �t
ulti-family Sq. Ft. -02 — tr
Residential Swimming Pools 2 5.00 C R0SS ST
Outlets:Re Light Sw.
Flrsf 20 .50 ADDRESS
Total No. Additional .30 pcIIgNN CCHH ���� I. N
APPLICANTK
Lighting F xtures First 20 50 - ADDR
Additional .30
Total No. CI Te
Fixed Appliances Not Over 1 HP
Range_Heater_D.W.
APPLI
Oven—Dryer_W.M. AQDR
Top _FAU —W.H._ C ! Te r
Hood_Fan —01—her LICENS
Disp.—Room Air Cond. 2'$0 REG. SLNUa*1;xa%nr_ Gass.
I HEREBY AOQ4WWLEDGE THAT I HAVE READ)TTIS Al'PLJCA-
PowerApparatusSiargeAppliances TION AND STATE THAT THE ABOVE IS CORRECT AND A(;REE TO
Size&Type HP, KW, KVA,or KVAR - COMPLY WITH ALL COUNTY ORDI AND STATE LAWS
2.50 REGULATING ELECTRICAL WI NG
Up to•1 Incl. I HEREBY CE THAT I PROPERLY RLGI D AND/OR
Over 1 to 10 Ind. 5._00 LICENSED AS RID BY L ANGELES CC)UN Y
Over 10 to 50 Ind. 12.50 CALFORNIA O E LEGAL WN
Over 50 to 100 Inc 25.00 DESCRI
Over 100 40.00 P EE
S TURF
SerykesTRICE NO. ED BY
0-200 Amp.Under 600 V 12.50 �!
iw
201-1000 Amp. Under 600 V 25.00
Over 1000 Amp.or Over 600 V 50.00 O O'
Temp. Power Pole&Appurtenances 10.0.0 C
Sign with O-w branch Circuit10.00 n n
Addtbnal Sign Bran<h Circuits 2'00 I ON > ;23 1 20 P
M sit CondJts&Conductors 10.00• IN O # 0 0 0 0 0 2
Other(See Complete Fee Schedule) �I E 2
F 0 0 0 r r
10
PERMIT FEE (Sub-Total) 0 3• G 3— 7 O
PLAN CHECKING FEE (One-Fourth Permit Fee) m
CA FFF
PERMIT ISSUING FEE $7.00 Q z 9
TOTAL FEE s.'� >
INSPECTION FINALID
i date. By }.tV►-. ms
C;'
""°" '°'"F'"° APPLICATION OR RECUR AL PIERMIT"
COUNTY OF LOS ANGEIJES BUILDING D SAFETY
FOR AP0tjGANTTb FGl IN
New Residential Bldgt.&Pools NO. FEF DD !K
1 &2-Family,Sq. Ft, $/ Is I LOCALITY �-
Multl-famllySci.Ft. NEA
Residential Swlmmiro Pools -
CROSS
rthesl Per Lght Jo. R�►o �s. /
first 20 '
Total No. Additional CIfY..5;7 /44, Tel.
K
I
Li htlnq FLxtures First 20 ADDRESS e
Total No. Addltk>nol CI 1e7f- Tel N .
Fixed Appliances Nof Over 1 HP
Range—Reciter D.W..— APPLICANT
Oven_Dryef_W.M.— ADDRESS
Top _FAU —W.H._ CITY Tel. Nb.
Hood—Fan- —Other LICENSE pRn
Dlsp.—Room Air Cond. REG.NUMBER� v f� matt.
I HERBY AD(NOWLEDGE THAT I WOVE READ THIS APPLICA.
Power Apparatus&Large Apphances T10N AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO
Size&T HP, KW, KVA,or KVAR COMPLY WITH ALL COUNTY AND STATE LAWS
Type REGULATING ELECTRICAL V19 RI
Up to 1 Incl. I+iEREBY CERTI I RERLY STERED AND/OR
Over 1.to 10 Incl. LICENSED AS REOU BY L GELES COU AND STATE OF
Over 10 to 50 Ind. CALIFORNIA OR E LEGAL O OABOVE
DESCRIBEDRESID E
Over 50 to 100 Inc.
PERMfT EE
Over l OQ SIGNA
Services. D R1CT NO. D BY
0-200-Amp.Under¢00 V
201,1000 Amp. Under 600 V
Over 1000 Amp.or Over 600 V
Temp. Power Pole&Appurtenances �. J �` 0 `�
Sign with One Branch Circuit
Additional Sign Branch Circuits INSPE{T10N > r
INFORMATION
Mbc Conduits S Conductors INFORMATION
�V�f
�527,7A
Other(See Complete Fee Scfule� SIDE
# 0 010 0'0 2
20017100
PERMIT FEE .ISub-Totals .010 o 1 7i 0 0 5
ne
PLAN CHECKING FEE Io -Fourth Permlt,Z !
� 0VA 0'6-'79
-PERMIT ISSUING FSE
TOTAL FES >
iNSPfCTION FiNALED
' date: By : �s
I
WORKER S'QOMPENSATIONDECLARATION
CE-B06G (2-BO) FOR ELECTRICAL PERMIT
. I E�08 '
I hereby -affirm that I have a certificate of consent to gaff COUNTY OF LOS ANGELES BUILDING AND SAFETY
insure, or ■ certificate of Workers'Compensation Insurance,or
a certified copy thereof fSec.3800,Lob.C
�,t}r�f�J/q S FOR APPLICANT TO FILL_ IN JOB r
Policy No.J]ttJ Compan7F' 'FU N W New Residential-UIdgs.&Pools EACH NO. FEE ADDRESS J
Certtfled copy Lr hereby furnished. fes+ 1 &2-Famlly,Sq. Ft.- LOCALITY
Certified copy L filed with the county building inspection
Multl-farnlly Sq.ft, CROSSST Q
PRTIF71CATE
Residential Swlmminp Pools OWNER OR
Date ADDRESS
Applicant /ZI�� I J 1". NVy FLpM NAME
Outlets: Rec�Light Sw. MAIL rya,
Irst 20 Vv��v
OF EXEMPTION PROWWORKERS' Total No. Additional CITY Tel No.0 1�
COMPENSATION INSURANCE PLAN ChFECK
(Thb rection need not be compfeted if the work Involved PPLICANT
by the petmlt is for one huodred.dontm ($100) or leas.) LldrtingFIxtur� Flrrt20 ADD-RES&
Total No. Additional.
I certify that in the performance of the work for which thLCITY Tel No. 0
permit is Issued, I ghall not employ any person in any manner Fixed Appllancea Not Over 1 HP t
PERMfT rN C�
to to become subject to the Workers'Compensation Laws. RangeT_F�eater_DA. �, APP CANT' Wa
Oven dryer_W.M.�— ADDRESS 85
Date Applicant Top _FAU W.H. Z.
Hood FenOther� CITY O el No. 3)
NOTICE TO APPLICANT: If, after making this Certificate of 75
Dlsp. Room Air Cond� C09
13xemptionsayou ghouls} become subject to the' Workers' RE N MBER law
Compensation provisions of the Labor Code, you murt forth- Power A,pperntui& Large Appliances DISTRICT NO. PROOESS D BY
with comply with such proviriogs or this permit shall be
deemed revoked Size&Type HP,KW, KVA,or-KVA
r Up to W' e ,�/
FINAL
LICENSED CON_TR.ACTOkS D$ Over 10 to 60 Incl.'
CLARATION DATE r!-17r VALIDATION
I hereby affirm that I sm Licensed dOder provisions of Chapter T Over 60•to 100 Inc- FINAL f
BY
9 (commencing with Section 7000) of DtTrision 3 of the Busi- Over 100
no" tpd ProfesMons Code, and my license Is in full force and
effect. Services I
License N Mber Lic,Claw 0-200 Amp.Under 600 V
201.-1004 Amp. Under 600 V
Contractor_ Date Over I OOO-Amp.or Over 60 V
HOME OWNER-BUILDER DECLARATION. Temp.Power Pole&AppurtanarKm
I hereby- ■ffh= that I am exempt from the Contractor's Sign with One Breach Circuit �;2 6,5,7,.8 A
Li nse Law for the following reason
Additional Sign Branch Circuits # o 0 0 0 o2
c4 g (Section 7032.5, Busi-
neas and Profesalons Code):
MIsC.Condolts&EonclUctors }
F1 I, as owner of the property, wLIJ do the work and the 2'6'0,'6.6,5 8'
structure is not intended or offered for,sale (Section Other (See Complete Fee Schedule)—
7044,,Business and Professions Code). ,° o'-,6 i,5 Q
CONSTRUCTION LENDING AGENCY .
GOA —S 2
I hereby,&?Mm that there Is a construction lending agency .
for the performance of the work for which this permit Is PERMIT FEE. (Sub-Total)
issued (Sec. 3097,Civ.C.).
Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee)
Lender's Addreu PERMIT ISSUING FEE
I certify that I bite read this application'and state that the,;,' TOTALftEE
above information Is Correct.I agree to comply with all County
ordinitnem and State laws regulating Electricsll wiripg, and
hereby authorize representatives of this County to enter upon
tee a vo-menti(n for inspection p SEE'R$VERSE,FOR EXPLANATQRY LANGUAGE ,
07V
Signature of ee Da
li"O COMPENSATFON Dom"°" f '°'B1 APPLICATION FOR ELECTRICAL PERMIT
'F affirm that I have a certificate of consent to self
er or 6 certificate of Worker' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY
a certified copy there-of
3 �r/f! Yr/�I L/ �Q
No. mpany PO!APPLW-W TO 171 IM /s �,�' Woo A `.
ertl#led copy Is hereby furnished. New Rpidentlal Bldgs. b Pools = EACH �' � � LOCALITY MP, '�
❑ Certified copy Is filed vAth the county building Inspec- 1 &2-Family, Sq. Ft. _ �C�,
ilon department. Multi-family Sq. Ft.�^ 16 _
//_/�; APp NEAREST
Resldentlal,SwlminingPools CROSS OR �f ����y�,yr1 /��/r/
Date licant FIRM NAME J Is ro 4 ec C
CERTIFICATE
OFNSATIONON FROM
NWORKERS' Outlets: Ret ght13!&. = of cbmPE
I'section need not be co If the work Iffvolwd First ti ,. .
the permM is for one hundred dollars (111M)or flies.)
�' Total No Additional CITY G/ fel. No.
I certify that In the performance of the work for which this A
N CHECK
permit Is Inued, I.shall not employ any Person In any manner 'j
so as to become subject to the Workers Compensation taws. Lighting Fixture First 20 O ADDRESS
Additional
Total No. CITY Tel. No.
Date nnf, crit Fixed Appllances No I HP p�7 c
NOTICE TO APPLICANT: 1f, after making this CerttWork of APPUC4Ni G �C C eo
'Exemption, you should become subject to the Workers Range— Neater D.W. ,
Compentat16n provisions of the Labor Code, you must forth- Oven — Dryer —W.M.— ADDRESS A5C 0 �W
wLth comply with such provisions or this permit shall be Top — FAU —W.H. — q
deemed revoked. CITY E Tel. No. /
LICENSED CONTRACTORS DECLARATION Hood _ Fan' _Other LI 11" rW
I hereby affirm that I am licensed under provisions of Chapter 9 Dlsp. — Room Air Cond. REG NUMBER T Class.C-�b
(commencing with Section 7000) of Division 3 of the Buslness Power Apparatus& Large Appliances f DISTRICT NO. BY
and Professions Code,and my license Is In full force and effect. f�
p�� Size &Type HP, KW, KVA, or KVAR' �f U O
License Num/ber C` �Dr�fZ"� Ic. Clan. �/� Up to 1 Incl. FIS U
Contractor �/ )/ -�`� Cd Dat, � Over I to 10 Incl. DATE VALID O
❑ `Over 10 to 50 Incl. FI
I am exempt under Sec. Over 50 to 1Q0 Inc. BY
B.BP.C_ for this reason Over 100
ige�� 1,��
Dat Services, Swbd., MCC&Paj)elboards JJ fy-7 ,1 0 a 3�A' —
P 0 -200 Amp. U oder 600 V , ( � / # 0,21
Signature 201 - 1000 Amp. Under 600 V v el 3141 l - 45§.50,
❑ Over 1000 Amp. or Over 600 V
Exemption for Reg. Malnt. Elect. 'o 0 4 5 9.5 06'
SINGLE FAMILY Temp. Power Pole&Appurtenances
HOME OWNER-BUILDER DECLARATION �
1 hereby affirm that I am exempt from the.Coniractor's License Slgn with One Branch Clrtult 11. 1 6 8 4
Law for the follow1W reason (Section 7031.5, Business and Additional Sign Branch Circuits
Professions Code):
❑ 1, as owner of the property, will do the work and the MISC. Conduits&Conductors
structure Is not Intended or offered for sale (Section Other (See Complete Fee Schedule)_
7044, Buslnesa and Profeaslons Code).
CONSTRUCTION LENDING AGENCY
1 hereby affirm that there.Is a construction lending agency for
the performance of the work for which this permit is Issued PERMIT FEE (Sub-Total)
(Sec. 3097, Civ.4C.). qq7 60
PLAN CHECKING FEE
Lender's Name
PERMIT ISSUING FEELender's Address
1 certify that I have read this application and state that the TOTAL FEE r
above Information Is correct. I agree to comply with all County
ordinances and State laws regulating Electrical wiring, and \
hen authorize Reprwmn Ives f this County to enter upon -
the o-mIt
l ed In Ion purposes.
�/L�/��_` SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Permittee Date �f
i
WORKERS'COMPENSATION DECLARAT" , , '76A463 (��o, APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I have ■ certificate of consent to self COUNTY OF LOS ANGLLESC BUILDING AND SAFETY
insure, or a certificate of Workers'Compensation Insuragce,or
a ca�rrt�iM�°d copy thereof Sec.3800,Lab.C.)
`'1 f f,`1�p�A f� 11�} FOR APOLICANT TO FILL IN JOB
ICY Nb Company_ EACH NO. FEE ADDRESS S
New Residential Bldgs.&Pools
�certlfled copy Is hereby furnished. 1 &2-Famlly,Sq. Ft. LOCALITY
❑ Certified copy b filed with the county building inspection Multi-family Sq. Ft. CROBS ST
department. Residential Swimming Pools OWNER OR
FIRM NAME
Date _ App4cant Outlets: Rec._--_LightSW. MAIL
—�Irst 20 AD -
CERTIFICATE OF EXEMPTION FROM WORKERS' total No. Additional CITY fsI N
COMPENSATION INSURANCE PLAN CI-(E K
(This section need not be completed if the wotjr )IIVOtted 20 APPLICANT 8
by the permit is for ow hundred Aonars ($100) or ten.) Lighting Fixtures Additional ADDRESS t]C
I certify that In the performance of the work for which this Tocol CITY Tel No. 0
permit Is issued, I than not employ any person in any manner Fixed Appliance* Not Over 1 HP U
PERMIT W
so as to become subject to the Workers' Compensation Laws. Range_ Heater_D.W. PPLICAN
Oven _ Dryer_W.M._ ADDRESS
Date L� Applicant Top _ FAU _W.H. z
Hood _ Fen _Other_ CITY elM412191-417
NOTICE TO APPLICANT: If, after making this Certificate of Dlsp, _ Room Air Cond` R _
Exemption, you should become subject to the ,Workers' RE NUMBER 00 Class
Compensation.proybdons of the Labor Code, you must forth- Power Apparatus& Large Appllence* DISTRICT NO. Plz:;�_
wtth comply with such provisions or this permit shall be Size&Type HP,KW, KVA,or KVA r
deemed revoked. iJ� G
Up to 1 Incl.
FINAL
�..�jQ
LICENSED CONjtRACIbRS'DEOver 1 to 10 Incl. DATE CLARATION Over 1 Q to 60 1 ncl.
VALIDATION
I hereby affirm that I am Licensed under provisions of Chapter Over ti0 to 100 Inc. FINAL
9, (commencing with Section 7000) of Dtvision 3 of the Baal- Over 100 BY f
ness and Professions,C6da, and my License is In hill force and
afro ct. � Services
LI Number7:���,����-'��//! Lic-Class 0-200 Amp• Under 600 V
� l,y�,� 201-1000 Amp. Under 600 V � -
t of n�rinct�r " +a�tse"t ZO O
3 Over 1000 Amp.or Over 600 V a L �/
HOME OWNER-BUILDER DECLARATION Temp. Power Pole&Appurtenance*
�7` :9-7'8 R 1 A
I hereby affirm that I am exempt from the Contractor's $Ign wlthsOne Branch Circuit f�.o • o o:e 2
License Law for the following reason (Section'7031.5, Busl- , Additional Sign B.0 Clrcultt [ 0 0 1 4 5 0
ness and Professions Code): ,
I, as owner of the prop", Misc.Conduits&Conductors ,
❑ P p", will do-the work and the Othef (See Colate
m Fee Schedule)— jo 0.0 1 4.5 Q
6.
structure it not Intended or offered for sale (Section Z 2 4� 3
7044, Bwinen and Professions Code).
CONSTRUCTION L$NDINO AGENCY ilt
I hereby affirm that there Is a construction lending agency
for the performance of the work for which this permit Is
I Issued (Sec. 3097,Cly.C.). PERMIT FEE (Sub-Total)
1,,epder's Name PLAN CHECKING FEE (One-Fourth Permit Fee)
Lender's Address �—
� PERMIT ISSUING FEE 0
I certify that I have read tills application and state that the TOTAL FEE
above Information Is Correct.I agree to comply with all County
ordinances and State laws rejtulating Electrical wiring, and
hereby authorize representative* of this County to enter upon
the abovementioned property for Impaction purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE
b
tura of Parmittv Date
COUNTY OF LOS ANGELES TEMPLE CITY f 0508 EMTk ICAL•P�11T
DEPARTMENT OF PUBLIC WORKS I 9701 LAS TUNAS EL 05Q8-005310036
BUILDING AND SAFETY / LAUD DEVELOPMENT TEMPLE CITY G 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
BK: 94 PG: 46 PC: 1 5600 GRACEWOOD AV
FEE DE$CRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917800000
ASSESSOR I"NFORMATION NUMBER: NEAREST CROSS STREET: LIVE OAK
8586-015-038 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: B3 LOCALITY; TEMPLE CITY, C
LB 200 AMP PANELS, MCC 1.00 PAH 38.85
TOTA1 FEE$ 66.60 ISSUFb ON: PROCESSED BY: PLAN BY: ENPIRES ON:
05/31/00 UT 11/27/00
GOLDEN STATE HEALTH CENTERS INC (818) 986-1550- ^^��
13347 VENTURA BL `li
SHRM 914233912 DESCRIPHUM OF WORK
ELECTRICAL FOR UNMANNED TELECOMUNI G FACILITY
APPLICANT: TEL NO:
NEXTEL COMMUNICATIONS (949) ki2-2300-
17275 DERIAN AVE., SPECIKL CONDITIONS:
IRVINE, G 92614
CONTRAT-'TOR: TEL. NO: 05 P.-GELES CCt/�r
APPROVALS DATE TOPECTOR SIMV70WF--
PROCESS COFMUNICATION DEVELOPERS (714) 427-6370-
3020 HARVARD ST. LIC. NO TEMPORARY POWER POLE
SANTA ANA, G 92704 696069/C20UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER: TEL. NO: UFER GR"D
' \•
DELTA GROUP ENGINEERING, INC. (949) 622-
2601 MAIN ST., *260 LIC. X111111MH CONDUI-T
IRVINE, G NONE
6LATER LINE
I 11i/`l(/ ��)� PLAST�C Y/N METAL Y/N
C ��, J�
0
D N'
c Service T�Nat
* ADDITIONAL DATA ON FILE
REPORT ID: DPR265 ROUTE TO: BS0508
COUNTY OF L09 ANGST TF20= CITY 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORMS 9701 LAS TUNAS EL 0508 1003180029
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
Pl-N : (626) 285-0488 ETT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
BR: 94 PO: 46 PC: 1 5600 GRACEWOOD AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917800000
ASSESSOR INFORMATION NEI-MEM: bMAREST CROSS STREET: BOQUE STREET
8586-015-038 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GR=: B3 L030U I7TY: TE PLE CITY, C
F2 208, 27TV LOT BR CLT 1.00 BR 27.30
TENANT: LA 100 AMP PANELS, MCC 1.00 PAN 38.85 ISSUED ON: PROCESSED BY: PLAN BY: EMPIRES ON:
SPRINT WTREaMS TOTAL FEES 93.90 03/16/10 SR 03/18/11
G : TEL. NO: FINAL TE FINAL BY: CODE:
GOLDEN STATE HEALTH CENTERS INC (626) 579-0310-
13347 VENTURA BL
SHRM 914233912 D CRI PTION OF WORK
1 BRANCH CIRCUIT AND SERVICE PANEL 100 AMP
APPLICANT: TEL. NO:
BEX S DEVELOPMENT INC. (714) 730-0606-
250 EL CAMIM REAL SPECIAL CONDITIONS:
TUSTIN, CA 92780
CONTRACTOR: TES,. NO: APPROVALS DATE INSPECTOR 9IGKhTURE
NETWORK COf44QNICAITION9 INSTALLATION (714) 278-1019-
2478 E. FENDER AVENUE SUITE H LIC. NO T124PORARY POWER POLE
F7rLERTON, CA 92831 B,C10 +
UNDERGROUND CONDUIT
ARCHITECT OR EMINUER: TEL. NO: LIFER GROUND
LIC. NO: ROOGH CONDUIT
ROUGH WIRJ19G
MAIN fa= T.
PLAMC Y/N METAL Y/N
UTILITY COMPANY NOTIFTID
+ ADDITIONAL DATA ON FILE
REPORT ID: DPP-265 ROUTE TO: 1390508
COMITY OF LOS ANGELES TEMPLE CITY 0508 ELECTRICAL PERMIT
DEPARTMIENT OF PUBLIC WORKS 9701 LAS TLRAS EL 0508 0503300007
BUILDING AND SAFETY / LAND DEVELOPMHIT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
BK: 94 PG: 46 PC: 1 5600 GRACBlOOD AV
FEE DESCR I PT I OI: OUlANT I TY: U0I1: AMOL T: TEMP CA 917800-}00
NEAREST CROSS STREET: LIVE OAK
8586-015-038 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: B3 LOCALITY: TEMPLE CITY, C
G1 OUTLETS-LGT SW,RECP 1.00 OUT 1.95
LB 200 AMP PAN�LS MCC 1.00 PAM 38.85ISSLED ON: PROCESSED BY: PLAN BY: EXPIRES .
CIMGUILAR WIRELESS LM OTHER PNL 0-394 AMPS 1.00 PAN 38.85 03/30/05 JK 09/26/05 .
M1 CONDUITS, CONDUCTORS 1.00 MIS 65.25
TOTAL FEES 172.65 .
GOLDEN STATE HEALTH CENTERS INC (818) 986-1550-
13347 VE1fTUU1 BL
SHRM 914233912 UUMIPTION OF WORK
ELECTRICAL FOR TELECOMMUNICATIONS FACILITY INSTALL 200 NPS
SERVICE AND PANEL
APPLICANT: TEL. NO-
HARRIS - MC MANAMA CONSTRUCTION (909) 491-5178-
21943 B06GS LANE SPECIAL CONDITIONS:
WILDOMAR CA 92595
CONTRACTOR: TEL. NO: APPROVALS DATE I
HARRIS-MANAMA CONSTRUCTION (909) 491-5178-
21943 BOGGS LN LIC. NO TEMPORARY POWER POLE
WILDOMAR, CA 92595 8354418
VELOCITELIMC. (949) 609-4999-
18701 FIT6H AVE. LIC. NO: ROMH CONDUIT
IRVINE, CA 92614 NONE
PLASTIC Y/N METAL Y/M
REPORT ID: DPR265 ROUTE TO: BS0508