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HomeMy Public PortalAbout5616 HALLOWELL AVE_Electrical__ DBS 5-A,�122--r44�� 7�� BUILDING a�p,7� MP ICATION FOR PE .OEPt�Qi1�EE1\1�7/p���g®�E HD IJHLIIIAI`iO E91�)lJ' SAFETY SYtll �All� CoZN � OF LOS ANGELES WM. J. FOXCHIEF ENGINEER Q NAME I , p //���-��,pp DISTRICT NO. GROUP ZONE PERMIT NO. ��- ADDRESS /< 111 ✓v r a / O ! tg�� W CITY %; Z TEL.NO. . �l�l ILEO FIRST INSPECTION DATE ISSUED' ..1 COUNTY V W CERT.NO. �j f' EXPIRES APPLICANT FILL IN HEAVILY OUTR'LINED PORTION ONLY � n B DESCRIPTION OF WORK JOADDRESS �� � � ���r�4•� v NUMBER OF OUTLETS ON CIRCUITS LOCALITY 5 LOCATION BY ROOMS NEAREST / p LIGHT OUTLETS JSW. PLUGS FIZT CROSS ST. Ila CIRCUIT A_113 C D E F G Ill w NAME Z MAIL 3 ADDRESS ® -- O CITY ����f I TEL NO. 1 AM THE LEGAL fBbssESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QU (FICA i,,Oid.. u ELECTRICIAN. H AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE OWNER. v CORRECTIONS � J Z 7- 0 TOTAL 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 a $ IL"ITYCO.NOTIFIED lJ__�S" TOTAL-FEE � FINAL DBS S-A 12-44 APPLICATION FOR PERA'I r IDEPAIITIVIEN'I' OF BUILDING AND SAFETY �������� COUNTY OF LOS ANGELES WM. J. FOX. HIEF ENGINEER a NAME AV// X_®ca el '� DISTRICT NO. GROUP ZONE PERMIT NO. � r �� ,� o �j7 <71v- D_ � ape U—a, ADDRESS s / ��1,i' �/2!°� —1 2 It <7 1 e U CITY r4 1 j REGE VED BY READ FOR DATE ISSUED >,i TEL.NO. FIRST INSPECTION W CERT.NO. EXPIRES 0• J I , �1 �— x APPLICANT FILL IN HEAVILY OUTLINED PORTION,QNLY, JOB DESCRIPTION OF WORD ADDRESS NUMBER OF OUTLETS ON CIRCUITS LOCALITY LOCATION BY ROOMS NEAREST LIGHT OUTLETS ISW. PLUGS F17(T CROSS ST. s CI CULT A B C D E F G H a: NAME /a 0 Z MAIL ,jj(/'20 3 ADDRESS CITY TEL.NO. AM THE LEGAL POSSESSOR OF THE�4BOVE LOS ANGELEE TE .S COUNTY CERTIF OF QU FICATIO .. ff ELECTRICIAN. I AM THE LEGAL,OWNER OF THE PROPERTY DESCRIBED 1 ' ABOVE OWNER. �{�' y p CORRECTIONS l ", CS I! i .fly — A 4 J J fFr/ ✓ �"o L7 Q O. 13 _ o tel. OTAL 77 77— No: OF OUTLAPPROVALS NO. OF FIXTURES 2 $ DATE INSPECTOR'S NAME U NO. OF MOTORS H.P. $ CONDUIT NO. OF SIGNS TRANS. $ WIRING NO. OF RANGES OR HEATERS $ FIXTURES MISCELLANEOUS $ POWER PERMIT FEE �D — /e se $ UTILITY CO.NOTIFIED, ��_ TOTAL FEE :WORKERS'I COMPENSATION DECLARATION 10/87 APPLICATION FOR ELECTRICAL PERMIT +I.heretiy, affirmirm that have a certificate of consent to self insure, CE-806G or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY ;copy ther0of(Sec!3800.Lab.C.) POljcy No.• Company FOR APPLICANT TO FILL IN JOB ��•//� ❑ .Certified co is hereby furnished. EACH NO. FEE ADDRESS v PY Y New Residential Bldgs.& Pools ❑ Certified copy is filed with the county building inspection 1 & 2-Family, Sq.Ft. $ _ $ LOCALITY NEAREST p O j� /� department. Multi-family Sq.Ft. CROSS ST. Date Applicant Residential Swimming Pools OWNER OR CERTIFICATE OF EXEMPTION FROM WORKERS' SAM NAME Outlets:Rec Light S. COMPENSATION INSURANCE QQ 00 ADDRESS ( completed if the work involved b This section need not be com the First 20 y Total No. Additional �i CITY L O� -� Tel.No. permit is for one hundred dollars ($100) or less.) 1 certify that in the performance of the work for which this permit PLAN CHECK L APPLICANT is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS Additional Total No.� CITY Tel.No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of Exemption,you should become subject to the Workers'Compensation Range_ Heater_ D.W. APPLICANT �liLe provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer L W.M._ ADDRESS provisions or this permit shall be deemed revoked. Top FAU J— W.H. I a� 0 CITY �� Q�j 2 Tel.No. Y Y�� C� LICENSED CONTRACTORS DECLARATION Hood Fan _ Other_ I hereby affirm that I am licensed under provisions of Chapter 9 Disp. Room Air Cond. LICENSE OR 4 p�j (commencing with Section 7000) of Division 3 of the Business and REG.NUMBER U/l/ Class. Professions Code,and my license is in full force and effect. DISTRICT NO._ X;�;� Power Apparatus& Large AppliancesSize& T�y�pe ,KW,KVA,or KVAR O License Number Lic.Class Up to 1 Incl. 190 FINAL U Over 1 to 10 Inc]. DATE ` IX VALIDATION Contractor Date Over 10 to 50 Incl. O ❑ I am exempt under Sec. Over 50 to 100 Inc. BY AL W B.&P.C.for this reason Over 100 Q„ 0Services,Swbd.,MCC& Panelb Date: oards ® N 0-200 Amp.Under 600 V r Signature 201 - 1000 Amp.Under 600 V ❑ - Exemption for Reg.Maint.Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY Temp.Power Pole& Appurtenances HOME OWNER-BUILDER DECLARATION •a I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit ;!:?;} ,g for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits - - 5-_ I,as owner of the property,will do the work and the structure Misc.Conduits & Conductors 1 ITEMS L"a is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) I "4 = 50 TALand Professions Code). .+.g:v-.r.7i _- CONSTRUCTION LENDING AGENCY L�; I .513 s;- I hereby affirm that there is a construction lending agency for the ::HHI I M performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total) Q Civ.C.). 0, /A _O PLAN CHECKING FEE 01301`-i E013;i J Lender's Namey'"� PERMIT ISSUING FEE / © ` f _ fr 7; _� ..i Lender's Address I certify that 1 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 property for ins pe tic, ur o S. SEE REVERSE FOR EXPLANATORY LANGUAGE Si re of Perffiiffee Date ••�' .. WORKERS'COMPENSATION DECLARATION E 1081 APPLICATION FOR ELECTRICAL PERMIT �l hereby C 'affirm that I have a certificate of consent to self insure, CE-806G or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copv,MTere9f(Sec.3800,1_ab.C.) Policy NO. Company FOR APPLICANT TO FILL IN JOB ❑ Certified copy is hereby furnished. EACH NO. FEE ADDRESS New Residential Bldgs.& Pools ❑ 1 & 2-Family,Sq.Ft. $ _ $ LOCALITY Certified copy is filed with the county building inspection department. Multi-family Sq. Ft. CROSS S 0/9 Date Applicant Residential Swimming Pools OWNER OR /w FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' rc COMPENSATION INSURANCE Outlets:Rec Light Sw. 9� °� ADDRESS �✓ First 20 (This section need not be completed if the work involved by the � Additional CITY No. Permit is for one hundred dollars($100)or less.) Total No. I certify that in the performance of the work for which this permit PLAN CHECK APPLICANT is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 72 ADDRESS Total No.2 Additional CITY Tel.No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT Exemption,you should become subject to the Workers'Compensation Range_ Heater_ D.W. 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. CITYr�.q�J�� Tel.No. ;/�y��� LICENSED CONTRACTORS DECLARATION Hood _ Fan _ Other_ I hereby affirm that I am licensed under provisions of Chapter 9 LICENSE OR (commencing with Section 7000)of Division 3 of the Business and Disp. — Room Air Cond. REG.NUMBER Class. Professions Code,and my license is in full force and effect. DISTRICT NO. PROCESSED BY Power Apparatus& Large Appliances (I' Size &Type HP,KW,KVA,or KVARP License Number Lic.Class Up to 1 Incl. FINAL V Over 1 to 10 Incl. DATE `/1 . VALIDATION Q Contractor Date Over 10 to 50 Incl. 77 I-- ❑ FINAL I am exempt under Sec. Over 50 to 100 Inc. BY W B.&P.C.for this reason Over 100 M- N Services,maCC& Panelboards Date: 0- 0 Amp.)Under 600 V I - Signature 201 - 100 Amp.Under 600 V ❑ Over 1000 Amp.or Over 600 V Exemption for Reg.Maint.Elect. SINGLE FAMILY Temp.Power Pole & Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law i it !_•7 a a for the following reason (Section 7031.5,Business and Professions Additional Sign Branch Circuits 77_..r Code): .i:r ( 42o"1 KI Misc.Conduits&Conductors T•y,L. I,as owner of the property,will do the work and the structure Other(See Complete Fee Schedule) is not intended or offered for sale (Section 7044, Business and Professions Code). ® TOTAL 4_2 70 CONSTRUCTION LENDING AGENCY . '.` 't — I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total) .I•jANGE a'j '• Civ. C.). / n PLAN CHECKING FEE Lender's Name ��/ 0020-0106 j 11/ �".`�=!i PERMIT ISSUING FEE , ,J Lender's Address : 1¢IE." iA ri i 1_ + 1 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 property for insp n purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE /Signature ofPennittee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1110200002 BUILDING AND- SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: FEES PAID 1 - BUILDING ADDRESS: ITR: 12392 LT: 18 BL: .001 - 5616 HALLOWELL AV J IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 ARCD CA 910078419 (ASSESSOR INFORMATION NUMBER: I INEAREST CROSS STREET: LIVE OAK 18586-013-024 JAI PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 597 GRID: B3 LOCALITY: TEMPLE CITY, Cl I JG1 OUTLETS-LGT,SW,RECP 57.00 OUT 88.70 J (TENANT: IG2 LIGHTING FIXTURES 35.00 LGT 59.10 (ISSUED ON: PROCESSED BY: PLAN BY: J JHA FAU LESS 3HP 1.00 FAU 10.90 110/20/11 SR J IH2 RES GRBG DISP LT 3HP 1.00 DIS 10.90 1 J (OWNER: TEL. NO: IH3 RES DISHWASHR LT 3HP 1.00 DIS 10.90 1F DATE FINAL BY: CODE: J KASUBUCHI, GREGG (626) 215-5438- IH4 RES RANGE HDS LT 3HP 1.00 HOO 10.90 1 l J 15616 HALLOWELL AV IHS RES WASH MACH LT 3HP 1.00 WAS 10.90 1 I+C J JARCD 910078419 IJB AC UNITS +3-10HP 1.00 AC 19.70 IDLeSCRIiPTION OF WORK J J ILN OTHER PNL 0-399 AMPS 1.00 PAN 38.80 JELECTRICAL ADDITION, REMODEL, HVAC SYSTEM AND ADD SUB-PANEL I I TOTAL FEES 288.60 1100 AMP I (APPLICANT: TEL. NO: I J IQUAN, ALBERT (626) 202-8328- 1 13139 HEMPSTEAD AVE 1 )SPECIAL CONDITIONS: I IARCADIA, CA 91006 I I J I (CONTRACTOR: TEL., NO: J (APPROVALS DATE INSPECTOR SIGNATURE JKASUBUCHI, GREGG K (626) 215-5438- 1 1� 15616 HALLOWELL AVENUE LIC. NO 1TEMPORARY POWER POLE J I I JARCADIA, CA 91007-8419 NONE I I I J (UNDERGROUND CONDUIT I I I I I I (ARCHITECT OR ENGINEER: TEL. NO: IUFER GROUND I I I IPOLYTECH DESIGN BUILD INC. (626) 321-2127- - 1 1 1 12025 SO. 4TH STREET LIC. NO: IROUCH CONDUIT I I I 1ALHAMBRA, CA 91803 NONE I 77� jZA I TROUGH WIRING /' ' / --I I J J J IMAIN WATER LINE I J J )PLASTIC Y/N METAL Y/N J 1_ 11 JUTILITY COMPANY NOTIFIED) I I I J I I I I J I I I I I J I I I I I I I I I I J I I I I I I J I I I I I I J I I I I I I J J I I I I I I I I J I I I I I J I J I I I J I J I I I I I J I I I I I I I I I I J I J I IREPORT ID: DPR265 ROUTE TO: BSO508 J I I J I I I