HomeMy Public PortalAbout6034 HART AVE_Electrical__ 76A663-CE806 3-64 AP LS CA MH FOR ELE&M `CAL %PERM[J(`/1 I�
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER rjyt
WILLIAM A.JENSEN, SUPT OF BUILDING " LOCALITY iG
NEAREST .
FOR APPLICANT TO FILL IN CROSS ST.
nrSWITCH..
TOTALNO. EACH FEOuT TS FIRST 20 $2O OWNER'.0 .MAILADD'L .1OADDRESS,'
OVER 20'TOTAL CITY ` TEL. NOGHTING FIR ST 20 20 '
FIXTURES } OVERA..'
20 .10 ELECTRICIAN.
RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS oo
GARB.DISP. BTA.COOK
CITY o TEL.NO. -
DISHWASH. AUTO.-WASH. STATE yf,
SPACE HTRS. BTA.APP.(:/p H.P.MAX.) .50 LICENSENO.
MOTORS: OVER NOT OVER H.P. \DISTRICTN GROU ZONE PRO�� BY
O 1 1.00
I 3 1.50 INSPECTION RECORD
D_
3 B 2.00 O
u
S 15 2.50
15 50 3.00
V
50 100 5.00 uJ
n.
N
SIGNS: NO.TRANS. ' Z.
NO.LAMPS
SERVICE 0.60OV-NOT OVER 200A 1.00
SERVICE 0-60OV•OVER 200 A. 2A0
SERVICE OVER 600V 5.00
MISC.
1 -
PERMIT ISSUING FEE- 2.00 (�
SUPPLEMENTARY PERMIT,ISSUING FEE 1.00
TOTAL FEE
D ..
1 E
HREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND. TATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. ,,. WIRING -1/f,
IHEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AB REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY �..
- POWER
SIGNATURE UTILITY CO.NOTIFIED i
OF PERMITTEE Z-
FINAL
LIDATION ARTHUR C. V
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
_ A Q; ; �I . 2 D 4.0 0- ._
7
DBS-5A-11.55 APPLICA` MN FOR ELECTRIC PERMIT
DBS-5A-
DIVISION OF BUILDING AND SAFETY w a , :
Deportment of County Engineer BUILDING
County.of Los AngelesADDRESS0 ,0I
JOHN A. LAMBIE, COUNTY ENGINEER per► 4
CASSATT D. GRIFFIN, SUPT OF BUILDING r LOCALITY
FOR APPLICANT TO FILL IN NEAREST
.9.t �Ii "
PERMIT FEES
` NUMBER OWNER
LIGHT OUTLETS MAIL
( RECEPTACLES ADDRESS � �
A
WALL SWITCHES FEE CITY TEL. NO.
TOTAL OUTLETS @ 5¢ $
ELECTRICIAN
ELEC. RANGES 25
ADDRESS
ELEC. HEATERS 25 r
KW EA CITY TEL. NO.
STAT
FIXTURES 5 LICENSE NO.
`SNS'. d- :•Y';
MOTORS DISTRICT NO. 1 GROUP ZONE READY FOR INSPECTION
lr NUMBER HORSEPOWER FEE �•�
r NEW MVD. HP OVER INC. EACH INSPECTION R CORD
1/2&LESS $ .25
1/2 2 .50
s.+
.2 5 1.00
5 15 1.50
15 50 2.50
50 200 5.00
MISC.
:a
a F _
NO.SIGNS NO.TRANS.
NO. SIGNS NO. LAMPS
FOR EACH PERMIT:
WIRING $1.00
FIXTURES $1.00
SUPPLEMENTARY .50 APPROVALS
TOTAL FEE $ DATE INSPECTOR'S SIGNATURE
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY " CONDUIT ��{{ �(
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING 'WIRING C/ a�l
ELECTRICAL WIRING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES r
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM E LEGAL OWNER OF THE ABOVE POWER
DESCRIBED RESIDENTIAL M:e-
10FINAL UTILITY CO.NOTIFIED
_ SIGNATURES
OF PERMITTEE
JOHN A.LAME,COUNTY ENGINEER' VALIDATION ARTHUR C.VEIT.CHIEF ELECT.INSPECTOR
CK MO CASH
WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) ADPL ICA II �®IIV' FOR ELEC•��0ICAL� PERNT
�f
I hereby affirm that I have a certificate of consent to self 76A663 u�u insure, ,
or a certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV.
copy tl�,ereof,(90,3800 Lab.C.)
Policy No, ` �QO Company riF r drew 1� FOR APPLICANT TO FILL IN JOB
ADDRESS
Ce,
Certified copy is hereby furnished. New Residential Bld9s.&Pools NO. EACH FEE
$ $ LOCALITY ��J
Certified copy is filed with the county building inspection 1&2-Family,Sq.Ft. NEAREST
� department. Multi-family Sq.Ft. — CROSS ST.
Date 711""Vie' Applicant�'LD"�iti� G� Reside ial Swimming Pools ASSESSOR
MAP BOOK PAGE PARCEL
CERTIFICATE OF EXEMPTION FROM WORKERS' utlets:Rec.-3 L OWNER OR
� Li
COMPENSATION INSURANCE �Light Sw.-� FIRM NAME �
� J
(This section need not be First 20 MAIL completed if the work Involved by the fYG► p ADDRESS �Q3
permit is for one hundred dollars($100)or less.) Total No. -Additional
I certify that it the performance of the work for which this permit CITY /iritv7L Tel.No.
is issued, I shall not employ any person in any manner so as to PLAN CHECK
become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANT
Total No. / Additional fir' ADDRESS
Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP.
NOTICE TO APPLICANT: If, after making.this Certificate of CITY Tel.No.
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 PERMIT
provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances APPLICANT
LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR, ADDRESS
I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl.
(commencing with Section 7000) of Division 3 of the'Business and CITY �Z - r� Tel.No.
Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. }
LICENSE OR i//-/,{"�fi� Class. a-
Over 50 to 100 Incl. REG.NUMBER �i'�/✓ O
.,/ Over 100 DISTRICT NO. `. P SED BY O
License Number ! 7� 2A / Lic.Class
Services,Swbd.,MCC&P nelbo s Q ``� �'L ��L c
moo; / �FJ FINAL O
Contracto-0-41 1Z�= ���'Date 7f/L a-I& / U V ' DATE f-
❑ I am exempt under Sec. 400-1000 Amp. Under 600 V �i - � W
VALIDATION
Over 1000 Amp.or Over 600 V FINAL d
B.&P.C.for this reasonBY (n
BRANCH CIRCUIT FEES
Date, 15A,or 20A,120V,Lighting or Recept. Z
Signatures--- J C2' y�j 1 To 10 Branch Circuits
11 To 40 Branch Circuits
41 Or More Branch Circuits
Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits }
SINGLE FAMILY Temp.Power Pole&Appurtenances r
HOME OWNER-BUILDERDECLARATION Sign with One.Branch Circuit ACCT°4
I hereby affirm that I am exempt from the Contractor's License Law t
for the following reason (Section 7031.5, Business and Professions Additional:Sign Branch Circuits 3303 84.60
Code):
1 ITEMS EMS
I, as owner of the property,will do the work and.the structure Misc.Conduits&Conductors. t
is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) D TOTAL 4'z..a -60
and Professions Code). CHECK ``a60
CONSTRUCTION LENDING AGENCY �•��q-NGE .00
I hereby affirm that there is a construction lending agency for the t-i!t
performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total)
Civ. C.)
PLAN CHECKING FEE 0000-0001 7/11/96
Lender's Name
PERMIT ISSUING FEE a 378 1 AM 9" 7
Lender's Address
I certifythat I have read this application and under penalty of purjury state TOTAL FEE Q
that the above 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 inspection purpose SEE REVERSE FOR EXPLANATORY LANGUAGE
SIGNATURE OF PERMITTEE DATE
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0412010015
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
TR: 5904 LT: 343 6034 HART AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801914
ASSESSOR INFORMATIO NUMBER: NEAREST CROSS STREET:
5384-014-014 Al PERMIT ISSUANCE FEE 27:75 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY, C
F1 120V, 15/20A BR;.CKTS 3.00 BR' 51.75
TENANT: G1 OUTLETS-LGT,SW,RECP 20.00 OUT 39.00 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
G2 LIGHTING FIXTURES 4.00 LGT 7.80 12/01/04 JK 05/30/05
LB 200 AMP PANELS, MCC 1.00 PAN 38.85
OWNER: TEL. NO: TOTAL FEES 165.15 FINAL DATE FINAL BY: CODE:
CHEUNG DONALD (626) 451-9834-
6034 HART AV
TEMP 917801914 DESCRIPTION OF WORK
ELECTRICAL FOR THE ADDITION & UPGRADE SERVICE TO 200 AMPS.
APPLICANT: TEL. NO:
SAME AS OWNER -
SPECIAL CONDITIONS:
CONTRACTOR: TEL. N0: APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER -
LIC. NO TEMPORARY POWER POLE
UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER: TEL. NO: UFER GROUND
LIC. NO: ROUGH CONDUIT
ROUGH WIRING zL C
MAIN WATER LINE
PLASTIC Y/N METAL Y/N
UTILITY COMPANY NOTIFIED
REPORT ID: DPR265 ROUTE TO: BS0508
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0203130004
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL D: FEES PAID BUILDING ADDRESS:
TR: 5904 LT: 343 6034 HART AV
FEE DESCRIPTION: QUANTITY: UOM:. AMOUNT: TEMP CA 917801914
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: GARIBLADI
5384-014-014 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY
F1 120V, 15/20A BR CKTS 1.00 BR 17.25
TENANT: G1 OUTLETS-LGT,SW,RECP 5.00 OUT 9.75 ISSUED ON: PROCESSED BY: PLAN EXPIRES ON:
TOTAL FEES 54.75 03/13/02 JK 09/09/02
OWNER: TEL. NO: FINAL DATE FINAL BY: CODE:
CHEUNG;DONALD (626) 451-9834-
6034 HART AV 2/ 1- -
TEMP 917801914 UESCKIPTION OF WORK
ELECTRICAL FOR RELOCATION OF LAUNDRY FACILITIES AND KITCHEN
REMODEL
APPLICANT: TEL. N0:
SAME AS OWNER -
SPECIAL CONDITIONS:
BOG E S Co,
CONTRACTOR: TEL. NO: ®� ���, APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER -
LIC. NO TEMPORARY POWER POLE
UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER: TEL. NO: UFER GROUND
LIC. NO: ROUGH CONDUIT
1111111
I , ROUGH WIRING
L�
I P n v� O L C W O n K 3 MAIN WATER LINE
w PLASTIC Y/N METAL Y/N
0
UTILITY COMPANY NOTIFIED
Ff
;r
Servi,' It°��11tl
REPORT; ID: DPR265 ROUTE T0: BS0508 :