HomeMy Public PortalAbout6003 IVAR AVE_Electrical__ ,76A663-CE806 10/72 APP UCCAMN FOR `ELECTPUCAL PERM
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER rJADS
BUILDING AND SAFETY DIVISION
ITY
ST
FOR APPLICANT TO FILL IN ST, f 4
,OUTLETS 4 NO. EACH FEE - OR _ I -
$ $ AME M
RECEPT. S ljL MAIL
ADDRESS
LIGHT TOTAL FIRST 20 �-� 25 A 44
CITY TEL. NO.
SWITCH OVER 20 .10
PLAN CHECK
FIRST 20 25 /1 APPLICANT
LIGHTING )l, TOT L Cf '
( ADDRESS -
FIXTURES I OVER 20 10
RESIDEN AL APPLIANCES CITY TEL. N0.
PER �
RANGE` DRYER / WTR. HTR._ ,. APPLICANT' l✓
STA. COOK DISP._/_F.A.U. ADDRESS � 0�---
r
SPACE HTR.—Al R COND. CITY EL. NO. �
CLOTHES WASH.rDISHWASH._L_ LICENSE ' �CLASS.f/ e)
REG. NUMBB ER
.FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I•HAVE READ THIS APPLICATION
ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
-MOTORS; TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES A,ND STATE' LAWS, REGULATING
IND..HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING.
SIZE& TYPE OVER TO "
I HEREBY-.CERTIFY THAT V PROPERLY REGISTERED AND/OR
0 — 1 '100 LICENSED. AS REQUIRED B' S ANGELES COUNTY AND TATE
'CALIFORNIA OR THAI THE LEGAL OWNER OF - AB
DESCRWED RESIDE NTI PROPERT .
1 — 10 3.00 0
PERMITEE V
10 — 50 5.00 SIGNATURE
50 — 100 10.00
U
DISTRICT N0. - PROCESSED BY W
100 — 500 15.00 wry cC/)
SIGN, GAS' SIGNAND ONE CIRCUIT 5.00 APPROVALS 'DATE I SPECTOR'S SIGNATURE
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE
SERVICENOTOVER600VOLTS OR200AMP 3.00 UNDERSLAB WORK .
SERVI CEOVER 600 VOLTS OR 200 AMP 10.00 ROUGH CONDUIT • '
TEMP SERVICE,POLE, &APPURTENANCES 5.00 WIRINGI�. a R 7 fJ/
TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES ,.
POWER AUTHORIZED,.` - -
UTILITY CO. NOTIFIED
FINAL 66nh .s%��f
PERMIT FEE (SUB TOTAL) N"OGT /�
wES: d/�—Z �1/3GG - �c.9"' e��1..v4s✓
PLAN CHECK FEE
PERMIT ISSUING FEE 3.00
TOTAL FEE
PLAN CHECK'VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH`
6.4 4r'4_'N0V 6 2 D 1. 2.25 A'�jd
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
n r��n1f1 n f�t1 I�/�5�� /� �I�y�� -l��y���/-7--'
76A663-CE806 9-67 ��1\I�Iy�il �C![1\��OIIp11 FOR ELI}!! 11 R9CAL ll E11�11�vn\�4 1 {
COUNTY OF LOS ANGELES V LSrJ ll tr�� 11Vl! IILLJJII
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION. BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS �Q O
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING ]LOCALITY
I• - ••-I -:• _. �ti... - .`k. NEAREST .�• z^
FOR APPLIC•A NT TO FILL IN CROSS ST.
NO. EACH FEE _
$ $ OWNER
'> RECEPT% ._ MAIL-
LIGHT TOTAL . FIRST 20 .20 ADDRESS '+
'i SWITCH_ OVER 20 .10 CITY TEL. NO.
•, LI,GHTING 1 TOTAL FIRST 20 .20 CONTRACTT
r )j
y' FIXTURES/� OVER 20 ..10 ADDRESS�J S� //j/��S
RA NGE.�DRYERW TR.HTR,_ . CIT /►"� �- TEL. N / !p
iSTA.COOK_DISP.-F.A.U._ LICENSE NO. 4SV +o
-` SPACE HTR. AIR COND. ( IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
!`-CLOTHES WASH. DISHWASH._ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING.
•.':
FAN-OTHER 1.00 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
MOTORS,TRANSFORMERS RATING CALIFORNIA OR THAT I AM EG L OWNER OF, AND INTEND TO
IND. HEATERS, ETC. HP. KW. KVA. RESIDE IN, THE ABO DE R ED ESIDENTIAL PROPERTY.
SIZE & TYPE OVER TO SIGNATURE
u' OF PERMITTEE
� 0 - 1 1.00 d
1 — 10 3.00 1 DISTRICT N GR Z f3 V
10 - so 5.00 '�
SO - 100 10.00 NOTES:
100 - 500 15.00 S t��-7"4"'7 &'oQ �a.n rsJt r .CL r a
SIGN,GASSIGN AND ONE CIRCUIT 3.00 /L 9. e"' " �.lp�G. td-j A t'fL Z
TUBE, OR ��Q�
MARQUEE ADDITIONAL CIRCUITS 1,.00 �., -1"p,kn s _
A5a6pd.f� r 4La
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 �' ISZ� �� ���✓!� �1,,, �� �
!,1 SERVICE OVER 600 VOLTS OR 200 AMP ,5.00
TEMP SERVICE, POLE, &APPURTENANCES 3.00
APPROVALS DATE INSPECTOR'S SIGNATURE
r° �G TEMP. POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
^i ISSUING FEE 2.00L') WIRING
WIRING
d FIXTURES
•I SUPPLEMENTARY ISSUING FEE 1.00 -
POWER AUTHORIZED
PERMIT FEE UTILITY CO.NOTIFIED
.1/ ..stl A
PLAN CHECK FEE (50% PERMIT FEE) 'f'.FINALTF
TOTAL FEE 5 JOSEPH C. ROOHAN
_-: ,•,. .a .zr -- irs ..-�1 SUPERVISING ELEC ICAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
.00SELAbo s 5 9' fLv 16 2 0 5.00-
SEE
E BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE -//
WORKERS'COMPENSATION DECLARATION 76A663. 10/81 0 0 0 0 0 0
1 hereby affirm that I have a certificate of consent to self CE-806G APPUCQTPON FOR ELEC�IMC AL> pEG3Fi�iv 'T o
insure„or a.certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILD ING.AND SAFETY
or a certified copy thereof (Sec. 3800, Lab. C.)
Policy No. -Company FOR APPLICANT,TO FILL IN JOB
V” EACH NO. FEE ADDRESS "+ i
Certified copy is hereby furnished. New Residential Bldgs. &Pools
1 & 2-Family, S Ft.—, $ — $ LOCALITY
Certified copy is filed with the county building inspec- y- q
tion department. Multi-family Sq. Ft. — 'NEAREST
CROSS ST:
Residential Swimming Pools OWNER OR
Date Applicant FIRM NAME
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec i ' Light Sw.'"''F_ MAIL
COMPENSATION INSURANCE ADDRESS
This section need not be completed if the work involved b First 20'
p Y Total No. CITY Tel. No.
1 the permit is for one hundred dollars ($100)or less.) Additional
PLAN CHECK r-
licertify'that in the performance of the work for which this APPLICANT
;permit is issued,'l shall not employ any person in any manner
., so.,as to become subject to the Workers'Compensation Laws. Lighting Fixtures ` First 20 ADDRESS
3' t Total No Additional
CITY Tel. No.
Date Applicant Fixed Appliances Not Over 1 HP PERMIT
NOTICETO APPLICANT:'If, after making this Certificate of APPLICANT
Exemption, you should 'become subject to ,the Workers' Range_ Heater—D.W.
Compensation provisions of the Labor Code, you must forth- Oven — Dryer —W.M.—. ADDRESS
wiih•,comply with such provisions or this permit shall be' Top FAU —W.H. —
deemed revoked. CITY Tel No..
Hood Fan —Other_
LICENSED CONTRACTORS DECLARATION 'LICENSE OR
I hereby affirm that I am licensed under provisions of Chapter 9 Disp. _ Room Air Cond. REG. NUMBER Class i i.
(commencing withSection7000) of Division 3 of the Business DISTRICT NO. PROCESSED BY a
<and Professions Code,and rriy license is in full force and effect: Power Apparatus& Large Appliances
Size &Type HP, KW, KVA,'or KVAR t r' o
License Number Lic. Class Up to 1 Incl. LU
IFINALOver 1'to'l0lncl. EContractorDate• VALIDATIOPdOver 10 to 50 Incl: ALIarri exempt under Sec. Over 50 to 100 Inc. Q
Over 100 d'
B.&P:C.for this reason O
y Services, Swbd., MCC & Panelboards a
Date: 0 -200 Amp. Under 600•V w
d
Signature ' 201 -.1000 Amp. Under 600 V
1J r+
Over 1000 Amp. or Over 600 Vf1
Exemption for Reg. Maint. Elect.
JW
\ 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
Additional Sign Branch Circuits
Law for the following reason (Section.7031.5, Business and
Professions Code): - i'1''J+ i tf f Int rr
aMisc. Conduits&Conductors y+-
1, as owner-'df the property, will do the work and the pf "4 ' }'e;
I
is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ D ++ *r"
7044, Business and Professions Code).
CONSTRUCTIONLENDING AGENCY
f I 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)
E� (Sec. 3097, Civ. C.).
PLAN CHECKING FEE
Lender's Name
PERMIT ISSUING FEE ,.•
Lender's Address
I certify that I have read this application and state that the TOTAL FEE C
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 purposes.
X 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 0901140015
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: FEES PAID I BUILDING ADDRESS: I
ITR: 5904 LT: 117 UN: .002 1 6003 IVAR AV 1
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 TEMP CA 917801522
(ASSESSOR INFORMATION NUMBER: I . I NEAREST CROSS STREET: 1
15386-011-062 JAI PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY, Cl
I JHA FAU LESS 3HP 1.00 FAD 10.95 D
(TENANT: JJB AC UNITS +3-10HP 1.00 AC 19.65 JISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
J TOTAL FEES 58.35 101/14/09 SR 07/13/09
DOWNER: TEL. NO: IFINAL DATE FINAL CODE: 1
IMR. & MRS. GALDOS (760) 724-4053-
16003 IVAR AVE. 1 r�
ITEMPLE CITY CA 91780 1 1DESCRIP ION OF WORK J
I JELECTRICAL FOR A/C - HEAT S TEM D
(APPLICANT: TEL. NO: 1 I
ICARRA CONTRERAS OF CONNOR AIR (626) 286-3157- 1 D I
14931 N. ENCINITA AVE I ISPECIAL CONDITIONS: I
ITEMPLE CITY CA 91780 J I I
ICONTRACTOR: TEL. NO: D JAPPROVALS DATE INSPECTOR SIGNATURE J
ICONNOR AIR CONDITIONING (626) 286-3157- 1 I 1 I
14931 ENCINITA AVE LIC. NO ITEMPORARY POWER POLE I 1 D
ITEMPLE CITY, CA 91780 403735 C20 1
I (UNDERGROUND CONDUIT I I I
(ARCHITECT OR ENGINEER: TEL. NO: 1 IUFEP.. GROUND I I
LIC. NO: I IROUGH CONDUIT 1 1 I
I IROUGH WIRING D 1
I IMAIN WATER LINE I I
D IPLASTIC Y/N METAL Y/N D
JUTILITY COMPANY NOTIFIEDI I I
J I I • I I I
I I I I I I
I I I I I I
I I I D I I
I I I I I I
I I I I I I
IREPORT ID: DPR265 ROUTE TO: BS0508 1 J I I
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