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brOUIVTY OF LOS ANGELES 77
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DEPARTMENT OF COUNTY ENGINEERC
BUILDING AND SAFETY DIVISION BUILDING j�
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JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY
NEAREST .
FOR APPLICANT TO FILL IN CROSS ST. ^�
- NO. EACH FEE
u RECEP��
$ $ OWNER
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LIGHT 1 � TOT�yA/L FIRST 20 .20 0014 _ DDRESI � � 13_ilVl.
SWITCH� �" OVER 20 ,0 .10 06 CITY �'�/i vP- TEL. NO. —{p—�tp��
PLAN CHECK '
LIGHTING TOTAL FIRST 20 .20 APPLICANT
FIXTURES OVER 20 .10 ADDRESS y
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CITY 'TEL. NO.
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SPACE HTR. AIR GOND. ADDRESS ?'c2. /t/
CLOTHES WASH.!_/DISHWASH_ - CITY - TEL. NO.`/(P72,pq�_-Sj
FA.N_OTHER 1.00 w - Nw.;61 -
LICENSE 0. �� _ CLASS..,,,i-e_P
y�MOTORS,TRANSFORMERS RATING . -
IND. HEATERS, ETC. HP._ KW. KVA. I HEREBI' ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
SITE & TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING.
0 - 1- 1.00
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
1 - 10 3.00 LICENSED AS REQUIRED BY LOS ANGELE COUNTY AND STATE OF
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CALIFORNIA OR THAT AM THE LEGAL O COUNTY OF, AND INTEND TO a
pe 10 - 50 5.00 RESIDE IN, THE VE DESr_p.IBED ESIDE NT,IAL PROPERTY. O
50 - 100 10.00 SIGNATURE U
OF PERMITTEE I Q
;i 100 - 500 '15.00
DISTRICT NO.1 GRoj.J6PO E P O ED BY
F TUBE, OR SIGN AND ONE CIRCUIT 3.00
MARQUEE ADDITIONAL C.IRCU IITS 1.00 ~'NOTES: - H
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 w Z
ji SERVICE OVER 600 VOLTS OR 200 AMP 5.00 -; -
I' TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE.
TEMP. POWER POLE
•+ UNDERSLAB WORK 17 1
ROUGH CONDUIT
PERMIT FEE, (SUB TOTAL) WIRING
FIXTURES
LPERMIT
K FEE (50� PERMIT FEE)
POWER AUTHORIZED
ING FEE 2.00 � ®�tUTILITYCO.NOTIFIED /?jTARY PERMIT ISSUING FEE 1.00 FINAL JOSEP C. ROOHAN
_ __ SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK. M.Q. CASH PERMIT VALIDATION CK. M.O. CASH
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- DESCRIPTION OF WORKNUMBER OF OUTLETS ON CIRCUITS
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IGHT OUTLETS PLUGS 'CORRECTIONS
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COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT -
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1208160040
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 _
PHONE: (626) 285-0488 EXT: -
(LEGAL ID: FEES PAID - - I' BUILDING ADDRESS:
ITR: 5904 LT: 23 1 - I 6209 IVAR AV 1
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( TEMP CA 917801526
(ASSESSOR INFORMATION NUMBER: 1I NEAREST CROSS STREET: 1
15386-,010-019 IA1 PERMIT.ISSUANCE FEE 27.80 '1" THOMAS PAGE: 596 GRID: 'H2 LOCALITY: TEMPLE CITY, Cl
IG1 OUTLETS-LGT;SW,RECP 2.00 OUT .4.00 I
(TENANT: IG2 LIGHTING FIXTURES 6.00 LGT 12.00 (ISSUED ON: PROCESSED BY: PLAN BY:: 1
1 I TOTAL FEES 43.80 108/16/12 SR 1
I I I I
(OWNER: TEL. NO: I IFINAL DATE FIN BY: CODE: 1
IKELLY CARMEN T (626) 286-0163-
1 6209 IVAR AV
ITEMP 917801526 - - I _ IDESCRIPTION OF WORK
I 12 OUTLETS AND 6 LIGHT FIXTURES FOR BATHROOM REMODEL
I I I I
1APPLICANT: TEL. NO:. - I -
IGLYCHER, ELINOR (877) 231-7389-
ISPECIAL CONDITIONS:
1CONTRACTOR: TEL. N0: I 1APPROVALS DATE INSPECTOR SIGNATURE 1.
IMEGA GROUP BUILDERS (877) 231-7389- 1 .
118375 VENTURA'BLVD #770 LIC. NO ITEMPORARY POWER POLE
ITARZANA, CA 91356 461004-B-*
I 1UNDERGROUND CONDUIT " ;I
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(ARCHITECT OR ENGINEER: TEL. NO: IUFER GROUND '(' I .
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I LIC. NO: 1 IROUGH CONDUIT
. I ROUGH WIRING II'
IMAIN WATER LINE
PLASTIC Y/N METAL Y/N_- i
(UTILITY COMPANY NOTIFIED( I 1
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I* ADDITIONAL DATA ON FILE I
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IREPORT ID: DPR265 ROUTE TO: BS0508 I
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