HomeMy Public PortalAbout5202 KAUFFMAN AVE_Electrical__ o O 0 Q PERM PER
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•- CESAA 175 APPUC�EM FOR ELEC�TREAL M
BUILDING AND AFETY DIVISIO
FOR APPLICANT TO FILL IN ,JOB .+
New Residential Bldgs.&Pools EACH NO. FEE ADDRESS^^ 5202 Fi.uf�'.iT1aY1 Ave
1 &2 Finaily Sq. Ft. $ — $ LOCALITY Terni-i7 P Ci tV
Multi-family Sq. Ft. — NEAREST
CROSS ST. T i a, h 0 S a
Residential Swimming-Pools OWNER OR
FIRM NAME Nichols
Outlets: Light,Switch& Receptacle ADDRESSAIL 202 Kauffmn
First 20
Additional CITY T •le City Tel. No:
PLAN CHECK
APP'LI'CANT
Lighting Fixtures
First 20 ADDRESS
Additional
CITY Tel. No.
PERMIT
Fixed Appliances Not Over 1 HP APPLICANT Morale's- electric
Range Heater D-W.
ADDRESS .R 1'3
1,7's9JOY,
Oven Dryer W.M.
Top FAU W.H. CITYPosemead 1,770 Tel. No. 280-4260
Hood Fan LICENSE OR O
REG. NUMBER 227962 Class.&—l0 c-3
Disp. A.C.
CD
' 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION Q
'r AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING W
Size&Type HP, KW, KVA,'or KVAR ELECTRICAL WIRING. d
Up to 1 Incl
U1 HEREBY CERTIFY THAT 1 AM PROPER Y EGISTERED AND/OR
�• ul/Ver 1 to 10 Incl." � Z O LICENSED AS REQUIRED BY LOB ANGEL NTV AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEG O NER OF TH ROVE
Over 10 to 50 Incl. DESCRIBED RESID &PROPERTY.
Over 50 to 100 Incl. PERMITEE ��-_ '.F
Over 100 SIGNATURE
DISTRICT NO. PROC SSED V
Services Q
0-200 Amp. Under 600 V �J OC/'
201 - 1000 Amp. Under 600 V1 APPROVALS DATE
I ECTOR'S
IGNATURE
Over 1000 Amp.or Over 600 V'
TEMP. POWER POLE
Temp.'Power Pole&Appurtenances UNDERSLAB WORK
Sign with One Branch Circuit
Additional Sign Branch Circuits ROUGH CONDUIT
(Other) WIRING
FIXTURES
POWER AUTHORIZED
PERMIT FEE. (Sub-Total) UTILITY CO.NOTIFIED
PLAN CHECKING FEE (One-Fourth Permit Fee) FINAL 5 7
PERMIT ISSUING FEEO
TOTAL FEE $10� 0 NOTES
PLAN CHECK VALIDATION CK. M,0. CASH PERMIT VALIDATION CK. M.0. CASH
4,.a 74--MAY :4 k i 0 5 u a�
WORKERS'COMPENSATION DECLARATION f C O
CE-806G �`� t�-803 toiai
CAPPLUC MO FOR ELECTRICAL p�ERN
1 hereby,affirm.tliat I have a certificate of consent td'self insure,
ora certificate of
workers''.Compensation Insurance;or,a certified COUNTY,'OF LOS ANGELES ",t, BUILDING AND'SAFETY ..
co thereo�c."3800 Lab.C.)
PY .pr1 ..,
Policy No. G / Company� ��J
❑ :Certified.copy,is hereby furnished New.ResidentiaLBldgs&FPools PPLI
CANT TO FILL IN JOB r V^ w
EACH NO. -FEE-
ADDRESS
Certified copy .is filed with,the county building inspection 1 & 2-Family;Sq.'Ft $ $ � �� G
_. .• NEAREST LOCALITY
-department '` Multi-family %Ft.' CROSS,Si e_
?( �aY Residential Swimming`Pools.` 'OWNER OR
Date' Appl icant
FIRM
a CERTIFICATE OF EXEMPTION'FRO WORKERS', '' ' 4 '` MAIL NA
ME '
Outlets.Rec Light Sw:
COMPENSATION.INSURANCE;rt - ,..; - 's . .`ADDRESS
(This'section need not be.completed'if the work involved by the ., First 20 , r C Tel.No.
pe hundred dollars•($100)or less), t.••_ ; Total No._ Additional' GC16,
CITY
LAN CHECK r t
I certify fhl 'in the pemploy.rmance of erson the,w�nkan r mannerhso permit „ 'APPLICANT'
is, ssued, . y,,P . y' as to
become subject to the,Workers Compensation,Laws ;.m>, Lighting Fixtures First 20-
Additional,,.
' ADDRESS
0.-
,Total,No. Additional ;;'.
Date Applicant +: CITY Tel No
...
- ;Fixed Appliances Not Over 1:HP PERMIT
NOTICE,''TO APPLICANT: If, .after;making:'this Cerfificate of -,
- APPLICANT yQE1h01DE1.Qi1�.S;
Exemption,you snould.become sabject,to the Workers'Compensation .Range_ Heater— D W: _.
provisions of-the L'a, Code, you must forthwith comply.with Such Oven Dryer W:M ADDRESS 2 (�j, Ve'.
FAU..— W.H
6
provisions or•this.permit shall be deemed revoked: - Top /
CITY O."/N Ca Tel No.. 66�2yS
LICENSED CONTRACTORS DECLARATION,';, Hood •- Fan Other=
l:,hereby affirm that I am,.-licensed.under provisions of Chapter 9 Disp. "-:Room Air Cond. Class`
- - LICENSE,OR
(commencing with Section 7000)of Division 3 of the Business and REG NUMBER 3 �r-
Professions Code;and rny-I'' se is;ip'full force and effect: DISTRIC N PR SED
Power Apparatus&targe-Appliances
f���j Size& Type HP,KW'KVA,'or KVAR. 'r Q
License Number ` I✓Q 7 Llc.Class a r k U..-
Up to 1 Incl ` FINAL
_
'Incl DAT
Over T to'10
Contractor Date n
E U VALIDATION,
Over 10 to 50;lncl Y1 �
❑- ,I am exe t under Sec. Over.50 to 100 Inc a
FINAL +
BY
'
- B'.&P.C,for this reason Over 100 �
Services Swbd YMCC,& Panel6oards'-' '�• •Z
Dater 0 200 Amp Under 600 V
a
Signature 201 1000
O Am':Under 6
g
00 V
❑ r
P
ver=1000 Amp:or Over 600 V
Exem tion for Reg. Maint Elect,
7
SINGLE FAMILY ,Temp Power Pole&rAppurtenances,_ ��r r '
HOME OWNER-BUILDER DECLARATION i ense Law Sign with One Branch Circuit, ttt•{i
I hereby affirm that.) am,,exempt from the Contractor's.L c
y:
for the followingreason Section 03 1,5,, aod'Professions Additional Sign Branch Circuits 3307 :'A•, ^ J
( t
++77 {{ryrye�
Code): ' • �
❑ Misc.
Conduits'&Conductors•'; F
a 1,=as owner:of the:property,will do 1heSwork and the structure ,,, ,
: C
Fee Schedule E .�
is not intended or pffered�tor sale (Section 7044;Business ) t i�i t7� �IF .a-a-a�0
Other(See Complete
and Professions Code). .
--
CONSTRUCTION LENDING AGENCY
CHANE
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)
a 0�I
Civ. C.)., c
PLAN CHECKING FEE. _ 0013Q-001- , 4I#6fI
Lender's Name " 77 .
PERMIT ISSUING FEE r- =� J ' 1 1,29 e
Lender's Address
- - I certify that J 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 inspectio purposes.
SEE-REVERSE FOR EXPLANATORY LANGUAGE
nature of Permit e -Date
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0206280025
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
TRz 15683 LT: 23 5202 KAUFFMAN AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803947
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LA ROSA
8589-010-023 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY
G1 OUTLETS-LGT,SW,RECP 8.00 OUT 15.60
TENANT: G2 LIGHTING 'FIXTURES 2.00 LGT 3.90 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
HA FAU LESS 3HP 1.00 FAU 10.95 06/28/02 JK 12/25/02
JB AC UNITS +3-10HP 1.00 AC 19.65
OWNER: TEL. NO: TOTAL FEES 77.85 FINAL DATE FINAL BY: CODE:
YAO JEA-SHENG;KO SHU M
5202 KAUFFMAN AV S
TEMP 917803947 DESCRIPTION OF WORK
ELECTRICAL FOR ADDITION
APPLICANT: TEL. NO:
H.P. WU DESIGN (626) 574-8907-
2215 LENTA LANE SPECIAL CONDITIONS:
ARCADIA -
CONTRACTOR: TEL. N0: APPROVALS DATE INSPECTOR SIGNATURE
GIANTECH INTIL CO. (626) 574-8907-
2215 LENTA LANE LIC. NO / `��', i" '�� A� TEMPORARY POWER POLE
ARCADIA, CA 91006 653650/6 UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER: TEL. N �� i� '� UFER GROUND
LIC. NO", _ �j j� ROUGH CONDUIT
i t ROUGH WIRING
MAIN WATER LINE f
PLASTIC Y/N METAL Y/N
UTILITY COMPANY NOTIFIED
` �\. ) �
REPORT ID: DPR265 ROUTE TO: OS0508