HomeMy Public PortalAbout5222 KAUFFMAN AVE_Electrical__ 76A"3-CES0610-62 APPLICATION FOR ELECTRICAL ERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS Z
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY
NEAREST
-FOR APPLICANT TO FILL IN CROSS ST.
RECEPT. TOTAL NO. EACH FEE
OUTLETS FIRST 20 $.20 $ OWNER L %C
LIGHT f MAIL •�
:�sul / VER ADDRESS_j 2
SWITCH. OVER ZO .10
-
TOTALf}fl- CITY TEL. NO.17
LIGHTING t/ FIRST 20 .20 (/(/
FIXTURES ) ADD'L ELECTRICIAN
`J OVER 20 •10
RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS
GARB.DISP. P"' STA.COOK A - / -
��TT 7`/. CITY TEL. NO.
DISHWASH. f/ .AUTO.-WASH.1 F, STATE -_
SPACE HTRS. STA.APP.(1/2 H.P.MAX.) .50 LICENSE NO. -
MOTORS: OVER NOT OVER H.P. DISTRICT N GR ' Z N R ED
O 1 1.00 n D ' -
1 3 1.50 .yam n INSPECTION RECORD e
3 • B 2.00
8 15 2.50 a V � O
15 50 3.00 `� 99
50 100 5.00 - - W
SIGNS: NO.TRANS. '
NO.LAMPS
SERVICE O-GOOV-Nor OVER 200A 1.00
SERVICE 0-600V-OVER 200,A. 2.00 -
SERVICE OVER 600V 5.00 '
MISC. ,
PERMIT ISSUING FEE 2.00 65
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE $
-I HEREBY ACKNOWLEDGE THAT 1 HAVE READ-THIS APPLICATION - APPROVALS DATE INSPECTOR'S SIGNATURE- '
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ,,,I -
ELECTRICAL•WIRING. WIRING 'py/pOy
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIREDBY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOV
DESCRIBED RESIDENTIAL PR ti POWER '
•SIGNATURE J� UTILITY CO.NOTIFIED -
OF PERMITTEE 1
FINAL
LIDATION ARTHUR C. VETT Y '
C MO CASH SUPERVISING'ELECTRICAL ENGINEER
0 Y5 JUL 1. 2 D 6.4C)N .
76A663-CE806 3-69 y, '
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APPLICATION FOR ELECTRICA PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING n
BUILDING AND SAFETY DIVISION ADDRESS o� ��
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY /,_
FOR APPLICANT TO FILL IN NEAREST
CROSS ST. h
NO. EACH FEE
RECEIPT. / $ $ OWNERj/ /MAIL
LIGHT TOTAL FIRST 20 ,20 n ESS ~�1j '`�/H'1 4.P✓
V CITY ' /L.. / TE L.NO. S� �
SWITCH OVER 20 .10 PLAN CHECK
LIGHTING TOTAL FIRST 20 ,20APPLICANT
FIXTURES } OVER 20 .10 ADDRESS
RANGE_DRYER_WTR. HTR. CITY TEL.NO.
STA. COOK_DISP. _F.A.U. CONTRACTOR
SPACE HTR. AIR COND. ADDRESS
CLOTHES WASH._DISHWASH. CITY TEL.NO.
FAN_OTHER 1.00 / LICENSE NO. CLASS.
MOTORS,TRANSFORMERS RATING If I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
IND, HEATERS, ETC, HP. KW. KVA. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING.
O - 1 1.00 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LIC EN5ED AS REQUIRED BY LOS ANGELES COUNTY AND STATEOF
1 - 10 3.00 CALIFORNIA OR THAT I AM THE LEGAL NER OF AND INTEND TO d
RESIDE IN, THE ABOVE DE RI RES NT L OPERTY. O
10 - 50 5.00 V
SIGNATURE p�
50 - 100 10,00 OF PERMITTEE O
F
100 - -5500 15,00 DIST . GRO ZONE PROCE D U
t//'J nL-
SIGN,GAS SIGN AND ONE CIRCUIT 3.00 N
TUBE, OR Z
MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES:
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00
SERVICE OVER 600 VOLTS OR 200 AMP 5.00 '
TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP. POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
WIRING �- / O
PERMIT FEE (SUB TOTAL) FIXTURES n A,, 2// fTjr�� .�ra
POWER AUTHORIZED
PLAN CHECK FEE (50% PERMIT FEE)
PERMIT ISSUING FEE 2.00 -2- VV UTILITY CO.NOTIFIED e
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL
TOTAL FEE JOSEPH C. ROOHAN
SUPERVISING ELEC ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
' &:'5 4 7 3R JWJ 9 2 Q 3.6 0,2,
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0501040004
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
TR: 15683 LT: 26 5222 KAUFFMAN AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803947
ASSESSOR INFORMATION N MBER: NEAREST CROSS STREET: BLACKLEY
8589-010-026 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY, C
G1 OUTLETS-LGT,SW,RECP 9.00 OUT 17.55
TENANT: G2 LIGHTING FIXTURES 2.00 LGT 3.90 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
TOTAL FEES 49.20 01/04/05 JK 07/03/05
OWNER: TEL. N0: FINAL DATE FINA Y: E:
JU, KIM/ISABEL (626) 285-6212- ��5-
5222 KAUFFMAN AV
TEMP 917803947 DESCRIPTION OF WOR
ELECTRICAL FOR ADDITION.
APPLICANT: TEL. NO:
SAME AS OWNER -
SPECIAL CONDITIONS:
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
ROUGH WIRING
MAIN WATER LINE
PLASTIC Y/N METAL Y/N
UTILITY COMPANY NOTIFIED
REPORT ID: DPR265 ROUTE TO: BS0508