HomeMy Public PortalAbout6043 KAUFFMAN AVE_Electrical__ 76A883C- CE8088 12/75 APPLICATION FOR ELECTRICAL PERMIT .
BUILDI G AND SAFETY DIV N
FOR APPLICANT TO FILL IN JOB ``�
rResidential
Bldgs.& Pools
EACH NO. FEE ADDRESS QTY r _
Sq. Ft. $ — $ LOCALITY
NEAREST
q. Ft. CROSS ST.
wimming Pools f) OWNER OR
t FIRna nln C J -
Outlets: Light, Switch-& Receptacle MAI L
ADDRESSC_ :C
First 20 _ ^
Additional h CITY jFe
4 = i Tel No
F PLAN CHECK
Lighting Fixtures APPLICANT •
First 20 'ADDRESS
Additional I''
CITY Tel No "
PERMIT
Fixed Appliances Not Over 1 HP APPLICANT
Range Heater_ D.W.
ADDRESS
Oven Dryer W.M.
Top - FAU W.H. CITY Tel. No.
Hood _ Fan LICENSE OR d
REG. NUMBER 3 Class.
Disp., A.C.
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
r' AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY O
Power Apparatus& Large Appliances I. WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING.
Size&Type HP, KW, KVA,or KVAR W
Up to 1 Incl. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR N
Z•
Over 1 to 10 Incl. LICENSED AS-REQUIRED BY LOS ANGELES COUNTY SAND STATE OF
• CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
Over 10 to 50 Incl. 4 DESCRIBED RESIDENTIAL PROPERTY.
Over 50 to 100 InCI. PERMITEE T
Over 100 t SIGNATURE !7jq- .
Services
DISTRICT NO. PR�5jED BY
{ 0 '
0-200 Amp Under 600 V U G M
201 - 1000 Amp. Under 600 V APPROVALS DATE INSP CTOR'S
Over 1000 Amp.or Over 600 V SIGNATURE_
TEMP. POWER POLE
Temp. Power Pole&Appurtenances UNDERSLAB WORK
Sign with One Branch Circuit
Additional Sign Branch Circuits ROUGH CONDUIT
vWIRING 3
(Other) '
It
FIXTURES
r POWER AUTHORIZED
PERMIT FEE (Sub-Total) t UTILITY CO.NOTI•F IED
PLAN CHECKING FEE (One-Fourth Permit Fee) FINAL
PERMIT ISSUING FEE �F Ire
-
NOTES'
FEE NOTES••'
PLAN CHECK VALIDATION CK. M.0. CASH !{ PERMIT VALIDATION CK M.O. CASH
. 7
' ® �.Q 0 ®N3
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0812040025
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID. FEES PAID BUILDING-ADDRESS-
ITR: 6561 LT: 113 1 6043 KAUFFMAN AV I
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 TEMP CA 917801742 \ I
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: - I
15385-018-005 IA1 PERMIT ISSUANCE FEE 27 75 1 THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY, Cl
I ILB 200 AMP PANELS, MCC 1.00 PAN 38.85 1
(TENANT: I TOTAL FEES 66.60 11SSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON•
I I 112/04/08 SR 06/02/09 I
1OWNER: TEL. NO: IFINAL DATE FIN BY: CODE: I
IHOLCOMB, DORIS (626) 287-1768- I ��
16043 KAUFFMAN AV I � � �
ITEMP 917801742 DESCRIPT ON OF WORK
REPLACE DAMAGED SERVICE PANEL 200 AMP UPGRADE NO NEW
I I ICIRCUITS
(APPLICANT: TEL. NO: 1 I
ITALBOTT ELECTRIC (626) 718-1105- I I
11887 E. WASHINGTON ISPECIAL CONDITIONS: 1
(PASADENA, CA 91104
ICONTRACTOR: TEL. NO: - _ _1' _ (APPROVALS DATE INSPECTOR SIGNATURE I
ITALBOTT ELECTRIC (626) 798-1105- 1
11887 E. WASHINGTON BLVD LIC. NO ITEMPORARY POWER POLE I I I
1PASADENA, CA 91104 196541010 * I I I I
I (UNDERGROUND CONDUIT I I I
F
(ARCHITECT OR ENGINEER: TEL. NO: 1 IUFER GROUND I I
I LIC. NO: IROUGH CONDUI I 1 I
1 I ROUGH WIRING
1 I IMAIN WATER LINE I I
PLASTIC Y/N METAL Y/N II
1 I UTILITY COMPANY NOTIFIED( I
I I I I I I
I I I I I I
I I I I I I
I I I I I I
I 1* ADDITIONAL DATA ON FILE 1 I
I . \ IREPORT ID: DPR265 ROUTE TO: BS0508 I 1