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Home My Public Portal About6127 KAUFFMAN AVE_Electrical__ COUNTY OF LOS ANGELES APPLICATION FOR PERNIIT DEPARTMENT OF COUNTY ENGINEER DIVISION OF BUILDING & SAFETY ELECTRIC WILLIAM . FOR. COUNTY ENGINEER. FOR APPLICANT TO FILL-IN DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRICIAN 1 !r , 7 / — ADDRESS 4937 PERSIMMON RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION ' !'EMPLE CITY, .CALIF, p� -'y CITY /� ) TEL. NO. /''�/ °LL'2 _�� COUNTY LICENSE NO, ��'�/ / EX IRE —3 Ate+➢ 7 BUILDING PERM FEER ADDRESS w F IK 7 NUMBER EACH FEE LOCALITY LIGHT OUTLETS NEAREST RECEPTACLES CROSS T WALL SWITCHES OWNER • /A'.�+L. TOTAL OUTLETS Sc $ liqU MAIL ELEC. RANGES, 25 ADDRESS ELEC. HEATERS 25 FIXTURES. 5 CITY TEL. NO. MISC. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS NUMBER OF'L16HT CIRCUITS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND 'AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS 1 CERTIFY THAT 1 ,POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER NEW MVD. HP' OVER INC. EACH OF THE RESIDENTIAL PROPERTY_DESCRIBED ABOVE. SIGNATURE OF , 1/2 2 .50 PERMITTE I 2. s 1.00 INSPECTION RECORD 5 •15 1.50 15 50 2.50 50 200 5.00 ' 200 500 10.00 J 500 1000 15.00 Q ` Z OVER 1000 20.00 M.G. SET/FREQ. CHANGER-HP - - - WELDERS:•AC-KVA - - GENERATORS - KW - - TRANSFORMERS-KVA TEMP. MOTORS (75% OF ORIG.) MOVED MOTORS•(75% OF ORIG.) MISC. - " - SIGNS NO. NO. TRANS. - APPROVALS - NO. NO. LAM FOR EACH PERMIT:, - DATE INSPECTOR'S NAME WIRING $1.00 CONDUIT C FIXTURES, ' $1.00 0 WIRING yvd' SUPPLEMENTARY .50 - FIXTURES 'POWER 2 �7- TOTAL FEE $ UTILITY CO. NOTIFIED INA 76A 663 DBS# B.A. 4-E2 _ COUNTY OF LOS ANGELES - APPLICATION FOR PERMIT DEPARTMENT OF COUNTY ENGINEER ELECT-Ric 1 DIVISION OF BUILDING & SAFETY 'WILLIAM 1. FOX, COUNTY ENGINEER FOR APPLICANT TO FILL IN DISTRICTNO. GROUP ZONE CPERMIT NO. ELECTRICIAN CHARLES W. HADEN ADDRESS 4937 PERSIMMON RECEIVED B READY FOR DATE ISSUED FIRST INSPECTION [ _ CITY TEL'. NO. D '9111 1 � COUNTY LICENSE NO. �` EXPIRES —3D:1 BUILDING ,e PERMFEES ADDRESS I4, NUMBER EACH FEE V' LOCALITY LIGHT OUTLETS � NEAREST �/ /��t� RECEPTACLES OSS WALL SWITCHES OWNER ' TOTAL OUTLETS Sc $ MAIL ELEC. RANGES 28 ADDRESS ELEC., HEATERS 25 FIXTURES 5 CITY - TEL. NO. MISC. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS NUMBER OF LIGHT CIRCUITS APPLICATION AND STATE THAT THE.ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLECIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER NEW MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. 1/2 9 LESS $ .25 - SIGNATURE OF 1/2 2 .50 PERMITTE 2 s 1. 0 5 is 1.5so INSPECTION RECORD Is 50 2.50 50 200 5.00 • 200 500 10.00 500 1000 15.00 1 }�`, Z OVER 1000 20.00 �T�v U G y M.G. SET/FRED. CHANGER-HP &'lc7'C/® � WELDERS: AC-KVA O GENERATORS •KW TRANSFORMERS-KVA , TEMP. MOTORS (75% OF OR1 .) - MOVED M TORS (75%PF ORI .) MISC. SIGNS NO.. NO. TRANS. - NO. NO. LAM APPROVALS FOR EACH PERMIT: - DATE INSPECTOR'S NAME WIRING - - $1.00Q 0 CONDUIT . / ,�,lj FIXTURES $1.00 WIRING _ SUPPLEMENTARY •50 FIXTURES - POWER TOTAL FEE $ I �6 UTILITY CO. NOTIFIED t .NAL 76A 663 OBB11 ZA. a-ez �. `rWQRKERS'COMPENSATION DECLARATION 76A663 10/81 APPLICATI®N FOR ELECTRICAL PERMIT i 14,,ereby affirm that I have a certificate of consent to self insure, CE-806G or a certificate of Workers' Compensation Insuran e, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy theApof(Sec. 38 0 b C.) Policy NO. Company FOR APPLICANT TO FILL IN ,JOB P ADDRESS• (P tified o y is hereby.furnished. New Residential Bldgs.& Pools EACH NO. FEE ❑ 1 & 2-Family, Sq.Ft. $ — $ LOCALITY 77 C Certified copy is filed' with the unty buildin 'nspection — NEAREST. / depart m t. Multi-family Sq. Ft. LCl JI-- 'T / CROSS ST. Date '� � Applicant //� Residential Swimming Pools` t: ti OWNER OR AJ -FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL, COMPENSATION INSURANCE Outlets:Rec Light Sw; — ADDRESS First 20. v (This section need not be completed if the work involved by theTotal NoAdditional ;CITY,• _ Tel.No. . permit is for one hundred dollars ($100)or less.) PLAN CHECK 1 certify that in the performance of the work for which this permit APPLICANT is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS Additional Total No.C2 CITY Tel.No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT /, , NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT VA/ Exemption,you should become subject to the Workers'Compensation Range_ Heater_ D.W. _ provisions of the Labor Code,you must forthwith comply with such Oven _ Dryer W.M._ ADDRESS `3 )-� provisions or this permit shall be deemed revoked. Top — FAU W.H. _ CITY LICENSED CONTRACTORS DECLARATION Hood — Fan Other_ �~ I hereby,affirm that I am licensed under provisions of.Chapter 9 LICENSE OR (commencing with Section 7000) of Division 3 of the Business and Disp. — Room Air Cond. Class REG.NUMBER Professions Code,and my license is in full force and effect. Power Apparatus& Large Appliances DISTRICT NO. P OCE D BY Size & Type HP,KW,KVA,or KVAR !G/ tk License Number J Lic.Classes Up to 1 Incl O FINAL Over 1 to 10 Incl DATE �/� Contractor �" Date FINAL I� VALIDATIONx ❑ Over 10 to 50 Incl. I am under Sec.exempt Over 50 to 100 Inc. BY h B.&P.C.for this reason Over 100 Services,Swbd.,MCC & Panelboards / Poo. f'' Date: 0- 200 Amp.Under 600 V Signature 201 - 1000 Amp.Under 600 V Over 1000 Amp. or Over 600 V Exemption for Reg.Maiht.Elect. 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 Law for the following reason(Section 7031.5,Business and Professions Additional Sign Branch Circuits Code): ❑ I,as owner of the property,will do the work and the structure Misc,'Conduits•& Conductors is not intended or offered for sale (Section 7044, Business Other (See Complete Fee Schedule) U� and Professions Code). CONSTRUCTION LENDING AGENCY 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) Civ.c.). - PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE • D ��,�_ Me ' Lender's Address I certify that I have read this application and state that the above TOTAL FEE information is correct. I agree to comply with all County ordinances and States regulating Electrical wiring, and hereby authorize rep resenti tfves of this to enter upon the above-mentioned ;nature e for ns cti .rose SEE REVERSE FOR EXPLANATORY LANGUAGE ' 3/l3 of Permi e Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0405270003 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ILDING ADDRESS:' ON FILE 6127 KAUFFMAN AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP; CA 917801744 AS UM INFORMATION BEL- NEAREST-CRM"STR_EE_T: GARIBALDI 5385-017-008 Al PERMIT ISSUANCE FEE 27.75 -THOMAS FAGc: 597 - GRID:'A2 LOCM PTY,: TEMPLE CITY; C G2 LIGHTING FIXTURES" 2.00 LGT 3.90 TENANT:- TOTAL FEES 31.65 ISSUED ON: PR5CESSED BY: EXPIRES ON: 05/27/04 V3 11/23/04 OWNER: TEL. NO: FINAL DATE FINAL BY: CODE: GE SHUNDI;XI JIEYUN (626) 285-7138 s r y� t, y:::I, `: 6127 KAUFFMAN AV TEMP 917801744 RK _ R 2 APPLICANT: TEL. NO: FABER (909) 949-4397- _ SPECIAL CON I1IUN5: CONTRACTOR: TEL. NO - � � , APPROVALS DATE INSPECTOR SIGNATURE FABER, JOHN WM. (909) 949-4397- -� ROOFING PLUS LIC. NO tTEMPORARY PO E POLE 20 N. CENTRAL AVE_ 70820-BHIC _ UPLAND, CA UNDERGROUND CONDUIT ARCHITECT OR ENGINFER: L. NO: I UFER GRO CNND _4-- — --" LIC. NO: ROUGH TOT,D—til T ROUGH ',i ,TING MAIN WATER LINE PLASTIC Y/N METAL Y/N UTILITYPIaFl NOTIFIED REPORT ID: DPR265 ROUTE TO: BS0508