HomeMy Public PortalAbout10146 LA ROSA DR_Electrical__ 76A653-CE806 5-62 APPLICATION FOR. ELECTRICAL PER7IAIT
COUNTY OF, LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER rLOCALI
BUILD_ ING AND SAFETY DIVISION ..REss 10 46 - 6 JOHN A. LAMBIE,.COUNTY ENGINEER
WILLIAM A. JENSEN,SUPT OF'BUILDING TY �-
FOR APPLICANT TO FILL IN CROSS 6T. Glickman
REC EPT.21.� TOTAL NO, EACH FEE
OUTLETS FIRST 20nAll
LIGHT 12MAIL
120 S 20 $ 00 OWNER'
Ll6rvi 1Z• ADD!L- o r� ADDRESS. 101 B
SWITCH. 19 ' OVER 20 29 -10 2 90
LIGHTING TOTAL FIRST 20 12 .2C1 2 CITY Temple Olt TEL. No.. -
FIXT.URES 12 ADD'L f0 ELECTRICIAN - e Electric
OVER 20 ��/� �1
RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS 40 S. Valley Blvd.
GARB.DISP. 1 STA.COOK p
CITY Rosemead TEL. NO: A' t 8 4191
-DI6MWA6H,- AUTO.-WASH. rD
\ p '
SPACE HTRS. STA.APP.(Ih..FLAX. 2 .50 188 1
MOTORS: ovEx NOT OVER H.P. OUP ZOdd_NI PRMD BY
0 f 1.005 1.50SPECTION RECORD
sz.00 .r (,Is 50 3.00 O50 100 5.00
SIGNS: NO,TRANS ONO„LAMPS LU
D_SERVICE 0.6000-NOT OVER 200A 1.00 Z
SERVICE.'-600V-OVER 200 X. 2.00
SERVICE OVER 600V 5.00
MISC.
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE- $ 13 t3U
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION [".ON
APPROVALS' DATE INSPECTOR'S SIGNATURE
ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLYDUIT' 7 �•{� 'J
WITH ALL'-COUNTY ORDINANCES AND STATE LAWS REGULATING ,w
ELECTRICAL WIRING. ING Vy
' I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/Oa
LICENSE' AS 'LlU1REO. LOS ANGELES COUNTY AND STATE OFURES Q
CALIFORNIA OR THAT M TH£ }ECAL OWN R OF THE ABOVE 1 T
DESCRIBED RESIDENT PROPERTY. ER 11
SIGNATURE ITY CO.NOTIFIED
OF PERMIT1
L IV• '9 y
ALIDATION AR uk C. VETT
CK MO CASHSUPERVISING ELECTRICAL ENGINEER
L,iuCi 2 U to. `CIL 31 2 D 1 3.3 0;,-
_`
7BA683,fEBOd 3-09 J�// O /_ /^ _///���
APPLICATION FOR ELECTRICAL ERMITr
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCA TY
FOR APPLICANT TO FILL IN NEAR E$T
CROS$ ST:
NO. EACH IF
S S OWNER
RECEIPT. MAIL
ADDRESS G J
LIGHT TOTAL FIRST 20 .20
SWITCH_ OVER 20 .10 CITY TEL.N
PLAN HECK
LIGHTING TOTAL FIRST 20 ,20 APPLICANT
FI%TURES OVER 20 ,10 ADDRESS '
RANGE DRYER WTR. HTR. CITY TEL.NO.
STA. COOK_DISP. _F.A.U. CONTRACTOR ( l
SPACE HTR. AIR GOND. AOpR ESS��
CLOTHES WASH. DISHWASH. ITV EL.NO.
FAN OTHER 1.00 LICENSE NO CLASS.
MOTORS,TRANSFORMERS RATING 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.
D - 11'0
IL 0 I HEREBY CERTIFY THAT PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATEOF
I - 10 3.00 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN, THE ABOVE DESCRIBED RESI ENTIAL PROPERTY. O
10 - 50 5.00 U
SIGNATURE
50 — 100 10DO H OF PERMITTE Ed O
100 - 500 15.00 DISTRICT NO. GROUP ZONE PRO E SED Y
V
W
S IGN,GAS SIGN AND ONE CIRCUIT 3.00 L37 D N
TUBE, OR Z
MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES:
0 L-*V-M 200 AMP 2.00 �A sT� �l/
SERVICE OVER 600 OLTS OR 200 AMP 5.00 WmlhI
TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE InsaeaTOR•s
TEMP. POWER POLE
UNDERSLAS WORK
ROUGH CONDUIT
WIRING
PERMIT FEE (SUB TOTAL) FIXTURES
POWER AUTHORIZED
PLAN CHECK FEE (50% PERMIT FEE) /
PERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED
SUPPLEMENTARY PER ISSUING FEE 1.00 FINAL
117 1
TOTAL FEE JOSEPH C. ROOHAN
SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CN. M.O. CASH PERMIT VALIDATION � M.o. CASH
?; O 8 8>` 'JDIi'111 -?-$ 9.0(0—
I SEE BAC✓, OF APPI,ICATION FOP COMPLETE FEE PCHFNHLF � 11i�F. LJ 8 1 9N JUN 1 2 D 7•"ON Q 1l'M
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1005270041
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL I➢. FEES PAID BUILDING ADDRESS:
ITS: 10821 LT: 5 BL: C . . 10146 LA ROSA DR
IFEE DESCRIPTION: QUANTITY: CON: AMOUNT: 1 TEMP CA 917803303
(ASSESSOR INFORMATION NUMBER: 1 NEAREST CROSS STREET: BALDWIN 1
18585-013-049 - 1A1 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY, Cl
IG1 OUTLETS-LGT,SW,RECP 19.00 OUT 37.05
(TENANT: IG2 LIGHTING FIXTURES 20.00 LGT 39.00 JISSUED ON: PROCESSED BY: PLAN BY-
1 112 RES GREG DISK LT 3HP 1.00 ITS 10.95 105/27/10 SR
IH3 RES DISHWASHRLT' 3HP 1200 DIS 10.95 1
IOWNER: TEL. NO: TOTAL FEES 125.70 (FINAL DATE FINAL BY: CODE: ' 1
KHAN, CHRISTIAN (626) 780-6650-
110146 LA ROSA DR.
TEMP 917801635 IDES CR IPTION OF WORK
ELECTRICAL FOR KITCHEN AND BATHROOMS REMODEL
(APPLICANT: TEL. N0:
SAME AS OWNER _ -
SPECIAL CONDITIONS:
I
I
(CONTRACTOR: TEL. N0:
SANE AS OWNER 1APPROVALS DATE INSPECTOR SIGNATURE
NO
LIC.
I (TEMPORARY POWER POLE I I I
UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER: TEL. NO: UFER GROUND
I I
LIC. NO: TROUGH CONDUIT
_ ROUGH WIRING
1 MAIN WATER LINE I I
PLASTIC Y/N METAL Y/N
1UTILITY COMPANY NOTIFIEDI
1 I I I
I
I 1
EXPIRED
I I I I
I 1 I I I I
I I I
(REPORT ID: DPR265 ROUTE TO: BS0508
I I I