HomeMy Public PortalAbout9243 LA ROSA DR_Electrical__ 7GAa63'd933'A 1,-_5M APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT No. GROUP ZONE PERMIT NO.
ELECTRICIAN R. F. Walton
REDY FOR
ADDRESS 5134 N. Acacia St. RECEIVED BY FIRST INSPECTION DATE ISSUED
CITY San Gab, TEL. NG.AT 68583 1AA _ I t—;--3��
COUNTY LICENSE NO. 1104 EXPIRES BUILDIADDRENG
9243 La Rosa Dr.
PERMIT FEES
-,NUMBER EACH FEE LOCALITY Temple Cit
LIGHT OUTLETS NEAREST
CR0S8 9T. "
RECEPTACLES
WALL SWITCHES OWNER B. E. Turner
TOTAL OUTLETS 5c $
MAIL
ELEC. RANGES 25 ADDRESS
ELEC. HEATERS 25 CITY TEL. NO.
FIXTURES 5 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
MISC. APPLICATION AND STATE THAT THE ABOVE I8 CORRECT
NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING.
MOTORS I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
NUMBER HORSEPOWERFEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
NEW Mvo. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
r
if I/2 & LESS $ .25 BIGPERMIRTTE�
/2 2 .50 9 fiXaa
2 5 1.00 INSPECTION RECORD
5 15 1.50
is 50 2.50
50 200 5.00
200 BOO 10.00 J
Boo 1000 15.00 Z
OVER 1000 20.00 V.
M.G. SET/FREQ. CHANGER-HPQ'
WELDERS: AC-KVA
- O
GENERATORS - KW
TRANSFORMERS - KVA
TEMP. MOTORS (75% or ORES.)
MOVED MOTORS (75% Or oRIG.)
MISC.
SIGNS
NO. NO.TRANS.
APPROVALS
NO. NO. LAMPS
FOR EACH PERMIT: DATE INSPECTOR'S NAME
WIRING $1.00 z' CONDUIT /
FIXTURES $1.00 r./ •WIRING / d .E_....i / y �2__
SUPPLEMENTARY ,5D FIXTURES
y/� POWER
TOTAL FEE 4 ;7c-§-
UTILITY CO. NOTIFIED A
FINAL
6� ,
WORKERS'COMPEVSATION DECLARATION 78-,863 10/81
CE-'806G .APPLICATION FOR ELECTRI ,AL PERMIT
I hereby affirm that I have a certficate of consent to self-insure, ,
or.a.dertificate of,Workers',C6mpensation Insurance, or a certified COUNTY OF L•OS'ANGELES BUILDING AND SAFETY
copy'thereof(Sec 3800,Lab.C), ,
Policy No -Company, FOR APPLICANT TO FILL IN- - 'JOB '
❑ C died copy is hereby"furn'ished 'New Residential Bldgs & Pools EACH '. NO. FEE ADDRESS
$ $ LOCALITY
copy, building ilid with,the county bwlding inspection 1 & 2-Family;Sq Ft.
department ' Multi-family Sq Ft — NEAREST
CROSS ST '
Date Applicant Residential Swimming Pools OWNER OR
FIRM NAME G
CERTIFICATE OF EXEMPTION,FROM WORKERS' " Outlets RecJ� Light' Sw L< MAIL .-
COMPENSATION INSURANCE; y i 111 ADDRESS.
COMPENSATION
section need,not be completed If the work involved by,the First 20 CITY Tel•No'
permit is for one'hundred dollars ($100)or`less.) Total Nd 2 .Additional 7
PLAN CHECK t _
(,certifythahln the performance of,the work,f.r which this.permit APPLCANT
is,issued, I'shall not employ,any person in.an manner so;as to ,
'becdme subject to the'Workers,Com_pensatio aws Lighting Fixtures_' First 20' ADDRESS- ;
(C/� Additional
Total No CITY, TeI.,No
`Date ~' • '••,'Applicant "` Fixed Appliances Not Over. HP PERMIT //::
NOTICE 'TO APPLICANT: ,If,.^•af er- making this Certificate 'of APPLICANT /S.[4.5 vVit, lP
Exemption,you should become subject to the Workers,Comp ensatlon - _Range_ Heater_ DW
;provisions of,the Labor Code, you must forthwith comply.with such' Oven _.Dryer — .W M ADDRESS u ��p{���j� '
provisioris or this permit shall;be deemed revoked. .Top. FAU _.W H. - CITY Tel.No
LICENSED,CONTRACTQRS DECLARATION -Hood Fan Other_ egg
I,hereby affirm that I;am licensed under provisions of 6apfer 9 LICENSE OR
(commencing with Section 7000) of Division 3 ofAhe-Business and aDisp Room:Air"Cond 6 Class -'
t REG NUMBER
Professions Code,and m'license is in full force'and effect. •power'Apparatus& Large Appliances DISTRICT NO PROCESSED B
ryry//'� /� / Size& Type HP,KW,KVA,or KVAR Q
' License Number _7(O D0L Lis Class Up to 1 Incl FINAL " V
Over 1 to 10 Incl DATE /� VAL TION' Q
Contractor�a — Date ��-9�77 Over 10 to 50 Incl �' - V
FINA '
❑ I am exempt under Sec. Over 50 to 100 Inc BY 8 2 5,7 A OW,.
B.&P.C. for this reason Over 100 �
Services,S'wbd,.MCC& Panelboards', " - r # o;o o`o 0 2.'-
Date
Z
Date oe
0-200 Amp.Under 600 V' {+'
Signatures 201 - 1000 Amp Under,6100 V - 5.1..0.0
Over 1000 Am or Over 600 V
ElExemption for Reg Maint'•Elect. p - F. AC) o,o 5,14,1-c=i
SINGLE FAMILY. Temp.Power Pole,,8,Appurtenances _ LJ :1:Q 2 B 8 7
HOME OWNER-BUILDER DECLARATION - Sign With,One Branch Circuit -
I hereby affirm that.) am exempt from the Contractor's•License:Law
Additional Sign Branch Circuits•
for the following reason(Section 7031.5, Business and Professions
Code): r
Misc.Conduits & Conductors
❑ I,as,owner.of the property,'will do'th'e'work and tFie structure is,not intended or,offered for sale (Section 7044, Business Other(See Complete Fee Schedule) ,
and Professions Code)
CONSTRUCTION LENDING'AGENCY
i
I hereby affirm*that-there•is a construction lending.agency;for the ;
performance of the work for which this,permd is issued(Sec 3097, PERMIT FEE (Sub-Total)
Civ C) r
PLAN CHECKING FEE
Lender's Name'
PERMIT ISSUING FEE
Lender's Address' y +
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 ll
and State laws regulating Electrical wiring, and,hereby authonze r
representatives of this County to'enter''upon the above-mentioned
property for ins esti purl) es.
SEE REVERSE FOR EXPLANATORY.LANGUAGE p, _
dna re
P mit e Date " '
• WORKERS' COMPENSATION DECLARATION CE8� 1D�B1 APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm Thdt I have a certificate of consent to self
insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY
a //o4( ified copy the eof (Sec. 3800, Lab. C.)�6�L ( /
K� It ����0` /1r,W iff�( FOR APPLICANT TO FILL IN JOB �j ��� `
oCompan `� ,/
❑ Certified co is hereb furnished. EACH NO. FEE ADDRESS
PY Y New Residential Bldgs. & Pools l
1 & 2-Family, S Ft. $ — $ LOCALITY 7
Certified copy is filed with the county building inspec- Y q
tion department Multi-family Sq. Ft. NEAREST
CROSS ST.
%r17 Residential Swimming Pools OWNER OR
Date LO Applicant FIRM NAME
CERTIFICATE OF EXEMPTION FROM WORKERS" ' Outlets- Rec I Light / Sw_ MAIL
COMPENSATION INSURANCE , % ADDRESS
(This section need not be completed if the work-Involved by First 20
Total No. Additional CITY Tel. No. ?``
the permit Is for one hundred dollars ($100)or less.) PLAN CHECK
I certify that in the performance of the work for which this APPLICANT
permit 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
Total No. Additional CITY Tel. No.
Date Applicant Fixed Appliances Not Over 1 HIPPERMIT
NOTICE TO APPLICANT- If, after making this Certificate of APPLICANT ,dNN'012
Exemption, you should become subject to the Workers' Range_ Heater�D.W `
Compensation provisions of the Labor Code, you must forth- Oven Dryer _ W M.— ADDRESS
with comply with such provisions or this 'permit shall be Top FAU._ —W H. CITY //''..,7/y1"
deemed revoked. HoodIf—cTel. No.Xy(_
Fan —Other_
LICENSED CONTRACTORS DECLARATION LICENSE O
I hereby affirm that I am licensed under provisions of Chapter 9 Disp. _ Room Air Cond REG. NUMBER 10 � r,Clasc ,)-
(commencing with Section 7000) of Division 3 of the Business DISTRICT NO PROCE BY
and Professions Code,and my license is in full force and effect Power Apparatus& Large Appliances
Size& Type HP, KW, KVA, or KVAR, . O
7 a — C FINAL /�j V
License Number f Lic Class Up to 1 Incl DATE ✓�/y QL
�0��0 7 Over 1 to 10 Incl J VAL ATION O
Contractor l X! Date Over 10 to 50 Incl U
❑ B V
I am exempt under Sec. Over 50 to 100 Inc. B W
CL
B&P.C. for this reason Over 100 N
Z
Services, Swbd., MCC& Panelboards
Date - 0 -200 Amp. Under 600 V
Signature 201 - 1000 Amp Under 600 V ;0268A
Over 1000 Amp or Over 600 V
❑ Exemption for Reg. Maint Elect. #,o o'o o 0 2
SINGLE FAMILY Temp. Power Pole & Appurtenances
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ( '°'° 1625
j hereby affirm'that I am exempt from the Contractor's License Additional Sign Branch Circuits _
Law for the following reason (Section 7031 5, Business and g o 0 0 1 6,2 cj t
Professions Code):
❑ j, as owner of the property, will do the work and the Mi sc Conduits&Conductors 0 6 1 7'a 8 7 `
structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ ,
7044, Business 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 PERMIT FEE (Sub-Total) 5-73
--
(Sec. 3097, Civ. C )
PLAN CHECKING FEE 1
Lender's Name
PERMIT ISSUING FEE v S
Lender's Address /
I certify that I have read this'application and state that the IIJOTAL FEE vr� 1 r
above information is correct. I agree to comply with all County
ordinances and State laws regulating Electrical wiring, and
hereby authorize represents sof this County to enter upon
the ove-mentioned erty or inspection purposes
z , 0-� .
SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Permittee Date Y
}
WORKERS'COMPENSATION DECLARATION CE-806G- 10/81
CAPPLICATION FOR ELECTRICAL PERMIT
I hereby a6fi.m that'I have.a certificate of-consent to self insure, So6
or a certificate of-Wbrkers' Compensatidn'lnsurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY
copy thereof (Sec. 3800,Lab C.)
Policy-No Company. FOR APPLICANT TO FILL IN JOBADDRESS ,
+❑ Certified copy is hereby,furnished EACH NO FEE
New Residential Bldgs & Pools
Certified copy is filed with the county budding inspection 1 & 2-Family,Sq Ft $ $ LOCALITY
— G o
department. Multi-family Sq Ft — NEAREST
CROSS ST
-�
Date Residential Swimming Pools OWNER ORr
Applicant FIRM NAME
Outlets Rec Light — Sw
ERTIFICATE OF EXEMPTION FROM WORKERS'% MAIL
COMPENSATION INSURANCE _ ADDRESS !L
(This-section need-not be completed if the work Involved b the First 20
permit is for one hundred dollars($100)or less.)
y Total No Additional CITY Tel.No
I certifythat in the performance of the work.for•which this permit PLAN CHECK
P P 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 CITY Tel.No
Dat ) �"•� Applicant s Fixed Appliances Not Over 1 HPPERMIT
6
NO 1 E TO APPLICANT If, after making this Certificate of
Exe ption,you should become subject to the Workers'Compensation Range_ Heater_ DW APPLICANT
provisions,of the Labor Code, you must forthwith comply with such Oven _ Dryer _ W M _ ADDRESS 150
provisions or this permit shall be deemed revoked Top — FAU _ W H _
CITY Tel No
LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other—
I.—her affirm that I am licensed under provisions of Chapter 9 Disp — Room Air Cond LICENSE OR Clas �
(commencing wdh'Section 7000) of Division 3 of the Business and REG NUMBER +jG�G J <<�
Professions Code,and my license is in full force and effect Power A DISTRICT NO P SSED Y
Apparatus& Large Appliances ^ t a
Size& Type HP,KW,KVA,or KVAR U 0
License Number ^2 4 17 _ Lic.Class/7 Up to 1 Incl. FINAL V
1-d•�� Over 1 to 10 Incl / — DATE �. �� VALIDATION 0
Contract'o �'iv Date U Over 10 to 50 Incl I—
❑ 1 4i FINAL V
I am exempt under Sec 7 Over 50 to 100 Inc BY 1Over 100 W
B&PC for this reason i/ N
Services,Swbd,MCC'&'Panelboards
Date J 0- 200 Amp Under 600 V
Signature r 201 - 1000 Amp Under 600 V
Over 1000 Amp or Over 600 V
❑ Exemption for Reg Maint.Elect
SINGLE FAMILY ;y Temp.Power Pole& Appurtenances
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit '
I hereby affirm that I am exempt from tie.Contractor's License Law Additional Sign Branch Circuits
for the following reason (Section 7031(5, Business and Professions
Code): r =
❑' Misc.Conduits& Conductors
I,as owner of the property,,will do the work and the structure
is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) , 7 3 Q,1 A
and Professions Code) # 0'0'0 0_0 2
CONSTRUCTION LENDING AGENCY
I hereby affirm that'Ahere is a construction lending agency for the ; -- 3 250
performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total)
Civ C) o 32505
.PLAN CHECKING FEE 0 6 2 2 m 8 7
Lender's Name
-` PERMIT ISSUING FEE v
Lender,'s Aadres;
I cer,t'�chat I have read this application and state that the above TOTAL FEE
infor" tion 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 inspection purposes.
� SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature df Permittee U .Date
(
WO _�SCOMPENSATION DECLARATION ` 20-0019DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT
76A663
I hereby affirm t shave a certlflcate of consent to self Insure, -
or a certificate o ker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES. DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV.
copy thereof(Sec Lab C)•
�?h'1'Fr �iinl�
P❑OI Cy NO.' tn�s,r party FOR APPLICANT TO FILL IN AD �` t�d
ADDRESS
Certified copy Is hereby furnished. New Residential Bldgs &Pools NO EACH FEE
$ $ LOCALITY U6
Certified co is filed with the,count building inspection 1&2-Family,Sq.Ft.
PY Y 9 P — NEAREST n
department, Multi-family Sq.Ft. CROSS ST c4 UL
Date Applicant (i I'C4WA& -T�Sx L Residential Swimming Pools -
ASSESSOR
PAGE PARCEL
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec. Li �Sw OWNER OR
Light
COMPENSATION INSURANCE' l g FIRM NAME ST�C—v�- ►til SLS
(Thls section,need not be completed if the work involved by the ADDRESS
/'_ First 20 MAIL
permit is for one hundred dollars($100)or less.) Total No C� Additional
I certify that In We performance of the work for which this permit CITY Tel.N.�OJ�irJ��
Is Issued, I shall not employ any person In any manner so as to PLAN CHECK
become subject to the Workers' Compensation Laws Lighting Fixtures First 20 APPLICANT
Total No Additional
DDRESS
Date Applicant
NOTICE TO APPLICANT. If, after making this Certificate of RESIDENTIAL APPLIANCES NOT OVER 3 HP CITY Tel No
Exemption,you should,become subject to the Workers'Compensation ^THER APPLIANCES NOT OVER 3 HP
provisions of the Labor Code, you must forthwith complywith such PERMIT �r
P Power Apparatus&Large Appliances APPLICANT 17,k)C_or this permit shall be deemed revoked' '
LICENSED CONTRACTORS DECLARATION Size,&Type HP,KW,KVA,or KVAR ADDRESS
I hereby aff�irm'thae'l'am licensed under provisions of Chapter Over 3 to 10 Incl. G
(commencing with Section 7000) of Division.3 of the Business a CITY P Tel.No ��O
Professions Code, and my license is in full force and effect. Over 10 to 50 Incl.
LICENSE B 5aVC1 Class. a
C,� G1, Over 50 t0 100 Incl. REG NUMBER J
License Number Do S L Llc.Class Over 100 DISTRICT NO. fi P OCESSED BY O
Services,Swbd.,MCC&Panelboards
I �� 1 Cr b�t'`'L L 0-399 Amp. Under 600 V FINAL 0
a DATE
Contract
❑ - 400-1000 Amp Under 600 V 7 ��
I am exempt under Sec VALIDATION V
Over 1000 Amp or Over 600 V FINA - a
B.&P C for-this reason BRANCH CIRCUIT FEES By45
(1)•
Date: 15A,or 20A, 120V,Lighting or Recept. Z_
1 To 10 Branch Circu Its
Signature 11 To 40 Branch Circuits
ED _ 41 Or More Branch Circuits
Exemption for Reg.Maint Elect. 15A,20A,206V To 277V Lighting Br Circuits y
SINGLE FAMILY Temp Power Pole&Appurtenances ,-r. g
HOME OWNER-BUILDER DECLARATION n..1--T.-a'
Sign with One Branch Circuit n
I hereby affirm that I am exempt from the Contractor's License Law Sig �,irJ= c�o is
for the following reason (Section 7031 5, Business and Professions Additional Sign Branch Circuits 'J 11
Code) 1 (� ;�
❑ I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors TOTAL- •._MS
snot intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) '�e ® �" f
and Professions Code) CHECK 51.15
CONSTRUCTION LENDING AGENCY CHANGE o(-Ijj
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)
• A ' I� PLAN CHECKING FEE 01300-000 �1f-."�7'
Lender's Name / / n� c
PERMIT ISSUING FEE (� s:. t 1 AM°31
Lender's Address TOTAL FEE
I certify that I have read this application and under penalty Of purjury state
that the above Information Is correct I agree to comply with all County
ordinances and State laws regulating Electrical wiring,and hereby authorize
repre entatives of this County to enter upon the above-mentioned property
for Ins tion pur es SEE REVERSE FOR EXPLANATORY LANGUAGE
SIGNATUI OF PERMITTEE DATE
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1110170048
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
ITR: 16475 LT: 102 9243 LA ROSA DR
I IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT: 1 TEMP CA 917803732
ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: RIO HONDO
18590-010-002 1A1 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 596 GRID: J5 LOCALITY: TEMPLE CITY, Cl
I IG1 OUTLETS-LGT,SW,RECP 10.00 OUT 19.40
TENANT: IG2 LIGHTING FIXTURES 4.00 LGT 7.80 JISSUED ON: PROCESSED BY: PLAN BY:
IRA FAU LESS 3HP 1.00 FAU 10.90 110/18/11 SR
IH2 RES GRBG DISP LT 3HP 1.00 DIS 10.90 1
OWNER: TEL. NO: IH3 RES DISHWASHR LT 3HP 1.00 DIS 10.90 IFINAL DATE FIN BY: CODE:
IWEIS STEVE;SHELLY (626) 285-3836- IH4 RES RANGE HDS LT 3HP 1.00 HOO 10.90 1
19243 LA ROSA DR IJB AC UNITS +3-10HP 1.00 AC 19.70 1�
ITEMP 917803732 I TOTAL FEES 118.30 IDESCRIPTION OF WORK I
I 1ELECTRICAL FOR KITCHEN REMODEL 1
(APPLICANT: TEL. NO: I
IO'LEARY, TOM (626) 287-0927- 1 I I
15823 AGNES AVENUE I ISPECIAL CONDITIONS: 1
ITEMPLE CITY CA 91780 I I I
ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE 1
ITOM O'LEARY CONSTRUCTION (626) 287-0927- 1 1
15823 AGNES AVENUE LIC. NO 1 ITEMPORARY POWER POLE I
ITEMPLE CITY, CA 91780 489354 i 1 11 I
i I (UNDERGROUND CONDUIT I I I
(ARCHITECT OR ENGINEER: TEL. NO: I IUFER GROUND I I I
LIC. NO: IROUGH CONDUIT I I I
I 1 1 '0% i
IROUGH WIRING 1
I I I I I
IMAIN WATER LINE I
I I IPLASTIC YIN METAL YIN I 1
I I I I I I
I 1UTILITY COMPANY NOTIFIEDI
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 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 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
s;
ADDITIONAL DATA ON FIF;B
y F: i ID.DPR265 ROUTS 905
B60 1Tr
s 2 .., 2..,•�..s. .r . .x ""h -,- #- MTr_. ,.t-.;.,. ._.s.-....• ..,K{ •,�•-.c:i; a _ z ,we;..
REPORT
y-c. -
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS
EL 0508 1103280005
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: FEES PAID BUILDING ADDRESS
ITR- 16475 LT: 102 1 9243 LA ROSA DR 1
I IFEE DESCRIPTION: QUANTITY UOM- AMOUNT: ( TEMP CA 917803732
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: RIO HONDO 1
18590-010-002 IA1 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 596 GRID: J5 LOCALITY. TEMPLE CITY, Cl
I IG1 OUTLETS-LGT,SW,RECP 45.00 OUT 72.50 1 I
(TENANT: IG2 LIGHTING FIXTURES 15.00 LGT 29.10 (ISSUED ON: PROCESSED BY: PLAN BY: I
TOTAL FEES 129.40 103/28/11 SR 1
I
TOWNER: TEL. N0: I IF AL E FIN B CODE: 1
IWEIS STEVE;SHELLY (626) 285-3836- I
19243 LA ROSA DR 1
I
ITEMP 917803732 6RtCKIPjION OF WORK 1
ELECTRICAL FOR NEW BEDROOM, F ILY ROOM AND PATIO
(APPLICANT. TEL. NO: I
1O'LEARY, TOM (626) 287-0927- I
15823 AGNES AVENUE 1 ISPECIAL CONDITIONS: 1
ITEMPLE CITY CA 91780
ICONTRACTOR: TEL. NO: 1 1APPROVALS - DATE INSPECTOR SIGNATURE 1
ITOM O'LEARY CONSTRUCTION (626) 287-0927-
15823 AGNES AVENUE LIC. N0 ' (TEMPORARY POWER POLE I I
ITEMPLE CITY, CA 91780 489354 B-1 1
(UNDERGROUND CONDUIT I I I
I 1
I I I
(ARCHITECT OR ENGINEER: TEL. NO: 1UFER GROUND I I
I - I
LIC. NO. i IROUGH CONDUIT I I
IROUGH WIRING II
I I IMAIN WATER LINE 1 1
1 I 1PLASTIC Y/N METAL Y/N 1 1 I
1UTILITY COMPANY NOTIFIEDI II
I I I I I I
I 1
I I I I I I
1 1 I I I I
REPORT ID. DPR265 ROUTE TO. BS0508
I I I
I I I I
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1106290009
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: FEES PAID I BUILDING ADDRESS:
ITR: 16475 LT: 102 1 1 9243 LA ROSA DR 1
I IFEE DESCRIPTION. QUANTITY: UOM: AMOUNT: 1 TEMP CA 917803732 1
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: RIO HONDO 1
18590-010-002 IA1 PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 596 GRID: J5 LOCALITY: TEMPLE CITY, Cl
I ILN OTHER PNL 0-399 AMPS 1.00 PAN 38.80 1 I
ITENANT: I TOTAL FEES 66.60 (ISSUED ON: PROCESSED BY: PLAN BY:
_.� 106/29/11 SR
I I I I
1 OWNER: TEL. NO: 1 1 F(IIINAL TE FIN Y CODE: 1
WEIS STEVE;SHELLY (626) 285-3836- 1 V `
9243 LA ROSA DR /J
ITEMP 917803732 1 IDESCRIPTION OF WORK
I I (ADD SUB-PANEL 100 AMP
I I I I
1APPLICANT: TEL. NO: I I
1O'LEARY,- TOM- - - (626) 287-0927- 1 - J
15823 AGNES AVENUE I 1SPECIAL CONDITIONS- 1
1TEMPLE CITY CA 91780 I
I I I I
I I I I
1CONTRACTOR: TEL. NO I 1APPROVALS DATE INSPECTOR SIGNATURE
1TOM O'LEARY CONSTRUCTION (626) 287-0927. 1 1
15823 AGNES AVENUE LIC. NO I ITEMPORARY POWER POLE
1TEMPLE CITY, CA 91780 489354 1 1
1 (UNDERGROUND CONDUIT
I I I I I I
(ARCHITECT OR ENGINEER: TEL. NO: 1 1UFER GROUND 1
I I I I
I LIC NO: 1 IROUGH CONDUIT
I I I I I I
IROUGH WIRING I I I
-` IMAIN WATER LINE I
IPLASTIC YIN METAL YIN
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1* ADDITIONAL DATA ON FILE
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I IREPORT ID DPR265 ROUTE TO BS0508 1
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