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76A66C-CE#'806 5-61 APPLICATION FOR ELECTRIC L- PERMIT -
COUNTY OF LOS ANGELES /yp4�
DEPARMENT OF COUNTY ENGINEERG�V / BUILDING !f J
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A.'LAMBIE. COUNTY ENGINEER
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT-TO FILL IN CROSS ST.
PERMIT FEES OWNER,
I T E M NUMBERI EACH FEE MAIL
OUTLE rk $ $ �, ADDRE
LIGHTS RECEPT 6W/j 10 •10 CITY TEL.
LIGHTING FIXTURES 10
ELEC._RANGES . CLO. DRYERSEL`ECTRIC N \
WATER HEATERS .50 ADDRESS / , •� r
ELEC.SPE HTRS. DISHWASHEQS i
CITY EL NO.
GARBAGE ISPOSERS / AUTO.-
STATE '
WASHERS Ir STA.COOKING UNITS ,25 /- �O LICENSE NO.
MOTORS: OVER INC. H.P. DIS ICT GROUPZO E P=CES Y
l 0— 1/. .28
1/2- 2 .50 D INSPECTION RECORD
2— 5 1.00 d� 4!n �'1"i V .5 f�� _ '0
5— 15 1.50
IS— 50 2.50
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50— 2005.00 u'v
W
SIGNS: NO TRANS. N
NO.LAMPS
SERVICE 0-600V 1.00
SERVICE OVER 600V 5'00
misc.
WIRING PERMIT 1.00
FIXTURE PERMIT 1.00 �-
SUPPLEMENTARY PERMIT 50 -
TOTAL FEE $
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
D
AN .STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT p�
ELECTRICAL WIRING. WIRING �
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS NGEL CO NTY AND STATE OF FIXTURES
CALIFORNIA OR THA 1 AM THE LEG R OF THE ABOVE -
DESCRIBED RESIDENT P PERT POWER
SIGNATURE UTILITY CO.NOTIFIED
OF PERMITTEE FINAL
�-"LIDATION ARTHUR C. VEIT
MO CASH
SUPERVISING ELECTRICAL ENGINEER
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76"4563°E-806'6/78' APPLICATION' FOR'ELECTRICAL PERMIT
COUNTY OF LOS ANGELES BUILDING ANDAFETY
FOR APPLICANT TO FILL IN JOBp
New Residential Bldgs&Pools EACH• NO FEE ADDRESS �X0-1 L.4A/ S'e e
1 &2-Family,Sq Ft $ 025 — $ LOCALITY �� 7-
Multi-famd'y Sq- Ft 02• — " ` NEAREST "
Residential Swimming Pools 25 00 - CROSS ST
OWNER OR r
FIRM NAME'
Outlets Rec Lbght Sw MA'lL
First 20 50 O ADDRESS
Total No /0_ Additional, 30 CITY_ Tel No
PLAN CHECK
APPLICANT
Lighting Fixtures First•20 •50 00 ADDRESS '
Additional 30
Total No CITY Tel No
Fixed Appliances Not Over 1 HP - PERMIT .. -
Range_Heater_D W APPLICANT (J' L dLGI
Oven_Dryer_W M ADDRESS 57,,,e S 1AA 44 q
Top _FAU _ WH . CITY Tel No
Hood—Fan =Other_
LICENSE OR x
Disp —Room Air Cond
25 0 REG NUMBER b' (� Class �—
I HEREBY•ACKNOWLEDGE THAT I HAVE.READ THIS APPLICAt
Power Apparatus&Large.Appliances TION AND STATE THAT THE-ABOVE IS CORRECT AND AGREE TO
COMPLY WITH ALL COUNTY. ORDINANCES AND, STATE LAWS
Size'&Type HP, KW, KVA,or KVAR REGULATING ECECTR)CAL WIRING '
Up to 1 Incl 2 50 HEREBY CERTIFY-THAT IAM PROPERLY REGISTERED AND/ .- 0
Over 1 to 10 Incl 5 00 LICENSED AS-REQUIRED BY LOS ANGELES COUNTY AND STATE OF V
Over 10 to 50 Incl 1 2 50- CALIFORNIA,OR THAT AM THE LEGAL OWNER OF THE ABOVE Q
DESCRIBED RESIDENTI ROPER 0
Over 50 to 100 Inc• 2500 t
40 00 PERMITEE
Over 100 SIGNATURE
Services DISTRICT NO - v• - ROCESS D BY �
0-200 Amp Under 600 V 12 50
- 201-1000•Amp Under 600 V 25 00
Over 1000 Amp or Over 600 V 5000Z
O
Temp Power Pole&Appurtenances 1000 Q
Sign with One Branch Circuit 1000 e
Additional Sign Branch Circuits 200 - INSPECTION >
'W
Misc Condu is&Conductors 1000 INFORMATION ON-REVERSE_. x
Other(See Complete Fee Schedule) SIDE v
Z
�4076A
'
PERMIT FEE (Sub-Total)
_Z
PLAN CHECKING FEE (One Fourth Permit Feel O
PERMIT ISSUING FEE $7.00 .6-6 O .� 5 p '
TOTAL FEE > -0 3 0'�7 9
r
`INSPECTION INAL DLU
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date � - � � f
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ' ELECTRICAL PERMIT -
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS - - EL 0508 1302120005
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 - - -
PHONE: (626) 285-0488 EXT:
(LEGAL ID: - - 1 •� FEES PAID BUILDING ADDRESS.
ITR. 26522 LT: 6 - 1 10105 LANDSEER ST 1
I IFEE DESCRIPTION:. QUANTITY: UOM:- AMOUNT TEMP CA 917803339 - 1
(ASSESSOR INFORMATION NUMBER: II NEAREST CROSS STREET: OLIVE - (-
18585-002-006 1A1 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 597 ' GRID: B4 .LOCALITY: TEMPLE CITY CAI
IG1 OUTLETS-LGT,SW,RECP 25.00 OUT 45 70 I
(TENANT: - IG2 LIGHTING FIXTURES 32.00 LGT 55.10 (ISSUED ON: PROCESSED BY: PLAN BY: I
I IHA FAU LESS 3HP 1.00 FAU 11.00 102/12/13 SR 1
IH2 RES GRBG DISP LT 3HP 1.00 DIS 11.00 I I
IOWNER- TEL. NO: IH3 RES DISHWASHR LT 3HP 1.00 DIS 11 00 IFI D TE FINAL BY: CODE: 1
IHADDAD, SERGE M - (323) 205-6236- IH4 RES RANGE HDS LT 3HP 1.00 HOO 11.00 1 C/y/c? - •I _
110105 LANDSEER ST . - IH5 RES WASH MACH LT 3HP 1.00 WAS 11.00 I �� 1
ITEMP 917803339 1JB AC UNITS +3-10HP 1.00 AC 19.70 ID SCRIPTION OF WORK
1 1 TOTAL FEES 203.30 125 OUTLETS, 32 LIGHT FIXTURES, A/C, FAU, GARBAGE DISPOSAL 1
I I IDISHWASHER, RANGE HOOD AND WASHING MACHINE 1
1APPLICANT: TEL. NO: I I
IWONG, YEUNG (323) 285-7931-
1611 E MISSION RD - 1 - ISPECIAL CONDITIONS: - 1
ISAN GABRIEL CA 91776
I I I I
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'ICONTRACTOR: TEL NO: _ - - (APPROVALS DATE INSPECTOR SIGNATURE
WAI TAK CONSTRUCTION INC - (626) 285-7931- I
1611 E MISSION ROAD LIC. NO ITEMPORARY POWER POLE I - 1 I
ISAN GABRIEL CA 91776 586138 * 1 I I 1 -
1 (UNDERGROUND CONDUIT I I
I I I I I I
1ARCHITECT OR ENGINEER: TEL. NO: IUFER GROUND _ -
I - I _ • . I I I I
1 LIC. NO: 1 IROUGH CONDUIT
1 IROUGH WIRING 1I
IMAIN WATER LINE I' I
I 1PLASTIC Y/N METAL Y/N
I I I
I (UTILITY COMPANY NOTIFIEDI 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 I 1 I I
IREPORT ID: DPR265 ROUTE TO: BS0508 I
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