HomeMy Public PortalAbout9677 LAS TUNAS DR_Electrical__ '6A663 CE-e06 16/781
APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN JOB C-
New Residential Bldgs.&Pools EACH NO. FEE ADDRESS
1 &2-Family,Sq. Ft. $ .025 — $ LOCALITY f r� C �•r
Multi-family Sq. Ft. .02 — NEAREST
Residential Swimming Pools 25.00 CROSS ST.
OWNER OR
FIRM NAME 4,- ! 7s h"✓�
Outlets:Rec Light Sw. MAIL
First 20 .50 ADDRESS
Total No. Additional .30 CITY Tel. No.
PLAN CHECK
APPLICANT
Lighting Fixtures First 20 50 ADDRESS
Additional .30 Total No. CITY Tel. No.
Fixed Appliances Not Over 1 HP PERMIT
APPLICANT
Range_Heater_D.W.
Oven—Dryer_W.M, ADDRESS
Top _FAU — W.H._ CITY Tel. No. (�
Hood_Fan —Other LICENSE OR
Disp._Room Air Cond. 2 50 REG.NUMBER,-36 C' f Class.e
1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA
Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO
Size&Type HP, KW, KVA,or KVAR COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING ELECTRICAL WIRING. per,
Up to 1 Incl. 2.50 0
I HEREBY CERTIFY HAT I AM PROPERLY EGISTE(ED'AN /OROver 1 to 10 Incl. 5.00 LICENSED AS REQUIRE BY LOS ANGELES C UNTY AST E OF U
Over 10 to 50 Incl. 12.50 CALIFORNIA OR TH IAM THE LEGAL f ER O HE BO E Ix0
Over 50 to 100 Inc.
25.00 DESCRIBED RESIDEN AL PROPERTY, 0
Over 100 40.00 PERMIT EE
SIGNATURE ti L Ge d.
N
Services DISTRICT NO. ESSE Y Z
0-200 Amp.Under 600 V 12.50 1
201-1000 Amp. Under 600 V 25.00
Over 1000 Amp.or Over 600 V 50.00 Z
O -
Temp. Power Pole&Appurtenances 10.00 Q
Sign with One Branch Circuit 10.00
Additional Sign Branch Circuits 2.00j
INSPECTION >
INFORMATION
Misc.Conduits&Conductors 10.00ON REVERSE _
Other(See Complete Fee Schedule SIDE v
Z
Q
J
d
PERMIT FEE (Sub-Total
Z
PLAN CHECKING FEE (One-Fourth Permit Feei O
PERMIT ISSUING FEE $7.00 0
J
TOTAL FEE >
INSPECTION FIINNALED �.. W
date: /, ���� By ., ��- Os
S3
DBS-SA 3.55 APPLICATION FOR ELECTRIC PERMIT 1
BS-SA
DIVISION OF BUILDING-AND SAFETY
Deportment of County Engineer r
County of Los Angeles BUILDING 772 C S
WM.J. FOX, COUNTY ENGINEER ADDRESS
CASSATT D.GRIFFIN, SUPT OF BUILDING
LOCALITY ZLL
FOR APPLICANT TO FILL IN NEAREST
PERMIT FEES CROSS ST.
NUMBER EACH FEE /
OWNER
LIGHT OUTLETS
MAIL
RECEPTACLES S�
_ADDRESS
WALL SWITCHES !!,,
TOTAL OUTLETS 52 $ CITY GJik le 4 TEL.NO.
ELEC.RANGES 25 ELECTRI IAN �0 �� v�C e
_ELEC. HEATERS 25 ADDRESS//
KW EA CITY !►. -3 --5 TEL. NO.
FIXTURES 5 LICENSE NO.
NUMBER OF LIGHT CIRCUITS - DISTRICT NO. GRSUP ZONE READY FOR INSPECTION
NUMBER OF REC TACLE CIRCUITS I
MOTORS
NUMBER HORSEPOWER j FEE `INSPECTION RECORD
NEW MVD. HP OVER INC. EACH
I/2&LESS $ .25
I/2 2 .50 }
2 5 1.00 n
5 15 1.50 •.j. -� , .�-'�
15 50 2.50
50 200 5.00
misc.
NO.SIGNS NO.TRANS. / L?�
NO.SIGNS NO.LAMPS
FOR EACH PERMIT:
WIRING $1.00 �l7
FIXTURES $1.00
SUPPLEMENTARY .50 APPROVALS
TOTAL FEE g012 DATE INSPECTORS SIGNATURE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CONDUIT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING
ELECTRICAL WIRING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTER AND/OR FIXTURES
LICENSED AS UIRED BY LOS ANGELES CO NTY AN STATE OF
CALIFO 0 THAT AM TU LEG Efto)'O THE ABOVE POWER
DESCRIBE I ENTI PR EIVT ./
UTILITY CO.NOTIFIED
SIGNA
OF P FINAL
WILLIAM J. FOX, COUNTY ENGINEER VALIDATION A.C.VEIT,CHIEF ELECT. INSPECTOR
O 6%6 6!R OEC 13 2 2.0 0 *�
0
D95-5A 3.53 APPLICATION FOR ELECTRIC PERMIT Z
DBS•SA
DMSION OF BUILDING AND SAFETY
Deportment of County Engineer BUILDING `
County of Los Angeles ADDRESS
WM.J. FOX, COUNTY ENGINEER 7
CASSATT D.GRIFFIN,SUPT OF BUILDING /
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
PERMIT FEES CROSS ST
NUMBER EACH FEE
OWNER O e
LIGHT OUTLETS MAIL 01Z7
RECEPTACLES _ADDRESS / Z.
WALL SWITCHES I
TOTAL OUTLETS 52 S CITY ` TEL. NO.
ELEC.RANGES 25 ELECTRICIAN
_ELEC. HEATERS 25 ADDRESSO 4L. G�
KW EA I _CITY 1— Z TEL.N
FIXTURES 5 LICENSE NO.
NUMBER OF LIGHT CIRCUITS - DISTRICT NO. I GROUP nZONE I READY FOR INSPECTION
NUMBER OF RECEPTACLE CIRCUITS
MOTORS
NUMBER HORSEPOWERFEE INSPECTION RECORD
NEW MVD. HP OVER I INC. EACH
1/z a LESS S .25
1/z 2 .50
2 5 1.00
5 15 1.50
15 50 2.50
50 200 5.00
MISC.
NO.SIGNS NO.TRANS.
NO.SIGNS NO. LAMPS
FOR EACH PERMIT:
WIRING $1.00 I Iii
FIXTURES $1.00
SUPPLEMENTARY .50 APPROVALS
TOTAL FEE $ DATE INSPECTOR'S SIGNATURE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CONDUIT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING
ELECTRICAL WIRING. -
IHEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGS COUNTY AND STATE OF
CALIFORNIA OR THA 1 AM THE E L OWNER OF THE ABOVE POWER
DESCRIBED RESIDEN A PTY
UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTEE/ FINAL
WILLIAM J. FA.COUNTY ENGINEER VALIDATION A.C.VEIT,CHIEF ELECT. INSPECTOR
;_G0 4 4 4 n WN 30 225 n
COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Department of County Engineer ��������
DIVISION OF BUILDING & SAFETY
WILLIAM J. FOX, County Engineer
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO.
ELECTRICIAN ----
-.-.r / RECEIVED BY READY FOR DATE ISSUED
AlRESS
_ �� � •'''1_r?T_y --s': — FIRST INSPECT'I ON
CITY TEL. NO.
COUNTY LICENSE NO. - EXPIRES_Y— ADDRESS
PERMIT
—
PERMIT FEES --
---
FEE
NUMBER EACH _ LOCALITY,;:ry�/�;• ,,' _-
LIGHT OUTLETS NEAREST
CROSS ST.
RECEPTACLESWALL SWITCHES OWNER 'S
TOTAL OUTLETS 5C $ — _— MAIL
ELEC. RANGES 25 ADDRESS22,
otgknt
ELEC. HEATERS 25 _CITY TEL. NO. — ,Y
FIXTURES 5
-- I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
MISC.
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL `HIRING.
MOTORS I CERTIFY THAT ! POSSESS THE ABOVE VALID LDS
_NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
NEW MvD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED A20VE.
-- -- i/2 6 LESS .25 SIGNATURE
O
'/2 ✓/�/i/y
2 s_ 1.00 INSPECTION RECOFD
5 15 1.501_
is so
50 200 5.00
_ 200 s00 10.00 -j
500 1 1000 15.00 4
-- Z
OVER 1000 20.00
129
_ M.G. SET/FR_EO_CH__A_N13ER-H_P— It
WELDERS: AC-KVA J 0
GENERATORS - KW
_ TRANSFORMERS - KVA
_ TEMP. MOTORS 175% OF ORIG.)
__ MOVED MOTGRS (75% OF CRIO.)
SIGNS �1
N0. NO.TRANS. APPROVALS
NO. NO. LAMPS _—_�—__ — __—
FOR EACH PERMIT: __—_..--___—__. _DATE INSPECTOR'S NAME
_WIRING_ $1.00 CONDUIT
$1.00 WIRING ---- .----
BUFPLEMENTARY v •50 FIXTURES —.-
POWER
TOTAL FEE s"o, n fI O
UTILITY CO. NOTIFIED
a' Q FINAL
T6A663 DBS#5A 4-52
RISS S-A 1-46 ,APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY ELECTRIC
OF LOS ANGELES
WM. J. FOX. CHIEF ENGINEER
Z DISTRICT NO. GROUP ZONE PERMIT NO.
S _NAME _
U ADDRESS
F- RECEIVED BY READY FOR DATE ISSUED
U CITY TTENO. FIRST INSPECTION
771
j COUNTY
W CERT.NO. S
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
DESCRIPTION OF WORK JOB -) -. / e)
DESCRIPTION _ADDRESS +:� ds
NUMBER OF OUTLETS ON CIRCUITS LOCALITY Flo _
LOCATION BY ROOMS NEAREST
LIGHT OUTLETS SW. _PLUG_S FIXT CROSS ST.
CIRCUIT A I B C 17E F G 1-1 w NAME
-- J z MAIL
3 ADDRESS
CITY TEL.NO.
I AM THE LEGAL POSSESSOR OF THE ABOVE LOS
G
ANELES COUNTY CERTIFICATE OF QUALIFICATION..
ELECTRICIAN.
I AM THE Lr_.EGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE _
OWNER.
CORRECTIONS
1
-- - Q
z
TOTAL
No. OF OUTLETS _ _ —_`l APPROVALS 9
NO. OF FIXTURES w ! I DATE INSPECTOR'S NAMS
NO. OF MOTORS H.P. CONDUIT
NO. OF SIGNS TRANS. $ WIRING
NO. OF RANGES OR HEATERS $ FIXTURES
[MISCELLANEOUS $ POWER
PERMIT FEE $ UTI LITY CO.NOTI FI ED
TOTAL FEE FINAL
APPLICATION FOR OCCUPANCY INSPECTION �
R APPLICANT TO FILL IN (Print or type only' COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDINGr �1 BUILDING AND SAFETY DIVISION
ADDRESS JP 4 77 .�Z. �•�� TvVAS N
/ c,� �f
CITY rt,� I,G C.// ( A ZIP JI/6f��j ADDRESS `�`�- �/ G.. ::3•,' t`'.,..a.
NO. OF BLDGS. LOCALITY
SIZE OF LOT z1 J NOW ON LOT
Jf S
TRACT i��v '' ( BLOCK LOT N OaI �' - �""` " "�""•�-`" .��`%`
V ASSESSD Fr
TELOWN E R I +i �f ism v,f NO. MAP BgOK PAGE PARCEL
� V ` DISTRICT TYPE FIRE PROCESSED BY
ADDRESS - CONST. ,f/ ZON E ,
CITY ZIP USE ZONE MAP
SIZE OF NO. OF NO.
EXISTING BLDG. STORIES ',` SPECIALf
CONDITIONS
PRESENT USE OF BUILDING Y'�t A:i./f BLDG. SETBACK FROM
FRONT PROP. LINE OF (STREET) }
TOTAL SETBACK FROM TYPE OF EXISTINGd
N0. PARKING
HIGHWAY + YARD = FRONT PROP. LINE HIGHWAY WIDTH Q
V
SPACE.6 PROVIDED _
Z
BJ.DG. SETBACK FROM
REASON FOR INSPECTION REQUEST ',�/� SIDE PROP. UNE OF (STREET)
HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF XISTIN
�rC IF fty }-/�✓{ 1f.�jr1/F'i f SIDE PROP. LINE HIGHWAY WIDTH J
+ = V
CORNER CUTOFF YES NO (�
PROPOSED MAX. OCC. OCCUPANCY GROUP =
AS VERIFIED OCCUPANT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LOAD
APPLICATION AND STATE THAT THE ABOVE IS COR-
RECT. EXIT HARDWARE:
El NO. OF EXITS NO SPEC. KNOWL.
PANIC DEVICES ElSIGNATURE OF J j- ! f" �'
APPLICANT
ADDRESSPARKING gEQ'D D PROVIDED D
SPACES •
644 1.00(v
ZIP
PHQ(!I�r
11.1 hl CHECKS PAYA13LETL7YOO:
HARVEY T. BRANDY COUNTY ENGINEER FINAL BY
DATE
APPLICATION VALIDATION CK. M.O. CASH
4 .�
6A662-CE992 t2-73
088 SA 25M SETS 2-47 ♦L7P3 C 1►E ION FOR
P Rwr
DEPARTMENT OF BUILDING AND SAFETY ELECTRIC
COUNTY OF LOS ANGELES
WM. J. FOX CHIEF ENGINEER
Q NAME ; % DISTRICT NO. GROUP ZONE PERMIT NO.
ADDRESS
1 • RECEIVED BY READY FOR DATE ISSUED
UU CITY / . TEL.NO. FIRST INSPECTION
.1 COUNTY
W CERT.NO. � EXPIRES
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
JOB
DESCRIPTION OF WORK ADDRESS
NUMBER OF OUTLETS ON CIRCUITS LOCALITY
LOCATION BY ROOMS
NEAREST
LIGHT OUTLETS lsw.I UGS I FIkT CROSS ST. ►S/�
CIRCUIT A B C D E F G I H 0! NAME
W
Z MAIL
ADDRESS L 4AB CITY L l.L� TEI_NO.1 AM THE LEGAL POSSESSO OF THE ANGELES COUNTY CERTIFIC TB OF QUALIFELE1 AM THE LEGAL OWNER OF THE PROPERT
ABOVE
OWNER.
v CORIIECTIONS
J
Z_
[7
R
O
TOTAL I
NO. OF OUTLETS $ 3o APPROVALS
NO. OF FIXTURES Z7 $ dAz . DATE INSPECTOR'S NAME
NO. OF MOTORS H.P. $ CONDUIT
NO. OF SIGNS-,�l- TRANS. $ J WIRING
NO. OF RANGES OR HEATERS $ FIXTURES
MISCELLANEOUS $ / POWER
PERMIT FEE $ / UTILITY CO.NOTIFIED ?
TOTAL FEE S FINALI �./
D.B.S.SA 2SM SETS 113-47 APPUCA IO FOR PER3ffT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES 'ELECTRIC
�� I�
WM. J. FOX CHIEF ENPINEE5
NAME '. r. !v DISTRICT NO. GROUP ZONE PERMIT NO.
U ADDRESS
K
RECEIVED BY READY FOR DATE ISSUED
IU CITY TEL.NO. a FIRST INSPECTION
J COUNTY
W CERT.NO. EXPIRES
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
JOB
DESCRIPTION OF WORK ADDRESS
NUMBER OF OUTLETS ON CIRCUITS LOCALITY MAIO#
LOCATION BY ROOMS
NEAREST p
LIGHT OUTLETS SW. PLUGS FIXT CROSS ST.
CIRCUIT A B C D E F G I H w l NAME
Mr
Z AIL
ADDRESS
O
CITY TEL.NO.
1 AM THE LEGAL POSSErSOR OF THE ABOVE LOS
ANGELES COUNTY CE:i:'iFICATE OF QUALIFICATION.,
1
ELECTRICIAN.
I AAI THE LIZZ L OWNER OF THE PROP$RTY AESCRIBED
ABOVE
OWNER.
r
Q
to
II O
1
f
TOTAL
NO. OF OUTLETS a $ APPROVALS
NO. OF FIXTURES F�J $ $ DATE INSPECTOR'S NAME
NO. OF MOTORS 3 H.P. 7 $ �` CONDUIT
NO. OF SIGNS TRANS. $ WIRING
NO. OF RANGES OR HEATERS $ FIXTURES
MISCELLANEOUS $ POWER
PERMIT FEE _$ UTILITYCO.NOTIFIED
TOTAL FEE @ _ FINAL
WORKERS'COMPENSATION DECLARATION CE-806G
10181 APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I have a certificate of consent to self CE-BO6G
insure, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY
or a certified copy thereof (Sec. 3800, Lab. C.)
Poli No.��/23/��ompany &LzFOR APPLICANT TO FILL IN JOB /_ r LGl
certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS (Q
❑ Certified copy is filed with the county building inspec- 1 & 2-Family, Sq. Ft. $ — s LOCALITY
tion department. Multi-family Sq. Ft. NEAREST
Residential Swimming Pools CROSS ST.
OWNER OR
Date Applicant
FIRM NAME
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw._ MAIL
COMPENSATION INSURANCE ADDRESS <.,gQ
This section neenote completed If the work involved b First 20
( tineed b
p Y Total No. Additional CITY Tel. No.
the permit is for one hundred dollars($100)or less.)
that in the performance of the work for which this PLAN CHECK
1 certify p 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 HP PERMIT
NOTICE TO APPLICANT: If, after making this Certificate of APPLICAN
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. —
deemed revoked. Hood Fan _ Other— CITY Tel. No112—
LICENSED
ZLICENSED CONTRACTORS DECLARATION LICENSE OIZ
I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. 2 ClaCS.—1
REG. NUMBER
(commencing with Section 7000) of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO. PROCE D BY >,
and Professions Code,and my license is in full force and effect. Q.
/l Size &Type HP, KW, KVA, or KVAR u
License NumberG� Lic. Class CJ Up to 1 Incl. FINAL
V �� �l�!(f�L-<J Date d '"— Over 1 to 10 Incl. DATE VALIDATION 19O
Contractor Over 10 to 50 Incl.
❑ FINAL (�
I am exempt under Sec. Over 50 to 100 Inc. BYy1.4 d
B.&P.C. for this reason Over 100 H
Services, Swbd., MCC& Panelboards Poo-
0
Z
Date: 0 -200 Amp. Under 600 V
Signature 201 - 1000 Amp. Under 600 V
❑ Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V
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 Additional Sign Branch Circuits
Law for the following reason (Section 7031.5, Business and
Professions Code):
❑ 1, as owner of the property, will do the work and the Misc. Conduits&Conductors
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)
(Sec. 3097, Civ. C.).
PLAN CHECKING FEE
Lender's Name
PERMIT ISSUING FEE
Lender's Address
I certify that I have read this application and state that the TOTAL FEE
LAI
above information is correct. I agree to comply with all County
ordinances and State laws regulating Electrical wiring, and
her by authori a representatives of this County to enter upon
t ab a-m tion property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
Signdture of Fl9rmittee bate
WORKER'S COMPENSATION DECLARATION 9 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT
78A88
I hereby affirrrythat I have a certificate of consent to self insure, 76AG63
or a�certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV.
copy thereof r(Sec.'3800 Lab.C.)
Policy No./; Company � FOR APPLICANT TO FILL IN JOB
ADDRESS Qr
Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE LOCALITY `
❑ 1 &2-Family,Sq.Ft. — 77
$ $
NEAREST
Certified copy is filed with the county building inspection _
department. Multi-family Sq.Ft. CROSS ST.
CJ
Residential Swimming Pools ASSESSOR
Date — Applicant MAP BOOK
PAGE PARCEL
CERTIFICATE OF EXEMPTION FRO(('WORKERS' OWNER OR G t C `p
COMPENSATION INSURANCE Outlets:Rec. Light Sw. FIRM NAME
First 20 �' MAIL Al,'
(This section need not be completed if the work involved by the Total No. Additional ADDRESS N. 1 J�
permit is'for one hundred dollars($100)or less.) � —
Wrl
I certify that in the performance of the work for which this permit CITY Tel. 8.2
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
ADDRESS
Date Applicant RESIDENTIAL APPLIANCES NOT OVER 9 HP.
NOTICE TO APPLICANT: If, after making this Certificate of CITY Tel.No.
Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. _
provisions of the Labor Code,you must forthwith comply with such power Apparatus&Large Appliances PERMITAPPLICANT
,�� A
/s
provisions or this permit shall be deemed revoked. Wwll '
LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS ew
I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. /
(commencing with Section 7000)of.Division'3 of the Business and CITY Tel:`O. O
Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. OF
Over 50 to 100 Incl. REG.NUMBER Class• d
O
(�
Over 100 DISTRICT NO. P ESSED BY o
License Number n l-L- Lic.Class Jq B V
Services,Swbd.,MCC&Panelboards Q
� /� ihs�
Contractor �G. "'�' , Date — ? 0-399 Amp.Under 600 V DATE / 0
F1 I am exempt under Sec. 400-1000 Amp.Under 600 V % VALIDATION V
Over 1000 Amp.or Over 600 V FINAL LLl
B.&P.C.for this reasonBRANCH CIRCUIT FEES BY CO
Date: 15A,or 20A,.120V,Lighting or Recept. Z
1 To 10 Branch Circuits
Signature 11 To 40 Branch Circuits
❑ 41 Or More Branch Circuits
Exemption for Reg.Maim.Elect. 15A,20A,208V To 277V Lighting Br.Circuits
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):
❑ 1,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)
and Professions Code).
CONSTRUCTION LENDING AGENCY HU.I
1 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) 3
�� 3 -10
Civ.C.) 03 :]0
PLAN CHECKING FEE 1 ITEMS
-
Lender's Name
PERMIT ISSUING FEE l TOTAL T AL 47m30
Lender's Address TOTAL FEE �O CHECK _47.1-20
I certify that I have read this application and under penalty of purjury state i
that the above information is correct. I agree to comply with all County CHAINGL .0-0—
ordinances and State laws regulating Electrical wiring,and hereby authorize
representatives of this County to enter upon the above-mentioned property
for inspection purpos SEE REVERSE FOR EXPLANATORY LANGUAGE _000• 7/12/95
1301 1 PM :32
SIGNATURE OF PERMITTEE— DATE
t COUNTY OF LOS ANGELES TEMPLE CITY # 0508• r ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS y' 9071 LAS TUNAS i `'r. EL 0508 9608080006
BUILDING AND SAFETY / LAND DEVELOPMENT j TEMPLE CITY CA
PHONE: (818) 285-0488 EXT:
LEGAL ID: FEES PAID BUILPING ADDRESS:
TR: 6561 LT: 128 9677 AS TUNAS DR
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP-`CA 917802103
ASSESSOR INFORMATION N BER: NEAREST CROSS STREET: KAUFFMAN
8587-020-011 :Al PERMIT ISSUANCE FEE •27.75 THOMAS-PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY
�F2 208, 277V LGT BR CKT 1.00 BR 27.30
TENANT: �JB AC UNITS +3-10HP 1.00 AC 19.65 ISSUED'ON: PROCESSED BY: PLAN BY: EXPIRES ON:
TOTAL FEES 74.70 08/08/96 TC 08/08/97
OWNER: TEL. NO: FIN DATE FINAL BY: CODE:
FIRESTONE ARTHUR;FRANCES M
2201 5TH AV
ARCD 910065312 DESCRIPTION OF WORK
CIRCUIT AND AIR COND. UNIT
APPLICANT: TEL. NO:
WUKMIR, NICK (818) 446-7478-
SPECIAL CONDITIONS:
CONTRACTOR: TEL.,NO: '� (D.# APPROVALS DATE INSPECTOR SIGNATURE
WUKMIR, JAMES (818) 442-2148-
a ��
11500 RAMONA BLVD. LIC. NO / �C TEMPORARY POWER POLE
EL MONTE, CA - 285626C-20 � � UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER: TEL. NO: / s"' GROUND
LIC. N0: ROUGH CONDUIT
L
ROUGH IRING
t... 1LJ n �r � Cf� i MAIN WATER LINE
PLASTIC Y/N METAL Y/N
UTILITY COMPANY NO IFI D
�
(9illrBce
REPORT ID: DPR265 ROUTE TO: BS0508
�. -COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS EL 0508 9806250002
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA
PHONE: (818) 285-0488 EXT:
LEGA D: FES PAID B I DINGADDRESS:., + `
TR: 6561 LT: 128 9677 1/2 LAS TUNAS DR
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA,917802103
0
ASSESSOR IN TION NUMBER. NEAREST CROSS"STREET: KAUFFMAN
8587-020-011 Al PERMIT ISSUANCE FEE 27.75 THOMAS"PAGE: 597 GRID:.A3 LOCALITY-TEMPLE CITY
G1 OUTLETS-LGT,SW,RECP 1.00 OUT 1.95
TENANT: TOTAL FEES 29.70 ISSUED ON: PROCESSED BY: PLA BY: ---EXPIRES ON:
06/25/98 UT 06/25/99
OWNER: TEL. NO: FINAL DATE FINAL BY: E:
FIRESTONE ARTHUR;FRANCES M (626) 446-7478-
2201 5TH AV
ARCD 910065312 DESCRIPTION OF WORK r
RELOCATE OUTLET IN RESTROOM
APPLICANT: TEL. NO:
BRIAN CHUNG (626) 307-4292-
9873 BROCKWAYSPECIAL CONDITIONS:
EL MONTE, CA ;-
:...
CONTRACTOR: TEL. N0: APPROVALS DATE INSPECTOR SIGNATURE
BRIAN CHUNG (626) 307-4292-
9873 BROCKWAY STREET LIC. NO TEMPORARY POWER POLE
EL MONTE, CA 91733 652729 CIO
Ad ``�,� UNDERGROUND CONDUIT
RC H I T ECTOREGI E ER TEL. NO: -'� �;�1 RGROUND
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LIC. NO:;'�, ___—_ �`al_111111 5`�.' ROUGH CONDUIT
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PLASTIC Y/N METAL Y/N
UTILITY COMPANY NOTIFIED
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REPORT ID: DPR265 ROUTE TO: BS0508
s: COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1208080037
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID
-I BUILDING ADDRESS: .I
ITR: 6561 IT: 128 I I 9677 B LAS TUNAS DR [
[FEE DESCRIPTION: QUANTITY: DOM: AMOUNT:[ TEMP CA 917802103
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET:
18587-020-011 IA1 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY, Cl,
IK1 SIGNS, OUTLINE LGT 1.00 SIG 38.90 I I
TENANT: I TOTAL FEES 66.70 ISSUED ON: PROCESSED BY: PLAN BY: I
108/08/12 SR 1
I I I
(OWNER: TEL. NO: I IFAAL DATE FINAL BY: CODE:
ILYDIA CHUNG (626) 286-0168- I I
19677 LAS TUNAS DR. I I
(TEMPLE CITY CA 93.780 [ (DESCRIPTION OF WORK
I I 11 SET OF CHANNEL LETTERS IVrERNALLY ILLUMINATED'W/LED I
I I ILIGHTING 1
(APPLICANT: TEL. NO: I I I
ISIERRA'S SIGNS INC. (626) 401-2544- I 1 I
[ I SPECIAL CONDITIONS: J�
I
I I
I I
ICONTRACTOR: TEL. NO: I IAPPROVALS DATE INSPECTOR SIGNATURE [
ISIERRA'S SIGNS INC. (626) 401-2544-, I 1
11930 N. ROSEMEAD BLVD. LIC. NO ' I [TEMPORARY POWER POLE I I I
S. EL MONTE, CA 91733 939544-C45 *I
I I IUNDERGROUND CONDUIT I 1
[ARCHITECT OR ENGINEER: TEL. NO: 1 IUFER GROUND
LIC. NO: 'i IROUGH CONDUIT I I
I I I
I �I IROUGH WIRING I I I
I I I
IMAIN WATER LINE I I I
IPLASTIC Y/N METAL Y/N
I I I [ I
I I [UTILITY COMPANY NOTIFIED[ I
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1 i i I i I
I ADDITIONAL DATA ON FILE
1 I I I
IREPORT ID: DPR265 ROUTE TO: BS0508 [ [
I [ I I I
° COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS
EL 0508 1208080035
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488' EXT:
ILEGAL ID: FEES PAID
_ I BUILDING ADDRESS':
ITR: 6561 IT: 128 I I 9677 A LAS TUNAS DR 1
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:1 TEMP CA 917802103 I
(ASSESSOR INFORMATION NUMBER': I I NEAREST CROSS STREET:
18587-020-011 lA1 PERMIT-ISSUANCE FEE 27.80 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY, Cl
I IK1 SIGNS, OUTLINE LGT 1.00 SIG 38.90 1
]TENANT: I TOTAL FEES 66.70 (ISSUED ON: PROCESSED BY: PLAN BY:
108/08/12 SR
(OWNER: TEL. NO: I IF AL DATE -FI BY: CODE:
ILYDIA CHUNG (626) 286-0168-
19677 LAS TUNAS DR.
I
(TEMPLE CITY CA 91780 � (DESCRIPTION OF WORK ]
I I 11 SET OF CHANNEL LETTERS INTERNALLY ILLUMINATED W/LED
I I (LIGHTING ]
(APPLICANT: TEL. NO: I
ISIERRA'S SIGNS.INC. (626) 401-2544- I I I
SPECIAL CONDITIONS: 1,
I
]CONTRACTOR: TEL. NO: 1 I (APPROVALS DATE INSPECTOR SIGNATURE ]
]SIERRA'S SIGNS INC. (626) 401-2544- I I
11930 N. ROSEMEAD BLVD. LIC. NO I ITEMPORARY POWER POLE I I ]
IS. EL MONTE, CA 91733 939544-C45 *I I I I
I ]UNDERGROUND CONDUIT ] I
1ARCHITECT OR ENGINEER: TEL. NO: ] IUFER GROUND I ] I
_ I I
LIC. NO: I I IROUGH CONDUIT' I ]
ROUGH WIRING 1 I
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I I (MAIN WATER LINE I ]
PLASTIC Y/N METAL Y/N I I ]
UTILITY COMPANY NOTIFIED( I ]
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I I I I I I
I I ] I
I ! I I I I I
I I I I ]
I f I I I I
I 1* ADDITIONAL DATA ON FILE
IREPORT ID: DPR265 ROUTE TO: BS0508
I I I
COUNTY OF LOS ANGLES TEMPLE CITY # 0508 ELECTRICAL PERMIT
! DEPARTMENT. OF PUBLIC WORKS 9701-LAS TUNAS' EL 0508 1110170050
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT: `
ILEGAL ID: I FEES PAID BUILDING ADDRESS: 1
ITR: 6561 LT: 128 I I 9677 1/2 LAS TUNAS DR
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:( TEMP CA 917802103
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET:
18587-020-011 1A1 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY, Cl
I IGl OUTLETS—LGT,SW,RECP 25.00 OUT 45.70 I
ITENANT: 1G2 LIGHTING FIXTURES 10.00 LGT 19.40 (ISSUED ON: PROCESSED BY: PLAN BY:
ITC SALON JHA FAU LESS 3HP 1.00 FAU 10.90 110/17/11 SR
I IJB AC UNITS +3-10HP 1.00 AC 19.70 1 I
(OWNER: TEL. NO: 1 TOTAL FEES 123.50 [F DATE FI BY: CODE: 1
ITC SALON YOUTHDERM.SKIN & BEAUTY
19677 1/2 LAS TUNAS
ITEMPLE CITY CA 91780 1 IDESCRIPTION OF WORK
I i (TENANT IMPROVEMENT — ELECTRICAL
(APPLICANT: TEL. NO: [ I
1ANAKIA INC., MATT JENG (888) 765-8982— 1 I
1713 W. DUARTE RD. 1 [SPECIAL CONDITIONS: [
IARCADIA, CA 91007 I [
I I I I
ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE I
IJ C Y CO. (626) 676-9888— 1 1 I
12012 LOWER AZUSA RD LIC. NO 1 ITEMPORARY POWER POLE I I I
IEL MONTE, CA 91732 C10582921 I I I [
I I (UNDERGROUND CONDUIT I I
[ARCHITECT OR ENGINEER: TEL. NO: I IUFER GROUND I 1
ICHIU, PATRICK (626) 288-6898— 1 1 I I [
1573 MONTEREY PASS RD #C LIC. NO:- 1 IROUGH CONDUIT I I
IMONTEREY PARK, CA 91754 12852 I I
I I TROUGH WIRING
I I IMAIN WATER LINE
I i 1PLASTIC YIN METAL YIN I [ I
I (UTILITY COMPANY NOTIFIEDI I I
I I I I I I
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[ IREPORT ID: DPR265 ROUTE TO: BS0508 I I I 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 1111030009
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: FEES PAID BUILDING ADDRESS:
ITR: 6561 IT: 128 I 1 9677 1/2• LAS TUNAS DR I
IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT:1 TEMP CA 917802103 1
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET:
18587-020-011 1A1 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: A3 LOCALITY. TEMPLE CITY, Cl
I • ILB 200 AMP PANELS, MCC 1.00 PAN 38.80 1 I
[TENANT. I TOTAL FEES 66.60 ISSUED ON: PROCESSED BY: PLAN BY: 1
ITC SALON 1 11/03/11 SR
1OWNER: TEL. NO: I IF AL DATE FINAL BY: CODE: 1
ITC SALON YOUTHDERM SKIN & BEAUTY - 1
19677 1/2 LAS TUNAS 1 I yH7- m 1
ITEMPLE CITY CA 91780 I 1D61SCRIPTION OF WORK ]
] 1PANEL UPGRADE TO 200 AMP
(APPLICANT: TEL. NO: 1
I
IJ C Y CO. (626) 288-6898- 1
I
ISPECIAL CONDITIONS:
I 1
1 1 I
ICONTRACTOR: TEL. NO: I APPROVALS DATE INSPECTOR SIGNATURE 1
IJ C Y CO. (626) 676-9888- 1 ]
112012 LOWER AZUSA RD LIC. NO 1 I
TEL MONTE, CA 91732 C10582921 I ITPORARY POWER POLE I 1
I ] 1UNDERGROUND CONDUIT 1 I
I I I I
(ARCHITECT OR ENGINEER: TEL. NO: JUFER GROUND
I - I
I
ILIC. NO: I TROUGH CONDIIIT I I I
(ROUGH WIRING I I I
IMAIN WATER LINE I I I
IPLASTIC YIN METAL YIN 1 I
(UTILITY COMPANY'NOTIFIEDI I ]
I I I I I I
I I I I I
I 1 I I I I
I I I I I I
I 1
I I I I I
I � .
I I I I I I
]REPORT ID: DPR265 ROUTE TO: BS0508-
I I I
I I I I