HomeMy Public PortalAbout4961 LOMA AVE_Electrical__ / /
41
6A663-CE806 5-62 APPUCA7i O 0 L mrpucAkl pamrT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS A961 x- Lam.
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A JENSEN, SUPT OF BUILDING LOCALITY Temple City
NEAREST
FOR APPLICANT TO FILL IN. CROSS ST.
RECEPT IS TOTAL , NO EACH FEE
OUTLETS' FIRST 20 $ $ OWNER
20
LIGHT o 2Q GG MAIL
934
SWITCH OVER 20 1 .10 1, ADDRESS
TOTAL CITY TEL NO.
LIGHTING FIRST 20 9 .20 1 8G
FIXTURES 9 ADD'L
OVFR 20 10 ELECTRICIAN Mansfield Electric
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RANGES CLO DRYERS WTR.HTRS 1.00 ADDRESS 1OOLp$ Fern 1�
GARB.DISP. 1 STA.COOK I
CITY TEL.NO.
DISHWASH. AUTO.-WASH. STATE p
8
SPACE HTRS STA.APP.(%H.P.MAX ) 1 .5O G LICENSE NO 1 018
MOTORS. OVER NOT OVER HP DISTall2f GR UP XNE �PF3Arl=%ESSED BY
O t 1.00
1 3 1.50 INSPECTION RECORD
3 'S 2.00
8 15 2 50 a
O
Is 50 300 V
50 100 500
0
NO TRANS ~
SIGNS• NO.LAMPS W
a
SERVICE 0.60OV-NOT OVER 200A 100 1 GG Z
SERVICE 0-60OV-OVER 200 A. 200
SERVICE OVER 600V 5.00
MISC.
PERMIT ISSUING FEE 2.00 2 pQ
SUPPLEMENTARY PERMIT ISSUING FEE 100
TOTAL FEE $ 1G G _
1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY CONDUIT ,
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING v't.�`�%
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS
REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AjJ THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL+15ROPERTY. POWER
SIGNATURE j _ UTILITY CO.NOTIFIED
OF PERMITTED
FINAL
VAIIDATION AR U C.'VEIT
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
LAt,0 5 2 5 41 FEB 4 2 D 1 0.7 0" c
CITY OF TEMPLE CITY - License286
76A663-.4E806 1-68 APPLICATION , FOR ELECTRICAL, P R11
q'NTY OF LOS ANGELES
-6lePAR�TMENT OF COUNTY ENGINEER BUILDING
4961 Loma
BUILDING AND SAFETY DIVISION
JOHN A. LAMBIE, COUNTY ENGINEER y
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY Te Cit
NEAREST -
FOR APPLICANT TO FILL IN CROSS ST
NO EACH FEE
$ $ OWNER Wi11i CCol
RECEPT MAIL
LIGHT-6TOTAL FIRST 20 20 ADDRESS4961 Loma
SWITCHl OVER 20 10 61TATemple CjtV TEL. NO.
PLAN CHECK
LIGHTING �TOTAL FIRST 20 20 APPLICANT
FIXTURES OVER 20 10 ADDRESS
RANGE_DRYER 1 WTR HTR._ CITY TEL NO
STA COOK_DISP _F.A U - CONTRAC T-ORCOnlee & Son Electric
SPACE HTR AIR COND ADDRESS1030 No Grandview Ave, -�
CLOTHES WASH DISH WASH CITY S.San Gabriel TEL. NO. 280-2007
FAN-OTHER 3 1 00 3 LICENSE IJO 242432 CLASS. C 10
MOTORS,TRANSFORMERS RATING
IND HEATERS, ETC HP KW KVA I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
SIZE & TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING
0 - 1 1 00
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
1 - 10 3 00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
- CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
10 - 50 IL
5 00 RESIDE IN, THE DESCRIP,ED RESIDENTIAL PERTY O
SIGNATUREAL
LJ
50 - 100 10 00 OF PERMITTEE
100 - 500 15 00 O
DISTRICT NO GRO P Z E CESS D BY G
19
SIGN GAS SIGN AND ONE CIRCUIT 3 00 ® o - W
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1 00 NOTES: ,� "-�,�6� S' /;G��� G'/.,♦ lam/% Z
SERVICE NOT OVER 600 VOLTS OR 200 AMP 1 2 00 2 00
SERVICE OVER 600 VOLTS OR 200 AMP 5 00 1,0e_,Ar6c,0 �`-r�G4i o %,-e,2 e- [-1
TEMP SERVICE, POLE, & APPURTENANCES 3 00 APPROVALS DATE INS PE Cf OR'S SIGNAf_U�E
TEMP POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
PERMIT FEE (SUB TOTAL) WIRING
FIXTURES
PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED
PERMIT ISSUING FEE 200 2 UTILITY CO NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1 00 FINAL 0 G
TOTAL FEE 7 00 JOS:EF6H C. ROOHAN
SUPERVISING ELECT CAL ENGINEER
PLAN CHECK VALIDATION CK M 0 CASH- i PERMIT VALIDATION CCK M 0 CASH
l.A O 7.5 5.6%xQ3 DEC 5 2 D 7.0 0
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE ��