HomeMy Public PortalAbout5527 LOMA AVE_Electrical__ 76A663.CES06 3-89. APPLICATION Io'C R ELECTRIC E !V o I T
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING �r.'i -_L�p—'
BUILDING AND SAFETY Dil/ISION ADDRESS `J f3l�iC, W t CR;
JOHN A. LAMBIE, COUNTY'ENGINEER: 7`
CASSATT D. GRIFFIN,SUP'$OF-BUILDING - LOCALITY'. ��.,,t-f? i.•h.� ,
FOR APPLICANT TO FILL IN. NEAREST
PERMIT FEES CROSS ST. J
1 T.E M NUMBER EACH REE OWNER _ A'10-
OUTLET $ $ MAIL J L/ 17 G
LIGHTS RECEPL�• ,,'BW: / /„ •1p �(� ADDRESS 7
LIGHTING FIXTURES - .10 / � CITY ( ��.o TEL
ELEC.RANGES CLO.DRYERS ELECTRICIAN R 0 V,s '
WATER HEATERS 0 ADDRESS -
.5 -
ELEC.SPACE HTRS.t DISHWASHERS
CITY it E 'r TEL NO.4'1
GARBAGE DISPOSERS-/. AUTO.-
STATE l /'i t+�•
WASHERS STA.COOKING UNITS .25 • v LICENSE NO.
MOTORS: OVER* INC. H.P. D1STRlGT NO. I GROUP I ZONE I A CESSED BY
'/2— 2 .50 INSPECTION RECTO
2— :5 1.00
5— IS 1.50
15— 56 2.50
so—Zoo 5.000AprY9
`'`
SIGNS: NO.TRANS. - -`• - J` - -
NO.LAMPS
SERVICE 0-600V t 1.00
SERVICE OVER 600V 5.00 - -
..WIRING PERMIT - 1.60'; �� 0 Q _-y } ��
FIXTURE PERMIT, 1.00 ���_- G? r #�. • D J•` � / 'J"_"� ''� -
SUPPLEMENTARY PERMIT'. .50*..
TOTAL FEE S
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ'THIS APPLICATION APPROVALS a DATE INSPECTOR'S*SIGNATURE
AND STATE THAT THE ABOVE.IS CORRECT AND.AGREE'TO COMPLY
WITH ALL COU NTY ORDINANCES AND' STATE LAWS' REGULATING CONDUIT '
ELECTRICAL WIRINGi /
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED :AND/OR WIRING -� •"'(�/`) ° ,~�1r ;' ':/ [/a`
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STIATE•OF -FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIA ROP ERTY. '�� -POWER
'SIGNATURE - UTILITY CO.NOTIFIEDFINAL
®p. 1k4IDATION ARTHUR C.VEIT,.
ELECTRICAL.ENGINEER
.CK MG :CASH ,SUPERVISING
YLrlu� s jrl�;t 3 2 A 1 1 .9 5
' k^ WORKERS' COMPENSATION DECLARATION ;zo-0019 DPW 3/87
Irhereby affirm that I have a certificate of consent to self -76A663
APPLICATION FOR ELECTRICAL PERMIT
insure,,,or a certificate of Workers' CompensationInsurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS
or o,µertified.copy thereof (Sec. 3800,,Lab. C.
Policy No. Company FOR APPLICANT TO FILL IN JOB
Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESSSSI a �61PIAIf
Certified copy is filed with the county building inspec- 1 & 2-Family;,Sq. Ft. $ — $ LOCALITY ✓=
tion department. NEAREST
p Multi-family Sq. m CROSS ST. �(i'i6t"a-ZlIl
Residential Swimming Pools OWNER OR
Date Applicant FIRM NAM Gi/ �Jd
CERTIFICATE OF EXEMPTION FROM,WORKERS'
Outlets: First 20 MAIL
Rec Light Sw._ /
COMPENSATION INSURANCE ADDRESS S110'
�
(This section need not be completed if-the work involved by Total No. Additional CITY 74rIl fl/ _. Tel. No�_P6'-3r,/(?0
the permit is for one hundred dollars ($100)or less.) PLAN CHECK
I certify that in he performance of the work for which this APPLICANT
permit is issued,,l 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.
Dote Applicant Fixed Appliances Not Over 1 HP PERMIT
NOTICE TO.APPLICANT: If, after making this Certificate of _ I I
APPLICATION
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. No.
LICENSED CONTRACTORS DECLARATION LICENSE OR
Disp. Room Air Cond. REG. NUMBER Class.
1 hereby affirm that I am licensed under provisions of Chapter9 -
(commencing With Section7000)of Division 3 of the Business Power Apparatus & Large Appliances DISTRICT NO. PROCESSED BY
and Professions Code,and my license is in full force and effect, 0-
Size
Size &Type HP, KW, KVA, or KVAR O
License Number Lic. ClassUp to 1 Incl. FINAL q / 0
Over 1 to 10 Incl. DATE VALIDATION
Contractor Dafe Over 10 to 50 Incl. O
FINAL
I am exempt under Sec. Over 50 to 100 Inc. U
LU
BY
B.&P.C. for this reason Over 100
Services, Swbd., MCC& Panelboards �P Z
Date: 0- 200 Amp. Under 600 V U —
Signature 201 - 1000 Amp. Under 600 V
DExemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V
SINGLE FAMILY
HOME OWNER-BUILDER DECLARATION Temp. Power Pole &Appurtenances
I herebyaffirm that I am exempt from the Contractor's License Sign with One Branch Circuit
P i`• i
Law for the following reason(Section 7031.5, Business and Additional Sign Branch Circuits "
Professions Code):
Misc. Conduits &Conductors
LYJ I;'as owner-of the property,-will.do the work T''''v=LC`and the DIMS'==_S'
structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)— ® a5
.Business and Professions Code).
11"i 1 A = S = 00
CONSTRUCTION LENDING AGENCY 'HEN
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
UL 1-€ `
Lender's Name _ ;s 'Pr
PERMIT ISSUING FEE 90
Lender's AddressQa�.t + _ =i
I certify that I have read this application and'state that the TOTAL FEE t7 9
above information 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
ts
Signature of Pet4ittee Date '-
_ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0611270016
BUILDING AND SAFETY/ LAND DEVELOPMENT TEMPLE CITY CA 91780 "
PHONE: (626) 285-0488 EXT:
LEGAL ID: 'FEES PAID BUILDING ADDRESS:f. -j
TR: 9751 LT: 0 BL: .001 UN: .002 5527 LOMA°•AV '-
FEE DESCRIPTION: QUANTITY: .UOM: AMOUNT: TEMP';CA4917802306
ASSESSOR INFORMATION NUMBER: _ '., NEAREST 'CROSS'=STREET: BROADWAY
5387-020-021 Al PERMIT ISSUANCE FEE '27.75' THOMAS',.PAGE: '596 GRID: H4' LOCALITY:.TEMPLE-CITY, C
H1 RES ELEC OVEN LT 3HP 1.00 OVE 10.95 -
TENANT: H2 RES GRBG DISP LT 3HP 1.00 DIS 10.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
H3 RES DISHWASHR LT 3HP , 1.00 DIS 10.95 11/27/06 JK 05/26/07
H4 RES RANGE HDS LT 3HP 1.00 BOO 10.95
OWNER: TEL. NO: H7 RES EXHAUST FANS .. i 1.00 EX 10.95 FINAL DATE FINALB CODE:
'P
WELLMAN RICHARD J;EVELYN R (626) 286-3090- LB 200 AMP PANELS, .MCC '� '1'"00 AN• 38.85
5527 LOMA AV r TOTAL FEES - 121.35
TEMP 917802306 - - �j _ -. DESCRIPTION OF WORK
` ELECTRICAL FOR KITCHEN, BATH REMODEL AND UPGRADE SERVICE
TO 200 AMP
APPLICANT: TEL. NO:
LAKE (626) 622-3459-
6866 ASTER CT. SPECIAL CONDITIONS:
CHINO, CA 91710 '
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
ROBERT LAKE JR. (626) 622-3459-
6866 ASTER CT. LIC. NO - - TEMPORARY POWER POLE -
CHINO, CA 91710 4254368 -- "
UNDERGROUND CONDUIT '
ARCHITECT OR ENGINEER: TEL. NO: UFER GROUND /
LIC. NO: ROUGH CONDUIT
ROUGH WIRING
MAIN WATER LZ
PLASTIC Y/N META Y/N
UTILITY COMPANY NOTIFIED
J
REPORT ID: DPR265 ROUTE TO: BS0508