HomeMy Public PortalAbout5649 LOMA AVE_Electrical__ 76A663 DpS 5A 11-50 - �
APPLICATION FOR PERMIT
DEPARTME14T OF -BUILDINGAND'SAFETY
'COUNTY'OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT- NO GR-OTUP ZONE PERMIT NO
ELECTRICIAN SSC+
ADDRESS 6 RECEIVED BY. READY.FOR -.DATE ISSUED
�... I/f G.. T—ap G f4 ., FIR T'I SPECTI N' {� /
CITY' a'1 d1I'1 f2 ��-'2t..0 TEL. NO��.//t' ✓� .,.fir. - • f D.
COUNTY LICENSE NO. -EXPIRESG.: � � BUILDING
Af
PERMIT FEES DDRESS.. 5 J / /�(i`a o
-
FEE
NUMBER EACH LOCALITY `.� 1 �)✓�- 04' I�
LIGHT OUTLETS - NEAREST.
- - CROSS ST. -
RECEPTACLES ` �
WALL SWITCHES OWNER •/ i .� - IJ /:� ALl .
TOTAL OUTLETS Sc $ ®� MAIL '
ELEC. RANGES25 ADDRESS
.ELEC. HEA RS - 25 CITY TEL.' NO.
FIXTUR '.°;5 , ... .
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
MISC. APPLICATION AND .STATE, THAT THE ABOVE IS CORRECT
NUMBER OF.LIGHT, CIRCUITSAND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF'RECE_PTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING.
MOTORS
NUMBER HORSEPOWER FEE 1 CERTIFY THAT I- POSSESS THE ABOVE 'VALID LOS
ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
NEW MVD. HP� OVER INC. //�1ED'
EACH OF THE .RESIDEN A ZRPERTY 'D CI!n ABOVE.
I
1/� &LESS $ .25 SIGNATURE OF,
1/2 2 .50 PERMITTE V -
z s 1.00
INSPECTION RECORD
5 15 - 1.50.. `'..•....
15 50 2.50 -
-50 - 200 "5.,00'
-- 200 .500 10.00 - - - J..
500 1000 15.00. _ Z
OVER 1000
M. G. SET/FREQ. CHANGER-HP
WELDERS: AC-KVA - - - 0
.GENERATORS-KW
TRANSFORMERS-KVA -
TEMP..MOTORS-(75%OF ORI G.)
MOVED MOTORS(75%OF ORIG.)' - -
-SIGNS •.
No. No. TRANS: APPROVALS
NO. NO. LAMPS
-.DATE INSPECTOR'S NAME
FOR EACH PERMIT? �.:, � - .... - . . _ "_, - ...
WIRING -- - - $1..00 f -_EI . .•CONDUIT
FIXTURES $1.00 WIRING I" - - - -
"SUPPLEMENTARY - :,`50 �••
FIXTURES -'
POWER
TOTAL FEE $ / UTILITY CO. NOTIFIED . A✓ '
o.. . FINAL
Y
76A663 DBS5A „_60 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF 'LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT . O. GROUP ZONE ,. PERMIT NO.
ELECTRICIAN
3IS2
/-�� RECEIVED BY READY FOR DATE ISSUED
ADDRESS /
_ �• FIRST INSPECTION
CITY TEL. NO. � ''
COUNTY LICENSE NO. EXPIRES ,/ BUILDING� /_
PERMIT FEES aDDREss GCJ
FEE
NUMBER EACH LOCALITY
it LIGHT OUTLETS Y NEAREST
RECEPTACLES - CROSS ST.
WALL'SWITCHES LY OWNER
TOTAL OUTLETS 5'r5 sc $ __I� MAIL
ELEC. 'RANGES _ 89 ADDRESS '
ELEC.._ HEATERS '25 CITY TEL. NO.
FIXTURES -/ Y S I HEREBY ACKNOWLEDGE ,THAT- 1 HAVE READ T141S.
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 WIRING.
MOTORS - 1 CERTIFY THAT, I POSSESS THE _ABOVE VALID LOS
NUMBER HORSEPOWERANGELES COUNTY LICENSE, OR I AM THE LEGAL, OWNER
FEE OF THE RESIDE TI OPERTY- ESCRIBED ABOVE.
NEW MVD. HP OyyV(�E\�R �I INC. EACH'
_ MLlA r�lkl/z &LESS $ .25 SIGNATURE.OF
(� PERMITTEE
1/2 2 ..50
2 _ 5 1.oo INSPECTION RECORD
'-
5 1s 1.50
t5 50 2.50 _
50' 200 5.00
200 500 10.00 „J
soo 1 1000 15.00 Q
OVER 1000 20.00 _ (�
M. G. SET/FREQ. CHANGER-HP .. O.'
WELDERS:-AC-KVA - - O
GENERATORS-KW
TRANSFORMERS-KVA
TEMP. MOTORS (75%OF ORIG.)
MOVED MOTORS (75%OF ORIG.)
MISC.
SIGNS
No. No. TRANS. I APPROVALS
NO- NO: LAMPS -
' DATE' ' INSPECTOR'S NAME
FOR EACH PERMIT: CONDUIT
WIRING $1.001 1 I IL /•
.FIXTURES - $1.00 _ / WIRING J•a'� ::�/a �/,�
E
SUPPLEMENTARY .50 I FIXTURES'
.. _ POWER
TOTAL FEE $� UTILITY CO. NOTIFIED
FINAL ,I�l/ v S
WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91)
76A663 APPLICATION FOR ELECTRICAL PERMIT lJ
I ti�preby affirm that I have a certificate of consent to self insure,
or a certificate of Worker's Compensation Insurance,'of'a'certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV.
copy'thereof(Sec. 3800 Lab..C.) JJ �
Policy No. Company - FOR APPLICANT�TO FILL IN ADDRESS /I`aDRESS •( Lo —
Certified'copy is hereby furnished. New Residential Bldgs.&Pools JOB
NO. EACH FEE LOCALITY ' '
$
Certified copy is filed with the county buildCZ
1 &2-Family,Sq.Ft. $
' nspectio NEAREST e�
ceprtment. t Multi-family Sq.Ft. CROSS ST.
Date T 1 -� Applicant Residential Swimming Pools ASSESSOR
. _ MAP BOOK PAGE a�� PARCEL e)l
CERTIFI ATE OF EXEMPTION FROM WORKERS' Outlets:Rec/ OR
Light Sw. ORM NAME
FI
COMPENSATIONINSURANCE
First 20 .MAIL
(This section need not.be completed if.the.work involved by the 775 1;1
permit is for one hundred dollars($100)or less.) Total No. Additional �i� ADDRESS
I certify thatin the perfdr'mance of the work for which this permit CITY Tel.No.
is issued, I shall not employ'any person inany manner So as to /' - .PLAN CHECK
become subject to,the Workers'Compensation Laws. Lighting Fixtur 1/O- First 20 APPLICANT '
Total No. Additional
ADDRESS
DateApplicant LIA ES NOT OVER 3 P.
NOTICE.TO APPLICANT: If-after making this Certificate of RESIDENTIAL APPo O CITY Tel.No.
Exemption,you should become subject to the Workers' Compensation OTHER APPLIANCES NOT OVER 3 HP.
rovisions of the'Labory"Code, ou must forthcomply with com I with such PERMIT
Power Apparatus&Large Appliances AAPPLICANTp
provisions or this permit shall be deemed revoked.'
LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS
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 N
Professions Code, and my license is in full force and effect. Over 10 to 50 Incl. u
LICENSE OR Ste( rClass.
Over 50 t0 100 Incl. REG.NUMBER `fes a
n-f Over 100 DISTRICT NO. P ESSED BY O
License Number v �Lic,Class �j 0
Services,Swbd.,MCC&Panelboards Q cc
(pA
Contractor Date 0-399 Amp.Under 600 V FINAL O
V � � - DATE -
❑ 400-1000 Amp._Under 600 V �-
I am exempt under Sec. VALIDATION U
Over 1000 Amp.or Over 600 VpINAL LU
B.&P.C.for-this reason BRANCH CIRCUIT FEES BY
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.•Maint. Elects 15A,_20A,208V To 277V Lighting Br.Circuits
SINGLE FAMILY Temp.Power Pole&Appurtenancestr• .a
HOME OWNER-BUILDER DECLARATION AIC. -T=a
I hereby affirm that I am exempt from the Contractor's License Law Sign..with One Branch Circuit __ _
for the following reason (Section 7031.5,.Business and Professions Additional Sign Branch Circuits 10.�
Code): 1 T F j'q
❑ 9.--i��y
I, as owner of the property,will do the work and the structure Mise.Conduits&Conductors f(_;; L _ =I -°
is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule).
and Professions Code). ® C "fi,P
CONSTRUCTION LENDING AGENCY CHANGE a;ou
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.)
PLAN CHECKING FEE 001 d0-0001 y s r
Lender's Name 1030
A " ''='
��- PERMIT ISSUING FEE •A e 81 "Q"
Lender's Address
I certify that I have read this application andunder penalty of purjury state TOTAL FEE D
that the above information is correct. I ag.ree 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 in 'poses. SEE REVERSE FOR EXPLANATORY LANGUAGE
01,
6d-� �S-
SIGN TURE OP PERMITTEE DA
WORKERS'COMPENSATION DECLARATION76-663 10781 APPLICATION FOR ELECTRICAL PERMIT
' -- .` CE-806G f-\ Fal JY f�
f hereby affirm that I have a'certificate of consent to self insure,
or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY
copy thereof(Sec. 3800,tab'. Cr)
Policy No: .Company _._ —
:: Certified copy is hereby furnished New Residential Bldgs.&FPools PL , " _ ADDRESS
f.
(CANT TO FILL IN "�-•.
EACH,- NO. FEE F:7 L�)�
LOCALITY r
Certified copy,is filed with the county building inspection 1 & 2-Family,Sq.Ft $ _
department:' • ••- •��, Multi-family Sq.Ft. NEAREST
, CROSS ST / %I�•/.�?`!�'
s - ;:Residential Swimming PoolsOWNER OR
Applicant Q.. - `�"-'l FIRM NAME. (Jti(.�..G'•}
CERTIFICATE-OF EXEMPTION FROM WORKERS" Outlets:Rec Sw. MAIL.
Light
COMPENSATION INSURANCE 'ADDRESS -
This section need,not be com Ieted,if,the work involved b the Additional �- 7r�./Ib '..' - No.
( P Y First CITY Tel.
.permit Is for one hundred dollars ($,100) or less) Totaf No.
r• PLAN CHECK " .�
I'certify-that in the performance.of the work,for which:'this permit APPLICANT
is-issued,,i;shall•not employ any person- n any manner so as to
become subject to the;Workers:Compensation,Laws., Lighting,Fixtures' 'First 20 ADDRESS-
6
Additional
ff,,�
Date �'-f / Applicant f�/�, ( �y pa, Total No. CITY Tel.No.
�+ Fixed Appliances Not Over 1 HP PERMIT
NOTICE• TO.. AP.P.LICANT, If;.,after .making this Certificate of APPLICANT ,
Exemption,.you'should become subject to the;Workers''Compensation Range_ Heater_ D.W. _, ' �� •, /`/ '✓
S / r✓�;�.
provisions'of the Labor 60cle.;you must„forthwith comply,with such Oven Dryer _ W.M._ ADDRESS, Tk IC'M it
provisions or this permit shall be deemed revoked. Top - FA -— W.H. ��h� f , f• s
LICENSED DECLARATION. 'Hood —_ Fan, Other_. TY ri✓/ �Ye�No.
CI
I hereby affirm that,I.am licensed under.,provisions of Chapter, 9VV
_ LICENSE OR '�7 f
(commencing with Section 7000) of Division.3;of the Business.and Disp:' Room Air'Cond. 4.xy� �� Class. (_�/'
REG.NUMBER '�j�J
Professions Code,and my license is,in full force and effect. Power Apparatus& Large Appliances- T , • a.
DISTRICT NO - I?RO SSED BY
Size&jyyPXH KW,KVA,or KVAR
Q 4 ��
License Number S(' Lic.Class 11 Incl FINAL V
:UIQ'!J ',r Over 1 to 10 incl. /O DATE / tg 0
.ContractorO��AQ j►t�'=C 3•Vp(?Date � S VALIDATION- �.
Over 10 to 50 Inc.,
U
I am exempt under Sec. Over 50 to 100 Inc.
FINAL
• BY W '
B.&P.C.for this reason. Over 100 N
Services,Swbd.,MCC,& Panelboards
Date: ® Z
0- 200 Amp.Under 600 V
Signature 201 -11000 Amp.Under 60b'V
❑ Over•1000 Amp.or Over,600 V
Exemption for Reg.Maint.Elect:
SINGLE.FAMILY Temp.Power.Pole& Appurtenances.
HOMEOWNER-BUILDER DECLARATION Sign with One•Branch Circuit L^1{ J1s,' '2 a t=ar
I hereby;affirm that Lam exempt from the Contractor's License Law
for the following reason (Section 7031:5;"Business and Professions -.Additional Sign Branch Circuits';
Code)
Misc.Conduits &Conductors s .ITEM
I,as owner of the,property,will do the work and the structure
s not intended or offered for sale (Section 7044, Business ... Other(See Complete Fee Schedule) Tt_i I` 6 � ,�-•r•
and Professions Code). c F: 61L.'50
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(Sec.3097, PERMITTEE (Sub,-Tot(Sub-Total) e
CHANGE s
Civ.C.).
PLAN CHECKING-FEE F '•as1-00-31 7/1719":
Lender's'Name a_! AM V`40
PERMIT ISSUING-FEE E 1,59 :. ., � N rn4- ,
Lender's Address
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
and State caws 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 of Permittee Date
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1106010002
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
{.LEGAL ID: { FEES PAID BUILDING ADDRESS: 1 '
ITR: 16134 LT: 2 - _ { 5649 LOMA AV {
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 TEMP CA 91780,2451 {
{ASSESSOR INFORMATION NUMBER: I. I NEAREST CROSS STREET: LAS TUNAS 1
15387-022-014 IA1 PERMIT ISSUANCE FEE 27.80 { THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY„ Cl
I IG1 OUTLETS-LGT,SW,RECP 1.00 OUT 1.90. 1
{TENANT: - I TOTAL FEES 29.70 (ISSUED ON: PROCESSED BY: PLAN BY: - 1
106/01/11 SR {
10WNER: _ TEL. NO: I IFI �DATEj FIN Y: CODE:
IJEE, DER (626) 643-3980- 1 1 �/ {
{5649 LOMA AV I I l
ITEMP 917802451 1 IDESCRIPTION OF WORK F
REPLACE ONE SWITCH {
I
(APPLICANT: TEL. NO:
ISAME AS OWNER -
I i ISPECIAL CONDITIONS: { -
{
I I I I
(CONTRACTOR: TEL. NO: 1 (APPROVALS ' - DATE INSPECTOR SIGNATURE 1
ISAME AS OWNER - _ I
I - LIC. NO I (TEMPORARY POWER POLE -
I I I
I (UNDERGROUND CONDUIT I I I
(ARCHITECT OR ENGINEER: TEL. NO: IUFER GROUND
1 LIC. NO: 1 IROUGH CONDUIT I 1
IROUGH WIRING I I I
IMAIN WATER LINE
IPLASTIC Y/N• METAL Y/N
I I I• I I I
UTILI"Y COMPANY NOTIFIEDI I I
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IREPORT ID: DPR265 ROUTE TO: BS0508