HomeMy Public PortalAbout5670 LOMA AVE_Electrical__ A
,76A663 DBS SA 3-5D � _.BION FOR PERMIT
DEPARTMENT OF BUILDING►AND SAFETXt,.�, + 1; i_
COUNTY OF LOS.A XG$'LES
WILLIAM J. FOX, CHIEF ENGINEER
. FOR APPLICANT TO FFILL
�ICN DISTRICT NO. GROUP ZONE PERMIT NO.
ELECTRICIAN SSOL'/ftC/ 7
RECEIVED BY READY FOR DATE ISSUED
.ADDRESS .9,(0 /! f�//��.A7�-AFS /.Tf/1��P/i / T LQ �._ _ FIRST INSPECTION
CITY Dn A-- X e- TEL NO.LC/��yqd! J 41
COUNTY LICENSE NO. EXPIRES �,�T®�SBUILDINire f�
PERMIT FEES ` G �ADDRESS � �� "� Aa.
COUNTY
�� �p
FEE LOCALITY //�' e'7 �•
AA� tot,
NUMBER EAC H
LIGHT OUTLETS NEAREST
CROSS ST.
RECEPTACLES
WALL SWITCHES 14 OWNER Is ,L /,d e
TOTAL ❑UTLETS ! Sc $ MAIL e3/i
ELEC. RANGES 85 ADDRESS.
ELEC. HEATERS I 25 CITY / /) � J �� TEL. NO.
FIXTURES 5
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
MISC. y
APPLICATION AND STATE THAT THE ABOVE 19 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 1 POSSESS THE ABOVE VALID L438
NUMBER. HORSEPOWER FEE ANGELES COUNTY LICENB OR-t\ M THE LEGAL OWNER
NEW MVD. HP OVER 1 INC. EACH OF THE RESIDENTIAL PROPERTYDESCRIBEDABOVE.
OI It- pL 17;dl'C %2 & LESS $ 25 °� 0 BIONATURE GF 7 I f 4 1
'/2 2 .50 PERMITTEE
2 5 1.00 INSPECTION RECORD,-
."-a 15 1.50
15 50 2.50 j
50 2013 5.00 r
200 SOO 10.00 J
500 1000 15.00 Z
OVER 1000 20.00 0
M.G. SET/FREQ. CHANGER-HP Q'
WELDERS:AC-KVA O
GENERATORS - KW
TRANSFORMERS - KVA
TEMP. MOTORS (75% OF ORIo.)
MOVED MOTORS (75% OF ORIG.)
MISC.
SIGNS
ND. NO.TRANS.
APPROVALS
NO. NO. LAMPS
DATE INSPECTOROS NAME
FOR EACH PERMIT:
$1�pp CONDUIT
WIRING
FIXTURES $1.00 QB WIRING i.�'� G•�/2'��
SUPPLEMENTARY ,g0 FIXTURES
POWER /
TOTAL FEE $ UTILITY CO.NOTIFIED
FINAL
WORKER S'COM PENSATION DECLARATION CE-806G (2-80) APPLICATION FORELECTRICAL PERMIT
I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY
insure, or a certificate of Workers'Compensation Insurance,or
a certified copy thereof(Sec. 3800, Lab.C.)
FOR APPLICANT TO FILL IN JOB
Policy No. Company New Residential Bldgs.&Pools EACH NO. FEE ADDRESS- O 9
Certified copy is hereby furnished. 1 &'2'Family,Sq. Ft. $ — LOCALITY
❑ Multi-family Sq. Ft. NEAREST
Certified copy is filed with the county building inspection CROSS ST O !�
department. Residential Swimming Pools OWNER OR
FIRM NAME
Date— Applicant 'Outlets: Rec_�;?, ( MAIL
20 ADDRESS\J
CERTIFICATE OF EXEMPTION FROM WORKERS'
Total'No. 14, Additional CITY i �•, Tel No.
COMPENSATION INSURANCE PLAN CHECK }d
(This section. need not be completed if the work involved APPLICANT O
by the permit is for one hundred dollars ($100) or less.) Lighting Fixtures . First ADDRESS U
Total No. Additionalcc
I certify that in the performance of the work for which thisFixed Appliances Not Over 1 HP CITY Tel No. 0
permit is issued, I shall not employ any person in any manner PERMIT
so as to become subject'to the Workers' Compensation Laws. Range_ Heater_,D.W. APPLICANT W
Oven _ Dryer_W.M._ ADDRESS le fn
Top _ FAU _W.H.._ Z
Date Applicant T "
Hood _ Fan _Other CITY eYN0__
NOTICE TO APPLICANT: If, after making this Certificate of Disp. _ Room Air Cond. LICENSE OR
Exemption, you should become subject to the Workers' REG.NUMBER Class
Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO. PiF OC SED BY
with comply with such provisions or this permit shall be
deemed revoked. Size&Type HP,KW, KVA,or KVAR
Up to 1 Incl.
FINAL
Over 1 to 10 Incl. DATE / _ { /
LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl 'D VALIDATION
I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL
9 (commencing with Section 7000) of Division 3 of the Busi- Over 100 BY
ness and Professions,Code, and my license is in full force and
effect. Services./ � �
0-20 Amp. Und r 0 V •�'�,
License Number Lia Class 201-1000 Amp. Under 600 V
Contractor Date Over 1000 Amp.or Over 600 V
1
HOME OWNER-BUILDER DECLARATION Temp.Power Pole&Appurtenances
I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit
License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits
ness and Professions Code):
Misc.Conduits&Conductors
1, as owner of the property, will do the work and the Other (See Complete Fee Schedule)—
structure is not intended or offered for sale (Section ;?'2
7044, Business and Professions Code).
CONSTRUCTION LENDING AGENCY' # o o o a o 2
1 hereby affirm that there is a construction lending agency
for the performance of2 the work for, which this permit is PERMIT FEE (Sub-Total) � `� a - 205.0
issued Sec. 3097,Civ.C.). `
Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) ° ° o 2 Q 8 0 U
Lender's Address PERMIT ISSUING FEE 0.2-7 8 0
I certify that I have read this application and state that the TOTAL FEE
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
Signature o Permittee Date
` COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1210030056
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
1TR: 16305 LT: 7 5670 LOMA AV 1
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( TEMP CA 917802450
ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: LAS TUNAS 1
15387-018-003 lAl PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY, Cl
I _1G1 OUTLETS-LGT,SW,RECP 8.00 OUT 16.00
(TENANT: JG2 LIGHTING FIXTURES 2.00 LGT 4.00 JISSUED ON: PROCESSED BY: PLAN BY:
TOTAL FEES 47.80 110/03/12 SR 1
I I I I
(OWNER: TEL. NO: I IFINALATE F BY: CODE: 1
CHEN, WEINA (626) 512-2978- 1 +//�►�� "1
15670 LOMA AV I
(TEMP 917802450 1 1D SE�ION OF WORK 1
I I (ELECTRICAL WORK FOR KITCHEN REMODEL 1
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(APPLICANT: TEL. NO:
(SAME AS OWNER - 1
I I (SPECIAL CONDITIONS: 1
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1CONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE I
(SAME AS OWNER - I I I
I LIC. NO I (TEMPORARY POWER POLE i I
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I I (UNDERGROUND CONDUIT 1 1 1
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(ARCHITECT OR ENGINEER: TEL. NO: 1 IUFER GROUND 1
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I LIC. NO: I (ROUGH CONDUIT I 1
1 I I ROUGH WIRING
i I I MAIN WATER LINE
1 i 1PLASTIC Y/N METAL Y/N I 1
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I I (UTILITY COMPANY NOTIFIEDI I 1
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1 (REPORT ID: DPR265 ROUTE TO: BS0508 1 1 1
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COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1307080017
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: FEES PAID BUILDING ADDRESS:
ITR: 16305 LT: 7 5670 LOMA AV
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 TEMP CA 917802450
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET:
15387-018-003 1A1 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY CAI
I IG1 OUTLETS-LGT,SW,RECP 12.00 OUT 24.00 1
(TENANT: IG2 LIGHTING FIXTURES 8.00 LGT 16.00 11SSUED ON: PROCESSED BY: PLAN BY:
TOTAL FEES 67.80 107/08/13 SR 1
1OWNER: TEL. NO: I IFINAL DATE FI A BY: CODE: 1
ILAM, PETER (626) 625-3839- 1 1 �1
15670 LOMA AV I I 'rl
ITEMP 917802450 1 IDE C IPT ON OF WORK 1
1 19 OUTLETS, 3 SWITCHES, AND 8 LIGHT FIXTURES
(APPLICANT: TEL. NO: 1
ISAME AS OWNER
I 1 (SPECIAL CONDITIONS: 1
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ICONTRACTOR: TEL. NO: I 1APPROVALS DATE INSPECTOR SIGNATURE
ISAME AS OWNER - 1
I LIC. NO I ITEMPORARY POWER POLE I I
11
1 1UNDERGROUND CONDUIT I i
(ARCHITECT OR ENGINEER: TEL. NO: IUFER GROUND I I
IANOKIA INC. (888) 765-8982- 1 1 1
1713 W. DUARTE ROAD, #G303 LIC. NO: 1 (ROUGH CONDUIT I 1
IARCADIA, CA 91007 NONE I I I 1
I ROUGH WIRING I'jam ' 1
T
1 I I '
IMAIN WATER LINE I
1 I IPLASTIC YIN METAL YIN 1 1
i (UTILITY COMPANY NOTIFIEDI I
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1 I I I I I
1 1 I I I I
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I I I I I I
I I I I I I
I I I I I I
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1 IREPORT ID: DPR265 ROUTE TO: BS0508 I 1
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