HomeMy Public PortalAbout6443 LOMA AVE_Electrical__ 1� TEMPLE CgTy
E ' 6 8-62 • APPLICATI®N FOR- ELECTRICAL PERMIT -
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER 'BUILDING /�
BUILDING AND SAFETY DIVISION ADDRESS N
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM-A JENSEN, SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST. uw xE i
RECEPT TOTAL NO TEACH FEE
OUTLETS FIRST 20 11 -$2O $ OWNER ,� �f-E4
,LIGHT l! MAIL
ADD'L 10 ADDRESS,
SWITCH, OVER 20 _
TOTALCITY TEL NO
LIGHTING 1 FIRST 20 .20
FIXTURES J( ADD'L1O ELECTRICIAN /Y�iY/E�t
OV R 20
RANGES CLO DRYERS WTR HTRS 1.00 ADDRESS
RB:DISP 6TA COOK - TEL NO. alp!
CITY
ISH ASH ' AUTO.-WASH STATE
SPACE HTRS STA APP.(l/.HP.MAX.) .50 LICENSE NO 15171(l
MOTORS. OVER NOT OVER H.P DISTRICTS N UP ZONE PR D BY
O 1 1.00 _L:47
(�)
1 3 150 INSPECTION RE RD
s 8 200
s / 7 /��� 1
8 15 250 / q/ �jct--.- U ~�
15 50 300 (� o e '.
,I O.
50 f00 Soo 'KII 3A ah"
% F Q
SIGNS NO TRANS
NO LAMPS
SERVICE 0.60OV-Nor OVER 200A 1100
' y" a
SERVICE O.60OV-OVER 200 A. 2.00 �' ,f
SERVICE OVER 600V 5.00 rye >
MISC. -
v ..
PERMIT ISSUING FEE 200 /y
SUPPLEMENTABY,'PERMIT ISSUING FEE 1.00
TOTAL FEE $ "
1 HEREBY ACKNOWLEDGE THAT I HAVEREADTHIS APPLICATION APPROVALS- DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH;ALL COUNTY ORDINANCES AND STATE LAWS REGULATING _
ELECTRICAL WIRING WIRING
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR �I
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES �-
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE `
DESCRIBED RESIDENTIAL PROPE O POWER
OF
SIGNATURE
yr/e�C� UTILITY CO.NOTIFIEPERMD
wj FINAL A" �.
VALIDATION ART UR C. VEIT
K MO CASH SUPERVISING ELECTRICAL ENGINEER
C
�1'1v01 G JAN 2 4 � D 9.9 p
76A663-CE806 11/70
COUNTY OF LOS ANGELES
U V u� IIISSSLLL��� v I/�11���111 ���VVV!!l�NN�ILLL��S WWWuvn UUU LLLJJJ
DEPARTMENT OF COUNTY ENGINEER BUILDINGWff t
BUILDING AND SAFETY DIVISION ADORES /v
COLEMAN W. JENKINS SUPERINTENDENT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL�IN CROSS ST
OUTLETS NO EACHI FEE
OWNER
RECEPT. I $ $ MAIL
LIGHT TOTAL FIRST 20 r 25 oZ
ADDRESS
CITY TEL NO. _
SWITCHOVER 20_ 10 PLAN CHECK '
LIGHTINGTOTAL FIRST 20 25 APPLICANT
FIXTURES
OVER 20 10 ADDRESS
APPLIANCES CITY TEL NO.
PERT
RANGE DRYER_WTR HTR APPMIICANT�Q /� Q /`� i
STA COOK DISP F A U. ADDRESS 6 yr )
SPACE HTR. AIR COND. CITY �. TEL NO 3/5
73
CLOTHES WASH. DISHWASH. LICENSE NOZ2 •-SL� CLASS —/(}
FAN OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS.APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING I WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND HEATERS, ETC HP KW KVA ELECTRICAL WIRING
SIZE & TYPE OVER TO
- I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 - 1 100 LICENSED AS RED IRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OVj4ER OF, AND INTEND TO )•^
1 - 10 300 RESIDE IN, THE ABO DESCRI R ENTIA PROPERTY O
SIGNATURE U
10 50 500 OF PERMITTEE
50 - 100 1000 - O
DISTRICTNO 19LASS ZONE PR C E Wen 0100 - 500 15000-( ul
0-
V)
SIGN, GAS SIGN AND ONE CIRCUIT 500 NOTES: Z
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 100
SERVICENOTOVER600VOLTS OR200A.MP 300
APPROVALS DATE INSPECTOR'S SIGNATURE
SERVI CE OVER 600 VOLTS OR 200 AM P 1000 -
TEMP POWER POLE
TEMP SERVICE,POLE, &APPURTENANCES 500
UNDERSLAB WORK
TEMP LIGHT OR RECEPT SYSTEM 300
> ROUGH CONDI UT
WIRING
FIXTURES
POWER AUTHORIZED
PERMIT FEE (SUB TOTAL)
UTILITY CO NOTIFIED
PLAN CHECK FEE
FINAL
PERMIT ISSUING FEE 300 17116111
JOP ROOHA
TOTAL FEE SUP RVISING ELECTPICAL ENGINEER,
PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION OCK 'M O CASH
465j-c-' JUL1 5 2 D 6.255 J
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
TEMPLE C2TV
7APPUCAMN FOR ELECTMCAL PERNT
COUNTY OF LOS ANGELES -77—
DEPARTMENT
DEPARTPAENT OF COUNTY ENGINEER BUILDING O
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A.LAMBIE{COUNTY ENGINEER
WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY
co 0
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
PERMIT FEES
OWNER C
ITEM NUMBER EACH FEE MAIL /
OUTLETS $ $ ADDRESS (O
LIGHTS RECEPT. SW. .10 Ra
LIGHTING FIXTURES 10 CITY i T
ELEC. RANGES CLO. DRYERS ELECTRICIAN
W A H EAT E R S .50 ADDRESS
ELEC PACE H . DISHWASHERS CITY TEL.NO.
a GARBAGE DISPOSERS AUTO.. STATE
LICENSE NO.
WASHERS STA.COOKING UNITS .25 v gym, sv `�t o
MOTORS: OVER INC. H.P. DIST ICT NQ. P I ZONE P CESSED Y
0 — 1/2 .25 o- —�i
'/2 — 2 ,50 INSPECTION RECORD
2 — 5 1.00
5 — IS 1.50 tG� v itls. p �"��C, .,r✓/Q_1�0.
15 — 50 2.50 — oc
50 — 200 5,00 OR
NO TRANS. W
D.
SIGNS: NO. LAMPS Z
SERVICE 0.600V 1.00
SERVICE OVER 600V 5,00
MISC.
WIRING PERMIT 1.00
FIXTURE PERMIT 1.00
SUPPLEMENTARY PERMIT ,50
TOTAL FEE
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT
ELECTRICAL WIRING. WIRING .Y/�,11T
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS AN L COUNTY AND STATE OF FIXTURES �!)'`��r�.' s,:n �
CALIFORNIA OR THAT 1 THE L AL OW R OF THE ABOVE
DESCRIBED RESIDENT PROP TY POWER
f 4
SIGNATURE UTILITY CO. NOTIFIED
OF PERMITTE
FINA
LIDATION ARTHUR C.VETT. v
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
;? 7 9Z:�; SEP 1 2 G 3 .4 j �A
n
y/I`��G�YIyL
WORKERS'COMPENSATION 4ECLARATiON 76A663CE-806 io/ai q PP IC A��®IIV� F®U'9 E ECTM p p PERNT
I )erebK affirm that I have a certificate of consent f3-s' ure,
CE-806G 6'�YI!—li"lL 6�Y LL �W IL
or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY
`copy thereof(Sec 3800,Lab C)
Policy.No Company FOR APPLICANT TO FILL IN JOB
EACH NO FEE ADDRESS
Certified copy is hereby furnished New Residential Bldgs &Pools LOCALITY
_ Certified copy is filed with the county building inspection 1 & 2-Family,Sq Ft $ — $
department Multi family Sq Ft — NEARESTF IF
CROSS ST
Date Applicant Residential Swimming Pools OWNER OR,
FIRM NAME
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec Light Sw MAILS
COMPENSATION INSURANCE ADDRESS'
(This section need not be completed if the work involved by the First 20
permit is for one hundred dollars,($100)or less)
Total No Additional CITY el No
CHECKPLAN
I certify that in the performance of the work for which this permit APPLICANT
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
Exemption,you should become subject to the Workers'Compensation Range_ Heater_ DW APPLICANT
provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer — W M ADDRESS
provisions or this permit shall be deemed revoked . Top — FAU WH _
LICENSED CONTRACTORS DECLARATION Hood _ Fan Other_ CITY Tel No
I hereby affirm that I am licensed under provisions of Chapter 9 Disp — Room Air Cond LICENSE OR
am
(commencing with Section 7000) of Division 3 of the Business and REG NUMBER CI
Professions Code,and'my license is in full force and effect Power Apparatus& Large Appliances _ DISTRICT NO !, PROCT4-A
Size& Type HP,KW,KVA,or KVAR Q
License Number Lic Class Up to 1 Incl 00 FINAL //�� V
Over 1 to 10 Incl '� /
Contractor Date DATE VALIDATION 0
❑ Over 10 to 50 Incl
FINAL
I am exempt under Sec Over 50 to 100 Inc BY W
Over 100 n-
B&P C for this reason . (�
Services,Swbd,MCC &Panelboards "+ Z
Date 0-200 Amp Under 600 V
Signature 201 - 1000 Amp Under 600 V t
❑' Over 1000 Amp or Over 600 V
Exemption for Reg Maint Elect
SINGLE FAMILY Temp Power Pole& Appurtenances
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit L'
I hereby affirm that I am exempt from the Contractor's License Law additional Sign Branch Circuits ALCTa�
for the following reason(Section 7031 5,Business and Professions _
Code) 1<'a� `1- AD
i aL
fG(
Ill I,as owner of the property,will do the work and the structure Misc Conduits& Conductors
� ITEMS not intended or offered for sale (Section 7044, Business Ot (Se om lete Fee Schedule)
and Professions Code) ��fL 2�' ®00
Tf_I
CONSTRUCTION LENDING AGENCY ��� ;r?•I f�
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) C:i"I91GE •V 1
Civ C)
PLAN CHECKING FEE
Lender's Name PERMIT ISSUING FEE VV
3 00 001313-0001 6! 1/913
Lender's Address y_ O i[��} 1 =V-
I certify that I have read this application and state that the above TOTAL FEE f
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
pr perty f inspection purposes
SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of ermittee Date
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1303260050 ,
BUILDING AND SAFETY / LAND DEVELOPMENT _ TEMPLE CITY CA 91780
PHONE (626) 285-0488- EXT '
ILEGAL ID _ 1 FEES PAID 1 BUILDING ADDRESS 1
ITR 12504 LT: 31 1 1 6443 LOMA AV 1
I IEEE DESCRIPTION: - QUANTITY UOM- AMOUNT I TEMP CA 917801332 1
(ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET EMPEROR
15382-018-018 . IAl PERMIT ISSUANCE_FEE 27.80 THOMAS PAGE 596 GRID H1 LOCALITY TEMPLE CITY CAI
I IG1.'OUTLETS-LGT,SW,RECP 3 00 OUT 6 00 1 1
(TENANT. 1G2 LIGHTING FIXTURES - 1 00 LGT 2 00 (ISSUED ON PROCESSED BY PLAN BY I
' 1H2 RES GRBG DISP LT 3HP -1 00 DIS 11 00 103/26/13 SR 1
1' IH3 RES DISHWASHR LT 3HP 1 00 DIS 11 00 1 I
(OWNER TEL NO - IH4 RES RANGE HDS LT 3HP - 1 00 HOO 11.00 1FI AL DAT - FINAL BY CODE
WONG, STEPHEN 4 _ _ (626) 278-3442-_ H7 RES EXHAUST FANS 1 00 EX 11 00,- h7
16443 LOMA AV ' _ _1 TOTAL FEES 79.80 1 l 1
ITEMP 91^7801332 1 IDESCRIPTION OF WORK 1
I 13 OUTLETS, 1 LIGHT FIXTURE, GARBAGE DISPOSAL, DISHWASHER, 1
_ IRANGE HOOD AND EXHAUST FAN'
IAPPLICANT TEL NO 1 I I
INGUYEN, Y V (626) 287-1022--
11321 ELM AVE UNIT G I u _ - _ ISPECIAL CONDITIONS - 1 -
I SAN GABRIEL CA- 91775
I 1= I
ICONTRACTOR TEL NO 1_ - 1APPROVALS - DATE INSPECTOR SIGNATURE
IAM CONTRUCTION_CO - (714)'622-0116-
18571 LANDERS DRIVE LIC NO 1 ITEMPORARY POWER POLE I - I
IMIDWAY CITY^ CA 92655" 625479 1 1 - 1 -1 1
_ (UNDERGROUND CONDUIT I I _ -
I
(ARCHITECT"OR ENGINEER- TEL NO - - 1UFER GROUND 1
LIC NO I _ IROUGH CONDUIT
1 1 IROUGH WIRING 1
1 1 IMAIN WATER LINE 1 I 1
1 1 IPLASTIC Y/N METAL Y/N
1 1 1UTILITY COMPANY NOTIFIEDI I I
I • I I I I I
I •` I _ I_ I I I
I 1 1 I 1 1
-
I I I I I I
I I - I I I I
1 IREPORT ID DPR265 ROUTE TO BS0508 1 1 1
1 1 \ I I I 1