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Home My Public Portal About9520 LAS TUNAS DR_Electrical__ D S-A 7-38 25M ' DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES ELEGFRIC NATURE OF INSTALLATION DISTRICT No. I GROUP TYPE PERMIT No _ .o ° ._- (}fes !! ! WIRING FIXTURES tI SERVICE"- � - II READY FOR AEtEIVEdSY DATE ISSUEd RANGE' _ HEATER I�i POWER FIRST INSPECTION SIGNS MISCELLANEOUS :APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY � z' _ JOB < NAME / .' ADDRESS � . _ �. ADDRESS � � UTA°. "�.! .°`o` _ LOCALITY. ('`�l�j NEAREST CITY - TEL N �U' CROSS ST." f COUNTY Y ll7 � - LICENSE:No. REG. N'O. DESCRIPTION OF WORK z MAL ADDRESS �� ;„ NUMBER OF OUTLETS ON CIRCUITS- U �- [[ii LOCATION BY ROOMS - - CITY J �$, �' ',,�, :Et No. LIGHT OUTLETS )S)SW. I � PLUGS FIXT. -CORRECTIONS ' CIRCUIT A B I C I' D-1 E I ( F'i G I H LIVINGROOMI DINING ROOMI BRFST. RM: I //•I I. I I I I I i _ ( I .. - _ _ ;. BATH I / J I "I •I I. I I I i _ I . ENT. HALL I I I I L- I I. I I I. I•. _ - HALL NO. FRONT PORCH I- ( I. I. I I I I - I' !f' ,�.-Q oUTSIDff (9 _KITCHEN _SERV. PCH. . i ISDRM. NO. " CLOSET � I• I I .'- .I .I ." I '..I I I I ... BoRIA. No. I I_ I I I 1 I ' I APPROVAL _ C:LOSE7. - Olt I I I I 113 - DATE INSPECTOR'%' NAMar . I CONDUIT, � z —To WIRING / n .TOTAL I .I { / I I-_.. IZj TEXTURES - NO. OF O 1 S_UTLE ! � � " POWER j, UTILITY CO. NOTIFIED! NO: OF FIXTURES . - FINAL NO. OF.MOTORS H. P. - $ - c `— 1 AM.THE LEGAL OWNER OF THE ABOVE LOS ANGELES. ' N6. OF SIGNS TRANS.' r COUNTY. REGISTRATION BER. $ NO. OF RANGES-OR-HEATERS $ e .ELECTRICIAN. S MISCELLANEOUs S 1 AM THE LEGAL OWNER OF THE PROPERTY'D6gCRIBED s ABOVE. PERMIT FEE S /Q/s - TOTAL FEE $ / �f�f OWNER. DB 5-A 4-39 25M - APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY � COUNTY OF LOS ANGELES SO-8299 ELECTRIC WM. J. FOX, CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT,NO. GROUP ZONE PERMIT No. WIRING FIXTURES SERVICE READY FOR - RECEIVED BY. DATE ISSUED RANGE I HEATER - POWER - FIRST INSPECTION _ SIGNS MISCELLANEOUS APPLICANT FILL IN HEAVILY OUTLINED PORTINN ONLY QJOB NAME Electrical Products Corp. ADDRESS 2116 E. Las- Tunas ADDRESS 1128 Venice Blvd.. LOCALITY Temple City W CITY LOS Angeles,Cal TEL No.PR-0371 CROSSSST. w COUNTY - W REG. NO. 361-E - EXPIRES 9-18-40 - K NAME Market Basket Compar>yy . DESCRIPTION OF WORK I 3 :AD MAIL DRESS 501 S. Broadway. ' NUMBER OF OUTLETS ON CIRCUITS .O .- LOCATION_BY ROOMS CITY "Pasadena Cal• TEL No. ' I LIGHT OUTLETS I SW.IPLUGS IFIXT. CORRECTIONS CIRCUIT A B 'C I D. j E I j F j G j H j Connecting one _neon sign . LIVING ROOM DINING ROOM BRFST. RM. BATH - - ENT. HALL _—- J - i I HALL NO.. _ F4 - __ - Z FRONT PORCH I_ I__ OUTSIDE I _KITCHEN- I I. _ !I^_L_ I t(7• f n f• Z SERV. PCH. No. CLOSET - BDRM• NO. � - I •' - CLOSET _ APPROVALS - �_' I I DATE INSPECTOR'S MAME -I-� _ CONDUIT WIRING TOTAL ! 17 I FIXTURES -• ` NO. OF OUTLETS -� $ POWER -"'v'� •� `/�, 666 NO. OF FIXTURES $ UTILITY CO. NOTIFIED NO. OF MOTORS H.' P. $ FINAL I �� NO. OF SIGNS 1 TRANS. ' 3 $ 1 00, 1 AM THE.LEGAL OWNER-PFF THE ABOVE LOS.ANGELES* COUNTY REGISTRATION -NUMBER. NO. OF RANGES OR HEATERS . $ MISCELLANEOUS' $ /�/ ELECTRICIANS. _ 1 AM.THE LEGAL.OWNER OF THROPERTY DESCRIBED PERMIT FEE $. 1 OO., ABOVE. TOTAL FEE S 2 100 OWNER. 76A663A-CE806A 4/72 APPLICATION R EL RICAL PERMIT COUNTY OF LOS-ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS LOCALITY FOR APPLICANT TO FILL IN jNEAREST CROS S ST, OUTLETS NO. EACHI FEE OWNER RECEPT.�g $ Is MAIL LIGHT TOTAL FIRST 20 ADDRESS �.} - GJ` SWITCH OVER 20 Cl TY / 4 4 TEL. N0. f PLAN CHECK LIGHTINGTOTAL FIRST 20 APPLICANT FIXTURES OVER 20 ADDRESS RESIDENTIAL APPLIANCES CITY TEL. NO- RANGE DRYERWTR. HTR. PERMIT APPLICANT p" l STA. COOK DISP. . F.A.U. ADDRESS J<75 _ hK Cf SPACE HTR. AIR COND. CITYTEL. NO. dAND/OR CLOTHES WASH. DISHWASH. LICENSE NO. all CLASSFAN OTHER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AN 4AND STATE THAT THE ABOVE IS CORRECT AND AGREE YMOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS NG IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING.SIZE & TYPE OVER TO 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTER0 -,1 LICENSED AS REQUIRED BY LOS ANGELES COUNTY ANF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, ANDO �1 - 1O RESIDE IN, THE ABOVE DESCRIPED RESIDENTIALY. NSIGNATURE10 - 50 OF PERMITTEE 50 - 100 DISTRICT NO. T .ASSSEDBZONE 100 — 500 D 8 �" SIGN, GAS SIGN AND ONE CIRCUIT NOTES: TUBE, OR MARQUEE ADDITIONAL CIRCUITS SERVICE NOT OVER 600 VOLTS OR 200 AMP APPROVALS DATE INSPECTOR'S SIGNATURE SERVICE OVER 600 VOLTS OR 200 AMP TEMP.POWER POLE TEMP SERVICE,POLE, &APPURTENANCES UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM ROUGH CONDIUT WIRING FIXTURES POWER AUTHORIZED PERMIT FEE (SUB TOTAL) PLAN CHECK FEE UTILITY CO. NOTIFIED FINAL PERMIT ISSUING FEE TOTAL FEE 70 PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION � m.o. CASH 37 5:r-JAN 2 2 U 57 � a:" �� D.B.S.5A 25M SETS 10-47 jj►�PHJaV�ATIO1�➢ FOR PE RyRy'I617'Lr DEPARTMENT OF BUILDING Allam SAFETY HJ�Vw��31`� 1�➢ FOR S Si�o�Fl COUI" 'Y OF LOS ANGELES � I W . J. FOX. CHIEF EN21Eft NAMELV DISTRICT NO. GROUP ZONE PERMIT NO. U-L ADDRESS 1,06 �iCiC.L{� G_�• , a ' RECEIVED BY READY FOR DATE ISSUED W C T N� TEL.NO. FIRST INSPECTION 5 J k„ —�8 I9 CERT.NO. EXPIRES APPUCANT FUL IN HEAVILY OUTLINED PORTION ONLYDESCRI] g ON OF WORK ADDRESS NUMBER OF OUTLETS ON CIRCUITS LOCALITY LOCATION BY ROOMS NEAREST LIGHT OUTLETS isw. PLUGS FIUT CROSS ST. CIRCUIT A B C D I E F G JH m NAME Z MAIL /_ q -� /) �� z ADDRESS (9 IY'n+4,�/ O CITY TEL.NO. 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFI T 0 QUALIFCATwNt. / _.) LSA T ELECTRICIAN. 6 IAM THE&EGAL 04YNER-OF THE PROPE,FtTY DESCRIBED ABOVE OWNER. COIMCTIONS Q z c� 0 TOTAL No. OF OUTLETs $ APPROVALS No. OF FIXTURES t/> e) S n Q DATE INSPECTOR'S NAME NO. OF MOTORS-!57H.P. $ C^ CONDUIT /) / NO. OF SIGNS TRANS._ S WIRING g 3 JG�C NO. OF RANGES OR HEATERS 3 FIXTURES ' r LANEOUS $ POWER FEE $ UTILITYCO.NOTIFIED F E S FINAL 7 - 7^ �_ )DEPARTMENT OF BU16ING AND SAFETY ZZA JL��Axxy1ll A"JL% A ALAKUTA-LA COUNTY OF LOS ANGELES WM. J. FOX. CHIEF ENGINEER ELECTRIC DISTRICT NQ-j GROUP ZONE PERMIT NO., NAME 7 pDRESS X 7-- RECEIVED By READY FOR DATE ISSUED CITY TEL.NO. it FIRST INSPECTION ot4 COUNTY W CERT.NO. (o ic-1, EXPIRE; APPLICANT FELL IN HEAVILY OUTLINED PORTION ONLY JOB DESCRIPTION OF, WORK ADDRESS JVI`�') NUMBER OF OUTLETS ON CIRCUITS LOCALITY 1' " LOCATION BY ROOMS NEAREST LIGHT OUTLETS -SW.1 PLUGS—FIXT CROSS ST.- CIRCUIT A IM c D I E F IG H NAME W z MAI, ADDRESS, RESS iv)it CITY 7772?t�P� `P� M' 6TEL-No. I AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELE A COUNTX CERTIFIC.pTEZQULyA�cgLI§l TIO& A LE"L 0 ELECTRICIAN. I AM THE OWNER OF THE PROPERTY DESCRIBED ABOVE OWNER. 2"(,ed c Af fil-p, CORRECTIONS z TOTAL ..OF OUTLETS ffi APPROVALS NO. OF FIXTURES ]DATE INSPECTOR'S NAME NO. OF MOTORS M.P., CONDUIT NO. OF SIGNS TRANS, WIRING NO. OF RANGES OR HEATERS FIXTURES MISCELLANEOUS POWER PERMIT FEE UTILITY CO.NOTIFIED TOTAL FEE FINAL WORKERS' COMPENSATION DECLARATION CE-806G '°'81 .APPLICATION FOR ELECTRICAL PERMIT I hereby affirm.that•1 ha've•a certificate of consent to self insure, fl 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.�7�_3Company FOR APPLICANT TO FILL IN JOB t�Certified copy is herebyfurnished. EACH NO. ., FEE _ ADDRESS New Residential Bldgs..&Pools Certified copy is filed with the county building inspection 1 & 2-Family,Sq.Ft. $ _ $ LOCALITY department. Multi-family.Sq.Ft. NEAREST u xl/�/ CROSS ST: Date 2Z' A lica Residential Swimming Pools OWNER OR pp m ,fes cr�/e v�� Y�c. FIRM NAME " CERTIFICATE OF.EXEMPT,ION FROM WORKERS' 3 L1 - MAIL utlets:Rec Light Sw. ,' N COMPENSATION INSURANCE U ADDRESS (This section need not be completed if the work involved by the ✓] First 20 14891 permit is for one hundred dollars($100)or less.) , Total No. w Additional O CITY � Tel.No. a I certifythat in the performance of the work for which,this permit PLAN CHECK p APPLICANT /YC-- 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 J Tel.No. S-3 Date Applicant Fixed Appliances Not Over 1 HP PERMIT a NOTICE TO APPLICANT: If, after making this Certificate of APPLICAN Exemption,you should become subject_to the.Workers'Compensation Range_ Heater DW provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer ADDRESS provisions or this permit shall be deemed revoked. Top i Fqq H. LICENSED CONTRACTORS DECLARATION Hood an Other_ CITY��Jf�/CQT� Tel.No.S7j 6 I,hereby affirm that I am licensed under provisions of Chapter 9LICENSE OR (commencing with Section 7000) of Division 3 of the Business and Disp. Room Air Cond. REG.NUMBER Class. Professions Code,and my license is In full force and effect.' DISTRICT NO. Ro SED BY Power Apparatus& Large Appliances p a� ` Size& Type HP,KW,KVA,or KVAR 1,1'��O �e ��L��C,J (� / FINAL Lic nse Number Lic.Class Up to 1 Incl. 22 Over•1 to 10 Incl. DATE 1 Z y '�/ VALIDATION O Contract e / Over 10 to 50 Incl. L O ❑ FINAL O I am exempt under Sec. Over 50 to 100 Inca BY a B.&P.C.for this reason Over 100 N Services,Swbd.,MCC& Panelboards Z Date: 0-200 Amp.Under 600 V Signature 201 - 1000 Amp.Under 600 V ❑ Over 1000 Amp.or Over 600 V Exemption for Reg.Maint.Elect. SINGLE FAMILY Temp.Power Pole& Appurtenances 7 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ' I hereby affirm that I am exempt from the Contractor's License Law A for the following reason(Section 7031.5, Business and Professions Additional Sign Branch Circuits 33u.7 19g•40 Code): T t,f� ❑ I,as owner of the property,will do the work and the structure Misc.Conduits& Conductors 1 f EMS is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) pop. 1OTAL IL98 _40 and Professions Code). CHECK 198.40 CONSTRUCTION LENDING AGENCY �- nn I hereby affirm that there is a construction lending agency for the r�HAWGE •00' performance of the work for which this permit is issued(Sec.3097, . PERMIT FEE (Sub-Total) / / (� Civ.C.). PLAN CHECKING'FEE_ _ 0000-0401 11/22/95 Lender's Name 3413 .1 AM11�,s1 PERMIT ISSUING FEE _ . Lender's Address f� 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 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 of Permittee Date WORKER'S COMPENSATION DECLARATION 720-0019 6A663 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that'I have a certificate of consent to self insure, or a certificate aLWorkev's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(S,,73800 Lab.C.) FOR APPLICANT TO FILL IN JOB �n S7 T'. '�ASC TN/ t7�T Policy No. Company ADDRESS LC/ C ,)J; 6 fJ 1' Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE LOCALITY ❑ 1 &2-Family,Sq.Ft. — — $ $ Certified copy is filed with the county building inspection NEAREST department: Multi-family Sq.Ft. CROSS ST. Date Applicant Residential Swimming Pools ASSESSOR _ PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' J�� '•-►� OWNER OR /n I/ COMPENSATION INSURANCE Outlets:Rea LLL Light Sw.TtL pO FIRM NAME C��/ �S l First 20 / O MAIL (This section need not be completed if the work involved by the Total No. Additional a'0 ADDRESS (�(�. (( permit is for one hundhed'dollars($100)or less.) I certify that in the performance of the work for which this permit CITY Tel.No.( cDu{D is issued, I shall not employ any person in any manner so as to 7 PLAN CHECK become subject to the Workers' Compensation Laws. Lighting Fixtures First 20 APPLICANT Total No. Additional • 20 �^ ADDRESS Date wv Applicant .� RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTI E TO AP LICANT: If, after maki g this Certif' of CITY Tel.No. Exemption,you should become subject to th Workers' Co ensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code, you must forthwith corn I with such PERMIT r P Y P Y APPLICANT / provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances LICENSED CONTRACTORS DECLARATION Size&Type P,KW,KVA;or KVAR ADDRESS I hereby affirm that I am licensed under provisions of Chapter 9Over 3 to 10 Incl. .lr ' (commencing with Section 7000) of Division 3-of the Business and CITY � Tel.No. Professions Code,and m license is in full force and effect. Over 10 to 50 Incl. LICESE OR IF w 1 Y Over 50 to 100 Incl. REG NNU BER �' Class.Ci 0- Over Over 100 DISTRICT NO. PMCSED BY O License Number Lic.Class (J � VServices,S bd. CC&Panelboards ` l L j' Contractor Date 'l AQ AFINAL 0 mp.Under 600 V J DATE F-1q� 400-1000 Amp.Under 600 V �� l�' ~ I am exe pt under Sec. 3 VALIDATION W Over 1000 Amp.or Over 600 V FINAL B.&P.C.for this reasonBY BRANCH CIRCUIT FEESa- Date: 15A,or 20A,120V,Lighting or Recept. Z_ 1 To 10 Branch Circuits Signature 9 11 To 40 Branch Circuits El Exemption Or More Branch Circuits Exemption for Reg Maint. Elect. 15A,207,208V To 277V Lighting Br.Circuits SINGLE FAMILY Temp.Power Pole&Appurtenances g HOME OWNER-BUILDER DECLARATION H_41 =s" 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 %3 3 ,_A1n 10 Code): 11TE( = . ......-.. . ❑ I,as owner of the property,wiltdo the work and the structure Misc.Conduits&Conductors. - I_ITAL 341 d.. 10 is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) "` rr-. ''ii..... .- ..... q 34 and Professions Code). q� }, �• _ CONSTRUCTION LENDING AGENCY 1 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) O Civ.C.) % U J-':1i i 1 ;r 4;� PLAN CHECKING FEE �' '�-` Lender's Name 1;�7 4 -- 1 - AN 8a56 PERMIT ISSUING FEE �j W Lender's Address I certify that I have read this application and under penalty of purjury state TOTAL FEE / O that the above information is correct. 1 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 g-�- �3 SIG ATUR OF PERMITTEE DATE WORKERS' COMPENSATION DECLARATION 76A663 10/81 APPLICATION 1=0R ELECTRICAL PERMIT - I hereby affirm that I'have a certificate of consent to •self insure, CE-806G or.a certificate of Workers' Compensation Insurance, or a certified . COUNTY OF LOS ANGELES BUILDING AND SAFETY coppy �regf 3 b�C.) PoItyy_/NGGIOo. !• �O_mpany FOR APPLICANT TO FILL JOB � , ❑ EACH NO. -FE ADDRESS 1r �4 L Certified copy,js hereby furnished. New Residential Bldgs.& Pools Certified copy is filed with the county building inspection 1 & 2-Family,Sq.Ft. $ _ $ LOCALITY department. Multi-family Sq.Ft. NEAREST CROSS ST. Date' !L Applicant Residential Swimming Pools OWNER OR - :FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL /�- ,COMPENSATION INSURANCE Outlets:Rec— Light — t 20. ADDRESS (This section need not be completed if the work involved by the First ion CITY T .No. permit is for one hundred dollars($100)or less.) .. Total No, Additional PLAN CHECK 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'Compensatio _ Lighting Fixtures First 20- ADDRESS Additional Total No. CITY Tel.No. Date pplicant Fixed Appliances Not Over 1 HP NOTICE TO A:P CANT: If, after making .this Certificate of PERMIT Exemption,yo should become subject to.the Workers'Compensation Range_ Heater_ DW., APPLICANT fj provisions.of.the Labor Code, you must forthwith comply with such Oven _ Dryer _ W.M._ ADDRESS g �' provisions,or this permit shall,be deemed revoked. Top — FAU W.H. CITY S yt el No. LICENSED CONTRACTORS DECLARATION Hood — Fan _•Other_ I hereby affirm that I am licensed under provisions of Chapter 9 Disp. Room Air Cond. LICENSE OR REG.NUMBER5C-2-7Cla s. (commencing with Section 7000) of Division 3 of the Business and , Professions Code,and my license is in full force and effect. Power Apparatus& Large Appliances, DISTRICT NO. F P SSED BAY 1;, Size&Type HP,KW,KVA,or KVAR U License Number Z Lic.Class C --fl Up to 1 Incl. FINAL Over 1 to 10 Incl. DATE 'Z` `l�_Q VALIDATION Q Contractor Date1,2--,--( Over 10 to 50 Incl. FINAL 7 �4 U ❑ - I am exempt under Sec. Over 50 to 100 Inc. BY a B.&P.C. for this reason Over 100 N Services,Swbd.,MCC& Panelboards Date: 0-200 Amp.Under 600 V• Signature 201 - 1000 Amp.,Under 600 V ❑ Over 1000 Amp.or Over 600:V . Exemption for Reg.Maint.Elect. SINGLE FAMILY Tempa Power Pole&"Appurtenances 2 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ACCT.a I hereby affirm that I am exempt from the Contractor's License Law for the following reason(Section 7031.5, Business and Professions Additional Sign Branch_Circuits, n Code): 3301 65.60 El 1,as owner of the property,will do the work and the structure Misc.Conduits &Conductors ER—COR isnot intended or offered for sale (Section 7044,'Business Other(See Complete Fee Schedule) 3301 and Professions Code). 3303 65.60 CONSTRUCTION LENDING AGENCY •1 hereby affirm that there is a construct nding agency for the 1 ITEMS performance of the work for which t ' permit is issued(Sec.3097, ' PERMIT FEE (Sub-Total) , o Civ. c.). TOTAL 65.60 PLAN CHECKING FEE "CHECK 65.60 Lender's Name PERMIT ISSUING FEE o CHANGE .fid Lender's Addre / / D I certify that I have read this application and state that the above TOTAL FEE !tom (o information is correct. I agree to comply with all County ordinances 0000-0001 12/ 595 and State laws regulating Electrical wiring, and hereby authorize t�VV representatives of this Count ,to enter upon the above-mentioned 3604 rtpta ' 6.'34 propeXtyfinspecti pur es. SEE REVERSE FOR EXPLANATORY LANGUAGE, Signat re 6Per dtee a e COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1204130011 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: (LEGAL ID: FEES PAID BUILDING'ADDRESS: ITR: 6561 _LT: 677 BL: .001 1 9520 LAS TUNAS DR I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( TEMP CA 917802104 1 (ASSESSOR INFORMATION NUMBER: I I - NEAREST CROSS STREET: 1 18587-012-013 IA1 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY CAI - I IK1 SIGNS, OUTLINE LGT 1.00 SIG 38.90 TENANT: I TOTAL FEES 66.70 (ISSUED ON: PROCESSED BY: PLAN BY: 104/13/12 , SR _ I (OWNER: TEL. NO: IFINAL DATE FINAL BY: CODE: IMEISHOW, LIN (626) 309-9395- - 19520 LAS TUNAS DR ITEMPLE CITY CA 91780 - _ IDESCRIPTION OF WORK INTERNALLY ILLUMINATE LED CHANNEL LETTER SIGN (APPLICANT: TEL. NO: INEW SIGNS (626) 571-9288- 18902 GARVEY AVE ISPECIAL CONDITIONS: - ROSEMEAD CA CONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE INEW SIGNS AND PRINTING (626) 571-9288- 1 1 18902 GARVEY AVENUE LIC. .NO ITEMPORARY POWER POLE 1 IROSEMEAD, CA 91770 956512-C45 I I (UNDERGROUND CONDUIT (ARCHITECT OR ENGINEER: TEL. NO: IUFER GROUND LIC. NO: IROUGH CONDUIT IROUGH WIRING MAIN WATER LINE PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED EXPIRED I* ADDITIONAL DATA ON FILE IREPORT ID: DPR265 ROUTE TO: BSO508 ~ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1212120041 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: ITR: 6561 LT: 677 BL: .001 1 9520 1/2 LAS TUNAS DR IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( TEMP CA 917802104 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 18587-012-013 IA1 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY CAI I _IK1 SIGNS, OUTLINE LGT 1.00 SIG 38.90 (TENANT: I TOTAL FEES 66.70 IISSUED ON: PROCESSED BY: PLAN BY: IGERMAN PIANO 1 112/12/12 SR OWNER: TEL. N0: I IFINAL DATA FIN CODE: IEDISON (626) 757-1098- 1 1 \ v 1114 LAS TUNAS DR (ARCD 910078512 I ID SCRIPTIOP WORK I IINTERNALL ILLUMINATED LED HANNEL LETTER WALL SIGN I I I I (APPLICANT: TEL. NO: 1 1 1 ILE, KEN (626) 571-9288- 1 I 18902 GARVEY AVE 1 (SPECIAL CONDITIONS: IROSEMEAD CA 91770 1 1 1 I I I I I I I I ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE INEW SIGNS AND PRINTING INC (626) 571-9288- 1 1 1 18902 GRAVEY AVE LIC. NO 1 ITEMPORARY POWER POLE I 1 ROSEMEAD/CA/91770 965512 1 I I ' I 1UNDERGROUND CONDUIT I I (ARCHITECT OR ENGINEER: TEL. NO: IUFER GROUND I 1 1 I - I I I LIC. NO: I (ROUGH CONDUIT 1 I I I I I I I 1 IROUGH WIRING 1 I I I I I I I I (MAIN WATER LINE 1 I 1 I I (PLASTIC Y/N METAL Y/N 1 1 I I I I I I I 1 1UTILITY COMPANY NOTIFIEDI I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I i I I I I I I I I I I I I IREPORT ID: DPR265 ROUTE TO: BS0508 1 1 1 I I I I I I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1111070035 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: (LEGAL ID: FEES PAID BUILDING ADDRESS: ITR: 6561 LT: 677 BL: .001 1 9520 LAS TUNAS DR IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( TEMP CA 917802104 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 18587-012-013 1A1 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, Cl 1G1 OUTLETS-LGT,SW,RECP 4.00 OUT 7.80 I I (TENANT: I TOTAL FEES 35.60 (ISSUED ON: PROCESSED BY: PLAN BY: I (OLYMPIA EDUCATION INSTITUTE I 111/07/11 SR OWNER: TEL. NO: I IFINAL DATE FINAL Y: CODE: 1 ILIN, MICHELLE (626) 309-9395- I 1 ,_ 5 1 19520 E. LAS TUNAS DR I I 1 ITEMPLE CITY CA 91780 I IDIESCRIPTION OF-WORK I (INSTALL 4 OUTLETS I I I I I (APPLICANT: TEL. NO: 1 I I ILIN, MICHELLE (626) 309-9395- (SPECIAL CONDITIONS: I I I I I (CONTRACTOR: TEL. NO: 1 IAPPR.OVALS DATE INSPECTOR SIGNATURE I IWEN JEN HE (323) 327-2734- 1 1 1 1187 S GARDNER STREET LIC. NO ITEMPORARY POWER POLE I I ILOS ANGELES, CA 90036 911301 B 1- 11 I 1 1UNDERGROUND CONDUIT I I 1 1ARCHITECT OR ENGINEER: TEL. NO: 1 IUFER GROUND I I I LIC. NO: I IROUGH CONDUIT 1 1 IROUGH WIRING 1 IMAIN. WATER LINE I 1 IPLASTIC Y/N METAL Y/N 1 1 1 1 (UTILITY COMPANY NOTIFIEDI I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I IREPORT ID: DPR265 ROUTE TO: BS0508 1 1 I I I I I I 76AG63 DBS 5A 11-50� - APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY. OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP. ZONE PERMIT NO. - ELECTRICIAN REC NED BY READY FOR DATE ISSUED ADDRESS Elek FIRST INSPECTION CITY. .TEL. NO. - J 7- 2" - 7 61 / 4 COUNTY LICENSE NO. EXPIRES BUILDING PERMIT FEES ADDRESS FEE ' -77 NUMBER EACH - LOCALITY • LIGHT OUTLETS NEAREST - CROSS ST. {RECEPTACLES WALL ' t WALL SWITCHES OWNER TOTAL OUTLETS Sc $ MAIL ELEC. RANGES 25 - ADDRESS ELEC. HEATERS 25 CITY - TEL. NO. FIXTURES 5 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS 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 I CERTIFY THAT I POSSESS THE ABOVE VALID LOS ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER NUMBER HORSEPOWER FEE EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. NEW MVD. HP OVER INC. rs—rte 1/2 &LESS $ .25 SIGNATURE OF 1/z 2 .50 PERMITTE 1p ,. >. e3'. 2' S 1.00 INSPECTION RECORD 5 15 1.50 15 50 2.50 - 50 200 5.00 F- 200 500 10.00 500 1000 15.00 Q U OVER 1000 20.00 - - ,j M. G. SET/FREQ. CHANGER-HP IL D WELDERS: AC—KVA 0 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: WIRING $1.-00 �. CONDUIT _ FIXTURES - $1..00 WIRING. SUPPLEMENTARY .50 - FIXTURES POWER TOTAL FEE $ UTILITY CO. NOTIFIED ® - FINAL ® p��p FOR yq� 1 � I)OS.S3 APPLICATION tl ®R ELECTRIC PERMIT IT i DBS•SA 3.55 DIVISION. OF BUILDING AND SAFETY • Department of County Engineer . , County of Los Angeles ADDREBUILDISS .�'j F0. WM.J. FOX, COUNTY ENGINEERADDRESS / t 2rii�CASSATT D.GRIFFIN, SUPT OF BUILDINGLOCALITYFOR APPLICANT TO FILL IN NEAREST PERMIT FEES CROSS ST. NUMBER EACH FEEOWNERLIGHT OUTLETS MAILRECEPTACLES ADDRESSWALLSWITCHES TOTAL OUTLETS 5¢ S CITY TEELEC. RANGES 25 ELECTRICIANr"7"�.,.� _ELEC. HEATERS 25 ADDRESS s'Q�t7 KW EA CITY y ' C A' Y�J TEL. N67/,' FIXTURES 5I LICENSE NO. I NUMBER OF LIGHT CIRCUITS — DISTRICT NO. GR P ZONE READY FOR INSPECTION NUMBER OF RECEPTACLE CIRCUITS I a ( /' If 'MOTORS �.• /� INSPECTION RECORD NUMBER HORSEPOWER FEE NEW MVD. HP OVER INC. .EACH Ic3I1� _ I/2&LESS $ .25 1/2 2 .50 2 5 1.00 5 15 1.50 I5 50 2.50 '50 1 200 '5.00 ot MISC. NO.SIGNS .NO.TRANS. NO.SIGNS NO. LAMPS FOR EACH PERMIT: ' WIRING $1.00 FIXTURES $1.00 SUPPLEMENTARY .50 APPROVALS TOTAL FEE S ` �'`� DATE INSPECTOR'S SIGNATURE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP L�—ICATIONN CONDUIT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND. STATE LAWS REGULATING WIRING ELECTRICAL WIRING. IHEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE. OF y CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE POWER DESCRIBED SIGNATUREESIDENTIAL PROPER7v• — //^'/ UTILITY CO.NOTIFIED OFPERMITTEE FINALfflwanmdmii u WILLIAM J. FOX.COUNTY ENGINEER VALIDATION A. C.VEIT,CHIEF ELECT. INSPECTOR ;�08 9 4 5 "' 0(','r 13 1 .5 U �I /Li Ply e � f_/r 76A663-CE806II/70 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES r DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. OUTLETS NO. EACH FEE 0 S $ OWNER RECEPT._ MAIL FIRST 20 ADDRESS LIGHT TOTAL .25 CITYTEL. NO-: SWITCH OVER 20 .10 - ,.7 PLAN CHEC � , LIGHTINGTOTAL FIRST 20 25 APPLICANT FIXTURES �10 OVER 20 ADDRESS APPLIANCES CITY TEL. NO, PERMIT < RANGE DRYER_WTR. HTR. APPLICANT STA. COOK DISP. F.A.U. ADDRESS — SPACE HTR. AIR COND. CITY TEL. N0. CLOTHES WASH. DISHWASH. LICENSE NO. CLASS. C_Se,)_ FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. SIZE IN TYPE OVER TO I HEREBY CERTIFY .THAT I AM PROPERLY REGISTERED AND/OR 0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO 1- 1 - 10 3.00 RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. O 10 - 50 5.00 SIGNATURE CJ OF PERMITTEE ® f 50 - 100 10.00 DI STRICT NO CLASS ZON P O BY H 1 00 - 500 15.00 /Ls a SIGN, GAS SIGN AND ONE CIRCUIT 5.00 NOTES: N ? TUBE, OR - MARQUEE ADDITIONAL CIRCUITS 1.00 SERVI CENOT OVER 600 VOLTS OR 200 AMP 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE S ERVI CE OVER 600 VOLTS OR 200 AM P 10.00 - TEMP.POWER POLE TEMP SERVICE,POLE, &APPURTENANCES 5.DO UNDERSLAB WORK TEMP LIGHT OR RECEPT, SYSTEM 3.00 ROUGH CONDIUT WIRING - FIXTURES POWER AUTHORIZED PERMIT FEE (SUB TOTAL) UTILITY CO. NOTIFIED PLAN CHECK FEE 1-417 �n PERMIT ISSUING FEE 3.00 JO! C. ROOHAN TOTAL FEE / SUPERV t0 NG ELECTRICAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALI ON CK. M.O. CASH L iuO u fu ? �' D IT n SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 76A663 DBS SA 11-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF.LOS ANGELES ELE(3TRIC 1 WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT, NO. GROUP ZONE PERMIT NO. ELECTRICIAN REC IVED BY READY FOR DATE ISSUED ADDRESS ��'m"" //E+l/ FIRST INSPECTION CITY TEL. NO. ! >� — 27 . '� D COUNTY LICENSE NO. ar EXPIRES 1 BUILDING PERMIT FEES ADDRESS ` FEE NUMBER EACH LOCALITY. 6.� e 77 LIGHT OUTLETS NEAREST . CROSS ST. RECEPTACLES WALL SWITCHES OWNER TOTAL OUTLETS Sc $ MAIL ELEC. RANGES 25 ADDRESS � - ELEC. HEATERS 25 CITY - TEL. NO. FIXTURES 5 1. HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS 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 I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. NEW MVD. HP OVER I INC. EACH n 1/2 a LESS $ .25 SIGNATURE OF 1/2 2 .50 PERMITTEE 2 5 1.00 INSPECTION RECORD 5 15 1.50 15 50 2.50 50 200 5,001 200 -500 10.00 - J Soo 1000 15.00 Z OVER 1000 20.00 M. G. SET/FREQ. CHANGER-HP WELDERS: AC-KVA O GENERATORS-KW I ' TRANSFORMERS-KVA TEMP. MOTORS (7S%OF ORIG.) - MOVED MOTORS (75%OF CRIG.) MISC. SIGNS -•.1 NO. NO. TRANS. I APPROVALS. NO. NO. LAMPS -DATE INSPECTOR'S NAME FOR EACH PERMIT: WIRING $1.00 CONDUIT FIXTURES $1.0 0WIRING SUPPLEMENTARY .'50 FIXTURES ' POWER TOTAL FEE $ UTILITY CO. NOTIFIED P FINAL 79A998 APPLICATION FOR ELECTRIC PERMIT 1 DBS•5q 11.59 DIVISION OF BUILDING AND SAFETY Deportment Of County Engineer BUILDING �✓� / �� C, County Of LOS Angeles ADDRESS /� J JOHN A. LAMBIE, COUNTY ENGINEER f /'yL)3� CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY ��e2J2 F C FOR APPLICANT TO FILL IN t NEAREST PERMT FEES CROSS ST. NUMBER OWNER LIGHT OUTLETS MAIL RECEPTACLES ADDRESS /�� / /// � /��'►s7 'U PV S WALL SWITCHES FEE _ /Fa- & TEL.NO. L CITY TOTAL OUTLETS @ 5¢ $ ELECTRICIAN viae>r Sj a4me, ELEC.RANGES 25 ADDRESS A A s Ave ELEC.HEATERS 25 CITY / A tz ai TEL.N 6p-/2 k� KW EA STATE FIXTURES 5 LICENSE NO. 9 3S MOTORS FEE DISTRICT NO. `I'S �I NE READY FOR INSPECTION NUMBER HORSEPOWER NEW MVD. HP OVER INC. EACH ,/2&LESS $ •25 INSPECTION RECORD Yz 2 .50 2 5 1.00 515 1.50 t5 50 2.50 50 200 5.00 M ISC. NO.SIGNS NO.TRANS. NO.SIGNS NO. LAMPS FOR EACH PERMIT: WIRING $1.00 FIXTURES $1.00 SUPPLEMENTARY .50 � APPROVALS TOTAL FEE $ DATE INSPECTOR'S SIGNATURE I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND ST TE LAWS REGULATING WIRING ELECTRICAL WIRING. I HEREBY CERTIFY THAT 1 AM PRO R GISTERED AND/OR FIXTURES LICENSED AS REQUI$E BY LOS ANG E TY AND STATE OF CALIFORNIA OR THAT I AM THE R OF THE ABOVE POWER DESCRIBED RESIREWiI4 PROPERTY I SIGNATURE UTILITY CO.NOTIFIED ^� OF PERMITTE FINAL JOHN A.LAMBIE,COUNTY ENGINEER VALIDATION ARTHUR C.VEIT.CHIEF ELECT. INSPECTOR CK MO CASH L U 4 1 7 5- JAN 15 Z 2.0 Q '� 76A663 DBS 5A 3-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY In COUNTY OF LOS ANGELES ffim"IC . 1 WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRICIAN i 1 �® 11143 1 ADDRESS CITY p L� RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION C/ .TEL. N13-21,F WI p COUNTY LICENSE No. EXPIRESBUILDING ADORESB PERMIT FEES NUMBER EACH FEE LOCALITY LIGHT OUTLETSCROSS ST.NEAREST r RECEPTACLES WALL SWITCHES OWNER TOTAL OUTLETS 5c, $ MAIL ELEC. RANGES 25 ADDRESS ELEC. HEATERS 25 CITY TEL NO. FIXTURES 5 d I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS 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 LAWB REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER NEW MVD. HP OVER INC. EACH OF'THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. %2 6 LESS .25 SIGNATURE OF '/2 2 .50 PERMITTEE 2 5 1.00 INSPECTION RECORD 5 15 1.50 15 5o 2.50 so 200 5.00 200 S00 10.00 J 500 1000 1 5.00 Z OVER 1000 20.00 (g M.G. SET/FREQ. CHANGER-HP R' WELDERS:AC-KVA O GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF DRIG.) MOVED MOTORS (75% oP DRIG.) MISC. SIGNS NO. NO.TRANS. J' NO. N0. LAMPS APPROVALS DATE INSPECTOR'S NAME FOR EACH PERMIT: WIRING $1.00 CONDUIT ee FIXTURES $1.00 WIRING � :�' P Sit 14,/ SUPPLEMENTARY .50 FIXTURES POWER TOTAL FEE $.: UTILITY Co.NOTIFIED FINAL Rqh V1RRl1RA �Iw�Annw __s.ci P_1-O_P��E T'�� vv rII LI RI/LV ly-IJ� TEMPLE CITY /70 APPLICATION FOR ELECTRICAL PERMIT /t COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER FAD ING BUILDING AND SAFETY DIVISION SS aJOHN A. LAMBIE, COUNTY ENGINEER ITY Temple City'COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING FOR APPLICANT TO FILL IN ST CROSS ST, OUTLETS NO. EACH FEE Newton OWNER �} RECEPT.� $ $ D 2 Fairview LIGHT , TOTAL FIRST 20 X20 .20 � OQ AD 97 OVER 20 7 7 7� CITRESSpY Arcadia TEL. NO. SWITCH2� / PLAN CHECK LIGHTING TOTAL IFIRST 20 20 APPLICANT OVER 20 ADDRESS FIXTURES �1, � -10 APPLIANCES CITY TEL. NO. PERMIT TT� RANGE DRYERWTR. HTR. APPLICANTU4arr Electric STA. COOK DISP. F.A.U. ADDRESS 15737 Old Valley Blyd SPACE HTR. AIR CONO. 2 2 2 00 CI TY Cl L. NO. CLOTHES WASH. DISHWASH. LICENSE NC 50843 CLLL CLAS ^, FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING 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 REQUIRED BY LOS ANGELES COUNTY AN STATE OF CALIFORNIA OR THAT I AM HE LEGAL OWNER OF, AN INTEND TO 1 - 10 3.00 RESIDE IN, THE ABOVE DESCR,IAPED /RESIDE NTI L PROPERTY. SIGNATURE /�l10r /- 50 5.00 OF PEJt.M'I'TTEE 111///��!!! 0 50 - 100 10.00 DISTRICT NO. �CLrAISS G�P ZONE `PW151p SED BY O 100 - 500 15.00 SIGN, GAS SIGN AND ONE CIRCUIT 3.00 NOTES: �O 7d - ® d TUBE, OR < ,� MARQUEE ADDITIONAL CIRCUITS 1.00It ' �Q °'1.e.o SERVI CENOTOVER 600 VOLTS OR 200 AMP 1 2.00 2 00 APPROVALS DATE INSPECTOR'S SIGNATURE S'ERVI CE OVER 600 VOLTS OR 200 AMP 5.00 TEMP.POWER POLE TEMP SERVICE,POLE, &APPURTENANCES 3.00 UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM 3.00 t 1 ROUGH CONDIUT 7I b WIRING PERMIT FEE (SUB TOTAL) a 80 FIXTURES POWER AUTHORIZED PLAN CHECK FEE (50% PERMIT FEE) UTILITY CO. NOTIFIED PERMIT ISSUING FEE 2.00 SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL W11/1 JOSE H C. ROOHAN TOTAL FEE 23 .801 ( SUPERVISING ELECTRICAL ENGINEER. PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH . Ar,-,6 .9 S o ':40,;: 9 2 D 23.80- SEE 3.8ONSEE BACK OF APPLICATION FOR COMPLETE SCHEDULE WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT I hereby'zffirm that I have a certificate of consent to self insure, 76A663 or a certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof:Sec.3800 Lab. C.) = Policy NO. Company FOR APPLICANT TO BILL IN ADDRESS J /,y/✓ D G�! Certified-co py is hereby furnished. New Residential Bldgs.&Pools H0.1 EACH FEE LOCALITY Certified co Is filed with the count building inspection 1&2-Family,Sq.Ft. — $ $ �' .. PY Y 9 P - — NEAREST department. Multi-family Sq.Ft. CROSS ST. Date Applicant Residential Swimming Pools ASSESSOR MAP PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS'. tf OWNER OR /� y COMPENSATION INSURANCE Outlets:Rec._Light Sw. /ed h FIRM NAME V < First 20 (- MAIL (This section need not be completed if the work involved by theADDRESS permit is for one hundred dollars($100)or less.) Total No. Additional 1 certify that in the performance of the work for which this permit CITY/ T.I.No.3 is issued, I shall not employ any person in any manner so as t0 PLAN CHECK O become subject to the Workers' Compensation Laws. Lighting Fixtures First 20 APPLICANT Total No. Additional j/�OJ1/p� GyG/ l ADDRESS Date ' Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTIC TO APPLICANT: If, after making this Certificate of CITY Tel..No. Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code, you must forthwith comply with such PERMIT p Y P Y APPLICANT YrY provisions or this permit shall•be deemed revoked. Power Apparatus&Large Appliances Size&Type HP,KW,KVA,or KVAR ADDRESS D' 9 LICENSED CONTRACTORS DECLARATION YP 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 Tel.No. Professions Code,and my license is in full force and effect. Over 10 to 50 Incl LICESE OR Over 50 to 100 Incl. REG.NNUMBER Class. G7 .d Over 100 DISTRICT NO. O SSED BY O License Number Lic.Class V � Services,Swbd.,MCC&PanelboardsG' T- 0-399 Amp. Under 600 V FINAL 0 ,,,ppp O Contracto Date DATE _ 1 am exempt under Sec. 400-1000 Amp.Under 600 V Over 1000 Amp.or Over 600 V FINAL VALIDATION W B.&P.C.for this reason BRANCH CIRCUIT FEES BY 0- Date: 15A,or 20A,120V,Lighting or Rt. Z A �7 1 To 10 Branch Circuits Signature 7 � 11 T040 Branch Circuits ❑ 41 Or More Branch Circuits Exemption for Reg.Maint.Elect. 15A2 20A,208V To 277V Lighting Br.Circuits' SINGLE FAMILY Temp. Power Pole&Appurtenances ..... "E HOME OWNER-BUILDER DECLARATION 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_ wtirL}� Code): t d &C it d Conus Conductors . I,as owner of the property;will do the work and the structure Misc. "-,-•r.-.( "'"":�'� is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) and Professions Code). F• """E' �� ' 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, PERMIT FEE (Sub-Total) Civ. C.) PLAN CHECKING FEE Lender's Name / = ' PERMIT ISSUING FEE !!> Lender's Address r,' j 1 certify that I have read this application and under penalty of purjury state TOTAL FEE (v0 that the 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 SIGNAIVRE OF PERMITTEE DATE