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'6A 663-CE806 5-52 - tl..�6'm�.�9��ION. ��9`O PERMIT
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COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY,ENGINEER BUILDING. ^
BUILDING AND SAFETY;DIVISION' ADDRESS Lynros6 Ave.
JOHN A. LAMBIE, COUNTY ENGINEER
VVILL1AM A. JENSEN,'SUP'T'OF BUILDING' ` -LOCALITY
NEAREST -
FOR APPLICANT TO FILL IN CROSS ST. Pal Mal
RECEPT. 3.5' TOTAL Relld ..: i
•OUTLETS .
NO. .EACH', FEE .. t
//''�� FIRST'20 $,LD $ - OWNER
LIGHT '.2 - I � MAIL
rr�[o] AD6'L O ADDRESS
^n
SWITCH. 2.2 - 8 OVER 20 .10.
LIGHTING TOTAL_ FIRST 20 20 1{ Q CI RX 'Temple Cit EL.,No
F-IXTU'RES } 21. AWL 10
yy ov'R 20 10. ELECTRICIAN -� pp7�R/O1b�TlBOT1 E16C '
RANGES CLO..DRYERB, j.WTR,.HTRS,L ' 1.00 - ADDRESS: -,335 N Ca:n' O23`":Blvd `
GARB.DISP.1;', .STA.COOK - - - -
- CITY Mbnr6yj a TEL.NO. as '
DISHWASH.l" AUTO.-WASH. • STATE' !� ` -
SPACE HTRS...G STA.-APP.(l/s WP.'MAX. S - •50 ! FD
O. 2706-
MOTORS: OVER NOT OVER H.P. "'
NO.' G OUP -Z NE P ESSED Y
3.
1 s - +•50 - INSPECTfON REC RD '
Ire
o'
i5 so s.00U
50 1005.00 . 0 1 �'� ' s�1; � .�,
SIGNS NO TRANS._ • ..,. -
�.•NO LAMPS -U:J
y
SERVICE 0-600V'-NOT 64ER 200A 1.00 ' '_l, h Q�9� ,•' _ ,5�1?t ,, '�? f A/'� tar. :P.. .'14
SERVICE 0-600V-OVER 200 A.,
Z
SERVICE OVER-600 .5.00
PERMIT ISSUING,FEE -`-. -• 2.00 - .. ,..... ..
SUPPLEMENTAFIY PERMIT ISSUING'FEE' 1.00
TOTAL FEE,,
H2O
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION. ~' -APPROVALS'" DATE - INSPECTOR'S'SIGNATURE' r
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY,
WITH ALL COUNTY ORDINANCES AND.STATE LAWS REGULATING CONDUIT, N' �
ELECTRICAL'WIRING. - WIRING f, . KOL �% •J`
1 HEREBY CERTIFY THAT I AM•PROPERLY REGISTERED AND/OR - �7 //M �:��'
LICENSED AS.REgUIRED BY LOS ANGELES COUNTY,AND-.STATE'OF FIXTURES'
X.i�fy, lr e. /"`�`u�.•--
CALIFORNIA,OR THAT 1 AM HE LEG .O WNEl�OF'.THE ABOVE
DESCRIBED RESIDENTN PR ERTY: .POWER
SIGNATURE �,^y✓�' UTILITY CO.NOTIFIED' " d`PR"Wf>!.9
' OF PERMIT TEE
.„ 7r.EE
Q O 11gOT1... LIDATION ARTHUR C. VEir' rAr .
GK MO CASH'-
SUPERVISING ELECTRICAL ENGINEER'
3{:8 8.6'-x' SEP2,D 2;:0,90— a,
/
76A663-CE806 5-62 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS l �,
JOHN A. LAMBIE. COUNTY ENGINEER 7a 7[ C fj' �'1.7--
WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY !�'/`� `�,C`/
FOR APPLICANT TO FILL IN CROSS ST. L / L L-
RECEPT. TOTAL NO. EACH FEE
OUTLETS FIRST 20 $20 $ OWNER zle2xy�l
LIGHT MAIL-
ADD'L f0 ADDRESS
:- SWITCH. OVER 20
� 1_
LIGHTING TOTAL FIRST 20I .20 CITY � 1��!( �l�/ TEL. NOS
FIXTURES ADD'L
10 ELECTRICIAN
111 OV R 2O
RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS IN Al I -� (10-A-1
GARB.DISP. STA.COOK
CITY L U'�fw�/[. !"1" TEL. NO. Z s
DISHWASH. AUTO.-WASH. STATE " ^�
SPACE HTRS. STA.APP.(�/s H.P.MAX.) .50 LICENSE NO. j� ( j
MOTORS: OVER NOT OVER H.P. DISTRICT NO. GROUP ZONE I P SSED�Y
0 1 1.00 f <r 2_
1 3 1.50 ll, I PECTION RECORD
3 8 2.00 ,
8 15 2.50 rte • C
O
15 50 3.00 V
50 100 5.00 0
0
H
SIGNS: NO.TRANS U
NO.LAMPS UJ
a
SERVICE 0-600V-NOT OVER 200A 1.00 Z
SERVICE 0.600V-OVER 200 A. Zoo
SERVICE OVER 600V 5.00
MISC.
PERMIT ISSUING FEE 2.00
SUPPLEMENTA13Y PERMIT ISSUING FEE 1.00
TOTAL FEE $
1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS 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
1 HEREBY CERTIFY THAT I M PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY L S ANGELE OUNTY AND STATE OF FIXTURES -
CALIFORNIA OR THAT I AM THE LEG N€R O$ THE ABOVE POWER
DESCRIBED RESIDENTIAL PR PERTY. 1
SIGNATURE ' UTILITY CO.NOTIFIED '
OF PERMITTEE i
FINAL
0CK
LIDATION ARTHUR C. VETT
MO CASH SUPERVISING ELECTRICAL ENGINEER
&4 0 7 � SEP ? 2 0 2.n 0 .
WORKERS'COMPENSATION DECLARATION CE 806G (2,80) APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm. that I have a certificate of consent to self COUNTY OF LOS ANGELES 7 BUILDING AND SAFETY
insure, or a certificate of Workers'Compensation Insurance,or /
a certified copy thereof���c. 3800 Lab.C.)
oI
icy � .7 T/ m� FOR APPLICANT TO FILL IN JOB ADDRESS �1J 7 ,� .SG7 S�
Y New Residential Bldgs.&Pools EACH NO. FEE ��D
Certified copy is hereby furnished.. 1 &2-Family,Sq. Ft. $ _ $ LOCALITY
Multi-family Sq. Ft. NEAREST
ertified copy is filed with the county building inspection CROSS ST ,da,
department. Residential Swimming Pools OWNER OR
Date 0 /Z � LFIRM NAMEApplicant 41-7104-Is LJw`3 Outlets: Rec.—Light—Sw. MAIL
First 20 ADDRESS APS V XVnfloSe S,
CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITYTel No. r
COMPENSATION INSURANCE Q }
PLAN CHEV< CL
APPLICANT 0
(This section need not be completed if the work involved
Lighting,
by the permit is for one hundred dollars ($100) or less.) Fixtures AdditioFirst o ADDRESS
nal �
Total No. 0
1 certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No.
permit is issued, I shall not employ any person in any manner PERMIT J-
so as to become subject to the Workers' Compensation Laws. Range_ Heater_D.W. APPLICANT d
Oven _ Dryer^W.M. ADDRESS
Date Applicant
Top _ FAU _W.H..
Hood —Tan —Other CITY w /� Tel No
NOTICE TO gPLICANT: If, after making this Certificate of Disp. Room Air Cond. LICENSE R 9-,
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. PRCE ED BY
with comply with such provisions or this permit shall be Size&Type HP,KW, KVA,or KVAR
deemed revoked. —�— C.� !'�C.6�
Up to 1 Incl.
FINAL
Over 1 to 10 Incl DATE VALIDATION
Q o �
LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl. tl
�
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 f
ness and Professions.Code, and my license is in full force and
effect. Services -
s SG��`� 0-200 Amp. Under 600 V Ile �'
License Number Lic.Class 1 201-1000 Amp. Under 600 V A& 12
Contractor Dat / Over 1000 Amp.or Over 600 V
HOME OWNER-BUILDER DECLARATION Temp. Power Pole&Appurtenances
Sign with One Branch Circuit ?'F 'f
I hereby affirm that I am exempt from. the Contractor's Additional Sign Branch Circuits fl
License Law for the following reason (Section 7031.5, Busi-
ness and Professions Code):
Misc.Conduits& Conductors
1, as owner of the property, will do the work and the Other (See Complete Fee Schedule)— ,L
structure is not intended or offered for sale (Section
7044, Business and Professions Code).
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is•a construction lending agency (1 1
for the performance of the work for which this permit is PERMIT FEE (Sub-Total)
issued (Sec. 3097,Civ.C.).
Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) c'
Lender's Address PERMIT ISSUING FEE 3
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
Signat re of P e
ittee Da
> COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0703080025
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: _ I FEES PAID BUILDING ADDRESS: 1
ITR: 26554 LT: 3 I I 10549 LYNROSE ST 1
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( TEMP CA 917802839
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: PAL MAL
18586-012-003 IA1 PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE: 597 GRID: C3 LOCALITY: TEMPLE CITY, Cl
I ILA 100 AMP PANELS, MCC 1.00 PAN 38.85 _ I
ITENANT: I TOTAL FEES 66.60 (ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: I
I I 103/08/07 JK 09/04/07
I
(OWNER: TEL. NO: I IFIFAL DATE FIN Y: CODE: 1
IKENDIG HAROLD;ELIZABETH TRS (626) 447-9168- 1
110549 LYNROSE ST I 1
ITEMP 917802839 I IDESCRIPTION bP WORK 1
1 1 IREPLACING ELECTRICAL SERVI E TO 125 AMP
I
1APPLICANT: TEL. NO: I I I
ISAME AS OWNER - I I I
I I ISPECIAL CONDITIONS:
I
I I I I
ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE
ISAME AS OWNER - I I— I
I LIC. NO 1 ITEMPORARY POWER POLE
I I I
I (UNDERGROUND CONDUIT 1-1I
I I
I I I
(ARCHITECT OR ENGINEER: TEL. NO: 1 1UFER GROUND I I I
I I I
1 LIC. NO: 1 IROUGH CONDUIT r I I
I I I
I I IROUGH WIRING I I I
I I I
IMAIN WATER LINE
I (PLASTIC YIN METAL YIN I
I I (UTILITY COMPANY NOTIFIEDI I
l
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
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1 IREPORT ID: DPR265 ROUTE TO: BS0508
I I I I I I