HomeMy Public PortalAbout9362 LOWER AZUSA RD_Electrical__ 7GA663-CESOG 3-69Gam/ 1,
• • APPLICATIONOF R ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING ^
BUILDING AND SAFETY DIVISION ADDRESS 3 G"L �cwlSft �'LuLr► lid
JOHN A. LAMBIE, COUNTY ENGINEER /'
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY �Arra C:'T�
FOR APPLICANT TO FILL IN NEAREST V?
CROSS ST. ied M s PNO. EACH FEE �4 �y
RECEIPT. /0 $ $ OWNER /•}/tL>i•z IJI2v +. �f-0r
MAIL
LIGHT /0 TOTAL FIRST 20 .20 4 �
ADDRESS
SWITCH � OVER 20 .1-010 ao CITY TEL.N0. ,4 2 3c1C10
PLAN CHECK
LIGHTING TOTAL FIRST 20 ,20 Z Cy APPLICANT
FIXTURES �U OVER 20 ,10 ADDRESS
RANGE_DRYER_WTR. HTR. CITY TEL.NO.
STA. COOK_D ISP._F.A.U. CONTRACTOR fsF-A;.-I""-1 � G CT P�m S
SPACE HTR. AIR COND. ADDRESS 73 fO S. U/,:-k Lim
CLOTHES WASH._DISHWASH. CITY /-Y�d r-r��C7✓ i1 TEL.NO. 9 L( 7 73 72-
FAN_OTHER 1.00 LICENSE N0. /6 4 4 �� CLASS. C'0
MOTORS,TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
IND. HEATERS, ETC, HP. KW. KVA. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
SIZE TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
' ELECTRICAL WIRING.
5 0 — 1 1.00 1 HEREBY CERTIFY THATI AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATEOF
1 — 1O 3.00 CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF. AND INTEND TO Cl
RESIDE IN. THE ABOV CRIBED RE TIA PROPERTY. /
10 - 50 5.00 \�
SIGNATURE
50 - 100 10+00 OF PERMITTEE ��--
100 — 500 1$.00 DISTRICT NO. GROUP ZONE
ZONE P CE SS EDC Y
SIGN GAS SIGN AND ONE CIRCUIT 3.00 '�'"'� - °u
TUB!, OR
MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES: 0&0Z 1tJLv
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00
SERVICE OVER 600 VOLTS OR 200 AMP 5.001 1
TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP. POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
WIRING
PERMIT FEE (SUB TOTAL) FIXTURES
PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED
PERMIT ISSUING FEE 2.00 -L to UTILITY CO.NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL ?J
TOTAL FEE / O� JOSEPH C. RO )HAN
SUPERVISING ELECT R L ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
� Ar,4 6 7 SE2 AFP27 2 D 14-00;;,
�
SEE BACK OF APPLICATION FOR COMPLETE FEE srHFOUI.F
MA669-CE806 6-62 APPLICATION FOR ELe TRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER. BUILDING
BUILDING AND SAFETY DIVISION
ADDRESS �p
JOHN A. LAMBIE, COUNTY ENGINEER .-�
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY
NEAREST 13
FOR APPLICANT TO FILL 1N CROSS ST.
RECEPT. TOTAL NO. EACH FEE
OUTLETS FIRST 20 $20111 OWNER
LIGHT MAIL
ADD'L 1.0ADDRESS
SWITCH. OVER 20
TOTAL CITY TEL.NO.
LIGHTING "1 FIRST 20 :20
FIXTURES 1 ADD'L
OVFR 20 fp ELECTRICIAN LO
F
RANGES CLO.DRYERS. WTR..HTRS. 1.00 ADDRESS .,
GARB.DISP. STA.COOK
CI?Y ^ TEL.NO. "dlrFS"L ry.
DISHWASH. AUTO.-WASH. STATE
SPACE HTRS. STA.APP'.(y$X.P.MAX.) .50 LICENSE.NG. e90 lV 2-& ,-
MOTORse OVER NOT OVER N.P. DI IT GROU ZONE P ESSED BY `
O 1 1.00 QQ
1 s 1.50 INSPECTION: RECORD
8 8 2.00
.8 1s 2.50 r
1s. so 8.00so foo s.00 '� �� �
NO.TRANS.
SIGNS, NO.LAMPS �/e�eA-
Q
SERVICE 0.600V-Nor OVER 200A 1.00 dod�p Es de f H'ic-/�. A/C--.d 0 S.
W
SERVICE 0-60OV-OVER 200 A. 2.00 �-
h
SERVICE OVJR 600 5.00 Z
MISC. f F
Z dl-�• f�Aa rLI —�+ L��?
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE. 8
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATII
APPROVALS DATE 1 ECTOR'S SIGNATURE.
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPDUIT
WITH ALL--COUNTY ORDINANCES AND STATE LAWS REGULATI
ELECTRICAL.WIRING. NG'
.1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE URES
CALIFORNIA 'OR THAT 1 AM THE. LEGAL OWNER OF 6—THE ABO
DESCRIBED RESIDENTIAL PROPERTY. ERSIGNATURE ol ITY CO.NOTIFIED
OF PERMITTEE
FINAL P-9-114434WI—7-4—6t
LID B ARTHUR .C. EIT
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
LALO 2 8 3 8"o NOV 22 2 D 5.0 Q"
C%ZW
7p663`CE806 468
APPLICATION FOR ELECTRICAL PERMIT
v COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS 9362 Lower Azusa Rd
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDINGLOCALITY Rosemead
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
NO. AC -FEE
$ S OWNER s
RECEPT._ MAIL
LIGHT TOTAL FIRST 20 .20 ADDRESS
SWITCH_ OVER 20 .10 CITY TEL. NO.CU38074
PLAN CHECK
LIGHTING iTOTAL FIRST 20 .20 APPLICANT
FIXTURES I OVER 20 .10 ADDRESS
RANGE—DRYER—WTR.HTR.— CITY TEL. NO.
STA.COOK_DISP.—F.A.U._ CONTRACTOR
Canvas Specialty
SPACE HTR. AIR COND. ADDRESS 7344 E. Bandini Blvd
CLOTHES WASH._DISHWASH._ CITY L.A. Calif. TEL. NO. 723-831
FAN—OTHER 1.00 LICENSE IJO. 249217 CLASS. CIO
MOTORS,TRANSFORMERS RATING
IND. HEATERS, ETC. HP. KW. KVA. I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
SIZE 6: TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING.
0 - 1 1.00
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
1 - 10 3.001 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
10 - 50 5.00 RESIDE IN, THE ABO 2DESCRIFED REPID.ENTIAL PROPERTY.
50 - 10010.00 SIGNATURE + V
OF PERMITI
roo - soo 15.00 DISTRICT NO. O Y c
TUBE,A SIGN AND ONE CIRCUIT 3.00 5.08 m` V
W
MARQUEE ADDITIONAL CIRCUITS 1.001 NOTES: H
Z
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00
SERVICE OVER 600 VOLTS OR 200 AMP 5.00
TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE
Temp lighting 36 ___solo
Outlets 4 TEMP. POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT AA
PERMIT FEE (SUB TOTAL) WIRING Z
FIXTURES
PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED
PERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL
TOTAL FEE JO.<EPk C. RO H
SUPERVISING EL GT IGAL ENGIN
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDK. O CASH
1 9 7 0 3 til 9 2 D .00- v
1EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
76A6fr3-CE866 9-67 APPLICATION FOR ELECTRICAL VERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING 2
BUILDING AND SAFETY DIVISION ADDRESS r'
JOHN A. LAMBIE. COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDINGLOCALITY
NEAREST
FOR APPLICANT TO FILL IN JCROSS ST.
NO. EACH FEE
RECEPT._
$ $ OWNER
MAIL
LIGHT TOTAL FIRST 20 .20 ADDRESS
SWITCH_ OVER 20 .10 CITY TEL. NO.
LIGHTING TOTAL FIRST 20 .20 CONTRACTOR Un
FIXTURES OVER 20 .10 ADDRESS
RANGE—DRYER_WTR.HTR._ CITY //TEAaL. NO ZS
STA.COOK_DISP.—F.A.U.._ LICENSE NO. vd
SPACE HTR. AIR GOND. 1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY_
CLOTHES WASH._DISHWAS H._ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
'ELECTRICAL WIRING.
FAN—OTHER 1 1..00 1 HEREBY CERTIFY THAT I AM PROPERLYREGISTERED AND/OR
MOTORS,TRANSFORMERS RATING LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE.OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF, AND INTEND TO
IND. HEATERS, ETC. HP. KW. KVA. RESIDE IN, THE ABOE DESCRIBED RE NTIAL PROPERTY.
SIZE & TYPE OVER TO
SIGNATURE
0 - 1 1.00 OF PERMITTEE
1 - 1D 3.00 DISTRICT O ROUP ZONE PROCESSED BY U
10 — so 5.00 ��. Occ
5o - 100 10.00 NOTES: G
UJ
100 - Soo 15.00 ft-
U)
SIGN,GAS SIGN AND ONE CIRCUIT 3.00
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00
SERVICE OVER 600 VOLTS OR 200 AMP 5.00
TEMP SERVICE, POLE, &APPURTENANCES 3.00
L / Pv +� APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP. POWER POLE
UNDERSLAS WORK
ROUGH CONDUIT
WIRING
ISSUING FEE 2.00
FIXTURES
SUPPLEMENTARY ISSUING FEE 1.00 POWER AUTHORIZED
PERMIT FEE
UTILITY CO.NOTIFIED q
PLAN CHECK FEE (50% PERMIT FEE) FINAL
TOTAL FEE V j/ JOSEPH C. ROOHAN
SUPERVISING ELEC CAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. 0. CASH
LA:GO 1 6 3 7- NOV 10 2 D 5.0 O N
--E BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
78A669-CE806 4-68 APPLICATION FOR ELECTR AL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
' JOHN A. LAMBIE. COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY7T
NEAREST
Air-
FOR APPLICANT TO FILkL IN CROSS ST.
N EACH FEE
$ $ OWNER S �r
RECEPT._ MAIL
LIGHT TOTAL FIRST 20 .20 ADDRESS /(/ 0 6
SWITCH_ OVER 20 .10 CITY Z.- TEL. NOe
PLAN CHECK 04
LIGHTING ITOTAL FIRST 20 .20 APPLICANTFIXTURES OVER 20 .10 ADDRESS
RANGE-DRYER-WTR.HTR._ CITY TEL. NO.
STA.COOK_DISP.-F.A.U._ CONTRACTOR
SPACE HTR. AIR COND. ADDRESS
CLOTHES WASH._DISHWASH._ CITY TEL. NO
FAN-OTHER 1.00LICENSE ICLASS..
MOTORS.TRANSFORMERS RATING
IND. HEATERS, ETC. HP. KW. KVA. 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
SIZE & TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
0 - 1 1.00 ELECTRICAL WIRING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
1 - 10 3.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF, AND INTEND TO
10 - 50 5.00 RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY.
P
50 - 100 10.00 SIGNATURE V
CD
OF PERMITTEE
100 - 500 15.00 DIST ICT G O P ON P c
TUBE, OR [S, IGN AND ONE CIRCUIT 3.00 C~D
W
MARQUEE DDITIONAL CIRCUITS 1.00 NOTES: y
Z
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00
SERVICE OVER 600 VOLTS OR 200 AMP 5.00
TEMP SERVICE, POLE. &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE
��/i Q70TEMP. POWER POLE
UNDERSLA13 WORK
ROUGH CONDUIT
PERMIT FEE (SUB TOTAL) �� WIRING
FIXTURES
PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED
PERMIT ISSUING FEE 12.00 UTI LI TY CO.NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL �.
TOTAL FEEQ�f JOSEPH ROO AN
SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIONCK. M.O. CASH
I afl, 7 8 n mg NjV z 5 2 D 8.0 0 N Q
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE tw
u t l
�eA9.>:�808,_9B APPLICATION FOR ELECTRIC PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING '
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
MUM F CROSS ST'
FLIGHTITNG
T E M NUMBER EACH FEE OWNER
$ $ MAIL
CEPT. SW. .10 ADDRESS
XTURES .10 CITY_ Im TEL
ELEC. RANGES CLO. DRYERS
ELECTRICIAN
WATER H EATERS •50 ADDRESS
ELEC.SPACE HTRS. DISHWASHERS
CITY TEL. NO
GARBAGE DISPOSERS AUTO.- STATE
WASHERS STA. COOKING UNITS .25 LICENSE NO. d a/
MOTORS: OVER INC. H.P.
DISTRICT.NO. OUP ZONE - OCESSE BY
0— 1/2 .25
1/2— z 50 I NSM=ON RECORD
2— 5 1.00
a— 15 1.50
Is— so 2.50
F 50—200 5.00
SIGNS: NO. TRANS. .
NO. LAMPS
SERVICE C-600V 1.00 +
SERVICE OVER 500V 5.00
M� e
WIRING RMIT r 1.00 a
FIXTURE PERMIT 1.00
SUPPLEMENTARY PERMIT 50
TOTAL FEE I $ ®qµ All.RO
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION DATE ,INSPECTORS SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY - CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING 1
ELECTRICAL WIRING. .WIRING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY L20§_AHGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THATHE L OWNER OF THE ABOVE
DESCRIBED RESIDENT. P PE POWER
ol
SIGNATURE 7 UTILITY CO.NOTIFIED
OF PERMITTEE
FINAL
CKcacMO ARTHUR C. VETT,
Mo CASH SUPERVISING ELECTRICAL ENGINEER
2- A •7 n
76AS63-CES06 8-62 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF'LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER fRAREST
79s
BUILDING AND SAFETY DIVISION
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A.JENSEN,SUPT OF BUILDING
FOR APPLICANT TO FILL 1N
RECEPT. 40 TOTAL NO. EACH FEE'
I� OUTLETS FIRST 20 p� ffi.20 $ O .OWNER .!
LIGHT pZo MAIL
.AWL � O ADDRESS
SWITCH. �(j OVER 20 j .,10
TOTAL CITY TEL.NO.
LIGHTING FIRST 20 .20
FIXTURES ' ADD'L f0 ELECTRICIAN
LA-01
OV R 20
RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS .10 CC
GARB.DISP. STA:COOK CITY TEL.NO. S
DISHWASH. AUTO.-WASH: STATE ^ /—
SPACE HTRB. STA.APP.(Vy X.P.MAX.) .50 LICENSE NO. Q
MOTORS: OVER Nor OVER H.P.
DIST%CT Pp.. GPOssyyUP ZONE P CESSED BY
O 1 1.00 4
1 s 1.50 1,46PECT10,t$ RECORD
a is 2.50
1s so s:oo
So too s:oo .O
SIGNS: NO.TRANS. Qd
NO.LAMPS AMPS FO-
SERVICE 0.600V-NOT OVER 200A . 1.00 W
SERVICE 0-600V-OVER 200 A. 2:00 y
SERVICE OVER 600V 5.00 ?
Mlsc.=C a_ r�
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 �1 '
TOTAL FEE i
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLIC&TION APPROVALS DATE INSPECTORS SIGNATURE
AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL-COUNTY ORDINANCES AND STATE LAWS REGULATING p ..
ELECTRICAL WIRING. WIRING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED.AS REQUIRED BY L68 ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA: OR THAT 1 AM THE LEGAL OWNER OF; THE ABOVE Q•
DESCRIBED RESIDENT AL PROPERTY. POWER
SIGNATURE UTILITY CO.NOTIFIED
TTEE
OF PERMIFINAL
(DATION ARTHUR C. VEIT
MO CASH SUPERVISING ELECTRICAL ENGINEER
UUO6 8 4 7Zo' DEC 15 2 D 14220-
• Y'
YLPAPLE CITY
i
16A663-CE806.8-62 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF.COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE. COUNTY ENGINEER
WILLIAM A.JENSEN.SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
RECEPT. l TOTAL --No. I EACH FEE
OUTLETS FIRST 20 $20 $ P_ OWNER
LIGHT \R MAIL
ADD'L ADDRESS
SWITCH. OVER 20 •10 _
LIGHTING
TOTAL F1RST20 .20 CITY TEL.NO.
�
FIXTURES ADD'L .10 ELECTRICIAN t
OVER 20
RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS
GARB.DISP. STA.COOK r
CITY TEL.NO.Z ffcs
DISHWABH. AUTO.-WASH. L CENSE NO.
Ocxy f�
iTATE
SPACE HTRS. - STA.APP.(V$H.P.MAX.) .50
MOTORS: OVER NOT OVER H.P. DISTRICT NO. IGROUP ZONE. P ESSED Y
' •O 1• 1.00 L ff I F_, 7 1 a, L
1 3 11.50 r INSPECTION RECORD
8 B 2.00
S 15 2.50 ! d
is so 8.00 `F' t �.
so 100 5.00 O
' - V
NO.TRANS•
SIGNS: NO.LAMPS O
SERVICE 0.600V-NOT OVER 200A f.00 G
SERVICE O-SOOV-OVER 200 A. 2.00 D_
N
SERVICE OVER 600V 5.00 ?
MISC.
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE ffi
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT:AND AGREE TO COMPLY CONDUIT C
WITH ALL•C6UNTY ORDINANCES•AND STATE LAWS REGULATING '
ff
ELECTRICAL WIRING. WIRING /�/t?/ [
��
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR ( - - / �'• �f
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. POWER
SIGNATURE _ UTILITY CO.NOTIFIED 11 716A
OF PERMITTEE FINAL '/ 7f11r �Vr�e• f''%
0 LIDATION - ARTHUR C. VEIT '
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
5704%G' NOV 9 2 D 4..660—
- LAW .
a
76p6M-CE$'OB X66 APPLICATION OW ELECTRICAL PERMIT 9.
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS .�
JOHN A. LAMBIE,'ICOUNTY ENGINEER '
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDINGLOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST. �' -r'~ W �
RECEPT. 1 OTOTAL NO. EACH FEE
UTLETS FIRST 20 $.20 $ OWNER �
LIGHT J} MAIL
SWITCHADWL 10 ADDRESS
OVER 20
TOTAL FIRST 20 .20 CITY TEL.NO.
LIGHTING 1 FIXTURES
FIXTURES J( ADWL 1O CONTRACTOR
.x OVER 20
RANGES DRYERS WTR.HTRS. 1.00 ADDRESS
GARB.DISP. STA.COOK CITY TEL.NO.
s
DISHWASH. AUTO.-WASH. STATE
SPACE HTRS. STA. APPL. .50 LICENSE NO=4 b
MOTORS: OVER NOT OVER H.P. DISTRICT O. G OU ZPNEE PRO 3
O 1 1.00 r %�
1 8 1.50 INSPEC ION RECORD a 41
s S 2.00
8 15 2'.50
15 SO 8.00 �
50 100 1 5.00 r V
SIGNS: NO.TRANS. O
NO.LAMPS 1u
SERVICE 0.600V-Nor OVER 200A 1.00 W
SERVICE 0.600V-OVER 200 A. 2.00 fn
z
SERVICE OVER 600V 5.00
OTHER (SEE COMPLETE FEE SCHEDULE)
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 APPROVALS OATS• INSPECTOR'S SIGNATURE
TOTAL FEE
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION UNDERSLAB WORK
AND STATE THAT THEABOVE IS CORRECT AND AGREE TO COMPLY ROUGH CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
I HEREBY CERTIFY THAT AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO POWER
RESIDE IN,THE ABOVE SCRIBED R fID TIAL PROPERTY. _
SIGNATURE UTILITY CO.NOTIFIED ''--VA
OF PERMITTEE,4011,
FINAL
VALIDATION--, JOSEPH C.:ROOHAN
CK MO SH SUPERVISING ELECTRICAL ENGINEER
LA o7 3 .9 8too M25 2 D 5,QO- V
IA6664e6666.60 APPLICATION OR ELECTRICA PERMIT. 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING ,r&p �� �a
BUILDING AND SAFETY DIVISION ADDRESS 4 n ,P'r
JOHN A.LAMBIE,COUNTY ENGINEER
WILLIAM A.JENSEN,SUP'TOF BUILDING LOCALITY
FOR APPLICANT TO FILL IN CROSS ST: t1i fi �
PERMIT FEES
OWNERI
ITEM NUMBER EACH FEE MAIL
OUTLETS, S S ADDRESS .
LIGHTS RECEPT. SW. .10
LIGHTING FIXTURES .10 CITY TEL.NO,
ELEC.RANGES CLO.DRYERS ELECTRICIAN a.ASI• '
WATER HEATERS .50 ADDRESS fI o^ P ,riCtf�L`�
ELEC.SPACE HTRS. DISHWASHERS C17Y TEL.NO.
GARBAGE DISPOSERS AUTO.- STATES �•
,WASHERS STA.COOKING UNITS 1 .25
LICENSE NO. ..
MOTORS: OVER INC. H.P. DISTRICT N OU ONE =CR2SE
—�
0— 1/2 .25 i
Va — 2 .00 INSPECTION RECO
1.00 _�.a�JL �t,...'-�..-, 0�..
8 1B 1.80 O
Grp.r_.,�. ... .,A 6 V
Is — Bo 2.80 f) ,
Q� O
BO — 200 5.00
SIGNS: No TRANS.
NO.LAMPS '�Z Lo-a N�'��' r f{3�4-�..�+� N
SERVICE 0.60OV 1.00 -
SERVICE OVER 600V 5.00
MISC. a
WIRINGl.PERMIT 1.00
FIXTURE PERMIT./6 1.00
SUPPLEMENTMY PERMIT ,BO.
TOTAL FEE
1 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
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR'•
LICENSED AS REQUIRED BY YO AN ELES COUNTY AND STATE OF 'FIXTURES
CALIFORNIA OR THAT E GAL OWNER-OF THE ABOVE
DESCRIBED RESIDE L ROPERTY �fJ POWER
SIGNATURE /�.' /, ya «�� jc/ UTILITY CO.NOTIFIED
OF PERMITTE
- FINA
VALIDATIO ARTHUR C.VETT.
CK Mo CASH SUPERVISING ELECTRICAL ENGINEER
` A'0 9 5 4 4 DEC 6 - 2 D 2.0 0
BA063-CKSQS.10.98 APPLICATION FOR ELECTRIC PERMIT 1
BUMDING AND SAMY DIVISION
Department Of County Engineer BUILDING
County of LOS Angeles ADDRESS [B.21
JOHN A.LAMHIE.COUNTY ENGINEER
CASSATT D. GRIFFIN.SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN' CROSS ST
PERMIT FEES
OWNE
LIGHTSRECEPTACLES SWITCHES
NUMBER 1 T E M EACH FEE MAIL ,
ADDRESS:.
TOTAL.OUTLETS $ .t0. $ , -
ELEC. RANGES, WATER HEATERS; CITY TEL.WQ
CLOTHES DRYERS .50
ELEC. SPACE HEATERS, STAT-Y. COOK. ELECTRICIAN
ING UNITS, GARBAGE DISPOSERS, ADDRESS
AUTO WASHERS, DISHWASHER .25
LIGHTING FIXTURES .10 CITY [ TEL.NO. Of
MOTORS STATE. a,
LICENSE NO.. d!/
HORSEPOWER
H:P... OVER INC. DISTR O. GROUP I ZONE READY FOR INSPECTION
V2 a LESS .25
JAA
>2 2 .50 INSPECTION RECORD
2 5 1..00
5 to 1.$0
IS 50 2:50
50 -- 200. 5.00
Z.
wop
l — `
GNS I17 NO.TRA -
NO.LAMPS
SERVICE O-B.00V 1.00
SERVICE OVER GOOV 5..00
WIRING PERMIT 1 1.00 1 G
FIXTURE PERMIT 1..00
SUPPLEMENTARY PERMIT 50
APPROVALS.
TOTAL'FEE S �. 00 .. '
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION 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 1 .AM PROPERLY REGISTERED AND/OR.. FIXTURES
LICENSED AS REQUIRED BY ANGELES COUNTY-AND STATE OF
CALIFORNIA OR THAT THE EGAL OWNER OF THE ASOVE POWER
DESCRIBFFD .RESIDEN P OPER "
SIGNATURE r UTILITY CO.. FIED
OF PERMITTEE .
FINAL
OHN A. L:AMBIE. ATION ARTHUR C.VEIT...
:OUNTY:ENGINEER7�
SUPERVISING ELECTRICAL ENGINEER.
,Mp MO CASH
F .�7 5 8 .8 � DEC 16 2 h 2:00
I
78A88C-CE#808 5.81
APPLICATION FOR ELECTRI.CA PERINIT
COUNTY OF LOS ANGELES
DEPARMENT OF COUNTY ENGINEER .BUILDING' "'` r
BUILDING AND. SAFETY DIVISION ADDRESS r�
JOHN A. LAMBIE. COUNTY ENGINEER
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN cRoss sT. G tr
PERMIT FEES OWNER m
1 T E M NUMBERI EACH FEE MAIL
OUTLETS: $ $ -ADDRESS L{/
LIGHTS RECEPT. SW. .10 CITY TEL. NO.
LIGHTING FIXTURES
ELEC..RANGES • CLO.DRYERS .10 ELECTRIC
IAN GC C
WATER HEATERS .50 ADDRESS"C�
ELEC.SPACE HTRS. DISHWASHERS
CITY TEL,NO. L
GARBAGE DISPOSERS AUTO.- STATE '`
WASHERS STA.COOKING UNITS ,2$ LICENSE NO. '
Morons: OVER INC. H.P. DIST N OUP ZONE P OCE D
0-11/2 .28 z
'/a— 2 ,$p INSPEC?ION RECORD
2— s
s— 18 1.50 f
1s— so 2.50
` s0= zoo 5.00 V
W
SIGNS: NO TRANS. H
NO.LAMPS z
SERVICE'0-6bOV 1.00 ` -
SERVICE OVER-600V 9.00
MISC.
WIRING PERMIT 1.00
FIXTURE PERMIT 1.00
SUPPLEMENTARY PERMIT $p
TOTAL FEE $
LANO,s�rATE
BY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE '
TE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY CONDUIT
LL COUNTY ORDINANCES AND STATE LAWS REGULATING
CAL WIRING. WIRING.
EBY. CERTIFY THAT I'AM PROPERLY REGISTERED AND/OR
ED AS REQUIRED BY•LOS ANGELES COUNTY AND STATE OF FIXTURES
NIA OR THAT 1 AM THB LEGAL OWNER OF THE AHCVE
ED RESIDENTIAL P ERTY. POWER
URE UTILITY CO:NOTlF1ED
MITTE FINAL ��►"+�b—
' `IALIDAT� ARTHUR C.VEIT
CK mo cps SUPERVISING ELECTRICAL ENGINEER
L 055271 ROY 28 2 U 200 IN
/
76A663-CES0612-65 APPLICATION FOR E.LECTRI L PERMI
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER >
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING- LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS.ST.
RECEPT. 1 TOTAL No. EACH FEE
OUTLETSI FIRST 20 S.20 S OWNER
LIGHT
SWITCH AIL
ADD'L 10 ADDRESS
OVER 20
TOTAL FIRST 20I .20 CITY TEL.NO.
LIGHTING FIXTURES
FIXTURES ADD•L CONTRACTOR
I
OVER 20 1O
RANGES DRYERS NRR.HTRS. 1.00 ADDRESS
GARB.DISP. STA.COOK CIT TEL.NO.
DISHWASH. AUTO.-WASH. STATE
SPACE HTRS. STA. APPL. .50 LICENSE NO.
MOTORSt_ OVER NOT OVER H.P. DIST IC� N GIRIALP I ZON P D
O 1 1.00
1 s 1.50 INSPECTION REEORD °-
O
3 a 2.00 U
ad
a 15 2.so O
I-
15 50 3.00 W
d
50 100 1 5.00 Z
SIGNS, NO.TRANS. _
NO.LAMPS
SERVICE O.BOOV-NO'r OVER 200A 1.00
SERVICE 0.60OV-OYER 200 A. 2.00
SERVICE OVER 600V 5.00
OTHER (SEE COMPLETE FEE SCHEDULE)
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 APPROVALS DATE INSPECTOR'S SIGN UFA
TOTAL FEE 111 4/- -- -
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION UNDERSLAB WORK
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ROUGH CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO POWER
RESIDE IN,THE ABD CRIBED RE IDE TIA ROPERTY.
SIGNATURE UTILITY CO.NOTIFIED
OF PERM ITTE
FINAL a
(DATION JOSEPH C. ROOHAN
CK MO CASH SUPERVISs ING ELECTRICAL ENGINEER
L&0.a:a:CS NOV Sp 2..D 4.00- 4
76AFpy -C,E�60<6;1/7D APPLICATION FOR ELECT1�i��WCf1T
• COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS g .2 ��,d�g Z jJ
COLEMAN W. JENKINS SUPERINTENDENT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
OUTLETS NO. EACH FEE
OWNER
RECEPT,:_ $ $ MAIL
'
LIGHT TOTAL FIRST 20 25 ADDRESS CITY TEL. NO.ell j',p J
SWITCH OVER 20 ,10
PLAN CHECK
LIGHTINGTOTAL
.10 FIRST 20 .25 APPLICANT
FIXTURES
OVER 20 ADDRESS
APPLIANCES CITY TEL. NO.
PERMIT
RANGE DRYER_WTR. HTR. APPLICANT A f/, S
STA. COOK DISP. F.A.U. ADDRESS �' ��►// y
SPACE HTR, AIR COND. CITY i it TEL. N0. ,4j
CLOTHES WASH.' DISHWASH. LICENSE NO. f CLASS.��
FAN OTHER 1.00 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE
AND 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
O - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THELEGAL OWNER OF, AND INTEND TO
I - 10 3.00 RESIDE IN, THE ABOVE DES C�RIBED RESIDENTIAL PROPERTY. d
SIGNA
10 - 50 5.00 OF PERMRITTEE�"✓G' O
50 - 100 10.00 0
DISTRICTNO. CLASS ZONE P D BY
100 - SOO 15.00 ® CIL,
SIGN, GAS SIGN AND ONE CIRCUIT 5.00 NOTES: N
TUBE, OR ?
MARQUEE ADDITIONAL CIRCUITS 1.00
SERVICENOTOVER 600 VOLTS OR 200AMP 3.00
APPROVALS DATE INSPECTOR'S SIGNATURE
SERVI CEOVER 600 VOLTS OR 200AMP 10.00
TEMP.POWER POLE
TEMP SERVICE,POLE, &APPURTENANCES 5.00
UNDERSEAS WORK
TEMP LIGHT OR RECEPT. SYSTEM 3.00
ROUGH CONDIUT
lok-6A _V4 WIRING
ge,f/ �� 5 FIXTURES
PERMIT FEE (SUB TOTAL) POWER AUTHORI7tED
UTILITY CO. NOTIFIED
PLAN CHECK FEE
FINALvPERMIT ISSUING FEE 9.00
JOS P C. ROOHAN
TOTAL FEE SUPYRVISING ELECTRICAL ENGI DCASH
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O.
L 0 2 5 7 1-2 NOV 15 2 D 6.0 0-
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
7BA663_C 468
~ - _ APPLICATION FOR ELECTRICAL PERMIF",
COUNTY OF LOS ANGELES
• DEPARTMENT OF COUNTY ENGINEER BUILDING pp
BUILDING AND'SAFETY DIVISION ADDRESS 7
JOHN A. LAMBIJE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY 7'
T
FOR APPLICANT TO FILL IN g$yT
NO. EACH FEE
RECEPT. $ $ OWNER. .
MAIL
LIGHT TOTAL FIRST 20 .20 ADDRESS
41-
SWITCH_ OVER 20 .10 CITY TEL. NO. JI
PLAN CHECK
LIGHTING ITOTAL FIRST 20 .20 APPLICANT
FIXTURES 1( OVER 20 .10 ADDRESS
RANGE-DRYER-WTR.HTR.- CITY TEL. NO.
STA.COOK_DISP._F.A.U._ CONTRACTOR
�c A�
SPACE HTR. AIR COND. ADDRESS
CLOTHES WASH._DISHWASH._ CITY TEL. NO.
FAN-OTHER 1.00 LICENSE WO� -2/7 CLASS.
MOTORS.TRANSFORMERS RATING
IND. HEATERS, ETC. HP. KW. KVA. I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
SIZE & TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING.
0 - 1 1.00
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
1 - 10 3.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
10 - 50 5.00 RES:M THE ABOVE DESCRIBED RESIDENTIAL PROPERTY.SIGC7
50 - 100 110.00 O'F PERMITTEE C
100 - 500 15.00 V
DIS CTO. RO P NE CESSED BY Lu
TUBE, OR SIG SIGN AND ONE CIRCUIT 3.00 Q ^Z N
Z
MARQUEE ADDITIONAL CIRCUITS 1.00
VTE
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00
SERVICE OVER 600 VOLTS OR 200 AMP 5.00
TEMP SERVICE, POLE, &APPURTENANCES 3.00DATE INSPECTOR'S SIGNATURE
UNDERSLAB WORK
ROUGH CONDUIT
PERMIT FEE (SUB TOTAL) WIRING
FIXTURES
PLAN CHECK FEE (50% PERMIT FEE)
POWER AUTHORIZED
PERMIT ISSUING FEE 2.00 UTILITYCO.NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL
TOTAL FEE JOSEPH C. ROOHAN
SUPERVISING ELECTRICAL EN.GI R
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CAS
� � 2653;0-D NOV12 2 0 5.30-
WE BACK 00 APPLICATION FOR COMPLETE FEE SCHEDULE
IA663-CE606 5-62 APPLICATION FOR ELECTRICAL- PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST. ad
RECEPT. TOTAL NO. EACH FEE
OUTLETS FIRST 20 S.20 �. OWNER
LIGHT MAIL
ADD'Lt0 ADDRESS
SWITCH. OVER 20
TOTAL CITY TEL.NO.
LIGHTING FIRST 2.0 .20
FIXTURES ADD'L OVR 20 .IO ELECTRICIAN
el
RANGER I CLO.DRYERS WTR.HTRS. 1.00 ADDRESS '• �cSGy�'�— �G�
'GARB.DIBP. BTA.COOKr
CITY S'!s�c..L TEL.N l0%9q
DISHWASI. AUTO.-WASH. STATE
SPACE HTRS. BTA.App.tVs H.P.MAX.) .so LICENSE NO. p
MOTORS, OVER NOT OVER X.P. DISTRIC G O. (ZONE P D
0 1 1.00 • a
I 8 1.50 INSPECTION RECORD
8 S 2.00.
S IS 2.50 nr.
1s so 8.00 u
so 100 5.00 D:
O
SIGNS: NO.TRANS. (��•
NO.LAMPS Lu
D.
SERVICE 0.600V-NOT OVER 200A N
1.00 / Z
SERVICE 0-600V-OVER 200 A. 2.00
SERVICE OVER 600V 5.00
MISC.'
PERMIT ISSUING FEE• 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE S
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE 18 CORRECT AND ACRES TO COMPLY CONDUIT
WITH ALL-COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICEMBED AS REQUIRED BY LOB ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENT AL PROPERTY. POWER
SIGNATURE UTILITY CO.NOTIFIED
OF PERMI fig,411
FINAL A9 fYqq
—
LIDATION ARTHUR C. VEIT
TCK MO CASH SUPERVISING ELECTRICAL ENGINEER
L.hl;o 7 5 3 7 NOV 2 g 2 D 3.00-
1A663-CES06 5-62 APPLICATION FOR ELECTRIC PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER FR
BUILDING AND SAFETY DIVISION 3
JOHN A. LAMBIE. COUNTY ENGINEER
WILLIAM A.JENSEN.SUPT OF BUILDING
FOR APPLICANT TO FILL IN
RECEPT. TOTALNO. EACH FEE
OUTLETS FIRST 20 ffi,2O ffi OWNER.
LIGHT MAIL '
ADD'L .10 ADDRESS
SWITCH. OVER 20
LIGHTING
TOTAL CITY TEL.NO.
l FIRST 20 .20
FIXTURES 1 0V9R ADD'2O L ,1O ELECTRICIAN
RANGES CLO.DRYERB WTR.HTRB. 1.00 ADDRESS
GARB.D18P. BTA.COOK r
CITY TEL.NO.
DISHWASH. AUTO.-WASH. STATE
SPACE HTRB. STA.APP.(Va H.P.MAX.) .50 LICENSE NO. Q zoa�p
MOTORSo OVER NOT OVER H.P. DIS3:RICJ,N - G O P ON P E D
O 1 1.00 (,,{{
1 a 1.50 INSPECTION RECORD
e s 2.00
6 is 2.50 d
is so 3.00 0
SO 100 5.00 D:
O
SIGNSi NO.TRANS- V
NO.LAMPS
W
D_
SERVICE 0.000V-NOT OVER 200A 1.00 h
SERVICE O-SOOV-OVER 200 A. 2.00
SERVICE OVER OOV 5.00
MISC. c;z 00
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE ffi
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE 18 CORRECT,AND AGREE TO COMPLY CONDUIT
WITH ALL•COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AB REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. POWER
SIGNATURE r UTILITY CO.NOTIFIED
OF PERMITTEE
FINAL
,/ ] LIDATION ARTHUR C. VEIT
MO CASH SUPERVISING ELECTRICAL ENGINEER
LAAO I; 6 4 6'%-o" DEC 2 7 2 D 4.0 0-
€''
SA663-CEim 5.62 ;APPLICATION FOR ELECTRICAL PER IT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS !Mx
JOHN A. LAMBIE• COUNTY ENGINEER rte'
ry
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY
ST
FOR APPLICANT TO FILL IN CR SSS .
RECEPT. TOTAL NO. EACH FEE J
OUTLETS FIRST 201701$2O $ d U OWNER
LIGHT
I ADD'L tO ADDRESS • y �+f��� '� 1r�1 Az•
SWITCH. OVER 20 /! �J �s
LIGHTING TOTAL FlaeT 20 .20 O CITY L• ✓ TEL.N /S�A 7�
FIXTURES } ADD�L .10 ELECTRICIAN L /!//'
OV R 2O
r
RANGES CLO.DRYERS VMS.HTRS. 1..00 ADDRESSL-0 736
GARB.DISP. STA.COOK r r'� r'1.
CITY TEL.NO. 6r
DISHWASH. AUTO.-WASH. STATE f /
SPACE HTRS. STA.APP.(Va X.P.MAX.) .50 LICENSE NO._ 6
21
MOTORS, OVER NOT OVER H.P. DISTRICT NO. I GROUP I ZONE PR CESSED VY
O 1 1.00
I 9. 1.50 INRECTION RECORD
a 6 2.00 ha h, L 'i't
s is 12.50
SO 700 5.00 <W _ x.�+�r
SIGNS, NO.TRANS• ��; ,jr l t • I
NO.LAMPS /;• trz,'-.i (2
SERVICE O-SCOV-NOT OVER 200A byO Y6' .' , 'r �i °s^!•. "�+�r��6'
Y Z
SERVICE'O.600V-OVER 200 A. 2.00 S1
SERVICE OVER 600V 5.00 �.�/�/Ii. 9� !•' iAA
ii
MISC.
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY,PERMIT ISSUING FEE 1.00
TOTAL FEE $ 3�
1 HEREBY ACKNOWLEDGE THAT 1 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 - T
ELECTRICAL WIRING. WIRING i_ a�
1 HEREBY CERTIFY THAT I oPROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY s NGELES COUNTY AND STATE OF FIXTURES a"
CALIFORNIA OR THAT I A E LEGAL OWNSprhROVE
DESCRIBED RESIDENTIAL RTY. / y�� / POWER Y
SIGNATURE ��f� 1 o/L/ UTILITY CO.NOTIFIED. --��
OF PERMITTEE v�+
FINAL s
VALIDATION ART C. VEIT
MO CASH SUPERVISING ELECTRICAL ENGINEER
7sa663-ceeoe a-ea APPLICATION FOR ELECT& I "PE4YIF
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING ��/ �
BUILDING AND SAFETY DIVISION ADDRESS pL
JOHN A. LAMBIE, COUNTY ENGINEER ell
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS sT.
RECEPT. TOTAL INO. EACH FEE _
OUTLETS FIRST 20 S.20 III
OWNER'
LIGHT MAIL
ADD/L .10 ADDRESS
SWITCH. OVER 20
. .
LIGHTING TOTAL� FIRST 20 .20 CITY TELNO •
FIXTURES ADD1L ,10 ELECTRICIAN
OVER 20
RANGES CLO.DRYERS WTR.HTRB. 1.00 ADDRESS ,? r , n/ A
�-
GARB.DIBP. STA.COOK CITY TEL.NO.r-Z F ��. i.
DISHWASH. AUTO.-WASH. STATE ^�
SPACE X7&8. STA.APP.(ya X.P.MAX.) ,SO
LICENSE NO. r20
MOTORSI OVER NOT OVER H.P. DIST ICTO. G UP ZONE P mptoy
ESSED B
O 1 1.00 52
1 s 1.50 INSPECTION RECORD �-
s 9 2.00 �� )Sy �� �. .d1LfrJl r �t9 /3d�s O
.8 15 2.50
o•C r. '�- � ALJ � L+�, ,�'b3+1.'t' I.O
1s so 3.00 ,A.A 11,401{ � —I w ~
V
50 100 5.00 LiJ
N
SIGNSI NO.TRANS• ' Z
NO.LAMPB
SERVICE O-SOOV-NOT OVER 200A 1.00
SERVICE 0-sOOV-OVER 200 A. 2.00
SERVICE OVER SOOV 5.00
misc.9 J
PERMIT ISSUING FEE 12.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE f
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL•COUNTY ORDINANCES'AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERF;L AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTI L•PROPERTY. POWER
SIGNATURE UTILI CO.NOTIFIE
OF,PERMITTEE FINAL I/Mdnej
LIDATION ARTHUR C. VErr
MO CASH SUPERVISING ELECTRICAL ENGINEER
A-L;b.7? 9 In DEC •3 2 D 4.00-
a, WORKERS'COMPENSATION DECLARATION CE-806 10/81 APPLICATION FOR ELECTRICAL PERMIT
I• hereby't5ffirm„that I have a certificate of consent to self CE-8066
+K'insure,orwa certificate of Workers'Compensation.Insurance, COUNTY OF LOS ANGELES ( BUILDING AND SAFETY
or p certified copy thereof.(Sec. 3800, Lab.. C.) (• ice' -1CI' _ OF TEMPLA CITY I
317002 STATS COMP.
Policy No. Company FOR APPLICANT TO FILL IN JOBS-A
ADDRESS 9362 LOWER AZUSA RD.
Certified copy is hereby furnished. I New Residential Bldgs. &Pools EACH NO: FEE
200 Certified copy is filed with the county building inspec- ) 1 &2-Family,Sq. Ft. $ — $ LOCALITY 38 B 4 TEMPLE CITY CA
tion-department. I Multi-family Sq. Ft. — NEAREST
-b6 GIBBS BROS a SESTRI Residential Swimming Pools, . OWNER ORFL
CROSS ST.
Date_ . Applicant FIRM NAME FIESTA FLOATS
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw._ MAII 9362 LOWER ASUSA RD.
COMPENSATION INSURANCE ADDRESS
This section d t be First 20,
�
( neenoe completed if the work Involved b Y i. Total No. Additional CITY T Tel. No.
the permit is for one hundred dollars($100)or less.)
PLAN CHECK
I certify that in the performance of the work for which this ,APPLICANT
permit 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 APPLICANT GIBBS BROS. ELECTRIC CO.
Exemption, you should become subject to the Workers' Range_ Heater—D.W. —
Compensation provisions of the Labor Code, you must forth- Oven —Dryer —W.M.— ADDRESS1754 •��T
. MAIN ST. LA. CA
with comply with such provisions or this permit shall be Top _ FAU —W.H. — 225-5945
deemed revoked: CITY Tao S ANGELES Mel. No.
LICENSED CONTRACTORS DECLARATION Hood _ Fan _Other— —
Disp. Room Air Cond. REG. UM Class.
I hereby affirm that I am licensed under provisions of Chapter 9 REG.NUMBER
(commencing with Section 7000),of Division 3 of the Business D B
DISTRICT NO. PROCES
and Professions Code,and my license is in full force and effect. Power Apparatus&Large Appliances /�� i.
91.
Size&Type HP, KW, KVA, or KVAR �i V
License Number 1.69324 Lic..Class C-10 Up to 1 Incl. FINAL V
GIBBS BROSS 6-86 Over 1 to 10 Incl. DATE VALIDATION
.09
Contractor' • Date❑ Over 10 to 50 Incl. FINA
I am exempt under Sec. Over 50 to 100 Inc. BY KIWI
B.&P.C. for this reason Over 100
Services, Swbd., MCC&Panelboards d {� c` 07�
Date:
0 -200 Amp. Under 600 V
Signature 201 - 1000 Amp. Under 600 V
❑ Over 1000 Amp..or Over 600 V
Exemption for Reg. Mainf. Elect.
SINGLE FAMILY Temp. Power Pole&Appurtenances
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit
I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits
Law for the followin g
(Section Section 7031,5, Business and ud
oo
Professions Code): O
❑ I; as owner of the property, will do the work and the Misc. Conduits&Conductors
structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)_
7044,.Business and Professions Code).
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is.a construction.lending agency for OC
the performance of the work for which this permit is issued PERMIT FEE (Sub-Total)
(Sec. 3097, Civ. C.).
PLAN CHECKING FEE
Lender's Name.
PERMIT ISSUING FEE D
Lender's Address -�
1 certify that I have read this application and state that the TOTAL FEE s•
above information is correct.]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
1 ,
I
,
! WORKERS'COMPENSATION DECLARATION i C�`03G 10/81 APPLICATION FOR ELECTRICAL PERMIT
"fl hereby af�rm that I have a certificate of consent to self ',
inure, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY 'Ijl
or ce'certified copy thereof(Sec. 3800, Lab. C.) I TEMPLE CITY
PolicyNo. Company STATE COW. FOR APPLICANT TO FILL IN JOB
ADDRESS 9362 L0111ER AZUSZ RD.
Certifie copy is hereby furnished: EACH NO. FEE
New Residential Bldgs. & Pools 38 $-4 TEIILPLF CITY CA
Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. $ — $ LOCALITY
tion deportment. } Multi-family Sq. Ft. — NEAREST
Date 686 Applicant CiIIBBS BRCS. Residential Swimming Pools .. '`' ` CROSS ST.
;; OWNER OR FIESTA FLOATS
FIRM NAME
CERTIFICATE OF EXEMPTION FROM WORKERS' I Outlets: Rec Light Sw. MAIL 8362 LGVER AZUSA RD.
COMPENSATION INSURANCE
(This section need not be completed If the work Involved by I First 20 ADDRESS
the permit is for one hundred dollars($100)or less.) I Total No. Additional CIN TENNE CLIMTel'. No, 2g3_6074
I certify that in the performance of the work for which this PLAN CHECK
permit is issued, I shall not employ any person in any man r APPLICANT
so as to become subject to the Worker pens io Lighting Fixtures First 20 ADDRESS
Total No. Additional
Date 11-6-85 a li n CITY Tel. No.
PF Fixed Appliances Not Over 1 HP PERMIT
NOTICE TO APPLICANT: If, after Bing thi Ce ficate o.
Exemption, you should become subject to the Workers' Range_ Healer_D.W. — APPLICANT
,i Compensation provisions of the Labor Code, you must forth- Oven _Dryer _W.M. ADDRESS 1754 N. MAIN ST.
with comply with such provisions or this permit shall be Top _ FAU —W.H.
deemed revoked. Tel. IVo.
I' Hood _ Fan _Other_ CITY. L03 ANGELES CA 225-5;345
LICENSED CONTRACTORS DECLARATION LICENSE OR e
Dis _ Room Air Cond.
Lu
I hereby affirm that I am licensed under provisions of Chapter 9 p' REG. NUMBER class.
(commencing with Section 7000)of Division 3 of the Business DISTRICT NO. PROCESS �-
and Professions Code,and my license is in full force and effect. l Power Apparatus 8 Large Appliances -
License Number
Size&Type HP,.KW, KVA, or KVAR' .V E
LicClass C-10
I 169324 .
Up to.1 Incl: FINAL it
10
Contractor GIBBS BROS. EL§WRIC11�6�85 i Over 1 to 10 Incl. DATE
VALIDATION
1 Over 10 to 50 Incl.
I am exempt under Sec. Over 50 to 100 Inc. BY N
B...&P.C. for this reason Over 100 Z
r Date: Services,Swbd.,MCC&Ponelboards cr t3V.
-0 -200 Amp. Under 600 V 1
Signature s 201 - 1000 Amp. Under 600 V
5
Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V
SINGLE FAMILY l
Temp. Power Pole&Appurtenances 3 5 A
HOME OWNER-BUILDER DECLARATION • Sign with One Branch Circuit
I hereby affirm that I am exempt from the Contractor's License
Law for the following reason (Section 7031.5, Business and ! Additional Sign Branch Circuits # o o o o o 2
Professions Code): ! o o =
ED 1, as owner of the property, will do the work and the
Misc. Conduits&ConductorsEE y I�
structure is not intended or offered for sale (Section. Other(See-Complete Fee Schedule)_ ,
7044, Business and Professions Code).
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for
I the performance of the work for which thisermit is issued
P PERMIT FEE (Sub-Total) ®d
(Sec. 3097, Civ. C.). -
�'
Lender's Name. PLAN CHECKING FEE
� �
PERMIT ISSUING FEE
Lender's Address
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
I ordinances and Sfate laws regulating Electrical wiring, and
hereby authorize represenpIves o Is Co ty fo enter upon h
the above-me y f inspe ur�poses¢ SEE REVERSE FOR EXPLANATORY LANGUAGE
5i nat a of Per it Date
WORKERS'COMPENSATION DECLARATION i CE-806 10/81 APPLICATION FOR ELECTRICAL PERMIT
VAL
affirm that I have a certificate of consent to self 1 CE-8066insu , a.certificate of Workers'Compensation Insurance, I COUNTY OF LOS ANGELES BUILDING AND SAFETY
or a certified copy thereof(Sec. 3800, Lab. C.) fQ� r
Policy No. 7J u�ompany � u �/� j FOR APPLICANT TO FILL IN JOB 36ADDRESS 2 C WOC . Z4 Z leb
Certified.copy is hereby furnished. I New Residential Bldgs. &Pools EACH NO. FEE I
❑ y, q• _ $ i LOCALITY r
Certified copy is filed with the ty it Ing inspec- j 1. &2-Family, S Ft. —g
L
tion department. I Multi-family Sq. Ft. NEAREST CROSS ST. 8 �/A
1440
Date Applicant —4/1 Residential Swimming Pools i NAME /
CERTIFICATE OF EXEMPTION FROM WORKERS' I MAIL
Outlets: Rec Light Sw._ ,�
COMPENSATION INSURANCE j First 20 ADDRESS Z LD(/►� �UZtA Xib
(This section need not be completed if the.work involved by I Total No. CITY Tel. No. . QZ
the permit Is for one hundred dollars($100)or less.) Additional
I certify that in the performance of the work for which this I PLAN CHECKAPPLICANT
permit is issued, I shall not employ any person in any manner
so as to become subject to the Workers'Compensation Laws. .1 Lighting Fixtures First 20 ADDRESS
Total No. Additional CITY Tel. No.
Date Applicant Fixed Appliances-Not Over 1 HP I PERMIT �.f'�/� �t �°�
NOTICE TO APPLICANT: If, after making this Certificate of I APPLICANT �Itf�,/IPLFJ �S V
Exemption, 'you should become subject to the Workers' I Range_ Heater—D.W.
Compensation provisions of the Labor Code, you must forth-., Oven _Dryer —W.M.— I ADDRESSaK Qp5q- &,V0
with comply with such provisions or,this. permit shall be. Top _ FAU —W.H. —
deemed revoked. Hood _Fan _Other— CITY ea Tel. 1V6.2 33._ 3 6q
LICENSED CONTRACTORS DECLARATION LICENSE OR Q
I hereby affirm that I am licensed under provisions of Chapter 9 ' Disp. _ Room Air Cond. REG:NUMBER jZ1W71 Class.C-Lo
(commencing with-Section 7000)of Division 3 of the Business 1Power Apparatus&Large Appliances DISTRICT NO: P CES D BY
and Professions Code,and my license is in full force and effect. p p,
,E 9Zsg� Size&Type HP;.KW, KVA, or KVAR• o
License NumQber7 7Lic.Class I Up to 1 Incl. FINAL W
[] lr Cz� Date "Z- v Over 1 to 10 Incl. I DATE r/ VALIDATION
Contractor Over 10 to 50 Incl. I
Elam exempt under Sec. Over 50 to 100 Inc. 4BY AL� use
B.&P.C.for this reason Over 100
Date. Services, Swbd., MCC.&Panelboards
0 -200 Amp. Under 600 V
Signature 201 - 1000 Amp. Under 600 V
❑
Exemption for Reg. Mainf,Elect. Over 1000 Amp. or Over 600 V
SINGLE FAMILY Temp. Power Pole&Appurtenances
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit
I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits
Law-for the following reason (Section 7031.5, Business and
Professions Code):
❑ I, as owner of the property, will do the work and the i M,sc. Conduits&Conductors
structure is not intended or offered for sale (Section Other(See Complete Fee Schedul'e)_ I ,
7044, Business and Professions Code).
96 d 4.3 A
CONSTRUCTION LENDING AGENCY t
I hereby affirm that there is a construction.lending agency for # 0 0 0 0 0 Z
the performance of the work for which this permit.is issued PERMIT FEE (Sub-Total.) I � o o � �5
(Sec. 3097, Civ. C.). + _
PLAN CHECKING FEE I o o o. 1 'a 5 0 v
Lender's Name '
i PERMIT ISSUING FEE 1202-86
Lender's Address
I certify that I have read this application and state that the I TOTAL FEE
above information is correct. I agree to comply with all County j
ordinances and State laws regulating Electrical wiring, and i
W.y
thorize epresentatives of thisCounty to enter upon
-m t' n pro rty for inspection purposes. I
SEE REVERSE FOR EXPLANATORY LANGUAGE
//Z6 - 9116
Sign um bywee Date
WORKERS'COMPENSATION DECLARATION 76A66310/81
kLECTRICAL
hereby affirm that I have a certificate of consent to self CE-B06GG APPLICATION FOR! PERMIT
insure, or a certificate of Workers'Compensation InSlt�ance, COUNTY OF LOS ANGELES BUILDING AND SAFETY
or a certified copy thereof(Sec. 3800,.Lab. C.) I
Policy No. 410216 Company State Fund FOR APPLICANT TO FILL IN JOB ADDRESS 9 362 Lower Azusa Rd.
Certified copy is hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE i
❑ 1 &2-Famil S Ft. $ 1—Is LOCALITY Temple City
Certified copy is filed with the county building ispec- Y� q•
tion departmenta ,, Multi-family Sq. Ft. — NEAREST
Date
-0/31/8�ldi4pplicant West ,Coast Ltt Residential Swimming Pools OWNER OR
FIRM NAME
CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL
COMPENSATION INSURANCE Outlets: Rec Light S.Ni._ I ADDRESS 9362 LOWer Azusa Rd.
This section need not be completed if the work involved b First ti Te le Cit
( P Y CITY � y T.I. Na.
the permit is for one hundred dollars($100)or less.) Total No. Additional
that in the performance of the work for which this PLAN CHECK
I certify P APPLICANT
permit 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
Date 11�1Z84 nppli nt 1 Total No. Additional CITY Tel. No.
Fixed Appliances Not Over 1 HP PERMIT
NOTICE TO APPLICANT: If, a er making this Certificate of APPLICANT west Coast Lighting
Exemption, you should become subject to the Workers' Range— Heater_D.W.
Compensation provisions of the Labor Code, you must forth- Oven —Dryer _W.M.— ADDRESS Ocean Park Blvd.
.with comply with such provisions or this permit shall be Top _ FAU —W.H. —
deemed.revoked. Room Air Cond. j CITYSanta Monica, Ch.No. 870-291
2d 1
LICENSED CONTRACTORS DECLARATION Hood — Fan _Other-
- LICENSE 224211
I hereby affirm that I am licensed under provisions of Cliapter9 Disp. REG.NUM
Class.BER C-1C .
(commencing with Section:7000)of Division..,3 of the Business DISTRICT NO. PROCES D BY
and Professions Code,and m license is in full force and effect. Power Apparatus&Large Appliances
I Size&Type HP, KW,KVA, or KVAR• O
License Number 224211 Lic. Class C-10 FINAL
Up}0 1 Incl.
�� 194 Over'l to 10 Incl. DATE�z _� r� VALI TION
Contractor Sam Simon Date �J
❑w�pa��}} pper�}} ghting Over 10 to 50 Incl. FINAle
TBfii'exiFVFider Over 50 to 100 Inc. B
BAP.C. for this reason Over 100
Date: Services, Swbd., MCC&Panelboards
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. i
.SINGLE FAMILY Temp. Power Pole&Appurtenances ��
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit.
I hereby affirm that I am exempt from the Contractor's License Additional Sign:Branch Circuits
Law for the following-reason (Section 7031.5, Business and
Professions Code): 1 o'o
❑ I, as owner of the property, will do the work and the Misc. Conduits Conductors p p q
structure is not intended or offered for sale '(Section Other(See Complete Fee Schedule)_
7044; Business and Professions Code). empOra eCOra 1 e 5: 0 0
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 PERMIT FEE (Sub-Total)
(Sec: 3097, Civ. C.).
PLAN CHECKING FEE
Lender's Name
PERMIT ISSUING FEE
Lender's Address f ,
I certify that I have read this application and state that the TOTAL FEE 15150
above information is correct. 1:agree to comply with a I County
ordinances and State laws.regulating Electrical wir ng, and
hereby authorize representatives of this County to enter upon
the ab ve-mentioned property for inspection ores. SEE REVERSE FOR EXPLANATORY LANGUAGE 1
..�, - / i
pur
wV-
Si ature of ermittee Dat ;
n
WORKERS'COMPENSATION DECLARATIO14 7GA663 10/81 APPLICATION FOR ELECTRICAL PERMIT
I 'hereby affirm that I have a certificate of consent to self CE-BO6G
orsa certified copy4r a O�Teeof reof�Sece3800, LabnsCajion insurance, COUNTY OF LOS ANGELES j BUILDING AND SAFETY
Policy No��` " Company— IS if : t f��J 1�1 b FOR APPLICANT TO FILL IN I JOB
Certified copy is hereby furnished. ADDRESS I New Residential Bldgs. $Pools EACH NO. FEE
❑ Certified copy is filed with the county building inspec- 1 $2-Family,Sq. Ft. $ — $ LOCALITY gr jjjq int
tion department. I Multi-family Sq. Ft. — NEAREST
1– 4a t� Residential Swimming Pools CROSS ST.
Date Applicant_ ► OWNER OR,
FIRM NAME �y��yvl
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw._ ADDRESS 3� (. 1�?jv /�
�iff
IL
COMPENSATION INSURANCE
(This section need not be completed if the work involved by First 20
the permit is for one hundred dollars($100)or less.) Total No. Additional CITE' (!� ec 7 Tel. No.
I certify that in the performance of the work for wPLAN CHECKhich this APPLICANT
permit is issued, I shall not employ any person in any manner
so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS
Total No. Additional
Date- Applicant CITY Tel. No,
NOTICE TO APPLICANT: If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT
Exemption, you should become subject to the, Workers' Range_ Heater—D.W. APPLICANT C
Compensation provisions of the Labor Code, you must forth- Oven —Dryer _W.M. ADDRESS ,D S.
with comply with such provisions or this permit shall be Top _ FAU —W.H. —
deemed revoked. ! Hood _ Fan _Other_ CITY AZZ Tel. 7'
LICENSED CONTRACTORS DECLARATION LICENSE OR
—
I hereby affirm that I am licensed under provisions of Chapter 9 Dis p' _ Room Air Cond. REG. NUMBER 6 � Class-JR. /Q
(commencing with Sectiod 7000)of Division 3 of the Business DISTRICT NO. PR E ED BY Q-
! Power Apparatus$Large Appliances
and Professions Code,and my-license is in full force and effect. , y
�,j /�, Size 8 Type HP, KW, KVA, or KVAR' i1 Vt g V
License Number /��C3✓� Lic. Class Up to 1 Incl. FINAL .� O
nl� C(� �g� Over 1 to 10 Incl. C GAS LIDATION H
Contractor Date
❑ d�}� �� Over 10 to 50 Incl. FINAL W
I. m e mpt u4er Sec. Over 50 to 100 Inc. BY 4
B.$P.C. for this reason II Over 100
Date: i Services, Swbd., MCC$Ponelboards I
0 -200 Amp. Under 600 V �'3 5'a 6
20 '2 '
Signature 1 - 1000 Amp. Under 600'V i
❑ I Over 1000 Amp. or Over 600 V # o o 0,0 o s
Exemption for Reg. Maint. Elect.
SINGLE FAMILY Temp. Power Pole$Appurtenances
HOME OWNER..BUILDER DECLARATION i Sign with-One Branch Circuit ' J'o ° 1'5 5 0
I hereby affirm that I am exempt from the Contractor's License
Law for the following reason (Section 7031:5, Business and Additional Sign.Branch Circuits 5
Professions Code): { ,. ?Cuc�l
❑ I, as owner of the property, will do the work and the Misc. Conduits$Conductors i `_ J
structure is not intended or offered for sale (S;ection Other(S Co1!plete FEQ�c le)_ ► �+j�Sj
7044, Business and Professions Code). ! �'1�Y1 cCfDt�:�Iif
CONSTRUCTION LENDING AGENCY I j
I hereby affirm that there is.a construction lending agerjcy for
the performance of the work for which this permit is 'ssued PERMIT FEE (Sub-Total)
(Sec. 3097, Civ. C.).
PLAN CHECKING FEE
Lender's Name i.
Lender's Address PERMIT ISSUING FEE /U
I certify that I have read this application and state that the I TOTAL FEE S;So
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. ,
thPr.
ention d property for ins ection purposes.I� SEE REVERSE FOR EXPLANATORY LANGUAGE
_
Signature of Permittee Date ,
11
WORKERS'COMPENSATION DECLARATION 10/81 APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I have a certificate of consent to self CE-806G
G
insure, or a certificate of Workers'Compensation InSLrance, COUNTY OF LOS ANGELES BUILDING AND SAFETY
or a certified copy thereof(Sec. 3e00, Lab. C.)
Policy No. 410216 Company State FUnd FOR APPLICANT TO FILL IN JOB ADDRESS 9362 Lower Azusa Rd.
Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE
Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. $ — $ LOCALITY Temple City
tion department. Multi-family Sq. Ft. — NEAREST
10/31/8 West Coast Ltp Residential Swimming Pools OWNER OR
CROSS ST.
Date Applicant 7
FIRM NAME
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw._ MAIL
COMPENSATION INSURANCE First 20 ADDRESS 9362 Lower Azusa Rd.
(This section need not be completed if the work involved by Total No. Additional CITY Temple city Tel. No.
the permit is for one hundred dollars($100)or loss.)
that in the performance of the work for which this PLAN CHECK
I certify P APPLICANT
permit 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
r ; Total No. Additional
Date 11 1/84 Appli 't' �-/-! f -� �1 CITY Tel. No.
� -- L Fixed Appliances Not Over 1 HP PERMIT
NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT West Coast Lighting
Exemption, you should become subject to the Workers' Range_ Heater—D.W. _
Compensation provisions of the Labor Code, you must forth- Oven —Dryer _W.M.— ADDRESS 3317 Ocean Park Blvd.
with comply with such provisions or this permit shall be Top _ FAU —W.H. —
deemed revoked. Hood _ Fan _Other_ CITYSanta Monica, Ch.No. 870-291
LICENSED CONTRACTORS DECLARATION LICENSE OR
I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. REG.NUMBER 224211 Class. C-1
(commencing with Section 7000)of Division 3 of the Business Power Apparatus&Large Appliances DISTRICT NO. PROCES D BY
and Professions Code,and my license is in full force and effect. S /0 0
224211 C-l0 Size 8 Type HP, KW, KVA, or KVAR S.V �
License Number. Lic. Class Up to 1 Incl. FINAL
Over 1 to 10 Incl. DATED C"- _`4��- VALI ATION
of
Contraccttoor�- • Sam Simon Date 1,.11f A4 Over 10 to 50 Incl. J
❑J'aTafri'ex9i der fighting Over 50 to 100 Inc. BY FINAL
Over 100
B.BP.C. for this reason '
Date: Services, Swbd., MCC 8 Panelboards
0 -200 Amp. Under 600 V
Signature 201 - 1000 Amp. Under 600 V
❑ Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V Q
SINGLE FAMILY Temp. Power Pole 8 Appurtenances /� •
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit C. '
I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits
Law for the following reason (Section 7031.5, Business and
Professions Code):
Misc. Conduits 8 Conductors p( 1 5 -
l, as owner of the property, will do the work and the I ) L 1 j,
structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)_ , 1
7044, Business and Professions Code). (1
CONSTRUCTION LENDING AGENCY Temporaryecora 1 e 0
I hereby affirm that there is a construction lending agency for
the performance of the work for which this permit is issued PERMIT FEE (Sub-Total)
(Sec. 3097, Civ. C.).
PLAN CHECKING FEE
Lender's Name
PERMIT ISSUING FEE
Lender's Address
I certify that I have read this application and state that the TOTAL FEE 15 a 50
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 abgve-mentioned property for inspection puroses. SEE REVERSE FOR EXPLANATORY LANGUAGE
hSig ature of Permittee Date
WORKERS'COMPENSATION DECLARATION 1 10/81 APPLICATION-FOR ELECTRICAL PERMIT
'
I hereiy�r affirr S'that I have a certificate of consent to self I CE-806G
G
Insure, or a certificate of Workers'Compensation Insurance, it BUILDING AND SAFETY U
COUNTY OF LOS ANGELES.
or a certified copy thereof(Sec. 3800, Lab: C'.) Temple CAy
Policy No. gIM09 Compomstate CGS?_ FOR APPLICANT TO FILL IN I JOB
Certified copy is hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE ADDRESS9362 Lower'Azusa Rd.
Certified copy is filed with the county building inspec- I 1 &2-Family, Sq. Ft. $ — $ LOCALITYMp 38 B-4
tion department. Multi-family Sq. Ft. —I . NEAREST
Dot 187 T.RF�.S RRQS Ff FC'I'� Residential Swimming Pobls '•' OWNER O
7 Applicant �*
' '■• ' FIRM NAM�IETA FIAATS
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec 6 Light Sw._ FIR IL 9362 Lower Azusa Rd.
COMPENSATION.INSURANCE
(This section need not be completed if the work involved by 6 First 20 ` -8
the permit is for one hundred dollars($100)or less.) Total No. ADDRESS
Additional 5 6 4 5 aTTEMPT F CITY . Tel. No. 74
I certify that in the performance of the work for which this PLAN CHECK
� APPLICANT
permit 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
CITY Tel. No.
Date applicant Fixed Appliances Not Over 1 HP
NOTICE TO APPLICANT: If, after making this Certificate of „� PERMIT
Exemption, you should become subject to the Workers' Range_ Heater_D.W. APPLICANT
Compensation. provisions of the Labor Code, you must forth- Oven —Dryer —W.M. ADDRESS 1754 N. MAIN ST.
with .comply with such provisions or this'permit shall be Top _ FAU —W.H. — ANGEL
M,revoked. Hood _ Fan' _Other_ CITY IAS FSS• CA Tel. W.;225-5945LICENSED CONTRACTORS DECLARATION �Cond. LICENSE OR
I hereby affirm that I am licensed under provisions of Chapter 9 Dis p' _ Room AirREG. NUMBER 169324 Class-C-10
(commencing with Section 7000)of Division 3 of the Business power Apparatus 8 Large Appliances ' DISTRICT ER P CE D BY
and Professions Code,and m license is in full force and effect. pp g pp � L4
License Number 169324 Lic. Class X10 Size&Type HP, KW, KVA, or KVAR j ✓!��' V
Up to 1 Incl. FINAL 0
Over 1 to 10 Incl.
DATE:/7.,.�. c
Contractor GIBBS BROS. Date 787 Over 10 to 50 Incl. �✓ VALIDATION
❑ V15;I am exempt under Sec. FI Over 50 to 100 Inc.B.&P.C. for this reason ? IOver 1.00z
Date: �ro, Services, Swbd., MCC&•Panelboards
0 -200 Amp. Under 600 V
Signature 201 - 1000 Amp. Under 600 V
❑ {
Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V
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. Additional Sign Branch Circuits y
Law for the following reason (Section 7031.5, Business and
Professions Code): 130
l0
0
El 1, as owner of the property, will do the work and the Misc. Conduits 8 Conductors
structure is not intended or offered for sale (Section I Other(See Complete Fee Schedule)_ ? ► �'�Q®�
7044, Business and Professions Code).
CONSTRUCTION LENDING AGENCY ISub Panel 15.00 1 1 .;0
1 hereby affirm that there is a construction lending agency fore
the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) 19.51C
(Sec. 3097, Civ. C.).
i PLAN CHECKING FEE
Lender's Name
PERMIT ISSUING-FEE 1 .rj
Lender's Address ;
I certify that I.have read this application and state that the! I TOTAL FEE 30.0.
above information is correct.F.-St,
to comply with all County
ordinances and State law ng Electrical. wiring, and I
hereby authorize repro this County to enter upon
the above-me r rty f inspection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
e �I
_>$Muralra or tee Date (,
WORKERS'COMPENSATION DECLARATION , CE-806 10/81 APPLICATION FOR! ELECTRICAL PERMIT
I hereby affirm that I have a certificate of consent to self CE-8066
insure, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY
or a certified copy thereof(Sec. 3800, Lab. C.)
Policy No. 410216 Company State Fund FOR APPLICANT TO FILL IN JOB
Certified copy is hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE ADDRESS 9 362 Lower Azusa Rd.
S $ —
Certified copy is filed with the county building ihspec- 1 &2-Family, q• Ft. $ LOCALITY Temple City
tion department. Multi-family Sq. Ft. — NEAREST
1Q/31/84d� West Coast LtC,� Residential Swimming Pools CROSS ST.
OWNER OR
Date -i4pplicant
FIRM NAME
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw._ MAIL
• COMPENSATION INSURANCE First 20 ADDRESS 9362 Lower Azusa Rd.
(This section need not be completed if the work involved by Total No. Additional CITY Temple City Tel. No.
the permit Is for one hundred dollars($100)or less.)
that in the performance of the work for which this PLAN CHECK
I certify P APPLICANT
permit 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
Additional
Dates Total No. CITY Tel. No.
NOTICE 10 APPL8ICANT:pIfII�6 ter makin this Certificate of Fixed Appliances Not Over 1 HP PERMIT
g Range— Heater—D.W. APPLICANT Wrist coast Lighting
Exemption, you should become subject to the Workers' 9
Compensation provisions of the Labor Code, you must forth- Oven — Dryer —W.M.— ADDRESS ocean Park Blvd.
with comply with such provisions or this permit shall be Top FAU —W.H. — „
deemed revoked. CITYSanta Monica, cn.No. 870�-291
LICENSED CONTRACTORS DECLARATION Hood — Fan —Other—
Disp. _ Room Air Cond. LICENSE 224211 Class.
I hereby affirm that I am licensed under provisions of Chapter 9 REG. NUMBER C-1
(commencing with Section 7000)of Division 3 of the Business DISTRICT NO. PROCES D BY
and Professions Code,and my license is in full force and effect. Power Apparatus&Large Appliances 0.
Size&Type HP, KW, KVA, or KVAR �V O
License Number 224211 Lic. Class C-10 Up to 1 Incl. � FINAL �p
Sam Simon Date 13-11194 Over 1 to 10 Incl. DATE G —� � VALI TION
Im
Contractor
} Over 10 to 50 Incl. FIN u
Tarti'exaaTLsnerghting Over 50 to 100 Inc. B / U&
Over 100 -
B.&P.C. for this reason U)► U)
Date: Services, Swbd., MCC&Panelboards
0 -200 Amp. Under 600 V
Signature 201 - 1000 Amp. Under 600 V
❑ Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V •;� a
SINGLE FAMILY Temp. Power Pole&Appurtenances �O 7
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit # �' 8
I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits
Law for the following reason (Section 7031.5, Business and
Professions Code): o o l 5,rJ
❑ property, Misc. Conduits&Conductors =
I, as owner of the
p ty, will do the work and the hSee Complete Fee Schedule q q Ustructure is not intended or offered for sale (Section Other( P )— 11 C
7044, Business and Professions Code). Temporanr Decoratife- 5. 0
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 PERMIT FEE (Sub-Total)
(Sec. 3097, Civ. C.).
PLAN CHECKING FEE
Lender's Name
PERMIT ISSUING FEE
Lender's Address
I certify that I have read this application and state'thot the I TOTAL FEE 15.- 50
above information is correct. I agree to comply with a,ll County
ordinances and State laws regulating Electrical wiring, and
hereby authorize representatives of this County to enter upon
theab ve-mentioned property for inspection pur oses. SEE REVERSE FOR EXPLANATORY LANGUAGE
L Sig ature of Permittee Date/
i I
WORKERS'COMPENSATIOND.ECLARATION I
CE-806G (2-80) APPLICATION FOR ELECTRICAL 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 , T/ �
a certified copy thereof(Sec.3800,Lal,.C.)
t )
Tit wCle 6d j FOR APPLICANT TO FILL IN JOB gy // ��pp
Policy N{r '7 ' J4pany �1 4A� �i.fnc ADDRES L 16*WcVf
f New Residential Bldgs.&Pools EACH NO. FEE 1 4
Certified copy is hereby furnished. I 1 &2-Family,Sq.Ft. $ — $ LOCALITY
�` DL
f Multi-family Sq. Ft. — NEAREST
' Certified copy is filed wi the county bui i specti in CROSS ST ��') Ci-w U�
department.• Residential Swimming Pools. / S
d� P FIRM NA AE 1,
Date-- /Applicant �,r �
.Outlets: Rec Light rst 42—
' 5U MAIL
YFirst -2fJ /ADDRESS AIP2_ rP � Gl �•
CERTIFICATE OF EXEMPTION FROM WORKERS' 1 Total No. Additional 0 }CITY. Tel No:
COMPENSATION INSURANCE
PLAN CHECKtl
(This section need not be completed,if the work involved 1 �v .2 p L APPLICANT V
Lighting Fixtures First 20
by the permit is for .one hundred dollars ($100) or less.•) ADDRESS
Additional 3L) SG' - cc
\ Total No. O
I certify that in the performance of. the work for which this CITY Tel No.
Fixed Appliances Not Over 1 HP
permit is issued, I shall not employ any person in any manner PERMIT f'
LJ
as to become subject to the Workers' Compensation Laws. 1 Range_Heater—D.W._ APPLICANT �` d
Oven _ Dryer_W.M._ ADDRESSN
Date Applicant � Top _ FAU _W,H.._ .
ZCIZ
Hood _ Fan _Other_ CITY ��• -1 Tel No.
NOTI'CE TO APPLICANT: If, after making this Certificate of Disp. _Room Air Condom LICENSE O
Exemption, you should become-subject to the Workers' ;REG.NUMBER- � 3 Class �!
Compensation provisions of the Labor Code,you must forth- Power Apparatus&Large Appliances `DISTRICT NO. PROCE'SSE'D BY
with comply withsuch provisions or this permit shall be.
deemed revoked. ' Size&Type HP,KW,KVA,or KVAR �.
Up to 1 Incl.
' FINAL
LICENSEWCONTRACTORS DECLARATION 1 Over 1 to 10 Incl. DATE VALIDATION
Over 10 to 50 Incl.
I hereby affirm that I am licensed.under provisions of Chapter I Over 50 to 100 Inc. FINAL
BY
9 (commencing with Section 7000)of Division 3 of the Busi- I Over 100 `
ness and Professions.Code, and my license is in full force and
effect. � I Services
License Numb__ Lic.Class 4 I 0-200 Amp.Under 600 V �• I
201-1000 Amp..Under 600 V 4
Contra a �[tt`3 "Z 2,— J? Over 1000 Amp.or Over 600 V
OME OWNER-BUIL .ER DECLARATION Temp.Power Pole&Appurtenances
Sign with One Branch CircuitL�
I hereby affirm that I am exempt from the Contractor's Additional Sign Branch Circuits
License Law for the following reason (Section 7031.5, Busi- 4
ness and Professions Code): -// /•' S
V L
Misc.Conduits&Conductors �j
ElI, as owner of the property, will do the work and the Other(See Complete Fee Schedule)— r�f �+ o '
structure is not intended or offered for sale (Section j ,� V
7044,Business and Professions Code). I Y
CONSTRUCTION LENDING AGENCY ,
I hereby affirm that there is a construction lending agency
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)
Lender's Address PERMIT ISSUING FEE
I certify that I have read this application and state that the I TOTAL FEE t']I
above information is correct.I agree to comply with all County
ordinances and State laws regulating Electrical wiring, and
hereby aut ize representatives of this County to enter upon
thT. r-me ti e e ty for inspection purposes. SEE•REVERSE FOR EXPLANATORY LANGUAGE
Py
ig tune 4 rmittee Date