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HomeMy Public PortalAbout10162 LYNROSE ST_Electrical__ 7SA663 DBS SA 3-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY � � COUNTY OF LOS ANGELES � 'S WILLIAM J. FOX, CHIEF ENGINEER �a FO APPLICANirFILL IN DISTRICT NO. GROUP ZONE PERMIT NO. I / / C945 ELECTRICIAN ADDRESS 40 � R�EC/E�IV�-E+�D/ BY READY FOR DA'T� ISSUED FIRST INSPECTION [LIGHT ITY TEL NO. OUNTY LICENSE NO. �Y G� EXPIRES BUILDING/&I ADDRESS / • PERMIT FEES 1 � FEE LOCALITY NUMBER EACH OUTLETS NEAREST RECEPTACLES CROSS ST. ,�,f�/�, WALL SWITCHES OWNER / -,CAu TOTAL OUTLETS 5C 111 1571 MAIL v i ELEC. RANGES 25 ADDRESS ELEC. HEATERS ` 25 CITY TEL. NO. FIXTURES °1 46 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE 18 CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWERANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER FEE OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. NEW MVD. HP OVER INC. EACH V2 a LESS $ .23 .S L• SIGNATURE OF %2 2 .50 PERMITTEE 2 5 1.00 SPECTION REC©RD 5 15 1.50 is SO 2.50 50 200 5.00 2013 600 10.00 J 500 1000 15.00 Z OVER 1000 20.00 (� M.O. SET/FREQ. CHANGER-HP Q� WELDERS:AC-KVA O GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF ORIG.) MOVED MOTORS (75% OF ORIG.) MISC. SIGNS NO. NO.TRANS. APPROVALS NO. NO. LAMPS DATE INSPECTOR'S NAME FOR EACH PERMIT: WIRING 1$1.00 d ?f CONDUIT FIXTURES $1,00 WIRING SUPPLEMENTARY .50 FIXTURES POWER TOTAL FEE Q UTILITY CO.NOTIFIED FINAL �m14)e 76A663-CE806 468 nPPU AU�DN FOR E pTU ® L PERMIT 10) BOUNTY OF LOS ANGELES IL JI DEBPARTMENT OF COUNTY UIILDING AND SAFETY DIVISION rE3LDING /JOHN A. LAMBIE, COUNTY ENGINEER DRESS Q l[O ZCOLEMAN W. JENKINS, SUPERINTENDENT OF BUILDINGCALITY � K!' /e 4AREST FOR APPLICANT TO FILL IN CROSS ST NO EACH FEE - RECEPT $ $ OWNER OCL MAIL LIGHT TOTAL FIRST 20 20 ADDRESS Q �m�+Z �• GS'e S SWITCH_ OVER 20 10 CITY C Cry TEL. NO. PLAN CHECK LIGHTING TOTAL FIRST 20 20 APPLICANT FIXTURES ___P— OVER 20 10 ADDRESS t� � RANGE_DRYER_WTR HTR._ CITY TEL NO STA COOK_DISP _F.A U CONTRACT-OR QCv1/6lr SPACE HTR AIR COND ADDRESS CLOTHES WASH _DISHWASH._ CITY TEL. NO. {° FAN_OTHER 1 00 LICENSE IJO CLASS. MOTORS,TRANSFORMERS RATING IND HEATERS, ETC HP. KW KVA I 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 ELECTRICAL WIRING 0 - 1 1 00 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 1 - 10 3 00 LICENSEDAS REQUIRED By LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO "I 1O - 50 5 00 RESIDE IN, THE ABOVE OESCRIRED RESIDENTIAL PROPERTY SIGNATURE C 50 - 100 10 00 OF PERMITTEE U 100 - soo is 00 =DISTRICT NO GR UP ZONE PROCESSED BY o TUBE,GOR AS SIGN AND ONE CIRCUIT 3 00 ..� �•I U / W MARQUEE ADDITIONAL CIRCUITS 1 00 NOT (p ✓ CL 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 POWER POLE - UNDERSLAB WORK ROUGH CONDUIT PERMIT FEE (SUB TOTAL) WIRING FIXTURES PLAN CHECK FEE (5017. PERMIT FEE) POWER AUTHORIZED PERMIT ISSUING FEE 2 00 2 C)� UTILITY CO NOTIFIED -� SUPPLEMENTARY PERMIT ISSUING FFEI 1 00 FINAL 1 TOTAL FEE JOSEPH C. ROOHAN SUPERVISING ELE ICAL ENGINEER PLAN CHECK VALIDATION CK M o CASH PERMIT VALIDATION CK M o CASH. C 8 9 1 0 R19 2 0 2.40 a _ EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE +•76A663-CE806 468 » APPLOCAT I® V FOR EE q IrRACAb ppR �rt COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING �dJ/n O JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS ((OO.L COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY NEAREST I FOR APPLICANT TO FILL IN CROSS ST YG N'�G NO, EACH FEE -' $ $ OWNER -r a k- RECEPT._ MAIL LIGHT - TOTAL FIRST 20 20 _ ADDRESS SCLbs'�C SWITCH_ OVER 20 10 CITY TEL. NO. ' PLAN CHECK LIGHTING �TOTAL. FIRST 20 20 APPLICANT FIXTURES OVER 20 10 ADDRESS RANGE_DRYER—WTR HTR._ CITY TEL NO STAB COOK�DISP _F.A U CONTRAC rOR hS 4�1 SPACE HTR AIR COND.—ADDRESS CLOTHES WASH.—DISHWASH._ CITY TCTEL. NO. ,FAN_OT,HER 1 00 C?, LICENSE IJO �d/DS�3 CLASS. -/O MOTORS.TRANSFORMERS RATING IND HEATERS, ETC HP .KW KVA I 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 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 'RESIDE IN; THE'A DESCRIP,ED ESIDENTI L PROPERTY r 50 - 100 10 00 OF PERMIT TEE �^"'a, CD . U 100 - 500 15 00 DIST ICSIGN,GAS aT GR P Z PR D o TUBE, OR SIGN-AND ONE CIRCUIT 3 00 I-- 6 A W ccMARQUEE ADDITIONAL CIRCUITS 1 00 NOTES: d c SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00 .2 Q 0 SERVICE OVER 600 VOLTS OR 200 AMP 5 00 e TEMP SERVICE, POLE, &APPURTENANCES 3 00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP POWER POLE ' UNDERSLAB WORK ROUGH CONDUIT PERMIT FEE (SUB TOTAL) WIRING FIXTURES PLAN CHECK FEE (507/PERMIT FEE) !� D A 4 *� POWER AUTHORIZED 4 PERMIT ISSUING FEE 2 00 0 UTILITY CO NOTIFIED SUPPLEMENTARY PERMIT ISSUING FEE 1 00 FINAL TOTAL FEE JOSEPH C. ROOHAN -SUPERVISING ELEC ICAL ENGINEER PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK M O CASH 8 6 9 W PAR 18 2 D 6.0 0 EE BACK OF APPLICATION'FOR COMPLETE FEE SCHEDULE 76A 663-C E806,,3-69 APPLICATION FOR ELECTRICAL PERMIT_ COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING �7 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 NO. EACH FEE $ $ OWNER RECEIPT. pMAIL �7 ` LIGHT TOTAL FIRST 20 ( - 20 l ©� ADDRESS CITY TEL.N0. SWITCH OVER 20 10 PLAN CHECK , LIGHTING TOTAL FIRST 20 ,20APPLICANT FIXTURES } / OVER 20 10 ADDRESS RANGE_DRYER_WTR HTR. CITY TEL.NO STA COOK_DISP F.A.0 CONTRACTOR SPACE HTR AIR COND ADDRESS ��7 LLLL ��jj CLOTHES WASH _DISHWASH. CITY TEL.NO FAN OTHER 1 00 LICENSE NO , CLASS -Jb 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. 0 - 1 1 00 1 HEREBY CERTIFY THAT AM PROPERLY REGISTERED AND/OR LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND 5TATEOF i - lO 3 OO CALIFORNIA OR THAT I AM THE LEGAL O HER OF, A D INTEND TO RESIDE IN, THE A CRIBED RE E TIAL PR ERTY. O 10 - 50 5.00 V SIGNATURE 50 - 100 10A0 OF PERMITTEE O 100 - 500 1500 DISTRICT NO GROUP ZONE PROCESSED BY G . 0 ( a SIGN,GAS SIGN AND ONE CIRCUIT 3 00 rn TUBE, OR Z MARQUEE ADDITIONAL CIRCUITS 1 00 NOTES SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00 1 00 SERVICE OVER 600 VOLTS OR 200 AMP 5 00 TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP. POWER POLE UNDERSLAB WORK ROUGH CONDUIT WIRING PERMIT FEE (SUB TOTAL) FIXTURES e 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 JOSEPH C. ROOHAN SUPERVISING ELECT CAL ENGINEER PLAN CHECK VALIDATION CK. M.0 CASH PERMIT VALIDATION ' M.D. CAS r- 3 0 0 9 DEC 9 2 D 5_.2Q 7 SEE BACK OF APPLICATION FOP COMPLETE FEE SCHEDULE 7,aA6163-0806111-71 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING O / �' H>Df�i BUILDING AND SAFETY DIVISION ADDRESS &/ C LOCALITY .` NEAREST FOR APPLICANT TO FILL IN CROSS ST. X �(1 C H-�eL OUTLETS NO EACH FEE OWNER RECEPT $ $ MAIL �7 FIRST 20 ADDRESS LIGHT TOTAL 25 CITY TEL. NO SWITCH OVER 20 10 PLAN CHECK LIGHTING 1 TOTAL FIRST 20 Z 25 ® APPLICAN Jj OVER 20 ADDRESS FIXTURES �► 10 RESIDENTIAL APPLIANCES CITY TEL NO. PERMIT RANGE DRYER_WTR HTR APPLICANT STA COOK DISP. F.A U. ADDRESS, d �� Qk, 4lL-e SPACE HTR, _AIR COND _CITY TEL. NO3`)Z CLOTHES WASH DISHWASH. LICENSE NO. /Q CLASS. FAN OTHER100 400 O I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION A 2, 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 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF a CALIFORNIA OR THAT I AM THE LEGAL WNER OF, AND INTEND TO 1 - 10 300 RESIDE IN, THE ABOVE DESCR IB RES,DEN AL PROPERTY O U 10 - 50 S00 SIGNATURE OF PERMITTEE O so - 100 1000 u DISTRICTNO CI ASS O PROLE SED BY Lu 100 — Soo 150093-Q — i N SIGN, GASSIGN AND ONE CIRCUIT 500 NOTES: Z TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 SERVICENOTOVER 600 VOLTS OR 200 AMP, 300 SERVICEOVER 600 VOLTS OR200AMP 1000 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP POWER,POLE TEMP SERVICE, POLE, &APPURTENANCES 500 UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM 300 ROUGH CONDIUT WIRING ZJ FIXTURES PERMIT FEE (SUB TOTAL) POWER AUTHORIZED UTILITY CO. NOTIFIED PLAN CHECK FEE L PERMIT ISSUING FEE 300 3 d 0FINAL 5 TOTAL FEE 07olo PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION (CK M 0 CASH t(1 � • . � Q SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE �]i k n q:m 5 3751 JUN 2'J5 2 D 7 T 0 0 ' 1 s 76A663A-:EBO6A 4/72 APPA CAIMN ®R R &PCAL PERN'T COUNTY OF LOS ANGELES �C r DEPARTMENT OF COUNTY ENGINEER BUILDING O / O t�- BUILDING AND SAFETY DIVISION ADDRESS LOCALITY 'T C NEAREST FOR APPLICANT TO FILLa IN CROSS ST. - I OUTLETS NO EACH FEE OWNER. $ $ C3 r ecl- RECEPT - MAIL �+ LIGHT Z TOTAL FIRST 20 .l ADDRESS Jd"4 Q_ (J 3 — CITY TEL. NO OVER 20 SWITCH PLAN CHECK LIGHTING FIRST 20 Z Q APPLICANT TOTAL FIXTURES 2 OVER 20 ADDRESS RESIDENTIAL APPLIANCES CITY TEL No. RANGE DRYER_WTR HTR PERMIT APPLICANT ONS \/y>LQN STA COOK DISP. F A U ADDRESS YO 3, !{✓�p, /N��, SPACE HTR AI R COND CI TY 2 �• TEL. NO. CLOTHES WASH DISHWASH LICENSE NO. !O os 3. CLASS. FAN t OTHER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY C=) MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING V IND HEATERS, ETC HP KW KVA ELECTRICAL WIRING SIZE & TYPE OVER TO p I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 - 1 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF W CALIFORNIA OR THAT I AM THE LEGAL ER OF, AND INTEND TO 1 - 1 O RESIDE IN, THE RIP. SID IAL PROPERTY h Z 10 - 50 SIGNATURE OF PERMITTEE 50 - 100 mli D I STRI CT NO Cl A9SZONE PROC SSE BY 100 - Soo (J B SIGN, GAS SIGN AND ONE CIRCUIT NOTES: TUBE, OR MARQUEE ADDITIONAL CIRCUITS SERVICENOTOVER 600 VOLTS OR 20OAMP SERVICEOVER 600 VOLTS OR 200 AMP APPROVALS DATE INSPECTOR'S SIGNATURE TEMP POWER POLE TEMP SERVICE,POLE, &APPURTENANCES UNDERSLAB WORK TEMP LIGHT OR RECEPT SYSTEM ROUGH CONDIUT WIRING FIXTURES POWER AUTHORIZED PERMIT FEE (SUB TOTAL) UTILITY CO NOTIFIED Alp PLAN CHECK FEE FINAL PERMIT ISSUING FEE TOTAL FEE PLAN CHECK VALIDATION CK M o CASH PERMIT VALIDATIONcK M o CASH 8 2 D 9.6 0 A" 76A663`CE-806(11 /78)-c %\ Il if UC /� 6HELE�TQ dy P QIW, �.. w x COUNTY OF LOS ANGELES BUILDING'AND SAFETY FOR APPLICANT TO FILL IN'• JOB ADDRESS:, _ , . Flew Residential Bldgs-&"Pools EACH NO FEE 1 &2 FoAy,Scl'Ft $. 025 - $ LOCALITY MUltl-fomily-Sq Ft 02 - NEAREST CROSS ROSS'ST Residential'SwLmmmg Pools _ 25 00 OWNER-OR- FIRM NAME 1 i Outlets Rec Light Sw.n _ MAIL First 20 50 ADDRESS' Total No Additional 30 CITY• PLAN C ECK> F „ APPLICANT Lighting Fixtures First 20' r50, ADDRESS Additional 30 _ _ --- Total No ~, CITY a Tel No p TT Fixed Applionces.Not Over I.HP• ._a :1 PERMIT APPLICAN - - Range_Heater_D W Oven—Dry`e'r W M' 'r ADDRESS s ^^ ; .Top _FAU W H CITY -�µ T - Hood_Fan _Other_ 2 50 LICENSE OR i Djsp _,Room Air Cond REG NUMBER Class�• I HEREBY ACKNOWLEDGE THAT I HAVE READ•THIS APPLICA Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS,CORRECT.AND AGREE TO Size&T COMPLY-.WITH,-ALL,-COUNTY^'ORDINANCES`AND"ST•ATEn'LAWS' ype HP, KW, KVA,or KVAR' ._.. 2 50 REGULATING ELECTRICAL WIRING s IFI. • '• O Up to )`Incl I-HEREBY CERTIFY'•THATLI-AWPROPERLY-REGISTERED"ANDYOR' -"'-U Over I to 10 Incl 5 00 LICENSED AS REQUIRED BY.LOS ANGELES COUNTY AND STATE OF, pc - Over.1.0 to.50 Incl 1 2 50.., CALIFORNIA QR THAT I AM THE LEGAL�OWNEROF THE f ROVE �•,A 25 00 DESCR E DENTIAL RTY , ?. pyo Over 50 to 100 Inc PERMITEE �+ 'Over 100 40.00 • SIGNATURE - y� �. Services' DISTRICT NO• " - ES �BY` 0- 200 Amp,Under 600 V '12 50 -201-,1000 Amp-'Under-600 V 25 00 Over-1000 Amp or Over 600 V 1 50 00 Z p Temp Power Pole&Appurtenances -10 00' Sign with One Branch Circuit, 1000 Additional Sign Branch Circuits 2 00' INSPECTION _ > • ' INFORMATION �W Misc Conduits&Conductors ON REVERSE- . z Other(See Complete Fee Schedule) u '9 T2 A . - ;'SIDE t ^Q # Ol0 0 0 0 2 1 PERMIT FEE (Sub Total) I ;l p 0 i PLAN CHECKING FEE (One-Fourth'Permit Fee) O ' �I 01,04-80. PERMIT ISSUING FEE _. $7'000M. TOTAL FEE , INSPECTION FINALED :E W date /_ i2� By 0" i � •- ®s WORKER'S COMPENSATION DECLARATION 20-0019 DPW 9/89 APPLICATION /�, ELECTRICAL �� �� ������ I hereby affirm that I have a certificate of consent to self Insure, 76A663 s CT IC - 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 LabC) Policy No j L 'rCompany ��±%2 7�SC G(� FOR APPLICANT TO FILL IN JOB • ADDRESS Certified copy is hereby furnished New Residential Bldgs &Pools EACH NO FEE _❑ /Yf 1e /1 &2-Family,Sq Ft Certified copy is fled with the county bwlding�inspection '- $ $ LOCALITY_ NEAREST i department Multi-family Sq Ft CROSSST go I A.j i/c.'� L/G�fC/11A/✓ Date I Applicant Residential Swimming Pools ASSESSOR MAP BOOK Q PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec -Light Sw OWNER OR —r/ r.,7 COMPENSATION INSURANCE First 20 FIRM ,/ 1 (This section need not be completed If the work,involved' MAIL by the ADDRESS 154-n,if 4's Job permit Is for one hundred dollars($100)or less), Total No Additional- I certify that in the performance of the work for which this,permit CITY Tel'No is issued, I shall not employ any person in any manner so as to t become subject to the Workers' Compensation Laws Lighting Fixtures First 20 - A PLAN LICANT CHECK Total No Additional . ADDRESS Date Applicant 15 OR 20A,120V BRANCH CIRCUITS NOTICE`TO APPLICANT If, after making this Certificate of CITY Tel No Exemption,you should become subject to the Workers'Compensation 1 TO 10 INCLUSIVE EACH IT provisions of the Labor Code, you must forthwith comply with such 11 TO 40 INCLUSIVE EACH APPLICANT 14 D?/C L$e L provisions or this permit shall be deemed revoked 41 OR MORE BRANCH CIRCUITS EACH �( LICENSED CONTRACTORS DECLARATION I - - ADDRESS /3t�Q�CS�TSh S7` d I hereby affirm that I am licensed'under provisions of Chapter 9 15 OR 20A,208V TO 277V LIGHTING EACH ^�/•" (commencing with Section 7000) of Division 3 of the Business and CITY �/� De,4Vq Tel C) Professions Code,and my license is in full force and effect RESIDENTIAL APPLIANCES UP TO 3HP LICENSE OR /,m I It �• Power Apparatus&Large Appliances _ _ REG NUMBER J �'-tf�7 C.i t class �� O ,rr Size&Type HP,KW,KVA,or KVAR DISTRICT NO PR E ED BY U License Number 2� ,/`�` ULI Lic Class / /`t C��LZ^i C_ - Up to 3 Incl L �_'� d P I�U/ Over 3 t0 10 Incl FINAL r Contractor Date ! Over 10 to 50 Incl DATE �7 •/ Z ❑ I am exempt under Sec _ Over 50 to 100 Incl ✓ VALIDATION BY Over 100 ` INAL B&P C for this reason , Services,Swbd,MCC&P.anelboards Date O�mp Under 600 V Q 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 r1`.•t•? a HOME OWNER-BUILDER DECLARATIONc- 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 Code) `.„ ❑ Misc Conduits&Conductors I,as owner of the property,will do the work and the structure is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) c and Professions Code) 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 s Lender's Name �T, � g a F1 a rl� PERMIT ISSUING FEE Lender's Address � 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 APPLICANT OR AGENT DATE COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1406230048 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT ILEGAL ID I FEES PAID BUILDING ADDRESS ITR 16957 LT 135 I I 10162 LYNROSE ST I IFEE DESCRIPTION QUANTITY UOM AMOUNT I TEMP CA 917802716 (ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET 1 18586-019-018 IAl PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 597 GRID B3 LOCALITY TEMPLE CITY CAI IF1 120V, 15/20A BR CKTS 1 00 BR 17 30 I ITENANT IG1 OUTLETS—LGT,SW,RECP 3 00 OUT 6 00 (ISSUED ON PROCESSED BY PLAN BY TOTAL FEES 51 10 106/23/14 SR (OWNER TEL NO I IFI ATE FIN Y ool ODE. I IBRASHEAR HOWARD K,MARJORIE A (626) 538-4647— 110162 LYNROSE ST I1j)71' 1 1TEMP 917802716 I IDC ipato& F WORK fI I I IE EC FOR WAL IN JET TUB I 1APPLICANT TEL NO I I I 1BOYANER, DAVID (714) 373-8545— I 1 115262 PIPELINE LN I ISPECIAL CONDITIONS I 1HUNTINGTON BEACH I I I I I I 1CONTRACTOR _ TEL. NO (APPROVALS DATE INSPECTOR SIGNATURE 1GALKOS CONSTRUCTION (714) 728-4631— I 115262 PIPELINE LANE LIC NO ITEMPORARY POWER POLE I 1HUDTTTNGTON BEACH, CA 92649 492715 * _ I I (UNDERGROUND CONDUIT I I I I I (ARCHITECT OR ENGINEER- TEL NO I 1UFER GROUND I I I I LIC. NO I 1ROUGH CONDUIT I I I I I I I IOf oq ROUCH WIRING I I I I IMAIN WATER LINE I IPLASTIC YIN METAL YIN I I I I 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- ADDITIONAL DATA ON FILE I I I IREPORT ID DPR265 ROUTE TO BS0508 I I I I I I I I I COUNTY OF LOS ANGELES TEMPLE CITY 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1312300010 ,BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT ILEGAL ID FEES PAID I BUILDING ADDRESS 1 ITR- 16957 LT 135 I 10162 LYNROSE ST J I IFEE DESCRIPTION QUANTITY UOM- AMOUNT TEMP CA 917802716 1 (ASSESSOR INFORMATION NUMBER I _ NEAREST CROSS STREET 1 18586-019-018 1A1 PERMIT ISSUANCE'FEE 27 80 THOMAS PAGE 597 GRID B3 LOCALITY TEMPLE CITY J I IG1 OUTLETS-LGT,SW,RECP 35 00 OUT 59 20 1 I ITENANT IG2 LIGHTING FIXTURES 12 00 LGT 24 00 (ISSUED ON PROCESSED BY PLAN BY J JHA FAU LESS 3HP' 1 00 FAU 11 00 112/30/13 SR I H1 RES ELEC OVEN LT 3HP 1 00 OVE 11 00 1 JOWNER TEL NO JH2 RES GRBG DISP LT 3HP 1 00 DIS 11 00 JFI AL FI AL Y- CODE. 1 JBRASHEAR HOWARD K,MARJORIE A - JH3 RES DISHWASHR LT 3HP 1 00 DIS 11 00 I 1 110162 LYNROSE ST JH4 RES RANGE HDS LT 3HP 1 00 HOO 11 00 I 1 ITEMP 917802716 JH7 RES EXHAUST FANS 1(j7f � �f 3 00 EX 33 00IDES R�-� IPTION OF WORK JJB AC UNITS +3-10HP 1 00 AC 19 70 ICHANGEOUT DAMAGED WIRING 1 J TOTAL FEES 218 70 1 J 1APPLICANT TEL NO J J GARCIA, JEFFREY (714) 267-4312- 1 J 1175 W ORANGETHORPE I ISPECIAL CONDITIONS 1 IPLACENTIA, CA 92870 I J 1CONTRACTOR TEL NO 1 - 1APPROVALS DATE INSPECTOR SIGNATURE J JACI (714) 996-3200- _ 1 1 J175 W ORANGETHORPE LIC NO J ITEMPORARY POWER POLE IPLACENTIA, CA 92870 572282 I 1 1 J 1 I I JUNDERGROUND CONDUIT 1ARCHITECT OR ENGINEER TEL NO 1 IUFER GROUND J I LIC NO J IROUGH CONDUIT I J I I I 1 1 IROUGH WIRING 1 J J I I IMAIN WATER LINE I I I JPLASTIC Y/N METAL Y/N J I I 1UTILITY COMPANY NOTIFIED( I 1 I I I I I I I I I I i I I I I J I I I I I I I I I I I I I I J I J J I I I I I I I I 1 IREPORT ID DPR265 ROUTE TO BSO508 1 1 1 1