HomeMy Public PortalAbout10200 NADINE ST_Electrical__ T&AG" D=°A 11-" APPLICATION FOR PERMIT
DEPARTMENT OFNG AND SAFETY ELECTRi C i
COUNTY OFF LOS LOS ANGELES
WILLIAM J FOX• CHIEF ENGINEER
FOR t79CANT TO FILL og DISTRICTGROUP I ZONE PERMIT MO
ELECTRICIAN ?p
RECEIVE DY DATE ISSUED
ADDRESS Rt INSPEF CTION
CITY v AL.NO /5'X/1 7
COU LICENSE NO EXPIRES BBUILDIN
UILDING lop •
PERMIT FIr
NUMBER OUTLETS EACH FEE LOCALI
•
LISHT BC NEAREST
CROSS ST
RECEPTACLES S •
!� O FIXTURES s OWNER
WALL SWITCHES 6 MAIL
CLIM RANGES 26 ADDRESS
ELEC HEATERS BS CITM TEL No
1 HEREBY Armowi,,cCeTHAT 1 HAVE READ THIN
NUMBER OF CIRCUITS INET EDS
Tom. APPLICATION AND STATE THAT THE ABOVE iB CORRECT
LIGHTS / RE E LES AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
MOTORS AND STATE LAWS REGULATING ELECTRICAL WIRING
Nuueem HORSEPOWER PEE I CERTIFY THAT I POSBEBB THE ABOVE VALID LOB
New MVC HP OVER INC am" ANGELES COUNTY LICENSE• OR 1 AM THE LEGAL OWNER
Va e Less 6 gs OF THE RESIDENTIAL P PERTY DESCRIBED ABOVE
9 so SIGNATURE OP
B B 1 00 PERMITTE
s 15 lea INSPECTION RECORD
is so 250
so ROD 600
SOO Soo law
Soo 1000 1500 J
OVER 1000 Roca Z
ma BET/PREQ CHANGER NP
WELDERS AC KVA Q'
GENERATORS - KW O
TRANSFORMERS - KVA
TEMP MOTORS (76 or calm)
MOVED MOTORS (7s or ORIS)
mine
SIGNS
TYPES No.TRANS.
o MPs APPROVALS
FOR EACH PERMITS DATE INSPECTOR'S NAME
WIRING Nice CONDUIT
FIXTYREB 100 WIRING
SUPPLEMENTARY_ So XIXTURCS x
00 POWER
TOTAL FEE • UTILITY 00 NOTIFIED 1/
FINAL
TEMPLE CITY
76A669-CE806 6.62 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS 01 O P .
JOHN A LAMBIE COUNTY ENGINEER /� f
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY
NEAREST n�
FO APPLI N O FIL IN CROSS ST -Aal&7eps8
RECEPT TOTAL NO EACH Phi
OUTLETS FIRST 20 S 20 S OWNER DLJ NO a I? Me
LIGHT //yy MAIL AlSWITCH /(/ ADD L ADDRESS /1910 O /ret 1ne
Z OVER 20 10
TBTAL CITY �/ZJ Ie �"f TEL NO T 132-2
LIGHTING FIRST 20 20
FIXTURES ADD LNtO ELECTRICIA
OV R 2O
RANGES CLO DRYERS WYE HTRS tool ADDRESS
OARS DISP STA COOK CITY TEL NO
DISHWASH AUTO WASH STATE
SPACE HTRS STA APP (%H P MAX) s0 LICENSE NO
MOTORGs ovum NOT OVER H P DISTCT O GROUP Z E P CESSED BY
o t too D
1 s 1150 INSPECTION RECORD
s s 200
8
is ago
is so s oo
BO too Soo V
Blame$ NO TRANS OC
NO LAMPS
SERVICE O 600V NOT OVER 200A 100 a 01
IL
SERVICE O 600V OVER 200 A 200 ! H
SERVICE OVER 600V S o0 Z
MISC
PERMIT ISSUING FEE 200 p�
SUPPLEMENTABY PERMIT ISSUING FEE too
TOTAL FEE 6
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI TION ALS DATE IN S•GNATURE
AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING WIRING
I HERESY CERTIFY THAT I AN PROPERLY RESISTXIS(D AND/OR
LICENSED AB REQUIRED BY LOS ANGELES COUNTY AND STATE OR FIXTURES
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTI PROPERTY POWER
SIGNATURE UTILITY CO NOTIFIED
OF IbERMITTEE
FINAL
If VALIDATION ARTHUR C VEIT
Cit MO (A63/ SUPERVISING ELECTRICAL ENGINEER
LQ 6 3 1 4 WAR 6 2 D 4.60- 4
f �
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78ASOPC�EStfB 8/61 APPLICATION FOR ELEC RICAL PERMIT ,
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER fADDRESS
LDING
BUILDING AND SAFETY DIVISION JOHN A LAMBIE COUNTY ENGINEER
WILLIAM A JENSEN SUP T OP BUILDING ALITYRESTP O FIL IN SS ST
RECEPT j TOTAL NO EACH FEE
OUTLETS FIRST 20 a 20 a OWNER
L 18X7 MAILelf
SWITCH ADD L ADDRESS
OYER 20 10
TOTAL CITY TEL NO
LIGHTING FIRST 20 SO
dip-
FIXTURES ADD L to ELECTRICIAN c
OV R 20
RANGES CLO DRYERS! WTR MTRS 100 ADDRESS
GARB DISP STA COOK
CITY TEL NO
DISHWASH AUTO WASH STATE
SPACE HTRS VIA APP (yi X P MAX) s0 LICENSE NO
MOTORS' ovER NOT OVER NP DISTIPCT NO. G P NE P ESSED BY
O f f DD }�
s 1 so INSPECTION RECORD
S s S oo
a Is ago Ou
IS so Soo r- S--&L
so 100 500 WAS PONg B s✓ At
SIGNS: NO TRANS � P
No LAN" !N VD
SERVICE O 600V NOT OVER SODA f 0o
SERVICE O SOOV DYKE 200 A S 0o
SERVICE OVER 600V goo
MISC
PERMIT ISSUING PER 200
SUPPLEMENTASY PERMIT ISSUING FEE 100 O
TOTAL FEE i
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION DATE 1 SIGMATUEX
AND STATE THAT THE ABDYE I!CORRECT AND AGREE TO COMPLY C6NDU1T
WITH ALL COUNTY ORDINANCE! AND !TATE LAWS REGULATING
ELECrwCAL WIRING WIRING
I HER®Y CEIRIPY THAT 1 AN PROPERLY REGISTER%b AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
ORWAISED MIUDENTIAL PROPBRTY POWER
SIGNATURE TILITY CO
OF NOTIFIED
PERMITTE
FINAL
LIDATION ARTHUR C VEIT
MO CASH SUPERVISING ELECTRICAL ENGINEER
Lilo 7 lb 3 8 APR 14 2 D 460- d
WORKER S COMPENSATION DECLARATION 20.0019 DPW(12 91) APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that 1 have,certificate of consent to self Kure 78A883
or a certificate of Worker s Compensation Insurance*ot a certified COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV
copy thereof(Sec 3800 Lab C)
Policy NO Company FOR APPLICANT TO FILL IN CRESS IO,too Q 1n�
Candied copy is hereby furnished New Residential Bldgs &Pools NO EACH FEE
Family Sq Ft — $ $ LOCALITY
El �Certified is filed with the county bud1&2
ding inspection — NEAREST ^,./�-Y L
department Mufti family Sq Ft CROgS ST 9 ly�i'� -�
Date Applicant Residential Swimming Pools ASSESSOR
MAP BOOK806
PAOEO/�b PARCEL O/Z
CERTIFICATE OF EXEMPTION FROM WORKERS Z�J OWNER O
�O
COMPENSATION INSURANCE Outlets Roe Light_-T-Sw FIRM NAME p CL.
M
���QQ
(This section need not be completed the work Involved by the MAIL
Total No I1Z��- First 20 Additional ADDRESS
permit is for one hundred dollars($100)or less)
1 certify that in the performance of the work for which this permit C!!!:2ft4b6 Tell
r is issued I shall not employ any person in any manner so as toPLAN CHECK
become subject to the Workers Compensation Laws Lighting Fixtures First 20 �� b APPLICANT di lladj3l
Total No Additional
Date Applicn' ADDRESS
Wnp a
NOTICE TO APPLICANT If after making thio of RESIDENTIAL APPLIANCES NOT OVER 3 HP to of C Tel N.44&-8313
Exemption you should become subject tp the Workers Compensation OTHER APPLIANCES NOT OVER 3 HP
provisions of the Labor Code you must forthwith comply with such Power Apparatus&Large Appliances �� 4
PAEPPMC NT
provisions or this permit shall be deemed revoked
LICENSED CONTRACTORS DECLARATION Size=Over
KVA or KVAR ADDRESS p 0 e
I hereby affirm that I am licensed under provisions of Chapter 8 3 to 10 Incl ��
(commencing with Section 7000)of Division 3 of the Business and CITE' Tel No
Professions Code and my license is in full force and effect Over 10 to 501nc1 LICENSE ORI I }
Over 50 to 100 Incl REG NUMBER 0 70 3 Chm j5 d
Over 100 DISTRICT NO P ED BY O
License Number Lic Class O U
Services Swbd MCC&Panelboards cc
Contractor Date 0 399 Amp Under 800 V D95 ATE O0
❑ I am exempt under Sec 400 1000 Amp oder 800 V ' W
Over 1000 Amp or Over 600 V Over
S&P C for this reason BRANCH CIRCUIT FEES NAL B co
Z
Date ISA or 20A 1�pY'rghting or Recept
I/ 1 To 10 Branch Circuits
Signature 11 To 40 Branch Circuits
uits
❑ Exemption for Reg Maint Elect 16A 20A 20 VV To 277V LLiightin Br Circuanch its
SINGLE FAMILY Temp Power Pole&Appurtenances11�� 3
HOME OWNER BUILDER DECLARATION Sign with One Branch Circuit a3 X71 20
1 hereby affirm that 1 am exempt from the Contractor s License Law
for the following reason(Section 7031 5 Business and Professions Additional Sign Branch Circuits
Code) 1 ITEMS
as owner of the property will do the work and the structure Misc Conduits&Conductors TUTAL 27E®20
is not intended or offered for sale(Section 7044 Business Other(See Complete Fee Schedule) , { �� i�
and Professions Code) AM
CONSTRUCTION LENDING AGENCY CHANE ,�I
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 Totaq J�� l p
Civ C)
�O`IV' PLAN CHECKING FEE 000D-0001 12/27/93
Lender s Name
PERMIT ISSUING FEE 3119 1 AM 9'0'
Lender s Address
I certify that I have read this application and under penalty of puqury state TOTAL FEE y0
that the above information is correct I agree to comply with all County
ordinances and State laws regulating Electrical wiring and hereby authorize
twee of this County to enter upon the above-mentioned property
for I i n p ose . SEE REVERSE FOR EXPLANATORY LANGUAGE
NATURE OF PERM DAVE
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1404020012
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285 0488 EXT
LEGAL IDI FEES PAID BUILDING ADDRESS
TR 15862 IT 23 10200 NADINE ST
IFEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917802727 I
ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET DAINES
8586 026-012 Al PERMIT ISSUANCE FEE 27 80 I THOMAS PAGE 597 GRID B3 LOCALITY TEMPLE CITY CAI
,F1 120V 15/20A BR CKTS 1 00 BR 17 30 I
ITT TOTAL FEES 45 10 ISSUED ON PROCESSED BY PLAN BY
104/02/14 SR
`OWNER TEL NO IFINAL JaTE FnJAL BY CODE 1
ILIN YINGXING (626) 872 3338- 1
110200 NADINE ST Iby-ol�k
I
(TEMP 917802727 I 1D CRI I OF WORK I I
lil I1 (INSTALLING 50 A BREAKER AND A 240V OUTLET
APPLICANT TEL NO - I
SAME AS OWNER
(SPECIAL CONDITIONS
I I— I
ICONTRACTOR TEL NO i (APPROVALS DATE INSPECTOR SIGNATURE
ISAME AS OWNER -
I LIC NO I (TEMPORARY POWER POLE I I
I IUNDERGROUND CONDUIT
1
(ARCHITECT OR ENGINEER TEL NO l I
i IUFER GROUND
LIC NO 1 ROUGH CONDUIT I I
I
IROUGH WIRING 0
I I IMAIN WATER LINE I
PLASTIC Y/N METAL Y/N
UTILITY COMPANY NOTIFIED
I
1 i I I
I I I
t I I
I I
I I I
I
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