HomeMy Public PortalAbout10209 NADINE ST_Electrical__ VGA*63 DBS SA S-se ® APPLICATION FOR PER=
DEPABTPAiT OF BUILDING AND sAFEFY ELECTRIC 1
COUNTY OF LOS ANGELES
WILLIAM J FOX CHIEF ENGINEER
FOR APPLICANT TO FILL INDISTRICT NO GROUP ZONE PERMIT NO
ELECTRICIAN REC Iv D BY READY FOR DATE 188690
ADDRESS FIRSTINSP6CTION
.—
CITY TEL NO
COUNTY L CENSE NO IREB BUILDING ��S L t
PE MT
ADDRESS v iv
--
NUMBER OUTLETS EACH FEE LOCALITY T16M PLE C/
LIGHTS sC NEAREST <L
1 V
RECEPTACLES 8 CROSS ST
,04 RIXTURES 5 OWNER II/ A/4'
WALL SWITCHES 5 MAIL It
ELEC RANGES 25 ADDRESS
ELEC HEATERS 28 CITY TEL NO
MISC
NUMBER OF CIRCUITS INSTALLED i HEREBY ACKNOWLEDGB THAT 1 HAVE READ THIS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
LIGHTS RKCEPT CLES 1000, AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
MOTORS AND STATE LAWS REGULATING ELECTRICAL WIRING
NuM6ER HORSEPOWER1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
FEE
NEW MYD HP dVBR INC EACH ANGELES COUNTY LICENSE OR 1 AM THE LEGAL OWNER
OF THE RESIDBNTIAL PROPDESCRIBED ABOVE.
a Lzes as
2 50 SIGNATURE OR 7
2 S 1 00 PERMITTER
Or-
a IS I so INXMON =ORD
1g 50 2 so
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50 200 500
200 800 f0 00
goo 1000 1g 00 J
OVER 1000 20 00 Z
M G SET RB CHANGER HP
WELDERS AC KVA
GENERATORS KW
TRANSFORMERS KVA
TEMP MOTORS 75 OR onto
MOVED MOTORS 75 OR ORIS
MISC
SIGNS
TYPES NO TRANS
TYPE NO LAMPS APPROVALS
FOR PERMIT. t DATE INSPECTOR S NAME
1
WIRING f 00 CONDUIT / u
FIXTURES100 WIRING ;�!
UPPL MENTARY so FIXTURES
A POWER
TOTAL FEE $ UTILITY CO NOTIR ED
FINAL
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7BA6119 C14106 8.6e APPLICATION FOR ELECTRI AL PERMIT
COUNTY OF LOS ANGELES i
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUP9MINTSHOWNTOPBUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
NO A FEE
RECEPT $ $ y OWNER 1r .�
MAIL
LIGHT_ TOTAL FIRST 20 20 ADDRESS
SWITCH_ OVER 20 10 CITY TEL NO
PLAN CHECK
LIGHTING }TOTAL FIRST 20 Z 20 APPLICANT
FIXTURES /� OVER 20 10 ADDRESS
RANGED'DRYER_WTR HTR _ CITY TEL NO
STA COOK_DISP _F A U_ CONTRACTOR
rr
SPACE HTR AIR CORD ADDRE a �Yeew e
CLOTHES WASH —DISHWASH __ CITY • TEL NO 141Y04-0"V
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FAN_OTHER 1 LICENSE NO CLASS +1 C
MOTORSTRANSFORMERS RATING
IND HEATERS ETC HP KW KVA 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
SIZE Q TYPE OVER TO AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY
WI TN
ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
O — 1 1 00 ELECTRICAL WIRING
I HEREBY CERTIFY THAT 1 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 Soo RESIDE IN THE 4ALCIVE DES RILED RESIDER L PROPERTY
SIGNATURE
50 — 100 10 00 OF PERMITTEE ' V
100 - 500 1s 00 DISTRICT O GR P Z P D
SIGN GAS SIGN AND ONE CIRCUIT 3 00
TUBE OR V
W
MARQUEE ADDITIONAL CIRCUITS 1 00 NOTES y
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00 Z
SERVICE OVER 600 VOLTS OR 200 AMP 5 00
TEMP SERVICE POLE R APPURTENANCES 300 APPROVALS DATE INSPECTOR 9 SIGNATURE
TEMP POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
PERMIT FEE (SUB TOTAL) WIRING
FIXTURES r ��
PLAN CHECK FEE (507 PERMIT FEE)
POWER AUTHORIZED
PERMIT ISSUING FEE 2 00 UTILITY CO NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEEI 1 001 FINAL aAws,
TOTAL FEE O JOSEPH C ROOHAN
SUPERVISING ELECTRICAL ENGINEER °
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK M o CASH
ME BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
e i
1
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1008030032
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 +
PHONE (626) 285 0488 EXT
LEGAL ID FEES PAID ' BUILDING ADDRESS I
ITR 15862 IT 21 I 10209 NADINE ST I
IFEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917802728 I
(ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET BALDWIN
18586 027 021 JAI PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 597 GRID B3 LOCALITY TEMPLE CITY Cl
IG1 OUTLETS LGT SW RECP 70 00 OUT 106 10 I i
TENANT G2 LIGHTING FIXTURES 20 00 LGT 38 80 ISSUED ON PROCESSED BY PLAN BY
HA FAU LESS 3HP 1 00 FAD 10 90 08/03/10 SR I
H2 RES GRBG DISP LT 3HP 1 00 DIS 10 90 I
(OWNER _ TEL NO IH4 RES RANGE HDS IT 3HP 1 00 HOO 10 90F F CODE I
IJOZEFCZYK IRENE H (626) 444 3022 IH7 RES EXHAUST FANS 1 00 EX 10 900 !T
I
110209 NADINE 3T II$ 200 AMP PANELS MCC 1 00 PAN 38 8 I I
ITEMP 917802728 TOTAL FEES 255 10 I M CR PTI N OF WORK I
YI��HOME EEXISTING SERVICE P INSTALL 200 AMP REWIRE THE
I
(APPLICANT TEL NO I I
GROSS GLENN (909) 464 9983
13615 DAISY CT y SPECIAL CONDITIONS
ICHINO CA 91710 r I I
ICONTRACTOR TEL NO (APPROVALS DATE INSPECTOR SIGNATURE
(SAFE WAY ELECTRIC CO (909) 464 9983
113615 DAISY CT LIC NO (TEMPORARY POWER POLE I I
ICHINO CA 91710 809692 C10
I (UNDERGROUND CONDUIT I I
ARCHITECT OR ENGINEER TEL NO I IUFER GROUND I I
I I
LIC NO ROUGH CONDUIT 1
ROUGF WIRING I
MAIN WATER LINE 16)
`, PLASTIC Y/N METAL Y/N
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PLASTIC
COMPANY NOTIFI I I10M
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