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Home My Public Portal About9541 OLEMA ST_Electrical__ IA663-CESOG 5-62 APPLICATION FOR ELECTRICAL PERMIT. COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER FA LDING BUILDING AND SAFETY DIVISION RESB 95.41 Olem JOHN A. LAMBIE.'COUNTY ENGINEER WILLIAM A.JENSEN;15UP T.OF BUILDING ALITY. Tem le City RESTFOR APPLICANT TO FILL IN SS.ST. RECEPT.3 2 TOTAL' NO. EACH FEE rr�� OUTLETS FIRST 20 6.20 S OWNER _ o _ .. LIGHT .2pp 4 MAIL 5472 Templp City R1178 SWI.TC— H.J,Zyy OVER L :70 ADDRESS 1 LIGHTING TOTAL CITYTem le C4_ TEL.No.-At FiR3T 20 � .20 . _ FIXTURES 1 24 ADD'L 1OID— 'ELECTRICIAN OY R ZO RANGSS tLo.DRYERS- R:HTRS. 1.00 1 1 n j ADDRESS 114 East School Street GARB.DISP. STA.COOK ' ' CITY COV]. TEL .No.. ET7) 21862 DISHWASHI AUTO.-WASH STATE .SPACE Hf , • STA.APPC:(L H.P.MAX.) 7 .50 3 .6 O LICENSE NO. 185376 MOTORS, OVER NOT OVER H.P. DIRICT O. GR P Z P O S O 1 1.00 3 2 1.1 1.150 150 INSPECTION R C RD s B 2.00 /513_ G .u�.4 Ei p ' C1. 1 1 �/ _ " 8 115 2.150 o,7&7— . .�(.O.Git .21+..+rtGl�_ /� � 0O 15 50 5.00 U i 50 100 5.00 l s` n A O SIGNSe NO.TRANS. - NO.LAMPS '"' Ji:►J SERVICE 0.6OOV-NO'TOVER 260A 1.00 - _ Z SERVICE 0-6.0OV-OVER 200 A. 2.00 SERVICE OVER 600V 5.00 MISC. PERMIT ISSUING FEE 2.00 2.00 SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE B 2 41 2 1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS.APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE 18 CORRECT AND.AGREE TO COMPLY .CONDUIT . I I r• ^—•7 WITH ALL-COUNTY ORDINANCES WAND STATE LAWS REGULATING ELECTRICAL WIRING. - WIRING - V 'r *• .%•� I HEREBY CERTIFY THAT-1 AM PROPERLY REGISTERED AND/OR j LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF_ FIXTURES CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL-RHOP r.. •POWER �y i •'" 814NATURE UTILITY CO.NOTIFIED ! D� .•G� /r /r +' OF PERMITTEE r FINAL IIDATION ARTHUR C. VEIT' CK MO CABN SUPERVISING ELECTRICAL ENGINEER 1�N L"o5 1 4 3% 'OCT 22 2 D 24.20- C9 iA653-CE.806 5-62 APPLICATION FOR ELECTRICAL PERMIT - COUNTY OF LOS ANGELES -DEPARTMENT OF,COUNTY ENGINEER BUILDING BUILDING AND SAFETY-DIVISION ADDRESS 2541 Oiem� JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A.JENSEN,SUP'T OF BUILDING LOCALITY Temple City NEAREST FOR APPLICANT TO FILL IN CROSS ST. Trewlan RECEPT. 2 TOTAL NO. EACH FEE OUTLETS • FIRST 20 s.PO S AIL OWNER'Otto Bal d__ LIGHT ADO'L ADDRESS• 4 Temple Cit. SWITCH. 2 OVER 20 .10, ' LIGHTING TOTAL FIRST 20 .20 CITY Temple City TEL.NOAT-7-5794 FIXTURES } ov B 20 ' .10 ELECTRICIAN B. Electric -RANGES .CLO.DRYERS. WTR.HTRS. 11.00. ADDRESS 114 East School Street " GARB.DISP. .• STA.COOK CITY Covina TEL.NO. 33 2-18`62 DISHWASH. AUTO.-WASH. STATE - SPACE HTRS, STA.APP.(Y=H.P.MAX.) .50' LICENSE NO. 18 5- 7 6' MOTORs. OVER NOT OVER H.P. DISTRICT'NO. GROUP ZONE PRO SEED BY 1 $ 1.5,0 INSPECTION RECORD 3 8 2.00 , B 1 s 2.50 cam. is so 3.00 50 100 5.00 0 .SIGNS, - NO.TRANS: NO.LAMPS IL SERVICE 0.66OV•NOT OVER 200A 1.00 Z SERVICE O.SOOV•OVER 200'A. 2:00 SERVI VER 600V5.00 MISC PERMIT ISSUING FEE 2.00 SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE s 3 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 rr ELECTRICAL WIRING. - WIRING 1 //,F. r..•3. , P r "1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR. LICENSED AS REQUIRED BY LOS GELES COUNTY AND.STATE OF FIXTURES CALIFORNIA OR THAT 1 AM T GAL OWNER OF THE ABOVE DESCRI13ED'RESIDENTIAL PRCF POWER f!• SIGNATURE UTILITY CO.NOTIFIED -her%/f `�'I'nt' �!�"''I��:v i'''l d OF PERMITTEE FINAL /P M�M• -. �` /% ` G� IDATION ARTHUR C:VEIT CK MO ';CASH SUPERVISING ELECTRICAL ENGINEER .1 �Go 3. 3 2 SEP 17 2 D :3.40 -.WORKERS"COMPENSATION DECLARATION 76A663 10/61 I herety affirm that I have a certificate of consent to self insure, CE-806G 'APPLICATION FOR ELECTRICAL PERMIT or a certificate of Workers'Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec.3800,LaWC.) Policy NAkno Soi604 Company i�� J;TJOB , FOR APPLICANT TO FILL IN ADDRESS2. is, ❑ Certified copy is hereby furnished. New Residential Bldgs.&Pools EACH NO.. FEE. ❑ 1 &2-Family,Sq.Ft. $ _ $ LOCALITY f+ T Certified copy is filed with the county building inspection, department. Multi-family Sq.Ft. NEAREST k7 CP Residential Swimming Pools CROSS ST. DF+[C 641111CDate Applican FIRM NAME OT70 CERTIFICATE OF EXEMPTION FR M WORKERS' Outlets:Ree—Light_Sw. MAIL COMPENSATION INSURANCE ADDRESS (This section need not.be completed'if the work involved by the First 20 Total No. Additional CITY permit is for one hundred dollars($100)or less.) 'r�dy�� Cl T Tel.No. ��s_y�Z7 I certify that In the performance of thatwork for which this permit PLAN CHECK aPPucaNT is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. Lighting Fixtu..res First 20 ADDRESS + Additional Total No. 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'Compensation Range_ Heater_ D.W. _. APPLICANT Aid -TW-C,14� �T�►' ,�/�IQ/C, 1�1 G provisions of the Labor Code,you must forthwith comply with such Oven _ Dryer- W.M._ ADDRESS i 1'Z2 YJaI 110 provisions or this permit shall.be deemed revoked: Top _ FAU W.H. _ CITYTel.No. LICENSED CONTRACTORS:DECLARATION Hood — Fan _ Other_ 1 AC,*o a* I:hereby affirm that I am.licensed under provisions of Chapter 9Air Cond: LICENSE OR (commencing with Section 7000)of Division 3 of the Business and Disp. — Room REG..NUMBER Class Professions Code;.and my license is in full.force and effect; Power Apparatus&Large Appliances DISTRICT NO. � PROCESSED BY Size&Type HP,KW;KVA,or,KVAR O License.Number S &/// J Lie.Class.-<'�O Up to 1'Incl. FINAL /// 8 �1 �•Over 1•to 10 Incl'. DATE Contractor 414 Timm Data. /1 / / ATION O Over 1:0 to 50 Incl. FINA ❑ I am exeinpt'under.See. Over 50'to 100 Inc. BY W B&P.C.for this reason Over 100 N Services,Swbd.;MCC&Panelboards , 04 Date 0-200 Amp.Under 600 V Signature 201 - 1000 Amp.Under 600 V ❑ 67 Over 1000 Amp.or Over 600 V Exemption for Reg.Maint.Elect. SINGLE FAMILY Temp.Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit i I hereby affirm that I am exempt from the Contractor's license Law Additional Sign Branch Circuits 8 for the following reason(Section 7031.5,.Business and Professions (; .],.9 Code): ' Misc.Conduits&Conductors 3307 17.50 ❑ 1,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) _ 1 ITEMS and Professions Code). Pol. OTAL -07.50 CONSTRUCTION LENDING AGENCY ,.50 CHECK 17 y 1 hereby affirm that there is.a construction lending agency for the performance of the work for which this peemit is issued(Sec.3097, PERMIT FEE (Sub-Total). CHANGE Xral ' - PLAN CHECKING FEE ' Lender's Name 1i 6/801PERMIT ISSUING FEE Lender's Address. 0245 1 X11 -2Q I certify. that.I.have read this application and state with.all that the:above' TOTAL FEE o information is correct.I agree to comply County rdinances and State laws regulating Electrical wiring, and hereby authorize representatives of this County to enter upon the above-mentioned pper r inspection pur. . sea. SEE REVERSE FOR EXPLANATORY LANGUAGE. ; nature Permittee Date ;