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� .. ..`..,.:.. !:...;��.�:� � tr;..,�._ •. -. •,APPLICATION FOR ]PERMLT
,.DESA TMENT OF BUILDING AND. SAFETY
COUNTY OF LOS ` GEI:ES :k x:.. .
. EICTRIC
WNI:. `;..FOX 'HIEFEPTGINEER:':a:_ '::: . ;:,mw.' !•. °
<: NAME' `DIS•TRICT'NO. GROUP ZONE PERMIT NO.
U AADRESS; :' ,... . ..�.�.
J i..:'': rRECEIYED BY.. READY,FOR DATE,ISSUED
CITYi:i3:'�. :e:•, _ .L:!• TEL.NC:ra`: ., t�.�":; FIRSTCNSPECTION'
J COUNTY" •�
W ,CERT.NO. EXPIRES
•-� APPLICANT, FYI.L IN HEAVdY::O.UTLINCD.PORTION,,ONLY
DESCRIPTION OF WORK loe;:• j ' ' "', �!/�
ADDRESS
,.
NUMBER OF OUTLETS ON•CIRCUITS•.> ': `LOCALITY ��-!Ir'L1
LOCATIOPI•.BY'ROOMR .':''::.: ::::;..., '• NEAfiE57' P
L71GNT..'OUTL,EL9 SW. PL''UGB= F114T CROSS ST'.
CIRCUIT,` A' 'B: ..0 D E ,F `G
t: MAIL: .•. :if .
a A'pDRESB. Z '(/7 .&�
.TELNO��
WAA1 '.:TH6'': GAL P088 SSOR- -OF, T.HE .ABOVE LAS
ANCi_ S.:COUINTY CERTIFICATE OF' OUALIF.LCATION..
ELECTRICIAN: .
t` 1, 78R•:*rte.QA ,OWNER.OF -HC PROPEATY D$SCRIBED.
OWNER.'
- J
Z
TOTAL a'l :
: 4n ..tiS4,;
No. OF OUTLETS < *� .:,� Y APPROVALS
1 NO:'OF FIXTURES "''= } DATE INSPECTOR'S.NAME '
NO:.OF MOTORS FIa:P.:'.'
NO:.OF.SIGNS TRANS.: S._ ;.:. W I'RINW: G
NO:00.RANGES OR HEATERS
MISCELLANEOUS 4p
OYvER
PERMIT FEE. /� S 44:
� UTILITYCO.NOTIFIED ) !
COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Department of County En4ineerELECTRIC
• DIVISION OF BUILDING_ & SAFETY -
WILLIAM J. FOX, County EngIneer
FOR APPLIDAN fT0 FILL IN DISTRIV NO. GROUP I ZONE PERMIT NO.
ELECTRICIAN
READY FOR DATISSUED
ADDRESS �- �CEIVED Y FIRST INSPECTION I E r
CITY. I TEL _T NO. IA r
COUNTY. LICENSE NO. EXPIRES BUILDING ` / ,�
PERMIT FEES 1 ADDRESS �? 4a s
^
NUMBER EACH' FEE LOCALITY �`. 'r F`� ���► l T 1
LIGHT—OUTLETS `L. NEAREST 12
CROSS 5T. �
RECEPTACLES �/vV���.. I Y �+..7��O
-
WALL SWITCHES L OWNER A� C-
TOTAL OUTLETS 50 9 AMAIL
DDRESS' —L• 6 "1 �L.I V
ELEC. RANGES 26 4
ELEC. HEATERS 25 CITY Q_ TEL NO. 64 -7 _
FIXTURES Z S Q' 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
MIBC. APPLICATION AND STATE THAT THE ABOVE 19 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 LOB
NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
New MVo. HP OVER INC. EACH OF'THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
A m LEBB 6 .25 SIGNATURE OF�
2 .60.
PERMITTEE—
'/2
2 . 5 1.00 INSPECTION RECORD
- 15 50 2.50
50 200 5.00
200 60010.00 J
5013 1000 15.00 Z
OVER 113013 20.00 L7
M.S. SET/FREQ. CHANGER-HP Q'
WELDERS"AC-KVA O
GENERAT93RO - KW
TRANSFORMERS - KVA _
TEMP. MOTORS (75% OF ORIS-)
MOVEIi MOTORS (75% OF CRIB.)
MISC.
SIGNS
NO. NO.TRANS.
APPROVALS
NO. NO.LAMPS
FOR ,EACH PERMIT" DATE INSPECTOR'S NAME
WIRING M1•.00 CONDUIT
FIXTURESi3OO. WIRING
SUPPLEMENTARY ,50 FIXTURES.
POWER' A
TOTAL FEE +� UTILITY CO.NOTIFIED
FINAL
76A063 DRS*5A 4-52 r
sMra'o�aw n•M APPLWATRON FOR PzBmr
IW' R •°F BAND '.' ELECTRIC i
COUNTY OF LOS ANGEM
WILLIAM a. roxv CNIlr EN■INEER '
FOR APPLICANT TO FILL IN OIBTRICr O. CROUP ZONE PERMIT NO.
BLECTRICIAN �
RECEIVED ■Y rIRBRETADINSPECOY RTION R DAT! NSIU®
ADDREw
CITY TEL.NC. ,-
O LICl ■! NO. ■NUIIL I�NO O r j -
PBSRQ'l'
NUM■ER OUTLETS EACH LOCALITY
.
LIMHTN NW1E■T
ROP ST.
REDEP'fACLq ■ Ca • •
FIXTUREfi ■ ° OWNER C2 14ff
WALL SWITCNE■ 6 MAIL .
ELEo. RANEEB i■ ' ADORES■
ELEO. HEATERS B■ CITY TEL. NO.
NUMBER or OIROUITR IN■TI •nl 1 N!R!■Y ACkNOWLIDDs THAT 1 HAVE HEAD THIN ,
TOTS / APPLICATION AND ■TATE THAT THE A■W! IN CORRECT
JJMHTE RED C AND ANNEX TO OOMPLY WITH ALL COUNTY ORDINANDES
MOTORB AND ■TAT! LAW■ RlBULATINB ELECTRICAL WIRING.
Nuwsp HCMEPOWER ME 1 CERTIRY THAT 1 POSEY THE ABOVE VALID LOB
mm M m. NP WAM INo. ICAM ANSELES COUNTY LIOEN■E. OR 1 AN a LE■AL OWNER
Vs i L m 6 .BS or THE RESIDENTIAL P AD A■OVL
■ •SD IMMATURE OF
R ■ 7.00 PlRMI
B 1s �.■D II�SPECTION SECOSD
1■ so ss0
an ■Do ILM
SO0 SDO 1C.00
SCE 1000 1d.00 -
OVER 1000 1110.00 Z
M.S. ■R oNAN■!R-HP •• p
WELDERBI AD-RVA 0
• SENlRATOR■ - ION
TRAN■RORNER■ - EVA
TEMP. MoTORs or oNu
O
MOVED MTOR or uninJ
HIED.
EIGNE
TYPE1 No.TRAN■.
NOg Mw APPROVALS
FDR EACH PERMITI DATE INEPEOTOR7 NAM!
WIRIND *1,oO CONDUIT
rocTUR)<■ 1.00 WIRING
r
PPL! SO R01TUR0
POWER
TOTAL 'FEE' � , UTILITY OIL NCTIr1ED
FINAL
'GASES=CESOG•'10-56 I APPLICATION FOR ELECTRIC PERMIT 1
BUILD= AND SAFETY DMSION
Department of County Engineer BUILDING
County of LOS Angeles ADDRESS (O (�
JOHN.A.LAMBM COUNTY ENGINEER
CASSATT D. GRIFFIN.SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
PERMIT FSM 'Er
n
LIGHTS RECEPTACLES • 3 SWITCHES OWNER IV^ 1 1,`i�//`•��� �d/�
.NUMBER 1 T E M 6 EACH EE MAIL `_ ! , [J• _
ADDRESS
TOTAL OUTLETS $ .IO $ lic 1110
,t
ELEC. RANGES, WATER. HEATERS, CITY TEL.NO.01�7 ib
CLOTHES DRYERS .50' "
ELEC. SPACE HEATERS, STAT'1f. cooH• ELECTRICIAK
INSUNITS, GARBAGE DISPOSERS, ADDRESS09
AUTO .WASHERS. DISHWASHER_ .25
LIGHTING FIXTURES .10: CITY TEL.,NO.
MOTORS STATE
LICENSE NO.
HORSEPOWERDISTRICT NO. JGROUP ZONE READY,FOR INSPECTION'
H.P. OVER INNC..
&LESS .25
y4 —
9 . .50 INSPECTION RECORD
S 5 1.00
15 So 2.50
50 — 200 5.00 qi " Co Cl�yy !�{{ATA t.v 1'
MISC. o�•�L11516A--,.-...,.,�.}
SIGNS I NO.TRANS
NO.LAMPS
SERVICE O-500V 1.00
SERVICE OVER SOOV 5.00,
WIRING PERMIT 1.00
FIXTURE PERMIT 1.00 --�
SUPPLEMENTARY PERMIT .SO APP$OVA18
TOTAL FEE $ DATE INSPECTOR'S SIGNATURE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS.APP CATION
AND. STATE THAT.THE ABOVE IS..CORRECT.AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY 'ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING.
WIRING ��
I HEREBY CERTIFY THAT I AN PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE POWER.
DESCRIBED RESIDENTIAL PROPERTY.
SIGNATUREI� UTILITY CO.NOTIFIED s�J
OF.PERMITTwI l`! ' FINAL
JOHN ALAMBIE. ATION ARTHUR C.VEIT... -"�-�•-�
.OUNTY NGINEEIZ SUPERVISING ELECTRICAL ENGINEER
K MO CASH
c`_A 12 3 7 AUG16 2 5:50
WORKERS'COMPENSATION DECLARATION 76-663 tD/Si APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I have a certificate of consent to self insure, CE-806G
or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY
copy thereof(Sec.3800,Labb.C.)
Pollcy No.4 7 0 0 5 3 8� Ipany U-S-F &G FOR APPLICANT TO FILL IN JOB
❑ Certified copy is hereby furnished. New Residential Bldgs.&Pools EACH NO. FEE ADDREss 9 6 6 9 OLIVE STREET
F
S
il
F
❑ amy, q. t. $ — $ LOCALITY Certified copy is filed with the county building inspection 1 &2- —
department. Multi-family Sq.Ft. NEAREST
RCRoss s7 TEMPLE CITY BLVD
Residential Swimming Pools
Y
Data l Appl' OWNER OR
/) FIRM NAME AGUSTINE ORTIZ
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec_Light—Sw. MAIL
—
COMPENSATION INSURANCE ADDRESS 9669 OLIVE ST.
(This section need not be completed if the work Involved by the First 20 CITY Tel.
permit is for one hundred dollars($100)or less.) Total No. Additional TEMPLE CITY N8'/287-206
I certify that in the performance of the work for which this permit APPLICANT K
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..
Data Applicant Fixed Appliances Not Over 1 HP PERMIT
NOTICE TO APPLICANT: If, after making this Certificate of APPUCANTC 0 B I N E ELECTRIC C O. INC.
Exemption,you should become subject to the Workers'Compensation Range_ Heater D.W.
provisions of the Labor Code,you must forthwith comply with such Oven _ Dryer_ W.M._ ADDRES CHESTNUT' S T.
provisions or this permit shall be deemed revoked. Top _ FAU W.H.
LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other— CITY A L H A M R A C A. Tel.No2- 82_0315
I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. LICENSE OR
(commencing with Section 7000)of Division 3 of the Business and REG.NUMBER 2 2 9 8 4 7 Class. C—10
Professions Code,and my license is in full force and effect. Power Apparatus&Large Appliances DISTRICT N PROCESSED BX
Size&Type HP,KW,KVA,or KVAR - V
License Number2 2 9 8 4 7 Lic.Class C-10 Up to 1 Incl. FINAL 8
C O S I N E E L E C T R Over 1 to 10 Incl. DATE VALIDATION
Contractor a Over 10 to 50 Incl. FIN V
4 ❑ 1 am exempt under Sec. Over 50 to 100 Inc. gY LL1
B.&P.C.for this reason Over 100 d.�
Services;Swbd.,MCC&Panelboards 15 . 00 1' 15 0 010. Z
o-200 Amp.Under 600 V
c gn,T 201 - 1000 Amp.Under 800 V
❑ Over 1000 Amp.or Over 800 V
Exemption for Reg:Maint.Elect.
SINGLE I'AMILY Temp.Power Pole&Appurtenances 7
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit
s� I hereby affirm that I am exempt from the Contractor's License LawAdditional Sign Branch Circuits -GGT•*
for the following reason(Section 7031.5,Business and Professions
Code): 3307 25.50
❑ I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors i ITEMS
is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) _
and Professions Code). ► TOTAL 25.50
CONSTRUCTION LENDING AGENCY CASH 25.50
I hereby affirm that there is a construction lending agency for the �t�w�r
Performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub Total) 15 00 ■00
Civ.C.).
PLAN CHECKING FEE
Lender's Name - 1 6/15/89
PERMIT ISSUING FEE 10 50 4 1 AM11�39
Lender's Address
I certify that I have read this application and state that the above TOTAL FEE .i
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 111D221150tion pyLoamSEE REVERSE FOR EXPLANATORY LANGUAGE
ee Date
COUNTY OF LOS ANGELES TEMPLE CITY
# 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS
EL 0508 0809170052
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID BUILDING ADDRESS:
1 ON FILE I 1 9669 OLIVE ST I
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:1 TEMP CA 917803250
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET:
18588-024-024 1A1 PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY, Cl
I IG1 OUTLETS-LGT,SW,RECP 2.00 OUT 3.90 1
TENANT: 1G2 LIGHTING FIXTURES 1.00 LGT 1.95 11SSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
1 i TOTAL FEES 33.60 109/17/08 SR 03/16/09 1
(OWNER: TEL. NO: 1 IFINAL DATE ^ FIN CODE:
IORTIZ, MR/MRSAUGUSTIN I �6(
(-,(t19669 OLIVE ST I I ( `
ITEMP 917803250 I IDESCRIPTION OF WORK
1 I 12 LIGHTS AND 1 OUTLET
(APPLICANT: TEL. NO: 1
O'LEARY (626) 287-0927- 1
5823 AGNES AVENUE 1 (SPECIAL CONDITIONS: 1
ITEMPLE CITY CA 91780 I
� I I
ICONTRACTOR: TEL. NO: 1 APPROVALS DATE INSPECTOR SIGNATURE 1
ITOM O'LEARY CONSTRUCTION (626) 287-0927- 1
15823 AGNES AVENUE LIC. NO 1 ITEMPORARY POWER POLE I I I
TEMPLE CITY, CA 91780 489354 B-1
1 i JUNDERGROUND CONDUIT I I I
1ARCHITECT OR ENGINEER: TEL. NO: JUFER GROUND
I - I
I I I
LIC. NO: i IROUGH CONDUIT I I ]
I (ROUGH WIRING
((MAIN WATER LINE I I I
PLASTIC Y/N METAL Y/N I I I
(UTILITY COMPANY NOTIFIED] ] I
I ] I
l
� I
I
I
IREPORT ID: DPR265 ROUTE TO: BS0508 1 I I I
I I I I I I