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Home My Public Portal About5307 PAL MAL AVE_Electrical__'�TEA663.CEf106iO-=s APPLICATION FOR ELECTRIC PERMIT 1 BUILDING AND SAFETY DIVISION Deportment of County Engineer BUILDING 2�� 77=7 hn,q County Of Los Angeles ADORE55 lJ /'/,/ JOHN A. LAMBIE. COUNTY ENGINEER CASSATT D. GRIFFIN. SUPT OF BUILDING LOCALITY NEAREST G FOR APPLICANT TO FILL IN CROSS ST. PERM FEES OWNER LIGHTS RECEPTACLES eWITCXEH NUMBRRi I T E M EACH FEE MAIL ADDRESS TOTAL OUTLETS R .10 S ELEC. RANGES, WATER HATERS, CITYTEL. NO. CLOTHES DRYERS .50 ELEC. SPACE HEATERS, STAT-Y. COOK. ELECTRICIAN b CAC. IMG UM ITi. HAPGAGE DISPOSERS, ADDRESS Q AOI/ d YS�}'� AUTO WASHERS, OISHWASXRR .25 ' LIGHTING FIXTURES .10 / CITY LJ/ ITA �I e 1Or 2 / TEL. NO. MOTORS STATE LICENSE NO. HORSEPOWER X.P. I OVER INC. DISTRICT NO. GROUP ZONE uenox uou Ixwecr iory V. D LESS .ze — 2 .301 1 INSPECTION RECORD 2 5 1.00 5 15 1.50 �A,LIR 0 16 50 2.50 50 200 5.00 MISC. h e' SIGNS I NO.TRANS NO.LAMPS SERVICE 0-600V 1.00 SERVICE OVER 600V 5.00 WIRING PERMIT 1.00 '^ FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .50 APPROVALS TOTAL FEE M DATE INSPECTOR'S SIGNATURE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION 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 AM PROPERLY REGISTERED AND/OR FIXTURES 362 L4 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I THE LEGAL QWNER OF THE ABOVE POWER 'SCRIBED RESIDENTIAL OPERTY. S SCRIBE RE ��J('r('[Sr, VTI LITY CO. NOTIFIED OF PERMITTEE FINAL _ JOHN A. LAMBIE. VALIDA�'[(i � ARTHUR C. VEIT. ' COUNTY ENGINEER CK Mo cARH SUPERVISING ELECTRICAL ENGINEER ._ _ I p0060E; AFR21 2 A 2AO :8 WORKERS COMPENSATION DECLARATION 76A603• 10/81 I hereby affirm that I have a certificate of con"pt to ,elf, d-iiji`G APPLICATION FOR ELECTRICAL PERMIT insure or a certificate of Workers Compensation Insurance COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof(Sec 3800, Lab C ) Policy No Company FOR APPLICANT TO FILL IN JOB2 D ,+` mR L if I-I✓� Certified copy is hereby furnished New Residential Bldgs 8 Pools EACH NO FEE ADDRESS J ❑ Certified copy is filed with the county building mspec 1 8 2-Fom ly Sq Ft $ — f LOCALITY TEI'V) (.r C /,r eon department Multi family Sq Ft — NEAREST CROSS ST Dote Applicant Residential Swimming Pooh OWNER ORFIRM OL31 Il.) 5 O N CERTIFICATE OF EXEMPTION FROM WORKERS' -aa- 6 MAIL NAME /9 M Outlets R Ltpht_Sw_ ylil COMPENSATION INSURANCE First 20 AOONF55 (This section need not be completed H the work Invelved by Total No _ Additional CITU Tel No the permit Is for ane hundred dellen(SI00)or less ) PIAN CHECK I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner APPLICANT so as to become subject to the Workers Compensation Laws Lighting Fixtures y Fest 20 ADDRESS Total No�` Additional Dote Applicant CITY Tel No Fuad Appliances Not Over 1 HP NOTICE TO APPLICANT If, after makes this Certificate of PERMIT Exemption you should become subject to the Workers Range_ Heater_D W — APPLICANT f}M O f31 Iv $ O Compensation provisions of the Labor Code you mull forth Oven _ Dryer — W M _ ADDRESS S a9 yV� with comply with such provisions or this permit shall be 1 _ FAU —W H — deemed revoked Hood _ Fun _Other_ CITY Tel No LICENSED CONTRACTORS DECLARATION LICENSE_ Room Au Cond LNSE OR Class I hereby affirm that I am licensed under provisions of Chapter 9 REG NUMBER (commencing with Section 7000)of Division 3 of the Business Power Apparatus 8 large Appliances DISTRICT NO PROLE D BY and Professions Code and my license is in full force and effect /r y License Number Lc Class Size 6 Type HP KW KVA or KVAR O V Up K 1 Ince FINAL �J L Over I to 10 Incl DATE 7 �( / VALIDATION IZ Contractor Dote Over 10 to 50 Incl FINAL G ❑ I am exempt under Sec Over 50 to 100 Inc BY C B 8P C for this reason Over 100 Z Dote Services, Swbd, MCC d Ponelboards ► 0 200 Amp Under 600 V Signature 201 1000 Amp Under 600 V ❑ Exemption for Rep Mont Elect Over I ODD Amp or Over 600 V SINGLE FAMILY Temp Power Pole 8 Appurtenances HOME OWNER BUILDER DECLARATION Sign with One Branch Circuit 3 O 8 4 A 1 hereby affirm that I am exempt from the Contractor s License Additional Sign Branch Circuits Low for the following reason (Section 7031 5, Business and , Professions Code) 2 ❑ Muc Conduits 8 Conductors /l 8 2S 1 es owner of the property, will do the work and the ( • • structure is not intended or offered for sole (Section Other(See Complete Fee Schedule)_ 70M, Business and Professions Code) ► • . • if c ?57 CONSTRUCTION LENDING AGENCY � 127—E ,3 I herebyaffirm that these n a construction lending agency for the performance of the work for which this permit is issued PERMIT FEE (Sub Total) (Sec 3097 Civ C ) PIAN CHECKING FEE Lender s Nome PERMIT ISSUING FEE tender s Address I certify that I have read this application and state that the TOTAL FEE above information is correct I ogree to comply with all County ordinances and State lows 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 Permrnee Date COUNTY OF LOS ANGELES TEMPLE CITY 0 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS EL 0508 9608150006 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE (818) 285-0488 EXT: LEGAL ID FEES PAID BUILDING ADDRESS TR 11290 LT 20 SL B 5307 PAL MAL AV FEE DESCRIPTION QUANTITY UOM. AMOUNT TEMP CA 917802845 ASSESSOR INFORMATION NUMBER NEAREST CRDSS STREET FREER 8585-021-029 Al PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID C4 LOCALITY. TEMPLE CITY F1 120V, 15/20A RR CKTS 1 00 BR 17.40 TENANT F2 208, 277V LGT BR CKT 0 00 BR 0 00 ISSUED ON PROCESSED BY PLAN BY txp IN" ON G1 OUTLETS-LGT,SN RECP 13.00 OUT 25 35 08/15/96 TC 08/15/97 G2 LIGHTING FI%TaES 2 00 LGT 3.90 OWNER: -M NO TOTAL FEES 74 40 FiRAL DATE FINAL BY- E MARTIN MARK J,PAMEY K (818) 579-4108- ro-tom 9;I 5307 PAL MIIL AV TEMP 917802845 UnTrMIUM of WORK ELECTRICAL FOR CONVERTING GARAGE TO DEN AND STORAGE APPLICANT TEL NO SAME AS OWNERCDNTRACTDR- TEL NO APPROVALS DATE IwsRTTfflr9MWURT-- - SPECIAL CONDITIONS- SAME AS OWNER - LIC. NO TEMPORARY POWER POLE UNDERGROUND CONDUIT ARCHITECT OR ENGINEER —TEL. N(r— UFER GROUND LIC NO ROUGH CONDUIT ROUGH WIRING FWrWVMR LINE PLASTIC Y/N METAL Y/N UTILITY COMPANY NOJIFM REPORT ID DPR265 ROUTE TO 850508