HomeMy Public PortalAbout5546 PAL MAL AVE_Electrical__ NN� APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINIZR r
UILDING
BUILDING AND SAFETY DIVISION DDR7EWJOHN A LAMSIE,COUNTY ENGIN®WILLIAMA JENSEN SUPTOPBUILDINGOCALITY
FOR APPLICANT TO FILL IN NEAREST /
PERM FEES CROSS ST_ 45L
OWNER
T[Y NUMB" PR MAIL
O ADDRESS
LIO11T[ a 10
LIGHTING FIXTURES 10 CITY A TEL.Noi
[tEa "NOW CL11 DRY[I1& ELECTRICIAN
WATER HEATERS SO ADDRESS
EL[C "SPACE DISHWASHSRD CITY TEL NO /
Oi DITOVS<tID AUTO LICENSE
��
mM STA .1 IN*uMTTS E8 LICEN86 NO
NOT ORHI IIIC H P DI5 RICT O GROUP NE P ESSED BY
0 — !+ 25 SID
V. — i HO INSPECTION RECORD
i — S 100
S — IS 1 80 O
V
I8 — 80 230 O
50 — 200 goo
SIGNS! ND TRANS y
NO LAYPe 3y
SERVICE O SOOV 1 00
SERVICE OVER SOOV 800
MISC
WIRING PERMIT 1 OO
FUTURE PERMIT 1 00
SUPPLEMENTARY PERMIT SO
TOTAL FEE
I HMMY ACRNOWL[DOE THAT 1 RAV[ READ THIS A41.1CATION APPROVALS GTc IN[P[GTOR'&eIONAnR[
AND &TAT[THAT THE AND" IS CORRECT AND AOR[i To COMPLY
WITH ALL COU- I ORDINANCW AND &TATE uWs REGYUTIMO CONDUIT
ZL TRIGL WIRING WIRING
1 H[R[eY THAT 1 AY PROPTT R[OIeTt•IT9 AND/011
LICOIe[D N REO IR[D EY LOe ANO[ YMTY AND RAT[ 01 PIXTU RHS � !!O � /
GLIPORNIA R AT I Y TH[ OP TNi AS01R
O[SCRIS[D EiTT WHR
SIONATUR6 UTILITY CO NOTIFIED w
5 1
OP PHRMI G9 �,,
/VALIDATION ARTHURC VETT.
Di ro cAEN SUPERVISING ELecrRICAL ENGINEDI
WORKERS COMPENSATION DECLARATION -696 10,91 APPLICATION FOR ELECTRICAL PERMIT
j hereby VimVimthat 1 have a certificcertificate of consent to sett CE
Insure
or a certificate of Workers Compensation Insurance or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY
copy thereof(Sec 3600 Lab C)
Policy No Company FON APPLICANT TO FILL IN JOB
❑ Certified co Is ha furnished EACH NO FEE ADDRESS
copy hereby New Residential Bldgs d Fools
❑ 1 8 2-Fartnly Sp Ft $ — $ LOC^LITY
Certified copy is filed with the county building Inspeclian
department Multi-family Sq Ft NEANESr
CROSS ST
Data Applicant Resldentrel Swimming PoolsOWNER Op
FWM NAME Alf JM/
CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec— Light _Sw MAL
COMPENSATION INSURANCE ADDRESS
(This eedlon need not be completed If the work Irwotied by the First 20 _
permit Is for one hundred dollars($100)or lees) Total No Additional CITY Tel
No
CHECK
I cerhfy that in the performance of the work for which this permit pp
m Issued I shall rot employ any person in any manner so as to
become subject to the Workers Compensatlon Laws Lighting Fixtures First 20 ADDRESS
Total No Additional CITY Tel No
Date ApWcam' PERM
NOTICE TO CANT tt after making Mu Certo pf Fixed Appliances Not Over 1 HP PERMfT
Exemption you should become subject to the Workers Compensation Range_ Heater— DW _ ^P�
provisions of the Labor Code you must forthwith comply with such Oven _ Dryer — W M — ADDRESS _
prowiwann or this permit shall be deemed revoked Top — FAU — WH
LICENSED CONTRACTORS DECLARATION Hood — Fen —,Other—
CITY Tel No
1 hereby affirm that 1 am licensed under provisions of Chaptar gLICENSE R
Division
(commencing with Section 7000) of Division 3 of the Business and DmP — Room Air Cord REG NUMBER
Professional Code and my license Is in full force and effect Power Apparatus d large Appliances DISTRICT NO BY
Sue d Type HP KW KVA or KVAR 6 Q�
License Number—c>) 176 Lc Class f l b Up to 1 Ind FINAL fJ 8
�/ �7�� Over 1 to 10 Incl DATE
��/fA�j7 VA& Date C/ VAUDATION p
Contractor Over 10 to 60 hot Iqo��
�I em exempt under Sec Over 60 to 100 Inc
BY
B dPC for this reason Over 100 N
Date Servcejq'6wk'q MCC d Penelboerde )
20 Amp Under 600 V
Signature f 201 - 00 Amp Under 600 V
❑ Over 1000 Amp or Over 600 V
Exemption for Reg Mamt Elect
SINGLE FAMILY Tamp Paver Pile d Appurtenances +)
HOME OWNER-BUILDER DECLARATIONSion with One Branch Cuourt
I hereby affirm that I am exempt from the Contractor s License Law
for the following reason (Section 7031 6 Business and Professors Additional Sign Branch Circuits
Cade)
❑ I as owner of the property will do the work and the structure Misc conduits d Corducom i I TFIi^
is not Intended or offered for sale (Section 7044, Business Olher(See Complete Fee Schedule) — �, i_ 25 o 50
and Professions Code)
' CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the "n•i'� •oro
performance of the work for which this permit is emned(Sec 3097 PERMIT FEE (Sub-Total)
Cry C)
PLAN CHECKING FEE 317/S9
LaMar a Nemo R/,/�
PERMIT ISSUING FEE + FrI12:02
Lenders Address
I certify that I hoe read this application and state that the above TOTAL FEE
information Is correct I agree to comply with all County ordinances '
and State laws regulatug Electncal wring and hereby authorize
representelFves of this County, to enter upon the above-mentoned
property for impact"purposes SEE REVERSE FOR EXPLANATORY LANGUAGE
IN111 IN
slurs d ittee r Data If
COUNTY OF LOS ANGELES TEMPLE CITY A 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL D508 0111260025
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT.
LEGAL ID ttt:b FAIV BUILDING ADDRESS
ON FILE 5546 PAL MAL AV
FEE DESCRIPTION QUANTITY: l04 AMOUNT TEMP CA 917802868
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET DAINES
8586-010-019 Al PERMIT ISSUANCE FEE 27 75 THOUS PAGE. 597 GRID: C3 LOCALITY: TEMPLE CITY
G1 OUTLETS-LGT SW,RECP 8 00 OUT 15 60
H2 RES GREG DIiP IT 3HP 1 00 DIS 10.95 ISSUED ON PROCESSED BY.-
H3 RES DISHWASHR LT 3HP 1 00 DIS 10.95 11/26/01 JK 05/25/02
144 RES RANGE HDS LT 3HP 1 00 HOO 10.95
TOTAL FEES 76.20 FINAL DATE FINAL BY. OWE:
WIECHMAN WILIAM H,DCRIS R HARVEY (626) 444-5649- /-�2
5546 PAL HAL AV 7"
TEMP 917802848 utscRipum OF WORK
GFCI'S, NEW APPLIANCES (HOUSING REHAB PRDJ)
APPLICANT TEL. No
G FELIX CONSTRUCTION -
4929 HALIFAX SPECIAL CONDITIONS
TEMPLE CITY
CONTRACTOR: TEL. PNGELES CO APPROVALS DATE INSPECTOR SIMRT0W--
G FELIX CONSTRUCTION (626) 401-1391-
4924 N HALIFAX RD LIC NO TEMPORARY POWER POLE
TEMPLE CITY CA 91780 449477 B
amummirowmirr—
ARCHITECT OR EXGINEER TEL NO UFER GROUND
LIC NO
ROUGH WIRING
L'P/L 1111111
UTW-91M LINE
Y/M
PUBLIC WORKS PLASTIC UTILITY COMPANY METAL YFI
h
r "N.
It 1
�e
Gb/�� ServNce 7hat�o(
REPORT ID OPR265 ROUTE TO 850508
COUNTY OF LOS ANGELES TEMPLE CITY IP 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0110110032
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91760
PHONE: (626) 285-0688 ERT:
LEGAL ID: FEES PAID BUILDING ADDRESS
O1 FILE 5566 PAL MAL AV
FEE DESCRIPTION- QUANTITY: 1101: AMOIRIT: TE1I) CA 917802848
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET- LIVE OAK
8586.010.019 Al PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID C3 LOCALITY. TEMPLE CITY
C2 SPAS, NOT TUBS, OTHR 1 00 SPA 54 65
TOTAL FEES 82 20 .
10/11/01 JK D4/09/02
OWNER TEL NO FINAL DAJE FINAL BY. CODE:
WIECHMAL HALIAM H,DORMS R HARVEY
5546 PAV
TEMP 917802USDESGRrPTIUM U' UKK -
ELECTRICAL FOR SPA MOTOR
APPLICANT TEL NO:
SAME AS OWNERCONTRACTOR -
SPECIAL CONDITIONS:
S PNGELES CO
APPROVALS DATE INsRTTM-9r0UTMF—
SAME AS OWNER
LIC NO TEMPORARY POWER POLE
UNDERGROUND MUMT--
ARCHITECT OR ENGINEER TEL NO UFER GROUND
LIC. 1N)////
ROUGH CONDUIT
�� � � " i111;11
> ROUGH WIRINU
MAIN W7MFTTWF—
Li >� G J� 1\ll a �J ��nI� PLASTIC Y/M METAL Y/M
UTILITY COMPART-ROMM
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O L F I�
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46/�c Serve ThaIL�ot
REPORT ID. DPR265 ROUTE TO- BSD508