HomeMy Public PortalAbout5636 PAL MAL AVE_Electrical__ ]EA663-CE809_Il-S/ APPLICATION FOR ELECTRIC PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER 7ADDRESS-S
BUILDING AND SAFETY DMSION iOHN A. LAMBIE, Couat, E. ..r
CASSAITDGR3FFRL Supt Of ldim FOR APPLICANT TO FILL IN PERMIT FEESITEM MUMBEw EACH PCE 5L.N
O S..qqffL GHT• (i MCEPT. • .IO
I /
LIGHTING FIXTURES .10 CITY E-ELEC.RANGES CLO.ORYERs ECTRIC AN
WATER HEATER• .50 ADDRESSELEC.SPACE HTR•. DISHWASHER•
GARBAGE DISPOSER• AUTO.- CITYWASHERS STA.COOKING UNITSMOTORS: ovER Inc. H.P.
0 — Ih ,2aDIS R GAov Fon iRvmnoN
1/E — 2 .50
z — a 1.00 -pr INSPECTION RECORD
a — 15 1.50
15 — 50 2.50
50— zoo 5.00 y
SIGNS: NO.TRANS.
NO.LAMP5
SERVICE O-SOON 1.00
SERVICE OVER SOOV 5.00 ,.
MISC. — --
WIRING PERMIT 1.00
FIXTURE PERMIT 1.00
SUPPLEMENTARY PERMIT .50
TOTAL FEE f AMOVAIS
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA 1 DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING -'2r,^ -
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STAT OF
CALIFORNIA OR THAT i AM THE LEGA OWNER OF-I�NE E
DESCRIBED RESIDENTI PROPS POWER
SIGNATURE UTILITY CO.NOTIFIED
OF PERM ITTE FINAL
VALIDATI� ARTHUR C.VEIT.
CK mo &5pSUPERVISING ELECTRICAL ENGINEER
CK NO &
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70w609 DEBDa 1= sB APPLICATION FOR ELECTRIC PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE COUNTY ENGINEER
G68ATTD GRIFFIN SUP T OF BUILowO LOCALITY
FOR APPLICANT TO FILL IN' , cCROSSNEAREST
ST
PERT FEES
aoss
MI
OWNER
ITEM NUMBER EACH FEE
OUTLE S S MAIL /
LIGHTS RECEPT 8W / 10 ADDRESS
J
LIGHTING FIXTURES 10 CITY EL NO
ELEC RANGES CLO DRYERS ELECTRICIA
WATER HEATERS 50 ADDRESS
E[-KC SPACE HTRS DISHWASHERS
CITY TEL NO
GARSAOE D16POSERS AUTO
STATE
WASHERS STA COOKING uNrts 25 LICENSE NO
MOTORS OVER INC HP , NSSED Y
O— 25
vz— 2 so lygtKCTION RECORD
2— 5 1 OO
5— 15 150
15— 50 250
50-200 500
SIGNS NO TRANS
NO LAMPS
SERVICE O 600V 1 00
SERVICE OVER 600V 500
MISC
WIRING PERMIT 1 00
FIXTURE PERMIT 1 00
SUPPLEMENTARY PERMIT 50
TOTAL FEE s APPROVALS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION DATE INSPECTOR S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGDLATING CONDUIT
ELECTRICAL WIRING
WIRING
I HEREBY CERTIFY THAT S PROPERLY REGISTERED ATE OR
CALIFORNIAL ICAS
REQUIRED BY LOB ANGELES COUNTY AND E STATE OF FIXTURES
CALIFRNSI THAT AM TH LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERj�' POWER /C
q /
SIGNATURE UTILITY CO NOTIFIED
OF EEkaa FINAL
®T VAI.IDATIPNN-,,
ARTHUR C VEIT
/J SUPERVISING ELECTRICAL ENGINEER
f�
CK MO CASH
I ACO6 5 6 7 KP,,� Z 8 2 A 1 .6Q0� �P
>uaea 0"IIA hao ® APPLICATION'FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES ELECTRIC ',
WILLIAM J FOX CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO GROUP ZONE PERMIT NO
ELECTRICIAN 'J /
ADDRESS { 1 , d / RECEIVED BY READY FOR DATE ISSUED
FIRST INSPECTION
CITY ..� TEL N -2 )f.
COUNTY LICENSE NO �s L EXPIRES -.3 V ^J - BUILDING ,y
PERMIT FEES ADDRESS V
I��yyS 0NUMBER OUTLETS EACH FEEO D LOCA
LITY
LIGHTS CROSS8T NEAREST
RECEPTACLES S
FIXTURES 8 OWNER 1 d/F/�vy1
Z
WALL SWITCHES S MAIL
,
RANGES 25 ADDRESS
r ELEC HEATERS 25 CITY TEL NO f
MISC
/ O I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
NUMBER OF CIRCUITS INSTALLED 1,61)
T APPLICATION AND STATE THAT THE ABOVE IS CORRECT
LIGHTS RECEPTACLES L/ AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
MOTORS AND STATE LAWS REGULATING ELECTRICAL WIRING
NUMBER HORSEPOWERFEE 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOB
uANGELES COUNTY LICENSE OR 1 AM THE'L60AL OWNER
New MVD HP ovQR INC cR OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
' e.9923
K 2 50 SIGNATURE OF / ' I1� C
PERMITTEE
2 8 1 00
1 S 15 1 SO INSPECTION RECORD
^15 50 2 50
SO 200 5 OD
200 500 19 00
SOO 1000 t5 00 J
-• Q
OVER 1000 -20 00
M G SEf FREO CHANGER HP O
W
WELDERS AC KVA 0
GENERATORS - KW
TRANSFORMERS - KVA
TEMP MOTORS (]5% of oBlc
MOVED MOTORS f75% OF oRIG ) _
MIBC
SIGNS
TYPE NO TRANS '
TYPE NO LAMPS
APPROVALS
FOR EACH PERMIT GATE -INSPECTOR S'NAME
WIRING $1 DO CONDUIT
FIXTURES $1 00 WIRING
SUPPLEMENTARY 50 FIXTURES
POWER
TOTAL FEE , 5 c'�� UTILITYCO NOTIFIED
<J FINAL'
i
rr NORKERS COMPENSATION DECLARATION 76A663tD/81 APPLICATION FOR ELECTRICAL PERMIT
I }igreby affum�lhiT I hove a certificate of consent to self CE BJ6G
int-re C.,a ertiftcate of Workers Compensation Insurance COUNTY OF LOS ANGELES BUILDING AND SAFETY
'or a certified copy thereof (Sec 3800 Lab C ) I a
P❑ol icy No Company FOR APPLICANT TO RLL IN JOB
Certified copy is hereby furnished New Residential Bldgs 8 Pools EACH VNO — ADDRESS Certified copy is filed with the county building mspec 18 2 Family Sq Ft S LOCALITYhon department Multi family Sq Ft NEAREST
CROSS ST
Residential Swimming Pools c OWNER OR
Date ApplicantFIRM NAMFCERTIFICATE OF EXEMPTION FROM WORKERS MAIL
COMPENSATION INSURANCE Outlets Re< Light_Sw -ADDRESS
(Thu section need not be completed d the work Involved by First 20
the permit is for one hundred dollars; ($100)or less ) Total No Additional CITY a Tel No
RAN CHKK
I certify that in the performance of the work for which this APPLICANT
permit is issued I shall not employ any person in any manner
so as to become sublect to the Wor s Compensation Laws Lighting Fixtures First 20 ADDRESS
` Total No Additional
Date pplicon CITY Tel No
NO TO PPL ICANT If, after making this Certs icate of Fued�Apphances Not Over I HP PERMIT
Exemption you should become subject to the Woikers Range_ Heater_D W _ APPLICANT
Compensation provisions of the Labor Code you must forth Oven _ Dryer _ W M — ADDRESS
with comply with such provisions or this permit shall be Top — FAU _W H —
deemed revoked CITY - Tel No
LICENSED CONTRACTORS DECLARATION ' Hood _ Fan _Other_
hereby affirm that I am licensed under provivDisp — Room Air Cond LICENSE OR Classons of Chapter 9 REG NUMBER
(commencing with Section 7000) of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NO P SSED BY
and Professions Code and my license is in full force and effect d
Size 8 Type HP KW KVA or KVAR r O
License Number be ClassUp to 1 Incl FINAL V
_Over 1 to 10 Incl DATE VAUDATIO Q
Contractor a Date Over 10 to 50 Incl V
❑ FINAL
I am exempt under Sac Over 50 to I00 Inc BV _ _ W
d
B 8P C for this reason Over 100 N
Seiv,ces Swbd MCC 8 Ponelboords" Z
Date 0 200 Amp Under 600V , �� 21_q sf
22078A
Signature 201 - 1tXX1 Amp Under 600 V
❑ Over 1000 Amp or Over 600 V # e s s e e 2
Exemption for Reg Maint Elect •
SINGLE FAMILY ' ( e e 11.25
Temp Power Pole 8 Appurtenances
HOMEOWNER BUILDER DECLARATION Sign with One Branch Circuit • is • 1 1 2 5 6
I hereby affirm that I am exempt from the Contractor s License Additional Sign Branch Circuits
Law for the following reason (Section 7031 5 Business and Q 5 2 1 -85
Pr esstons Code)
Misc Conduits 8 Conductors
as owner of the property will do the work and the Other (See Complete Fee Schedule)—
structure is not intended or offered for sole (Section ` ►
704E Business and Professions Coda) ,
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for
the performance of the work for which this permit is issued PERMIT FEE (Sub Total) i
(Sec 3097 Civ C ) _ r
PLAN CHECKING FEE -
Lender s Name
PERMIT ISSUING FEE
Lenders Address
I certify that I have read this application and state that the TOTAL FEE `
above 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 inspection purposes
SEE REVERSE FOR EXPLANATORY LANGUAGE
ignature of Permittee Date
WORKER I haveCOMPENSATION DECLARATION 7SA6aS DPW(12 91) APPLICATION FOR ELECTRICAL PERMIT . ll
8-001
I hereby affirm that I have a certificate of consent to sell insure
or a certificate of Worker is Compensation Insurance or a certified COUNTY OF LOS ANGELES • DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV
co//pp��i t9ereol(6ec,{33v00 Lab C)
POIIcy No ?115OSA Company l FOR APPLICANT TO FILA IN ATORESS 5
❑ Certified copy is hereby furnished New Resltlent al Bldgs d Pools NO $
EACH S FEE LOCALITY �11p.*
❑ Certified copy is filed with the county building Inspection 1 8 2 Family Sq Ft NEAREST
department , e n �p'�1 — Mulh family Sq Ft GROSS ST L„��'
Date � Appliant 1]` Residents]Swimming Pools ASSESSOR
MAP BCOK PAGE PAACFL
T CERTIFICATE OF EXEMPTION FROM WORKERSOutlets RK Light? Sw OWNER OR
COMPENSATION INSURANCE ,' First 20 O FIPM NAME
(This section need not be completed If the work involved by the ,2 MAIL
permit is for one hundred dollars($100)or lees), Tota]No L Additional ADDRESS 5
Tel No
I certify that In the performance of the work for which this Dermis
c+
CITY _
Is Issued I shell not employ any person In any manner so as to r
become subject to ilia Workers Compensation Law LI hbn Furfures First 20 PLAN CHECK
1 p 9 g APPLICANT
Total No Additional
ADDRESS
51
Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP
NOTICE TO APPLICANT If after making this Certificate of CITUDiflt�e TO No d{o 5
Exemption you should become subject to the Workers Compensation OTHER APPLIANCES NOT OVER 3� 1 ,,w �
provisions of the Labor Code you must forthwith comply with such ABERMR N/VG T.�p L t
provisions or this permit shell be deemed revoke0
r Power Apparatus 8 Large Appliances APPLICANT GIJ�e/r e-'
` LICENSED CONTRACTORS DECLARATION' Size 8 Type HP KW KVA or KVAR _ ADDRESST--
I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Ind
(commencing with Section 7000) of Division 3 of the Business and "ITy044yTeI Nil- O
Professions C6de and my license is in full force and effect Over 10 to 50 Incl }
Over 50 to 100 Ind LICENSE ORCWa l0
REO NUMBER d
Over 100 O TRICT NO PROCESSED BY O
License Number �N12ss Uc Class �� p U
p Services Swbd,�-MGC�B P r .�d �Qp ir
Contractor {��LL� VI'�'T�LDate �—I�� 13 0 397AIhp Under 600 l �� Fro pAl 0
F-1
- 400 1000 Amp Under 600V
am exempt under Sec Over 1000 Amp or Over 600 V FINAL VALIDATION W
B 8P C-for this reasonBY Q.
Q� BRANCH CIRCUIT FEES _ U)
ate JO�1 "15A or 20A, 120V L Bra
Recept Z
- - r- �(NAL� 1 Too 10 10 Brarmh Circuits 3 r - -
S gna�ure 11 To 40 Branch Circuits - 2 _
❑ Exemption Ia RegMaint Elect 15A 20A 208V To 277VOLghng Br Gra ts Its r ACCT. A
t
SINGLE FAMILY Temp Power Pole 8 Appurtenances
HOME OWNER BUILDER DECLARATION n with One Branch Circuit [
I hereby affirm that I am exempt from the Contractors License Law Sig ` 1 ITi.f
E15
for the following reason (Section 7031 5 Business and Professions Additional Sign Branch Circuits
Code) - _ TOTAL 133 _ 70
ElI as owner of the property will do the work and the structure Misc Conduits 8 Conductors CTTHL1ClryE�C/'K1/
12.70
is not intended or offered for sale (Section 7044 Business Other(Sae Complete Fee Schedule) LLfl�������T��'[' _ _
and Professions Code) CWh%-E .00
CONSTRUCTION LENDING AGENCY _ flflfn-i-M1 i
I hereby affirm that there is a construction lending agency for the / 00 J'.r `1V01 „b/IL 4:
performance of the work for which this permit is Issued (Sac 3097 PERMIT FEE (Sub Total) _
Civ C) O??3 1 AM10:19
PLAN CHECKING FEE
Lender s Name
PERMIT ISSUING FEE �o j
Lender Address
I certify that I have read this application and under penalty of pur]ury state TOTAL FEE --
that the above Statenfcrnrnal
ws r g carred I agree wring
comply vnih all County /� 1,
ordinances and State laws regulating Eleclncal mnng end hereby authorize (f{/ %0 /
representatives of this County to enter upon the above mentioned property
faenspection guTrosys p.� SEE REVERSE FOR EXPLANATORY LANGUAGE
���'./J� /�; In—1 1—r ,
&&NATURE OF P ITTEE DATE
-• COUNTY OR LOS ANGELES TEMPLE CITY 0 0506 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0608210020
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0408 EXT
LEGAL ID FEES PAID BUILDING ADDRESS
ON FILE 5636 PAL MAL AV
PEE DESCRIPTION QUANTITY DOM AMOUNT TEMP CA 917802853
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET LIVE OAX
8586-009-018 Al PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID C3 LOCALITY TEMPLE CITY C
G1 OUTLETS-LGT SN RECP 58 00 OUT + 90 30
TENANT G2 LIGHTING FIXTURES 16 00 LGT 31 20 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON
TOTAL FEES 149 25 08/21/06 JR 02/17/07
OWNER TEL NO FINAL DATE ''7, FIN CODE
THANVICTOR
5636
5636 PAL MAL AV
TEMP 917802853 pE CR IPTION Ov WORK
ELECTRICAL FOR ADDITION
APPLICANT TEL NO
WANG (626) 821-0672-
735 M DUARTE ED 203 SPECIAL CONDITIONS
ARCADIA CA 91107
CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE
TRAN VICTOR (626) 327-0155-
5636 PAL MAL AVE LIC NO TEMPORARY POWER POLE
TEMPLE CITY CA 91780 NO" ,
UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER TEL NO LIFER GROUND
LIC NO ROUGH CONDUIT
ROUGH WIRING
MAIN WATER LINE
PLASTIC YIN METAL YIN
UTILITY COMPANY NOTIFIED
t
REPORT ID DPR265 ROUTE TO BS0508