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76A6 DOS SA 11-30 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY ELECTRIC
COUNTY OFF LOSLOS ANGELES
WILLIAM J FOX. CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE 2yRMIT NOb
ELECTRICIAN R_ F Walton
RECEIVED BY READY FOR DATE 7ISSUED0
ADDRESS 5134 N. ACao,a St. FIRST INSPECTION ' �
CITY San Gab TEL No AT 68583
COUNTY LICENSE NO 1104 EXPIRES BUILDING
PERMIT FEES ADDRESS 9218 Pentland St.
NUMBER EACH FEE LOCALITY Temple Cit
LIGHT OUTLETS NEAREST
CROSS BT
RECEPTACLES
WALL SWITCHES OWNER B. E. Turner
TOTAL OUTLETS Be S MAIL
ELEC RANGES 25 ADDRESS
ELEC HEATERS 2S CITY TEL NO
FIXTURES 5 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
MISC APPLICATION AND STATE THAT THE ABOVE IS 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 I POSSESS THE ABOVE VALID LOB
NuraeER HORSEPOWER ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
FE[
NEw MVD HP DYER IHD [ADH OF THE RESIDENTIAL PROP[ DEBCRIB O ABOVE
/AA6 LEDs S 25 SIGNATURE OF
_ 1 2 So PERMITTE
2 5 1 D INSPECTION RECORD
_ S 1S 1 so
is so 250
50 200 500
_ 200 500 1000 J
_
500 '000
1S O0 Z
OVER 1000 20 OO 13
M 0 SET FRED CHANGER-HP a•
WELDERS: AC-KVA O
GENERATORS - KW
TRANSFORMERS - "A
TEMP MOTORS (75X1 OF ORIR)
_MOVED MOTORS (75% of ORIG) _
MISC
SIGNS
NO NO TRANS
APPROVALS
NO NO LAMPS
FOR EACH PERMIT DATE INSPECTOR•B NAME
WIRING $1 00 CONDUIT
FIXTURES $1 00 WIRING �✓ a' 'L-G a�
SUPPLEMENTARY SO FIXTURES
aw� POWER
TOTAL FEE m� UTILITYCO NOTIFIED
FINAL 1
lwe l'�0 1 r"
76A663-CE806 B•62 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION
ADDREBB
JOHN A LAMBIE COUNTY ENGINEER
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN I CROSS 6T
RECEPT TOTAL I NO .EACH FE[
OUTLETS FIRST 20 6 20 8 S� OWNER
LIGHT147 ! MAIL
SWITCH G OVER
to
ADDRESS
OVER 20
TOTAL CITY TEL NO
LIGHTING FIRST 20 20 C Q
FIXTURES _ ADD L
� OVER 20 to ELECTRICI
RANGES CLO DRYERS WTH WETS 1100 A
DDRESS
OARS DIET STA COOK
OISHWASH AUTO WASH AESPACE HTRS STA AFF (W H P MAX BD ENSE NO
MOTORS OVER NOT OVER HP IST ICT NO GR U Z NE P ESSED BYO 1 + 00
1 — a + Ko INSPECTION RECORDa — B 200
6 16 2SO
1D 60 900 1
60 100 6 00li
0
SIGNS NO TRANS K
NO LAMPS 1110--'
SERVICE 0600V NOT OVER 200A 100 ly
SERVICE O BOOV OVER 200 A 200 N
SERVICE OVER 600V 500 ?
MISC
PERMIT ISSUING FEE 200 ow
SUPPLEMENTARY PERMIT ISSUING FEE 100
TOTAL FEE I Q
I KKR.ESY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR S S GNATURZ
AND STAT[ THAT THIS ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT /
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING WIRING (L
1 HERESY CERTIFY THAT�I AN PROPERLY 1ROIST[R[D ANO/OR J
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THA5,1 AM TH.E LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDE. PROPERTY POWER
SIGNATURE UTILITYCO NOTIFIED
OF PERMITTE
FINAL % I�OV✓
—VALIDATION ARTHUR C'VEIT
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
LA;0 7 6 6 4G JUL 18 2 D 6 80-
WORKERS COMPENSATION DECLARATION CE8636G IY 801 APPLICATION FOR ELECTRICAL PERMIT
76 6
I hereby affirm-that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY
Insure or a certificate of Workers'Compensation'Insurance or
a certified copy thereof(Sec 3800 Lab C)
FOR APPLICANT TO FILL IN .JOB
Policy No Company EACH NO FEE ADDRESS
F1 Certified
Residential Bldgs & Poole
Certified copy is hereby furnished 1 & 2 Farrdy,Sci Ft $ — $ LOCAL IT
❑ u Multi family Scl Ft - N R ST
Certified copy filed with the county budding inspection CROSS ST
wi
Residential Swimming Pools
department GI4faE"Ir�
FIRM NAME
Date Applicant Outlets Rea-Light Sw A 9 ADDRESS r
' /� ust 20
i CERTIFICATE OF EXEMPTION FROM WORKERS Total No x- 2__ 1 Additional CITY Tel Nc Z(o
COMPENSATIONINSURANCI, y
' � PLAN CHECK a
(This section need not be completed if the work Involved PPLICANT O
by the permit is for one hundred dollars (5100) or less) Lighting Fixtures Fust ADDRESS I U
Total No � Addrtioronel X
1 certify that In the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No 0
'permit is issued, I shall'not employ any person In any manner PERMIT �s ^ U -
so as to become subject to the Workers Compensation Laws Range_ Heater_Ow APPLICANT !-1 4
�
Oven Dryer_W M ADDRESS N
Dete'�f7i��'�,� 7•
L Applicant _ _�r�L2;i - Top — FAU _W H 20� Z
Hood Fan _Other_ CITY i Tet No -2
NOTICE TO APPLICANT If after making this Certificate of Disp _ Room Air Cond_ LICENSE UH
Exemption 1ou_should become subject to the Workers I REG NUMBE Cla
Compensation provisions of the Labor Code you must forth Power Apparatus& Large Appliances DISTRICT NO D BY
with comply with such provisions or this permit shell 6e
deemed revoked Size&Type HP KW KVA or KVAR
.. Up to 1 Incl
FINAL
Over 1 to 10 Incl Dq E / / Q
LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl CIS �/' c/ if"LI DAT' N
I hereby affirm that 1 am licensed under provisions of Chapter Over 50 to 100 Inc FINAL
9 (commencing with Section 7000) of Division 3 of the Bust Over 100
neBY
ss and�Professions Code and my license is in full force and r
effect Services' / /J
l„ 0 200 Amp Under 600 V
License Numbe (4 Lic Class
_ 201 1000 Amp Under 600 V Q
Contrite tod Date !4 Over 1000 Amp or Over 600 V
HOME OWNER BUILDER DECLARATION Temp Power Pole&Appurtenances
I hereby i affirm that I am exempt from the Contractor s Sign with One Branch Circuit
License Law for the following reason (Section 7031 5 Bust Additional Sign Branch Circuits 3717.6 A
ness and Professions Code) i '
Mlsc Conduits&Conductors f '. 0 02
1 as owner of the property will do the work and the Other(See Complete Fee Schedule)— o-
structure is not intended or offered for sale (Section - 2'•1- 3 4,9 0
7044 Business and Professions Code) ' "
CONSTRUCTION LENDING AGENCY _ _ u •E• 3 4 9 0 6
I hereby affirm that there is a construction lending agency 1 11 '
for the performance of the work for which'this permit is PERMIT FEE (Sub Total) A 2'6'-g'2'
issued (Sec 3097 Cw C) ZS�-: -
Lender's Name PLAN CHECKING FEE (One Fourth Permit Fee)
Lenders Address PERMIT ISSUING FEE
S
4hereba
at I have reed this application and state that the TOTAL FEE t
mah orrect I agree to comply with all County
an Stat laws regulating EleUncal wiring and repre entat v of this County to enter upon
t ed D r inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE
^Z6 ���
gnature of Permutee i Date i
, 4
WORKERS COMPENSATION DECLARATION 76A663 ,oiei APPLICATION FOR ELECTRICAL PERMIT
1 hereby a11Lrm.ihat I have a cerhlicale d consent to Self acture ���
or.:a certi(,cete of Workers Compensation Insurance or a certified
, 1 *,COUNTY OF+LOS'ANGELES + BUILDING AND SAFETY
ropy thereof(Sec 3800 Leb�'fr
s 1&,S�y6rrJ•7LQSC7 .�X ' -Y� l _
PUIICy NO Company � FOR APPLICANT TO FILL IN ,` I JOB r '
� 1
Certified copy�s hereby furnished� , 1 New Restlerit�al Bldgs 8 Pods � EACH - NO FEE ��E
Opy
'❑ •Certified copy cis'filed With the county bui{ding mspedicrn 1 & 2-Family Sq Ft` - + $ — $ LOCALITY �� 7
., depart nt ' f Mule-famity Sri Ft — _ CRSS ST c •-1 t
Date Applicent�rµ• \ ,
Residential Swimming Pools OWNER OR
ti ' a FIRM NAME'^
CERTIFICATE'OF EXEMPTION FROM WORKERS. p ��- - Q,
..• 4 COMPENSATION INSURANCE , ,, -Outlets Rec�,Light:� Sw _ qt /O ��.,AD01ES3�+��1_ ^ y
(This section need rat be completed d the work urvdv dlby the First 20' O O
,Permit Is for one hundred dollars ($100) or leas) ,
Total No � Addt honsl -CITY C . 1� Tel No
I certify that 6 the performance of the work for which this permit
- us!issued I shall not' APPLICANT
'employ any person in,airy,manrrer so,as lo
2
r become subject to the Workers Compensation Laws I-ghting Fixtures First 20: ' � J` '� ` � J ADDRESS ,
`
A' - Total No - Additional _
Date - Applicant Y , r r +, CITU 1,' TeI No 1
NOTICE TO APPLICANT-If after making this Certificated Fixed Applranc/es Not Over 1 HP P UC ,
Exemption you should become subject to'the Workers Compenaonnri .,R6ngoJL Heater_ DIN ,� ���M A
pnonsannn
s of the Labor Code you must fortlth comply with such O.en—Dryer _2 W M ADDRESS 15S�+Y
, provisions or the permit shall be deemed revoked . , Topp FAU, _ WH ?
A
LICENSED CONTRACTORS DECLARATION' + ' Hood -� Fan _ Other= CITY , `• Tel No
hereby affirm that I'am.lieensed under provisions f Chapter 9 « `'-Disc^ Room Am Coed /� �/ y Q IX:EN6E OR _ Close
ommenpng with Section 7000),of Division 3 of the BUBInBae and REG NUMBER
essions Code and my license is in full lone and effect . Power Apparatus& Large Appliar,ces - DISTRICTNO E ED By
ren/ . ' {IIS• Size& Type HP KW KVA or KVAR Q"
"a Number 0..i '( ,tae Class Tom/ y Up to 1 Incl + • FINAL
`^L UOver 1 to 10 Ind DATE,
tractor �'�v` , " ' `Date 1��� 1 n VALIDATIOO
N
Ower 10 to 50 Incl 0
FI
I am exempt under Sec + '' - Over 50 to 100 Inc . , BYE - - • W
B&PC for this reason Over 100 + d
I . l a N
Date SerWces Swbd MCC& Panelboards , ,, Z
0;200 Amp Under 600 V
Signature _ - 201 - 1000 Amp Under 800 V,
^ Over 1000 Amp or Over 600 V
F-1Exemptionfor Reg Maint Elect',,
' `SINGLE FAMILY � Temp Power Pole& Appurtenances _ ( _
HOME OWNER-BUILDER DECLARATION ' + ,Sign with One Branch Circuit , ' ,!.J�7^n , 74.4: +
I hereby affirm that I am exempt from the Contractors License Law' . _ v t ,
for the following reason(Section 7031 5 Business and Prefesaonsl ' Additional Sign Branch Cira,itsl .' _ - -1 ITEM
Cadet I ' H „ TOTAL ,' . 74...41
Eles owner,of the roe Meac Conduits&Conti '
p p rty will d6 the work and the structure ether + _� .i HELY
is not intended or offered for sale (Section 7044 Busmess (Sea Complete Fee Schedule) e a W 74.41
and Professiore Code) CHAIv'GE� ; ' ,[f[I
CONSTRUCTION LENDING AGENCY j 7 ^� ._i" J•, -' r ` v
I'h4mby affirm that there is a construction lending agency for the ' ` ♦+
Performance of the Work for which this permit is issued (Sec 3097 ' pERMR FEE ^ '(Sub-Total)' ' '.�' �` �UOOO-0�70I JO/16/91,
Civ C) r �, {
PLAN CHECKING FEE
' Lenders Name • y , -
PERMIT ISSUING FEE
Larders Address ` •, ) ' '•' r , ' +[. ` e+� 1Y' • ',r! .-"-i i\N`
I certify that I have read this application and staterve that the atx , TOTAL FEE
informati6t I agree to comply with all County ordmances r, ,` •' +
Aato laws r dating ElBctrical winrp end hereby authorize
.t•.. - - - - ...
attes County to enter upon the above-mentionedfor i Purposes
SEE REVERSE FOR EXPLANATORY LANGUAGE - •� - - -- --r v!-. --.. _. t: ,. - y . -
Signature of PermRtee ate I s , ' - ,¢ r ~ J✓ r' , y, ,1 h '
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1401150018
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL I➢ FEES PAID 1 BUILDING ADDRESS 1
ITR 16475' IT 120 9218 PENTLAND ST
(FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917803735
(ASSESSOR INFORMATION.NUMBER NEAREST CROSS STREET
8590-010-020 Al PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 596 GRID IS LOCALITY TEMPLE CITY CA
1P2 PC RES PVd0KW 153 90
TENANT IP3 INVRTR RES PVl10KW 27 90 ISSUED ON PROCESSED BY PLAN BY
TOTAL FEES 209 60 01/15/14 SR
I I
IOWNER TEL h0 I FINAL DATE FINAL pY CODE r
DANIELS S EUGENE MATHILDA M - ^�/ }-A`( 411,'9218'PENTIAND ST
(TEMP 917803735 (DESCRIPTION OF WORK
I (INSTALL (8) PHOTOVOLTAIC SOLAR PANELS FLUSH ON ROOF 1
1APPLICANT TEL NO I _
ZELLMER FRED T (818) 528-4634-
18306 W MANCHESTER AV- (SPECIAL CONDITIONS
PLAYA DEL REY 90293
1
CONTRACTOR TEL NO _ IAPPRJVAL4 DATE INSPECTOR SIGNATURE _
Al SOLAR POWER (855) 410-4700- I
115025 OXNARD ST #200 LIC NO TEMPORARY POWER POLE
VAN NUYS CA 91411 493623
(
j
1UNDERGROUND CONDUIT 11 ARCHITECT OR ENGINEER TEL NO IUFER GROUND III
I -
LIC NO (ROUGH CONDUIT
IROUGH WIRING I I 1
I
MAIN WATER LINE
(PLASTIC Y/N METAL Y/N -
UTILITY COMPANY NOTIFIED
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REPORT ID ➢PR265 ROUTE TO BSO508
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COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC NORRS 9701 LAS TUNAS EL 0508 1401140034
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID FEES PAID I BUILDING ADDRESS
TR 169'!5 LT 120 9218 PENTLAND ST
IFEE DESCRIPTION QUANTITY DOM AMOUNT TEMP CA 917803735
(ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET
18590-010-020 IA1 PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 596 GRID J5 LOCALITY TEMPLE CITY CAI
I ILA 100 AMP PANELS MCC 1 00 PAN 38 90
ITENANT TOTAL FEES 66 70 (ISSUED ON PROCESSED BY PLAN BY
101/14/14 SR
IDANIE TEL NO 1 FINAL TE FINAL Y CODE
10ANIELS S EUGENE MATHILDA M I�
19218 PEN91780373 $T
(TEPP 91'1803"135 1 DESCRIPTION F WORK
(ELECTRICAL MAIN PANEL UPGR7,DE 125 AMP
(APPLICANT TEL NO I I I
IZELL%R FRED T (818) 528-4634-
18306 W MANCHESTER AV I (SPECIAL CONDITIONS
IPLAYA DEL REY 90293
CONTRACTOR TEL NO IAPPROVALS DATE INSPECTOR SIGNATURE 1
IA1 SOLAR POWER (855) 910-4700- 1
115025 OXNARD ST #200 LIC NO ITEMPORARY POWER POLE I
(VAN NUYS CA 91411 493623 1
UNDERGROUND CONDUIT
(ARCHITECT OR ENGINEER TEL NO I UFER GROUND 1
LIC NO 1ROUGH CONDUIT
I
TROUGH WIRING YT
MAIN WATER LINE
PLASTIC YIN METAL YIN
UTILITY COMPANY NOTIFIED
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(REPORT ID DPR265 ROUTE TO BS0508
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