HomeMy Public PortalAbout9560 PENTLAND ST_Electrical__ 76A668 DBS SA 11-533 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY ELECTRIC
COUNTY OF LOSOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO.
ELECTRICIAN I T,�
ADDRESS � �� gyp' ,r �"! RECEIVE BY FIRSTNSPECTION READY FOR DATE ISSUED
CITYi'Y4'/L`f•f'R ` +fJ TEL NO
COUNTY LICENSE NO. EXPIRES BUILDING 9f�e
PERMIT FEES ADDRESS
FEE LOCALITY
NUMBER EACH A 6
LIGHT OUTLETS NEAREST !�
RECEPTACLES CROSS ST.
WALL SWITCHES OWNER t�C', � G ✓ I
TOTAL OUTLETS Sc 8 MAIL
ELEC. RANGES
25 ADDRESS I.F6 ia /v'� r d 4
ELEC. HEATERS 25
CITY moi-TEL. NO. firms
FIXTURES 5 1 HEREBY A19KNOWLED13E dCrHAT I HAVE READ THIS
M15C. 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 I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOB
NumHER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
NEw MvD. HP ovER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
Va A LESS S .25 BIGNATURE OF
I/2 2 .50 PERMITTEE _
2 s 1.013 INSPECTION--RECORD _
---
15 5O 2.50 �/:� 6S"'
so Zoo 5.013 ;i ��
a
f „� 1- _ �t�r_• �� �
ZOO Boo 10.00 �g ps+%d J
Boo toxo 15.00 � Z
OVER 1000 20.00 [�
M.G. BET/FREQ. CHANgER-HP T E
WELDERSiAC-KVA
GENERATORS - KW
TRANSFORMERS - KVA
TEMP. MOTORS (75% OF 13111113.)
v
MOVED MOTORS (75 :1F 0010.)
MISC.
SIGNS
NO. NO.TRANS.
APPROVALS
NO. NO.LAMPS
FOR EACH PERMIT: DATE INSPECTOR'S NAME
WIRING 101.013 CONDUIT
FIXTURES $11.00 WIRING
SUPPLEMENTARY .50 FIXTURES
�r POWER
J� f
TOTAL FEE _�� UTILITY CO..NOTIFIED
FINAL �G
10 76ASS3 5A 85M BETS 7-48 Aa*1**/'INION FOR
*1L�n71� T
DEPARTMENT of BOILDnvG Ar�D SAFBTY A�EialL�aLEii L� /��'ll I�Cl��
f COUNTY OF LOS ANGELES
J. FO GI EER
Z / DISTRICT NO. GROUP ZONE PERMIT NO.
NAME .✓ /r. ` 1
0U-, ADDRESS
J / /g
GhTY�fd>1ws .1 ,/ TEL.NO. RECEIVED 13Y READY FOR DATE ISSUED
FIRST INSPECTION
COUNTY
LICENSE NO. EXPIRES
AP CANT FILL IN BEAVMY OUTLINED PORTIO ONLY
JOB
DESCRIPTION OF WORE -ADDRESS ;2///441��
NUMBER OF OUTLETS ON CIRCUITS LOCALITYY.
LOCATION BY ROOMS NEAREST
LIGHT OUTLETS ISW. PLUGS FIIiT CROSS
CIRCUIT A B C D E F G H a: NAME �llil t -C`tet
Z MAIL
Gf 3 ADDRESS
CITY fi -i ii syn a L.TENO.
I AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGLES COUNTY CERTIF CATE OF UA,LIIFFIICOATI
/L IU ,. .
ELECTRICIAN.
I AM T=L GAL OWNER OF THE PROPF,RTY DESCRIBED
ABOVB
OWNER.
EtCORREL"1'IONS
—
z
o
TOTAL A�p
NO. OF OUTLETS =`J / =' �,' APPROVALS
NO. OF FIXTURES (� E `�� DATE INSPECTOR'S NAME
NO. OF MOTORS H.P. / $ CONDUIT o
NO. OF SIGNS TRANS. ffi WIRING
NO. OF RANGES OR HEATERS S FIXTURES
MISCELLANEO S S POWER
PERMIT FEE ffi J UTILITY CO.NOTIFIED
TOTAL FEE a
CDD 101 APPLICATION FOR ELECTRICAL PERMIT LI
BUILDING Y
DEPARTMENT OF COMMUNITY DEVELOPMENT ADDRESS ay C. japlowN
BUILDING AND SAFETY SECTION LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
OUTLETS NO. EACH FEE
OWNER
RECEPT.S, $ $ MAIL
LIGHT TO AL
FIRST 20 .25 ADDRESS
CITY ! TEL. NO.
SWITCH OVER 20 .10
PLAN CHECK
LIGHTINGTOTAL FIRST 20 25 APPLICANT
OVER 20 ADDRESS
FIXTURES .10
APPLIANCES CITY TEL. NO,
PERMIT d
RANGE DRYER_WTR. HTR. APPLICANT G-�r
STA. COOK DISP. F.A.U. ADDRESS
SPACE HTR. AIR COND. CITY TEL, NO. ..
CLOTHES WASH.-,401—DISHWASH. LICENSE NO. CLASS.
FAN OTHER / 1.00 I HEREBY ACKNOWLEDGETHAT I HAVE READ THIS APPLI-
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO
COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGU-
MOTORS, TRANSFORMERS RATING LATING ELECTRICAL WIRING.
IND. HEATERS, ETC. HP. KW. KVA.
S1ZE & TYPE OVER TO LAT:
HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND
OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE
0 - '
1.00 OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND IN- },
TEND TO RESIDE IN. THE A OVE DESCRIBED RESDENTIAL PROP- O
i - 10 300 ERTY.
10 - 50 5.00 SIGNATURE V
OF PERMITTEE O
50 - 100 IOAO DISTRICTNO. CLASS ZONE PR EBBED BY F-
100 - 500 15.00 .0$ �/ 9-4 Q
SIGN, GAS SIGN AND ONE CIRCUIT 5.00 NOTES: Z
TUBE, OR z
MARQUEE ADDITIONAL CIRCUITS 1.00
SERVICENOTOVER 600 VOLTS OR 200AMP 3.00
APPROVALS DATE INSPECTOR'S 91GNATURE
SERVICEOVER 600 VOLTS OR 200AMP 10.00
TEMP.POWER POLE
TEMP SERVICE,POLE, &APPURTENANCES 5.00
TEMP LIGHT OR RECEPT. SYSTEM 3.00 UNDERSLAB WORK
ROUGH CONDIUT
WIRING .°S -�!n /t7 �� ;
FIXTURES 5`43 "'J-V- 2
POWER AUTHORIZED
PERMIT FEE (SUB TOTAL) /
PLAN CHECK FEE
UTILITY CO. NOTIFIED ���► �/ ��
_
PERMIT ISSUING FEE 3.00 •FINAL {`
TOTAL FEE
PLAN CHECK VALIDATION
L'_Q4AY 5 2 D 1 2.7 5 a�d
9199
PERMIT VALIDATION
•SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
78A888 1385 SA 11-50 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS.'ANGELES ELE A
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN
DISTRICT NO. GROUPZONE PERMIT NO. '
ELECTRICIAN 1f �- -,f/
RECEIVED BY READY FOR
ADDRESS �rT"7 „ / l f/J,� `)� `d
FIRST INSPECTION DATE ISSUED
CITY ” �V I STEL. NO. (/ V
COUNTY LICEDISeogO. EXPIRES BUILDING
ADDRESS ��+'
PERMIT'FEES .gI
NUMBER EACH FEE LOCALITY !_I!�•f.-l'i �,. � 6''[��'� ,l
LIGHT OUTLETS . NEAREST
CROSS ST. �1.�+•''W�.:rI'�` �1•
1
RECEPTACLES -, -'
WALL SWITCHES OWNER (4,15
�rC_�
TOTAL OUTLETS 5C.8 MAIL
ELEC. RANGES 28 ADDRESS,
ELEC. HEATERS 25CITY / "�6t 1•�(` t:( TEL. NO. '®
FIXTURES s I HEREBY ,ACKNOWLEDGE HAT 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 I CERTIFY THAT I POSSESS THE ABOVE VALID LOS
NUMB eR HORSEPOWER ANGELES COUNTY LICENSE. OR I AM THE LEGAL OWNER
FEE
NEW MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
.
1/2 S 1 Ess $ 25 )SIGNATURE
PERMI'ITEE
1/2 2
2 5 1.00 INSPECTION RECORD
5 -15 1 1.50
15 50 2..50
50 200 5.00
200 Soo 10.00 J
Soo 1000 1s.00 Z
OVER 1000 20.00
M.-G. SET/FREQ. CHANGER-HP
WELDERS:AC-KVA
GENERATORS-KW
TRANSFORMERS'-KVA
TEMP. MOTORS (7S%OFORIG.)
MOVED MOTORS (75%OFORIG.)
MISC.
SIGNS
NO. NO.TRANS. I APPROVALS
NO. NO. LAMPS
FOR EACH PERMIT•
DATE INSPECTOR'S NAME
WIRING 51.00 CONDUIT
FIXTURES $'1.00 WIRING / J ,G
SUPPLEMENTARY gp FIXTURES
POWER �.
TOTAL FEE �- � - $ / J x UTILITY CO. NOTIFIED �l�.•�• : .
® - (J FINAL �"Grl.Sf�a� •:R. /P.J S�.
WORKER'S COMPENSATION DECLARATION 20.009 DPW(72.91) APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I have a certificate of consent to self insu e, 78A6fi3.
or a certificate of worker's Compensation Insurance, or a certif rcr COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV.
copy thereof(Sec.3800 Lab.C.) 's
POIICy No. Company FOR APPLICANT TO FILL IN JOB ADDRESS 75bo
e
ritlaAA
F1r
Certified copy is hereby furnished. Neu Residential Bldgs.&Pools NO. EACH FE
II _ $ $ LOCALITY Q,�
F1 Certified copy is filed with the county building Inspection 1 &2-Family,Sq.Ft. _ NEAREST
department. Multi-family Sq.Ft. CROSS ST.
Residential Swimming Pools ASSESSOR
Date Applicant MAP BOOK PAGE PARCEL
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec. OWNER OR 1„ O
COMPENSATION INSURANCE Light First 20 rJt Sw. FIRM NAME
. �O n O �J
/ �
(This section need not be completed the work Involved by the MAIL
Total Nm Additional ADDRESS
permit is for one hundred dollars($1000)or less.)
I certify that in the performance of the work for which th' permit CITY Tel.No.
Is issued, I shall not employ any person ' a ann o as to PLAN CHECK
become subject to the orkers'Compe Lighting Fixtures / First 20APPLICANT
Total No. (® Additional
ADDRESS
Date ` Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP.
NOTICE TO APPLICANT: If, after making this Certif tate of CITY Tel.No.
Exemption,,you should become subject to the Workers'Com ensation OTHER APPLIANCES NOT OVER 3 HP.
provisions of the Labor Code, you must forthwith comply ith suchP RMiT
provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances PPLICANT �1
LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS 2'� .
I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. �� 2
(commencing with Section 7000) of Division 3 of the Business and CITY Tel.No. J
Professions Code,and my license is in full force and effect. Over 10 to 50 Incl.
REG.N O Clens /�
Over 50 to 100 Incl. REG.NUMBER � C- C-
Over 100 DISTRICT NOO. P O SSED BY
License Number Lic.Class y U
Services,Swbd.,MCC&Panelboards ��® Q
Contractor Date 0-399 Amp.Under 500 V DATE —Q O
❑ I am exempt under Sec. 400-1000 Amp.Under 500 V `— ' V VALIDATION W
Over 1000 Amp.or Over 600 V FINAL 11
B.&P.C.for this reasonBV to
BRANCH CIRCUIT FEES
Date: 15A,or 20A,120V,Lighting or Recept. Z
1 To 10 Branch Circuits
Signature 11 To 40 Branch Circuits
❑ 41 Or More Branch Circuits
Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits
SINGLE FAMILY Temp.Power Pole&Appurtenances
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 4 c� _I A
1 hereby affirm that I am exempt from the Contractor's License Law
for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits
Code): _
❑ I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors
k �S !!•_
is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) , Tj j T Al
and Professions Code). ."y�r _
CONSTRUCTION LENDING AGENCY _r._u a
I hereby affirm that there is a construction lending agency for the �� :
performance of the work for which this permit is issued(Sec. 3097, PERMIT FEE (Sub-Total) 30 0
Civ.C.)
PLAN CHECKING FEE
Lender's Name
PERMIT ISSUING FEE �� f) -:50 y
E %i f 1
Lender's Address rT
I certify that I have read this application and under penalty of purjury state TOTAL FEE �U
that the abve information correct. I agree to comply with all County
ordinances a d t Ia s r ulating Electrical wiring,and hereby authorize I
represents t s to enter upon the above-mentioned property
I
for i ec SEE REVERSE FOR EXPLANATORY LANGUAGE
SIGNATURE OF PERMITTEE DATE
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0306120013
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: S PAID BUILDING
TR: 14572 LT: 22 9560 PENTLAND ST
�
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803844
0 ON NEAREST CROSS STREET: CLOVERLY
8590-013-019 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY
F1 120V, 15/20A BR CKTS 10.00 SR 172.50
T G1 OUTLETS-LGT,SW,RECP 44.00 OUT 71.40 TSSUEQ ON: PROCESSED BY: PLAN BY: -EXPIRES ON:
G2 LIGHTING FIXTURES 10.00 LGT 19.50 06/12/03 JK /09/03
H2 RES GRBG DISP LT 3HP 1.00 DIS 10.95
OWNER: TEL. NO: H9 RES APPL LT 3HP 1.00 RES 10.95 FINAL DAT p FINAL BY: CODE:
HOLLEY ROBERT C;ANNE S - LB 200 AMP PANELS, MCC 1.00 PAN 38.85 L Cb - Q
9560 PENTLAND ST TOTAL FEES 351.90
TEMPLE CITY 91780 DESCRIPTION
UPGRADE TO 200AMP PANEL, NEW OUTLETS & LIGHTS, GARBAGE
APPLItANT: TEL. NO: DISPOSAL & 240V0LTS 50AMPS STOVE; BRANCH CIRCUIT FOR EACH RM
HAROUT DERHAGOPIAN (626) 794-3000-
2033 QUEENSBERRY RD SPECIAL CONDITIONS:
PASADENA 91104
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SI A RE
ACTIVE ELECTRIC (626) 794-3000-
2033 QUEENSBERRY RD. LIC. NO TEMPORARY POWER POLE---
PASADENA, CA 91106 414071/C10
UNDERGROUND CONDUIT
ARCHITECT OR NG 0: _ R GROUND
LIC. NO: ROUGH CONDUIT
ROUGHUIRING 07��00
IN WATER LINE
PLASTIC Y/N METAL Y/N
UTILITYN 0 IED
REPORT ID: DPR265 ROUTE TO: BS0508
t 1
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS EL 0508 9610100047
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA
PHONE: (818) 285-0488 EXT:
- LEGAL ID: FEES-PAID BUILDING ADDRESS:
TR: 14572 LT: 22 9560 PENTLAND ST
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803844
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: CLOVERLY
8590-013-019 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY
H7 RES EXHAUST FANS 1.00 EX 10.80
TENANT: TOTAL FEES 38.55 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
10/10/96 TC 10/10/97
OWNER: TEL. NO: FINAL DATE FINAL Y: CODE:
HOLLEY ROBERT C;ANNE S - /�
9560 PENTLAND ST 10-3t-j
TEMP 917803844 DESCRIPTION OF WORK
REMODEL BATHROOM
APPLICANT: TEL. NO: � �
OAKRIDGE CONSTRUCTION CO. (818) 287-7244-
5842 ALESSANDRO `b --� SPECIAL CONDITIONS:
TEMPLE CITY, CA
CONTRACTOR: TEL. N0: APPROVALS DATE INSPECTOR SIGNATURE
OAKRIDGE CONSTRUCTION CO. (818) 287-7244-
5842 ALESSANDRO LIC. NO �,i;'* U \ �._ EMPORAR POWER POLE
TEMPLE CITY, CA 91780 505643/B
UNDERGROUND CONDUIT
OR ENGINEER: - I� )>'j'ARCH CT - f� �lti ER GROUND
LIC. N0: I!lir _ J ROUGH CONDUIT
ROITG I WIRING
�- LYS
�\ �/ ! MAIN WATER LINE
BLASTIC Y/N METAL Y/N
UTILITY COMPANY NOTIFIEff
(�2
REPORT ID: DPR265 ROUTE TO: BS0508
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ' ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0212200013
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
GA PAID IL ADDRESS:
TR: 14572 LT: 22 9560 PENTLAND ST
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803844
ASSESSOR ON NEAREST CROSS STREET: CLOVERLY
8590-013-019 Al PERMIT ISSUANCE FEE 27,75 THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY
G1 OUTLETS-LGT,SW,RECP 2.00 OUT
TOTAL FEES 3 .65 SS 0 C B PIR 0 :
12/20/02 JK 06/18/03
OWNER: TEL. 0: FINAL DATE FINAL BY: CODE:
HOLLEY ROBERT C;ANNE S (626) 309-0297-
9560 PENTLAND ST
TEMP 917803844 DESCRIPTION 0 R
REPLACE 20UTLETS IN SEDRM (PREVIOUSLY CONVERTED FROM GARAGE-
PERMITTED IN 1952)
APPLICANT: TEL. O:
SAME AS OWNER - v j- - "�'' 1
`� SPECIAL CONDITIONS:
CONTRACTOR: TEL. NO: O "J 0koj UD 15 APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER -
LIC. NO TEMPORARY POWER POLE
UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER: TEL. NO: UFER GROUND
LIC. NO: ROUGH CONDUIT
ROUGH
MAN WATER LINE
PLASTIC Y/N METAL Y/N
UTILITY CO AN 0
I
REPORT ID: DPR265 ROUTE TO: BS0508