HomeMy Public PortalAbout5313 PERSIMMON AVE_Electrical__ - v
�I
76A888-CE806 9-84 APPLICATION FOR Eil CTRICAL PERMIT .
COUNTY OF LOS ANGELES
DEPARTMENT OF-COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPT, OF BUILDING LOCALITY'
CROSSS T. c
FOR APPLICANT TO FILL IN '
RECEPT. TOTAL NO. EACH FEE �� / '
LIGHT ' OUTLETS FIRST 20 $.20 $ OWNER W
MAILR �31,
ADD r J
SWITCH. OVER 20' .10 ADD ESO
,�oo
LIGHTING TOTAL I FIRST 20 .20 CITY [b TEL.NO.
FIXTURES i
_ ADD'L I
OV9R 20 ,10 ELECTRICIAN
RANGES CLO.DRYERS WTR.HTR8. 1.00 ADDRESS `
GARB.DISP. STA:COOK CITY TEL.NO.
DISHWASH. AUTO.-WASH. STATE `
SPACE HTRB. ' STA.APP.(y=H.P.MAX.) .50 LICENSE NO.
MOTORS: OVER NOT OVER H.P. DIST ICT G .P Zip O D-
O • 1 1.00
1 3 - 1.50 INSPECTION RECORD'
3 S 2.00 ' d
S 1.5 2.50 � U
1.5 so 3.00
50 100 5.00 ; U
SIGNSt NO.TRANS. W
NO.LAMPS i- Z
I
SERVICE 0-SOOV-NOT OVER 200A 1.00 ! I'
SERVICE O-SOOV-OVER 200 A. 2.00
SERVICE OVER SOOV 5.00 I
MISC.
- I .
PERMIT ISSUING FEE 2.CQ0 I.
-SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE IN R'B SIGNATURE
AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL-COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
- HEREBY.CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATEOF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN, THE ABOODESCRIBED RESIDENTIAL PROPERTY. POWER
SIGNATURE V UTILITY CO.NOTIFIED i
OF PERMITTEE
FINAL V
VALIDATION JOSEPH C. ROOHAN
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
L{CO 9 0 1 JAM 21 2 D 3.0,0Ncu
WOrm th'COMPENSATION Tale RATIOM CE-80676A663, 10/81 APPLICATION FOR ELECTRICAL PERMIT
I horeby affirm that I have a cerfrfidJte et cbnsenf to self ' CE-806G
insure, or a certificate of Workers'Compensation Insurance, COUNTY OF IOS ANGELES BUILDING AND SAFETY
or a certified copy thereof(Sec 3800, Lab. C.)
Policy No. Company FOR APPLICANT TO FILL IN JOB ADDRESS 3/3 PLRSi/"dii 0�
11Certifiedcopy is hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE _
F-1Certifiedcopy is filed with the county building inspec- 1 &2-Family, Sq. Ft. $ — $ LOCALITY /w LL! V 19A1_1
tion department. Multi-family Sq. Ft. — NEAREST
Residential Swimming Pools CROSS ST.
OWNER OR
Date Applicant FIRM NAME ELL,
CERTIFICATE OF EXEMPTION FROM WORKERS' dQ g J a MAIL n4 tl( O
Outlets: Re Li ht S v
COMPENSATION INSURANCE a 7S ADDRESS 13 �S!
This section need not be completed if the work Involved b First 20
( p y Total No. Additional CITY+- �0�(1' Q Tel No.L
the permit is for one hundred dollars(S1U or less.)
I certifythat in the erformanc of the w for hick this PLAN CHECK
P �" APPLICANT
permit is issued, I shall not employ any pe on in an manner
so as to become subject to the orkers' pmpens i Lawsy / Lighting Fixtures First 20 ADDRESS
y� Total No. Additional
�/ Applicant CITY Tel. No.
Date Fixed Appliances Not Over 1 HP PERMIT
NOTICE TO APPLICANT: If, after ing this Qertificat of APPLICANT
Exemption, you should beco ubject to
the Workers' Range_ Heater_D.W.
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_
LICENSE OR
I hereby affirm that I am licensed under provisions of Chapter 9
Disp. Room Air Cond. REG. NUMBER Class.
(commencing with Section 7000)of Division 3 of the Business DISTRICT NO. PROLE BY
and Professions Code,and m license is in full force and effect. Power Apparatus&Large Appliances
y Size&Type HP, KW, KVA, or KVAR del 0
License Number Lic. Class Up to 1 Incl. FINAL V
Over 1 to 10 Incl. DATE VALIDATI
09
Contractor Date Over 10 to 50 Incl. OA0
❑ FINAL
I am exempt under Sec. Over 50 to 100 Inc. BY IL
B.&P.C. for this reason Over 100 U1
Date: Services, Swbd., MCC&Panelboards ►
0 -200 Amp. Under 600 V
Signature 201 - 1000 Amp. Under 600 V
❑ Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V 0 8 a 5 A
SINGLE FAMILY Temp. Power Pole&Appurtenances ' o a 0 0 0 2
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit
I hereby affirm that I am exempt from the Contractor's License 0 - 21L75
Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits
Professions Code): 0 0 0 2 a,7 5 C5
I, as owner of the property, will do the work and the Misc. Conduits&Conductors 9 p
structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)_ Q 15 4
7044, Business and Professions Code).
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)
(Sec. 3097, Civ. C.).
PLAN CHECKING FEE
Lender's Name
PERMIT ISSUING FEE 175
Lender's Address
I certify,tat I have read this application and state that the TOTAL FEE
a e infor ti 0rrecf. I agree to comply with all County
/AbrdinOnc d Stat laws regulating Electrical wiring, and
her
u orize r resenfafives of his County to enter upon
t the abo -menti ed property spection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
Lb
i at of Perm'tee Date
c , . w . . 0
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORgS 9701 LAS TUNAS I EL 0508 9903190007
BUILDING AND SAFETY / LAND BEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL D: FEES PAID BUI DING ADDRESS:
TR: 13613 LT: 34 5313 PERSIMMON AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ITEMP CA 917802802 ,
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET:
8573-004-013 Al PERMIT ISSUANCE FEE 27.75 ,THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY, C
LB 200 AMP PANELS, MCC 1.00 PAN 38.85
TENANT: TOTAL FEES 66.60 ISSUED 0 PROCESSED B A Y: EXPIRES ON:
03/19/99 VG 03/19/00
OWNER: TEL. NO: FINAL DATE FINAL BY' CODE,
CABRERAS, EFRAIN - 7,v
5313 PERSIMMON AV
TEMP 917802802 DESCRIPTION uF WORK
UPGRADE ELECTRICAL SERVICE T 200 AMP
- APPLICANT: EL.
-) CARBO ELECTRIC -
SPECIAL CONDITIONS:
ANGELES CO
CARBO ELECTRIC EL. N357-2294- �.�5 APPROVALS DATE INSPECTOR SIGNATURE
502 E. LOS ANGELES AVE. LIC. NO TEMPORARY POWER POLE
MONROVIA, CA 91016 750911CIO
UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER: EL. NO: - ! ER GROUND
LIC. NO: L 1111111 ROUGH CONDUIT
ROUGH WIRING
MiUD ��� ��j 01ro-RKS
MAINNATER LINE
�IPLASTIC Y/N METAL Y/N
� J
UTILITY CO PA 0 D
\ n 0 � ? -11i
�7 p
Service Thai
I
i
i
REPORT ID: DPR265 ROUTE TO: BS0508