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76A663-CE6061_68 APPLICATION FOR ELECTRICAVPERMIT
COUNTY OF LOS ANGELES
DEPARTMENT BUILDING AND SAFETY DIV DIVISION TBLDING �- 3 w� i/i1/{�J Df�
JOHN A. LAMBIE. COUNTY ENGINEER RESS w /D
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDINGALITY �Q ��, V I�FOR APPLICANT TO FILL IN REST tNO. ACH FESS ST.
S s OWNER
',RECEPT._ MAIL Vol ` A G '�
LIGHT TOTAL FIRST 20 .20 ADDRESS l V
SWITCH_ OVER 20 .10 CITY61 TEL.. NO.
PLANCHE
LIGHTING �TOTAL, FIRST 20 .20 APPLICANT KFIXTURES OVER 20 .10 ADDRESS
RANGE_DRYER_WTR.HTR._ CITY TEL. NO.
G+,CSSTA.COOK—DISP.—F.A.U.— CONTRACTOR jJT jj-q ISITA ?(,+,C—
SPACE
PACE HTR. AIR COND: ADDRESS *3 1 vf, dqA&�/ f 1
CLOTHES WASH._DISHWASH.- CITY IA TEL. NO. �l66IbI
FAN-OTHER 1.00 LICENSE NO. CLASS.
MOTOR RATING
IND. HEATERS, ETC. HP. KW. KVA. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
SIZE &'TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
0 - 1 1.00 ELECTRICAL WIRING.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/DR
1 - 10 3.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO a
10 - 50 5.00 RESIDE IN, THE AB E DE CRIBED RESIDENTIAL PROPERTY. O
50 - 10010.00 SIGNATURE V
OF PERMITTEE ad
100 - 500 15.00 0
DI TRICT NO. G P ONE P, -CESSED BY G
SIGN.GAS SIGN AND ONE CIRCUIT 3.00 �� Lu
TUBE, OR p,
MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES: / ' (fI _ le - Z
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 Q
SERVICE OVER 600 VOLTS OR 200 AMP S.00
TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP. POWER.POLE
OT UNDERSLA B.WORK
ROUGH CONDUIT
,PERMIT FEE (SUB TOTAL) WIRING
PLAN CHECK FEE (SO% PERMIT FEE) FIXTURES
POWER AUTHORIZED
,PERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED } oca) �.��' r-
SUPPLEMENTARY PERMIT ISSUING FEE 1.0o FINAL
TOTAL FEE E'i JOS PH C. ROOHAN
SUPERVISING ELEC CAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
LA(;o 5 a 4 2'%'DAUG 2'Q 2 D 4.o 0- 4
EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
"eG36CE8015;'0174 APPLICATION OR 6E8ikl'f.AL PERMIT �J
COUNTY OF .LOS.ANGELES
DEPARTMENT.OF COUNTY ENGINEER; JOB.
BUILDING AN'D'SAFETY_DIVISION ADDRESS � d„3 !,TEL.;NO. y.L yLOCALI:TY '�NEARESTFOR APPLICANT TO FILL IN _ CROSS ST. d•/ rl•� _NO. EACHFEE NE OUT.LETS FRM'.NA1'0ME [>1JRECEPT:_ $ $ MAIL
LIGH.T TOTAL FIRST 20 2g' ..A,DD.RESS- .t.CI TY 1, +* � �'. :NO./ �"dlSWITCH OVER 20 ;10PLAN CHECK
LIGHTING. :FIRST 20 20AP.P'LICANT
TOTALOVER 20 •ADDRESS
FIXTURES .f0 _RESI'DE'N.TIAL APPLIANCESCITY"
PERMIT
RANGE DRYER_WTR. HTR. APPLICANT. rrs':•� . /:.V �rLJ
STA..COOK 'DISP. F.A.U. ADDRESS Vw yAs
SPACE HTR. AI•R CONO.' CITY' // r c TEL, NOZ, -_7:/
CLOTHES WASH. DISRWASH. LIGNUMOBR CLASS.0-4 to
REG..NUMBER`, 3
FAN OTHER 1.00 I HEREBY ACKNOWLEDGE'THAT 1 HAVE READ THIS APPLIC TION
AND STATE THAT THE ABOVE -IS CORRECT AND AGREE TO COMPLY
MOTOR 9, TRANSFORMERS RATING ' WITH ALL COUNTY 'ORDINANCES AND STATE LAWS REGULATING
IND. HEATERS, ETC. 'HP..KW.KVA. ELECTRICAL WIRING.
SIZE & TYPE OVER TO� _
' 1 I HEREBY 'CERTIFY THAT 1 AM PROPERLY REGISTERED.AND/OR
0 — 1 1.00 / LICENSED- AS REQUIRED BY L06 ANGELES COUNTY AND STATE.OF
LALIFOR'N IAOR THA I. AM THE LEGAL OWNER OF THEABOVE
1 — 10 3.00 DESCRIBED RESIDENTIALPROPERTY.� / C.3
SIGNAT J/` CD
10 — SU 5.00 SIGNATURR 11gE. 4f .°
50 — 100 10.000-
DISTRI.C.T NO.' P SED BY. y
100 = 5OO 15,00
Z
SIGN, .GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS: DATE INSPEC9WAIGNATURE
TUBE,-OR
MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE
SERVI-CENOT OVER600VOLTS'OR200AMP 3.00 UNDERS.LAB WORK
SERVICEOUER.600VOLTSOR20OAMP 10.00. ROUGH CONDUIT
TEMP SERVICE,POLE,.&APPURTENANCES 5.00 WIRING
TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES
POWER AUTHORIZED
UTILITY CO. NOTIFIED.
FINAL 7-7
PERMIT FEE (SUB TOTAL) NOTES:
PLAN CHECK FEE
PERMIT'ISSUING FEE 3.00
TOTAL FEE
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION ('��••. M.Q. C45H
9 6 1"DMAY 18 2- 1) 1 2.0 0
,SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE °
•a
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0611140005
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
TR: 13613 IT: 42 5403 PERSIMMON AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802804
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET:
8573-003-017 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: C3 LOCALITY: TEMPLE CITY, C
HA FAU LESS 3HP 1.00 FAU 10.95
TENANT: IS N-RES WTR HTR IT 3HP 1.00 WTR 15.30 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
TOTAL FEES 54.00 11/14/06 JK 05/13/07
OWNER: TEL. NO: FINAq//�pMBY: CODE:
MEDLEY, CHARLOTTE (626) 579-0123- /L/\V��(1 II
5403 PERSIMMON AV
TEMP 917802804 DESCRIPTION OF NORK
(1) 220 V ELEC CIRC FOR REPLACE UNIT
APPLICANT: TEL. NO:
FRED (323) 726-2600-
119 LA PORTE ST. #A SPECIAL CONDITIONS:
ARCADIA, CA 91006
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
GLENN HEATING AND A, C (323) 726-2600-
119 LA PORTE ST #A LIC. NO TEMPORARY POWER POLE
ARCADIA CA 91006 827367 C20
UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER: TEL. NO: UFER GROUND
LIC. NO: ROUGH CONDUIT
ROUGH WIRING
MAIN WATER LINE
PLASTIC YIN METAL YIN
UTI;,ITY COMPANY NOTIFIED
REPORT ID: DPR265 ROUTE TO: BS0508