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Home My Public Portal About5410 PERSIMMON AVE_Electrical__ COUNTY OF LDS ANGELES APPLICATION FOR PERMIT Department of County Engineer �� DIVISIONSION OFOF BUILDING & SAFETY WILLIAM J. FOX, County Engineer FOR I T TO 1 LIN DISTRICT NO. GR UP Z13NE PERMIT NO. ELECTRICIA r RIVED BY READY FOR ADDRESS 0 FIRST INSPECTION CITY TIC NO COUNTY LICENSE NO. EXPIRES BUILDING PERMIT FlffS ADDRESS NUMFEE NUMBER EACH LOCALITY LIGHT OUTLETS / NEAREST CR . ST. WALL SWITCHES OWNER TOTAL OUTLETS 5C 9 MAIL ELEC. RANGES 25 ADDRESS CLEC. HEATERS 25 CITY TEL NO. FIXTURES 5 _ 1 HEREBYKNDWLED THAT 1 HAVE READ THIS MIBC. APPLICATION AND STAT NAT 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 LOS Nuu1BER HORSEPOWER FEE ANGELES COUNTY L?ENS OR I AM THE LEGAL OWNER NEW MVD. HP OVER INC. EACH OF THE REBIDENTI P PE DE RI ABOVE. I/s a LEGS 9 .25 SIGNATURE OFAl %s 2 .50 PERMITTEE 2 s 1.00 INSPECTION RE ORD 5 is 1.50 is 50 2.50 _ 50 200 5.00 200 s00 10.00 J Soo 1000 15.00 Z OVER IOOO 20.00 [7 M.G. SET/FREi2. CHANGER-HP WELDERS:AC-KVA O GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF ORID-) MOVED MOTORS (75% aF ORID.) MIBC. SIGNS NO. NO.TRANS. -N I3.O. NO.LAMPS T7 FOR EACH PERMITS DAT INSPECTOR'S NAME WIRING $1.00 f�� CONDUIT FIXTURES 91.00 f WIRING SUPPLEMENTARY .50 _—r FIXTURES POWER _ TOTAL FEE 8 „ UTILITY CO.NOTIFIED FINAL ISA533 DBS#5A 4-52 DEPARTMENT OF BUII.DING AND SAFETY APPLICATION rUl[ rZulvul COUNTY OF LOS ANGELES ELECTRIC WM. J.,FOX CHIEF ENGINEER' NAME i=il ° { r:�fi't c ,, DISTRICv�TjNO. GROUP ZONE PERMIT']NO�. ADDRESSQ 0� y� �.] g F.j `TEL.NO_ .L. 11.7 9s'G,+ �CEIV BY READY FOR DATEISSUED FIRST INSPECTION COUNTY W CERT.NO.4,p&i s EXPIRES APPLICANT FILL 10K HEAVILY OUTLINED PORTION ONLYJOB y DESCRIPTION OF ®Mid. ADDRESS iP' f il- v - PY NUMBER OF OUTLETS ON CIRCUITS LOCALITY w �i:v LOCATION BY ROOMS NEAREST J LIGHT OUTL l8w.I PLUGS FdT CROSS ST. CIRCUIT A B C D E F G H `oc NAME Li�..+2 D/ ��1. 3 ADDRESS �7 ta�[ tr C- 14-eA A CITY �0 TEL.N04re I AM THE LEGAL POSSESSOR OF THE ABOVE LAS ANGELES COUNTY CERT I OF UALIFIC yyT ON.. � vZm @i� �� • ELECTRICIAN. L AM THE LWAL OWNER'OF THE PROI�F.RTY DESCRIBED /��A s` 'ABOV6 �e •"1i a ,e 7'�, ` OWNER. a � r d�O�EC�ONS ' J Q Z O TOTAL NO. OF OUTLETS . $ / APPROVALS X10. OF FIXTURES 1� ffi JDA pNE INSPECMOR•S NAME NO. OF MOTORS H.P. ffi :CONDUIT NO. OF SIGNS TRANS. ffi WIRING ( t NO. OF RANGES OR HEATERS ffi FIXTURES MISCELLANEOUS ffi 1 t POWER PERMIT FEB ffi I a1S UTILITYCO.NorIF1ED /� ,� TOTAL FEE Q FINS 7GAG63-CE.806 3-69 : - �APPLICATION FOR ELECTRI .: COUNTY OF LOS ANGELES. DEPARTMENT,OF COUNTY ENGINEER 13UILD'ING AND SAFETY DIVISION BUILDING ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN .NEAREST J NO. EACH FEE cROSS,ST. _ RECEIPT. $ $ OWNERMAI e,£' ADDRESS - LIGHTTOTAL FIRST 20. l 20 G , �y / JCITY. �/ ' TEL.N0.� SWITCH OVER 20 .10 PLAN CHE CIC LIGHTING TOTAL FIRST 20 .20 (�uAPRLICANT FIXTURES )-.2-- r-OVER 20 ,10 -:ADDRESS RANGE_DRYER_WTR. HTR. CITY TEL.NO. STA. COOK_DISP._F.A.U. _CONTRACTOR SPACE HTR. AIR COND. 'ADDRESS CLOTHES WASH._DISHWASH. CITY TEL.NO. FAN_OTHER 1.00 ''LICENSE NO. CLASS. MOTORS,TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION IND. HEATERS, ETC, HP. KW. KVA. AND STATE THAT THE. ABOVE 15 CORRECT AND AGREE TO COMPLY SIZE & TYPE OVER -TO WITFI ALL COUNTY -ORDINANCES AND STATE LAWSRE&ULATING. •,ELECTRICAL WIRING. " O - 1 1.00 ' I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES 'COUNTY AND 9TATEOF 1 - 10 3.00 CALIFORNIA OR THAT I AM, HE LEGAL OWNER NO INTEND TO S T RESIDE IN, THE ABOVE DESCRIBED RESIDENTI P PERTY. C 10 — so 5.00" L _ SIGNATURE pI 50 - 100 1000 OF PER'MITTE c(' 100 — 500 15A0 DISTRICT NO. GROUP PREE SED BY w SIGNTUBEj,OR SIGN AND ONE CIRCUIT 3.00. �!' TLrn / Z MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES: SERVICE NOT OVER 600 VOLTS'OR 200 AMP / 2.00 Z O SERVICE OVER 600 VOLTS OR 200 AMP 5.00 TEMP SERVICE,POLE, &AP.PURTENANCES 3.00 APPROVALS 'DATE INSPECTOR'S SIGNATURE TEMP..POWER POLE UNDERSLAB WORK ROUGH CONDUIT WIRING PERMIT FEE (SUB TOTAL) FIXTURES POWER"AUTHORIZED 0 PLAN CHECK FEE (50% PERMITTEE) " PERMIT ISSUING FEE 2.00 'UTILITY.CO.NOTIFIED SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL TOTAL FEE JOSEPH C: ROOHAN SUPERVISING ELECTR L ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH 3'4 3" 3R_ A-122 -2 D 6.8O�- SEE BACK OF APPLICATION FOR'COMPLETE FEE SCHEDULE - ., 7GA663-CESOG 8-69. _ "" APPLICATION FOR ELECTRICAL PERfia I COUNTY OF LOS ANGELES DEPA•RTiMENT OF COUNTY ENGINEERILDING ;y BUILDING AND SAFETY DIVISION ADDRESS JOHN A. L'AMBIE, COUNTY ENGINEER - COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY NEAREST ,p FOR APPLICANT TO.FILL IN CROSS ST. NO. EACH FEE RECEIPT. $ 9 OWNER MAIL LIGHT / TOT�AL FIRST 20 lQ .20 O ADDRESS e / SWITCH ,/ OVER'20 ,10 CITY TEL.NO. PLAN CHECK LIGHTING TOTAL FIRST 20 .P0 26 APPLICANT FIXTURES' }� OVER 20 ,10' ADDRESS RANGE DRYER_WTR. HTR. 'CITY TEL.NO. STA. COOK_DISP._F.A.U. CONTRACTOR _ SPACE HTR. AIR COND.. ADDRESS CLOTHES WASH._DISHWA'SH. CITY TEL.N0. FAN_OTHER 1.00 LICENSE NO. CLASS. MOTORS,TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION IND. HEATERS, ETC, HP. KW. KVA. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY SIZE 8•.TYPE OVER TO WITH ALL,COUNTY ORDINANCES AND STATE LAWS REGULATING ',.ELECTRICAL WIRING. O - 1 1.00 I HEREBY CERTIFY THAT 1 AM PROPERLY REGIS ED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNT AND ATE OF I - 10 .3.00 CALIFORNIA OR THAT I AM THE LEGAL OWNER O , AND TEND TO RESIDE IN; THE ABOVE ED RESI IA PROP TY. 10 _ 50 5.00 _ SIGNATURE -F 50 _ 100 10DO OF PERMIT u 100 - SDO i5:0O .DISTYI k&.. CROUP ZO P ED BY SIGN,GAS •SIGN AND ONE CIRCUIT 3.00 - TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES: SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 SERVICE OVER 600 VOLTS OR 200 AMP 5.00 TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP. POWER POLE UNDERSLAB WORK ROUGH CONDUIT / WIRING i ✓ 1�/ 7 PERMIT FEE (SUB TOTAL) FIXTURES PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED PERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED SUPPLEMENTARY PERMIT ISSUING FEE 1.00 V FINAL 1 TOTAL FEE JOS P C. ROOHAN SUPERVISING ELECTRICAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH - PERMIT VALIDATION CK. M.0 CASH SEE BACK OF APPLICATION FOR COMPI.FTE FEE SCHEDULE - -- �� APPLICATION OR EL �tICA' PERMIT 76A663-CE006 10/74 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER FADDRE BUILDING AND SAFETY DIVISION Y FOR APPLICANT TO FILL IN T. 414 112-AZ'I OUTLETS N0. EACH FEE RME RECEPT. S $ MAIL FIRST 20 �� ADDRESS LIGHT TO y CITY TEL. NO. SWITCH OVER-20 JL. (19 PLAN CHECK LIGHTING FIRST 20 APPLICANT 1 TOT L � � � ' J( VER 20 ADDRESS FIXTURES O RESIDEN TIAL,APPLIANCES CITY TEL. NO. PERMIT RANGE • DRYER_WTR. HTR. APPLICANT STA. COOK DISP. F.A.U. ADDRESS SPACE HTR,_ AIR COND. CITY2 TEL, N0. CLOTHES WASH. DISH WASH. LICENSE Off- REG. NUMBER ,'l� �/Q CLASS.lL Tv Tom. FAN OTHER f,�. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW.KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO ' I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR . 0 -•1 100r LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ?. CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE CD 1 - 1D. 3.00 DESCRIBED RESIDENTI L PROPERTY. V 10 - 50 5.00 'PERMITEE SIGNATURE r L V 50 - 100 10.00a DISTRICT NO. OC ED BY y 100 - 500 15.00 O Z SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTO 'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE SERVICENOTOVER 600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK SERVICEO.VER600VOLTS OR200AMP10,00 ROUGH CONDUIT TEMP SERVICE,POLE,&APPURTENANCES 5.00 WIRING �� C• TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES POWER AUTHORIZED. UTILITY CO. NOTIFIED �y _ FINAL PERMIT FEE (SUB TOTAL) NOTES: PLAN CHECK FEE PERMIT ISSUING FEE 8.00 v ` TOTAL FEE • PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH 0 5 0 ti aDR 1 2 1 5.6 0 A::d SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE V Wcat ER'S COMPENSATION DECLARATION 20. 019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT78A663I hered I have a certificate of Consent to self insure, I or a cWorli 's Compensation Insurance, or a certified. I COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec.3800 Lab.C.) Y No. Company Policy CFOR APPLICANT TO FILL IN JOB J/ F1Pan ADDRESS G•10 b Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE LOCALITY ❑ Certified co is filed with the county building inspection I 1 &2-Family,Sq.Ft. _ $ $ , PY tY 9 P ) NEAREST �. department. Multi-family Sq.Ft. CROSSST. Date Applicant Residential Swimming Pools ASSESSOR MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec. Light `Z Sw. FlRM NAME(� I if �� COMPENSATION INSURANCE First 20 MAIL (This section need not be completed if the work Involved by the ADDRESS �'Q permit is for one hundred dollars(S100)or less.) Total No. Additional AI I certify that in the performance of the work for which this permit CITY Tel.No. 1?0 41 is issued, I shall not employ any person In any manner so as to PLAN CHECK become subject to the Workers'Compen tion Laws. Lighting Fixtures First 20 APPLICANT Total No. Additional 7- ADDRESS Date 2 Applican RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE O A PL CANT: If, a making this ificate of CITY Tel.No. Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code,you must forthwith comp) with such PERMIT 'yam P y Y Power Apparatus&Large Appliances APPLICANT AGo_,_Z � provisions or this permit shall be deemed revoked. LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. (commencing with Section 7000)of Division 3 of the Business and CITY Tel.No. Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. LICENSE oR �- Over 50 to 100 Incl. REG.NUMBER C� IL Over 100 DISTRICT NO. PROCESSED BY 0 License Number Lic.Class 0 Services,Swbd.,MCC&Panelboards it i 0-399 Amp.Under 600 V FINAL 0 Contractor Date DATE ❑ I am exempt under Sec. 400-1000 Amp.Under 600 V to_( VALIDATION W Over 1000 Amp.or Over 600 V FINAL d B.&P.C.for this reason BRANCH CIRCUIT FEES BY &Q>r a) Date: 15A,or 20A,120V,Lighting or Recept. Z I 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits Exemption for Reg.Maint.Elect. 16A,20A,208V To 277V Lighting Br.Circuits SINGLE FAMILY Temp.Power Pole&Appurtenances auu^y o 4 47"30 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit } A� ITEMk7 c 30 I hereby affirm,that I am exempt from the Contractor's License Law fo the following reason(Section 7031.5, Business and Professions Additional Sign Branch.Circuits ECK 4 CHANGE I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors W1'IAfyGE o is not intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule) , It r and Professions Code). Q1�W—t� 01 8/25/95 CONSTRUCTION LENDING AGENCY uWLi tatJV I hereby affirm that there is a construction lending agency for the �1 AIS 9:04 performance of the work for which this permit is issued(Sec. 3097, PERMIT FEE (Sub-Total) Civ.C.) PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE � Q Lender's Address I certify that I have read this application and under penalty of purjury state TOTAL FEE �Q that the 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 Ins etk'ibn purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE g —* qr I SIGNATURE OF PERMSTEE • DA ' WORKERS'COMPENSATION DECLARATION 70DPW 3/87 APPLICATION FOR ELECTRICAL PERMIT O I.�,hereby''� . Tfirm that I have a certificate of consent to self cE-soya iniulre, or a celrtificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or,a cgLtified co .y thereof(Sec..3800, Lab. C.) PC 4.60690 REPUBLIC INDEMN Policy'No. ompany FOR APPLICANT TO FILL IN JOB 1-1-Certified copy is hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE ADDRESS 5.410 PERSIMMON. AVE r-j $ ._ $ Certified copy is filed with the county building inspec- � 1 &2-Family, Sq. Ft. LOCALIT'TEMPLE CITY NEAREST tion department. f Multi-family Sq'. Ft. 8/31/92' t Residential Swimming Pools. CROSS ST. Date App.lica FIRM N o=ALVIN NGUYEN FIRM N CERTIFICATE OF EXEMPTI N FROM WORKERS' �• I ` MAIL Outlets: Rec Light Sw._ 1 COMPENSATION INSURANCE �• ADDRESS5.41O PERSIMMON AVE.. (This section need not be completed if the work involved by !Total No. AddiFirst tional CITTEMPLE CITY Tel. rs8.18-444-8 48 the permit Is for one hundred dollars($100)or less.) - PLAN CHECK 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 Lighting Fixtures First 20 ADDRESS so as to become subject 4o the Workers'Compensation Laws. Additional Date Applicant NIA Total No. CITY Tel. No. NOTICE TO APPLICANT: If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT Exemption, you should become subject to the Workers' Range— Heater—D.W.'— APPLICATIONIRVINEWEST HTG. & A/C Compensation provisions of the Labor Code, you must forth- Oven -_ Dryer —W.M.— ADDRESS638 SOUTHERN AVE. with comply with such provisions or this permit shall be. ,)Top. ,— FAU —W.H. — CIT�rjgANGE 8OO Tel. No.'j14-92.1- deemed revoked. Hood — Fan —Other— LICENSED.CONTRACTORS DECLARATIONLICENSE OR Disp. Room.Air Cond. _ REG. NUMBER 4.68609 Class. C2'0.,.I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business Power Apparatus&Large Appliances DISTRICT NO. P ED BY >- and Professions Code,and my license is in full force and effect. d Size&Type HP, KW, KVA, or KVAR . �� p License•Num r 468609 Lic. Clbss. C2.0• Up to 1 Incl. FINAL U ' 5 Over 1 to 10 Incl. DATE: cc Contra '8/3:1/92 (o"� VALIDATION p ❑ Over 10 to 50.Incl. FINAL 1 am exempt under Sec. Over 50 to 1-00 Inc. gY 0 LU B.&P.C. for this reason Over 100 Z Services, Swbd., MCC&Panelboards Z Date.: 0-200 Amp. Under 600 V 7- Signature Signature 201 - 1000 Amp..Under 600 V ❑ Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY a 2. Y HOME OWNER-BUILDER DECLARATION Temp. Power Pole&Appurtenances I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit 'f's* Law for the following reason (Section 7031.5, Business and Additional;Sign Branch Circuits 7 ` s L . Professions Code): ,, M•, ❑ 03 1, as owner of the property, will do the work and the Misc. Conduits&Conductors M�, f itm structure is not intended or offered for sale(Section 7044, Other(See Complete Fee Schedul'e.� •r Business and Professions Code). CONSTRUCTION LENDING AGENCY & "T'-rr CWC - 84.03 I hereby affirm that there is a construction.lending agency forsa�To', w .001the performance of the work for which;this,permit is issued PERMIT FEE (Sub-Total) =5�5:' 8 - (Sec. 3097, Civ. C..). !� N/A' PLAN CHECKING FEE 9I 4I4 Lender's Name ' j PERMIT ISSUINGFEE 114.74 "" . 1 AN �o i Lender's Address _ l 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 .. i ordinances and State laws regulating Electrical wiring,•and ! hereby authorize representatives of this County to enter upon 4heove-mentioned operty for inspection purposes. SEE:REVERSE FOR EXPLANATORY LANGUAGE -A 11' 8/31/92 I ;te of Perrni ee Date ®s t COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0703300013 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: JTR: 13613 IT: 20I 5410 PERSIMMON AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:I TEMP CA 917802803 ASSESSOR INFORMATION NUMBER: I INEAREST CROSS STREET: FREER 8573-005-008 JAI PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: C3 LOCALITY: TEMPLE CITY, Cl IG1 OUTLETS-LGT,SW,RECP 5.00 OUT 9.75 I TENANT: G2 LIGHTING FIXTURES 1.00 LGT 1.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: TOTAL FEES 39.45 03/30/07 JK 09/26/07 OWNER: TEL. NO: �F! DAT F BY: CODE: TANG, MINK (626) 665-9199- ��7/ 5410 PERSIMMON AV TEMP 917802803 IDESCRIPTI011 OF WORK 15 OUTLETS AND 1 LIGHT FIX P. FOR GAME ROOM APPLICANT: TEL. NO: TANG (626) 665-9199- 15410 PERSIMMON AVE. (SPECIAL CONDITIONS: TEMPLE CITY CA 91780 CONTRACTOR: TEL. NO: JAPPROVALS DATE INSPECTOR SIGNATURE ITHOI, KATHY (626) 279-5145- 15410 PERSIMMON AVE. LIC. NO TEMPORARY POWER POLE TEMPLE CITY, CA 91780 NONE UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: JUFER GROUND LIC. NO: I ROUGH CONDUIT (ROUGH WIRING MAIN WATER LINE {PLASTIC YIN METAL YIN UTILITY COMPANY NOTIFIED I I I i REPORT ID: DPR265 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1106150058 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: (LEGAL ID: IFEES PAID I BUILDING ADDRESS: I ITR: 13613 LT: 20 1 5410 PERSIMMON AV I I FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:( TEMP CA 917802803 I ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 18573-005-008Al PERMIT ISSUANCE FEE 27.80 1 THOMAS PAGE: 597 GRID: C3 LOCALITY: TEMPLE CITY, Cl I ILB 200 AMP PANELS, MCC 1.00 PAN 38.80 1 1 ITT: I TOTAL FEES 66.60 (ISSUED ON: PROCESSED BY: PLAN BY: I I 106/15/11 SR (OWNER: TEL. NO: F30ALDDATT[EE FI BY: CODE: I (TANG, KATHY (626) 279-5145- 1 I l}j[ `� 5410 PERSIMMON AV (TEMP 917802803 I 1DDSCRIPTION OF WORK 14 I CHANGE SERVICE PANEL TO 200 AMP I 1APPLICANT: TEL. NO: I I 1 (SAME AS OWNER 1 (SPECIAL CONDITIONS: I I I (CONTRACTOR: TEL. NO: I (APPROVALS LATE INSPECTOR SIGNATURE ISAME AS OWNER ILIC. NO 1 (TEMPORARY POWER POLE I I I 1 I (UNDERGROUND CONDUIT ISI I (ARCHITECT OR ENGINEER: TEL. NO: - i IUFER GROUND �Ibo I / •1/\y 1 I LIC. NO: I (ROUGH CONDUIT IAxJTI1•a�/lP I (ROUGH WIRING 1 I I I I I I 1MAIN WATER LINE I I I I 1 (PLASTIC YIN METAL YIN I I I I 1 (UTILITY COMPANY NOTIFIED( I I I I I I I I I I I I I i I I I I I I I I I I I I I I I I I I I I I I I I I I 1 I I I I I I I I I I I i (REPORT ID: DPR265 ROUTE TO: BS0508 I I I I I I