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Home My Public Portal About5626 PERSIMMON AVE_Electrical__ '76A66.3-Ci"B06I.1 }j APPLICATION FOR ELECTRICAL PERMIT L.1 -'' COUNTY OF LOS ANGELES • DEPARTMENT OF COUNTY ENGINEER TBUILDING [ p 6 M,5�/YJ/fJdi✓ AvgBUILDING AND SAFETY DIVISIONFOR APPLICANT TO FILL IN NEAREST h I VL VIS Iy OUTLETS NO. EACH FEE OWNER d)9"A I.b t /V o 1�i0 RECEPT.Q $ S 2-� LIGHT y8 TOTAL FIRST 20 a0 2ADDRESS 'edle J ."mm 0,-v0,-v5 Q ` `- SWITCH ` 0 J t OVER 20 I 10 CITY -7-el4PI-4 C/T,7TEL. NO./ 7 &*S9.3 PLAN CHECK LIGHTING TO FIRST 20 APPLICANT Q I�rv,ele FIXTURES .10 1 � D �'3 IJ T TOTAL 2S OVER 20 ADDRESS . RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT RANGE DRYER_WTR. HTR. .APPLICANT O �I✓N✓09. STA. COOK DISP. F.A.U. ADDRESS, SPACE HTR. AIR COND. CITY TEL. NO. CLOTHES WASH. DISHWASH. LICENSE NO. CLASS. FAN--LOTHER 1.00 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 1.00 LICENSED AS RE0U IRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO it 1 - 10 9.00 RESIDE IN, T E ABOVE D��E}}}SCRI R�IDENTIAL PROPERTY. O 10 - 50 5.00 OF PERMRTTEE .�fh FIL'�. w 50 100 10.00 - t;DISTRICTNO. CLASS ZONE OCESSED;Y to 100 - 500 t 5.00 h SIGN, GAS =AND.ONE CIRCUIT 5.00 NOTES: Z TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 SERVI CENOT OVER 600 VOLTS OR 200 AMP 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE SERVI CEOVER 600 VOLTS OR 200 AMP 10.00 TEMP.POWER POLE TEMP SERVICE,POLE,&APPURTENANCES •5.00 TEMP LIGHT,OR RECEPT. SYSTEM 3.00 UNDERSLAB WORK ROUGH CONDIUT WIRING FIXTURES n�,, •/�� PERMIT FEE (SUB TOTAL) POWER AUTHORIZED UTILITY CO. NOTIFIED 1J PLAN CHECK'FEE !f PERMIT ISSUING FEE 3.00 FINAL TOTAL FEE 46 PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH' 3 o . 773 AUG 31 6:1 0 A SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 76_6,63-CEA.Qb 10/72 APPLICATION FOR LECTRI A PERMIT COUNTY OF LOS ANGELES DEPARTMENT AND SAFETY YDIV DIVISION1APPLICANT AD 1� �V , )/"Jw ADDRESS LOCALITYNEAREST ' )y7 5 FOR APPLICANT TO FILL INCROSS ST. a I OUTLETS N0. EACH FOWNER OR FIRM NAME b PPVA LD /Y P VA xv S S RECEPT._ MAIL FIRST 20 25ADDRESS , �s �•� k. JA4M Or-,j LIGHT TOTAL CITY EL. NO.�• �.r� SWITCH_ OVER 20 10 K G ��•` PLAN CHECK LIGHTING FIRST 20 .25 TOTAL FIXTURES OVER 20 .10 ADDRESS RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT RANGE DRYER_WTR. HTR. APPLICANT yo, >P w STA. COOK DISP. F.A.U. ADDRESS SPACE HTR.' AIR COND. CITY TEL. NO. CLOTHES WASH. DISHWASH. LICENSE OR CLASS. REG, NUMBER FAN OTHER 1.00 1 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. ELE'CTR ICAL WIRING. SIZE & TYPE OVER TO 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 - 1 1.00 LICENSED AS RED IRED BY LOS ANGELES COUNTY. AND STATE OF CALIFORNIA OR THAI I AM THE LEGAL OWNER OF THE ABOVE y, 1 - 10 300 /S DESCRIBED RESIDENTIAL PROPERTY. 3 (/ C.3 10 — 50 5.00 PERMIT E- SIGNATURE /1/- rl;�� •"+ cc O 50 — 100 10.00 DISTRICT NO. ROCES ED BY yvj 100 — 500 15.00 U _Q '67 SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS v DATE INSPECTOR'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1..00 TEMP. POWER PbLE SERVI CENOT OVER 600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK SERVICEOVER 600 VOLTS OR200AMP 10.00 ROUGH CONDUIT TEMP SERVICE,POLE,&APPURTENANCES 5.00 WIRING --7 c TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES , POWER AUTHORIZED ' UTILITY CO. NOTIFIED . � FINAL PERMIT FEE (SUB TOTAL) NOTES: PLAN CHECK FEE PERMIT ISSUING FEE 3.00 Q� TOTAL FEE Q(J PLAN CHECK VALIDATION CK: M.0. CASH PERMIT VALIDATION CK. M.0. CASH 0 9 Zr'!-MAR 1.5 2 0 6.Q SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE WORKERS'COMPENSATION DECLARATION CE-806 APPLICATION FOR ELECTRICAL PERMIT I h&s �a£fsrm�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. � Policy No. Company FOR APPLICANT TO FILL IN JOB ADDRESS GAG �� )JYll1')��i to New Residential Bldgs.&Pools EACH •NO. FEE � ❑ Certified copy is hereby furnished. 1 &2-Family.Sq. Ft. $ — $ LOCALITY , A C ?/ ❑ Multi-family sq. Ft. _ CROSS ST l if a Certified copy is tiled with'the county building.inspection Residential Swimming Pools AX department. a FIRM NAME LO. l! Date Applicant Outlets: Rec. Light Sw. 3.• ADDRESS First 20 CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional' CITY ) C t Tel No. 2-Q 293 COMPENSATION INSURANCE PLAN CHECK 4. (This section need not be completed if the work involved id-,APPLICANT CCP by the permit is for one hundred dollars ($100) or less.) Lighting Fixtures First io ADDRESS Total No. 4- Additional O I 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 PERMITW so as to become subject to the Workers'Compensation Laws. Range_Heater D.W._ APPLICANT' 4 a Oven Dryer A W.M. ADDRESS �� U2 Date Applicant Top _ FAU _W.H.._ Hood _ Fan _Other— `� CITY NOTICE TO APPLICANT: If, after making:this.Certificate of Disp. _Room Air Cond._ 6 LICENSE OR Exemption, you should become subject to the Workers' REG.NUMBER Class Compensation provisions of the Labor Code,you must forth- Power Apparatus&Large Appliances DISTRICT NO. IPRCEaSSBY a with comply with such provisions or this permit shall be deemed revoked. Size&Type HP,KW,KVA,or KVAR Up to 1 Incl. FINAL -� Over 1 to 10 Incl. DATE _/z VALIDATION LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl. I hereby affirm that I am licensed under provisions of Chapter Over 50'to 100 Inc. FINAL 9 (commencing with Section'7000 of Division 3 of the Busi- BY. nd ( B ) Over 100 f(iC.i ness and Professions.Code.,dnd my license is in full force and effect. Services License Number Lic.Class '0-200 Amp.Under 600 V 20.1-1000 Amp.Under 600 V Contractor Date Over 1000 Amp.or Over 600 V HOME OWNER-BUILDER DECLARATION Temp.Power Pole&Appurtenances I hereby affirm that I am. exempt from the Contractor's Sign with One Branch Circuit License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits neis;soapd Professions Code): f 3 0 9.8 A Misc.Conduits&Conductors , as owner of the property, will do the work and the Other(See Complete Fee Schedule)— strgcture is not intended or offered for said (Section # o 0,0 0 o 2 7044,Business and Professions Code). CONSTRUCTION'LENDING AGENCY 2 -'o 2 4, 1 0 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is, PERMIT FEE (Sub-Total) o o b 2(I, 1 0 c issued(Sec.3097,Civ.C.). Lender's Name PLAN CHECKING.FEE (One-Fourth Permit Fee) 0 t3,0 1 —82 v Lender's Address PERMIT ISSUING FEE 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' ordinances and State laws. regulating Electrical wiring, And hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. � SEE'REVERSE FOR EXPLANATORY LANGUAGE 2 t- 82, Signature of Permittee Date L'OUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0709240008 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: I FEES PAID I BUILDING ADDRESS: I ITR: 13935 IT: 32 I I 5626 PERSIMMON AV I I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:] TEMP CA 917802808 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: LIVE OAK 18573-010-008 IA1 PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE: 597 GRID: C3 LOCALITY: TEMPLE CITY, Cl I ILB 200 AMP PANELS, MCC 1.00 PAN 38.85 1 TENANT: TOTAL FEES 66.60 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: I I 109/24/07 SR 03/22/08 ]OWNER: TSL. N0: I ]FINAL DAT FI CODE: IDONOVAN DONALD D;NORMA I TRS (626) 447-0593- I 1 / 15626 PERSIMMON AV I I ITEMP 917802808 I ID SCR PTION OF WORK I I I (UPGRADE SERVICE PANEL TO 200 AMP APPLICANT: TEL. NO: SAME AS OWNER _ I I 1 1 (SPECIAL CONDITIONS: 1 I I ICONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE I ]SAME AS OWNER - I I I LIC. NO I ITEMPORARY POWER POLE I I I I ] (UNDERGROUND CONDUIT I 1 I I I I ARCHITECT OR ENGINEER: TEL. NO: - I iUFER GROUND LIC. NO: i IROUGH CONDUIT I I IROUGH WIRING I 1 I ] IMAIN WATER LINE IPLASTIC YIN METAL YIN I I1 1 UTILITY COMPANY NOTIFIED I I I I I I IREPORT ID: DPR265 ROUTE TO: BS0508 I ] I 1 I I I I I I COUNTY (Sly' LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORXS 9701 LAS TUNAS EL 0508 0710030003 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: I FEES PAID I BUILDING ADDRESS: I ITR: 13935 IT: 32 I I 5626 PERSIMMON AV I I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:( TEMP CA 917802808 I (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: LIVE OAK 18573-010-008 IA1 PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE: 597 GRID: C3 LOCALITY: TEMPLE CITY, C I IG1 OUTLETS-LGT,SW,RECP 12.00 OUT 23.40 I I ITENANT: IG2 LIGHTING FIXTURES 6.00 LGT 11.70 (ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 1 I IH9 RES APPL IT 3HP 1.00 RES 10.95 10/03/07 SR 03/31/08 I I TOTAL FEES 73.80 1 I 1OWNER: TEL. NO: 1 FINAL DAT FI Y. CODE: 1DONOVAN DONALD D;NORMA I TRS (626) 447-0593- I 1 5626 PERSIMMON AV I I v 1 ITEMP 917802808 1 1DPTION OF WORK 1 I I IRE-WIRE SHED 12 OUTLETS, 6 LIGHT FIXTURES 1 I I I 1APPLICANT: TEL. NO: I I I ISAME AS OWNER 1 1SPECIAL CONDITIONS: I I I ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE I SAME AS OWNER LIC. NO I TEMPORARY POWER POLE I I I I I (UNDERGROUND CONDUIT I I I 1ARCHITECT OR ENGINEER: TEL. NO: I IUFER GROUND I I I I LIC. NO: I IROUGH CONDUIT I I I 1 I (ROUGH WIRING I I 1 I MAIN WATER LINE I I IPLASTIC YIN METAL YIN I I I (UTILITY COMPANY NOTIFIED( I I I I I I I I I I 1 I 1 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 1 I 1 I I I I IREPORT ID: DPR265 ROUTE TO: BS0508 1 1 I I I I I 1 I I