HomeMy Public PortalAbout5761 PRIMROSE AVE_Electrical__ CITY OF TEMPLE CITY
76A665-.CE806 4-68 APPLICATION FOR ELECTRICAL PERMIT 4#-r A
COUNTY OF LOS ANGELES __
DiPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS 5761 No Primrose Ave,
JOHN A. LAMBIE. COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY Temple Cit
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NO. EACH FEE Dr. Richard Ross
$ $ OWNER
RECEPT._ MAIL
LIGHT 1 TO�AL FIRST 20 2 .20 40 ADDRESS as job np
SWITCH 1' OVER 20 .10 CITY TEL. N0.287-8532
PLAN CHECK
LIGHTING �.TOTAL FIRST 20 1 .20 20 APPLICANT
FIXTURES 1 OVER 20. .10 1ADDRESS
RANGE_DRYER—WTR.HTR.— CITY TEL. NO.
STA.COOK_DISP._F..A.U._ CONTRACTOR Cobine Electric Co.
SPACE HTR. AIR COND. ADDRESS 1607 Chestnut St.
CLOTHES WASH._DISHWASH._ CITY Alhambra /� TEL. NO. 282-0315
FAN—OTHER 1.00 LICENSE. IJO. 229847 CLASS. C-10
MOTORS,TRANSFORMERS 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 15 CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
1s 0 - 1 1 1.00 1 oo ELECTRICAL WIRING.
I HEREBY CERTIFY THAT I -AM PROPERLY REGISTERED AND/OR
1--1A2 1 - 10 1 3.00 OO LICENSED AS REOUIRED BY. LOS. ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
10 - 50 5.00 RESIDE IN, THE ABOVE DESCRI .ED RESIDENTIAL PROPERTY. C)
r - V
50 - 100 10.00 SIGNATURE O
OF PERMITTEE
100.- 500 15.00 U
DISTRICT GROU VNE P D
TUBE, OR SIGN AND ONE CIRCUIT 3.00 H
Z
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 CONDUI Iew
PERMIT FEE (SUB TOTAL) 4 60 WIRING
FIXTURES
PLAN CHECK FEE (50°k PERMIT FEE) POWER AUTHORIZED
PERMIT ISSUING FEE 2.00l 2 OO UTILITY CO.NOTIFIED1
SUPPLEMENTARY PERMIT ISSUING FEE 1.00FINAL
TOTAL FEE 6 60 -J&S9P4 C. ROOHAN
SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION _ CK. M.0. CASH PERMIT VALIDATION 'K. M.D. CASH
t AN 9 4 7 .Irx2 APR 1 2 D 6.60- 1
8E BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
�� U. X-"
78A889 CE808 1;/70 APPLICATION FOR ELECTRIC PERNII
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS ij
JOHN A. LAMBIE. COUNTY ENGINEER LOCALITY toQ
COLEMAN W. JENKINS. SUPERINTENDENT OF BUILDING
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
OUTLETS N0. EACH FEE r -
OWNER
RECEPT._ $ $ MAIL
LIGHT TOTAL
FIRST 20 .20 ADDRESS
OVER 20 CITYAj?k TEL. N0.
SWITCH CP— .10 PLAN CHE K
LIGHTING `T T AL FIRST 20 20 APPLICANT OVER 20 ADDRESS
FIXTURES .f0
APPLIANCES CITY TEL. NO.
PERMIT
RANGE DRYER_WTR. HTR. APPLICANT
STA. COOK DISP. F.A.U. ADDRESS
SPACE HTR. AIR COND. CITY TEL. N0.
CLOTHES WASH. DISHWASH. LICENSE 0. CLASS.
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. ELECTRICAL WIRING.
SIZE & TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 - 1 1.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT1 A THE GAL NTEND TO
I - 10 9.00 RESIDE IN, THE A IB ENTIA ROPERTY.
SIGNATURE
10 - 50 &DO1 OF PERMITTEE V
50 - 100 IOAO C{
DISTRICT NO CLA9 GRO ZONE P 0 S BY
100 - 500 18.00 loACt
SIGN, GASSIGN AND ONE CIRCUIT 8.00 NOTES: N
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00 z
SERVICENOTOVER 600 VOLTS OR 200AMP 2.00 a
APPROVALS DATE INSPECTOR'S SIGNATURE
SERVICEOVER600 VOLTS OR 200AMP 8.00
TEMP.POWER POLE
TEMP SERVICE,POLE,&APPURTENANCES 8.00
UNDERSLAB WORK
TEMP LIGHT OR RECEPT. SYSTEM 8.00
ROUGH'CONDI UT
WIRING
FIXTURES
PERMIT FEE (SUB TOTAL) / ��
POWER AUTHORIZED
PLAN CHECK FEE (50% PERMIT FEE)
UTILITY CO. NOTIFIED
PERMIT ISSUING FEE 2.00
FINAL
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 JOSEPH C. ROOHAN
TOTAL FEE r SUPERVISING ELECTRICAL ENGINEER.
PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION CK. M.0. CASH
L nr oL� APR20 2 D 4.8 0- 4
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
° COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1206270019
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
[LEGAL ID: I FEES PAID I BUILDING ADDRESS: I
[TR: 6561 LT: 662 UN: .003 I 5761 PRIMROSE AV I
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:[ TEMP CA 917802508 [
[ASSESSOR INFORMATION NUMBER: I [ NEAREST CROSS STREET: WORKMAN [
18587-011-029 IA1 PERMIT ISSUANCE FEE 27.80 [ THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, Cl
1 IG1 OUTLETS-LGT,SW,RECP 10.00 OUT 20.00 1 I
(TENANT: IG2 LIGHTING FIXTURES 2.00 LGT 4.00 (ISSUED ON: PROCESSED BY: PLAN BY:
1 IH2 RES GRBG DISP LT 3HP 1.00 DIS 11.00 06/27/12 SR
IH3 RES DISHWASHR LT 3HP 1.00 DIS 11.00 1 1
[OWNER: TEL. NO: 1H4 RES RANGE HDS LT 3HP 1.00 HOO 11.00 IFINAL DATE FI AL BY: CODE: 1
ICHI-JUNG HUANG, TZU-YEN HUANG (626) 512-8066- I TOTAL FEES 84.80 1
15761 PRIMROSE AV 1 1
(TEMP 917802508 I I�IPT OF WORK 1
I I 110 OUTLETS, 2 LIGHT FIXTURES, GARBAGE DISPOSAL, DISHWASHER 1
I I IRANGE HOOD FOR KITCHEN AND TWO BATHROOM REMODEL
(APPLICANT: TEL. NO: 1 I 1
ISAME AS OWNER
[ I ISPECIAL CONDITIONS: 1
I I
I I I
ICONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE 1
ISAME AS OWNER - I I 1
LIC. NO I ITEMPORARY POWER POLE
1 1 1
I I [UNDERGROUND CONDUIT I I I
I I I
[ARCHITECT OR ENGINEER: TEL. NO: 1 1UFER GROUND I I I
_ I I I
1 LIC. NO:- 1 IROUGH CONDUIT I I I
I L I I
(ROUGH WIRING I I I
1 1 IMAIN WATER LINE I I I
I I IPLASTIC Y/N METAL Y/N I I I
I 1 [UTILITY COMPANY NOTIFIED[ 1 I
I I I I I I
r
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
I I I I I I
I I I I
I I I I I I
I IREPORT ID: DPR265 ROUTE TO: BS0508 [ I
I I I I I