HomeMy Public PortalAbout5823 PRIMROSE AVE_Electrical__ APPLICATION FOR PF MW
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES , '1 ELECTRIC
WM. J. FOX CHIEF ENGINEER
a NAME DISTRICT NO. GROUP ZOONE/ `PER/MIT NO.
�y
ADDRESS yY n
CITY�t�+l f Fr% i7•T' `�+ q /' �q a �13Y READY FOR DATE ISSUED
••81 f�S 2 TEL.NO.�ff/'c5`���iri� �///�� � _FIRST INSPECTION
W CUNTY
ERT.NO. �7 Y d � EXPIRES C�ti� ,J' G�
r
APPLICANT FILL IN IIEAVIL)I OUTLINED PORTION ONLY
DESCRIIP9�'IION OF WORD ADDRESS I rf
NUMBER OF OUTLETS ON CIRCUITS LOCALITY 'f' C9
LOCATION BY ROOMS NEAREST /
LIGHT OUTLETS ISW. PLUGS FniT CROSS ST.
CIRCUIT A B C D E F,, G H X NAME w "re,
3 w AAl1
ADDRESS F�1l9rR ..
CITY TEL.NO.
1 AM THE LEGAL POSSESSORoOFI THE ABO-V,E LOS
ANGEJ.ES COUNTY CERTIFIC�►TZ,O/I U/1LIFl ON.L
v ELECTRICIAN.
AI Am BO BTHU L OWNER OF rr
TH6 PROPFJ3DESCRIBED
OWNER.
����rg�
d)RRF YI®NS
l
J
Q
Z_
S
IY
O
TOTAL
NO. OF OUTLETS qg �jr6y :T40 APPROVALS
*10. OF FIXTURES �+ V' ®� I DATE INSPECTOR'S NAME
NO. OR MOTORS H.P. S I CONDUIT
NO. OF SIGNS TRANS. 11 ! WIRING / �/ �r _�/)•n PjJTi-�y,e
NO. OF RANGES OR HEATERS S �. ! FIXTURES
MISCELLANEOUS / $ /I yy POWER
PERMIT FEE (a 0y UTILITY CO.NOTIFIED
TOTAL FEE FINAL
FIENFLE CITY.
I6A663-CE8o6-�62• APPLICATION- FOR -ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT.OF COUNTY ENGINEER- BUILDING
BUILDING.AND SAFETY DIVISION -.ADDRES AA JfN§45. —
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A.JENSEN,SUPT of BUILDING LOCALITY • L-
NEAREST
FOR-APPLICANT TO FILL IN - •CROSS.ST.
RECEPT. TOTAL NO.- EACH I .FEE
OUTLETS- FIRST 20 'r ^ $.2o s$. OWNER'
LIGHT' MAIL
� ADD'L , ADDRESS ..
SWITCH. �L.— OVER 20 7C •. (/
LIGHTING TOTAL FIRST 20 .20 CITY TEL.NO 63/
yD
FIXTURES } ADD'L 1O, ELECTRICIAN
OVIER 20
RANGES CLO.DRYERS• WTR.HTRS. 1.00 ADDRESS' '
GARB.DISP. STA.COOK - e
. . CITY TEL.NO.
DISHWASH: ' •'AUTO.-WASH: STATE
a
SPACE HTRS. / BTA.APP.(ys H.P.MAX.) -.50
L;_lCENeX NO.
MOTORS: OVER NOT OVER H.P. DISTRICT NO. G OUP NE CESSED B•. -
O 1 1.00
1 s 1.so INSPECTION RECORD
s
s 1s 2:so
15 '50 3.00 >- .
so. 100 5-100 � O
SIGNSI NO.TRANS '
NO,,,LAMP8 _
SERVICE 0.60OV-NOT OVER 200A 1.00 Lu
SERVICE 0.600V-OVER 200 A. 2:00
• N
SERVICE'OVER 600V 5.00 ?
MISC.
PERMIT ISSUING FEE ,. 2.00
SUPPLEMENTARY PERMIT ISSUING FEE1.00
.TOTAL FEE r$
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE ,
AND STATE THAT THE ABOVE 18 CORRECT AND AGREE.TO COMPLY CONDUIT P' ted.. !•
WITH ALL-COUNTY,ORDINANCES AND STATE ,LAWS REGULATING e +►ry
ELECTRICAL WIRING. • WIRING
I HEREBY CERTIFY THAT I AM PROPERLY'REGISTERED AND/OR ,r. /ir?, �,...-+�!l• +� y�
` LICENSED AS REQUIRED BY LOS ANGELES.COUNTY AND STATE OF .FIXTURES / d't SW= =.Z�A✓x ::rr���'/ _
CALIFORNIA OR THAT '1 A E LEGAL OWNER OF THE ABOVE
:DESCRIBED RESIDENTIAL E l 'POWER
SIGNATURE -7-UTILITY CO.NOTIFIED '�
OF PERM]. TE c _ 2/�,_h {
FINAL !G—/ 57-
VALIDATIO. ARTN•UR C:VEIT" '
CK MO CASH= SUPERVISING ELECTRICAL ENGINEER
5 2 8 0 -OCT 2 7 2 D 4.0 O N
D.B.B.SA 25M BETS 113-47 UTIO\ FOR P1C+iIIlYiSB.
COUNTY OF-LOS ANGELES
sAw ELECTRIC
WW1. J. FOX CHIEF EN INEER it
z DISY CT,1110. GROUP ZONE; �ERNII
a NAME }
U �
ADDRESS
CITY TEL NO. g b g RECEIVED 6Y FIRST NSPECTION DATEfISSUED
d -COUNTY
CERT.NO. EXPIRES
APPUCANT M.L IN HEADY OgJTLI1�1ED�PORTION OINI
IDESC IMON OF WORK ADDRESS
NUMBER OF OUTLETS ON CIRCUITS LOCALITY
LOCATION BY ROOMS
NEAREST
LIGHT OUTLETS SW. PLUGS FII'T CROSS ST.
CIRCUrr A 13 1 C 1 D' E Fjr- 1FI 99 NAME
Z MAIL
' ADDRESS '
` CITY TEL.NO.
0 1' AM THE LEGAL POG ESSOR OF THE ABOVE LOS
ANGELES COUNTY CER' �Y. U�ALIFI TION..
ELECTRICIAN.
8 AM I_rp_3 L M Ai.AWNMt OF THIS PROPZRTY Dry,.CRIBED
ARCMs
owNeo_
ciolmci o-ffls
I
' S
r
R '
O
[FERMIT
.
F OUTLETS $ Z�� APPRO"ALS
F FIXTURES ® $ ® DATE INSPECTOR'S NAME
F MOTORS H.P. $ CONDUIT d �p
F SIGNS TRANS. $ WIRING _ �f' Io ,o5, 4 a
F RANGES OR HEATERS $ FIXTURES
LPOWERFEE $ . UTILITYCO.NOT:FIED
FEE S FI A x- `j r� v a" Yf 5
P
WORKER'S COMPENSATION DECLARATION !7SA019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT
76A863
I hereby affirm that I have a certificate.of consent to self Insure, I APPLICATION ELECTRICAL
or a certificate of Worker's Compensation Insurance,or a certified + COUNTY OF LOS AI' ELES~. DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV.
copy thereof(Sec.3800 Lab.C.) 1
Policy No. Company FOR APPLICANT TO FILL IN JOBn, �y '
ADDRESS � �./ V
❑ Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE
LOCALITY
=
El Certified
Certified copy is filed with the county building inspection 1 &2-Family,Sq. . S S
department. Multi-family Sq.Ft. CROSS ST. L,A-,5 7211VAS
Date Applicant. Residential Swimming Pools. ASSESSOR
MAP BOOK PAGE PARCEL
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec.—Light Sw. OWN NAMFIRME
COMPENSATION INSURANCE
e . completed If the-work Involved First 20
MAIL
(This section need notbe com b p y the Total No. Additional ADDRESS (J/L4
permit Is for one hundred dollars($100)or less.)
I certify that in the performance of the work for which this permit CITY PL, G e Tel.No0g�37
is issued, I shall not employ any person in any manner so as to PLAN CHECK
become subject to the Workers'Compsation Laws Lighting Fixtures First 20 APPLICANT'
Total No. Additional
ADDRESS
Date —� Applicant 0 .
RESIDENTIAL APPLIANCES NOT OVER 3 FIRNOTICE TO APPLICANT: If, aft making this Certificate of CITY Tel.No.
Exemption,you should become subjdbt to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP.
provisions of the Labor Code, you must forthwith comply with such PERMIT
p y p y Power Apparatus&Large Appliances APPLICANT l
provisions or this permit shall be deemed revoked.
LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS Q�
1 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 yi L. Cl Tel.No.,91V1
Professions Code,and my license•is in full force and effect. Over 10 to 50 Incl.
Over 50 to 100 Incl.. LICENSE OR / ry./ Class.G%./O a
REG.NUMBER
L /�a. Over 100
v 9 Ll..Class DISTRICT NO. P ESSED BY U
License Number
yf Se swbd�.,.MCC PannaWaards d• l/O
FINAL
Contractor IgA2 DLNAL Al�'Cv Date' +� � ,b�"�a Am l M 600 V D❑ DATE O 400-1000 Amp.Under 600 V
I am exempt under Sec. VALIDATION V
Over 1000 Amp.or Over 600 V FINAL
IAL
B.&P.C.for this reason. BRANCH CIRCUIT FEES BY
Cl)
Date: 15A,or 20A,12OV,Lighting or Recept. Z_
1 To 10 Branch Circuits
Signature 111 To 40 Branch Circuits
41 Or More Branch Circuits
❑ Exemption for Reg.Maint.Elect. 15A,20A,20BV To 277V Lighting Br.Circuits
SINGLE FAMILY Temp.Power Pole&Appurtenances
HOME OWNER-BUILDER DECLARATIONAOGTan
I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit Ir
for the following reasoh(Section 7031.5, Business and Professions Additional Sign Branch Circuits 3303
Code): . 65.60
❑ I,as.owner of the property,will do the work and the structure Misc.Conduits&Conductors 1 ITEMS
is not intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule) ; t TOTAL 65 o 60
and Professions Code). CHECK 65.60
CONSTRUCTION'LENDING AGENCY CHANGE1 hereby,affirm that there is a construction lending agency for the 000
performance of the work for which this permit is issued(Sec. 3097, PERMIT FEE (Sub-Total) Q,
Civ.C.) PLAN CHECKING FEE 0000-0001 3/14/96
Lender's Name PERMIT ISSUING FEE a 5308 1 AM 9:27
Lender's Address /��
I certify.that I have read this application and under penalty of purjury state TOTAL FEE !�I
that the above information is correct. I agree to comply with all County
i
ordinances and State laws rdguiating Electrical wiring,and hereby authorize I 1
representatives of this County to enter upon the above-mentioned property
for ins ion purpose SEE REVERSE FOR EXPLANATORY LANGUAGE
SIGU E OFPFME DATE, I �.�
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 4 9071 LAS TUNAS EL 0508 9609240001
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA
PHONE: (818) 285-0488 EXT:
-LEGAL ID: FEES PAID BUILDING ADDRESS:
TR: 6561 LT: 667 5823 PRIMROSE AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802111
ASSESSOR INFORMATION 8 R: NEAREST CROSS STREET: WORKMAN
8587-012-006 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY
G1 OUTLETS-LGT,SW,RECP 2.00 OUT 3.90
NA ff T T. HA FAU LESS 3HP 1.00 FAU 10.80 ISSUED ON: -PROCESSED BY: PAN BY: EXPIRE ON:
JY MOTORS, 5HP 1.00 MOT 19.65 09/24/96 TC 09/24/97
TOTAL FEES 62.10
OWNER: TEL. NO: FINAL DATE FINAL BY:qk & COD
CARTER SAM D (818) 286-3465-
5823 PRIMROSE AV -Zi_
TEMP 917802111 DESCRIPTIO WORK
REPLACE HEATING SYSTEM AND ADDING A
APPLICANT:
AAA GRANGER'S A/C CO. (818) 579-3680-
16336 ARROW HWY. ® L E� � SPECIAL CONDITIONS:
IRWINDALE, CA [L��
CONTRACTOR: TEL. NO: ®� APPROVALS DATE INSPECTOR SIGNATURE
AAA GRANGER'S A/C CO (818) 962-6855-
16336 ARROW HIGHWAY LIC. NO TEMPORARY POWER POLE
IRWINDALE, CA 91706 273596
UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER: TEL. 0: UFER GROUND
LIC. N0: ROUGH CONDUIT
ROUffirVIRING
r-u Bo L�C 0'Fl K'S MAIN WATER LIME
PLASTIC Y/N METAL Y/N
0 � •.ti TILIT COMPANY NOTIFIED
i-vi
REPORT ID: DPR265 ROUTE TO: SS0508