HomeMy Public PortalAbout5931 RENO AVE_Electrical__ 76AG63-CE80611/70, APPLICATION FOR ELECTRICAL PERMIT `
:. . ' COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER FNEAREST
G
BUILDING AND SAFETY DIVISION S ,•
14
COLEMAN W. JENKINS SUPERINTENDENT OF BUILDING TY
FOR APPLICANT TO FILL IN ST.
OUTLETS NO. EACH FEE -
OWNER
$ 5
RECEPT. MAIL
LIGHT TOTAL
FIRST 20 25 ADDRESS
OVER 20 CITY TEL. NO.
SWITCH . .10 PLAN CHECK
LIGHTING TOTAL FIRST 20 .25 APPLICANT
FIXTURES
OVER 20 .10. ADDRESS
Z.
APPLIANCES CITY TEL. NO.
PERMIT
RANGEDRYER_WTR. HTR. APPLICANT
STA. COOK DISP. F.A.U. ADDRESS
SPACE HTR. AIR COND. CITY NO.�
CLOTHES WASH. DISHWASH. LICENSE N0. 2 CLASS
FAN OTHER 1.00 1HEREBY 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 1 AM PROPERLY REGISTERED AND/OR
0 - 1 1.00LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO >-
1 - 10 300 RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. CL
SIGNATURE J U
10 - 50 5.00 OF PERMITTEE OC
50 - 100 10.00 0
DISTRICTNO. KLASS ZONEPR SS Y
100 — S00 15.00 c- r r ( Wa
SIGN, GAS=SG ONE CIRCUIT 5.00 NOTES: cn
TUBE, OR 1 �Z
MARQUEE ADDITIONAL CIRCUITS 1.00 0 f
SERVI CENOTOVER 600 VOLTS OR 200 AMP 3.00
APPROVALS DATE INSPECTOR'S SIGNATURE
SERVICEOVER 600 VOLTS OR 200AMP 10.00
TEMP.POWER POLE
TEMP SERVICE,POLE,&APPURTENANCES 5.00
TEMP LIGHT OR RECEPT. SYSTEM 3.00 UNDERSLAB WORK
ROUGH CONDI:
me V
WIRING
FIXTURO
PERMIT FEE (SUB TOTAL) POWER AUTHORIZED
UTILITY CO. NOTIFIED
PLAN CHECK FEE - �
PERMIT ISSUING FEE 3.00 FINAL Xlzatt
JOSEPH
IV7/7L-PH C. ROOHAN
TOTAL FEE SUPERVISING EL I AL NINEER
PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION CK. CASH
,QQSE ' 2 6 . 2 D 8,00-
SEE
E BACK OF APPLICATION FOR COMPLETE SCHEDULE
'16A063--CE60$ 11/70 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER TADDRE
G ij�
BUILDING AND SAFETY DIVISION S JTY�COLEMAN W. JENKINS. SUPERINTENDENT OF BUILDING
TFOR APPLICANT TO FILL IN ST.
OUTLETS NO. EACH FEE
OWNER
RECEPT.� $ $ MAIL
LIGHT TOTAL
FIRST 20 25ADDRESS
OVER 20
SWITCH_j__l 10 CITY TEL. NO.PLAN CHECK
LIGHTINGTOTAL FIRST 20 .144 .29 APPLICANT
FIXTURES
OVER 20 .10' ADDRESS
APPLIANCES CITY TEL. NO.
PERMIT .
RANGE DRYER_WTR. HTR. APPLICANT z4
STA. COOK DISP. F.A.U. ADDRESS �j�
SPACE HTR. AIR COND. CITY,00 411 TEL. N0.
CLOTHES WASH.* DISHWASH. LICENSE NO._?_ 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 THAT I AM THE LEGAL OWNER OF, AND INTEND TO }
- 1O 3,00 RESIDE IN, THE ABOVE DESCRIBED 'RESIDENTIAL PROPERTY. 0
SIGNATURE U
10 - 50 5.00 OF PERMITTEE a,
50 - 100 10.00 DISTRICTNO. CLASS ZON PR SED B Q
100 - 500 15.00 Q
SIGN, GAS SIGN AND ONE CIRCUIT 5.00 NOTES: N
TUBE, OR ?
MARQUEE ADDITIONAL CIRCUITS 1.00
SERVI CENOTOVER 600 VOLTS OR 200 AMP 3.00
SERVI CEOVER 600 VOLTS OR 200 AMP 10.00 APPROVALS DATE INSPECTOR'S$IGKATURE
TEMP.POWER POLE
TEMP SERVICE,POLE,&APPURTENANCES 5.00
UNDERSLAB WORK
TEMP LIGHT OR RECEPT. SYSTEM 3.00
ROUGH CONDIUT
WIRING
FIXTUR"
PERMIT FEE (SUB TOTAL) POWER AUTHORIZED
UTILITY CO. NOTIFIEDPLAN CHECK FEE y
FINAL
PERMIT ISSUING FEE 3.00 Age-
JOSEPHIC. OQHAN .
TOTAL FEE ' SUPERVISING EC CAL ENGINEER.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDAT 0 K. M..O. CASH
LACo4 FEB 22 2 0 5N
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
SASGB-C•ESOS 3-52 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS C�
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN 'CROSS ST. [51/yGi�
RECEPT. TOTAL NO. EACH FEE f�
OUTLETS FIRST 20 111.210111 OWNER
LIGHT MAIL r
SWITCH. OVER'20 .10 ADDRESS ✓t,!
LIGHTING TOTAL FIRST'20 .20 CITY TEL.N �r,Cd
FIXTURES } ADD'L 10 ELECTRICIAN
OV R 20
RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS
GARB.DISP. STA.COOK
CITY TEL.NO.
DISHWASH. AUTO.-WASH. STATE ,
SPACE HTRS. BTA.APP.(Va H.P.MAX.) .50 LICENSE NO.,
MOTORS, OVER NOT OVER H.P. DISTRICT NO. I GR UPO E P SEED BY
O 1 1.00
I a 1.50 INSPECTION RECORD
s e 2.00
8 to 2.50 k.
isso 3.00 'u
50 too S.00 O
NO.TRANB• F
SIGNS, NO.LAMPS Lu
G.
SERVICE O-SOOV-NoT OVER 200A 1.00 H
Z
SERVICE O-SOOV-OYER 200 A. 12.00
SERVICE OVER SOOV 5.00
MISC.
PERMIT ISSUING FEE 12.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INBPECrOR'B SIGNATURE
AND.STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL •COUNTY, ORDINANCES'AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR v
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES M
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. POWER
SIGNATURE UTILITY CO.NOTIFIED
OF PERM ITTE FINAL
TI ARTHUR C. VEIT
CK MO CASH SUPERVISING ELECTRICAL ENGINEER .
Lj06 1 7 2%—D OCT29 2 A 2,80-
APPLICATION FOR (ELECTRIC PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER �ADDRESS
UILDING
BUILDING AND SAFETY DIVISION JOHN A. LAMBIE. COUNTY ENGINEER
WILLIAM A.JENSEN,SuP T OF BUILDING OCALITY
FOR APPLICANT TO FILL IN NEAREST
PERNIIT FEES CROSS ST.
ITEM NUMBER I EACH FEE OWNER
:. OUTLETS: $ E MAIL
LIGHTS RECEPTr' SW. .10 30 ADDRESS
LIGHTING FIXTURES .10 CITY Y.. TEL.NoA r ���� Z.
ELEC.RANGES CLO.DRYERS ELECTRIC N
WATER HEATERS .50 ADDRESS
ELEC.SPACE HTRS. DISHWASHERS CITY TEL.NO.
GARBAGE DISPOSERS AUTO.- STATE
WASHERS STA.COOKING UNITS .25 LICENSE NO.
MOTORS: OVER INC. H.P. DISTRICT NO. I GROUP I ZONE P SS Y
0— 1/a .28 .:z
VE— z .50 INSPECTION RECORD
2— s 1.00
5— 1s 1.50
i5— s0 2.50
SO—200 5.00
SIGNS: NO.TRANS. _
NO.LAMPS
SERVICE 0-600V 1.00
SERVICE OVER 600V 5.00
MISC.
WIRING PERMIT 1.00
FIXTURE PERMIT 1.00
SUPPLEMENTARY PERMIT s0
TOTAL FEE 50
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY j
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT
ELECTRICAL WIRING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR WIRING
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. POWER
SIGNATURE UTILITY CO.NOTIFIED
OF PERMITTE •FINAL �f
�r VALIDA AR H R
CK Mo CASH SUPERVISING ELECTRICAL ENGINEER
LkCo 6.0 4 4 9 FEB 3 2 A 1.3.0 18 .
'eVrCifKERS�'COMPENSATIOI,y DECLARATION 76A663 10/81 APPLICATION. FOR ELECTRICAL PERMIT
I f�ereby affirm that I have a certificate of consent to self CE-806G
ins4,re,'or a dertificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY
or a certified copy thereof(Sec.3800, Lab. C.)
Policy No. " " Company FOR APPLICANT TO FILL IN JOB
ADDRESS ?j Ave Q.
Certified copy is hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE
Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. $ — $ LOCALITY
tion department. Multi-family Sq. Ft. — NEAREST
Residential Swi ming Pools CROSS ST. "WL"
Date Applicant OWNER OR
M �( T 1
CERTIFICATE OF EXEMPTION FROM WORKERS' FIRMIL
NAME � J tY�l
COMPENSATION INSURANCE Outlets: Rec Light Sw.�First 20 ADDRESS rQ r 4,0
This section need not be com
( pleted if the work Involved b y Total No. Additional CITY �' Tel. No.� ?� .6 ./r
the permit is for one hundred dollars(1100)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
so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS /
.,)�i_/ y ✓(r Total No.�_. Additional
isp� iinr'w 9/t. r CITY .,
LIZ
Date � Applicant- Fixed Appliances Not Over 1 HP PERMIT;
NOTICE TO APPLICANT: If, after making s Certificate of
Exemption, you should become subject to the Workers' Range_ Heater D.W. APPLICANT
Compensation provisions of the Labor Code, you must forth- Oven —Dryer —W.M. ADDRESS
with comply with such provisions or this permit shall be Top _ FAU —W.H. —
deemed revoked. CITY Tel. No.
LICENSED CONTRACTORS DECLARATION Hood _ Fan _Other—
Disp. _ Room Air Cond. LICENSE Class.
I hereby affirm that I am licensed under provisions of Chapter 9 REG.NUMBER
(commencing with Section 7000)of Division 3 of the Business DISTRICT N PRO ED B
and Professions Code,and my license is in full force and effect. Power Apparatus&Large Appliances �
lJ O
Size&Type HP, KW, KVA, or KVAR'
License Number Lic. Class Up to 1 Incl. FINAL fl:
Over 1 to 10 Incl. DATE
Contractor Date ALIDATION
I�
Over 10 to 50 Incl. FI LL
I am exempt under Sec. Over 50 to 100 Inc. B p�
BAP.C. for this reason Over 100 Z
Date: Services,Swbd„ MCC&Ponelboards 11011.0 -200 Amp. Under 600 V
Signature 201 - 1000 Amp. Under 600 V
❑ Over 1000 Amp. or Over 600 V
Exemption for Reg. Maint. Elect.
SINGLE FAMILY Temp.Power Pole&Appurtenances 636.1 A
HOME OWNER-BUILDER 0 0 0 DECLARATION Sign with One Branch.Circuit o 0
I.hereby affirm that i am exempt from the Contractor's License Additional Sign Branch Circuits,
Law for the following reason (Section 7031.5, Business and
Professions Code): o 'a 0 3 6 5
I, as owner of the property, will do the work and the Misc. Conduits&Conductors
structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)_ , 01,20
—S 7
7044, Business and Professions Code).
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending-agency for
the performance of the work for which'th,is permit is issued PERMIT FEE (Sub-Total')
(Sec. 3097, Civ. C.).
PLAN CHECKING FEE
Lender's Name
PERMIT ISSUING FEE I 4Q LS
Lender's Address
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 3 6,25
hereby authorize representatives of this County to enter upon
the above-mention rope ty or inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature .f Permittee Date
1t
COUNTY OF LOS ANGELES 1 TEMPLE CITY # 0508 LECTRICAL PERMIT
'DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS EM_0508 971125000'
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA
PHONE: (818) 285-0488 EXT:
LEGAL E JIM ING ADDRESS:-
TR: 5904 LT: 134 L5931-RERO-AV--J
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: EMP CA 917801529
ASSESSOR INFORMATION NUMB : NEAREST CROSS STREET:
5384-018-030 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY
G1 OUTLETS-LGT,SW,RECP 5.00 OUT 9.75
G2 LIGHTING FIXTURES 1.00 LGT 1.95 S D . PROCESSED : P BY: E P ES ON:
TOTAL FEES 39.45 11/25/97 UT 11/25/98
OWNER: TEL. O: FINAL DATE FINAL BY: CODE:
TRUONG,KHANH (626) 454-3138-
5931 RENO AV 1-74-10
TEMP 917801529 DESSUIPTION OF WORK
ELECTRICAL FOR LIVING ROOM EXTENO ON
APPLICANT: TEL. N0:
SAME AS OWNER -
SPECIAL CONDITIONS:
,� L E S C
CONTRACTOR: TEL. NO: �`� ® APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER - `�
LIC. NO cbTEMPORARY POWER POLE-
UNDERGROUND
OUNDE GROUND CONDUIT
ARCHITECT OR ENGINEER: TEL. 0: UFER GROUND
LIC. NO:; - '� I I � ROUGH CONDUIT
11
ROUGH I I G ���--+•-F
�pp — ---- — o MAIN WATER LINE
o� PLASTIC Y/N METAL Y/N
UTILITY COMPANY NOTIFIED
13
.7�B�``�� '-•�I� ISI �� �/ Y
I
REPORT ID: DPR265 ROUTE TO: 9S0508