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Home My Public Portal About5410 ROSEMEAD BLVD_Electrical__ 7SA663 CBS SA 3-sC APPLICATION. FOR PERMIT` DEPARTMENT'OF BUILDING AND.SAFETY , COUNTY OF LOS ANGFLES_ ELM WILLIAM:J. FOX, CHIEF ENGINEER" " TO FILL IN. O,R-AP, CANT DISTRI NO, GROUP ZONE PERMIT NO. /�_ G 3�33/ ELECTRICIAN. / . .RE EIVED BY READY FOR DATE ISSUED' ADDRESS•� - 'G Q-' •R `! IS TPP - . P-11.6 � �•FIRS/T�INBPECTIDN .� "CITY T'�GF3 , 1 .. TEL NO., (lWW.. //" COUNTY LICENSE NO. ". EXPIRES' :3D �� .. BUILDING, 'ADDRESS' ./:O // .' /0.. •.Q.�1 PERMIT FEES FEE LOCALITY NUMBER EACH' „ LIGHT OUTLETS �:• NEAREST •RECEPTACLES. - ;�. . CROSS ST. WALL_SWITCHES OWNER. TOTAL 'DUTLETS ., .56 $ -1.6 MAIL `.r ELEC.: RANGES: - 25 I`� ADDRESS' - - ELEC._HEATERS- ... 25. _ . • . CITY _ _ TEL. NO.' . _ - .. FIXTURES- : 5 J ,' �1" HEREBY ACKNOWLEDGE- THAT 1 HAVE'.READ THIS , MISCz APPLICATION AND STATE"•THAT,THE ABOVE-IS'-CORRECT NUMBER OF,LIGHT-CIRCUITS ,/ -�� ,AND 'AGREE �TO' COMPLY WITH ALL.COUNTY'ORD7NANCEB NUMBER OF RECEPTACLE CIRCUITS "- t AND, STATE'LAWS REGULATING ELECTRICALWIRING. . -MOTORS I CERTIFYTHAT .1 POSSESS THE ABOVE VALID. LOS COUNTY LICENSE,: OR I AM NuME3ER , HORSEPOWER,. ' - - ANGELES COU ' - THE LEGAL OWNER FEE . _ NEw Mvo. 'HP' OVER ^IHc. EACH OF-THE RESIDENTIAL pP,R,.O,PERTY DESCRIBED ABOVE. LEss ,G .25 SIGNATURE •d p f��lr 1 . %2. • 2. ....50 PERMITTE6.� _ .. c INSPECTION RECORD .. 5- is 755D.. 2.50 I-,?- / •.50.. ' 2130 - '.5.06 -� C�../.-.Q.+BttG 1Ce...r ..�`^G.nJ'I�'S . 2013 500 -l b.00 C J!•- - .-1::. . -� � i J /.•: '7"'a'.�fid Oi�dlw/. Q. SOD 1000 1.5.00 ' OVER'.1'000 - 20.00 ,'+,'t: -7" .L r, i •`,• - E M.O. SET/FREQ. CHANGER-HP O WELDERS:AC-KVA GENERATORS.-.-KW TRANSFORMERS•:- -kVA � •-- - r TEMP. MOTORS`(75%rOF.oRhV) - . MOVED MOTORS (75%'E]F 6RIG3,• . - r BIGNS NO.TRANS. ,, N0:' .NO. LAMPS 4. - - ,A;PPROVALS' _ .. FOR EACH PERMIT:,.. . �'�. "' '{'DATE INSPECTOR'S NAME- _ E � . CONDUIT WIRING $1:00 WIRING' LUMP-.FIXTURES $1.013 - ... "-...r•" /�/:T1... SUPPLEMENTARY ` -� .50. - FIXTURES - . .- _, .. POWER TOTAL FEE UTILITY CO.NOTIFIED •, • :: ..' - ... 'FINAL �.� :.. DBS-5A 12',54 APPLICATION F0R ;ELECTR1.C.--PE'RM1T. DIVISION OF BUILDING AND SAFETY DLpartment of County Engineer County,of Los Angeles Bu1LdING WM. J. FOX, COUNTY ENGINEER ADDRESS l"'l O CASSATT D. GRIFFIN,'SUP•T OF BUILDING' FOR APPLICANT TO FILL IN LOCALITY PERMIT FEES NEAREST CROSS ST. � FEE ]60 NUMBER EACHLIGHT OUTLETS J;. • OWNER �ii.if�_IL/f(! �L�2SJi�i 'aRECEPTACLES MAIL ADDRESS ��WALL SWITCHESTOTAL OUTLETS F�t $ 0• CITY. TEL. NO. ELEC.'RANGES 25 1 ELECTRICIAN•ELEC. HEATERS 25ADDRESSKW EACITY - , 0 TEL. NC�,IFIXTURES - f 5A LICENSENO.. NUMBER OF LIGHT CIRCUITS - D_ISTRICO: GRO UP ZONE READY FOR INS PECTJ ON NUMBER OF RECEPTACLE CIRCUITS- - - ]GROUP . Al MOTORS _ NUMBER HORSEPOWERFEE INSPECTION RECORD NEW MVD. HP OVER INC. - EACH 1/2&LESS $ ..25 1/2 .2' .50 - 2 5 1.00 .:5 15 '-. 1.50 . . - . 15 - : 50 '.2.,50 . . '50 200 5.00 - - MISC. - NO. SIGNS NO. TRANS. NO. SIGNS N0. LAMPS - •\ FOR EACH PERMIT: WIRING - $.100'. - FIXTURES� $4.00 CT - SUPPLEMENTARY 'APPROVALS . TOTAL FEE $ DATE. INSPECTOR7S SIGNATURE I HEREBY ACKNOWLEDGE THAT 1. HAVE-TEA'D THIS APPLICATION CONDUIT AND STATE THAT THE ABOVE IS CORRECT AND.AGREE TO COMPLY I ' WITH ALL COUNTY ORDINANCES AND.STATE •LAWS REGULATING - WIRING -1 S'�""• ..n..:_^---,.�- ELECTRICAL WIRING '"• - . .I .. 1HEREBY CERTIFYTHAT' I--AM PROPERLY-REGISTERED.AND/OR FIXTURES 1 •LI CENSED AS REQUIRED BY 'LOS ANGELES COUNTY. AND STATE OF POWER ' 'CALIFORNIA OR THAT I AM THE%LEGAL OWNER �OF THE.ABOVE _ DESCRIBED RESIDENTI PROPERTY: UTILITY CO. NOTIFIED ' SIGNATURE - OF PERMITTEE FINAL WILLIAM J. FOX. COUNTY ENGINEER VALIDATION" zG4n 1 �_ �Y Z l. n OCTcT-1 � : 2 2 1-5 . .� DEPUTY 76A663-(,%E1806 8-62 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES x DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY'DIVISION ADDRESS r JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. REC EPT, TOTAL NO. EACH - FEE - OU I S FIRST 20 $.p0 20 i QQ OWNER LIGHT- MAIL ADD'L n j f 'D. ADDRESS SWITCH. _ �- OVER 20 3( 0 3 J ' LIGHTING rTOTAL FYRST 20I ;Q .20 ' &� 'CITY - - . NO. , FIXTURES } �" I OV DR 20 70 0 ELECTRICIAN ` RANGES CLO.DRYERS I WTR.HTRS. 1.00 ADDRESS GARB.DISP. STA.COOK CITY I L. NO. DISHWASH. AUTO.-WASH. • ^ STATE SPACE HTRS. STA.APP.(a:H.P.MAX1' 3 .50 ,' SV LICENSE NO. ( �J MOTORS: OVER NOT OVER H.P. - DISTRICT NQ. GROUP I ESS O - 1 1.00 3 'oL I.5o INSPECTION RECORD 3 . 8 2.00 8 15 2.50 15 50 - 3.00 ITIA v'R- / L,I' F C 50 loo 5.00 6 v 4 o J , SIGNS: NO.TRANS NO.LAMPS •/ - - - - - O. SERVICE 0.60OV-NOT OVER 200A 1.00 �/' LJ W SERVICE 0.60OV-OVER 200 A. 2.00 a• N SERVICE OVER'600V 5.00 ? MISC. PERMIT ISSUING FEE 2.00 J. SUPPLEMENTA13Y PERMIT ISSUING FEE 1:00 .TOTAL FEE $ 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ-THIS'APPLICATION APPROVALS . DATE INSPECTOR'S SIGNATURE AND,STATE THAT THE ABOVE. IS CORRECT AND AGREE TO COMPLY CONDUIT i WITH ALL COUNTY ORDINANCES AND STATE LAWS.REGULATING ]�/ j� ,(q�/j, ELECTRICAL WIRING.` - 'WIRING .)/)Y�CT-IYIT I HEREBY CERTIFY THAT. 1_ AM. PROPERLY REGISTERED.AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT I AM THE LEG WNER OF TH_E ABOVE - DESCRIBED RESIDE% RPPERTY. �q POWER SIGNATURE Ct CyrC-" �!_^'��•C� - UTILITY CO.NOTIFIED' OF PERMITTEE FINAL .B �� :moi}✓ ` 7!//{!�`IY.OL`�.rt4^ LIDATION. ARTHUR.C:_VEIT " SUPERVISING ELECTRICAL ENGINEER' CK MO . CASH COUNTY OF OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer „ DIVISION OF BUILDING & SAFETY WILLIAM J. FOX, County Engineer ELECTRIC FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. l ELECTRICIAN �- M .' GREEN R ED Y READY FOR DATE ISSUED ADDRESS j gS. BOSEMEAD.. BLVD. , FIRST INSPECTION CITY ',,�CQS� '9VA TEL. NO. SyyY 3--6 COUNTY .LICENSE NO. EXPIRES .d c7. BUILDING PERMIT FEES ADDRESS FEE NUMBER EACH LOCALITY LIGHT OUTLETS' NEAREST CROSS ST. RECEPTACLES /J WALL SWITCHES — OWNER4::;- �t �// TOTAL OUTLETS 5e $ AF MAIL 1u /LQ /1✓ fe.sf yS'�( ELEC. RANGES 25 _. "- --- ELEC. HEATERS 26 CITY TEL. NO. FIXTURES 5 IV �' 1 HEREBY ACKNOWLEDGE THAT I HAVE .READ THIS MISC. - APPLICATION AND .STATE THAT THE ABOVE 13 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 1 POSSESS THE ABOVE VALID LOS NUMBER (HORSEPOWER 'FEE - ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER NEW MVD. HP OVER INC. EACH _ OF THE REBIDENTI -�P E DES¢RIBED ABOVE. I/2 a LESS $ .25 SIGNATURE F /2 2 .50 PERMITTEE ----------- 2 5 1.00 INSPECTION, RECORD 5 15 1.50 - �// 1'� av is 50 2.50 /!/i!/3-� 7, _ 50 200 S.DO 200 500 10.00 J Q SOO 1000 15.130 - Z -- _ 'OVER -1000 20:00 - L7 M.G. SET/FREQ. CHANGER-HP WELDERS:AC-KVA - GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF ORIO•) MOVED MOTORS (7S% OF ORIG.) MISC. SIGNS NO. NO.TRANS. - APPROVALS NO. NO. LAMPS - -- - DATE INSPECTOR'S NAME FOR EACH PERMIT: - WIRING l81.00 ®C9 CONDUIT. FIXTURES $1.00 WIRING SUPPLEMENTARY .50 FIXTURES POWER / TOTAL FEE ! UTILITY CO.NOTIFIED A �Jp'•� FINAL 76A663 DBS#5A 4-52 �� WORKERS COMPENSATION DECLARATION,', 200019DPW(12.`91) 76A663 APPLICATION FOR ELECTRICAL PERMIT . 1 hereby affirm that I'have a certificgte of consent to self insure, fora certificate-of WorkeCs''Compensation Insurance o'r a-certified COUNTY OF LOS:ANGELES -DEPT. OF PUBLIC-WORKS BUILDING AND SAFETY DIV. 4 'copy the reof,(Sec.�3800 Lab C':), i _ , ,00� /per. Polis Company LJ�Z��/� FOR APPLICANT TO.FILL IN JOB- :' ADDRESS, ified copy isheretiyfu.mished New Residential Bldgs &;Pools ' 1&2 Family,.So.Ft. Certified co is filed with the count .buildln I,ns ectiom , LOCALITY N .,PY .., .,,Y 9, P , ., NEAREST r O `•EACH .- 'FEE' department' wrJ Mulp family Sc:,Ft. ,CROSS ST. k.n ( Residential8wim'ming Pools A§SeSSOR . PP4J✓ y p - Date' '/D/7.�Cv.L- .Applicant � � - 7 . ,.,. - ..•:. - - .:,. - - MAP BOOK . .. CERTIFICATE OF EXEMPTION FROM WORKERS "' OWNER dF, -Outlets:Rec:—'Lig ht Sw. COMPENSATION INSURANCE' > T' T / FIRM:NAME,. s.�. First 20' ,P AGE PARCEL: (This sectlon,ri not be.z6ompleted if the work Involved:by the,. go�aESs perms Is forone hundred dollars($100)or less.) / ` Total No Z Additional I, CITY certlfy that;inthe performance of;the work for whlch:tFis permit is'issued, I shall not employ-any person—in ary manner'so as-to 'PLAN CHECK'. become subject to 1F e Workers',Compensatlon,Laws Lighting Flxturea FifSY20 APPLICANT - 9 Total No'- _. Additional Date APPlicant0{-�_JJ�J RESIDENTIAL-APPLIANCES NOT OVERS HP: ADDR -NOTICE TO,APPL•ICANT:,If; after"'making,;t Fi i's,'Ceftifiicate of CITY E TeL No." SS j orkers::Compensation, 'OTHER APPLIANCES NOT.OVER 3 HP:' Exemption you should become sub ect`.to-the W provisions Wthe=Labor Code, you must forthwith comply witt;such I APE RM f C V provisions or;thss permit shall be deemed""revoked. . Power Apparatus&Large"Appliances �, •: Size&Type HP KW,KVA,ot.KVAR . LICENSED CONTRACTORS DECLARATION YP -, ADDRESS'% Thereby:affirm ihat'I am licensed under provislons?of Chapter'9 Iry (commencing with-Section 7000) of,-Division3;of°dhe.Business and. (, Over 10 to 50nn1 hd'my license is in full force and effect:"- } cl. Over 3'to 10 Professioris Code a N } CITY. • Tel:,No - � LICENSESE OR ` - 6ver,50 to,100 incl.:- - - REG.NUMBER �� -�j Class.Cc'JC' Over-'.100• • IS - - PESSED BY _ License Number' • ilc.Class Y 0 Services,Swbd:`MCC&•Panelboards �� . �D TRICT NO e .. FINAL - O 0'-399 Am Und r 600 V Contractor 'Date DATE U P _. - - 400-•.1000 Amp.Under 600 V I am exempt under Sec: VALIDATION LV Over 1000_Amp,,or Over 600 V .. , FINAL -..-, �... B.&P,C for this reason fA Date ACor 20A,i20 FEES ting or Receipt.BRA 15 _ . BY 1 To.10.Branch Circuits" Signature_. ;. „v: 11 T 0 40 Branch Cucuits r r anch Circuits 4100"Mo e Br t �': Exemption for.Reg•Maint.Elect. 15A;20A,208V To 277V Lighting Br:Circuits,` SINGLE FAMILY Temp._Power Pole&`Appurtenances HOMEOWNER-BUILDER DECLARATION ' I hereby affirm°_that f am exempt from the Contractor s License Law Sign with One erancli:Circud r ¢ _ for the'following reason (Section 7031.5;,Buslness,and-Professions `Additional Sign;Branch Circuits ? »" Code):, :. ' Miss:Conduits.&-Conductors _ s I, as owner of'the property,;will do the work and the structure: xryf ��— 4 i_ is not Intended or offered for sale (Section 7044, Business Otherr(See Complete Fee Schedule) + _ -_ and Professions Code)::: y.a CONSTRUCTION LENDING AGENCY,?. -_- I.hereby affirm that there Is a"construction.:Iending�agency for,the performance of'the.work for which this permit Is-issued (Sec 3097, PERMIT FEE (SuJo PLAN CHECKING FEE t 'Lender'shame - a. PERMIT ISSUING FEE' a r • - TOTAL FEE I certify-that)have read this application and under.penalty�of'purjury state that the above information is correct.•I agree to comply wlth,:all County , ordinances"and State laws,regulating Electrical wiring;and hereby authorize. 'representatives of-this County to enter uponahe above =mentioned'projierty P • for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE' SIGNATURE UP OERMITTEDATEr'