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HomeMy Public PortalAbout5500 ROSEMEAD BLVD_Electrical__ 70A663 CEEOS 11 TI APPLICATION FOR ELECTRICAL PERMIT LJ - OLJNTY OF LOS ANGELES TIEPARTMENT OF COUNTY ENGINEER BuILDINc Q BUILDING AND SAFETY DIVISION ADDRESS OD e r✓ LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST jeo*d Ula OUTLETS EA" FEE RECEPT� S S OWNER MAIL ��^^((J� LIGHTyL TOTAL FIRST 20 O 25 ADDRESS SWITCH OVER 20 10 U CITY TEL NO PUN CHECK LIGHTING i TOTAL FIRST 20 Zt FI%TURES Ip .�.rl APPLICANT /( OVER 20 V ✓ ADDRESS .'10 RESIDENTIAL APPLIANCES CITY TEL NO T RANGE_DRYER_WTR HTR_ APPLPERMIICANT � " � It STA COOK_DISP_F A U _ ADDRESS p VE/. SPACE HTP AIR GOND Cl TEL NO -tij CLOTHES WASH _DISHWASH_ LICENSE NO CLASS CILV FAN—OTHER 100 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STAT[ THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS TRANSFORMERS RATING WITH ALL COUNTY ORDINANCE! AMD !TATE LAW! REGULATING IND HEATERS ETC HP KW RVA ELECTRICAL WIRING SIZES TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 — 1 100 LICE NSEO A! REQUIR[0 BY LOS ANGELES COUNTY AND STAT[ OF 0_ CALIFORNIA OR THAT I AM THE LEGAL OW MER O�� AMO INTEND TO I — 10 3 SDo RESIDE IN THE A E DESCRIBED RLt10 11T1 PROPERTY V 10 — 50 Bpp SIGNATURE GC OF PERM I TTE O 50 — 100 1000 DISTRICT NOCLAlS ZO CESSED BY 100 - 500 t5oo �O d N SIGN GAS SIGN AND ONE CIRCUIT 5 D NOTES 6.36 Z TUBE, OR MARQUEE ADDITIONAL CIRCUITS IGO 6. ltocl ) BERVI CENOT OVER 600 VOLTS OR 200 AMP Sm APPROVAL! DATE 01![CTIRD SIGNATURE BERVICEOVER 600 VOLTS OR 200 AMP 1000 �� TEMP POWER POLE TEMP SERVICE,POLE, BAPPURTENANCES 500 UNOERSLAB WORK TEMP LIGHT OR RECEPT SYSTEM 900 ROUGH CONDIUT WIRING FIXTURES PERMIT FEE (SUB TOTAL) POWER AUTHORIZED UTILITY CO NOTIFIED PLAN CHECK FEE PERMIT ISSUING FEE 50C) FINAL It -3 -16 TOTAL FEE <771 PLAN CHECK VALIDATION c M D CASH PERMIT VALIDATION cR M 0 CASH 6'8 5A vt . a 8 1 5 53 0 •9+ SEE SAM OF APPLICATION FOR COMPLETE SCHEDULE ` r r.A..aC- C.Sa.B 12,79 APPLICATION FOW ELECTRICAL PERMIT BUILDING AND SAFETY DIVISION FOR APPLICANT TO PILL IN New Residential Bldgs & Poole EACH NO FEE ADDRESS Oo hl h4EA l 1 &2 Finady Sq Ft $ — $ LOCALITY Y 41cX2 C—L Multifamily Sq Ft — NEAREST CROSS ST Residential Swimming Pools OWNEROR FI FRMNAME �, e W h- Outlets Light Switch& Receptacle MAIL Flrft 20 ADDRESSAi r11L Additional CITY Tel No PLAN CHECK Lighting Fixtures APPLICANT First 20 ADDRESS Additional CITY Tel NoPER IT AD Fixed Appliances Not Over 1 HP APPLICANTSUPER-409. sum r; ADL/. Range_ Heater_ DW ADDRESS 00 sel.tPs s'T Oven _ Dryer _ W M Top FAU WH CITY ,U Tal No (s 17 Hood _ Fan _ _ LICENSE OR p 8 Dlap _ AC REG NUMBER / � Clan N.noY Ia .00. I HAYS ..AD THIS APPLICATION oarwra r AIT.. . 1. wNo L..S. TO C.. pyH Power Apparatus& Large Appliance; N.Y. ALL .RDiNANeo AN. •rwr. LAWS A.aulwIIH. V Size Type HP, KW, KVA or KVAR j Up to 1 Incl I e.w..Y c IPV r AMP .w LY W T...o ANo/o.Over 1 t0 10 Incl N..D AS "9001... .1 THAT L.O.L.. ....TY AND .TAT. OF CA LIP O.NIw T T 1 A. TN. ..w ..N.. oP TN. ...V Over 10 t0 60 Incl ...cwu.o [f/./y/�N/nyw_)L P(.,o�.P(.`wr Over BD LO IDD Incl PERMITU RJ/ Over IOD SI6NATUA DISTRICTED B Services 0-200 Amp Under 600 V 201 1000 Amp Under 600 V APPROVALS DATE S NATURE Over 1 ODO Amp or Over 600 V TEMP POWER POLE Temp Power Pole&Appurtenances UNDERSLAB WORK Sign with One Branch Circuit 3 ROUGH CONDUIT Additional Sign Branch Circuits (Other) WIRING FIXTURES POWER AUTHORIZED PERMIT FEE (Sub Total) UTILITYCO NOTIFIED PLAN CHECKING FEE (One Fourth Permit Fee) A4;2� 0 FINAL PERMIT ISSUING FEE NOTES TOTAL FEE LAN CHECK VALIDATION CK MO CASH PERMIT VALIDATION CK MO CASH 0 4 59SEP 2 2 2 7.0 0 A83 ]BAGEL-CKBOG 10/74 APPLICATION R ELECTRICAL PERMIT COUNTY OF LOS ANGELES �g DEPARTMENT OF COUNTY ENGINEER ADDRESS O gxv ' BUILDING AND SAFETY DIVISION LOCALITY C� NEAREST J ""4 FOR APPLICANT TO FILL IN CROSS ST d OUTLETS FEE OWNE oR G S FIRM ME RECEPT_ MAIL I LIGHT_ TOTAL FIRST 20 q ADDR SS / SWITCH OVER 20 CITY TEL NO PLAN CHICK LIGHTING TOTAL FIRST 20 Z,S APPLICANT FIXTURES OVER 20 AD. ADDRESS RESIDENTIAL APPLIANCES CITY TEL NO PERMIT �+ RANOE_DRYER_WTR HTR_ APPLICANT STA COOK_DISP _F A U ADDRESS SPACE HTR AIR CONO CITY p TEL NO REG CLOTHES WASH DISHWASH_ NUMBER (a CLASS G FAN OTHER 100 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AOR[[ TO COMPLY MOTORS TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STAT[ LAWS REGULATING IND HEATERS ETC XP KW RVA ELECTRICAL WIRING SIZES TYPE OVER TO I HERESY CERTIFY THAT 1 AM 091.95 C NTY AND S AND/OR O — I 100 LICENSED AS REQUIRED I SY LOS ANS[LES COUNTY AND STATE OF CALIFORNIACDOR T AM THE LSS AL W N[R 01 THE ABOVE 1 — lO 300 DlBCRIS[D RCS TIAL PROPERTY p U 10 — SO SOD PERMITEE SI GNATUR NO. SO — 100 1000 DISTRICT NO CE 0 BV W IDO — 600 1500 S o g SIGN GAS SIGN AND ONE CIRCUIT SOO APPROVALS OISPCCTOMB EwNATuR[ TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 TEMP POWER POLE SERVI CENOT OVER 600 VOLTS OR 200 AMP S00 UNOERSLAB WORK \ SERVICEOVER 600 VOLTS OR 200AMP IOAO ROUGH CONDUIT TEMP SERVICE,POLE 6 APPURTENANCES 500 �� WIRING TEMP LIGHT OR RECEPT SYSTEM 300 FIXTURES POWER AUTHORIZED_ UTILITY CO NOTIFIED FINAL PERMIT FEE (SUB TOTAL) NOTES _ PLAN CHECK FEE PERMIT ISSUING FEE 300 Q TOTAL FEE PLAN CHECK VALIDATION CK M 0 CASH PE MIT V(ILIDATION CK M 0 cASN 925x "1 12.00 � � SEE BACK Of APPLICATION FOR COMPLETE SCHEDULE WORKERS COMPENSATIONDECLARATION of corse awe tD,BI APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self �'�' inwre or a certificate of Workers Compensation Insurance COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec 3800 Lab C ) Policy No P28193 Compony ZENITH FOR AMIICAM TO RU IN mB MXCertifiedcopy is hereby furnished New Residential Bldgs & Pools EACH NO FEE ADDRESS 5500 NO ROSEMEAD BLVD ❑ Certified copy is filed with the county budding inspec- I &2 Family, Sq Ft f — >< LOCALITY TEMPLE CITY lion deportment Multi-family Sq Ff — NEAREST Residential Swimming Pools OW R OR ST Date—Applicant FIRM NAME TEMPLE CITY CAR WASH CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec__Light I Sw� L 5500 N O R O S E M E A D BLVD COMPENSATION INSURANCE ADDRESS (This section need not be completed R m the work Iolw6T' TotalNo d Add First10 � CITY TEMPLE CITY Tel No 287 993 the permit Is for one hundred dollars({100)or less) Additional I certify that in PLAN CHECK the performance of the work for which this Am CANT REF 8 ASSOCIATE$ permit is issued I shall not employ any person.n any manner so as to become subject to the Worker'Compensation Laws Lighting Fixtures First 20 ADDRESS 8980 GL E NOA K S BLVD Total No Additional CITYSUN VALLEY Tel No 768 607 Date Applicant Fixed NOTICE TO APPLICANT If, after king this Certificate of Appliances Not Over 1 HP Exemption you should become subject rato the Workers' Range, Healer—DW _ APPLICANT REF8ASSOCIATES{NICHOLSO } Compensation provisions of the Labor Code you must forth Oven _Dryer _W M _ ADDRESS 8980 GLENOAKS BOULEVARD with comply with such provisions or this permit shall be Top _ FAU _WH _ 768 607 deemed revoked Hood _ Fan _Other_ CITY SUN VALLEY Tel No LICENSED CONTRACTORS DECLARATIONLICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Dnp _ Room Au Cond REG NUMBER 327427 Class el (commencing with Section 7000) of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO P BY and Professions Code and my license n in full force and effect © O Size&Type HP KW KVA or KVAR r", 327427 Number-327427 Lie Class B1 Up tot Ind FINAL V G NICHOLSON 7/11/83 Over I to 101nd Dye Q K Contractor Date VALWATION ~O c'-fU-T RE 8 A $ Over 10 to 50 Incl FINAL /I V I ons exempt u er c Over 50 to t00 Inc BY �. / G6i // N B&P C for this reason Over 100 r� Services Swbd MCC& Ponelbcards INSTALLATION OF 6 GASOLINE 2 Date 0 200 Amp Under 600V ,DISPENSERS ON NEW ISLAND Signature 201 - 1000 Amp Under 600 V Over 1000 Amp or Over 600V USING EXISTING CIRCUIT TO ❑ Exemption far Reg Mount Elect OPERATE REMOVE DISPENSERS- SINGLE FAMILY Temp Power Pole&Appurtenances NEW CONDUIT 3/4^ RIGID - HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit NO- 12 WIRE FOR EXISiT1VNtP I hereby affirm that I am exempt from the Contractor s License Additional Sign Branch Circuits Low for the following reason (Section 7031 5 Business and CONTROL CIRCUIT - 2 Professions Code) THREE TRADES IN USE: ❑ I as owner of the property will do the work and the Miu Cordran 8 Conductors r r structure a not intended or offered for sole (Section Other(See Complete Fee Schedule)— MASONRY , PIPING1CCOCTRiCAL 7044 Business and Professions Code) illoTHREE SETS PLANS AftA�CHE� ` CONSTRUCTION LENDING AGENCY C r ) _A z 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued PERMIT FEE (Sub Total) (Sec 3097, me C ) PIAN CHECKING FEE /G Lender's Name PERMIT ISSUING FEE Lender s Address 1 certify that I have read this application and state that the TOTAL FEE ,^ above information is correct I agree to comply with all County dimnces and State laws regulating Electrical wiring and h reby authonze representatives of this County to enter upon a ve menLionno property for in i Pu set / SEE REVERSE FOR EXPLANATORY LANGUAGE TION Wm that I him a caBAcans of Consent o CE Iso ,D,a, APPLICATION FOR ELECTRICAL PERMIT 1 hereby affirm that I have a certdicare d consent ro eel insure, �llaeo or a.comficate of W rkere Cortlpensatnon Irtsun=e or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy tiere�of(Sao 3800 Lab C) ,PpIICy No 05ff-4&6 Company�'- r'✓ f" D FOR APPLICANT TO FILL IN DB (1l�Jy Certified copy is hereby furnished New ReatlentlN Bldpa 8 Poole EACH NO FEE ❑ 1 8 2-Famiy Scl FL S — S LOCALITY Certified copy a riled with the cps � budding napecbon Q Date �� ktlntu-fainly Sq Ft NEARE — ST wR APOic Residential Swlmmlrp Pools OWNER OR R FIRM NAME UN�►u CERTIFICATE OF OF EXEMPTION IVIOM WORKERS Outlets Rec—L04 —SIN — MAL COMPENSATION INSURANCE ADDRESS FD' 239 v (This section need not be completed R the work bw~by the First 20 permit is for oma hundred dollars($100)or less) Total No Additional CITY r ( Tel No I certify that m the pedormenos of the work for which the permit PLAN CHECK is issued, 1 shell not employ arty Person In any mariner so as to APPLICANT become subject to the Workefs Compensation Laws Lighting FIXWM Fret 20 ADDRESS PQ ?�C a,(C3 Date Applicant Total No Additional CITY OR-64 /VPA Tel No'71-V77Y Q �APPENOTICE TO APPLICANT If, eller meWrp this Certificate Of Fixed Appkermtea Not Over 1 HP Exemption you should beconre lsublect to the Vntrkere Cortpemauon Range— Hinter— DW _ xemptionCANT D nil 7 So n► 9 prowsioro of the Leber Code you met forthwith comply with such Wen — Dryer— W M — ADDRESS PCO adx a X03 provisions or this panel shall be deerned revoked Top — FAU — WH — UGENSED CONTRACTORS DECLARATIONRoad — Fan Olhler— CITY 623A Ll#,,DA4 Tel No 7 7/-, ?3 I hereby exam that I am ncensed under provepns of Chapter B LICENSE OR (cornmendrq with Section 7000) d DM=n 3 d wp the Buee and OsP — Roan Au Cold REO NUMBER �/� cm•.C-!o C '(S Prolerasras Code,and my Ircemee Is In full force and effect. Power Apparatus 8 Large Appliances DKITRICT NO By Number Q L`I ' � man�O C, i is Size 8 Type HP KW KVA o KVAR �l� L�.L�t/ p License .?� �Q L� '-"T Up to 1 Incl FINAL C� Over 1 to 10 Incl. Convacta�K.CO + �'ti Dare /�4'S� Over to to so Ina �� -2 2 9L vauoaTTON ❑ I em exempt under Sec Over 80 to 100 W FINAL BY W B3PC for the reason Wer 100 ani to Serwcee 8wbd,MCC d Pansitloards ► .Z.. O- 200 Amp Under 800 V SignaWre 201 - 1000 Arty Undo 800 V ❑ Exemdnon for FQ MaiOver 1000 Amp or Wer 800 V Maim Elect SINGLE FAMILY_ Temp Powar Pia b Appurtenances 2 I hereby affirm that IME Iaam exempt from the ContractorSignLicense Law SIOn coni One Branch Circuit ACCT.? Cordal following reason(section 70316 Busineea and Prdeeaens Additional Sign Branch Cuonne 3 65.60 ❑ 1 as owner of the property will do the work and the structure Awdit c Con8 Corductas 1 ITEMS e ria Intended or offered for sale (Section 7044 Business Other (Sea Complete Fee Seed") — TOTAL 65.60 and Professions Code) (1C 65.60 CONSTRUCTION LENDING AGENCY 1 hereby affirm that there s a comtrmanon lending agency for the CHANGE .00 Performance of the work for which the permit is issued(Sec 3087 PERMIT FEE (Sub-Total) CN C) Larders Name PLAN CHECKING FEE OOOD_=j 1/26/96 PERMIT ISSUING FEE p2 Q 4464 1 AM10:05 Larders Address I certify that I have read this appkcabon and state that the above TOTAL FEE Information a correct I agree to comply with alt Counfy ordinances and State lswe rspulabrig Electrical wrong and hereby authorise repress Ip+ee o County to enter upon the abowrmennasd Property 1r vs t purpoaee SEE REVERSE FOR EXPLANATORY LANGUAGE of Perrrdttee Date WORKERS COMPENSATIONDECLARATION to aa3 10y91 APPLICATION FOR ELECTRICAL PERMIT ' ' I.hneraby affirm that I leave a certHcare d consent o sell Insure CE cE eoeD or a cerbfcale Of Workers•Compenaeton Insurance or a carhhed COUNTY OF LOS ANGELES BUILDING AND SAFETY copy t Bred(Sec NO 38,000 LLa-br�C-"03r Policy MVNQ�"� W rCompany F rPiMO�y1� FOR APPI.IGNT TO FILL IN JOBRESS SS o �u\P.A ✓n Certified copy is hereby furnished New Residential Bldo 8 Pods EACH NO FEE ADDobL ❑ 1 d 2-Family So Ft $ — S LOCALITY Certified coq ls bled with the county bwldirnp sepectbn deparment Multi-family Sq Ft NEAREST A, cRoss sr C IoW A Date 1--$Ko Applicant CID MPe"rIQ— Residential Swimming Pools OWNER WNFIRS OR —rG 17 AZ G„tyre Ret_ Light _ CERTIFlCATE OF EXEMPTION FROM WORKERS Sw MAIL COMPENSATION INSURANCE ADDRESS .SD aS 4Z-AACAO &Lys (This section need not be completed H the work Involved by the Fast 20 Permit Is for we hundred dollars($100)or lees) Tom No AdditionalCfT\'T 1—e1v�e G I'r Tel No �7 I certifythat in the perfmmerce d the work for which this Dermal PLAN CHECK17 mpued I enao not employ any person m any manner so a to become subject to the Werkem Companseton Laws Lighting Fixtures Fast 20 1ADDRESS Trial No Additional CITY Tel No Date Applicant NOTICE TO APPLICANT 11, after meWrq this CeCertificateFixed Appliances Not Over 1 HP APPLICANTPERNUT C o MR"CCOL M //j- d Exemption you should become subject to ftWorkers Comoeraetlon Range_ Heater— D W _ pransons of the Labor Code you must forthmnth comply with such Oven _ Dryer — W M — ADDRESS $ 1 L4o-1LT' V k-g- O prowabns or this Dermad shall be deemed revoked Top — FAU _ WH — LICENSED CONTRACTORS DECLARATION Hood _ Fen _ Other— CITV Ax kk4A..O 11 No I hereby affirm that I am licensed urdw pa waione of Chapter p Drep — Room Air Cond UCENSE OR RS10�l Or C om/ (canrnnancwq with Section 7000)d Drvo gn 3 of the Busand il Profeaeone Code and my license a in full force and effectDISTRICT NO SSED BY Power Apparatus 8 Large Apparcea License Number 56?-10SSize 8 Type HP KW KVA or KVAR r r Lc Clave "1O - IQ/O Up to 1 Ind FINAL (� DATE 2_ z -q Contractor CoMPe-TC� Data �—B`/� over Ito 10 trnd VALIDATION ❑ Over 10 to 60 Ina FINAL I am exempt under Sec Over 6o to 100 Inc BY B6PC for this reason Over 100 N Dere Services Swbd MCC 8 Pamelboards ► 0- 200 Amp Under 800 V Signature 201 - 1000 Amp Under 600 V ❑ Examphon for Rep Mata Elect Over 1000 Amp or Wer 600 V SINGLE FAMLY Temp Power Pole 8 Appurtenances 2 HOME OWNER-BUILDER DECLARATION Sign vvdhn Ore 8rarnch Grprit 1 hereby affirm that I am exempt from the Contractor's License Law Adddiortal San ranch Cessna AaT• for the fdlowmg reason(Section 7031 6 Business,and Professions code) 3,303 91.40 ❑ 4 W owner of the property will do the work and the structure W= Cornduls d Cornclud0fe 1 Um rs not iP r ntendtledis r offered for sale (Section 7044 Business Guar(See Compere Fee Schedule) — ► TOTAL 91 40 CONSTRUCTION LENDING AGENCY CWCK 91.40 1 hereby affrm that there a e construction lending agency for the /ylA�1Fl .00performance d the work for which this perind a mumd(Sec 3087 PERMIT FEE (Sub-Total) Lenders Narre PLAN CHECKING FEE 0000-0001 1/ 8/96 Lentlera Address PERMIT ISSUING FEE a'Z y 4138 1 PM12:04 I cerbfy that I he" reed this application and state that the above TOTAL FEE �r Wormahon o correct I agree to comply with all Count' ordinances and State I& brig E I wrong and hereby authorize represerdat�a to enter upon the abovo-menuaed SEE REVERSE FOR EXPLANATORY LANGUAGE — �-46 2*udure of mea Date