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Home My Public Portal About5630 ROSEMEAD BLVD_Electrical__ . COUNTY OF LOS ANGELES APPLICATION FOR PERMIT DEPARTMENT OF COUNTY ENGINEER DIVISION OF BUILDING & SAFETY ELECTRIC 1 WILLIAM 1. FOS. COUNTY ENGINIM FOR APPLICANT TO FILL IN DISTRICT NO. GROUPZONE PERMIT NO. ELECTRICIAN e��G•, C s' L I c-� c->3vcyrl- ADDRESS 0 CQ 44V � RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION CITY a TEL. NO. d A,s e COUNTY LICENSE NO. EXPIRES BUILDING / S/n //l �p PERMIT FEES ADDRESS 4� .7'Y /N NUMBER EACH FEE LOCALITY -P 9 LIGHT OUTLETS NEAREST �+ P RECEPTACLES CROSS ST. �D WALL SWITCHES OWNER TOTAL OUTLETS SC S MAIL ELeC.-'RANGES 25 ADDRESS ELEC. HEATERS 28 FIXTURES 5 FIXTURES Q� CITY TEL:-NO. I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS NUMBER OF LIGHT CIRWIT8 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER'OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS NuMSER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER New MVD. HP OVER I INC. EACH OF THE RESIDENTIAL PROPERTY CEBCRISED ABOVE: YdaLESS S .25 SIGNATURE OF e I/2 2 .50 PERMITTEE 2 5 1.00 INSPECTION RECORD s Is 1.50 1s so 2.50 So Poo 5.00 200 Boo 10.00 -7v!:, e-- xne Rs xl AO J Soo f000 15.00 ] a• OVER 1000 20.00 Z 2 M.G. SET/FREQ. CHANGER-HP t w It O WELDERS.• AC-KVA �- _J /� Q V[0/?X—w q GENERATORS-KW A AA lG/1 s TRANSFORMERS-KVA j TEMP. MOTORS (75% OF CRIG.) MOVED MOTORS (75% OF ORIG.) MISC. SIGNS NO. NO.TRANS. APPROVALS NO. NO. LAMPS FOR EACH PERMIT- WIRING INSPECTOR'S NAME WIRING $1.00 O® CONDUIT w FIXTURES $1.00 Cts WIRING / SUPPLEMENTARY .50 FIXTURES i POWER ,e TOTAL FEE $ 930 UTILITY CO. NOTIFIED of aAp ....�/ FINAL 76A 88S 088# 8A. 4-82 I D.D.S.SA 23M SETS 10.47 17�!'ff'1/�rt ION FM ]DEPARTMENT OF BUILDING AND SAFETY BLTiatauaiiVl� Y'lY �1T�18 COUNTY OF LOS ANGELES ELECTRIC WM. J. FOX CHIEF ENGINEER NAME DISTRICT NO. GROUP I Z.OIjE PERMIT NO. ADDRESS q- NUMBER CITY TEL.NO. RECEIVED BY READY FOR DATE ISSUED COUNTY wl ! FIRST INSPECTION CERT.NO. ® EXPIRESAPPLICANT FILL IIN DEAVILY OUTLINEDPORTION ONLY JOB DESCRIPTION OF WORK ADDR ��& �� -%9• �OF OUTLETS ON CIRCUITS LOCALITY LOCATION BY ROOMS NEAREST Coe LIGHT OUTLETS SW. PLUGS FOLT CROSS ST. CIRCUIT A B C D E F G IH E NAME • . , Z MAIL ADDRESS O CITY TEL.NO. 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGF_.,t.E8 COUNYY CERTIFI 6 ELECTRICIAN. I OAN Tula L-EOA1.OWNER OF TRIM FROPF,RTY DESCRIBED AB OWNER. COHI$. MONS J Q _Z L7 E D TOTAL d NO. OF OUTLETS 57 APPROVALS NO. OF FIXTURES a' DATE INSPECTOR'S NAME NO. OF MOTORS H.P. $ CONDUIT NO. OF SIGNS TRANS. WIRING NO. OF RANGES OR HEATERS $ FIXTURES MISCELLANEOUS / I.,# F POWER y PERMIT FEE $ 1 �- �I�NA CO.NOTIFIED y / TOTAL F ® -1 I APPLICATION FOR ELECTRIC PERMIT 1 DIVISION OF 13=3NG AND SM= - J D6p unt{yr ent of County R19III66! ADDRESS !O JOHN A.LAMBIE.COUNTY AngelENGINEER � CASSATT D.GRIFFIN.SUPT OF BUILDING LOCALITY FPORERMA T LI�c�ANT TO FILL IN NEAREST oss SI'. NUMBER OWNER LIGHT OUTLETS MAIL RECEPTACLES • ADDRESS WALL SWITCHES FEE CITY TEL.NO. TOTAL OUTLETS ® Ed $ ELECTRICIAN + ELEC.RANGES 1 25 ADDRESS C.HEATERS 1 25 KIN CITY TEL.NO STATE FIXTURES B LICENSE NO. MOTORS DISTRICT NO. GROUPZONE READY FOR INSPECTION NUMBER HORSEPOWER FEE l I �.I NEW MVD. HP OVER INC. EACH ��/�� Y��Q/� �T _ Y2 @ LESS $ .28 MSPFaCiTION RECORD Y2 2 .SO 2 s 1.00 s is 1.50 / 1s so 2.so ' SO zoo 8.00 p� MISC. /1 I.-- NO. -NO.SIGNS NO.TRANS. NO.SIGNS NO. LAMPS FOR EACH PERMIT' WIRING $1.00 FIXTURES $1.00 SUPPLEMENTARY .80 APPROVAL$ TOTAL FEE $ DATE INSPECTOR'S SIGNATURE I HEREBY ACKNOWLEDGE THAT I HAVE.READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING S6 C ELECTRICAL WIRING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE POWER DESCRIBED RESIDENT[AL PR �../ SIGN_ATUR6 UTILITY CO.NOTIFIED OF PERMITTEE I FINAL JOHN A.LAMBIE.COUNTY ENGINEER 7, ATION,, ARTHUR C.VEIT.CHIEF ELECT.INSPECTORASAPR24 2 5.05 N '6A663aF:-806(6ne) APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES BUILDI,tG�AND SAFETY FOR APPLICANT TO FILL INJOB New Residential Bldgs.&Pools EACH NO. FEE ADDRESS 1 &2-Family,Sq..Ft. $ .025 — $ LOCALITY L - Multi-family Sq.Ft. .02 — NEAREST CROSS ST.J— Residential Swimming Pools 25.00 OWNER OR FIRM NAME Outlets:Rec Light Sw.. MAIL First 20 •50 1. ADDRESS Total No. Additional .30 CITY Tel.No. PLAN CHECK APPLICANT Lighting Fixtures First 20 •50 ADDRESS Additional .30 Total No. CITY Tel.No. Fixed Appliances Not Over 1 HP PERMIT APPLICANT;" I� Range_Heater_D.W.— Oven—Dryer_W.M. ADDRESS 3 Z'. (j 7 Top _FAU —W.H._ CITY Tel.Nlig Hood_Fan —Other LICENSE OR g Disp._Room Air Cond. 2.50 REG.NUMBE Class/_ /Q I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA• Power Apparatus&Large Appl ionces TIONAND STATE THAT THE ABOVE IS CORRECT AND AGREE TO Size&T e HP,KW,KVA,or KVAR COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS yp REGULATING ELECTRICAL WIRING. Up to 1 Incl. 2.50 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR Over.) to 10 Incl. 5.00: LICENSED AS REQUIRED BY L SANGELES COUNT AND STATE OF Over 10 to 5.0 Incl. 12.50 CALIFORNIA OR THAT I THE LEGAL'OWN OF THE ABOVE O Over 50 to 100 Inc. 25.00 DESCRIBED RESIDENTI OPERTY. 0 Over 100 40.00 PERMITEE SIGNATUR H ,Services DISTRICT NO. PROCESSED BY Z 0-200 Amp.Under 600 V 12.50 }� 201-1000 Amp.Under 600 V 25.00 0 rZ I 0 :�cvaall, Over 1000 Amp.or Over 600 V 50. � Z C A° o 0 0 0 2 Temp.Power Pole&Appurtenances 10.00 Sign with One Branch Circuit 10.00 2 - 24,50 Additional Sign Branch Circuits 2.00 INSPECTION > INFORMATION ° - 2&5035 Misc.Conduits&Conductors 10.00 ON REVERSE = 0222-79 Other(See Complete Fee Schedule) - SIDE v 2 5' d PERMIT FEE (Sub-Total) o o r13 o o Na PLAN CHECKING FEE (One-Fourth Permit Fee) n_ o IV PERMIT ISSUING FEE $7.00 7 O j ° ( � ;O oOn �Cn �T TOTAL FEE ° O O IV � CH INSPECTION FINA�jE W date: ®s J_4`' s' ' By , o WQthat I COMPENSATION DECLARATION 2D-0019 DPW(12.81) APPLICATION FOR ELECTRICAL PERMIT LI 76A663 I hergby affirm that I have a certificate of consent to self insure, or a FertifloWe-ofWorker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Seg._3800 Lab.C.), Policy NO. �Company FOR APPLICANT TO FILL IN JOB k—oc! ADDRESSertified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE LOCALITY1 &2-Family,$q.Ft. $ $ ertified copy is filed with the county building Inspection — NEAREST department. Multi-family Sq.Ft. CROSS ST. Date Applicant. Residential Swimming Pools ASSESSOR MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec. Light Sw. OWNER OR _ COMPENSATION INSURANCE FIRM NAME (This section need not be completed If the.work Involved by the First 20 MAIL permit is for one hundred dollars($100)or less.) Total No. Additional ADDRESS certify that in the performance of the work for which this permit CITY Tel.No. is issued, I shall not employ any person in any manner so as to PLAN CHECK become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANT Total No. Additional ADDRESS Date: Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: If, after making this Certificate of CITY T4.No. Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code,you must forthwith comply with such PERMITT provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances LICENSED CONTRACTORS DECLARATION Size,&Type HP,KW,KVA,or KVAR ADDRES I 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 Tel.NoA -21A Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. REG. LICEN OR Class/' /J }a r Over 50 to 100 Incl. REG.NUMBER (�Z Over 100 DISTRICT N0. SSED BY V License Number Lie.Class � Services,Swbd.,MCC&Panelboards .J Contractorag& ate 0-399 Amp.Under 600 V DATFINAE 0 .❑ 400-1000 Amp.Under 600 V I am exempt under S (�� VALIDATION V Over 1000 Amp.or Over 600 V FINAL a B.&P.C.for this reasonBRANCH CIRCUIT FEES BY fA Date: 15A,or 20A,120V,Lighting or Recept. Z 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits 41 Or More Branch.Circuits ❑ Exemption for Reg.Maint.Elect, 15A,20A,208V To 277V Lighting Br.Circuits 2 SINGLE FAMILY Temp.Power Pole&Appurtenancesr•f" } = HOME OWNER-BUILDER DECLARATION 't �r I herebyaffirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit for the ollowing reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits ESti=SLI Code): 1 J. 0 I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors , is not intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule) TO•H'- _"`� -50 and Professions Code). 'CHECK 64.50 CONSTRUCTION LENDING AGENCY CHANGE NO I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total) Civ.C.) PLAN CHECKING FEE i IvI.Ij}_j jf'•,ii :�iyQ:1 Lender's Name / �y`•() r• �s° (moi Lender's Address PERMIT ISSUING FEE I certify at I have read this application and under penalty of purjury state TOTAL FEE that t above information is correct. I agree to comply with all County ordin es and State laws regulatin ctrical.wiring,and hereby authorize repr s n tires of this County to to Pon the above-mentioned property for• coon purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE AIGNIP01 ERM E �� DATE