HomeMy Public PortalAbout5676 ROSEMEAD BLVD_Electrical__ 7C•'.663-C(;,O81i/70 APPLICATION FOR ELECTRICAL PERMIT
:�[� COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADORE
13
COLEMAN W. JENKINS SUPERINTENDENT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
OUTLETS N0. EACH FEE /
OWNER
RECEPT._ $ $ MAIL s
LIGHT TOTAL
FIRST 20 25 ADDRESS v
CITY TEL. NO.
SWITCH- OVER 20 .10
PLAN CHECK
LIGHTINGTOTAL FIRST 20 •25 APPLICANT
FIXTURES
OVER 20 •,p ADDRESS
APPLIANCES CITY TEL. NO.
PERMIT
RANGE DRYER_WTR. HTR. APPLICANT
STA. COOK DISP. F.A.U. ADDRESS
SPACE HTR, AIR COND. CITY TEL. NO.
CLOTHES WASH. DISHWASH. LICENSE NO. CLASS.
FAN OTHER1.00 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THEABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING WITH ALL COUNTY OIRDI NANCES 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 THAT I AM THE LEGAL OWNER OF, AND INTEND TO >-
1 - 10 3.00 RESIDE IN, AS SCRIBED RESIDENTIAL PROPERTY. O
SIGNATURE U
10 - 50 5.00 OF PERMITT E
50 - 100 10.00 1 DISTRICTHO, CLASS ZONE ROLE SED BY O
100 - 500 15.00 g U
SIGN, GASSIGN AND ONE CIRCUIT 5.00 NOTES: N
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.001
SERVICENOTOVER 600 VOLTS OR 200 AMP 3.00
APPROVALS DATE INSPECTOR'S SIGNATURE
SERVICEOVER 600 VOLTS OR 200 AMP 10.00
TEMP.POWER POLE
TEMP SERVICE,POLE, IN APPURTENANCES 5.00
UNDERSLAB WORK
TEMP LIGHT OR RECEPT. SYSTEM 3.00
ROUGH CONDIUT
WIRING
FIXTURES
'POWER AUTHORIZIED
PERMIT FEE (SUB TOTAL)
UTILITY CO. NOTIFIED
PLAN CHECK FEE
FINAL
PERMIT ISSUING FEE 3.00 �� JOSEPH C. ROOHAN
TOTAL FEE 'O� SUPERVISING ELECTRICAL ENGINEER.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION Q) M.0. CASH
,00-SAr'-1 Y 3 4L-- JUL 14 2 U 8.00-
SEE
EE BACK OF APPLICATION FOR COMPLETE SCHEDULE
L •
• K •COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
• DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS EL 0508 9701130025
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA
PHONE: (818) 285-0488 EXT:
EGAL E BUILDING AD R SS:
TR: 12157 5676 ROSEMEAD BL N
-, FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 91780
ASSESSOR VWFOR14ATION NUMBER: NEAREST CROSS STREET: LAS TUNAS
Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY
G1 OUTLETS-LGT,SW,RECP 18.00 OUT 35.10
G2 LIGHTING FIXTURES 18.00 LGT 35.10 ISS 0 PROCESSED BY: PLA P .
;K1 SIGNS, OUTLINE LGT 2.00 SIG 77.70 01/13/97 TC 01/13/98
TOTAL FEES 175.65
OWNER: TEL. NO: FINAL DATE FINAL BY: CODE:
MOBILE OIL (818) 953-2608- /7
3700 W. 190TH STREET 2 L�
TORRANCE, CA 90509 DESUKIPTION DESCRIPTIONOF WORK
INSTALL 18 NEW FIXTURES AND TWO SIGN CIRCUITS FOR NEW
APP EL. CANOPIES
DONCO & SONS, INC. (714) 771-5730-
SPECIAL CON DIT ONS:
CONTRACTOR: TEL. 0: ;' APPROVALS DATE INSPECTOR SIGNATURE
DONCO & SONS, INC. (909) 771-5730- G� ,;, ,: �a
725 N. CYPRESS ST. LIC. NO [� r;.• �.ii p O ER OL
ORANGE, CA. 92686 434616C-10
SA ®hfk o 'i o,n d' UNDERGROUND CONDUIT
ARCHITECT 0 G R: 0: MR-WOUND
LIC. NO: I I ROUGH CONDUIT
SOUGH WIRING
MAIN WATER LINE
\ BLASTIC Y/N METAL Y/N
f1
UTILITY COMPANY 0 D
vio
S3�
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REPORT ID: DPR265 ROUTE TO: BS0508
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,.76A663-CES0611/70 APPLICATION FOR C�RIC L P MIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS (O
OCOLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY 'r
NEAREST /yip
FOR APPLICANT TO FILL IN CROSS ST.
OUTLETS NO. EACHI FEE
OWNER ',6FjW
RECEPT._ $ $ MAIL
ADDRESS ��/(✓l��
LIGHT TOTAL FIRST 20 ,2g
CITY TEL. NO.
SWITCH OVER 20 1p
--- PLAN CHECK
LIGHTING TOTAL FIRST 20 .25 APPLICANT
OVER 20 ADDRESS
FIXTURES .f0
APPLIANCES CITY TEL. N0,
PERMIT r
RANGE DRYER_WTR. HTR. APPLICANT G�
STA. COOK DISP. F.A.U. ADDRESS
SPACE HTR. AIR COND. C I TYe TEL. N0.
CLOTHES WASH. DISHWASH. LICENSE NO. CLAS 7:�v
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 WIT 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 1,00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORN HAT HE LEGAL OWNER OF, AND INTEND TO >-
1 - 10 3.00 RE91DE I T DESCRIBED RESIDENTIAL PROPERTY. a
10 - 50 5,00 SIGNATU O
OF PER ITTE
50 - 100 10.00 O
DIS�TRICTNO. JCLASS ZONE CESSED BY
CL
100 - 500 15.00 0,�, Q� -2 w
SIGN, GAS SIGN AND ONE CIRCUIT 5.00 NOTES: h
TUBE, OR z
MARQUEE ADDITIONAL CIRCUITS 1.00
SERVI CENOTOVER 600 VOLTS OR 200 AMP 3.00
SERVICEOVER 600 VOLTS OR 200AMP 10.00 APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP.POWER POLE
TEMP SERVICE,POLE,&APPURTENANCES 5.00
UNDERSLAB WORK
TEMP LIGHT OR RECEPT. SYSTEM 3.00Af/sc oaa eq- / j
ROUGH CONDIUT
d� WIRING
~ / t FIXTURO
POWER AUTHORIZED
PERMIT FEE (SUB TOTAL)
UTILITY CO. NOTIFIED
PLAN CHECK FEE
FINAL
PERMIT ISSUING FEE 3.00 JOSEPH C. ROOHAN .
TOTAL FEE ,��O D SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
76A663-CEB0611/70 APPLICATION FOR ELECTRICAL PERMIT IJ
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS 5676 Rosemead Blvd.
COLEMAN W. JENKINS SUPERINTENDENT OF BUILDING{ LOCALITY Temple City
NEAREST Las Tunas
FOR APPLICANT TO FILL IN CROSS ST.
OUTLETS NO. EACH FEE TEMPLE CITY CHAMBER OF COMM
OWNER
RECEPT._ $ $ MAIL
LIGHT TOTAL
FIRST 20 2g ADDRESS
CITY TEL. NO.
SWITCH OVER 20 10
PLAN CHECK
LIGHTING l FIRST 20 2S APPLICANT
)} TOTAL
OVER 20 ADDRESS
FIXTURES .10
APPLIANCES CITY n EL. NO.
PERMIT
RANGE DRYER_WTR. HTR. APPLI
STA. COOK DISP. F.A.U. ADDRESS 3 3,
SPACE HTR. AIR COND. CITY TEL. NO. .y2, 3
CLOTHES WASH. DISHWASH. LICENSE N0.7 3 & CLASS. L 6
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 1 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 a
1 - 1O 3.00 RESIDE IN, THE ABO DE R ED RE 4DENT1AL PROPERTY.
O
10 - 50 5.00 SIGNATURE V
OF PERMITTEE a,
50 - 100 10.00 0
D19$JCTN CLASS ZONE ROLE D BY V
100 - 500 15.00 �� LU
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 SIGNATURE
TEMP.POWER POLE
TEMP SERVICE,POLE,IN APPURTENANCES 5.00
TEMP LIGHT OR RECEPT. SYSTEM 3.00 UNDERSLAB WORK
Xmas Street Lighting ROUGH CONDIUT
25 sockets WIRING
FIXTUR
POWER AUTHORIZED
PERMIT FEE (SUB TOTAL)
UTILITY CO. NOTIFIED
PLAN CHECK FEE
FINAL
PERMIT ISSUING FEE 3.001 JOSEPH C. ROOHAN
TOTAL FEE SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
FE FjIVED: .
` I.riE,o 3 3 6 3 M NOV 22 4 d D ,Q 011
City Manager
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
7BA663-CES061/70 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING 5 7. Rosemead Blvd*
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER LOCALITY TWIIE CITY
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING
NEAREN RE
FOR APPLICANT TO FILL IN CROSS ST LAS TUNAS
FRECEPT.
ETS NO. $EACH $ ' FEE . OWNER TOEM CITY CHMER OF CO E
MAIL
TOTALFIRST 20 20 ADDRESS
CITY TEL. NO.
OVER 20 ,10
PLAN CHECK
LIGHTING TOTAL
FIRST 20 .20 APPLICANT
FIXTURES
OVER 20 .10 ADDRESS
APPLIANCES CITY TEL. NO.
PERMIT y
RANGE DRYER_WTR. HTR. APPLICANTy-�f B3?.lvi7 C/
STA. COOK DISP. F.A.U. ADDRESSS �Wjj- Ise /ff""'
SPACE HTR. AIR COND. CITY _1"', TEL. NO.
CLOTHES WASH. DISHWASH. LICENSE NO.• l�J�, � CLASS.
FAN OTHER 1.00 1HEREBY ACKNOWLEDGE THAT 1 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 B TYPE OVER TO
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OW OF, AND INTEND TO
1 - 10 3.00 RESIDE IN, THE A�,Q� CRIRED ES ENT L PROPERTY.
.
SIGNATURE O O
10 - 50 5.00 OF PERMITTEE V
50 - 100 10.00
DI STRI CT NO. CL S2gjj GROuP PROCE BE Y
100 - 500 15.00 G
W
SIGN, GAS SIGN AND ONE CIRCUIT 3.00 NOTES: a'
TUBE,.OR Z
MARQUEE ADDITIONAL-CIRCUITS 140
SERVI CENOT OVER 600 VOLTS OR 200AMP 2.00
APPROVALS DATE INSPECTOR'S SIGNATURE
SERVICEOVER600 VOLTS OR 200AMP 5.00
TEMP.POWER POLE
TEMP SERVICE,POLE,&APPURTENANCES 3.00
UNDERSLAB WORK
TEMP LIGHT OR RECEPT. SYSTEM 3.00
ROUGH CONDIUT
WIRING
50 sockets FIXTURES
PERMIT FEE (SUB TOTAL)-
POWER AUTHORIZED
PLAN CHECK FEE (50%'PERMIT FEE)
UTILITY CO. NOTIFIED '
PERMIT ISSUING FEE 2.40
FINAL O
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
JOSEPH C. ROOHAN
TOTAL FEE SUPERVISING ELECTRICAL ENGINEER.
PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION CK. M.0. CASH
Fee waived: ? 5c- NGV1S 2 D ,Q-O~
City nage ~�64
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
76ASGS-CES06 3-69
APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER TBUILDING ,y�/
BUILDING AND SAFETY DIVISION SS �7(G7
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDINGITYFOR APPLICANT TO FILL IN ST ���ST.
NO. EACH FEE
25
$ $ OWNER
RECEIPT. MAIL
LIGHT TOTAL
FIRST 20 ,20 ADDRESS 1 `
CITY • TEL.NO.
SWITCH OVER 20 .10 PLAN
LIGHTING TOTAL �OV
FIRST 20 20 APPLICANT
K
FIXTURES } ER 20 ,10 ADDRESS
RANGE_DRYER_WTR. HTR. CITY TEL.NO.
STA. COOK_DISP._F.A.U. CONTRACTOR ef---iwx
SPACE HTR. AIR COND. ADDRESS /• ®� �� ��c/
CLOTHES WASH._DISHWASH. CITY .-4 TEL.NO ��
FAN_OTHER 1.00 LICENSE N0.Q48v/ CLASS.
MOTORS,TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
IND. HEATERS, ETC, HP. KW. KVA. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
, ELECTRI CAL WIRING.
O - 1 1.00 O W 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
1 - 10 3.00 CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF, AND INTEND TO .GL
RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY.
10 - 50 5.00 a \(
SIGNATURE
50 - 100 IOAO OF PERMITTEE
'100 - 500 15.00 DISTRICT NO. GROUP ZONE PROCESSED BY
S/ ns
SIGN,GAS [SIGN AND ONE CIRCUIT 3.00
u
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS1.00 NOTES:
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 •�•
SERVICE OVER 600 VOLTS OR 200 AMP 5.00
TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTORS SIGNATURE
TEMP. POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
WIRING
PERMIT FEE (SUB TOTAL) FIXTURES
PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED
PERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL
TOTAL FEE JOSEP C. ROOHAN
SUPERVISING ELECIJUrAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION C CK. M.O. CASH
e 7 IR FLBj 3 2 0 14.0 O N ��
I SEE BACK OF APPLICATION FOR COMPLFTF FF.E SCHE GULF
r
76A669-CE8061-68 APPLICATION FOR ELECTRIC A PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS 56T6 Roseme&d & Las Tanis
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY Temple City
NEAREST
FOR APPLICANT TO FILL IN
CROSS ST. Las Tanis
NO. EACH FEE
RECEPT.
$ $ OWNER Mobil Oil
7�j MAIL
LIGHT /�' TOTAL FIRST 20 d .20 Od ADDRESS
SWITCH OVER 20 �� .10 .2bo CITY TEL. NO.
HECK
LIGHTING FIRST 20 PLAN'CANT
p� �aO .20 '� 0� APPLICANT
FIXTURES JTOTAL,
"7 ® OVER 20 31 .10 /0 ADDRESS
RANGE—DRYER_WTR.HTR.— CITY TEL. NO.
STA.COOK_DISP.—F.A.U.— CONTRACTOR Vic Stein Elec. InC.
SPACE HTR. ' AIR COND. ADDRESS 12 S• Melrose
CLOTHES WASH._DISHWASH._ CITY Placentia gp.1676TEL. NO. 528-2141
FAN OTHER 1.00 LICENSE IJO. 219596 CLASS. C10
MOTORS,TRANSFORMERS. RATING
IND. HEATERS, ETC. HP. KW. KVA. I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
SIZE & TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
�1 `Q ELECTRICAL WIRING.
-
0 .1 1.00 d O
n a I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
lip 111.r LJQp 1 - 10 J 3.00 G� �I LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER'OF, AND INTEND TO
10 50 5.00 RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. 0
50 - 100 10:00 SIGNATURE V
]TEMP.
F PERMITTEE I%
100 - 500 15.00 DIST CTNO. GOUP NE P O ED. G0TUBE,A SIGN AND ONE CIRCUIT 3.00 WMARQUEE gDDITIONAL CIRCUITS 1.00 NOTES Z
SERVICE NOT OVER 600 VOLTS OR200 AMP ® 2.00 d2SERVICE OVER 600 VOLTS OR 200 AMP 5.00
TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE
POWER POLE
UNDERSLAS WORK 44
ROUGH CONDUIT
PERMIT FEE (SUB'TOTAL) WIRING
FIXTURES
PLAN CHECK .FEE (5096 PERMIT FEE) POWER AUTHORIZED
PERMIT ISSUING FEE 2.00 0,0 UTILITY CO.NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1..00 I FINAL
TOTAL FEE ® JOSEP C. ROOHAN
SUPERVISING ELEC CAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
Itr,_ 4356i:_' AR 3 2 D 26.70-- ��
EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
WORKERS'COMPENSATION DECLARATION I CE 806G tOist APPLICATION FOR ELECTRICAL PERMIT
I?hereby affirm that I have a certificate of consent to self Insure,
or,a certificste'of Workers'Compensation Insurance,or a certified COUNTY OF LOS ANGELES BUILDING AND.SAFETY
copy'thereof (Sea 3800,Lab.C.)
Policy No. Company FOR APPLICANT TO FILL IN JOB
❑ Certified,copy is hereby,furnished.. I EACH NO. FEE ADDRESS
• � New Residential Bldgs.&Pools _ � J
❑ Certified, copy is'filed,with the county building inspection 1 &2-Family,Sq.Ft. $ $ LOCALITY
department. Multi-family Sq.Ft. — NEAREST
CROSS ST. U012 09945.
Date Applicant Residential Swimming Pools OWNER OR /
FIRM NAME L.
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec Light•Sw.Z MNL
COMPENSATION INSURANCE First 2.0 . 10 ADDRESS � l
(This section need not be completed if the work Involved by the I.No.
permit Is for one hundred dollars.($100)or less.) Total No. Additional CITY
I certify that in the-performance of the work.for which this permit PL CHECK
is issued; I,shall,not employ any person in any manner so as to APPLICANT
become subject)).the.,Workers'Compensation Laws.. Lighting Fixtures First 20' O 0� 'ADDRESS
Additional
Total No.�� CITY Tel.No.
Date - Applicant Fixed Appliances Not Over 1 HP
NOTICE TO APPLICANT-Af, after making this Certificate of PERMIT
Exemption,you should,become subject to the Workersr'Compensation Range_ Heater, D.W. _ APPLICANT
All
provisions of the Labor Code,you must forthwith'comply with such' Oven ._ Dryer_ W;M._ ADDRESS
provisions or this permit shall be deemed revoked: Top FAU W.H. L, CITY ��" TeL No
LICENSED CONTRACTORS DECLARATION. Hood _ Fan Other_ 071
' o
I hereby affirm.that I am ��g
licensed under provisions of Chapter 9 Disp. Room Air Cond. ya LICENSE OR / 7 �..
(commencing with Section 7000)of Division 3 of the Business and REG.NUMBER Class
Professions Code,and my license is in full force and effect. DISTRICT NO. P C SED BY
Power Apparatus&.Large Appliances
Size&Type HP,KW,KVA,or KVAR IJ, IS
License-Number 7.61 Lic.Class. �`l Up to 1 Incl. FINAL t_!
Over 1 to 10 Incl. DATE ` •:JAS .jVALIDATION. 4
= A I :::_... ARP
Contrector' A yCD Date Over 10 to 50 Incl. FINAL V
❑ lam exempt under Sec. Over 50 to 100"Inc. BY QW.
Over 100 ; f' IIIA v rj
BAP.C.for this reason �'(�` 1' ':Z
Services,Swbd.,MCC&Panelboards
Date: 0-200 Amp.Upder 600 V , Q
SignE fie(• 201 - 1000 Amp.Under 600 V
❑ Over 1000 Amp.or Over 600 V
Exemption for Red.Maint.Elect:'
SINGLE FAMILY Temp.Power Pole&Appurtenances
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit `
I-hereby'affirm that I amexempt from the Contractor's License Law .':'- A.
for the following reason(Section 7031:5,Business and Professions 7 Additional Sign Branch Circuits =e a
Code):. :,. "� ;r _X_
Misc.Conduits&Conductors
❑ I,as owner of the property,will do the work and the structure
is not intended dr offered'for sale (Section 7044, Business Other(See Complete Fee Schedule)
and Professions Code). ,
CONSTRUCTION LENDING AGENCY _,'8-3 _
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) yt•�ti _ L�c
Civ.C.). '
PLAN CHECKING FEE
Lte
' Name ��-
PERMIT ISSUING FEE
Address..
that I have read this application and state that the above TOTAL FEE
on is correct.I.agree to comply with all County ordinances
laws regulating Electrical wiring, and hereby authorize
tatives of this County to enter upon the above-mentioned
for inspection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
nature of rmittee Date
WORKERS'COMPENSATIONDECLARATION
CE-806G (2-BO) APPLICATION FOR ELECTRICAL PERMIT 6) 07
CE-806
I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES r BUILDING AND'SAFETY
insure,or a certificate of Workers'Compensation Insurance,or
a„eAr�%fip{l,cojxth�re2f(Sec.3800,Lab.C.)
1177 ((11 ttJJttSSIITT I S L+O FOR APPLICANT TO FILL IN JOB
Policy No. Company�4,,,, vMbb New Residential Bldgs.&Pools EACH NO. FEE ADDRESS 5676 N. Rosemead Blvd.
❑ Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ — $ 1LOCALITY Temple City
— A
Certified copyMulti-family Sq. Ft.'is tiled with the county building.inspection CRNEOSSRESSTT
Las. Tunas.
department. Residential Swimming Pools OWNER OR
Date 4-6-81 Applicant Edwards Electric FIRM NAME
Outlets: Rec.—Light Sw. ADDRESS
First 20
CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. AdditionalCITY Tel No. }
COMPENSATION INSURANCE PLAN CHECK >
('This section A need not be.completed if the work involved APPLICANT U
by the ,Lighting Fixtures First 20 ADDRESS
permit is for one hundred dollars ($100) or less.) i A Ir
Additional �
Y y
I certify ,that in the performance of the work for which this Total No. bI.TY Tel No. 0
permit is issued I shall not employ an person in any manner Fixed Appliances Not Over 1 HP
P . P PERMIT
so as to become subject to the Workers'Compensation. Laws. Range_Heater D.W._ APPLICANT E d
Oven _ Dryer_W.M._ ADD,RESS •0
253-5 S'.. 3rd Ave. Z
Date Applicant Top _FAU _W.H. 447-5096
.
Hood•_ Fan _'Other_. CITY Arcadia TeI No.
NOTICE TO APPLICANT: If, after making this Certificate of Disp. —Room Air Condom LICENSE OR
Exemption, you should become subject to the Wotkers' I REG.NUMBER Class C-1
Compensation, provisions'of the Labor Code,you must forth- Power Apparatus& Large Appliances DISTRICT NO. PROCESSED BY
deemed revoked. '
with comply with such provisions or this permit shall be Size&Type HP,KW,KVA,or KVAR
Up to 1 Incl. I e
1
Over 1 to 10 Incl. FINALDATE
LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl.. VALIDATION
I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. SINAL,BY
9 (commencing wixh Section 7000)of Division 3 of the Busi- Over 100 I !
ness and Professions.Code,and my license'is in full force and I ,
effect. Services
License Number 257191 Li..Class C-10 0-200 Amp.Under 600 V
Edwards Elec+,, 1982 201-1000 Amp.Under 600 V
E
Contractor Y3a Ju1y Over 1000 Amp.or Over 600 V ��Z
HOME OWNER-BUILDER DECLARATION Temp.Power Pole&Appurtenances I -
I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit -
License Law for the following reason (Section 7031.5, Busi-• Additional Sign Branch Circuits i
ness and Professions Code): 1 1 4 7 6.2 A
Misc.Conduits&Conductors J
❑ I,-as owner of the property, will do the work and the Other(See Complete Fee'Schedule)— I 0 0 0 0 0
structure is not intended or offered for sale (Section
7044,Business and Professions Code). o c o 0 0 0 0 K
CONSTRUCTION LENDING AGENCY '
I hereby affirm that. there is a construction lending agency 0 4, 14-81
for the .performance of the work for which this permit. is PERMIT FEE (Sub-Total)
issued(Sec.3097,Civ.C.).
Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) ,
Lender's Address PERMIT ISSUING FEE
I certify that,I.have:read this application and state that the TOTAL FEE No Fee
above information is.correct.I agree to comply with all County
ordinances and State laws regulating.'Electrical wiring, and I
hereby authorize.representatives of this County to enter upon
the abov :mentioned property for inspection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE
, -_ 4-6-81 ,
Signature of Permittee Date
WORKERS'COMIWNSATIONN bk9LARATION I 76A663
.,: , CE-8066 (2-80) APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I have. a certificate of wsent to self! ;COUNTY OF LOS ANGELES BUILDING AND SAFETY
insure,or a certificate of Workers'Compensationansurance,ort
a certi idAp� tJUof(Sec.3800,Lab.C.)
% +a
wi O %V1 5 L911
CA FOR APPLICANT TO FILL IN JOB
Policy No. Company y' � I EACH NO. FEE ADDRESS (]
New Residential Bldgs.&Pools
it Certified copy is hereby furnished. I 1 &2-Family,Sq. Ft. $ — $ LOCALITY �—
ElCertified co )s filed ith the count 1 ' I Multi-family Sq.Ft. — NEAREST
py y g inspection! Residential Swimming Pools CROSS ST
department. OWNER OR
i FIRM NAME
Dated Applicant Outlets: RecLight SW. g MAIL
First 20 ADDRESS 6VI 2
CERTIFICATE OF EXEMPTION FROM WORKERS' Total No.i-/ Additional CITYTel No. }
COMPENSATION INSURANCE PLAN CHECK
(This section need not be completed if the work involved APPLICANT V
by the permit is for one hundred dollars ($100) or less.) Lighting Fixtures First 20 ADDRESS W
Total No.
Additional 0
Fixed Appliances
I certify that in the performance of the work for which this Not Over 1 HP CITY Tel No.' 13
permit is issued, I shall not employ any person in any manner PERMIT ' W
so as to become subject to the Workers'Compensation Laws. Range—Heater—D.W._ APPLICANT N
Oven — Dryer_.W.M._ ADDRESS Z
Date Applicant Top _FAU _W.H.
Hood _ Fan —Other CIT Tel No.
NOTICE TO APPLICANT: If, after making this Certificate of Disp. _Room Air Cond— ICEN OR
Exemption, you should become subject to the Workers' REG.NUMBER k19 Class
Compensation provisions of the Labor Code, you must forth- Power Apparatus&Large Appliances DISTRICT NO. PROCESSE B
with comply with such provisions or this permit shall be Size&Type HP,KW,KVA,or KVAR
deemed revoked. �j
Up to 1 Incl.
FINAL
Over 1 to 10 Incl. DATE
LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl. VALI DA N
I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL• +
9 (commencing with Section 7000)of Division 3 of the Busi- Over 100 BY
ness and Professions Code, and my license is in full force and
effect. Services IVY
License Numberr� 2� Lic.Class ��� ) 0 200 Amp.Under 600 V
201-1000 Amp.Under 600 V
Contractor�!EDate le�>—(.-�S Over 1000 Amp,or Over 600 V
HOME OWNER-BUILDER DECLARATION Temp.Power Pole&Appurtenances ;E 2 8 6 8 A
I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit # o o o 0 0 2
'License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits - 8325
ness and Professions Code):
Misc.Conduits&Conductors . 0 0 8 3 2 5 5
I, as owner of the property, will do the work and the Other(See Complete Fee Schedule)—
structure is not intended or offered for sale (Section 0 a 0 b—8 5
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 this permit is PERMIT FEE (Sub-Total)
issued(Sec.3097,Civ.C.).
Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee)
Lender's Address PERMIT ISSUING FEE 10 0
certify th I e r d this application and state that the TOTAL FEE $ .�
bove infor ti n i or ct.I agree to comply with all County
ina as d tat 1 ws regulating Electrical wiring, and
eby ut e p se tatives of this County to enter upon.
abo - t ne ro arty for inspection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE
Signatu ittee Date
�tL
WORKERS'COMPENSATION DECLARATION 7&&,M9DPW 3/e7APPLICATION FOR ELECTRICAL PERMIT`y affirm that I have a certificate of consent to self
7&&,M3
0666
insui r a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS
or a 4 tified copy thereof(Sec. 3800, Lab. C.)
Policy !11so3 2 Company 11410W 04 40.0 FOR APPLICANT TO FILL IN JOB f
Certified co ishereby furnished. EACH NO. FEE ADDRESS 676 �o5�w`tad /v(�
PY� Y rNewResidential Bldgs. &PoolsCertified co is filed with the count buildin $ _ $ LOCALITY
py ' y g inspec- ily, Sq. Ft.tion department. ily Sq. Ft. NEAREST LasN RST.ORu'vei S
�,_ -�J Residential Swimming Pools ow
Date Applicant G FIRM NAME /'106;:1 0 of
CERTIFICATE OF EXEMPTION FROM WORKERS r/f Outlets: Rec Light Sw._ J MAIL 3Q �/eSf �g M Mt �/,,, '�
COMPENSATION INSURANCE ADDRESS
�vrb't
all
(This section need not be completed if the work involved by CITY Tel. No.
the permit is for one hundred dollars($100)or less.) Total No. First 20 Additional
' 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 Qr0
so as to become subject to the Workers'Compensation Laws: Lighting:Fixtures First 20 + 0 ADDRESS
.� /��
' Total No..�; Additional
Z— CITY Tel. No.
Date Applicant Fixed.Appliances Not Over 1 HP PERMIT t 1 r
NOTICE TO APPLICANT' If, after making this Certificate of Range— Heater—D.W. — APPLICATION 101ft' i1L � X 96,d �•'"
Exemption; you should become subject to the Workers' 9 /I�
,Compensation provisions of the Labor Code, you must forth- Oven — Dryer —W.M.— ADDRESS/%67( Sy I,ffq r t/N, H
with comply with such provisions or this permit shall be Top — FAU —W.H. —
deemed revoked. CITY � v Tel. No.?(y4t-
Hood Fan —Other—
LIGENSEt)CONTRACTORS DECLARATION LICENSE OR
Disp. — Room Air Cond. — REG.NUMBER 29q vejt Class.C—to
I hereby affirm that I am licensed under provisions of Chapter 9
(commencing with Section 7000)of Division 3 of the Business Power Apparatus&Large Appliances DISTRICT NO. P SSED BY !-
and Professions Code,and my license is in full force and effect. . 6 f/ U
v Size&Type HP, KW, KVA, or KVAR o
License Number. 2 •o Lic. Class C'(17 Up to.1 Incl. FINAL
DATE p cc
Over 1 to 10 Incl. ��z -- l \ VALIDATION 0
Contractor Terri �c�rE r r✓CIS Date -g Over 10.to 50 Incj:, F-
FINAL°O- 9! -U
I am exempt under Sec: Over 50 to 100 Inc. BY W
B.&P..C. for this reason Over 100 a
Z
Services, Swbd., MCC&Panelboards Z
/Date. 0-200 Amp. Under 600 V
Signature
4_;4 td�— j 201 - 1000 Amp. Under 600 V
Exemption for Reg.Maint. Elect. Over 1000 Amp. or Over 600 V
SINGLE FAMILY Temp. Power Pole&Appurtenances ;-
HOME OWNER-BUILDER DECLARATION '' :
� Sign with One Branch Circuit
I hereby affirm that I am exempt from.the Contractor's License l n Branch Circuits
Law for the following reason ,(Section 7031.5, Business anAdditionaSig
d
Professions Code); - `1 I ITEMS
II Misc. Conduits&Conductors
Ell, as owner of the property, will do the work and they _770
structure is not intended or offered for sale(Section 7041, Other(See Complete Fee Sc he ule_ 1 L(� -
Business and Professions Code). i , + "�'^ -NSTRUCTION LENDING AGENCY 1�ir A tiEWI�3- �i_°i Al-
.I hereby affirm that there is a construction lending agency for E' �t �7i
the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) Q
(Sec. 3097,.Civ. C..).
PLAN CHECKING FEE ii(Io i _
Lender's Name -•
PERMIT ISSUING FEE 489101 I A01,II°(
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,
hereby authorize representatives of this County to enter upon
the above-mentioned property for Inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
✓6KA 6444iy /. 7 Y/
Signature of Permittee f Date �'
WORKER'S COMPENSATION DECLARATIONQO-OOj9OPW(12-91) �I
I hereby-affirethat I have a certificate.of consent to self inswe, 72LO63 APPLICATION FOR ELECTRICAL PERMIT
or a certificate of Worker's Compensation Insurance., or•a certified ,COUNTY OF LOtANGELES DEPT.OF PUBLIC WORKS. BUILDING AND SAFETY DIV.
copy thereof(Sec.3800 Lab.
_ C QA
sp f� I
Policy N ���o Q C 4ny g2f- Q/►/r./ FOR APPLICANT TO FILL IN ADDRESS (P-70N. oseenfd(t
❑ Certified copy is hereby furnished. New Residential Bldgs.&PNO. EACH FEE. LOCALITYools _ $ $
❑ Certified co is filed with the county building inspection 1&2-Family,Sq.Ft.
copy tY g� P NEAREST
�depart To nt.92 Multi-family Sq.Ft. CROSS ST.
Date `^ Applicant Residential Swimming Pools ASSESSOR
P BOOK
PE PARCEL
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec._Light SW- FIRMIn
COMPENSATION INSURANCE GD �Q ENME Q
First 20 MAIL
(This section need not.be completed If the work Involved by theTotal No. Additional ADDRESS y m
permit Is for one hundred dollars($100)or less.)
I certify that in the performance of the work for which this permit CITY ' avn%31e_ 0 1 Tel.No.
isissued, I shall not employ any person in any manner so as to PLAN CHEC
become subject to the.Workers'Compensation Laws. Lighting Fixtures First'20 APPLICANT tLe
Total No. Additional
ADDRESS
Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP.
NOTICE TO APPLICANT: If, after making this Certificate of CITY ,� Q e •?
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 PERMIT
P Y P Y APPLICANT 6 LO
provisions or this permit shall be deemed revoked.. Power Apparatus&Large Appliances
LICENSED CONTRACFORS.DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS! \ /
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 { 7WNo.
Over 10 to 50 Incl. LICENSE OR
Professions Code,and my license is in full force and effect. f ��^y !� >
Over 50 to 100 Incl. REG.NUMBER CI�'ti,.i/�/ ✓ n-
Q
C10
/0 Over 100 DISTRICT NO. R EBBED BY U
License Number •+a Lic.Cr_ lass: I
Services,Swbd.,MCC&Panelboards � fr
Contractor Date 0-399 Amp.Under 600 V DAA '/
❑ I am exempt under Sec. 400-1000 Amp.Under 600 V t 1 19 VALIDATION V
Over 1000 Amp.or Over 600 V FINAL d
B.&P.C..for this reason BRANCH CIRCUIT FEES BY i
Date: - 15A,or 20A,12OV,Lighting or Recept, q ' Z
1 To 10 Branch Circuits
Signature 11 To 40 Branch Circuits
F141 Or More Branch Circuits
Exemption for Reg.Maint.Elect. 15A,20K 208V To 277V Lighting Br.Circuits 2
SINGLE FAMILY Temp.Power Pole&Appurtenances
HOME OWNER-BUILDER DECLARATIONA ACCT.
40
hereby affirm that I am exempt from the Contractor's License Law Sin with One Branch Circuit 40
g
for the fallowing reason(Section 7031.5, Business and Professions Additional Sign Branch Circuits 3303 61.60
code): 1 ITEMS
❑ 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) , I TOTAL 61.60
and Professions Code). CHECK 61o60
CONSTRUCTION LENDING AGENCY I CHARGE .00
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 0000-0001 12/18/95
Lender's Name 3822 1 AN .9 C 13
PERMIT ISSUING FEE f�
Lender'sAddress
I certify that I'have read this appiication and under penalty of purjury state 'TOTAL FEE (O
that the above Information is correct. I agree to comply with all County
ordinances and State laws regulating Electrical wiring;and hereby authorize
representatives of this County to enter upon the abotwmentioned property
for I action purposes, r_^ y ' • SEE REVERSE FOR EXPLANATORY LANGUAGE
. . z-1 /�
SI RE OF PERMITTEE r DATE I
TION
y Worm that
I have
a certificate
DECLARATION 76A663 10/81 APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I have a certifirnte of consent to self CE-806G
insure, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY
or a certified copy thereol Sec. Lob. C.)
Policy No. W d Company MA/WI be FOR APPLICANT TO FILL IN JOB r�/y6 �E��• D
Certified copy is hereby furnished. EACH NO. FEE ADDRESS 'S New Residential Bldgs. &Pools LOCALITYTEI(,� (,E Cj
Certified copy is filed with the count buildinginspec- 1 &2-Family, Sq. Ft. $ ._ $
tion epar end Multi-family Sq. Ft. 'NEAREST t
Residential Swimming Pools CROSS ST. l6Y6+8 7-WRv
Date Applicant — OWNER OR //�� OI•L
FIRM NAME Of/IL �Z
ERTIFICATE OF EXEMPTION FROM WORKERS' II MAIL
Outlets: Rec Li ht�1..Sw._ ADDRESS • • a
COMPENSATION INSURANCE g O b�OX k65��
(This section need not be completed if the work Involved by 3 First 20 CITY
Total No. Additional 'QE « Tel. No.
the permit Is for one hundred dollars(;100)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
Total No. Additional CITY Tel. No.
Date Applicant Fixed Appliances Not Over 1. HP PERMIT // y� /� �+
NOTICE TO'APPLICANT: If, after making this Certificate of APPLICANT h Af A • SkQei
Exemption, you- should become subject to the Workers' Range_ Heater_D.W. —
Compensation provisions of the Labor Code, you must forth- Oven —Dryer —W.M.— ADDRESSlogo* t7• e ress 419
with comply with such provisions or .th'is permit shall be Top _ FAU —W.H. — �.3
deemed revoked. CITYr>O�RA Tel. rVo.
Hood _Fan _Other—LICENSED'CONTRACTORS DECLARATION.• - LICENSE OR
I hereby affirm that I am licensed under provisions of Chapter 9 Disp. _ Room Air Cond. REG.NUMBER 088.25 Class. p?Q
(commencing with Section 7000) of Division 3 of the Business DISTRICT NO PROCES D Y
and Professions Code,and my license is in full force and effect. Power Apparatus&Large Appliances �-'� l'Cj
Size&Type HP, KW, KVA, or KVAR vo
License Number 0 Lic. Class C-240Size
Up to 1 Incl.
og
Contractor �"'�' Date Z Over 1 to 10•Incl.. DATE �� VALID ION
Over 10 to 50 Incl. FINAL
I am exempt under Sec. Over 50 to 100 Inc, BY
B.&P.C. for this reason Over 100- G
Date: Services, Swbd.,.MCC&Ponelboards
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
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 2283,8A
I hereby affirm that I am exempt from the Contractor's License # 0 0 0 a 0
Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits o 0 1 275
Professions Code): _
Misc. Conduits&Conductors o 0 o 1 2.7 5
I, as owner of the property, will do the work and the , 0 9 0 4�8 5
structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)_
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 this permit is issued PERMIT FEE (Sub-Total) D
(Sec. 3097, Civ. C.).
PLAN CHECKING FEE
Lender's Name
PERMIT ISSUING FEE
Lender's Address
I certify that I have read this application and state that the TOTAL FEE r Z .7
above information.is correct..I agree to comply with all County
ordinances and State laws regulating Electrical wiring, and
hereby uthorize representatives of this County to enter upon
thea ve-menti ed property for inspection urpos S. SEE REVERSE FOR EXPLANATORY LANGUAGE
}7 J
Signature of Perms tee- Dcfte
• COUNTY OF A ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ELA508-980812-036�'
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA
PHONE: (818) 285-0488 EXT:
LEGAL ID: FEES PAID 1 B •I-L-D'1NG ADDRESS"
5676 ROSEMEAD_BL.fN
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP-CA-91780
ASSESSOR INFORMATION UMBER: NEAREST CROSS STREET: LAS TUNAS
Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY
F1 120V, 15/20A BR CKTS 1.00 BR 17.25
TENANT: TOTAL FEES 45.00 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
08/12/98 UT 08/12/99
OWNER: TEL. NO: FINAL DATE FINAL BY: CODE:
MOBILE OIL -
3700 W. 190TH STREET
TORRANCE, CA 90509 DESCRIPTION OF WORK
INSTALL ADDITIONAL SENSORS TO EXISTING TANK MONITOR SYSTEM
APPLICANT: E O:
CHARLES COLLEY 92392 -
7470 SVL BOX _ __-_-_ SPECIAL CONDITIONS:
VICTORVILLE
CONTRACTOR: TEL. N0:
ISLAND CONSTRUCTION & MAINTENANCE APPROVALS DATE INSPECTOR SIGNATURE
(760) 955-6806- >�;
7470 SVL BOX LIC. NO rTEMPORARY POWER POLE
VICTORVILLE, CA 92392 667042010 -
v UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER: TE 0: ,� , ; ; .-I'i f ' UFER GROUND
LIC. NOe�; _ I �r i I `�_ +�, ROUGH CONDUIT
- - -- -- — -
ROUGH WIRING
MAIN WATER LINE
PLASTIC Y/N METAL Y/N
- ----- - - - -1_ — -- - -
UTILITY COMPANY NOTIFIED
REPORT ID: DPR265 ROUTE TO: BS0508
COUNTY OF LOS ANGELES TEMPLE CITY 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0405270021
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL D: FEES PAID BUILDING ADDRESS:
TR: 12157 i 5676 ROSEMEAD BL N
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 91780
ASSESSOR INFORMATION NUMBER: NEAREST 'CROSS STREET: LAS TUNAS
Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY
K1 SIGNS, OUTLINE LGT 1.00 SIG 38.85
TENANT: TOTAL FEES 66.60 ISSUED 0 PROCESS BY: PLAN BY: EXPIRES ON:
05/27/04 VG 11/23/04
OWNER: TEL. NO: FINAL DATE FINAL BY: CODE:
MOBIL OIL /�,
3700 W. 190TH STREET �"��%�( C.�--_
TORRANCE, CA 90509 DESCRIPTION OF WORK
ELECTRICAL FOR SIGN
APPLICANT: TEL. 0:
CERVANTES (909) 240-2955-
10115 BEDFORD DR. SPECIAL CONDITIONS:
RNCHO CUCAMONGA91730
CONTRACTOR: TELL. N0: APPROVALS DATE INSPECTOR SIGNATURE
JEFF HORTICK CONSTRUCTION CO. (909) 593-9539-
2700 N. GAREY AVE. LIC. NO TEMPORARY POWER POLE
POMONA, CA 91767 586164 B
UNDERGROUND CONDUIT
MRI.HITECT OR ENGINEER: TEL. NO: UFER GROUND
LIC. NO: ROUGH CONDUIT
ROUGH WIRING
MAIN WATER LINE
PLASTIC Y/N METAL Y/N
TILITY COMPANY NOTIFIED
REPORT ID: DPR265 ROUTE TO: BS0508
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0111080001
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 DUPLICATE
PHONE: (626) 285-0488 EXT:
ES PAID BUILDING ADDRESS'
TR: 12157 5676 ROSEMEAD BL'N
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 91780
ASSESSOR B : NEAREST CROSS STREET: LAS TUNAS
AW PC CITY $109.35 MIN 0.00 109.35 THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY
Al PERMIT ISSUANCE FEE 27.75
JX MOTORS, LT 3 HP 6.00 MOT 91.80 ISSUED PROCESSED Y: EXPI S .
TOTAL FEES 228.90 11/13/01 JK 05/12/02 .
OWNER: TEL. N0: NAL DATE FINA BY: CODE:
MOBILE OIL -
3700 W. 190TH STREET
TORRANCE, CA 90509DESCRIPTION
CONDUITS MODIFICATIO SPENSERS
APPLICANT: L. NO:
FRED FIEDLER AND ASSOCIATES (213) 381-7891-
2322 WEST THIRD ST SPECIAL CONDITIONS:
LOS ANGELES 90057
H NTRACTOR: INC. (909)N623-2502- O GELE- L'o��}` APPROVALS DATE INSPECTOR SIGNATURE
COVEY350 E. COMMERCIAL ST LIC. NO y TEMPORARY POWER POLE
POMONA CA 269354/HA2
i UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER: T . - � _ r GROUND
LIC. N07'� ROUGH CONDUIT
Jt. I L UG W I R I NG
L �n n�n ���� RAIN-WATER LINE
� IIv11 � ILi7 \\J 00 PLASTIC Y/N METAL Y/N
-- UTILITY C P 0 IFIED
a 0
fj
Ex
service Thai
* ADDITIONAL DATA ON FILE
REPORT ID: DPR265 ROUTE TO: BS0508
I
COUNTY OF LOS ANGELES i TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0110160008
s ► BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: S L G D R S :
TR: 12157 5676 ROSEMEAD BL N
FEE DESCRIPTION: QUANTITY: LION: AMOUNT: TEMP CA 91780
ASSESSOR0 NUMBER: ' NEAREST CROSS STREET: LAS TUNAS
k1 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY
K2 ADDITIONAL SIGN CKTS 1.00 CIR 12.90
TENANT: I TOTAL FEES 40.65 ISSUED 0 : PROCESSED BY: PLAN B : UP-ME-S-0.
MOBIL 10/16/01 JK 04/14/02
OWNER- TEL. NO: FINAL DAT FINAL BY: CODE:
MOBILE OIL - i t"3� _(9t
3700 W. 190TH STREET
TORRANCE, CA 90509 D CR 0 0 0
REMOVE 2 MONUMENT SIGNS, INSTALL NEW 201 SINGLE POLE SIGN
APPLICANT: TEL O:
DONCO & SONS INC (714) 771-5730-
725 N. CYPRESS ST SPECIAL CONDITIONS:
ORANGE, CA 92687
ES co
CONTRACTOR: TEL. 7 �/�/ APPROVALS DATE INSPECTOR SIGNATURE
� A�
DONCO AND SONS (714) 771-5730-
725 N. CYPRESS STREET LIC. NO TEMPORARY POWER POLE
ORANGE, CA 92667 435616/C61 * /
UNDERGROUND CONDUIT
ARCHITECT OR ENG ER: T L. 0: E G O D
LIC. N0� 1111111 ROUGH CONDUIT
r
I�
ROUGH R G
r`n n D n CC ���0 I WATER LINE
IIJr J U ILIA IIJI� 8
PLASTIC Y/N METAL Y/N
L C NO I IED
co
4 OZ 0 Q ccs
Service
* ADDITIONAL DATA ON FILE
REPORT ID: DPR265 ROUTE TO: SS0508