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Tenen3 cEBGe ,D,T2 APPLICAT ON ICOR ELECTRICAL PE IT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
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MOTORS TRANSFORMER$ RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND HEATERS ETC HP KW RVA ELECTRICAL WIRING
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FINAL 411 J
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7eA$e3-ceeoe I0,72 APPLICATION FOR ELECTRIC4 PERMIT
COUNTY OF LOS ANGELES �r 2
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!EC SACK OI APPLICATION FOR COMPLETE SCHEDULE
'°"°°' `�"°° '°"' APPLICATION FOR ELECTRICAL PERMIT
' COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER oB
BUILDING AND SAFETY DIVISION
LOCALITY
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MOTORSTRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IMO HEATERS ETC HP KW KVA ELECTRICAL WIRING
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PLAN CHECK VALIDATION CK VHERMIT VA N M 0 CAS"
1 'r,948513 NAR 9 20 43.80 0
SZE BACK OF APPLICATION FDA COMPLETE SCHEDULE
°"' APPLICATION(FOR ELECTRICAL -PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER 7AE
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN
OUTLETS ND IE
RECEPT_ S S
LIGHT_ TOTAL
FIRST 20 2S ADDRESS
OVER 20 CITY TEL NO
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CLOTHES WASH DISHWASH _ F�GE NUMBER / CLASS
FAN—OTHER 1 00
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
ANO STATE THAT THE ABOVE 0 CORRECT AND AOREE TO COMPLY
MOTORSTRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND HEATERS ETC HP KW RVA ELECTRICAL WIRING
SIZE ■ TYPE OVER TO
IHERESY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR
O - 1 100 LICE NIED AS RCOUIRED BY LOS ANGELES COUNTY AND STATE 01 }.
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SERVICEOVER600 VOLTS OR 200AMP 1000 ROUGH CONDUIT
TEMPSERVICE,POLE 5 APPURTENANCES 500 WIRING
TEMP LIGHT OR RECEPT SYSTEM 800 FIXTURES
POWER AUTHORIZED
UTILITY CO NOTIFIED
FINAL -36 7
PERMIT FEE (SUB TOTAL) NOTES Z LG� �ijD
PLAN CHECK FEE /1
PERMIT ISSUING FEE S00
TOTAL FEE
PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION CK M D CASH
5 6 6P MR 2? �2 D 9L O Am
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 07 \/l�p
APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
PARTMENT OF COUNTY ENGINEER A&
UILDING AND SAFDIVISIONADDRESS 9,5423
OR APPLICANT TO FILL IN LOCALITY e
New Residential Bldgs 6 Pools EACH NO FEE N T �. I
1 &2 Family Sq Ft E 025 — $ ST
Multi fomdy Sq F 02 — FIRM NAM
Residential Swimming Pools 2000 MAIL
ADDRESS
Outlets Rec Llght_Sw CITY Tel No
First 20 50LICHECK
_
Total No Additional 30 APPLICANT G
ADDRESS
r A
Lighting Fixtures First 20 50 CITY Tel No
Total No
Additional 30 PERMITp C
Fixed Appliances Not Over 1 HP ADDRESS
Range—Heater—D W _ CITY Tel No JITAT'Oven_Dryer_W M_ LICENSE OR
Top —FAU _WH REGNUMBERHood—Fan _Other_ HEREBY ACKNOWLEDGE THAT HAVE READ iH6 APPLIUTIDnp — RoomAirCond 2 00 THAI THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL C
AN ES AND STATE LAWS REGULATING ELECTRICAL WIRING
Power Apparatus 8 Large Appliances
Size 8 Type HP KW KVA or KVAR I HEREBY CEUIFY THAT I AM PROPERLY REGISTERED AND/OR LKENSED AS
U to 1 Ind REOLIIRED BY LOS ANGELES COUNTY AND STATE OF CADFORNIA OR THAT I AN
P 200 THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY
Over I to 10 Incl 5 00
Over 10 to 50 Ind 1000
PERMITTEE Q
Over 50 to 100 Inc 20 00 SIGNATURE y
30 00 d
Over 100 IFIXTU
RICT NO J1'�QQ D Y
Services
0 200 Amp Under 600 V 1250 APPROVALS DA E ISIGNATOURE _
201 1000 Amp Under 600 V 2500
Over 1000 Amp or Over 600 V 5000 POWER POLE
Temp Power Pole 6 Appunanarces
1000 RSLAS WORK
Sign with One Branch Circuit 1000 H CONDUIT
Additional Sign Bronch Circuits 2 00 G
Misc Conduits&Conductors 1500 RES
Other See Complete Fee Sch uIel R AUTHOR!ZED
Y CO NOTIFIED
PERMIT FEE ISub Total) NOTES
PLAN CHECKING FEE (One Fourth Permit Feel
PERMIT ISSUING FEE $600
TOTAL FEE
PLAN CHECK VALIDATION CK MO CASH PERhUT VALIDATION K M OCASH
71 3 4�JUN 22 z e 9.0 0 •�
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE ms
'ewMe as "e" 10/" APPLICATION FOR ELECTRICAL PERMIT L]
COUNTY OF LOS ANGELES pg �+
DEPARTMENT OF COUNTY ENGINEER gpDRESS �J
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN LOCALITY '
New Residential Bldgs &PL»h EACH NO FEE NEAREST
1 6 2 Family Sg Ft E 025 — E
OWNEROR
Multifamily Sq F D2 — FIRM NAME 1.6 I GE
Residential Swimming Pools 2500 MAILADDRESS
Outlets Rec Lrght_Sw CITY Tel No
First 20 50 PLAN CHECK
Total No Additional 30 APPLICANT
ADDRESS
Lighting Fixtures First 20 50 1 1 CITY Tel No
Total No �--E��L r1 `
Additional 30 PERMIT `� — Q
Fixed Appliances Not Over I HP ADDRESS D \ v N
Range_Heater—D W _ CITY %I Tel No z697-0-7Oven_Dryer_W M_ LICENSE RTop —FAU —WH _ REG NUMBERClHood_Fan _Other— I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APFLKADap _ Room Air Cond — 250 THAT THE ABOVE 6 CORRECT AND AGREE TO COMPLY WITH ALLANCES AND STATE LAMS REGULATING ELECTRICAL WIRING
Power Apparatus&Large AppliancesSize 8 Type HP KW KVA or KVAR I HEREBY CERTIFY THAT I AM FROPERIY REGISTERED AND
REONRED By LOS ANGELES COUNTY AND STATE OF IFORNIA Oe THAT I AM
Up to Intl 250 THE lEWLO EDESCRIBE _D IDE TIA o
Over 1 to 10 Ind 500 r�
PERMITTEE
Over 10 to 50 Incl 1250 CD
Over 50 to 100 Inc
2500 SIGNATURE
Over 1 OD 40DISTRICT NO PROCESSED BY
Z
Services �NSSpp��
0 200 Amp Under 600V 1250 APPROVALS DATE ISIGNATOURE
201 1000 Amp Under 600 V 25 00
Over 1000 Amp or Over 600V 5000 TEMP POWER POLE
UNDERSLAB WORK
Temp Power Pole b Appurtenor[es 1000
Sign with One Branch Circuit 1000 ROUGH CONDUIT
2 00
Additional Sign Branch Circuity WIRING
Mist Conduits B Conductors 1000 FIXTURES
Other(See Complete Fee Scheduler POWERAUTHORIZED
UTILITY CO NOTIFIED
FINAL
PERMIT FEE (Sub Totah NOTES
PLAN CHECKING FEE One Fourth Permit Feel
PERMIT ISSUING FEE $700 1 -7601
TOTAL FEE *I nad
PLAN CMECK VALIDATION CK M O CASH PERMIT VALIDATION CK M O CASH
2 4 3giuN 28 2 D 1 0.0 0 •�8
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE �) I�
•TBABSO CESGS 10/73 1 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES tt
DEPARTMENT OF COUNTY ENGINEER fFIRM
(� y� S C? r'YT C� h
BUILDING AND SAFETY DIVISION
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LIGHT_ TOTAL
FIRST 20 25 , L�.i ADDRESS
((� CITY TEL NO
SWITCH_ "J OVER 20 10 PLAN CHECK
TOTA
LIGHTING FIRST 20 25 7 APPLICANT
FIXTURES 10
OVER 20 ADDRESS 1
RESIDENTIAL APPLIANCES CITY TEL NO
PERMIT iJ ��+ Q '7RANGE_DRYER_WTR HTR_ APPLICANT V `/�/. v
STA COOKDISP _F A U _ ADDRESS L/
SPACE HTR AIR CONO CITY A 16 " 1 t- C TEL NO l 7 S�Q
CLOTHES WASH DISHWASH — LEGE HUMBER e!l 1 'CLASS
FAN_OTHER 100 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 E LEC T RICAL WIRING
SIZE B TYPE OVER TO
HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
- Y
� 41 d r G Q - 1 100 V (� LICE HSEO AS REQUIRED BY LOS ANGELES COUNTY AND TATE OF
CALIFORHIA OR THAT I M THL L AL OWNER OT T E ABOVE U
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ROUGH CONDUIT
TEMP SERVICE POLE B:APPURTENANCES WIRING
TEMP LIGHT OR RECEPT SYSTEM FIXTURES
POWER AUTHORIZED
UTILITY CO NOTIFIED
LISSUING
FINAL
(SUB TOTAL) NOTES
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK l M O CASH
� i" 1yu3r, 7
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
76p653 CEBOB 10/72 APPLICATION FbR ELECTRICAL P IT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER n°oBoaEss�prju JJ
BUILDING AND SAFETY DIVISION
I LOCALITY
FOR APPLICANT TO FILL IN CROSSSSTZI/dJ�/�E.iG.
OUTLETS xo EACH FEE OWNER
NAME
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PLAN CHECK
FIRST 20 2S APPLICANT J
LIG �`,'�
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F: TURES OVER 20 10 ' ADDRE6 !(/, UiLG'N
RESIDENTIAL APPLIANCES ClTv j TEL N04ro
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STA COOK_DISP _F A U _ ADDRES � y ,o
1 SPACE HTR AIR GOND CITY I/�PL/✓�� TEL Nqktf
CLOTHES WASH DISHWASH_ LICGE NUMBER co CL
FAN_OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
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MOTORS TRANSFORMERS RATING WIT N ALL COUNTY ORDINANCES AND STATE LAWS REOULATIN6
IND HEATERS ETC HP KW KVA ELECTRICAL WIRING
SIZE B TYPE OVER TO
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR y
0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF [L
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POWER AUTHORIZED 1
UTILITY CO NOTIFIED
FINAL
PERMIT FEE (SUB TOTAL) NOTES
PLAN CHECK FEE
PERMIT ISSUING FEE 900 va
TOTAL FEE 10U
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK M D CASH
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
76A663 CE806 '0"2 APPLICATION FLECTRICAL PERMIT
COUNTY OF LOS ANGELES g
RESS
DEPARTMENT OF COUNTY ENGINEER O
BUILDING AND SAFETY DIVISION ADO
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LIGHT_ TOTAL FIRST 20Zy. ADDRESS
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RANGE_DRYER_WTR HTR_ PERMIT
APPLICANT
STA COOK_OISP =F A U _ ADDRESSAve
SPACE HTR AIR COND Clry ',IICV TEL NO
CLOTHES WASH DISMWASH_ LICEWMI R
REG NUMBER CLASS
FAN—OTHER 100 I HEHES' ACKNOWLEDGE THAT 1 HAVE READTHIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT ANo AGREE TO COMPLY
MOTORS TITANS POPMCRS RAT]No
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PLAN CHECK FEE
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TOTAL FEE 600
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0 1 OPM 25 2 D 6.0 0A-98
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
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TeAees.C[SOS-11."APPLICATION FOR ELECTRIC PERMIT I
COUNTY OF LOS XNCM S _
DEPAS bMff OF COUNTY ENGUMM SUILADDI O
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1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION DATE- INSPECTOR S SIGNATURE
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ELECTRICAL WIRING WIRING
1 HEREBY CERTIFT THAT I AM PROPERLT REGISTERED AND/OR '
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
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DEPARTMENT OF COUNTY ENGINEER ao ADDRESS O 3
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LOCALITY �g Ka RL E�Er
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LIGHT_ TOTAL FIRST 20 26 ADDRESS !'/�� Ld 4 1 .!'toA✓a�
SWITCH OVER 20 la CITY TEL NO
PLANCHECK
TOTAL
LIGHTING FIRST 20 zD APPLICANT
FI%TURES 10
OVER 20 ADDRESS
RESIDENTIAL APPLIANCES CITY TEL NO
PERMIT
RANGE_DRVER_WTR HTR_ APPLICANT G
STA COOK DISP _F A U _ ADDRESS
SPACE HTR AIR GOND CITY
CLOTHES WASH DISHWASH_ LICENSE OR �j
REG NUMBER,ZS — Z CLASS
FAN_OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND !TATE THAT THE ABOVE 15 CORRECT AND AOREE TO COMPLY
MOTORS TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND HCATER$ ETC HP KW KVA ELECTRICALWIRING
SIZE & TYPE OVER TO
HEREBY CERTIFY THAT I AMRE01l TEREO AND/OR
Q _ 1 100 LICENSED AS REQUIRED BY LO! ANGELES
GELE! C COUNTY AND STATE OF
CALIFORNIA ORTHAI I AM THE LEGAL OWNER OF xE ABOVE
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SERVI CENOTOVER 600 VOLTS OR 200 AMP 300 UNDERSLAB WORK
SERVICEOVER 600 VOLTS OR 200AMP low ROUGH CONDUIT
TEMP SERVICE,POLE &APPURTENANCES 600 WIRING 1
TEMP LIGHT OR RECEPT SYSTEM 300 FIXTURES
POWER AUTHORIZED
UTILITY CO NOTIFIED
FINAL F
PERMIT FEE (SUB TOTAL) NOTES
PLAN CHECK FEE [_641r 9 Rr/^Al E i F_n ?
PERMIT ISSUING FEE 300
TOTAL FEE
PLAN CHECK VALIDATION CK M D CASH PER T VAyIDATION cK M G CASH
6 6 Ot�JUN 21 q I 6.0 O AW
SEE SACK OF APPLICATION FOR COMPLETE SCHEDULE _
76A663 CE-W6(11 /78) -FO
IO
APPLICATION L (CAL PE _
COUNTY OF LOS ANGELES BUILDING2 D SAFETY ,
FORAPPLICANT TOFILLIN ADDRESS O3 E-
New Residential Bldgs'&Pools- EACH NO FEE - '-'
1 &2 Family Sq Ft E 025 - E LOCALITY
Mulh {omdy Sq Ft 02 RE
CROST
ResidepI Swimming Pools 25 00 —'OWNER OR - - - ---
FIRM NAME
Outlets Rec_Light_Sw _ MAIL _
First 20 50 ADDRESS
_Total No Additional 30 CIT - -Tel No
PLA CH K
.. APPLICANT_
Lighting Fixtures First 20 50 ADDRESS
Total No -Additional 30
CITY Tel No
Fixed Appliances Not Over I HP PERMIT --
Range.Hearer_D W _ APPLICANT
41
Oven�_Dryer_W M_ ADDRESS 66xf - -
Top —FAU _ WH _ _ CITY651C Tel Np, _..
Hood—Fan _Chher_ LICENSE __
Disp Room Air Cond 2 50 REG NUMBER f Class _ y
Power Apparatus&Large Appliances g pp I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI A
TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO
Size 8 Type HE KW KVA or KVAR _ COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS !
2 50 REGULATING ELECTRICAL WIRING iL
Up to 1 InI HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR —V
Over i to 10 Incl 5 00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF �pGyj
Over 10 to 150 0Ind - 1250---- CALIFORNIA HAT AM THE LEGAL O/ T}iE ABOVE T6
Over 5010 1001st 25 00 DESCRIBED R IDE TIAL PROPERTY
Over 100 4000 _ PERMITEE
SIGNATURE ��
Services - DISTRICT N PR -'
0 200 Amp Under 600 V 1250
201 1000 Amp Under 600 V 2500
Over 1000 Amp or Over 600 V 5000
Temp Power Pole d Appurtenances 10 00 r
Sign with One Branch Circuit 10 00 30
Additional Sign Branch Circuits 2 00 _ INSPECTION
Io 0o I INFORMATION yy"
Misc Conduits a Conductors ON REVERSE 4
Other(See Complete Fee Schedulel_ SIDE V
:28222A
PERMIT FEE (Sub Torah
A
PLAN CHECKING FEE Ione Fourth Permit Feel 219' 0G
0 2i
PERMIT ISSUING FEE E7 00 _ _ 9.TOTALFEE 1213-79
INSPECTION FINALED
dare -7 - to _�b By �'�", It
(Ps
COUNT: OF cos ANGELES APPLICATION FOR PERM
DEIIOF COUNTY AF ELECTRIC 1
DIVISION
ON O OENGINEER
SUlI.DII�iG 6 SAFETY
WIITIAM , COUNTY ENG MER
FOR API UTRANTO FILL IN DISTRICT NO GROUP NE PERMIT NO
ELECTRICIA
ADDR HCHIVIrD BY READY FOR DATE ISSUED
FIRST INSPECTION
CITY TEL N OT
COUNTY LICENSE - BUILDING
PERW Fm ADDRHSH
Tb
NUMBER EACH FEE LOCALITY
LIGHT OUTLETS NEAREST
RECEPTACLES _
WALL SWITCHES OWNER Mel
TOTAL OUTLETS ae
MAIL
ELEC RANGES IIS ADDRESS i
BLHC HEATERS IIS
LIXTUMIS a CITY TEL NO
misC 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
NUMBER OFUG CIR RS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
NU OF RECEPTACLE CU AND AGREE TO COMPLY WITH ALL COUNTY RDINANC
MMOTORSAND STATE LAWS REGULATING ELECTRICAL WIRING
I CERTIFY THAT 1 POSSESS THE ABOVI[ VAUD LO
NuHORSQPOWER FEE ANGELHS COUNTY LICENSE OR I AM THE LEGAL OWNS
Naw M. HP OVa11 INE aACX OF THE RlSIDERTI PROPERTY DESCRIBED ABOVE
li S IIe
SIGNATURE OF
VA s ao PEea1m
s a 1 040
�CTION BEWBD
5 1S 1 5o
IS SO II 50
So 200 5 DO
E00 OO 1000 J
500 1000 in Do a
Z
OVER 7000 2000 0
Y SET FRED CHANGER-XP a
WELDERS, AC-KVA O
GUN TORS-KW
TRANSFORMERS-KV
TEMP MOTORS 7 or ama
MOVED MOTORS 75 or oF1a
SC
SIGNS
NO NO TRANS AMOVALS
PERMIT, DATE I HCTOR'S NAME
WIRING $1 00 CONDUIT 1
FIXTURES $1 00 WIRING
F 50 FIXTURES
POWER
TOTAL FEE 5 , ZS UTILITY CO LfWIFIED
FINAIL il
7l OU 02a IIA o51
)eAeel CO Ilae NP 6/70 APPLICATION F ELECTRIC PERMIT
COUNTY OF LOS ANGELES opBg BUILDING AND
FOR APP1_14= TTO FILL IN ADDRESS
New Residential Bldgs &Pools EACH NO FEE
1 &2 Family Sq Ft Y — $ LOCALITY
Multi family Scl Ft — N7AREST
T
Residential Swimming Pools
tFA
Outlets Rec_Lght_Sw MAILL.
First 20 ADDRE
Total No Additional CITY Tel No
PLANHK
APPLI NT
Lighting Futures First 20 ADDRESS
Total No Additional
CITU Tel No
Foxed Appliances Not Over 1 HP 'PERMIT
Range—Heater—D W _ APPLICAADDRESS
Oven—Dryer—W M
Top _FAU _ WH _ CITY t Tel No —
Hood—Fan _Other_ LICENSE-
Dnp _Room Air Cond REG NU Clas
I HEREBY A KNOWL THAT I HAVE READ THIS APPLICA
Power Apparatus&Large Appliances TION AND STATE THAT TH ABOVE IS CORRECT AND AGREE TO
Size&Type HP KW KVA or KVAR COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING ELECTRICAL WIRING
Up to 1 Ind I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR O
Over I to 10 Ind LICENSED AS REQUIRED BY LOS ANGELES CO TY AND STATE OF Y
Over 10 to 50 Incl CALIFORNIA T AM THE GAL OF THE ABOVE
Over 50 to 100 Inc DESCRIB S N IAL P
Over 100 PERMIT
fSTRICT
NAT RE
Seances NO P E E J&eY
0 200 Amp Under 600 V s^s r O Q
201 1000 Amp Under 600 V vJ vAf
Over 1000 Amp or Over 600V =
O
Temp Power Pole&Appurtenances i
Sign with One Branch Circuit
Addmonol Sign Branch Circuits INSPECTION
yy
Mn< Conduits&Conductors t<
ors ON REVERSE 3
Other r m�Fee Schedule)_ SIDE U -2 51 0'6 A
p .'0d'e2
2 • • 1000
PERMIT FEE ISub Total) • •'• 1,Q005
PLAN CHECKING FEE Ione Fourth Permit Feel
0625-79
PERMIT ISSUING FEE =o
TOTAL FEE �A >
INSPECTION FINALED �,,J`
date tl/Z� By
60J WORKERS'COMPENSATION DECLARATION CE 806 APPLICATION FOR ELECTRIC PERMIT
1 • CE 806G (2 80) � i
I hereby affirm that 1 have or a certificate of consent to self COUNTY OF LOS ANGELES B N D SAFETY
insure or a certificate of Workers'Compensation Insurance,or
a certified copy thereof(Sec 3800,Lab C) '
Policy No Company FOR APPLICANT TO FILL IN JOB
New Residential Bldgs &Pools EACH NO FIVE ADDRESS Q
0 Cenefed copy is hereby furnished 1 &2 Family,Sq Ft $ __ S LOCALITY
RCertified co y g P Multi family So Ft MPF O
department copy filed with the county building inspection Residential Swimming Pools CR ST
V OWNER OR
Date Applicant a�f FIRM NAME
Outlets Ret ight�7L Sw AIL
v Fust 20 ADDRESS S 10,3 N ResE 41
CERTIFICATE OF EXEMPTION FROM WORKERS' Total No Additional CITU C Tal No 81,
!�
COMPENSATION INSURANCE
PLAN CHECK �� }O
6d n APPLICANT ��� /C U
(Thu permctitin need not be hundred xl if the work or less Lighting Fixtures First 20 17 �1 O�. I O s A u4,
by the permit u for one hundred dollars ($I00) or leu) g g Additional ADDRESS G 7 t1
I certifythat n the Total No�� / f
1 performance of the work for which this Fixed Appliances Not Over 1 HP CITY L� Tel No 3 FCUJ-
permit is Issued, 1 shall not employ any person in any manner PERMIT
so as to become subject to the Workers'Compensation Laws Range_Heater D W PP (CANT 3 W
Oven — Dryer_W M DRESSk. tp
Date///O=�Apphcant -, ' r Top _ FAU W H CITY-} Tel No g�p 3`f 3 Z
Hood _ Fan �Other_ /FML PL� V l
NOTICE TO APPLICANT I after making this Certl icate of Disp _ Room Air Cond_ L CENSE R '7 5'� Class C
Exemption you should come subject to the Workers REG NUMBER4 40
Compensation provisions of the Labor Code you must forth Power Apparatus& Large Appliances DISTRICT NO PRO E BY
with comply with such provisions or this permit shall be Size&Type HP, KW KVA or KVA er
deemed revoked a
Up to 1 Incl FINAL
/
LICENSED CONTRACTORS DECLARATION Over 1 t0 10 Intl DATE Over 10 to 50 Incl !p VALIDATIO
I hereby affirm that 1 am licensed under provisions of Chapter Over 50 to 100 Inc FINAL .._
9 (commencing with Section 7000) of Division 3 of the BussOver 100 3V
ness and Professions Code, and my license is in full force and
effect Services ( ^ ,41141
S/ G /O /-0.200 Amp Under 600 V ��(/Ze
License Number Lic Class p 201 1000 poop Under 600 V
ContractorAl C FIE Date �� ` O Over 1000 Amp or Over 600 V
HOME OWNER BUILDER DECLARATION Temp Power Pole&Appunenances
1 hereby affirm that 1 am exempt from the Contractor's Sign with One Branch Cirmit
License Lew for the following reason (Section 7031 5, Busi Additional Sign Branch Circuits
ness and Profmsions Code)
Muc Conduits&Conductors
O 1 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 _ 3 0 Q U A
7044, Business and Professions Code)
CONSTRULTION LENDING AGENCY # • • • a • 2
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) 2 - 30.60
issued (Sec 3097 Civ C)
Lender s Name PLAN CHECKING FEE (One-Fourth Permit Feel •i• • 3 Q 6 0
Lender's Address i
PERMIT ISSUING FEE 1111, 0-80
I certify that 1 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
thea a men tied property for impaction purposes
\ SEE REVERSE FOR EXPLANATORY LANGUAGE
p
O'O
nature of Permittee 41, Date
WORKER S COMPENSATION DECLARATION DPW(12 91) APPLICATION FOR ELECTRICAL PERMIT IJ
I hereby aflNm that 1 have a certificate of consent to self insure
or a certificate of Worker a Compensation Insurance or a certified COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV
copy thereof(Sec 3800 Lab C)
Policy No 70Z Og/ Company STipT6 r4f VP FOR APPLICANT TO FILL IN .foe
❑ Certified is furnished '��� 6Sa3 --ft/ �GISCieeC
copy Y New Residential Bldgs 8 Pole NO EACH FEE
(p� — $ $ LOCALITY TtreepC'G C/
d
L91Caroledtm copy q filed with the county building inspection 1 8 2 Family Sci Ft
department Multi feisty F Sq Ft — C�BST
Date /- /7 Applicem ✓eA5C �!1{sr Restdemiel Swimming Poole ASSESSOR
MAP BOOK PAGE PARCEL
CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec —Light Sw _ OWN E,= t?O/1ST a1/
COMPENSATION INSURANCE FIRM
20
(This secUon need not be completed If the work Involved by the ADDRESS
permit Is for one hundred dollars($100)or leu) Total No Additional FirstMnIL 7 SPLrO,✓ T
I certify that in the performance of the work for which this permit CITY /7o G'.d Tet eZ -y 7
is issued I shell not employ any person in any manner so as to PUN CHECK
become subject to the Workers Compensation Laws Lighting Fixtures First 20 APPLICANT p,y L E Ttr/i✓
Total No Addmonal ADDRESS
Date Appkranl - 17 !� Ls.✓ tr
RESIDENTIAL APPLIANCES NOT OVER 3 HP
NOTICE TO APPLICANT O alter o the Workers
Certificate oCompensation
of Cm �reMr Tet No -
Exemptron you ehLab became subject to the Workers Cly with such OTHER APPLIANCES NOT OVER 3 HP _
provisions of the permit
Coda you deemed
forthwith comply with each Power Apparatus s Large Appliances APPLICANT /vF��C i✓P
provisions or INS perms shell be deemed revoketl
LICENSED CONTRACTORS DECLARATION Sue 8 Type HP KW KVA or KVAR ADDRESSar /;kozli
I hereby affirm that I em licensed under provisions of Chapter B Over 3 to 101nc1
(commencing with Section 7000) of Division 3 of the Business and CITY TM
Professions Code and my license is in lull force and effect Over 10 to 50 Ind LICENSE OR }
b Over 50 to 1 D Ind REG NUMBER Q�(
L1sae f•- $ d
License Number /z,, a/ Llc Class �'-�s Over 100 DISTR$GT NO p P ED BY O
Services Swbd MCC 8 PanelboaNs ,�O Cit
Contractor✓f/1SrOI /1r0,l Date - 17-9V 0 399 Amp Under 800 VDATE
(Iy, ,,/� { O
El I ant exempt antler Sec 400 1000 Amp Under 800 V I� Z q J n V
Over 1000 Amp or Over 600 V FINAL d
B dP C for this reason BRANCH CIRCUIT FEES BY
Date 15A or 20A 120V Lghung or Recept 2
A /�� 1 To 10 Branch Circuits
nature -Jc 11To40 ranch Caane
41 Or More Branch Craun 'i
❑ Exemption for Reg Maint Elect 15A 20A 20 VV To 277V Lighting Br 0=0 -
SINGLE FAMILY Temp Porter Pole 8 Appurtenances Ai-'.T.AT
HOME OWNER BUILDER DECLARATION Sign woh One Branch Circuit 7� c
1 hereby affirm that 1 am exempt from the Contractors License Lew ,3[Ij 63.4.
for the following reason (Section 7031 5 Business and Professions Additional Sign Branch Circuits
Code) 1 TT—r M-
I as owner of the property will do the work and the structure Misc Conduits 8 Conductors TOTAL 63 w 45,
is not intended or offered for este (Section 7044 Business Other(See Complete Fee Schedule)_
and Professions Code) , i-HE[N 63.4!c
CONSTRUCTION LENDING AGENCY CHANGE Al
I hereby affirm that there is a construction lending agency for the
performance r)ance of the work for which this permit m issued(Sec 3097 PERMIT FEE (Sub-Total)
PLAN CHECKING FEE
Lenders Name '703 1 AI11O%4',
PERMIT ISSUING FEE �G
IArmer a Address TOTAL FEE G�,
I cenity that I have reed this application and under penalty of purjury state
that the above information is carred I agree to comply with all County
ordinances and State laws regulating Electrical vnnng and hereby authonze
representatives of this County to enter upon the above-menticned property
for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE
7 TY
e�AfUHE OF PERYRTEE DATE
I �?
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0406140003
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE* (626) 285-0488 EXT
LEGAL ID FEES PAID HUI
ON FILE 6503 ROSEMEAD SL-
FEE DESCRIPTION QUANTITY LON AMOUNT SGAS CA 917751936
ASSESSOR • NEAREST CROSS STREET EMPEROR '^"
5381-030-009 AW PC CITY $109 35 MIN 0 00 670 53 THOMAS PAGE. 596 GRID H1 LOCALITY SAN GABRIEL,`C
Al PERMIT ISSUANCE FEE 27 75
TENANT F1 120V, 15120A BR CKTS 46 00 BR 683 25
ISSUED ON PROCESSED BY PLAN BY MwEr-ar-
SAN GABRIEL VALLEY DENTAL GROUP G1 OUTLETS-LGT SW,RECP 4 00 OUT 7 80 06/14/04 VG 12/11/04
IB N-RES WTR HfR LT 3HP 1 00 WTR 15 30
OWNER JA HEATSIGN , OUT +3-10HP 3 00 SI 58 95 I�g_ FINAL BY CODE
7215 ROSE JOSEPH (626) 286-2156- K1 SIGNS, OUTLINE LMT 1 00 SIG 38 BS /Y1 /
7215 ROSEMEAD BLVD LB 200 AMP PANELS; MCC 2 00 PAN 77 70
TEMPLE CITY 91780 LD 400 AMP PANELS, MCC 1 00 PAN (6 OS DESCRIPTION OF WKK
TOTAL FEES 1,656 18 ELECTR>CAL FOR DENTAL TENANT IMPROVEMENT
APPLICANT TEL NO
CDREY/BRAEUTIGAM (626) 449-9380-
696 E COLORADO #226 SPECIAL
PASADENA, CA 91101
CONTRACTOR
AP L H
SOUTH CAL CONSTRUCTION (818) 264-1531- - - _ ,
6419 VANALDEN AVE LIC NO TEMPORARY POWER POLE
RESEDA, CA 91335 756435 B
G
ARCHITECT
COREY, BRAEUTIGAM (626) 449-9380-
696 E COLORADO BLVD , #226 LIC NO ROUGH CONDUIT
PASADENA, CA 91101 NONE WIRING-
ROUGH
PLASTIC Y/N METAL Y/N
REPORT ID DPR265 ROUTE TO BSO50B
COUNTY OF LOS ANr.LK 7-rDLc CITY A 0568 ELECTRICAL Fc-
DEPA°TMENT OF PUBLIC I00KS ^"'OI LAS TUNAS EL 0508 04101
OUILDI)1I, AND SAFETY / LAND DEVELOPMENT TEMDL' CITY CA 91780
.. _ ,126) 285-0488 EX
FEES
ON FILE LDI,iG ADDRESS
i�3 ROSEMEAD BL
FEE DESrRIFTTOP QUANTITY UGH AMOUNT ..5 G 917751936
ASSESSOR Nroo A', J' ,PEST CROSS STREET EMF
5381-030-009 Al PERMIT ISSUr,CE FEE 27 75 -L100S PPGE 596 GRID II. L-ALITY SAN GABRIEL,
K1 SIGNS, OUTL NE LGT 1 00 SIC 38 85
[ENANTTOTAL FEES 66 60 0
10/14/04 JK 04/12/05
OWNER: - N -
FINAL BY
_ I
ROSE
7215 ROSEM JOSEPH (626) 286-2156- 57� U
7215 ROSEMEAD 6LVJ
TEMPLE CITY 0'73C unzh NI-dvuroRK -'
ELECTP,,A,- OR SIGN
t
APPLICANT
L 1'�
A STAR SINGS (318` 982-1611-
11920 VALERlu ai PM - NDITIONS -�
N HOLLY1A100 C^ 91605
L NO TP -VA;,, INSPLCfOR �IGNATURE -i
A STAR SIGNS (818) 982-1611-
11920 VALER,O STRcLT LIC NO TENFdkA.t1T-'�6 p L.
NORTH HOU V-OD, C4 91605 592403C45
UNDERGROUND CONDUIT
ARCHITECT OR EI 1V 51�hT(j TJFCR G'01D -
LIC NO OLE OONDJIT -
i
_- - FYNTET -L-P.TE
PLASTIC I/N METAL Y/N _ -
T1TT�+�c0A6AAS-pbTT�I
I—'
i
I
REPORT ID DPR265 ROUTE TO BS0508
COUNTY OF LOS ANGELES TEMPLE CITY { N 0508 %LBCTRICAL PERMIT
DEPARTMENT OF PUBLIC NOR" 9701 LAS TUNAS ✓ EL 0508 0506140021
BUILDING AND SAFETY / LAND DBVELOPMBNT TEMPLE CITY CA 91780
PHONE (626) 285-0488 E=
LEGAL IO PEES PAID BUILDING ADDRESS
ON PILE
6503 CA 9177 917755 BL
Y%8 DESCRIPTION QUANTITY DUN AMOUNT SGAB CA 1936
ASSESSORINFORMATION NND®eR NEAREST CROSS STREET
538
5381-030-030-009 Al PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID 81 LOCALITY TEMPLE CITY C
D3 BOOTH LGT SYSTEM 1 00 BOO 16 20
TENANT TOTAL PEES 43 95 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON
06/1+/05 JH 12/11/05
OWNER TEL NO P 9AT% PIN BY CODE
BERNSTEIN DONALD W CO TR
810 DEVON AV `O
LOSA 90022508
DESCRIPTION OF WORA
ELECTRICAL POR PIR% ORR STAND 2005
APPLICANT TEL NO
J S A ELECTRICAL SERVICE (626) 836-5881-
SPECIAL CONDITIONS
CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE
J S A ELECTRICAL SERVICE (626) 836-5881-
38 E NONTECITO MIT 9 LIC NO TEMPORARY POWER POLE
SIERRA MADRE CA 91024 760126CIO
UNDERGROUND CONDUIT
ARCHIT&CT OR BNGIN88R TEL NO UPER GROUND
LIC NO ROUGH CONDUIT
ROUGH WIRING
WAIN WATER LIN%
PLASTIC YIN METAL YIN
UTILITY COMPANY NOTIFIED
REPORT IO DPR265 ROUT% TO BS0508
COONTY OF LOS ANGELES TEMPLE CITY F 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TURAS BL OSOS 0606130057
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (676) 785-0488 EST
f
LEGAL ID FEES PAID BUILDING ADDRESS
ON FILE 6503 ROSEMEAD BL - � 1
FEE DESCRIPTION QUANTITY UOM AMOUNT SGAS CA 917751936 --
ASSESSOR INFORMATION NUMBER NBARSST,CROSS STREET
5381-030-009 Al PERMIT ISSUANCE FEE 77 75 � `THOIRPS,PAGE 596 GRID H3 ;LOCALITY TEMPLE CITY, C
D3 BOOTH LGT, SYSTEM 1 00 BOO 16 70
TENANT TOTAL PEES 43 95 ISSUED ON PROCESSED BY PLAN BY EAPIRRS ON )
06/13/06 JH 17/10/06 i
ERNTRL NO _ P LW1T'gI FIFINAL BY CODE
B1VIN DONALD M CO TR
9 - ,!fblb
8100 S DEVON AV
L09A 900747508 DRFMIFTION R NORM
ELECTRICAL FOR PIRENORIC STAND 7006
APPLICANT TEL NO
J S A ELECTRICAL SERVICE (676) 836-5881-
SPECIAL CONDITIONS
i
CONTRACTOR TEL NO APPPOVALS DATE INSPECTOR SIGNATURE
J 8 A ELECTRICAL SERVICE (676) 836-5881-
38 B MONTECITO UNIT 9 LIC NO ) L TEMPORARY ROVER ROLE
SIERRA NADRE CA 91074 760136CIO
UNDDRGROURD CONDUIT
ARCHITECT OR ENGINEER TEL NO U76R GROUND
LIC NO ROUGH CONDUIT
ROUGH MIRING
MAIJ MATER LINE
PLASTIC YIN METAL YIN
UTILITY COMPANY NOTIFIED
REPORT ID DPR765 ROUTE TO BS0508
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORM 9701 LAS TUNAS EL 0508 0706180026
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 6KT
LEGAL ID FEES PAIDBUILDING ADDRESS
1 ON FILE 6503 ROSEMEAD BL I
FEE DESCRIPTION QUANTITY DOM AFDOMT SGAB CA 917751936
ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET
5381-030-009 Al PERMIT ISSUANCE FEE 27 75 I THOMAS PAGE 596 GRID H1 LOCALITY TEMPLE CITY, Cl
D3 BOOTH I.GT, SYSTEM 1 00 BOO 16 20
ITEWANT TOTAL FEES 43 95 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON
TEMPLE CITY PONY BASEBALL 06/18/07 SR 12/15/07
I
OWNER TEL NO FINAyi qfy� CODE
JBERN STEIN DONALD W CO TR
810 DEVON AV
�IOSA 900242508 I DESCRIPTION OF WORK
IELECTRICAL FOR FIREWORKS STAND 2007 1
APPLICANT TEL NO
PEGGY PIERCE (626) 355-4942-
1150 E MONTECITO AVE SPECIAL CONDITIONS
SIERRA MADRE 91024
CONTRAC-MR TEL NO APPROVALS DATE INSPECTOR SIGNATURE
IJ S A ELECTRICAL SERVICE (626) 836-5881-
1150 E MONTECITO AVE SUITE D LIC NO TEMPORARY POWER POLE
SIERRA MADRE, CA 91024 760126C10 1
UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER TEL NO IUFER GROUND I I
LIC NO I (ROUGH CONDUIT
ROUGH WIRING
I
FAIN PATER LINE
PLASTIC YIN METAL YIN I
jI UTILITY COMPANY NOTIFIED
� i I
I
1 I I I 1
I I �
I �
1 I
I �
REPORT ID DPR265 ROOTS TO BS0508 1
COUNTY OF LOS ANGELES TENPLE CITY N 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0806170004
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
ILEGALN IDFILE FEES PAID BUILDING ADDRESS
O6503 ROSEMEAD BL
IFEE DESCRIPTION QUANTITY DOM AMOUNT SGAB CA 917751936
(ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET
15381-030-009 IA1 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID H1 LOCALITY TEMPLE CITY Cl
TENANT �D3 BOOTH LGT, SYSTEM 1 00 BOO 16 20
TOTAL FEES 43 95 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON
TEMPLE CITY PONY BASEBALL I I06/17/a8 SR 12/14/oe
I I �
TOWNER TEL NO FIpiAL DATE FIN51,BY CODE
BERNSTEIN DONALD W CO TA
1810 DEVON AV
ILOSA 900242508 jD^RIPTION OF FORA
(ELECTRICAL FOR FIREWORKS STAND 2008
(APPLICANT TEL NO
JPEGGY PIERCE (626) 355-4942-
1150 E MONTECITO AVE SPECIAL CONDITIONS
SIERRA MADRE 91024
I I
CONTRACTOR TEL NO
APPROVALS DATE INSPECTOR SIGNATURE
S S A ELECTRICAL SERVICE (626) 836-5881-
150 E MONTECITO AVE SUITE D LIC NO TEMPORARY POWER POLE
(SIERRA MADRE CA 91024 760126C10
_(UNDERGROUND CONDUIT
I I
(ARCHITECT OR ENGINEER TEL NO IUFER GROUND
LIC NO IROUGH CONDUIT
I ( I ROUGH WIRING
E
IN WATERLINEEASTIC Y/N METAL Y/N
ILITY COMPANY NOTIFIED
I I I I I I
I I I I
I I
I � I
IREPORT ID DPP265 ROUTE TV SS0508
COUNTY OF LOS ANGELES TEMPLE CITY R 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0906170038
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID FEES PAID BUILDING ADDRESS
ON FILEI 6503 ROSEMEAD L
FEE DESCRIPTION QUANTITY DOM AMOUNT I SGAB CA 917751B936
(ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET
15381-030-009 Al PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID H1 LOCALITY TEMPLE CITY, Cl
ID3 BooTH LOT SYSTEM 1 00 BOO 16 20
TENANT I TOTAL FEES 43 95 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON
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IOHNER TEL NO FI�AI. DAlE(y FINAL BY CODE
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PEGGY PIERCE (626) 355-4942-
150 E MONTECITO AVE SPECIAL CONDITIONS
SIERRA MADRE 91024
CONTRACTOR TEL NO APPROVALS DATE INSPECTOR 9IGNATORE
J s A ELECTRICAL SERVICE, INC (626) 926-4997- I
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COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1006090037
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID FEES PAIDBUILDING ADDRESS
ON FILE 6503 ROSEMEAD BL
ASSESSOR INFORMATION
(FEE DESCRIPTION QUANTITY DOM AMOUNT I SGAB CA 917751936
NUMEER NEAREST CROSS STREET
15381-030-009 IA1 PERMIT ISSUANCE FEEI
27 75 THOMA9 PAGE 596 GRID H1 LOCALITY TEMPLE CITY C
D3 BOOTH U3f, SYSTEM TOTAL FE00 ES 016 20
TENANT 00 43 95 TISSUED ON PROCESSED BY PLAN BY
TEMPLE CITY PONY BA9ERALL 06/10/10 SR
]OWNER TEL NO FZ[ L DATE FY CODE
IJOSEPH R096NHERG (626) 286-2156- (/V�//�/✓`•'Yl/{�V,
6503 N ROSEMEAD SL
TEMPLE CITY CA 91780 DESCRIPTION OF FORK
FIREWORKS STAND LIGHTING 2010
(APPLICANT TEL NO
TNT FIREWORKDS, BRAD HUDSON (714) 738-1002-159
555 N GILBERT ST ISPECIAL CONDITIONS
FULLERTON CA 92833
K C LTR TEL NO (APPROVALS DATE INSPECTOR SIGNATURE[ C ELECTRIC (562) 867-M 17-
6509 GLORYWHITE ST LIC NO IT04PORARY POWER POLE
LAKEWOOD, CA 90713 699521 C101(UNDERGROUND CONDUIT I
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REPORT ID DPR265 ROUTE TO M0508
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COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1105030030
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
(LEGAL ID FEES PAID BOILDING ADDRESS
ON FILE 6503 ROSEMEAD BL
IFEE DESCRIPTION QUANTITY UOM AMOUNT $GAB CA 917751936
(ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET
15381-030-009 1A1 PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 596 GRID H1 LOCALITY TEMPLE CITY C
I 1D3 BOOTH WT SYSTEM 1 00 BOO 16 15
ITENANT TOTAL FEES 43 95 ISSUED ON PROCESSED BY PLAN BY
ITEMPLE CITY PONY BASEBALL 105/03/11 SR 1
TOWNER TEL NO I IFI DATE F BY CODE
IROSENBERG, DORREN (626) 286-2156- 1I
16503 N ROSEMEAD SL Acyl
ITEMPLE CITY CA 91780DEQ. IPTION OF YORK
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(APPLICANT TEL NO
ITNT FIREWORMS, BRAD HUDSON (714) 738-1002-159 1 I 1
1555 N GILBERT ST 1SPECIAL CONDITIONS I
FULLERTON CA 92633
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)REPORT ID DPR265 ROUTE TO BS0508 I
COUNTY OF IDS ANGELES TEMPLE CITY K 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC FORKS 9701 LAS TUNAS EL 0508 1205290046
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID FEES PAID BUILDING ADDRESS
ON FILE6503 ROSEMEAD BL
IFEE DESCRIPTION QUANTITY DOM AMOUNT SGAB CA 917751936
(ASSESSOR INFORMATION NUMBER I 1 NEAREST CROSS STREET EMPEROR 1
15381-030-009 IAT PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 596 GRID H1 LOCALITY TEMPLE CITY Cl
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IROSENBERG DORREN (626) 286-2156- IZ
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COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC FORKS 9701 LAS TUNAS EL 0508 1306030073
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID FEES PAID BUILDING ADDRESS
ON FILE 1 6503 ROSEMEAD BL
IFEE DESCRIPTION QUANTITY DOM AMOUNT BOAS CA 91]]51936
ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET EMPEROR
5381-030-009 1A1 PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 596 GRID H1 LOCALITY TEMPLE CITY Cl
ID3 BOOTH LOT SYSTEM 1 00 BOO 16 15
TENANT I TOTAL FEES 43 95 ISSUED ON PROCESSED BY !PLAN BY
TEMPLE CITY AYSO 06/03/13 SR `
OWNER TEL NO IFI/}y�CAALL F?NAL�BY CODE
6503ROSSNeAR DORREN (626) 286-2156- I L�1 ?j 3
6503 N ROS EMHAD BL �C
ITEMPLE CITY CA 91780 I DFSCRI TION OF MORN
IFIREWORKS STAND LIGHTING 2013
(APPLICANT TEL NO
ITNT FIREWORKS BRAD HUDSON (714) 738-1002-159
1555 N GILBERT ST SPECIAL CONDITIONS
FULLERTON CA 92833
ICONTRAR TEL NO I IAPe'ROVALS DATE INSPECTOR SIGNATURE
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R C ELECTRIC (719) 699-0106- I— I
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COUNTY OF LOS ANGELES TEMPLE CITY # 0506 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS
EL 0508 1405270071
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID FEES PAID BUILDING ADDRESS
ON FILE 6503 ROSE14EAD BL
FEE DESCRIPTION QDANTITY UOM AMOUNT SGAB CA 917751936
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET EMPEROR
5381-030-009 Al PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 596 GRID H1 LOCALITY TEMPLE CITY Cl
ID3 BOOTH IGT SYSTEM 1 00 BOO 16 20
TENANT TOTAL FEES 44 00 ISSUED ON PROCESSED BY PLAN BY
TEMPLE CITY AYSO I 05/27/14 SR
(OWNER TEL NO (FINAL DATE FINAL Y Imo! CODE
IROSENBERG DARKEN (626) 286-2156- �y// _
16503 N ROSEMEAD BL a`� 'y V/
(TEMPLE CITY CA 91780 DESCRIPTION OF WORK
1 i FIREWORKS STAND LIpNTING 2014 1
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TNT FIREWORKS, BRAD HUDSON (714) 738-1002-1159
555 N GILBERT ST SPECIAL CONDITIONS
FULLERTON CA 92833
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ICONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE
R C ELECTRIC (714) 699-0106-
I4440 CHARLEMAGNE AVE LIC NO TEMPORARY POWER POLE
LONG BEACH CA 90808 699521
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