HomeMy Public PortalAbout5928 ROWLAND AVE_Electrical__ 78A663-CE806 9-67 APPLICATION FOR ELECTRICAL PERMI�
COUNTY OF LOS ANGELES
DEPARTMENT OF'COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS57J-9OW
JOHN A. LAMBIE. COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDINGLOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NO. EACH FEE 4
$ $ OWNER. @ iL/luC� L.1 to
RECEPT._ - MA I
AIL
LIGHT TOTAL FIRST 20 .20 ADDRESS W
SWITCH OVER 20 .10 CITY C TEL. NO. r
LIGHTING �TOTAL FIRST 20 .20 CONTRACTOR�/ W/Yia/ a l-gtiJFIXTURES OVER 20 .10 ADDRESS
}Ac6l it/ q
RANGE—DRYER_WTR.HTR.— CITY COV;NA TEL. NO. i I- Q
STA.COO K_DISP._F.A.U.-Y-- LICENSE NO. aOVGP-Y
SPACE HTR. AIR COND.—y— - 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
CLOTHES WASH-DISHWAS H._ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
��`` ELECTRICAL WIRING.
FAN—OTHER .2 1.00 Dv 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
MOTORS,TRANSFORMERS. RATING LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
IND. HEATERS, ETC. HP. KW. KVA. RESIDE IN, THE ABOVE DESCRISIM RESIDENTIAL PROPERTY.
SIZE & TYPE OVER TO
SIGNATURE ,i
il
0 - 1 1 1.00 OF PERMITTEE
1 - 10 3.00 DISTRICT O. GROUP Z PRO D BY V
10 _ 50 S.,001
50 - 100 10.00 NOTES: Lu
100 - 500 15.00 J2
y
SIGN•,GAS SIGN AND ONE CIRCUIT 3.00
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00
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 INSPECTOR'S SIGNATURE
TEMP. POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT A
WIRING ] -�,o AO°� AR
ISSUING FEE 2.00 15v �—
FIXTURES
SUPPLEMENTARY ISSUING FEE 1.00 POWER AUTHORIZED
PERMIT FEE UTILITYCO.NOTIFIED
PLAN CHECK FEE (.50% PERMIT FEE) FINAL �� Q
TOTAL FEE JOSEPH C. ROOHAN -
SUPERVISING ELE CAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
20-:ELACoZ.5-0-Ir Jm $ 2 D 420-
EE
BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Department of County Engineer
DIVISION OF BUILDING & SAF47Y
WILLIAM J. FOX, County Engineer
DISTRICT NO. GROUP ZONE PERMIT NO.
FOR APPLICANT TO F IN Jl� C_ C/ZT6,Ir
(� ELECTRICIAN _
RECEIVED BY READY FOR DATE ISSUED
ADDRESSFIRST INSPECTION
CITY TEL NO. JC'-o9f
' COUNTY LICENS O. EXPIRES BUILDADDRESS
NUMBER
10111
FEES
NUMBER EACH FEE LOCALITY
LIGHT OUTLETS NEAREST
CROBB ST. /`7tJ"r1 G�•'w��=� 4
RECEPTACLES 72
WALL SWITCHES �_ e
OWNER 1J.; 2�- �k.�.•."�.;«.;+ , �q
TOTAL OUTLETS Sc i9 d MAIL ~ •�
ELEC. RANGES 25 ,
ADDRESOKI1 �wf !1 i l� f��� ..
ELEC. HEATERS 25 VL
CITY
FIXTURES 6 s sO /iu'i-.J:p� at•a �9 TEL. NO.
v
1 HEREBY IYyyACKNOWLEDSFgy THAT 1 HAVE READ THIS
MISC. APPLICATION AND STATE THAT THE ABOVE IB CORRECT
NUMBER DF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING.
MOTORS 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
NUMBER HORSEPOWERFEE ANGELES COUNTY LICENSE. OR 1 AM THE LEBAL OWNER
NEW MvD. HP OVER INC. EARN OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
Y8 a LE813 111 .25 SIGNATURE OF
Iis 2 .591 PERMITTE �_
✓ !/ / ! V
2 B 1.00 ,INSPECTION RECORD"
5 1B 1.50
Is so 2.50
_ s0 200 5.091
200 son 10.00 J
6910 1000 15.00p � ��� �, Z
OVER 1000 20.00 y}yF' p
M.G. BET/FREW. CHANGER-HP I/ > In u,
WELDERS'AC-KVA _
GENERATORS - KW 1;Ay+jq I?IJA 14 egg apse-lelgr-D
TRANSFORMERS - KVA
TEMP. MOTORS (75% OF ORIG.) _ ..//''
MOVED MOTORS (75% DF DRIB.) 6'/
MIBC. /F
SIGNS RIJOR10
NO. NO.TRANS. -may,
APPROVALS
NO. NO.LAMPS ( C! s
FOR EACH PERMIT' DATE INSP CTOR'B NAME
WIRING 161.00 CONDUIT 1? "e[ n� `.ZZ•
FIXTURES 1111.00 WIRING
SUPPLEMENTARY .50 FIXTURES
POWER
TOTAL FEE16 •urILITY co.NOTIFIED
FINAL V3 (1-1 -1/1-1 4XVIKU7
48A663 DBS#5A 4-52
M SA 25M
DBDEP�ET DEPARTMENT OF BUILDING AM SAFE i g 411 ®N FOR PEE=
COUNTX OF LOS ANGELES ELECTRIC
WM. J. FOX CHIEF ENGINEER°
a NAME DISTRICT NO. GROUP ZONE PERMIT NO.
ADDRESS 2 °
sal.
�y o RECEIVED BY READY FOR DATE ISSUED
._
CITY pp (L.?1 !TEL.NO. L FIRST INSPECTIONCOUNTY
d RT.NO. V� _ EXPIRES
APPLICANT FILL IN HEAVILY AtTLINED POIi.TION ONLY
DESCRIMON OF WORK ADDRESS �s6
NUMBER OF OUTLETS ON CIRCUITS , LOCALITY
LOCATION BY ROOMS
NEAREST �ry �
LIGHT OUTLETS JSW. PLUGS I Fl7[T CROSS ST. ! !�
CIRCUIT A B C D E F IG FI I N NAME � ev uIII MAIL
> r x
ADDRESS
c 1 6,/ '-
CITY:r
�� s- TEL No.
I AM 1HE LZAAL POSS OR OF THE ABOV-pp LOS
ANGELES COUNTY C In fI TE F UALIVIC�•1'A.
•4
ELECTRICIAN,
4 AM THIO LWAL ER OF 4H4r ROPF,RTY DESCRI
ABOVX
OWNER.
9 CO MONS
J
Q
Z
R'
O
TOTAL
NO. OF OUTLETS S D APPROVALS
NO. OF FIXTURES !8AS' DATE INSPECTOR'S NAME
NO. OF MOTORS H.P. $ CONDUIT /f
NO. OF SIGNS TRANS. B WIRING
NO. OF RANGES OR HEATERS 5i FIXTURES
MISCE LAN OUS S POWER
PERMIT FEE 1 UTILITY CO.NOTIFIED % f
rowel_FEg 1 FINAL % �G�•(•f'sem
-.., -" IgE-BO6G (2-801
RS'COMPENSATIONDECLARATION 3 APPLICATION FOR ELECTRICAL PERMIT
CE-80
Yhereb? affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY
insure,or a certificate of Workers'Compensation Insurance,or
a certified copy thereof(Sec.3800,Lab.C.)
FOR APPLICANT TO FILL IN JOB mU
Policy No. Company
New Residential Bldgs.&Pools EACH NO. FEE ADDRESS
Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ — $ LOCALITY �� �� ow;A.
Multi-family Sq.Ft. NEAREST
Certified copy is filed with the county building inspectionSS ST
Residential Swimming Pools CRO
department. OWNEROR Mo— /_/4Gt /��
FIRM NAME fA
Date Applicant Outlets: Rec.—Light Sw. MAIL
First 20 ADDRESS SAI'Ve,:
CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY Tel'No.
COMPENSATION INSURANCE PLAN.CHECK
�a
APPLICANT
(This section need not be completed if the work involved V
t 20 First Fixtures xtures rs
by the permit is for one hundred dollars ($100) or less.) LigADDRESS Cc No. Additional O
I certify that in the performance of the work for which this Fixed Appliances Not-Over 1 HP CITY Tel No. U
permit is issued, I shall not employ any person in any manner PERMIT 5;AX9u�L /1 .�_ 9 W
so as to become subject to the W rkers'Compensat r Laws. Range_Heater D.W._ APPLICANT 1'-i�Cs Oi/ a
�e ¢ Oven _ Dryer_W.M._ ADDRESS 92_&0�Ze �� CO
Date Q Applicant Top _ FAU _W.H.._ —
:Hood _ Fan _Other_ CITY Tel No.2
NOTICE TO APPLICANT: If, after making this Certificate of Disp. Room Air Cond._ . LICENSE OR
Exemption, you should become subject to the Workers' �( AI REG.NUMBER Z ass e-/to
Compensation provisions of the Labor Code, you must forth- Power A;Af, �I?R A np�
with com ly.with such pparatus Large ppliances DISTRICT NO. PROCESSED BY
p provisions or this permit shall be
deemed revoked. Size&Type HP,KW,KVA,or KVAR S�or
Up to 1 Incl.
FINAL
Over 1 to 10 Incl. DATE
LICENSED CONTRACTORS DECLARATIONOver 10 to 50 Incl. -� VALI TION
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. Servic
0-200 mp.Under 600 V �+
License Number Lic.Class 201-1000 Amp.Under 600 V
Contractor Date Over 1000 Amp.or Over 600 V
HOME OWNER-BUILDER DECLARATION Temp.Power Pole&Appurtenances
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 2 9 1.7A
,7 A
ness and Professions Code):
Misc.Conduits&Conductors # o,0 0 0 0 2
I, as owner of the property, will do the work and the Other(See Complete Fee Schedule)— t,p,
structure is not intended or offered for sale (Section
7044,Business and Professions Code). 1 - 2900
CONSTRUCTION LENDING AGENCY
1 hereby affirm that there is a construction lending agency
for the performance of the work for which this permit is PERMIT FEE (Sub-Total)
o o o 2 9 O Q 23
issued(Sec.3097,Civ.C.).
Lender's Name PLAN CHECKING FEE* (One-Fourth Permit Fee)� o9. 1 6y85
Lender's Address PERMIT ISSUING FEE
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
Lhthoritze represe x of this County to enter uponmenioned p perty fo inspection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE
Signature of Permittee Date
I i
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0212170019
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL I D, FEES PAID BUILOM ADDRESS:
TR: 6561 LT: 19 5928 ROWLAND AV
FEE DESCRIPTION: QUANTITY: LION: AMOUNT: TEMP CA 917802240
ASSESSOR 0 0 ER: NEAREST CROSS STREET: LAS TUNAS
8587-032-011 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY
HA FAU LESS 3HP 1.00 FAU 10.95
TENANT: TOTAL FEES 38.70 ISSUED 0 PROCESSED L EXPIRES O :
12/17/02 JK 06/15/03
OWNER: TEL. 0: FIN DAT FINAL BY: CODE:
JENKINS;MALIA - Z
5928 ROWLAND AV
TEMPLE CITY 91780 D S R P 0 0 R
C/O FURNACE
APP TEL.-NO:
GERI FOX (FAST TRAK PERMIT SERVICE) (909) 279-0604-
5030 VICEROY AVENUE SPECIAL CONDITIONS:
NORCO 92860
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
AIR-TRO INC. (626) 357-5311-
1630 S. MYRTLE AVE. LIC. NO TEMPORARY POWER POLE
MONROVIA, CA 91016 258228 C20
UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER: L. N0: UFER GROUND
LIC. NO: ROUGH CONDUIT
ROUGH WIRING__
MAIN WATER LINE
PLASTIC Y/N METAL Y/N
UTILITY COMPANY NOTIFIED
REPORT ID: DPR265 ROUTE TO: BS0508