HomeMy Public PortalAbout5505 RYLAND AVE_Electrical__ 7GA663 D86 SA 3-50 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES �� 7MECTRIC' I
WILLIAM J. FOX, CHIEF ENGINEER C
FORPPLIOANr,TO FILL IN DISTRICT O. GROUP ZONE PERMIT NO.
ELECTRICIAN �1/1✓L�✓ ,L'.%J+�. RE C LVED BY READY FOR Cj E I ED
ADDRESS aI d11474h ) .• FIRST INSPECTION
CITY TEL NO.
COUNTY LICENSE NO. 6 EXPIRES BUILDINGZ52- 4-6
� _
PERMIT .FEES ADDRESS , -- r� �t
c
NUMBER EACH .FEE LOCALITY
LIGHT OUTLETS NEAREST /
RECEPTACLES CROSS ST.
WALL SWITCHES OWNER
TOTAL OUTLETS 5D IB aL () MAIL
ELEC. RANGES 85 ADDREEB
ELEC. HEATERS 25 CITY TEL. NO.
FIXTURES 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
MISC. 11�� 12 1- APPLICATION AND STATE THAT THE ABOVE IS CORRECT
•
NUMBER LIGHT CIR08ITS 3 AND AGREE TO COMPLY WITH ALL. COUNTY 'ORDJNANCES
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, DRQ 1 AM THE. LEGO
AL OWNER
HER
MVD. HP OVER INC. EACH OF THE RESIDEN,TQkL PROPERTY DESCRIBEDABOVE.
s'
YX
6 LE89 E .25 SIGNATURE OF , .+ e.
'/2 2, .50 PERMITTEL l _. s: 1'�'-fir
r
A` /
2 5 l.aD G' NSPECTION RECORD
5 75 1.50
15 50 2.50
5o ZOO 5.00
200. Sao 10.00 J
BOB luau 15.00 Z
OVER 1000 20.00. 0
M.Q. SET/FREQ. CHANGER-HP Q'
WELDERS•AC-KVA .O
GENERATORS - KW
TRANSFORMERS - KVA
TEMP. MOTORS (75% or ORID.)
MOVED MOTORS (75% OF ummJ
MISC.
SIGNS
NO. NO.TRANS.
NO. NO.LAMPS APPROVALS
FOR EACH PERMIT: //DATE INBPECTORFS NAME
WIRING $1.00 CONDUIT
FIXTURES. $7.00 ?) WIRING. 4- ¢it ff,%r
rr
SUPPLEMENTARY .50 FIXTURES
- r
POWER
TOTAL FEE S UTILITY CO.NOTIFIED
FINAL �li y ! y
76A663-CE8061-68 APPLICATION FOR ELECTRICA ,PERMIT
COUNTY OF LOS ANGELES
DEBPARTMENT OF COUNTY UILDIN.G AND SAFETY DIVISION ADDRESS 5505 Ryland`
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY Temple City
FOR APPLICANT TO FILL IN NEAREST
CROSS ST. Daiens
NO. EACH FEE
$ $ OWNER High
REC.EPT._ MAIL 5505
LIGHT RY TOTAL FIRST 20 .20 ADDRESS land
SWITCH_ OVER 20 .10 CITY Temple City TEL. NO. X4.8-3070
PLAN CHECK
LIGHTING TOTAL FIRST 20 .20 APPLICANT
FIXTURES OVER 20 .10 ADDRESS
RANGE—DRYER—WTR.HTR.— CITY TEL. NO.
STA.COOK_DISP.—F.A.U._ CONT.RACTORWarr 4leCtriC
SPACE HTR.-AIR COND. ADDRESS 15737'.O1d-Valley lvd
CLOTHES WASH._DISHWASH.- CITQity Of IndUStry 0.333-5918
FAN-OTHER 1.00 LICENSE 1,10.250-843 CLASS.0-10
MOTORS,TRANSFORMERS RATING
INb. HEATERS, ETC. HP. KW'. KVA. I HEREi iCK LEDGE THAT I 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
ELECTRICAL WIRING.
0 - 1 1.00
I HEREBY .CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
1 - 10 3.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND: STATE OF �,
CALIFORNIA OR THAT I A THE LEGAL OWNER OF, AND INTEND TO
10 - SO 5.00 RESIDE IN, THE ABO DESCRI D RESIDENTIAL PROPERTY. Q
SIGNATURE u
50 - 100 10.00 OF PERM TEE ad
100 - Soo 15.00 DI$?ICT G ZONE E P OC SE o
SIGN GAS TUBE, OR SIGN AND ONE CIRCUIT 3.00 D.
MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES Z
SERVICE NOT OVER 600 VOLTS OR 200 AMP 1 2.00 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
PERMIT FEE (SUB TOTAL) WIRING
PLAN CHECK FEE (50% PERMIT FEE) FIXTURES
4 04a
POWER AUTHORIZED
PERMIT ISSUING FEE 2.00
UTILITY CO.NOTIFIED 44gif AD -=4-aloe
ia
i6
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 ]FINAL
TOTAL FEE 00 JOSEPH C. ROOHAN
SUPERVISING ELEC CAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK M.O. CASH
- Lin 5 4 7 3- JUL 15 2 0 4..0 0-
EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE / .
78A663-cE6081'-68 APPLICATION FOR ELECTRICAL.. PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS SCJ J7
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, $UPERINTENDENT OF BUILDING LOCALITY .Q.
oalc
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
NO. EAC FEE
RECEPT.
$ $ OWNER
MAIL
LIGHT TOTAL FI.RST 20 .20 ADORES im
SWITCH OVER 20 ..10. CITY TEL. NO.
PLAN CHECK
LIGHTING TOTAL FIRST 20 .20 �® APPLICANT
FIXTURES OVER 20 .10 ADDRESS
RANGE_DRYER—WTR.HTR.— CITY TEL. NO. I
STA.COOK_DISP.-/—F.A.U._ CONTRACTOR
).
SPACE HTR. AIR COND. ADDRESS Q / I✓
,CLOTHES WASH._DISHWASH.-L-
d b' v TEL. NO.
FAN OTHER 1.00 LICENSE NO. ��^� CLASS.ga:-mjeb
MOTORS,TRANSFORMERS RATING
IND. HEATERS, ETC. HP.'KW. KVA. 1 HEREBY ACKNOWLEDGE THAT I 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
ELECTRICAL WIRING.
0 - 1 1.00
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
1 - 10 3.00 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 N, THE ABOVE. D CRIBED RESIDENTIAL PROPERTY. Q
SIGNATURE V
50 - 100 10.00 OF PERMIT ad
100 - 500 15.00 DISTgRI T NO. GWUP P O
NE CESSED BY
SIGNGAS
TUBE, OR Is SIGN AND ONE CIRCUIT 3.00 Lu
MAROUEE ADDITIONAL CIRCUITS 1.00 NOTES: Z
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
PERMIT FEE (SUB TOTAL) WIRING
FIXTURES
PLAN CHECK FEE (50% PERMIT FEE) ti
POWER AUTHORIZED �
PERMIT ISSUING FEE' 2.00 UTILITYCO.NOTIFIED / '
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL
TOTAL FEE JOSEPH C. ROOHAN
SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION M.O. CASH
LkO5 2 2 VE X26 2 D 9.,2.0- co
:E BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
76A663-CE80610/72 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER =FSSoT jV, w� ,4:BUILDING AND SAFETY DIVISIONTY B( �^p7/
T ��++
FOR APPLICANT TO FILL IN CROSS ST. yes
OUTLETS NO. EACH FEE OWNER ORt,
RECEPT.� $ $ FIRM NAME CiAC.� eS n
MAIL
LIGHT TOTAL .25
FIRST 20
ADDRESS �� 'V, 61� k9) AS-`
SWITCH_ OVER 20 10 CITY TEL. NO.'1flJ��j!°���.
PLAN CHECK
LIGHTINGTOTAL FIRST 20 .25 APPLICANT
FIXTURES
OVER 20 .10 ADDRESS
� _
RESIDENTIAL APPLIANCES CITY TEL.. NO.
PERMIT n
RANGE DRYER_WTR. HTR. APPLICANT % � k ttbC
STA. COOK DISP. F.A.U. ADDRESS JORTCbAbIAA 1 t
SPACE HTR. - AIR COND. CITY TEL. NO.
CLOTHES WASH. 01SHWASH. LICENSE
GENNUM9ERk_qsc ` CLASS. jib
FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
ANDSTATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING WITN ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND. HEATERS, ETC. HP. KW. KVA. ELECTR-ICAL WIRING.
SIZE & TYPE OVER TO '
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/Op
0 - 1 1.00 LICENSED AS REQUIRED BY LOS ANGELES C NTY AND STATE OF
CALIFORNIA OR THAI I AM THE LEG L O ER OF THE ABOVE
1 - 10 3.00 DESCRIBED RESIDEN L: PROPERT
O
PERMIT EE 1 C.2
10 - 50 5.00 SIGNATU n;
O
50 - 100 10.00 I-°
DISTRICT tJO. PRO SSED BY W
100 - 500 15.00 7" /4 _ y
_ I� _Z
SIGN, GAS =Sr ONE CIRCUIT 5.01) APPROVALS DATE INSPECTOR'S SIGNATURE
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE
SERVICENOTOVER 600 VOLTS OR 200AMP 3.00 UNDERSLAB WORK
SERVICEOVER 600 VOLTS OR 200 AMP n 10.00 ROUGH CONDUIT
TEMP SERVICE,POLE,&APPURTENANCES- 5.00 WIRING '��
TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES
POWER AUTHORIZED
UTILITY CO. NOTIFIED
FINAL
PERMIT FEE (SUB TOTAL) NOTES:
PLAN CHECK FEE
PERMIT ISSUING FEE 3.00
TOTAL FEE
PLAN CHECK VALIDATION CK. M.D. CASH PERMIT VALIDATION ('QK: M.O. cae
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
7 3' 911r'JUN 1.2 2 0 7.
WORKER'S COMPENSATION DECLARATION 20.0019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I have a certificate of consent to self insure, 76A683
or a certificate of Worker's 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, Company FOR APPLICANT TO FILL IN JOB
ADDRESS J�O UT�
Certified co Is hereby furnished. NO. EACH FEE ADDRESS
copy y New Residential Bldgs.&Pools _ $
$
� r� !
❑ Certified copy is filed with the county building inspection 1&2-Family,Sq.Ft. t�Ci
department. Multi-family Sq.Ft. CROSS ST. ' �s s
Date Applicant Residential Swimming Pools ASSESSOR
MAP BOOK PAGE PARCEL
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec._Light Sw. FIRM NAME ..j Aij
Q
COMPENSATION INSURANCE
First 20 MAIL i
(This section need not be completed the work involved by the Total NoAdditional ADDRESS 7',' )r f/1')fc f/SL E-
permit is for one hundred dollars($1000 .)or leas.)
I certify that in the performance of the work for which this permit CITY PLL d4 Tel.No.0d—�
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 Tel.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 APPLICANT
provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances
LICENSED•CONTRACTORS 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 Tel.No.
Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. >_LICENSE Cleas.
Over 50 to 100 Incl. REG.NUMBB ER d
Over 100 DISTRICT NO. P O SSED BY V
License Number Lic.Class
Services,Swbd.,MCC&Panelboards � a:
0-399 Amp.Under 600 V FINAL 0
Contractor Date DATE
❑ 400-1000 Amp.Under 600 V /,f� Z Z, 3 VALIDATION V
I am exempt under Sec. lL
Over 1000 Amp.or Over 600 V FINAL
.B.&P.C.for this reason BRANCH CIRCUIT FEES BY
Date: ilk
t5A,or 20A,120V,Lighting or Recept. y� OSignature Z
1 To 10 Branch Circuits /i t To 40 Branch Circuits
❑ 41 Or More Branch Circuits _
Exemption for Reg.Maint.Elect. 15A,20A,2D8V To 277V Lighting Br.Circuits 1
SINGLE FAMILY Temp.Power Pole&Appurtenances �p},,+��'
HOME OWNER-BUILDER DECLARATION '•`-''r• °F
I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit _ 1 ti i� t_I
for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits U-12", -r
Code): I I I T Et u
❑ 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) TOT AL .42-90
and Professions Code). ® CHECK
CONSTRUCTION LENDING AGENCY CHANGE130
"=
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 IL) ) —J 1 i 10/22,19"S
Lender's Name lc, y L
PERMIT ISSUING FEE �. L.zo
Lender's Address
I certify that I have read this application and under penalty of purjury state TOTAL FEE
that the above information is correct. I agree to comply with all County
ordinances and State laws re ulating Electrical wiring,and hereby authorize
representatives of.this C nt to enter upon the above- entioned property
! inspe 'on purposes SEE REVERSE FOR EXPLANATORY LANGUAGE
2 sJ
SIGNATURE OF PERMITTEE DAT
I ..
WORKER'S COMPENSATION DECLARATION 20.0019 DPW(72-97) APPLICATION FOR ELECTRICAL PERMIT
•I hereby affirm that I have a certificate of consent to self insure, 76A663
nr a certificate ol"Worker's 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. Company FOR APPLICANT TO FILL IN JOB �If � /• 1
1IIS .
Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE ADDRESS �l1LOCALITY
❑ $ $Ft
S
-Family, q. . _
Certified copy is filed with the county building inspection 1 &2 NEAREST
department. Multi-family Sq.Ft. CROSS ST.
Date Applicant Residential Swimming Pools ASSESSOR
p
PAGE (� PARCEL
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec. Light S4Y. + OWN NAME
COMPENSATION INSURANCE ,(Pb
First 20 MAIL
(This section need not be completed If the work Involved by the Total No. Additional ADDRESS
permit is for one hundred dollars($100)or less.)
I certify that in the performance of the work for which this permit CITY Tel.No.
is issued, I shall not employ ariy person in any manner so as to PLAN CHECK
become subject to the Workers`Compensation Laws. Lighting Fixtures . First 20 D APPLICANT
( % Total No. Additional ADDRESS
Date tiApplicant RESIDENTIAL APPLIANCES NOT OVER 3 HP.
NOTICE T A PLICANT: If, after making this Certificate of CITY Tel.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 PERMIT y�
P Y P Y LICANT � J/'
provisions or this permit shall be deemed revoked:' Power Apparatus&Large Appliances
LICENSED CONTRACTORS DECLARATION Size&Type HP KW,KV AR AR p ADDRESS? FfOILLEO Sr
I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 t 1 ncl. �a
(commencing with Section 7000)of Division 3 of the Business and CITY �� (� Tel.No.
Over 10 to 50 Incl. ?
Professions Code,and my license is in full force and effect. LICENSE OR / r?G V ��� 11
Over 50 to 100 Incl. REG.NUMBER C, ! Class.
J ! —r Over 100 DISTRICT NO. P 0 SSED BY U
License Number �� � tl Lic.Class G.� o�
-Services,Swbd.,MCC&Panelboards �v O
Contractor Data V �� 0-399 Amp.Under 600 V DATE F—
❑ I am exempt under Sec. 400-1000 Amp.Under 600 V ��/� �g - W
Over 1000 Amp.or Over 600 V VALIDATION.
FINAL al
B.&P.C.for this reason BY
BRANCH CIRCUIT FEES L1(�y,;z
Date: 15A,or 20A, OV,Lighting or Recept.
1 To 10 Branch Circuits
Signature . 11 To 40 Branch Circuits 1 ITEMS
❑ 41 Or More Branch Circuits :+ - - ,—_
Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits I fi� a o.a_s
SINGLE FAMILY Temp.Power Pole&Appurtenances trAECK 77.55
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit
I hereby affirm that I am exempt from the Contractor's License Law C11 ,I )j
for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits
Code):
❑ 1,as owner of the property,will do the work and the structure Misc.Conduits&Conductors rrl( i)_y(s;.n•,
is not intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule) LI_ � �1 � +
and Professions Code). +i: i AM 11:ti 1
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(Sec. 3097, PERMIT FEE (Sub-Total)
Civ.C.)
PLAN CHECKING FEE
Lender's Name
PERMIT ISSUING FEE
Lender's Address
I certify that I have read this application and under penalty of purjury state TOTAL FEE �.
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 above-mentioned property
for inspection pur res. SEE REVERSE FOR EXPLANATORY LANGUAGE
SIGNATURE OF PeWTTEE DA.