HomeMy Public PortalAbout5203 SANTA ANITA AVE_Electrical__ 781889
11,11A11,11AA9 APPLICATION ■ ®R ELECTRIC PERMIT
I ■
�.
8.8$'
..$VISION OF BUILDING AND SAFETY _
,a Deplatnent of. County Engineer
County of Los Angeles BUILDING
WM.J.FOX.COUNTY ENGINEER ADDRESS
CASSATT D.GRIFFIN.SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
PENT FEES CROSS ST.
' NUMBER EACI4. FEE
OWNER �. ��•�P�A b
LIGHT OUTLETS
RECEPTACLES MAIL
ADDRESS
WALL SWITCHES
TOTAL OUTLETS 5¢ $ a CITY TEL.NO.
ELEC.RANGES 25 ELECTRICIAN a r/�
+_ELEC. HEATERS 25 ADDRESS eAge 011'-
KW EA CITY / O / TEL.NO
t -
FIXTURES 5 LICENSE NO.MENEM
cTat
NUMBER OF LIGHT CIRCUITS
DISTRICT NO. GROUP ZONE READY FOR INSPECTION
NUMBER OF RECEPTACLE CIRCUITS I X
MOTORS dQ�
NUMBER HORSEPOWER FEE INSPECTION BE :ORD
NEW MVD. HP OVER INC. EACH
s �2&LESS $ .25 13
1/z 2 :5o
2 5 1.00
r 5 15. 1.50 ...
15 .50 2.50.
50 200 5.00
MISC.
f
NO.SIGNS NO.TRANS.
NO.SIGNS NO..LAMPS
FOR EACH PERMIT:
WIRING $1:00 D
FIXTURES $1.00 9999
SUPPLEMENTARY .50 APPROVALS
TOTAL FEE S V DATE INSPECTOR'S SIGNATURE
1 HEREBY ACKNOWLEDGE THAT I HAVE READ 71115 APPLICATION CONDUIT
AND:STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY .
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING
ELECTRICAL WIRING.
1 'HEREBY CERTIFY THAT 1 AM PROPERLY 'REGISTERED ANDIOR FIXTURES
LICENSED AS.REQUIRED BY LOS ANGELES COUNTY AND STATE OF' '. "l?
CALIFORNIA UR THAT I AM THE LEGAL .OWNER OF THE ABOVE POWER
DESCRIBED RESIDENTIAL PR ERTY.
UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTEE FINAL, /
WILLIAM J.FOX.COUNTY ENGINEER VALIDATION A.C.VEIT.CHIEF ELECT.INSPECTOR
} ,0 Z7 1_rnMV23 2 3.90 0
l rmthat
WORKERS" Ihave COMPENSATION DECLARATION F76A663 10/81 APPLICATION FOR ELECTRICAL PERMIT
' I hereby affirm that I have a. certificate of consent to self 'CE-t1U6G.
insure, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES fes' BUILDING AND SAFETY
or a certified copy thereof(Sec. 3800, Lab. C.) +
Policy No. Company FOR APPLICANT TO FILL IN JOB
Certified copy is hereby furnished. New Residential Bldgs. 8 Pools
EACH NO. FEE ADDRESS8,�
+ 1 8 2-Family, Sq.'Ft. $ — $ LOCALITfT
Certified copy is filed•with the county building inspec- y'
tion NEARESTCROSS ST.
department. Multi-family Sq. Ft. —
' Date Applicant Residential Swimming Pools OWNER OR
( FIRM.NAME
' CERTIFICATE OF EXEMPTION FROM WORKERSvViA
'
+I Outlets: Rec �Light Sw._ MAIL
e7fADDR
ESSCOMPENSATION INSURANCE First 20
I (This section need not be completed if the,work Involved by Total No. — Additional CITY Tel. No.
�. the permit.is for one hundred dollars($100)or less.)
ECK
i certifythat in the performance of the work for which this APPLIPLACANT C NT
p 'APPLICANT
permit is issued, I shall not employ any erson in any manner
so as to become subject to the Workenir Compensation Laws. Lighting Fixtures First 20ADDRESS
! e Total No. ® Additional
DcteS — PPLican,
�h 1CITY Tel.'No.
Fixed Appliances Not Over 1 HP PERMIT.
NOTICE TO APPLICANT: if, after making this Certificate of MN
Exemption,. you should become subject. to the -Workers' Range Heater APPLICANT +
Compensation provisions,of the Labor Code, you must forth- Oven ._Dryer W.M.— ADDRESS —Zot.r
S with-comply with such,provisions or this permit shall be. Top _ FAU —W.H. —
+ deemed revoked. CITY. TeI...N6.
I, Hood .Fan _Other— e
LICENSED CONTRACTORS DECLARATIONS LICEN. OR
I hereby affirm that I am licensed under provisions of Chapter 9 Disp. Room Air Cond. Class.
REG. NUMBER :S G
(commencing with Section 700 0)of Division 3 of the Business` DISTRICT NO. PROCES D BY and Professions Code,and my license is.in full force and effect. Power Apparatus 8 Large Appliances
Size 8 Type HP,KW, KVA; or KVAR'
License Number Lic. Class C — Up to 1 Incl. FINAL. J
^' c/ 09
Over 1 to 10.Incl. DATE F � VALIDATION
Contractor �C Date — f+b
Over 10.to 50 Incl.
❑ FINAL
I am exempt under Sec.' Over 50 to 100 Inc. BY •r,, �� �
iaiD B.BP.C. for this reason Over 100 �
Services, Swbd., MCC 8 Ponelboards o-2 e
0 -200 Amp. Under 600'V 1�
Signature 201 -'1000 Amp. Under 600 V 1
Over 1000 Amp. or Over 600 V
i Exemption for Reg. Maint. Elect.
SINGLE FAMILY
� Temp. Power Pole 8.Appurtenances .0 f;7. 1 A
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ?r o 0 0. o 0 2
I hereby affirm that I am exempt from the Contractor's License +
Additional Sign Branch Circuits
Law for the following reason (Section 7031.5, Business and v+! vU'p
Professions Code):
2' O
I, as owner of the property, will do the work and the Misc. Conduits 8 Conductors o „ L1 C C 3,
structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)_
3 7044, Business and Professions Code). ® G' C —E 4
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) .,r.
i (Sec. 8097,Civ:C.).
PLAN CHECKING FEE
Lender's Name PERMIT ISSUING FEE Q
{ Lender's Address D�,I
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 epresen'tatNes of this County to enter upon
the above-m.e + ed party for inspection purposes.
I' , S r SEE'REVERSE FOR EXPLANATORY LANGUAGE _
Ar—
autt fPeignto --7-
re Date j
WORKERS'COMPENSATION DECLARATION 20.0019 DPW 3/87
I hereby affirm that I'�have a certificate of consent to`self .' .CE XE-806G A.PPL�•G�►T.0 FOR E.L ,C CAL PERMIT O
insure, or:a certificate of Workers'Compensation;Insurance, ' \, COUNTY bF LOS ANGELES DEPT. OF PUBLIC.WORKS
oro certified copy thereof(Sec. 3800, Lab. C.
+ I'
Policy No.' Company FOR APPLICANT TO FILL IN a' JOB
Certified co , is hereb furnished. EACH NO. FEE 'ADDRESS
py y ` New Residential Bldgs. &Pools.
Certified co is filed with the county building ' $
Py ty ,. g inspec- 1 8 2-Family, Sq...Ft. LOCALITY
j NEAREST
tion department. 1 Multi-family Sq. Ft; CROSS ST. .../1E
Residential Swimming Pools OWNER.OR
Date ; Applicant FIRM NAME / 1
Ai CERTIFICATE.OF.EXEMPTION FROM WORKERS' Outlets: Rec 1 1.ight�Sw.ZZ 0 MAIL
COMPENSATION INSURANCE :ADDRESS D�
First 20
(This section need not be eompleted.if the work involved byTotal No._L4� Additional CITY Tel, No. a-
the Permit Is for one hundred dollars($100)or less.)
.•� +PLAN CHECK•.,
I certify that in the performance of the:work'for which this ] APPLICANT
permit is issued, I shall not emplpy any person in-any manner
so as to become subject to the Workerse Com p nsation Laws. j Lighting Fixtures' First 20 I ADDRESS
Additional- AZO
Date ,'� �G?-a + (+ Total No. CITY Tel. No.
�� RPlican G I:
NOTICE TO APPLICANT: If,,after king this Certif'i of Fixed Not Over 1 HP PERMIT
Exemption', you should becom subject to the rliers' I Range— Heater..—D.W. — (APPLICATION
Compensation provisions df the Labor Code;you must forth- Oven'!— Dryer —W.M._ !ADDRESS
with comply with such provisions or this permit shall be, j, Top , — FAU —W.H. — w+
deemed revoked., (CITY ' Tel:s'No.
Hood —.Fan —Other—
• LICENSED CONTRACTORS DECLARATION ILICENSE OR
1 Disp. ;_ Room'Air Cond. _ REG.NUMBER ' •Class.
I hereby affirm that I•am licensed under provisions of Chapter 9
(commencing with Section 7000.)of Division 3 of-the Business II Power Apparatus.&Large Appliances (DISTRICT NO. P S$ED BY
i. d.
and Professions Code,and my license is in full force and effect. •' I.
Size&Type HP, KIN, KVA, or KVAR, % O U
License Number. Lic. Class, Up to 1 Incl. FINAL „
DATE
Over 1'to.1'0 Incl. , VALIDATION
Contractor• Date
❑ :• Over 10 to 50 Incl. FINAL r ~
I am exempt under Sec. Over 50 to,100 Inc. BY, W
B.&P.C. for this reason' I' Over 100 I' d
Date I Services, Swbd:., MCC&Pakelboards Z
0-200 Amp.•Under-606 V
Signature 201 -1000 Amp. Under 600 V 4, b
r Over 1000 Amp. or Over 600 V
❑ Exemption for'Reg. Maint. Elect. i
SINGLE FAMILY
Temp. Power Pole&Appurtenances
HOME OWNER-BUILDER DECLARATION, t +r•
-I,hereby offirm'ihat I am exempt from the Contractor's License Sign with One Branch Circuit s_kl7
Law for the following reason (Section 7031.5, Business and 4 Additional Sign Branch Circuits.
Professions Code):
❑ I, as owner of the property, will do the work and the �i Misc. Conduits'&'Conductors �; 3-1� ! _sus 5
structure isnot intended or offered for•saleSection.7044, I Other(See Complete Fee Schedule)_, Ti t _
-+"'' 7�.
Business and Professions Code). ( tiJ+�'' i=r
CONSTRUCTION LENDING AGENCY
n�r,a
I hereby,affirm that there is a construction lending agency for p •.+�,a+ •
the performance of the work for which this permit is issued PERMIT FEE (Sub-Total)
(Sec. 3097, Civ. C.). i' 1.''. !•_l--+)£_I`_!i al a/7
PLAN CHECKING FEE h t+
Lender's Name
PERMIT ISSUING FEE �
Lender's Address TOTAL FEE �
I certify that I have read this application and state that the
above information is correct. I agree to comply with all County `1
ordinances and State laws regulating Electrical wiring, and d ,
hereby authorize representatives of this County to enter upon +
the above-mentioned property for inspection purposes. ! SEE REVERSE FOR EXPLANATORY LANGUAGE
ADSSignature of Permittee Date , I
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 9909300004
.BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL D: FEES PAID BUILDING ADDRESS:
TR: 13363 LT: 7 5203 SANTA ANITA AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803622
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: FREER
8574-009-007 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: D4 LOCALITY: TEMPLE CITY, C
G1 OUTLETS-LGT,SW,RECP 13.00 OUT 25.35
TENANT: G2 LIGHTING FIXTURES 4.00 LGT 7.80 SS ED 0 PR C SS BY: PLAN BY: EXPIR ON:
TOTAL FEES 60.90 09/30/99 VG 03/28/00
OWNER: TEL. NO: FINIL D TE AL BY: CODE:
HUYNH CUONG;TRAN HUONG (626) 575-0361- AA
5203 SANTA ANITA AV 1T J2_600
TEMP 917803622 DESCRIPTION 0
ELECTRICAL FOR ADDI ION
APPLICANT: . N0:
SAME AS OWNER -
SPECIAL CONDITIONS:
GE LE S C
CONTRACTOR: TEL. N0: ®�� APPROVALS DATE INSPECTOR SIGNATURE
-
SAME
SAME AS OWNER
LIC. NO TEMPORARY POWER-POLE
UNDERGROUND CONDUIT
ARCHITECT OR NGINEER: TE 0: - UFER GROUND
LIC. NO• ROUGH CONDUIT
I) 1111111
I�f �
ROUGH ING
GUS
L
n n nOKS MAIN ATER LINE
\1V/111V// ILJ _LCI PLASTIC Y/N METAL Y/N
UTILITY COMPANY 0 D
C 6 a ,^
O ❑ � ����
ElEl
c Service Thai
REPORT ID: DPR265 ROUTE TO: SS0508
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELE-7RICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0:10220023
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY C:. 51780
PHONE: (626) '---U48b EXT:
LECA ID: FEES PAID BUILDI G ADDRC��:
ZR: 13363 LT: 7 5203 SANTA ANITA AV
FEE DESCRIPTION: QUANTITY: UOM: A140UN1. TEMP CA 91780367,
ASSESSOR INFORMATION NUffB—Eff--- NEAREST CROSS STREET: FREER
8574-009-007 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: D4 LOCALITY: TEMPLE CITY, C
F1 120V, 15/20A BR CKTS 4.00 BR 69. SUE
00 _
TE APTT: F2 208 277V LGT BR CKT 1.00 BR i.7.30 SD ON: P OCESSc: Sy' N BY: E RES G;i.
G1 OUTLETS-LGT,SW,RECP 36.00 OUT 60.60 10/22/04 JK 04/20/05
G2 LIGHTING FIXTURES 12.00 LGT 23.40
UP,'!ER: TEL. NO: H5 RES WASH MACH LT 3HP 1.00 WAS ^.4�5 FIN L DA !r AL LAY: CODE:
HUYNH CUONG;TP.AN HUONG (213) 367-4671- TOTAL FEES 2 ,�
'1 .�'L' I eE
:S233 SANTA ANITA AV
�7E!?P 917803622 DESCRIPTI� OF WORK
EL[CTRICAOLNFOR THE ADDITION
APPLICANT: TE 0:
=ME AS CI:NER
�iECIAL CONDITIONS:
i
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
LIC. NO TEMPORARY POWER POLE
UNDERGROUND—CONDUIT
ARCHITECT OR UN1 R: TEL. 0: LF ZTGROUND
LIC. N0: �iOU-H CONDUIT —
1
i I jROJGi1 k .ING
frlAIN ATER LINE —
PLASTIC Y/N METAL Y/H
UTILITY CONPA Y NO I IE9
1
REPORT ID: DPR265 ROUTE TO: 9S0508
e, s
COUNTY OF LOS ANGELES TEMPLE CITY 4 0508 f-ECHANICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS i+E 0508 0410220003
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGA ID: FEES AID B IL^IR:G PDDR SS:
TR: 13363 LT: 7 5203 SANTA ANITA AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917R03622
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: FREER
8574-009-007 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: D4 i;.,,:'•;Y; TEMPLE CITY, C
02 COMPRSR < 100 KBTU 1.00 COM 27.00
TENANT: 08 FURNACE/HEATER <100 1.00 UNI 27.00 ISSUED ON: ROCESS D BY: PLA BY: _XPIRES 0N :
41 VENTILATION FAN 1.00 FAN 15.75 10/22/04 JK 01/20/05
TOTAL FEES 97.50
OWNER: TEL. NO: FINA DA E FINAL BY: 1. DE:
HUYNH CUONG;TRAN HUONG (213) 367-4671-
5203 SANTA ANITA AV d�
TEMP 917803622 DESCRIPTION OF WOR
HVAC FOR ADDITION
APPLICANT: TEL. NO:
SAME AS OWNER
SPECIAL CURD-1 16NS:
CONTRACTOR: TEL. NO: APPROVALS DATE 1,50ECTOR SIGNATURE
SAME AS OWNER -
LIC. NO FA WALL FLANCE
COMBUSTION AIR OPENINGS
ARCHITECT OR ENGINEER: EL. 90: DUCT OR
1.I C. NO: AC/COMPRESSOR
THERMOSTAT
r FIRE DAMPERS ---'-+
SMOKE DET EC7I p Jlr, S
COMMERCIAL HOOD -
REPORT ID: DPR264 ROUTE TO: 850508