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APPLICATION FOR ELECTRICAL PERMI
COUNTY OF LOS ANGELES
DEPART ENT OF COUNTY ENGINEER BUILDING 7
BUILDING AND SAFETY DIVISION ADpgEsS �7Dr
JOHN A LAMBIE, COUNTY ENGINEER
COLEMAN W JENKINS SUPERINTENDENT OF BUILDING I LOCALITY
FOR APPLICANT TO FILL IN NEAREST C
CROSS ST J
NO EACH ICE
I { 3 OWNER
RECEIPT _
LIGHT TOTAL FIRST 20 20ADDRESS
SWITCH 3 OVER 20 10 CITY TEL NO
PLAN CHECK
LIGHTING TOTAL FIRST 20 20 D APPLICANT
FIXTURES OVER 20 10 ADDRESS
RANGE_DRYER_WTR HTR CITY TEL NO
STA COOK_DISP _F A U CONTRACTOR
SPACE HTP —AIR CORD ADDRESS
CLOTHES WASH _DISHWASH CITY TEL NO
FAN OTHER 1 00 LICENSE NO 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 C TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING
O — 1 1 00 I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED MO/OR
JLICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATED•
1 — 10 3 OO CALIFORNIA OR THAT 1 AM E LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABOVE D C I O RE 10 NTIAL P PERTY O
10 — SO 5 00 u
SIGNATURE
Sp — 100 fODO OF PERMITTEE Q
100 — SDO 1500 rTEMPPOWER
GR :one PR e 13
ppSIGN,GAS SIGN ANDONE CIRCUIT 3 00 NTUBE, OR Z
MARQUEE ADDITIONAL CIRCUITS 1 OO 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 OAT. IMSPECTERS BKMAnn.
LE
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 GO FINAL
TOTAL FEE JOSEPH C ROOHAN
4. SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION C. M 0 CASH PERMIT VALIDATION cK M G CASH
IAP433b�— a°H 3 2 0 280-
SEE BACK OF APPLICATION FOR COMPLFTF FEE Sf HFnULF ,
BOUNTY of Los ANGELES APPLICATION FOR PERMIT
Department of Connie Engineer ��������
DIVISIONSION OFFBUILDING 8n SAFETY
WILLIAM J FOX Coeob EOElnwr �
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMITA NO.
ELECTRICIAN 0 5 1-0
R [IVSD BY READY FOR DAT[ ISSUED
ADDRESSAd FIRST INSPECTION _
CITY TEL N rlfJ
COUNTY LICENSE NO EXPIRES BUILDING �]
P FEES ADDRESS �C
r[E LD
NUM CR EACH LOCALITY
LIGHT OUTLETS NEAREST
RECEPTACLES CRONOWr
WALL SWITCHES OWNER
TOTAL OUTLETS rc MAIL
ELEC "HOES 95 ADDRESS
[LEO HEATERS 95
CITY
FIXTURES 6 0 TEL. NO
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
M19C APPLICATION AND STATE THAT THE ABOVE IB CORRECT
NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS AND STAT[ LAWS REGULATING ELECTRICAL WIRING
MOTORS 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS
NUMS[R HORSEPOWER FEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
NEW MVo HP EVER Iw5 [11QN Or THE RESIDENTIAL PROPERTY DESCRIBED ABOVE
A LEE, a 95 610MATURK Or
ya 9 50 PERMITTER
9 B 100 INSPECTION 4-ORD
5 15 1 50
is BG 950
SO 900 Sao
900 S® 1000
.1
600 1000 1 B 00 Z
OVER 1000 40 00
MG BET/FRED CHANGER-HP
WELDERS AC-KVA O
GENERATORS - KW
TRANSFORMERS - KVA
TEMP MOTORS (75% or DRIG)
MOVED MOTORS (76 Or DB1G)
SC
SIGNS
NO NO TRANS.
NO NO LAMPS APPROVALS
FOR EACH PERMITI DA7r INSPECTOR'S NAME
WIRING 411,00 CONDUIT
FIXTURES Bl OO WIRING —! O
WJPPLIIMENTARY 50 FIXTURES
POWER
TOTAL FEE 7�� UTILITYCO NOTIFIED
���LLL.•��� I FINAL
IGA858 DBS#5A 4-52
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COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 9912160005
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 ERT
LEGAL ID FEES PAID BUILDING ADDRESS
ON FILE 5243 SERENO DR
FEE DESCRIPTION QUANTITY LON AMOUNT TEMP CA 917803044
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET
5388-019-005 Al PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID H4 LOCALITY TEMPLE CITY
LA 100 AMP PANELS, MCC 1 00 PAN 38 85
TENANT TOTAL FEES 66 60 ISSUED ON PROCESSED BY PLAN BY EXMIM
12/16/99 UT 06/13/00
OWNER "E-0— FINAL DATE FINAL BY dpl -CODE
ASHLEY ROBERT L (818) 287-5892- 1 / 1' t'
5243 SERENO DR /z-'+� 'Z 7 OCL!/
TEMP 917803044 DESCRIPTI OF WORK
NEW 100 AMP SERVICES UPGRADE - HCUNG REHAB
APPLICANT TEL NO
G G HEST ER (909) 392-4949-
588 LANTANA ST SPECIAL CONDITIONS
LA VERNE, CA
CONTRACTOR TEL NO- 5 PNGELES co� APPROVALS
G G HESTER AND SON ELECTRIC (9D9) 392-4949- �,� NTf 1
588 LANTANA ST LIC NO TEMPORARY POWER POLE '
LA VERNE CA CA 91750 474648 C10
/ UNDERGROUND
LIC NOMAIN WATER LINE
/ 1111111
ROUGH CONDUIT
F'U B L I C WORKS PLASTIC Y/N METAL Y/N
UTILITY COMPANY NUTITM
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D
46/�c Service That�ot
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REPORT ID. DPR265 ROUTE TO BS0508