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Home My Public Portal About5043 SULTANA AVE_Electrical__ GGG SA It SS APPLICATION FOR ELECTRIC PERMIT 1 DIVISION OF BUMMG AND SAFETY Al �'�m reree JOHN A LA BIB.Coi ENOIN=R CASSATT D GRIFFIN SVP T Or BUILDING ALITY FOR APPLICANT TO FILL IN REST'PEBb= FEES B BNUN � NER LIGHT OUTLETS MAIL RECEPTACLES 1 ADDRESS WALL SWITCHES FE 6 CT' NO TOTAL OU'TLE'TS U ISO 4 ELECTRICIAN ELEC RANGES Ea ADDRESS ELEC HEATERS 2n K\V CRY TEL NO ON STATE Ll FIXTURES p LICENSE NO MOTORS DISTRICT N GFjQUP ZONE ASADT roB ISIIPCCTIoe NuMBCR HORSEPOWER FIZZ s 3-./ N[M mw HP ovKII IND CALX VVV 27SP ION B=BD s t®e 2a E eo 2 s t o0 a is t eo is no 2 ao 50 II00 p 00 MISC NO BIONS NO TRANS NO SIGNS NO LAMPS FOR EACH PERMIT WIRING 11t00 FIXTURES $I 00 SUPPLEMENTARY a0 APPBOVAIS TOTAL FEE DATE INSPECTOR'$SIGNATURE 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPInCATIOX AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING / 1 ELECTRICAL WIRING 1 HEREBY CERTIFY THAT I AY PRO T E R A /OR FIXTURES LICENSED AS REQUIRED BA LOB ANG OF CALIFORNIA OR THAT I THE OVE POWER DESCRIBED RESIDENTIAL OPEBTT O SIGNATURE UTILITY CO NOTIFIED /0 176 OF PERM ITTE FINAL It JOHN A LAMB COUNTY EN 1NEERATION ARTHUR C VEIT.CHIEF ELECT. INSPECTOR OK YO WX 5.30 ;�8757NLR JUL 31 ? ^ _ ' � v p , I TSA 669•CE6D8 S•62` APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDIFIG SQ 3 5 9AA BUILDING AND SAFETY DIVISION ADORES. JOHN A LAMBIE, COUNTY ENGINEER WILLIAM A JENSEN,SUP T OF BUILDING LOCALITY _fE/Yl'f�L.E NEAREST �F OO APPLIC T T FILCROSS ST C pieREOEPTTOTAL Mo uol —OUTLETS FIR5T 20 0 [Lp i OWNERLIGHT MAIL SWITCH 1(0 AOD•L RESSy ov[R20 .3 ,0TOTAL ' CITY TEL NLIGHTING F1ReT 20LOFI%TURES ADD'L Ip ELECTRICIAN v R 20100 ADDRHSSQ-Dx GARS DIM STA COOK CT• wvv Pk TEL NO DaY DIaWASH AUTO WASH STATE SPA=HTIS I STA ARF (w HP MAX I / SO LICENSE NO MOTORS' OYER NOT OVER H P T DIST�1 N GROUP ZONE ED B O , 100 V� I — a ISO i INSPECTION RE Tp A a 6 200 �C2' 4 _ O12 t+'ie..t.Q S IS 860 IS e0 300 a So — 100 Soo O SIGNS NO TRANS , -.A v NO IMPS II 11�1 Li r SERVICE O BOW-Nm ova 200A 100 IL SERVICE O 600V Ova 100 A 2 00N Z SERVICE OVlR 60OV boo i MISC �- If PERMIT ISSUING FEE 800 SUPPLEMENTARY PERMIT ISSUING P!E f00 TOTAL FEE Is Lo I HERESY ACIMOWLEOa[ THAT I HAVE RIAD THIS A LICATION ALMGAT[ I OR SSI AMD STAT[ THAT THE Ae IS COIIIS[m AM AOMIA TO COMPLY CONDUIT WITH ALL COUNTY OROINAMCES AND RATE LAWS REOULATINa E RICAL WIRINa WIRING I HaoY CERTIFY THAT 1 AM PROPERLY REGISTIRSD AND/OR LICENSED AS MU1RED BY LOS ANaEIjS COUNTY AND STATE OF FIXTU LI CAFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE AEOK D[SCRISED mIO[MTI ROFeRrY POWER Q r' SIGNATURE UTILITY 00 NOTIVIIgD OF PERMITTEE PI NAL (DATION ARTHUR C VETT 10- K MO CASH BUPlRVIBING ELSCTRIGL ENGINEER L4L07 4 6 3�2 JAN12 2 D 1 0,50- v WORKERS COMPENSATION DECLARATION 7E 10/B1 APPLICATION FOR ELECTRICAL PERMIT I hereby effoCE 1106rrt that I have a certificate of consent to self insure ar a certificate of Workers Compensation Insurance COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec 3800 Lob C ) Pat'cy No Company FOR AMUCANT TO FILL IN AJOB New Residential Bldgs 8 Pools Certified copy is hereby furnished EACH NO FEE ❑ Cemified copy is filed with the county building nspec- 18 2-Family, Scl Ft $ — $ LOCALITY hon deportment Multi family Scl Ft — NEAWS Residential Swimming Pools C _ 7_ Date Applicant OR FIRM OWNENAME �S CERTIFICATE OF EXEMPTION FROM WORKERSMAIL COMPENSATION INSURANCE Outten Rec_Light_Sw_ ADDRESS O fIf A?v (This stolon need not be completod If the work Involved by First 20 the pormlt Is for one hundred dollars($100)or less) Total No Additional CITY C� Tel No PLAN CHECK I certify i that m the performance of the work for which this APPLICANT permit is issued I shall not employ any rsn in y manner so as to'become subject to the Wor6 o Ghon Lighting Fixtures First 20 ADDRESS `� Total No Additional Dote CE / T If an CITY Tel No NOTICE TO APPLICANT If after making thu Certificate of Feed Appliances Not Over 1 HP PERMIT Exemption you should become subject to the Workers Range_ Heater_D W _ APPLICANT Compensation Provisions of the Labor Code, you must forth Oven _ Dryer _ W M — ADDRE r with comply with such provisions or this permit shall be T _ FAU —W H deemed revoked CITYTel N LICENSED CONTRACTORS DECLARATION Hood _ Fan _ Other— Dap _ Room Air Cond LICENSE OR ��-� Class (commencing with Section 7000) of Division 3 of the Business power Apparatus 8 Large Appliances DISTRICT NO PROCES Y r and Professions Code and my license a in full force and effect R Size 8 Type HP KW KVA, or KVAR O -A OCR License Number r Li< Class G Up to 1 Incl FINAL n ' 47 Over 1 to l0 Incl DATE `�"_S-�� VALIDATION O Contract G Dote Over 10 to 50 Incl ❑ I am exempt under SecINAL P Over 50 to 100 IncInt 8V B 8P C for this reason Over 100 4,1111 = Date Services, Swbd , MCC 8 Panelboards �fJ 0 -200 Amp Under 600 V Signature 201 - 1000 Amp Under 600 V ❑ Exemption for Reg Maint EleOver 1000 Amp or Over 600 V ct SINGLE FAMILY Temp Power Pole 8 Appurtenances '4 0 9 3 7 A HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor s License Additional Sign Branch Circuits • • • s s 2 Law for the following reason (Section 7031 5, Business and Professions Code) 2'- s ) 750 ❑ I as owner of the property will do the work and the M,sc Conduits 8 Conductors ) 75 06 ( P Fee Schedule)— Complete See 100 structure is not intended or offered for sole (Section Other 7044 Business and Professions Code) 0 4 Oro—'8 3 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) (Sec 3097 Civ C ) PLAN CHECKING FEE - - - Lender s Name PERMIT ISSUING FEE , Lender s Address 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 ordin and State jaws ting Electrical wrong, and her hor,ze sen is unty to enter upon _ th a-men Pr ns tion purposes ` - SEE REVERSE f-0R EXPLANATORY LANGUAGE Signature of Pe it ee pate �J COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC FORKS 9701 IAS TUNAS EL 0508 1311190039 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT (LEGAL IO FEES PAID I BUILDING ADDRESS ON FILE 5043 SULTANA AV IFEE DESCRIPTION QUANTITY DOM AMOUNT TEMP CA 917803046 (ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET 15388-020-022 1A1 PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 596 GRID HS LOCALITY TEMPLE CITY CAI I ILA 100 AMP PANELS, MCC 1 00 PAN 38 90 -� TENANT TOTAL FEES 66 70 ISSUED�ON -=PROCESSED BY PIAN BY 111/_9/13 ^ SR OWNER TEL NO FTNnr. Frvn*./g�Y CODE HESS, DOUGLAS (626) 393-6352- 15043 SULTANA AV 1 ITEM@ 917803046 1 MSLRM I OF WORK I REPLACE MAIN ELECTRIC PANEL TO 100 AMP APPLICANT TEL NO I , HUGHES, SOB (951) 520-7116- 1 I 147 W RTE 66 #605 ISPECIAL CONDITIONS I GLENDORA CA 91740 I 1CONTRACTOR TEL NO 1 1APEROVALS GATE INSPECTOR SIGNATURE 1 1ACCURATE HS INC I I 1147 W ROUTE 66 LIC NO (TEMPORARY POWER POLE I IGLENDORA/CA/91740 860517 1 1 —1-1 J UND�RGROUNO CONDUIT ARCHITECT OR ENGINEER TEL NO � i UFER GROUND LIC NO IROUGH CONDUIT I I_ IROCOH HIRING I 1 MAIN WATER LINE 1 I PLASTIC Y/N METAL YIN 1 I UTILITY COMPANY NOTIFIED_ 1 I 1 1 I I I � I I I I I 1 i I I I - IREPORT IO DPP-265 ROUTE TO BS0508 I I