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HomeMy Public PortalAbout4349 TEMPLE CITY BLVD_Electrical__ c it y U I F tiYL �, t 'Ty APPLICATION FOR ELECTRIC PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE. COUNTY ENGINEER CASBATT D GRIFFIN,SUPT or Su1Lm NG LOCALITY FOR APPLICANT TO FILL W ti PEEM PEES ROSS ST X�1.64 J of ITEM HUMEen Ewcx Fu 1< OUTLETS t t LIGHTS RCCIPT SW f0 LIGHTING FIXTURES to CITY TEL NO osc RANOl/ "0 DRYERS ELECTRICIAN WATER HEATERS BO ADDRESS 4EG SPACE HT DISHWAeHOtS CITY TELN QANBAGE DISPOSENB AVTG BrATE —� C—/d WASHERS STA COOKING UNITS on LICENSE NO MOTORS OVER INC Hp 0 IGROUP ZONE O— / / /•JIt- 00 3ItA 7, 't 3 V / so o 04SPECTION RECO E— s loo IB— BO 250 so-900 500 H .s SIGNS NO TRANS NO LAN" SERVICE O-BOOV 100 /y _ A p SERVICE OVER BOOV Boo MISC. WIRINGPERMIT ADD FIXTURE PERMIT 100 SUPPLEMENTARY PERMIT SO TOTAL FEE t/ 10'0 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AFPLIGTIGNkFI) EA BIpBGTOR S MONATURs AND STATE THAT THE ABOVE W CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ICAL WIRING sI HEERE" CERTIFY THAT I AM TRORRLT REGISTERED ANDIOR LICENSED All, REQUIRED BY LOS ANGELES OUNTY AND STATE OFI I T I DDQ IBBEO OR ut AM THE L[ OF THE ABOVEIr /f I �.. j SIGNATURE D /A OF PERMI _I 1 y I / FINAL a. v /"MAMN OUPERVISINO ELECVEITTRICAL ENGINEER Ila�y' ro OABH [�_a1 9 1 5 `2 ;-KY 1 2 4 12.5 0 APPLICATION FOR ELECTRIC PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE. COUNTY ENGIN. CASSATTD GRIFFIN,11111PT OF BUILDING LOCALITY FOR APPLICANT TO FILL W NEAREST PERM FEES CROHS ST IT[M NuN[sR [ACIIFE[ OWNER OUTLETS MAIL LIGHTS 1D RECEFT GW ADDRE88 LIGHTING FIXTURES to CITYTEL-NO . Corti"I.^ RANQ= CLO Corti" ELECTRICIAN WAT[R HEATERG 30 ADDRESS <L.[C SPA=HTRE. DHOIWAQHBtD GARSAGQ DIIPOEQfIH AVTO- ffi � L J N CrI WAEHOD QA COOIONGUNTTQ Ea ST EO MOTORS OVER ING HP / aO 1 _ o— .0 Oe v.— s ao RTE�rN b s— a IOD 67 a— to tgo IT( r /9/r 1a— so 200 ao-200 goo SIGNS No TRAN6 No LVIPQ S®tVICEO-000V 100 O SERVICE OVER GOOV goo MISC WIRING PERMIT '.LOO Q FIXTURE PERMIT 1 00 SUPPLEMENTARY PERMIT g0 TOTAL FEE Is Z100 1 HERESY ACXNOWL GE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATA INEPECTOREEIONATURQ AND STAT[ THAT THU "0" 1E CORR[CT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND WATt LAWS REGULATING CONDUIT ELELT111CAL WIRING 1 HRLY ERTD LE ELES CERTIFY THAT 1 AM •ROPERLY RQOIffEm RANO/OR WIRING LIRNE[D " REQUIRE [Y OANGCOUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT 1 AM THE LEGALOWbIKR OF THE ASOVE DEQCRI[ED RESIDENT FIDRT POWER SIGNATURE UTI LITY CO NOTIFIED / 1 OFPERMITTE NAL pp �/� 1 �r /VPCSDATION SUP RV181NG FI vGTRICALENGINEER L." WO YO CASH 1 6 ;.'.7 1 2D 7.0 0 TION TION WORKERS CI have certificate of corse cc 006' taut APPLICATION FOR ELECTRICAL PERMIT �� CE 006G I$ereby affirm that I have a certilimte of consent to self insure or o certificate of Workers Compensation Insurance COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec 3800 Lab C ) Policy No Company FOR APPLICANT TO RLL IN JOB T Certified copy ,s hereby furnished New Residential Bldgs 8 Pools �� NO FEE ADDRESS \ t- ❑ Certified copy is filed with the county budding mspec 18 2-Family, Sq Ft = — $ LOCALITY l tion department Multi-family Sq F — NEAREST 1 Residential Swimming Pools OWNER CROSS ST OR Dote Apphcont FIRM NAME Q CERTIFICATE OF EXEMPTION FROM WORKERSMAIL Q COMPENSATION INSURANCE Outlets Rec_Light_Sw_ ADDRESS It '� I (This Faction reed not be completed If the work Involved by First 20 ' Tot the permit Is for ono hundred dollars ($100)or leu ) al Na Additional CITY rL Tel PIAN CHECK I certify that in the performance of the work for ch this APPLICANT permit,s issued I shell not employ any person in ny rarer so as to become subject to the era Camps no L ws- Lighting Fixtures Fmt 20 ADDRESS s- Total No Additional Date 2-`a-� 1 Appl,ca CITY Tel No Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT If after mak, t s Cernh of Range Heater_D W APPLICANT c'NW Exemption you should become sublet the o an, 9 Compensation provisions of the Labor Coda you m at th Oven _ Dryer _W M — ADDRESS with comply with such provisions or thn permit II be Top _ FAU __WH — �t WS12 deemed revoked Hood _ Fon _Other_ CITU 1e - Tel No LICENSED CONTRACTORS DECLARATION LICENSE OR I herebyaffirm that I am licensed under p D,sp Room Air Cond Class provisions of Chapter 9 REG NUMBER (commencing with Section 7000) of Division 3 of the Business DISTRICT NO P BY and Professions Code and my liters,s,n full force and effect Power Apparatus 8 Large Appliances 0 2 A�J gg Size 8 Type HP KW KVA a KVAR License Numbs, ^-L O 3 Lc Class -,� Up to 1 Incl FINAL / /J 0: ��1L r^,���-- Over 1 to 10 Incl DATE (///" L/7/ VAUDA N 0 Contractor A4914 �e Date 2 NA Over 10 to SO Incl t ❑ I am exempt u Sec FINAL LLI p Over 50 to 100 Inc BY N B 8P C for this reason Over 100 Z Date Services Swbd, MCC 8 Panelboards , 8 6 5 2 2 A 0 -200 Amp Under 600 V # a a a a e 2 Signature 201 - 1000 Amp Under 600 V Exemption for Reg Maint Elect Over I DO()Amp or Over 600 V l o 939.50 ❑ xG rM� SINGLE FAMILY Temp Power Pole 8 Appurtenances HOME OWNER BUILDER DECLARATION with One Branch Circuit I hereby affirm that I am exempt from the Contractor's LSign ¢ense Additional with Sign Branch Circuits Low for the following reason (Section 7031 5 Business and Professions Code) ' ❑ I as owner of the property will do the work and the Mac Conduits 8 Conductors structure is not intended or offered for sole (Section Other (See Complete Fee Schedule)— Pilo Business and Professions Code) CONSTRUCTION LENDING AGENCY I hereby affirm that there iso construction lending agency for 0 the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) (Sec 3097 Gv C ) PLAN CHECKING FEE , Lenders 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 ordinances and St a laws regulating Electrical wiring and rittereby authorize r ti r sentaves of this County to enter upon abtio ro M r m ove man spectwn purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Signet ZY f Perminee _ 2 —