HomeMy Public PortalAbout4819 TEMPLE CITY BLVD_Electrical__ TGAGGS,CEIDG 10/72 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF-LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER ���� 4819 Temple City Blvd
BUILDING AND SAFETY DIVISION
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST y�,�f�
OUTLETS O E.C., IEE OWNER
NERIRM IORE Growers Marker-
RECEPT $ $
ADDR
MAILESS4819 Temple City Blvd
LIGHT_ TOTAL FIRST 20 �. b
CITY ample City TEL NO 287 0815
SWITCH_ y _ OVER 20 10
PLAN CHECK
LIGHTING TOTAL FIRST 20 2R APPLICANT
FIXTURES 10
OVER 20 ADDRESS
RESIDENTIAL APPLIANCES CITY p TEL NO
RANGE_DRYER_WTR HTR_ PPL,�ANT2' Ragmor Electric CO
STA COOK DISP F A U _ ADDRESS 315 So. San Gabrje
SPACE HTR AIR GOND CITY San Gabriel TEL NO ZO 0
CLOTHES WASH DISHWASH_ LICENSE OR
REG NUMBER 251206 CLAS
FAN_OTHER 100 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE If CORRECT AND AGREE TO COMPLY
MOTOR! TRANSFORM ERS RATING WITH ALL COUNTY ORDINANCES AND !TATE LAW! REGULATING
IND HEATERS LTC HR KW KVA ELECTRICAL WIRING
f12C 6 TYPE OVER TO
HERESY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
O - 1 100 LICENSED AS REQUIRED ST LOS ANGELES
LES COUNTY AND STATE OF
CALI IORNIA OR 1 AM THE LEGAL OWNER OP T O E y
1 - 10 300 DESORIIED R OE IAL PROPERTY O
10 - 50 X00 PERMITEE C
SI GNATUR p
so - 100 low W1
DISTRICT NO P_apCESSED BY 1
100 - 500 1300 _
Y � f
SIGN GAS SIGN AND ONE CIRCUIT Sw APPROVALS DATE INSPECTOR'S SIGNATURE
TUBE OR
MARQUEE ADDITIONAL CIRCUITS IN TEMP POWER POLE
SERVI CENOT OVER 600 VOLTS OR 200AMP 3w UNDERSLAB WORK
SERVICEOVER 600 VOLTS OR 200 AMP IOw ROUGH CONDUIT
TEMPSERVICE POLE C APPURTENANCES Sw WIRING
TEMP LIGHT OR RECEPT SYSTEM 9w FIXTURES
POWER AUTHORIZED
UTILITY CO NOTIFIED
FINAL / J/
PERMIT FEE (SUB TOTAL) S NOTES
PLAN CHECK FEE
PERMIT ISSUING FEE 9w 0 (�
TOTAL FEE
PLAN CHECK VALIDATION CR M D CASH PERMIT VALIDATIONcK M D CASH
^7
SEE RAM 01 APPLICATION FOR COMPLETE SCHEDULE
APPLICATION FOR PERJUT
DEPABTbIENT OFG AND SAFETY ELECTRIC 1'
COUNTY OFF LOS LOS ANGELES
WILLIAM J FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO GROUP ZONE PERMIT NO.
ELECTRICIAN p < C-Z D
RECEIVED BY READY FOR DATE 18SUED
ADDRESS ^1 ^ FIRST INSPECTION �J
CITYTEL NO I�_ • _
COU LICENSE NO — BX 1 A BUILDING .!J
PERMIT FEES ADDRESS J
NUMBER OUTLETS EACH FEE LOCALITY
LIGHTS Sc NEAREBT
RECEPTACLES D CR086 ST
FIXTURES D OWNER
ALL SWITCHES D MAIL
ELEC RANGES 25 ADDRESS
ELEC HEATERS 25 - CITY NO �—
ISC
NUMBER OF CIRCUITS INSTALLED I HERESY ACKNOWLEDOi THAT 1 HAVE READ THIS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
LIGHTS RECEPTACLES AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
MOTORS AND STATE LAWS REGULATING CLECTRICAL WIRING I
NUM[[D HORSEPOWER1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
[W vo HP Ov[ INC [AC"
OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
•"'e 28
2 DO SIGNATURE OF
2 D 1 00 PERMITTE¢ �
D 1D 1 DO INSPECTION RECORD
1D SO 2 SO
50 200 S 00
200 Doo 10 00
12O15 DO 'J
a
OVER 10001000 20 00 Z
M G BCT FRED CHANGER-HP
WELDERS AC"A
GENERATORS - KW
TRANSFORMERS - KVA
TEMP MOTORS ]D aF om
MOVED MOT ]D° of oEla
MISC
SIGMS
TYPE NO TRANS -
TYPE NO LAMPS
APPROVALS
FOR EACHPERMIT
DATE INSPECTOR S NAM
WIRING t1 00 0 0 CONDUIT
FIXTURES 8, 00 WIRING
QUPPLEMEKTARY so FIXTURE•
POWER
TOTAL FEE • / �� UTILITY co NOTIFIED
FINAL
79ABOM CESS612-ep APPLICATION FOR ELECTRIC PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT BUIL N AND SAFETYDMSIONER ADDRRESS 4819 Temple Cit Blvd
JOHN A LAMBIE.CouNrY ENa1Nme Temple City.
CABBATT D GRMFFIN.Burr or BuLLO DIMLOCALITY P
FOR APPLICANT TO FILO PI NEAREST Lower AZuZe Road
ST
PERM FEES er r e
ITEM lNUMSznl EACH PEE OWNER
OUTIHTC Ll R[C¢Pi g sW lB f 1O f Q1 a60 ADDRESS emP 8 9 4
LIGHTING FIXTURES 33 10 J S0 CITY TEL
QLEC RANGES CLO DRYERS ELECTRICIAN Ue a eC T 0
WATER HEATERS 60 ADDRESS 601 So e im S to
d[C SPACE HTRS DISHWASHERS
CITY TEL NO
SMSAOQ OIp1`OEpRp AUTO
STATE
WASHERS STA COOKING UNITS Ep LICE SE NO
MOTORS OVER INC HP DIS RIOTUP PR S
o— V. 1/20 g 26 200
VE— z eo 3PECTION RECORD
2— 6/ 100
6— iH 7 1 160 1, 00
15— 60
50-200 500
SIGNS NO TRANS
NO LAMINS
SERVICE 0-600V too
SERVICE OVER 600V Boo
MISC
WIRING PERMIT 100
FIXTURE PERMIT 1 00 110
SUPPLEMENTARY PERMIT 60
TOTAL FEE f 10 .40 APPROVALS
IHEREBY ACKNOWLEDGE THAT I HAVQ READ THIS APPLICATION DATE INSPECTORSSIGNATURE
AMD STATE THAT THE ASOVQ IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCQB AND STATE LAWS REGULATING CONDUIT
ELECTRICAL WIRING
WIRING
I HEREBY CERTIFY THAT 1 AM PROPERLY UNTY HRED ATE OR
LICENSED AS RIOUIRiD pY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 AM THE LSOAL OWNER Of THE ABOVE
DESCRIBED RESIDENTIAL POWER
SIGNATURE UTILITYCO NOTIFIED
OF PERMITTE
m' DATION 9URC VETT
UPE
CN YO CASHUPHRVIBING ELECTRICAL ENGINEER
UCD6 6 7 13 FM 18 2 A 1.0 R4 0 lq
76A6810ER06 8-62 APPLICATION FOR ELECTRICAF-'P-
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADORERS C19 Zq
JOHN A LAMBIE COUNTY ENGINEER
WILLIAM A JENSEN, SUP T Or 1h1ILDINa LOCALITY
NEAREST
FOR AP T CRoee eT
R[CEPT TOTAL NO EACH r[[
OUTLETS FIRST 20 0�O / OWNER uz
r V(
LIGHT MAIL
SWITCH ADD'L 10 ADDRESS
OVER 20
TOTAL CITY TEL
LIGHTING FIRST 20 20
FIXTURES ADD'L 1O ELECTRICIAN
OVER 20
RANGES CNA DRY101e WTI, MIU 100 ADDRESS G• LArkAm 'I
GAR[ DIV STA COOK CITY nA[ EL DIWWASH AUTO WASH STATESPACE HTRE STA APP (%HP MAXI !f0 LICENSE NOMOTORS, Draw NOTCV[R HP DISTRI T NO GRZrP Z
O 1 too
1 a 160 INSPECTION RECORD
S S 200
S IS 260
1S 50 ]00 G
RO 100 Soo 0
61GNS, No TRANS GI
No LAMPe 0
SERVICE O SOOV NOT ova 200A 100 10
SERVICE O SOOV OVER 200 A 200 N
SERVICE OVER SOOV S OD Z
MISC
nPA&Arirff palr. -
PERMIT ISSUING FEE 200 '
SUPPLEMENTARY PERMIT ISSUING FEC 100
TOTAL FEE 3
1 N[N[SY ACXNOWL[DO[ THAT 1 HAK HEAD THIS APPLICATION &EE89YAO mu I"mFKCTM•SIGNATURE
AMD RAT[ THAT THE ABOVE IS COIDQCT AND AGRI[ TO COMPLY CONDUIT
WITH ALL COUNTY ORDINAMC4 AND STAT[ LAW[ REGULATING
[LSCTRICAL WIRING WIRING
1 HERESY CERTIFY THAT I AM PRaP[RLY RIaIST[1RD wHo/ow
LIC[NSmS
Aw QU1R[DEY Lo ANGST COUNTY AND STAT[ or FIXTURES
GLIFORMIA GR THAT 1 AM LEGAL o R or TH[ AEOV[
DESCRIS[D w[SID[WI,L P POWER
SIGNATURE _ UTILITY CO NOTIFIED
OF=111ITTI
FINAL
LIDATION 'N/. '' ARTHUR C VBIT
CK GN {
MO
SH Iv SUP[RVISINa ELECTRICAL ENGINEER
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TSAGSB-CESOG IO EO APPLICATION FOR ,LECTRICAL PERMIT 1
COUNTY OF LOS ANGELES
DEPARMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE. COUNTY ENGINEER I
WILLIAM A. JENSEN. SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST 4/
PERMIT FEES OWNER
ITEM NUMBER EACH R[ MAIL /. ._ .l
OUTLETS, S S ADDRE88 ,'GSC,�VI�K/
LIGHTS REC[PT. SW. I .10CITY yam/ Q
LIGHTING FIXTURES .10
SLED. RANGES CLO.DRYERS ELECTRICIAN
WATER HEATERS .SO ADDR I" ;7
[LEO.OAC[HTRS. DISHWASHERS O '/
CITY TEL D. "1
GARBAGE DISPOSERS AUTO.- STATE
WASH[b STA.COOKING YNITS .25 INCENSE NO.
Moroxs, OVER INC. P.
DISTRICT.NO. I GROUP ZONE PR CESSED B
D— /0 3 .25 7S
VE— 2 .BD INSPECTION RE-CORD
}
2— E 1.00 �' r"•/6 1 �iCtd� O
. 'T— V
a— Is 1 �aY >/i.s, Ek otbaI�d3"��-- �
15— aD 2.50
BO— 200 5.00
d
SIGNS: NO TRANS.
NO.LAMPS
SERVICE O.SOOV 1.
SERVICE OVER BOOV 8.00
MISC.
WIRING PERMIT 1.00
FIXTURE PERMIT 1.00 Q
SUPPLEMENTARY PERMIT .so
TOTAL FEE f
1 "EMERY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS OATS IMO[CTOR'S SIGNATURE
AND STAT[ THAT THE ABOVE I8 CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
1 HEREBY CERTIFY T T I AM PROPERLY REGISTERED AND�OR
LICENBEO AS REOU D1 BY LOS AND ES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR T T AM THE OWNER F THE ABOVE
OE9Cft,BED TI P RT POWER
SIGNAT RE UTILITY CO.NOTIFIED
OF PER FINAL
,,"IDATION ARTHUR C.VEIT
no DASH SUPOWISING ELECTRICAL ENGINEER
LP02 0 1 9 e AU-62 8 2 D 6 .6 5 a
7"648 C1008 7 NS -APPLICATION FOR ELECTRIC PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER ABUILDING DDRESS 4819 Temple City 1_ � .
BUILDING AND SAFETY DIVISION
JOHN A LAMBIE COUNTY ENGINEER
CASSATT D GRIFFIN SUPT OF BUILDING LOCALITY Temple City
FOR APPLICANT TO FILL IN NEAREST Lower Azuza Road,
PEHMrr FEES OWNER starMarket
I T E M NUMB" EACH FEN
OUTLETS 5 sw f f0 s SO AMAIL DORwaG 4819 Temple City Blvd.
LIGHTS R[CE"
LIGHTING FIXTURES 10 C Temple.
ELEC RANGES CLO DRYERS ELECTRICIAN e C r C•
W A T E R HEATERS DO ARI I
ADDRESS S
ELEC SPACE HTRS DISHWASHERS
GARBAGE DISPOSERS AUTO- CITY Alhambra, TEL No AT 31
STATE 3083
WASHERS STA COOKING UNITS YD LICENSE NO
MOTORS OVER INC H
DISTRICTN O P ZONE PR ESSE
0— y. ze .� �
1/2— z Do DiSPEC17ON HECOHD
z— D 1 00
D— 15 1 DO
- 4
1D— Do 250
`11 ;
Do—zoo Doo 1
l
SIGNS No TRANS
NO LAMPS I
SERVICE O DOOV 100 I -,
SERVICE OVER DOOV 500 ..L
Mlsc
WIRING PERMIT 1 00 00
FIXTURE PERMIT 1 00
SUPPLEMENTARY PERMIT DO
TOTAL FEE t APPROVALS
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION DAT[ INSPECTOR S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING WIRING
1 HERESY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIOENTI PERTY POWER
SIGNATURE UTILITY CO NOTIFIED
OF ITT
ATLON ARTHUR C VETT,
CR YO CASH
SUPERVISING ELECTRICAL ENGINEER
1&6,1 TD'S FEB $ 2 A 150 2
�?G1T-a.F'Ti
"""""'°"°"' APPLICATIO FO ELECTRICAL PE MIT
COUNTY OF LOB ANGELES
DEPARTMENT OF COUNTY ENGINEER nB�REss
BUILDING AND SAFETY DIVISION
LOCALITY of
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
OUTLETS NO H FEE OWNER OR
FIRM NAME
RECEPT_
$ S MAIL
LIG'IT
TOTAL FIRST 20 20 ADDRESS
CIN TEL NO
SWITCH_ OVER 20 Ip
PLAN XECK of
TOTAL
LIGHTING FIRST 20 APPLI T
FI%TURES 10
OVER 20 ADDRESS
OF
RESIDENTIAL APPLIANCES
CITY 6L 0
PERMIT
RANGE_ORYlR_WTR HTR_ APPLI CA
STA COOK_DISP _F A U _ ADDRESS
SPACE HTR AIR CONO CENT q { TEL NO
REQNUMBE
CLOTHES WASH DISHWASH R _ CLASS
FAN OTHERI00 1 HERESY ACKNOWLEDGE THAT I HAV[ READ THIS APPLICATION
•ND STATE THAT THE MOV[ IS CORRECT AND AOR[[ TO COMPLY
MOTORS TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND HEATERS' ETC HP KW XVA ELECTRICAL WIRING
SII[ S TYPE OVER TO
HERESYCERTIFY THAT I AM PROPERLY R[01■T[R[0 AND/OR
Q _ 1 100 CALIFSSVEOUIRED BY LOS ANGELES COUNTY AN
CALIF NIA TH 1 AM TX L WK[R ASOV 8
1 — 10 !OO o[sc Ie[o [ TIAL PR R
10 — 60 SOD PER IT
SI
50 — 100 1000VNOTES
ICT NO OC ED BY
100 — 500 1000 '_5706 z
SIGN GAS SIGN AND ONE CIRCUIT GOOPPROVALS DAT[ AsGEC /IOMTum
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 100POWER POLE
SERVICENOTOVER 600 VOLTS OR 200 AMP amSLAB WORK
SERVICEOVER 600 VOLTS OR 200 AMP IOD0 CONDUIT
TEMP SERVICE,POLE 6 APPURTENANCES 000G
TEMP LIGHT OR RECEPT SYSTEM 300RES
AUTHORIZED
CO NOTA FIEOPERMIT FEE (SUB TOTALS PLAN CHECK FEE
PERMIT ISSUING FEE 300
TOTAL FEE
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION M 0 CASH
704lt0-30 - a! 9A0
SEE SACK OF APPLICATION)FOR COMPLETE SCHEDULE 1 `
TeAeas-c[aoa 1-e7 APPLICATION FOR ELECTRICAL PMMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION wDDRES6 /
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS, SUPERINTENDENT OF BUILDING I LOCALITY
NEAREST
APPUCANT TO FILL N I Cf10BB BT
RECEPTlI TOTALNO EACH
LIGHT l OUTLHTB FIRST 20 A 20 A OWNER
J MAIL
SWITCH ADD L 1O ADDRESS
OVER 20
TOTAL FIRST 20 20 CITY TEL NO
LIGHTING 1 FIXTV RES _
FIXTURES J ADD L to CONTRACTOR L T i
OVER 20 �1 �(
SANGRE DRYERS WTR MRS 100 ADDRESS a iS - 0
GAR[ DIM ETA COO[
CITY TEL No T (o
DIWWAIN AUTO WASH STATE /
SMC[HYMN RA ARL BO LICENSE NO 6
MOTORS, ovER HOTGVER HF DISTRICT NO G P Z NE PROCESSED BY
O 1 100 -Z
1 — s 160 INSPECTION RECORD
s B 200 T•C. GEC /16
B 15 260
IS BO 300
BO 100 500 0
SIGNS NO TRANS GI
NO LANDS rO
SERVICE O 600V NOT MEN 200A 100 Yj
SERVICE 0 GOOV OVER 200 A 200
SERVICE OVER BOOV 600
OTHER (ME COMPL[T[ FEE SCHEDULE)
7a7v dr1&11,r1"6 3S zo0
PERMIT ISSUING FEE 200 o
SUPPLEMENTARY PERMIT ISSUING FEE 100 APPWYVAL8 "m 1
TOTAL FEE B
IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION UNDERBLAB WORK
AND STAT[THAT THE ABOVE IN CORRECT AND AGREE TO COMPLY ROUGH CONDUIT -\
WITH ALL COUNTY ORDINANCES AND STAT[ LAWS REGULATING
CL[CTRICAL WIRING WIRING
I HEREBY CERTIFY THAT 1 AM PBOP[RLY R OISTER[D AND/OR FIXTURES l
LICENSED AS REOUIR[D BY [ N"AND STAT[OF
CALIFORNIA OR THAT I AM LEO OF AND INTEND TO POWER
RESIDE IN THE ABOVE D[ [D AL PROF[RTY
SIGNATURE UTILITY CID MOrIFIRD I �-
OF PERMITTEE FINAL (D �O�YLtI�
VALID JOSEPH C ROOHAN
CK O G6 SUPERVIGING ELECTRICAL ENGINRR
Li"
0% 23 2 D 4.20-
7"a6a-c[EoE u-SE APPLICATION FOR rELECTRIC*PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS TFhf //
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS, SUPERINTENDENT OF BUILDING LOCALITY 2elsl�&Z IF
NEAREST
FOR APPUCANif 10 FILL IN CROSS BT
RECEPT l TOTAL No I EACH I FE[ Y
11\ ou7LEre
LIGHT FIRST 20 Sao S OWNER
MAIL
SWITCH ADD L 1O ADDRESS
OVER 20
TOTAL FIRST 20 20 CITY L NO
LIGHTING FIXTURES
FIXTURES ADD L OVER 20 10 CONTRACTOR
RANGES DRYERS WrR IRR[ 100 ADDRESS b Off
GARS Ols OTA COOK CITY TEL NO -/
DISHWASN AUTO WASH STATE O /I
8PACE MRS STA A I- 60 LICENSE NO (�
MOTORS OVER NOT OVER HF DIS/T�RICT O GROUP ZONE P CE D BY
O 1 1 00 _ c .
1 5 150 INSPECTION RECORD
5 B 200
S 15 250
15 5o Soo d
O
50 100 500 V
SIGNS NOTRANS m
NO LAMFS e4 - Z 7—1, L? �. O
SERVICED BOOV NOT ova 200A 1 DO Q C
SERVICED SOOV OVER 200A 200
Z
SERVICE OVER SOOV 500
OTHER 1[[[ CONFL[T[FE[SCHEDULE)
PERMIT ISSUING PE[ 200 Q
SUPPLEMENTARY PERMIT ISSUING PEE 100 DAY[ I
TOTAL FEE S Q
1 HERESY ACKNOWLEDGE THAT 1 HAVE READ THIS AFPLICATIOH UNDERSLAB WORK
AND STAT[THAT THE ABOVE IS CORRECT AND AOR[[TO COMMY ROUGH CONDUIT
WITH ALL COUNTY ORDINANCES AND STAT[ LAWS REGULATING {(
ELECTRICAL WIRING WIRING V
LICI HERESY CERTIFY THAT I AM PROR[RLY REGISTERED AND/OR FIXTURES
AS REQUIRED BY LOS ANGELES COUNTY AND STAT[ OF
ULI FORNIA OR THAT I AM TH LEGAL OWNER OF AND INTEND TO POWER
RESIDE IN THE
ASpv�OESC [ [S [NTIAL FROP7<RTY
SIGNATURE N✓ UTILITYCO NOTIPI D
OF
PERMITTEE —AL
VA 9H:) JOSEPH C ROOHAN
M0
CK MO CASN BUP[RV151NG EL[CTRIGL ENGINEER
TH L8 2 0 66 APR26 2 D 3.00~ 4
76AG63-CES06 11-r1 1
APPLICATIO OR ELE RICAL PERMIT
lJ
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER 7ADORESS
DING
BUILDING AND SAFETY DIVISION ESS
r
LOCALITY
FOR APPLICANT TO FILL IN EST
S ST S
OUTLETS ILR
5
RECEPT_
LIGHT_ TOTAL
FIRST 20 ESS
L TEL NO
SWITCH_ OVER 20 10
CHEC
LIGHTING l FIRST 20 23 ICANT
)j TOTAL
OVER 20 ESSFIXTURES 10RESIDENTIAL APPLIANCES TEL NO
ITRANGE_DRYER_WTR HTR_ I CA! ap
STA COOK_DISP _F A U _ ESS
SPACE HTR AIR GOND CITY TEL NO
CLOTHES WASH DISHWASH_ LICENSE NO 337 CLASS C,/O
FAN_OTHERI00 I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
•ND STAT[ THAT THE ABOVE IS CORRECT AND AOR[[ TO COMPLY
MOTORS TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND HEATERS [TC HP KW RVA ELECTRICAL WINING
SIZE B TYPE OVER TO
HERESY CERTIFY R THAT I AM PROPERLY REGISTERED AND/OR
EOF
O — 1 100 LICENSED AS REQUIRED D RY l0a EG ANGELES COUNTY AND STAT[ TO
CALIFORNIA OII THAT I TN[ LEGAL OWNER 01 AND INTEND TO
1 — 10 300 RES1D[ IN TN[ A YL O[SCRIBED R[aMTI PROPERTY 0
10 — 50 BOO SIGNATURE -
OF PERMITTEE O
60 - 100 1000 C
DIarRICT NO ICLASS _ zoNL 1ILY
too - 600 1500 PRoc ED a d
N
SIGN GAS SIGN AND ONE CIRCUIT 600 NOTES �fH ?
TUBE OR
MARQUEE ADDITIONAL CIRCUITS 100
SERVICENOTOVER 600 VOLTS OR 200AMP 900
SERVICE OVER 600 VOLTS OR 200AMP 1000 APPROVALS DAT[ IKlLC1GR'S SIGNATURE
TEMP POWER POLE
TMPSERVI CE POLE hAPPURTENANCES e00
UNDERSLAB WORK
TEMP LIGHT OR RECEPT SYSTEM 390
ROUGH CONDIUT
WIRING
_I FIXTURES
POWER AUTHORIZED
PERMIT FEE (SUB TOTAL)
UTILITY CO NOTIFIED C
PLAN CHECK FEE
FINAL
PERMIT ISSUING FEE 900
TOTAL FEE
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK M 0 CAM
(Ar18 5 473 JUN25 2 D 8.00-
SEE SACH OF APPLICATION FOR COMPLETE SCHEDULE
745^154S3 CIE eaeR 9�e APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER JOB RES$ _•1(_ E- C� I/
BUILDING AND M
FETY DS A
N DD
FOR APPLICANT TO FILL IN LOCALITY G
New Residental Bldgs &Pools EACH NO FEE NEAREST OLU ✓
1 &2 Family Sq Ft E 025 — b / �
WNtRUN
Multi family Sq Ft 02 — ' OFIRM NAME ��1 (p . �(J
Residential Swimming Pools 2000 MAIL
ADDRESS r"
Outlets Rec Light_Sw CITY Gi Tel No
1, First 20 50 PLAN CHLLK /
Total No Additional 30 APPLICANT
ADDRESS I I
Lighting Fixtures i First 20 50 1 1 CITY Tel No
Total No Additional 30 1 PERMIT A
Fixed Appliances Not Over I HP ADDRESS Q T �—
Range—Heater—D W _ CIT E [�) Tel No��
Oven _Dryer_W M— LICENSE OR-
Top ^ D
—FAU —WH — REG NUMBER Goss
Hood—Fan _Other— I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND SPATE
Dnp — Room Air Cond — 2 00 THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDIN
. ANCES AND STATE LAWS REGULATING ELECTRICAL WIRING
Power Apparatus&Large Appliances
Size'&Type HP KW KVA or KVAR I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS
U I Incl _ REQUIRED BY LOS ANGELES COU Y AN STATE OF CALIFORNIA OR THAT I AM
Up to 2O0 THE LEGAL OWNER OF BO D INNTIAL PRO
Over 1 to 10 Incl 500 �'
Over 10 to 50 Ind -1000 PERMITTEE 0
Over 50 to 100 Inc 2000 SIGNATURE
Over 100 3000 DISTRICT NO PROC ED BY 0
Services Is—I
0 200 Amp Under 600 V 1250 INSPECTORS 6E�
201 1000 Amp Under 600 V
2500 APPROVALS DATE SSIGGNAATURE Z
Over 1000 Amp or Over 600 V 5000 TEMP POWER POLE
Temp Power Pole&Appurtenarces
1000 UNDERSLAB WORK
Sign with One Branch Circuit 1000 ROUGH CONDUIT
Additional Sign Branch Circuits200 WIRING
Mlsc Conduits&Conductors 1500 FIXTURES
Other) m Bete ScheduleI POWERAUTHORIZED
O
UTILITYCO NOTIFIED
FINAL LZ'7 7
PERMIT FEE (Sub Totall. NOTES
PLAN CHECKING FEE (One Fourth Permit Feer
PERMIT ISSUING FEE i6 08
TOTAL FEE s Qv
PLAN CHECK VALIDATION CK MO CASH PERMIT VALIDATION IMC, CASH
07 1"JUN 17 '2 0 — 9.0 0 A�yD s
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
76AE63-CES05 1 BB APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING /
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS, SUPERINTENDENT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
++ CROSS ST
NO EACI
RECEPT L S 2Cl OWNER
MAIL
LIGHT_ TOTAL FIRST 20 20 ADDRESS
SWITCH_ _� OVER 20 10 CITY TEL NO
PLAN CHECK
LIGHTING TOTAL FIRST 20 20 APPLICANT
FI KTURES OVER 20 10 ADDRESS
RANGE_DRYER-WTR HTR - CITY TEL NO Y
STA COOK_DISP _F A U CONTRAC TORS rQ
SPACE HTR _AIR GOND ADDRESS/10 J�7 -5
CLOTHES WASH -DISHWASH CIT TEL NO r
FAN-OTHER 1 00 s CLASS - Q
LICENSE NO
MOTORS TRANSFORMERS RATING
IND HEATERS ETC HP KW KVA I HEREBY ACKNOWLEDOE THAT I HAVE READ THIS APPLICATION
SIZE 6 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 HERESY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
1 - 10 3 00 LICENSED AS REQUIRED BY L ELES COU N T ANO STATE OF
CALIFORNIA OR THAT I AN E LEO L ER ♦KO INT EMO TO a
10 - 3p s 00 IIESIOf IN THE AS
DESIRI E E MTIAL PROPERTY O
50 - 100 1000 SIGNATURE 1..)
OF PERMITTEE �
100 - 500 1s 00 DISTRICT O G OUP ZONE R/ptESSED BY 0
SIGN GAS SIGN AND ONE CIRCUIT 3 00 Fiw P4, ISl
TUBE OR // Ll
MARQUEE ADDITIONAL CIRCUITS 1 00 NOTES V S Z
SERVICE NOT OVER 600 VOLTS OR 200 AAP 2 00
SERVICE OVER 600 VOLTS OR 200 AMP 6 00
TEMP SERVICE POLE 6 APPURTENANCES 3 00 APPROVALS DATE INSPECTORS SIGNATURE
L'41-lAto 367 '] O
TEMP POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
PERMIT FEE (SUB TOTAL) WIRING
FIXTURES
PLAN CHECK FEE (SO% PERMIT FEE)
POWER AUTHORIZED
PERMIT ISSUING FEE 200 c>O UTILITY CO NOTIFIED r
SUPPLEMENTARY PERMIT ISSUING FEE 100 FINAL le,4r
TOTAL FEE 24 . 2.b I JOSItPWC R01 HA
SUPERVISING ELECTRI L ENGIN ER
PLAN CHECK VALIDATION CK M Q CASH PERMIT VALIDATION CK M 0 CASH
LPLO5 1.4 8 t JUN 21 2 D 420- 4
ME BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
76A669-CEB06 8.62 APPLICATION FOR ELECTR AL PER
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE. COUNTY ENGINEER
WILLIAM A JENSEN SW T OF BUI MINE LOCALITY
1F PPLIC O CROSS BY
RECEPT TOTAL NO [AOf F[[ /'
OUTLETS FIRST 20 1111,0141 OWNER C 1
LIGHT MAIL /
!WITCH ADD2 10 ADDRESS 1O b wk-- 39
OVER'L �]
TY / TEL NO 4 13 a R G' 6
LIGHTING 1 TOTAL F1R1T 20 YO CI
FIXTURES 11 AOD'L 1O ELECTRICIAN
ov R 20
eer—
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GARS, OEP RA COOK
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MOTORS. OvEIR HOT OVRR HP DISTRICT UP NE P E
O — 1 too
1 — a ISO INSPECTION RECORD
S — 8 200
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6 15 2 6O
c-*,w 6 — 6o 300 A t
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SERVICED 600V NOT OVRR 200A 100
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PERMIT ISSUING FEE 200
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TOTAL FEE 6 U
I NEWSY ACKNOWLIGG[ THAT 1 HAV[ R[AO THIS APPLIATHDRAPPROVALS DAT[ IM![ 01-8111M
AND STAT[ THAT TH[ AROW Il CORRECT AND AGRd6 To COMPLY CONDUIT
WITH ALL COUNTY ORDINANCU AND STATE LAW[ REGULATING
RIJI RICAL WIRING WIRING 1 L I
1 H[ROY C[RTIA THAT 1 AM MOP[RLY R10181[Rm AND/OR
IJC[N® AS RROUIRm GY LOR ANDRUS COUNTY AND STAT[ OP FIXTURES
CALIFORNIA OR THAT 1 AM THK LKGAL OWHRR OF THE ABOVE
DRS,CIIIRRD RERIDENTIAL PROPRRTY POWER
SIGNATURE UTILITY CO NOTIFIED"
OF PERMITTE
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VALMID ARTHUR C VER
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78A889-CEEOS 8-62 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELE8
DEPARTMENT BUILD NG AND SAFETY DIVIBIONER FCCALITY
RDINIGI
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a
JOHN A LAMBIE COUNTY ENGINEER ^ .
WILLIAM A JENSEN SUP T OF BUILDING l.r
NEAREST
A C I IN cpoae 8T J,L/L
LIGHTRECETOTAL FIRET20 NO � 0 rq OWNER CiS
LIGHT OUTLETS
MAIL
SWITCH OVER 20 10 ADDRESS
TOTAL CITY L n O0 /47f— TEL NoLIGHTING F"'OT 20 EO FIXTURES ADD'LtDELECTRICIAN hEV//J S OV R 2ORANGES CLO DRYERS WTR MYq to0 ADDRESS �1 �yGAq DIST SIA COON CITT TEL NO/7TDISMWASN AUTO WASH STATE VACS HTq RTA ATT (Y.HP MAI[ I a0 LICENSE NO9 LOMOTORS1 OVER NOT OVER HP DISTR CT N( G5,,SSEDBO t too
t a 1a0 INSPECTION RECORD
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15 SO 300
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SERVICE O SOOV OvKR 200 A 200
SERVICE OVER SOOV 500 Z
MISC
PERMIT ISSUING FEE 200
SUPPLEMENTARY PERMIT ISSUING FEE too
TOTAL FEE _
1 HRRESY ACKNOWLEDGE T T I MAINE READ THIS APPLICATION APPROVAL00 DATE INSPRCrOR 4 PIGNAT
AMO R7149ATE TMAT YE ABOVE IS CORRECTQ AND AGRTO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND SLATE LAWS gGULATING .ryyam� OL
ELECTRICAL WIRING WIRING r I.RJ
1 HEREBY CERTIFY THAT I AM PROPERLY qOl ETE11EL ANO/OR
UCENEED AS REQUIRED BY LOS &NOBLES COUNTY AND STATE OF FIXTURED
GUFORNIA OR THAT 1 AM THB "GAL OWNER OF THB ASOVE
DESCRIEBD mvIDENTIAL PROP t POWER
SIGNATURE UTILITY CO NOTIFIED
OF PERMITTEE
FINAL
�IIDATION A UR cfvEn
CK MO GSH BUO2pVISING ELECTRICAL ENGINEER
Liuo 6 7 5 9- ItAR 19 2 D 3.00-
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Teeaae ceaoa ase APPLICATION FOR ELECTA ERMIT Q
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
le 77-
JOHN A LAMBIE COUNTY E'=NZER
COLEMAN W JENKINS, SUMNINTENDIENT CI BUILDING LOCALITY T
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
A
RECEPT_ S OWNEQ
MAIL
LIGHT_ TOTAL FIRST 20 20 ADDRESS
SWITCH_ OVER 20 10 CITY TEL NO
PLAN CHECK
LIGHTING TOTAL FIRST 20 20 APPLICANT
FI%TURES OVER 20 10 ADDRESS
RANGE_DRYER—WTR HTR CITY TEL NO
STA COOK_DISP _F A U COATRAC ron
SPACE HTR _AIR COND _ ADORES /r S
CLOTHES WASH _DISHWASH a I T-2zeRrAl
FAN—OTHER f 00
LICENSE NO CLASS - e
MOTORSTRANSFORMERS RATING
IND HEATERS ETC NP KW KVA I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
S1ZE 6 TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING
O 1 1 00
` I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
1 10 3 00 LICENSED AS REQUIRED SY LOS A LES DUN Y AND STATE OP
IROUGH
RNIA OR THAT I AM THE'LEOAL 0 R AND INTEND TO T
ID SO 5 00 I IM THE ABOVE OESCPIPE S NTIAL PRORCRTY OTURE
SO - 100 1000 RMITTEECD
100 - 500 15 00RICT OG OUP ZONE OCE55 BYSIGN GAS SIGN AHD ONE CIRCUIT 3 00 'TUB! ORMARQUE! ADDITIONAL CIRCUITS 1 00SSERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00
SERVICE OVER WO VOLTS OR 200 AMP S 00
TEMP SERVICE POLE 6 APPURTENANCES 3 00APPROVALS DATE UUPECTOR3 SHINATURE
POWER POLE
RSLABWORK
H CONDUIT
PERMIT FEE (SUB TOTAL) G
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PLAN CHECK FEE (50% PERMIT FEE) R AUTHORIZED
PERMIT ISSUING FEE 2 00 TY CO NOTIFIED �SUPPLEMENTARY PERMIT ISSUING FEE 1 00 L
TOTAL FEE 1 J EPH C ROOHAN
SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK M 0 CASH
Ur, 0 5 4 3 jui 17 2 D 5.00
'SEE EACK OF APPLICATION FOR COMPLETE PEE SCHEDULE
76AG63-CE606 3-69 / a l 1
APPLICATION FOR ELECTRICA PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION AODREIS
JOHN A LAMBIE, COUNTY ENGINEERESN E
COLEMAN W JENKINS SUPERINTENDENT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST J
NO EACH I[[
$ f OW HER
RECEIPT MAIL
LIGHT TOTAL
FIRST 20 20 ADDRESS
CITY TEL NO
SWITCH_ OVER 20 10 PLAN CHECK
LIGHTING TOTAL FIRST 20 20 APPLICANT
FIKTUi ES OVER 20 10 ADDRESS
RANGE_DRYER_WTR HTR CITY o TEL NO �j--�J
STA COOK_DISP _F A U CONTRACTOR-4r/Y TG/,/Jr E(`C
SPACE HTR _AIR COND ADDRES yy/49 S' ` S / b_ *ojy`✓
CLOTHES WASH _DISHWASH CITY // / TEL
FAN OTHER 1 00 LICENSE NO4F2 �EQ CLAS — O
MOTORS TRANSFORMERS RATING I HERE BY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
IND HEATERS, ETC HP KW KVA AND STATE THAT THE ABOVE Ip CORRECT AND AGREE TO COMPLY
SIZE 6 TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING
O - I 1 DD 1 HERESY CERTIFY THAT 1 AM PROPERLY REGISTERED 410/Of
ICEN1[D AS REQUIRED BY LOS ANGELES COUNTY AND STAT[OF
1 - 1D 3 DD CALIIORNIA OR THAT 1 AM THE L[ L G HER 0I AND
IRTCND TO
RESIDE IM THE ApOV [ SI RTIAL PRDIER TY O
10 - 50 500 V
SIGNATURE
b0 - 100 10DO OF PERMITTEE O
100 — 500 1500 DIST�T N 'flGpoyP xo11e o EaeeD aY
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WER POLE
/ / UNDERSLAB WORK
ROUGH CONDUIT
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PERMIT FEE (SUB TOTAL) F
IXTURES N/
PLAN CHECK FEE (50% PERMIT FEE) OWER AUTHORIZED 'f
PERMIT ISSUING FEE 2 00 TILITY CO NOTIFIED
INAL
SUPPLEMENTARY PERMIT ISSUING FEE 100 �
TOTALFEE JOSEPH C ROOHAN
SUPERVISING ELE ENGINEER
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK M o CASH
Ur.�15 4 3 49 JLRI 7 2 0 8.00^' q
SEE SACK 01 APPLICATION FOR COMPLFTF FEE SCHFOULF
7Meas Dae ew n-eo - APPLICATION FOR PERM
DEPARTMENT OFG ASAFETY
ELECTRIC 1
COIINTY OFF LOS LOS ND ANGELES
WILLIAM J FOX CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO GROUP ZONE PERMIT NO
ELECTRICIAN
RECEIVED BY READY FOR DATE ISSUED
ADDRESS FIRST INSPECTION
CITYi d TEL NO
COON 8 ESS 1 L C/ /.�
PERMTf FEES
F[[ ADDR
NUMBER CHI LOCALITY
LIGHT OUTLETS N
CRUREBT
OS BT
RECEPTACLES
WALL SWITCHES OWNER t
TOTAL OUTLETS SC • MAIL y/ t t eF.,
[LEC RANGES pS ADDRESS DD
ELEC HEATERS 28CITY Q e/ 10
FIXTURES
1 HE .O, CKNOWLEDGE THAT I HAVE READ THIS
M SC APPLICATION AND STAT[ THAT THE ABOVE 19 CORRECT
NUMBER OF LIGHT CIRCUITS AND AOR[[ 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 LOB
Nu era HO EPOWQi ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
F[E OF THE RESIDENTIAL PROPERTY D ABOVE.
NEW Mv0 HP o.R IRC [AC'H
2 W
1 e I 00 IIS SIGNATURE OF
1 PHRMITTE T�
2 B 1 OGO INSPECTION RECORD
S 15 1 SO
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200 Soo 10 00
Soo 1000 1000
OVER 1000 2000 (�
M G SET FRED CHANGER-HP K
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GENERATORS-KW
TRANSFORMERS-KVA
TEMP MOTORS (75 OF Oa1e
MOVED MOTORS 4 75OT ORIF
B '
SIGNS
NO NO TRANS APPROVALS
NO O LAMM
DATE INSPECTOR B NAME
FOR EACH PERMIT
WIRING 1 00 CONDUIT
FIXTURES *too WIRING I
BUPPLEMENT RY 3o FIXTURES
7 POWER
TOTAL FEE UTILIT'CO NOTIFIED
'P
FINAL, I 1 C'T—
76A6°3d�06(11/78'- AP CA N FOR CAL PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY T _ `
FOR APPLICANT TO FELL IN `[ (], 4
New Reirdentiol Bidgs &PoADDRESS -
Pools EACH NO - FEE--- 40 - - - - -
182 Family Sq Ft S 025 - $ LOCALITY
Multi family Sq Ft 02 - NEAREST ,or_ ,
Residential25 00 STOWNlzROR-
dential Swimming Pools _
I
Outlets Rec—Light_Sw _ MAIL-
First
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First 20 50 A RE - -
- Total No -Additional 30 CITY CC CC .Tel IN
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- - -Additional 30 _
Total No CITY OA g4
Tel No 9,
Fixed Appliances Not Over 1 HP _ - - MIT- — --- •--- -•
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APPLICANT '!^
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Top —FAU — WH — _ CITY- _ - -Tel Na.___._._._- -
'Hood_Fan Other_
Di - LICENSE OR ^-p
sp _RoomAirCond __ 250 7ZY1
REG NUMBER L, 3'G____ Closs�•¢�
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA
Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO 2 50 -
Size 8 Type HP KW KVA or KVAR . i COMPLY WITH-ALL COUNTY ORDINANCES-AND'SfATE-CAWS =
REGULATING ELECTRICAL WIRING /
_ Up to 1 Incl 1 HEREBY CERTIFY THAT I'AM'PROPERLY REGISTERED AND/OR
Over 1 to 10 Incl 5 00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
-- Over 10 ro 50 Incl 12 50- CALIFORNIA OR THAT_I-AM THE LEGALOvt'NER OF-THE ABOVE w
Over 50 to 100 Inc
25 00 DESCRIBED RESIDENTIAL PROPERTY
Over 100 4000 - PERMITEE __
SIGNATURE
Services - DISTRICT NO -� - P 'BY
0 200 Amp Under 600V 1250
201 1000 Amp Under 600 V 2500 - -U• -`Over 1000 Amp or Over 600 V 5000
Temp Power Pole&Appurtenances 1000 -14- t •Z'
Sign with One Branch Circuit �_ 1000 v
Additional Sign Branch Circuits ' 2 00jFee)
INSPECTION_—' .+
11 D ooINFORMATION _ 0 2 S 3 A
Mac Conduits&Conductors - -ON REVERSE -" t
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-
• SIDE - -----� � . a. . . 2
2 • • 17. 00
PERMIT FEE (Sub _ _s, _ ^' • • • 117' 005
PLAN CHECKING FEE (One Fourth Permit 0,508-80
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TOTAL FEE > ,
dateINSPJQN FINALED
dote `L. 0 -Sy PBY es
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>.....-DR.G. 10/741 ✓vM PL—� G Fry
APPLICATION FOR ELECTRICAL P MIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER ,{OOgESg b f9 Tp� uTy LV
BUILDING AND SAFETY DIVISION
LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
OUTLETS 90 EACHOWNER OR
S S FIRM NAME ' O V
RECEPT MAI
LIGHT A- TOTAL FIRST 20 O 25 8 ADDRESS B l 9 TEM 0I U d
ISWITCH—.5—
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PLAN CHECK
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(SPACE HTR AIR COND CITY
Ng �5 6Ll OI'LL - TEL NO � -A.SOS-
CLOTHES� WASH _OIBMWADX ro b!0 NUMBER a�// Z 0 CLASS C /0
FANJ�,OTH ERS rb u+AO_ 4� I HEREBY ACXNQWL9009 THAT 1 HAVE READ THIS APPLICATION
AND STAT[ THAT THE ABOVE IE CORRECT AND AGN[[ TO COMPLY
MOTORS, TRANSFORMERS RATING WITN ALL COUNTY OROINAMC[S AND STAT[ LAWS REGULATING
IND HEATERS, [TC HP KW KVA 1 It aCTNICAL WINING
[ME S TYPE OVER TO
$PrHEREBY CERTIFY THAT I AM PROPERLY R[SIST[R[0 AND/OR
0 — 1 00 LICE
"BID AS REQUIRED BY LOS ANI[LES COUNTY AND STAT[ OF
CALIIORNIA ON THAI I AM THE
L[G AL OWNER OP TN[ ABOVE 'r_
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10 - 80 PERMITS! //J� ////////����////
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too - 800 IeOo
09 z
SIGN GAS SIGN AND ONE CIRCUIT 500 APPROVAL DAT[ IMV[C SsmmYuN[
TUBE OR
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SERVI CENOTOVER 600 VOLTS OR 200AMP UNDERSLAS WORK
SERVICEOVER 600 VOLTS OR 200AMP , 1500 l� ROUGH CONDUIT
TEMP SERVICE,POLE, &APPURTENANCES SOO WIRINGA062—
TEMP LIGHT OR RECEPT SYSTEM 500 FIXTURES
POWER AUTHORIZED
UTILITY CO NOTIFIED
FINAL
PERMIT FEE (SUB TOTAL) ✓fes NOTES
PLAN CHECK FEE
PERMIT ISSUING FEE Iva
4 S�
TOTAL FEE b0 L.9S
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION cK M 0 CASH
2 u L 9 5 -w
SES SACK OF APPLICATION FOR COMPLETE SCHEDULE J
Q�SIY�lif LIrC_eL.sJ IN �
APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES ELECTRIC P�YR'C 1
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. GROUPI ZONE PERMIT NO.
ELECTRICIAN .S e. /e F 71
RECEIVED BY READY FOR DAT[ ISSUED
ADDRESS FIRST INSPECTION
T[L NO /� �- — �_20-SD
CITY
COUNTY LICENSE NOEXPIRES 37) SUILDINO
PERMM FEES ADDRcea
NUMBER OUTLETS EACH FE[ LOCALITY L
LIGHT Be D CROBB NR' T
R.— - i
RECEPTACLES B
FIXTURES S OWNER
_ WALL SWITCHES S MAIL
[LEO RAMSES 25 ADOR[�
ELEC. HEATERS 43 , CITY A MO
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
NUMBER Or CIRCUITO INSTALLEOt
TQTAi APPLICATION AND STATE THAT THE ABOVE IS CORRECT
LIGHTS [ PTA L AND AGR[[ TO COMPLY WITH ALL COUNTY ORDINANCES
MOTORB AND CFATE LAWS REGULATING ELECTRICAL WIRING
NUMBER HORSEO
PWER FEE I CERTIFY THAT I POBBESS THE ABOVE VALID LOB
N[w MVG HP OVLR IHo EACH AMGELER COUNTY LICENSE. OR 1 AM THE LEGAL OWNER
of THE RESIDENTIAL PROPERTY DESCRIBED ABOVE
1/2 p BO SIGNATURE
PERMIT Er �-
B IB I BD INSPECTION RECORD
1B Bo asD
Bo 9013 B OO �].Y•1'•F �.,.��1J • ✓n i! L oyA d' 2 -R/-✓�7 .�i 1
200 Boa 1000 /C.t. -✓,c
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TEMP MOTORS (76 Cr DAIS)
MOVED MOTORS (75OF GRID)
MIND
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TYPEt NO TRANS
NO uM PB APPROVALS
FOR EACH PERMIT DATE INBPECTOR•B NAM[
WIRING B1 GC CONDUIT
FIXTURES sl OC -/jjo WIRING /
BUM So FIXTURES
POWER
TOTAL FEE B A 2,0 UTILITY Ca NaTlrlcD /
d� FINAL ` JQ
T"`EEy-Ci'"G 10'74 APPLICATION FOR LECTR1& PERMIT
--COUNTY OF LOS ANGELES FJAODSRESS 1
.DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION
ITYSTFOR APPLICANT TO FILL IN ST OUTLETS " F6CoRS S AMERECEPT
LIGHT_ TOTAL FIRST 20 Ey ADDRESS
mee
TEL NO
OVER 20 CITY T
SWITCH_ 10 PLAN CHECK
LIGHTING
TOTAL FIRST 20 25 APPLICANT
OVER 20 10 ADDRESS
FI%TURES
RESIDENTIAL APPLIANCES CITY TEL NO
PERMIT
RANGE_DRYER_WTR HTR_ APPLICANT7.
STA COOK_DISP_F A U AGGRESS
SPACE HTR AIR COND CITY
TEL NO,7/
CLOTHES WASH DISHWASH_ 0.EGHNUMBER CLASSG
FAN_OTHER 100 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORSTRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGUUTINO
IND NEATENS ETC HP KW KVA ELECTRICAL WIRING
SIZE & TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANOATR
0 - I IGO LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNE OF THE ABOVE
I - 10 500DE5CRIrEO RESIDE L PROPERTY
PERMITEE
10 - 50 500 SIGNATURE
SO - 100 IOOO LY
DISTRICT a RO ED
100 - 500 1500 ��57 UO z
SIGN GAS SIGN AND ONE CIRCUIT 500 APPROVALS DATE IMS SSIOKATURE
TUBE OR
MARQUEE ADDITIONAL CIRCUITS IOD TEMP POWER POLE
SERVICENOTOVER 6D0 VOLTS OR 200AMP 300 UNDERSLAB WORK
SERVI CEOVER 600 VOLTS OR 200AMP 1000 ROUGH CONDUIT
TEMP SERVICE,POLE &APPURTENANCES 500 WIRING
TEMP LIGHT OR RECEPT SYSTEM 500 FIXTURES
POWER AUTHORIZED
UTILITY CO NOTIFIED
FINAL
PERMIT FEE (SUB TOTAL) NOTES ,
PLAN CHECK FEE
PERMIT ISSUING FEE 300
TOTAL FEE -loo
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION M 0 CAB"
w - 8 5 2izAPR 22 2 e _12.0 0 A98
SEE SACK OF APPLICATION FOR COMPLETE SCHEDULE
7eA553-ceeoe 11 T, APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELESqUDDLReSS
1
DEPARTMENT OF COUNTY ENGINEER rl L
BUILDING AND SAFETY DIVISION
CFOR APPLICANT TO FILL IN OUTLETS IeRECEPT LIGHT_ TOTALFIRST 20
CITU TEL NO
SWITCH OVER 20 Ip
PLAN CHECK
LIGHTING 1 TOTAL FIRST 20 25 APPLICANT
FIXTURES 10
T
OVER 20 ADDRESS
RESIDENTIAL APPLIANCES CITY TEL NO
RANGE_DRVER_WTR XTR_ PERMIT
APPLICANT
STA COOK_DISP _F A U _ ADDRESU?Q
SPACE HTR AIR GOND CITY TEL NO 2
CLOTHES WASH DISHWASH_ LICENSE NO I 17 CLASS
FAN_OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STAT[ THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STAT[ LAWS REGULATING
IND HEATERS ETC HP KW KVA ELECTRICAL WINING
SIZE S TYPE OVER TO
I NER[SY CERTIFY THAT I AM PROPERLY REGISTERED ATE OF
Q _ 1 100 CALIFORNIALICENSEDAS RE THAT
NY LOS LEGAL
COUNTY AND STATE OF
CALIIORM. OR THAT I A THE LEGAL ORMLA 9 AND INTEND TO O
1 — 10 SOU RESIDE IN THE AS [ Dl lCRla[�D '/R/�/II D[XTJRL PROPERTY v
SIGNATU10 — 60 NOD OF PERMRTTEE /2_ j / IiIL�L�� �— K
0
60 — 1DO 10.00
DOTRIC�T NO j CLASS ZONE P [SEED
100 — 600 15M ,0 N
SIGN GAS SIGN AND ONE CIRCUIT 5 D NOTES ?
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1-0O
SERVI CENOTOVER 600 VOLTS OR 200 AMP 300
SERVICEOVER 600 VOLTS OR 2OOAMP Ip APPROVALS DAT[ OR[CTOR'S[ISIMTURE
TEMP POWER POLE
TEMP SERVICE,POLE, IS APPURTENANCES
UNDERSLAB WORK
TEMP LIGHT OR RECIEPT SYSTEM 300 (ICJ
ROUGH CONDIUT
WIRING N� 7/
FIXTURES /
PERMIT FEE (SUB TOTAL) POWER AUTHORIZED lji 1 7Z
UTILITY CO NOTIFIED
PLAN CHECK FEE
PERMIT ISSUING FEE 3040 FINAL
TOTAL FEE
PLAN CHECK VALIDATION CK M 0 CASH PER V IDAT40N (!Dm G CASH
LAC067243 2 0 1100- q
$EE BACK OF APPLICATION FOR COMPLETE SCHEDULE
WORKER
tI haveCOMPENSATION DECLARATION 76ASSo DPW(,29„ APPLICATION-FOR ELECTRICAL PERMIT lJ
I hereby affirm that I have a certificate of consent t0 self insure 71883
or a certificate of Worker a 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 AIWDGNT TO FlLL n1 ZIESS �✓
Cemhed copy is hereby furnished New Residential Bldgs 8 Pools NO EACH FEE LOCALITY
❑ Certified copy is filed with the county building inspection 1 8 2 Family Sq Ft — $ $ NEARE9r L
department Multi family Sq Ft — NR TT
Date Applicant Residential Swimming Pools ASSESSOR
MAP BOON PAGE PARM
CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec _Light_Sw FlRMENR OR �Q Lr �4
COMPENSATION INSURANCE
(This section need not be completed If the work Involved by the Frat io �t ,.(
permit Is for one hundred dollen($100)or leu) Total No Additional ADDRESS Q U ZD
I canny that in the performance of the work for which this permit crrYA 4–C A� Tel No
is issued I shall not employ any person any manner 0 as to PUN ClIECK
become su ject to the Workers Compen n laws Lighting Fixtures First 20 APPLICANT
II Total No Additional ADDRESS
Date V Appli ZARESIDENTIAL APPLIANCES NOT OVER 3 HP
NOTICE T APPLICANT If eft m n thio ertdicete of CITY TN No
Exemption you should become subject to the Workers Compensation OTHER APPLIANCES NOT OVER 3 HP
proviaions of the Lobar Code you must forthwith comply with such PERMD
provisions or this permit shell be deemed revoked Power Apparatus 8 Large Appliances APPLIG )&2M Iral
' LICENSED CONTRACTORS DECLARATION Sao 8 Type HP KW KVA or KVAR ADDRES39Da
I hereby affirm that I am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business and Over 3 to 101nc1 CITY B62 eAil
To Ne
Professions Code and my license 19 In full force and effect Over 1010 50 IMI
LICENSE OR Cisss 4jo
d
Over 50 to 100 Incl REG NUMBER
Licence Number Lm Clear Over 100 DISTRICT NO �O4 P( BSEp By _ U
�� Services Swbd,MCC 8 Panelboerds
Contract Dete_��?!�E 0 398 Amp Untler B00 V oArE
LJ 400 1000 Amp Under 80O V
I flirt exempt under Sec V
Over 1000 Amp or Over 000 V DNAL VALIDATION Wd
B 8P C for thus reason BRANCH CIRCUIT FEES BY
Date 15A or 20A 120V Lighting or Recept Z
1 To 10 Branch Circuits
Signature 11 To 40 Branch Gmuns
41 More Branchr_1 Exemption for Reg Merit Elect 15A 2DA 20 VV To 277VOLghong Br Grans
uits
SINGLE FAMILY Temp Power Pole 8noes 2
S�9^with One Branch Circuit
HOME OWNER BUILDER DECLARATION ApirAC `r
I hereby affirm that I em exempt from the Contractor s License Lew cun ACCT.
for the following reason (Section 7031' 5 Business and Professions Additional Sign Branch Circuits
Code) JJW T2t1? 48.60
�a�
❑ I as owner of the Property will do the work and the structure Misc Conduits 8 Conductors I 1 I u IJ
is not intended or offered for sale (Section 7044 Business (See Complete Fee Schedule) ' TOTAL 48 . 60
and Professions Code) CHECK 48.60
CONSTRUCTION LENDING AGENCY
1 hereby affirm that there is a construction lending agency for the C .DO
performance of the work for which this permit Is issued (Sac 3097 PERMIT FEE (Sub-Totap
Civ C)
PLAN CHECKING FEE 0G[O–000I 6/26/96
Lender a Name "
PERMIT ISSUING FEE �' � 7134 1 Ah11:47
Lenders Address
I cemfy that I have read this application and under penalty of purjury state TOTAL FEE 6
that the above mformatxn is correct I agree to comply with all County
ordmences d State laws regulating Electrical wring and hereby authorize
repreaen vas of this County to enter upon the abovementioned property
for In on pu SEE REVERSE FOR EXPLANATORY LANGUAGE
n Ru pA
k,;t7- at_ 3 7 ,
WORKERS COMPENSATION DECLARATION 76A663 10/8I APPLICATION FOR ELECTRICAL PERMIT
' I hereby affirm that I have a certificate �
icate of consent to self
insure or a 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 Ffll IN ADDRESS �p C B
Certified copy is hereby furnished New Residential Bldgs 8 Pools EACH NO FEE O
❑ _ _ f JA
LOCALITY L
Certified copy is Bled with the county building inspec 1 &2 Family Sq Ft E e 1
tion deportment Multi family Sq Ft — NEAREST
CROSS ST W
Residential Swimming Pools OWNER OR
Dote APPhmnt FIRM NAME
CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec_Light_Sw_ MAk '
COMPENSATION INSURANCE F rst 20 a ADDRESS
(This section need not be completed If the work Irwd b
olvey Total No Additional CITY Tel No
the permit Is for one hundred dollars ($100)or less )
I certify that in the performance of the work for hKh rhes, PIAN CHECK
APPLICANT
permit is issued I shall not employ any person ma r
so os to become subject to the Wo n hon ws Lighting Fixtures First 20 ADDRESS
Total No Additional
Dote CITY Tel No
4Tplican Fixed Appliances Not Over 1 HP PERMIT
NOTICE TO APPLICANT If after making this Certificate of AFRICAN
Exemption you should become subject to the Workers Range_ Heater_D W
Compensation provisions of the Labor Code you must forth Oven _ Dryer — W M — ADDRESS S^
with comply with such provisions or this permit shall be T — FAU —W H —
deemed revoked Hood _ Fan _Other_ CI el No
LICENSED CONTRACTORS DECLARATION
I her off em that I am licensed under Disp _ Roam Air Cond - LICE OR Class AA
hereby provisions of Chapter 9 REG NUMBER
(commencing with Section 7000) of Division 3 of the Business Power Apparatus B Large DISTRICT NO BY d
and Professions Code,and my license is in full force and effect APP° 9 Appliances ,� r
Size &Type HP KW KVA, or KVAR ll/ 0 8
License Number sd� 3 Lic Class ���D Up to 1 Incl FINAL — d'
Over 1 to 10 Incl DATE VAIIDATI
Co actor Date Over 10 to 50 Indb
FINAL Lys
I am exempt under Sec Over 50 to 100 IrrcBV n.
B 9P C for this reaOve 100 /
son Z
Services Swbd MCC 8 Panelboords
to 0 -200 Amp Under 600 V
Signature – 201 - 1000 Amp Under 600 V
❑ Over IDDO Amp or Over 600 V
Exemption for Reg Mont Eject
SINGLE FAMILY Temp Power Pole 8 Appurtenances
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
for the following reason (Section 7031 5, Business and
Professions Code)
❑ I as owner of the property, will do the work and the M,sc Conduits&Conductors
structure is not intended or offered for sole (Section Other (See Complete Fee Schedule)_
7044 Business and Professions Code) ► ;27369A
CONSTRUCTION LENDING AGENCY # e'•e e • e 2
I hereby affirm that there iso construction lending agencyfor
the performance of the work for which this permit is issued PERMIT FEE' (Sub-Total) 1 • • 1 550
(Ser 3097 Civ C ) • - 15505
• PLAN CHECKING FEE Q k 3 0 e.8 7
Lenders Nome
PERMIT ISSUING FEE �Q
Lender s Address
I certify that I hove read this application and state that the TOTAL FEE /17r
above mformahon is correct I agree to comply with all County '
ordinances and State jaws regulating Electrical wiring and
hereb a eprose ntahv f this County to enter upon .
the ave men on d prop r ins Ghon purposes SEE REVERSE FOR EXPLANATORY LANGUAGE
gna u of Permittee - Date
I W RKERSCOMPENSATION DECLARATION 20-0019 DPW(1281) APPLICATION FOR ELECTRICAL PERMIT IJ
I hereb 'allmm that I have a certificate of consent to sell Insure
or a ce�dlcate df Worker s Compensation Insurance or a certified COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV
copy thereof(Sac 31100 Lab _C) y- - 110 ,
Policy No r Company FOR APPLICANT TO FlM LL JOB
ADDRESS 48 Tem
Certrllad copy tit hereby furnished L New Residential Bldgs 48
8 Poole NO EACH FEE
ple City Filyd
of Temple City Rlyfj
❑ LOCALITY
", Certifmd copy is filed with the county building Inspection I&2 Family Sq Ft — B S C
departmentMulti family Sq Ft
"C o se and Lower AzuEla Rd
Date Applicant Residenbal Swimming Pools ASSESSOR
t MAP BOOK PAGE PAACFt
CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Res -L Light_Sw _ OWIN ER OR Kare Youth League
COMPENSATION INSURANCE - RPMNAIJE
Finst 20
(This section need not be tiomMAILpleled If the work Involved by the Total No Additional ADDRESS P.O, BOX 1 18
psrtnS Is for'one hundred dollars($100)or Ilea)
I certify that�lnn the performance of the work for Which this permit CITY' Arcadia 91066 Ta 18- Q
Is Issued I shall not employ any pere In'any manner so as to
become s blest to,the Workers Comp. ebon -a" Lighting Fixtures 2 First 20 APPLCgM K
Total No 3 Additional
Q ADDRESS
Date 2" Applicant RESIDENTIAL APPLWICES NOT OVER 3 HP
NOT I 'TO APPLICANT II alta, m In th s ertdtnate of CITY Ta No
Exemption you should,bacome subject to the Workers Compensation OTHER APPLIANCES NOT OVER 3 HP
provisions of the Labor Code you must forthwith comply with such PERMIT 1
provisions or this permit shall be deemed revoked Power Apparatus 8 Large Appliances APPuCANT G.G, Hester and Son
0 LICENSED CONTRACTORS DECLARATION Sao&Type HP KW KVA or KVAR ADDRESS 9024 E. Greenwood Ave.
I hereby affirm that I am licensed under provisions of Chapter B Over ata 101nc1
(commencing with Section 7000)of Division 3 of the Business and CITY San Gabriel 9177T
Professions Code and my license to to full force and effect Over 10 to 50 Ind
Over 50 to 1001nci NRED� NwBBER474648 01e°' C-1 o a}
License Number'4-7 r LIC Clas; r� Over 1DO DIBTRICT NO
b Senecas Swbtl MCC 8 Patelboards d U
Conbector Date Z p 0 398 Amp Under 600V FINAL
emDATE 0
❑- 400 1000 Amp Under 600 V 6
I am...pt/unde'r Sec VALIDATION U
Over-10100 Amp or Over 600 V FINAL W
B 8P C for this reason BY
BRANCH CIRCUIT FEES
CIRCUIT d
Date 15A or 20A 120V Lighting or Recept Z
1 To 10 Branch Grcucts -
�Slpneture - 11 To 40 Branch Circuits
❑ _ 41 Or More Branch Circuits +
Exemption for Rep Meml Elect 15A 20A 208V To 277V ugthng Br Cawrts
SINGLE FAMILY Tamp Power Pole&Appurtenances
HOME OWNER BUILDER DECLARATION
I hereby affirm that I am exempt Dom the Contractors License Lew Sign with One Branch Circuit 4�.
for the following reason (Section 7031 6 Business and Professions Additional Sign Branch Circuits
75
Code) j IMF,
❑ I as owner of the property will do the work and the structure Mlsc Conducts 8 Conductor; TOT♦ALL. - 45 . 75
Is not Intended or offered for sate(Section 7044 Business Other(Sea Complete Feq Schadule) .. �NEy.T
and Professions Code) / v 45.7`
OONST14UCTION LENDING AGENCY CHANGE .00
I hereby affirm that there Is a construction lending agency for the
performance of of the Work for which this permit Is Issued (Sac 3087 PERMIT FEE (Sub-Total 0000--0001 6� ���
Civ C)
PLAN CHECKING FEE
Lander s Name 051-79 1 ACI 9:11
PERMIT ISSUING FEE
Lender s Address '
1 sanity,that I he"read this application and under penalty of purlury state TOTAL FEE
that the above Infonnabon Is correct I agree to comply with all County -
ordlnanceeandStatelawaregulatingElectncal winng andherebyauthor¢e
repress 11tivoil of this County to enter upon the abova-mentioned property - -
for me coon pure°es SEE REVERSE FOR EXPLANATORY LANGUAGE
P n EE L a
WORKERS COMPENSATION DECLARATION 76A6e3 10/81 APPLICATION FOR ELECTRICAL PERMIT
I•hereby affirm that I have a certificate of consent to sett insure CF 9oeG
o,a certdl�'eto of Workers Cornpensatwn Insurance or a certded COUNTY OF LOS ANGELES BUILDING AND SAFETY
copy thereof(Sec 3800 Lab C)
Policy NO Gomparly FOR APPLICANT TO FILL IN ,IDB �f
❑ Cartifed copy is hereby furnished New Resdentel EACH NO FEE ADDRESS ygl9 N PLE CIT LY
• , Bldgs 8 Pada
❑
Certified copy is filed with the county building nspectwn 1 8 2-Family Sq Ft $ — $ LOCALITY LOb)ee AZUS14
department Multi-famlty Sq Ft — NEAREST
CROSS ST
Date 'Applicant Residential Swimming Pools OWNER OR /1 c E
nRM NAME Y-r -c. O�I N LVA��
^
CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Roo Light — Sw MaL
COMPENSATION INSURANCE ,AO LSs P0 BD I$
(This section need not be completed if the work rmolved by the First 20
permtt is for one hundred dollars ($100) or lees) Total No Additional CfTYCAOIA Tel No
Big
I certify that in the performance of the work for which this permit PLAN CHECK
is issued I shall not employ any person in any manner so as to PPPUGNi
became subject to the Workers Comp Lighting I�phLnp Fixtures FirstAdds 20 ADDRESS
Date 10'z✓9� Applicant / Total No Pdtlrtxmal r CITY Tel No
NOTICE TO APPLICANT If, after making this Certificate of Fixed Appliances Not Over 1 HIP PEgggT
Exemption you should become subject to the V brkers Conparsaton Range_ Heater_ DW _ =Z72TANT P P•
provisions of the Labor Code you must forthwith comply with such Oven _ Dryer _ W M _ ADDRESS 835' N Q L14A16
provisions or this permit shall be deemed revoked Top _ FAU _ WH
LICENSED CONTRACTORS DECLARATION Hood — Fan _-Other_ GITYPLE C Tel No N
I hereby affirm that I am licensed under provisions of Chapter 9 Disp — Room Air Cond — - "a NUMBER $3 �°° C� 0
(commencing wrth Section 7000)of Division 3 of the Business and
Professions Code and my license m in full force and effect DISTRICT NO PROCESSED BY
Flower Apparatus 8 Largo Appliances y�
Size 8 Type HP KW KVA or KVAR G!�(,!f K,
Lcerse Number g Lic Clash 4f-16 Up to 1 Ind — FINAL
��S a.f. Over Ito 101I DATE ' VALIDATION 00
Contractor to —'T Over 10 to 50 Incl v/ OC(p / FU
FlNAL i P/� r
❑ I am exempt under Sec Over 60 to 100 Inc BY G7� W
BAPC for this reason Over 100 N
Data Serwces Swbd MCC 8 Parelboards Z
0-200 Amp Under 600 V
Signature 201 - 1000 Amp Under 600 V
Over 1000 Amp or Over 600 V
❑ Exemption for Rep Mamt Elect
SINGLE FAMILY Tsmp Power Pole A Appurtenances
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit a
I hereby affirm that I am exempt from the Contractors License Law AI�T.r
for the following reason (Sectcn 7031 6 Business and Professors Additional Sign Branch CArcuits i s
Code)
❑ I as owner of the property will do the work and the structure Mlsc Conduits d Conductors 1 ITN7
is not intended or offered for sale (Section 7044 Business Other (Sea Complete Fee Schedule) 23 - 00
and Professions Code) CHECK TQTAL OTAL �..CQI
CONSTRUCTION LENDING AGENCY
' 1 hereby affirm that there is a constriction lending agency for the Nn$ ,00
performance of the work for which the permit is issued(Sac 3097 PERMIT FEE (Sub-Total)
Cm C)
PLAN CHECKING FEE
Lenders Name Q QQ[)jJ—[�GO1 E/iS/'i 1
that PERMIT ISSUING FEE �TY 7732 1 AN113:1�
Larders I s OQ
I certify that I have read ihr9 applCatxxl and state that the above TOTAL FEE
information is correct I agree to comply vnth all County rxdinsnces
and State laws regulating Electrical mining and hereby authonze
representatives of Ihrs�unty to enter upon the above-mentioned
props e�ch -
SEE REVERSE FOR EXPLANATORY LANGUAGE
�-2s_9�
rgnat Permittee Date
WORKERS COMPENSATION DECLARATION 76n6e3 ,p,ai APPLICATION FOR ELECTRICAL PERMIT fl hereby affirm that I have a certificate of consent f0 Ball insure CE 8086
or a certificate of Workers Compensation Insurance or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY
copy thereof(Sec 3800 Lab C)
Policy No COmparry, FOR APPLICANT TO FILL IN JOB
El copy is hereby furmshad New Residential Bldgs 8 Pools EACH NO FEE ADDRESS �_
G yJD
❑ Certified copy is filed with the county building inspection 1 8 2-Family Sq Ft $ — $ LOCALITY -� aVW&V OF /_V"A. Q
#VA LSO
department' Multi-family SO Ft — NEAREST
Data Applioant I Residential Swimming Pools GROSS
R OR
FIRM NAME KALE V0a T9
CERTIFICATE OF EXEMPTION FROM WORKERSMAIL
COMPENSATION INSURANCE . Outlets ReLight _ Sw — A KESS P-0• 909 //8
(This section need not be completed if the work Ini olved by the First 20
permit is for one hundred dollars($100) or leas)
Total No Additional CITY q(CC(0 Tel No
1 certify that in the performance of the wort( for which this permit PLAN CHECK
is Issued I shall not employ any person in any manner so as to APPLICANT
become subject to the Workers Compensation cos Lghhrig Fixtures First 20 ADDRESS
/n--75'-9 Total No Additional
Date Applicant .'--+�/ CITY Tel No
NOTICE TO APPLICANT H after malting this Certificate of
Fixed Apdienlces Not Over 1 HP PERMIT
Exemption you should become subject to the Workers Compensation Range— Heater— DW — APPLICANT Q.P. ilkA=0TWAV
prov ore of the Labor Cade you must forthwith comply with such Oven _ Dryer _ W M _ ADDRESS JA3s
provisions or this permit shall be deemed revoked
LICENSED CONTRACTORS DECLARATION H000d _ Fan _ Other_ `� CITY T6YhPL(!r C' Tel No qW-3729
I hereby affirm that I am licensed under provisions of Chapter 9 n Dwp — Room Air Cond ` LICENSE OR /O
(commencing with Section 7000) of Division 3 of the Business and REG NUMBER Class
Professions Code and my Ix nse is in full force and effectDISTRICT NO E BY
Power Apparatus 8 Large Appliances 06
Size 8 Type HP KW KVA or KVAR (v 1 f( ( O
License Number Lio Class Up to 1 Ind FINAL 8
` -��^�D over 1 to 10 Incl DATE ConON
a.
tractor IO Over 10 to 50 Incl ` l i-4 FINALEl I ?�
em exempt under Sec Over 50 to 100 Ine " i BY' '
B&PC for this reason
1 Over 100 O.
Services Swbd MCC 8 Panelboards e ® 2
Date 0-200 Amp Under 800 V y ^
Signature 201 - 1000 Amp Under 600 V - \ ACCT•T
❑ Exemption for Reg Maint Elect Over 1000 Amp o I Over 600 V 1 3307
SINGLE FAMILY Temp Power Pole 8 Appurtenances 1 ITM
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit TOTAL la. 00
I hereby affirm that I am exempt from the Contractors Licera6 Law
for the following reason(Section 7031 5 Business and Professions Additional Sign Branch Circuits CASH 18.00
Code)
❑ I as owner of the property will do the work and the structure Misc Conduits 8 Conductors CHAT .00
is not intended or offered for sale (Section 7044 Bustriess Other(See Com to Fee Schedule) ,
and Professions Code) 0000-0001 6727/40
CONSTRUCTION LENDING AGENCY '
I thereby, affirm that there is a construction lending agency for the - 1101°9 1 Ail 7:46
performance of the work for which this permit is Issued(Sec 3097 PERMIT FEE (Sub-Total) '
Civ C)
PLAN CHECKING FEE
Lenders Name
PERMIT ISSUING FEE
Lenders Address -
I certify that I have mad this application and state that the above TOTAL FEE
nfonnatm is correct I agree to comply with all County ortlinerices
and State laws regulating Electrical wiring and hereby authorize
nepreeentatms of th County t eider upon the above-mentionetl
o e e pur os SEE REVERSE FOR EXPLANATORY LANGUAGE
Sigre6-2s-90 ,
lure of Permiha Date
WORKERS COMPENSATION DECLARATION ,UiBt APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I have a certificate of consent CE 806 ent to self ��'
insure or a certificate of Workers Compemation Insurance COUNTY OF LOS ANGELES BUILDING AND SAFETY
or a certified copy thereof (Sec 3800 Lab C )
P❑oliicy No Company FOR APPLICANT TO FILL IN JOB
yD
Certified copy is hereby furnished New Residential Bldgs 8 Pools EACH NO FEE ADDRE '619 Liv_
❑ Certified copy is filed with the county building mspec 1 8 2-Family, Sq F1 $ — f LOCALITY
hon department Multi family Sq Ft — NEAREST
Residential Swimming Pools CROSS ST
Date—Applicant OWNER OR
FIRM NAME
CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec_Light_Sw. lVVikiL
COMPENSATION INSURANCE ADDRESSFust 20
Totalsection nod not be completed If the work Involved by Total No Additional CITY_ (� Tel No
the permlt Is for one hundred dollars($100)or less)
I certify that in the performance of the work for which this P55N CHECK
permit is issued 1 shall not employ any person in any manner APPLICANT
so as to become sublect to the Worke 'Come on la Lighting Fixtures First 20- - ADDRESS
Total No Additional
41y�9 CITY re Na
Dote T If a t Fixed Appliances Not Over 1 HP PERMIT
NOTICE TO APPLICANT I4 after mokmg this Certificate of APPLICANT S
Exemption you should become subject to the Workers Range_ Hooter_D W
Compensation provisions of the Labor Code you mustiforth Oven _ Dryer _ W M — ADDRESS
with comply with such provisions or this permit shall be Top _ FAU _WH _
_ uG
deemed revoked Head Fan _Other— CITY Tel No 0 391
LICENSED CONTRACTORS DECLARATION Disp _ Room Air Cond LICENSE OR �j
1 hereby offvm that I am licensed under provisions of Chapter 9 REG NUMBER Q S'3 Class –/d
(commencing with Section 7000) of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NO / PROCESSED Y
and Professions Code and my license is in full force and effect `\1 t
a Size 8 Type HP KW, KVA, or KVAR
s IL
License Nu Lic Class C�/ Up to I Incl FINAL V
6�1!/ti Over 1 to 10 Incl DATE VALIDATION K
Connacror to— Over 10 to 50 Incl FIN O
❑ I am exempt under Sec Over 50 to 100 Inc
B 8P C for this reason Over 100 yl
Dote Services Swbd , MCC 8 Ponelboards Z
0 -200 Amp Under 600 V
Signature 201 1000 Amp Under 600V
❑ Exemption for Reg MoI Over 1000 Amp or Over 600 V
int Elect
SINGLE FAMILY Tam Power Pole 8 1
P Appurtenances
HOME OWNER BUILDER DECLARATION Sign with One Branch CircuitCircuit2
I hereby offvm that I am exempt from the Contractors License y
Low for the following reason (Section 7031 5, Business and Additional Sign Branch Circuits- - ACCT.•
Professions Code) 3307 15.50
❑ 1, as owner of the property will do the work and the Misc Conduiti 8 Conductors 1 ITEl15
structure is not intended or offered for sole (Section Other (See Complete Fee Sc edule)_
7014 Business and Professions Code) O ► TOTAL. 15.50
CONSTRUCTION LENDING AGENCY .�. 15.50
I hereby affirm that there is o construction lending agency for ��..sL�I�,s��st�� �10r�t
the performance of the work for which this permit is issued PERMIT FEE (Sub Total) .-- UWE .00
(Sec 3097 Civ C )
PLAN CHECKING FEE -
Lender s Name
PERMIT ISSUING FEE ODOD-0001 6/26/89
Lander s Address 418E 1 PI112�18
I certify that I have read this application and state that the TOTAL FEE J J
above information is correct I agree to comply with all County t
ordinances and State laws regulating Electrical wiring and
hereby authorize rep sentatives of this County to enter upon - -
t ntio a for is purposes SEE REVERSE FOR EXPLANATORY LANGUAGE
i nature of Permittee Date
WORKERS COMPENSATION DECLARATION � tO,B, APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I have a certificate of consent to self
insure or a certificate of Workers Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY
or a certified copy thereof (Sec 3800 Lob C )
P❑ol icy No Company FOR APPLICANT TO FILL IN JOB
Certified copy is hereby furnished New Residential Bldgs 8 Pools EACH NO FEE ADDRESS
❑ Certified copy is filed with the county building impac- 1 8 2-Family, Sq Ft = — f LOCfWTV ?�A `
tion department Multi-family Sq Ft — NEAREST
CROSS ST
Residential Swimming Foals OWNER OR
Date Applicant 2 7 FIRM
CERTIFICATE OF EXEMPTION FROM WORKERS' Outten Rec_LightSw J MAIL
COMPENSATION INSURANCE ADDRESS
(This secllon need not be com lotod K the work Involved Font 20
R Total No Additional - CITY- _ _ - Tel No
the j»rmlf Is for one hundred dollen ($100)or less)
I certify that in the performance of the work for which this RA�PLAN
APPLICANT
permit is issued I shall not employ any person in any manner
so as to become subject to the Workers'Compensation Laws Lighting Fixtures Forst 20 ADDRESS
Total No—.0— Additional CITY Tel No
Date Applicant Foxed Appliances Not Over 1 HP PERMIT
NOTICE TO APPLICANT If after making this Cenificate of I
APPLICANT
you should become subject to the Workers' Range_ Heater_D W
Compensation provisions of the Labor Code you must forth- Oven _ Dryer —W M — - ADDRESS
with comply with such provisions or this permit shall be Top — FAU —W H —
deemed revoked Hood Fan —Other_ CITY Tel No
LICENSED CONTRACTOR _
S DECLARATION, LICENSE OR
I hereby affirm that I am licensed under provnoom of Chapter 9 Disp _ Room Au Cond REG NUMBER Class "
(commencing with Section 7000) of Division 3 of the Business DISTRICT NO PROCE BY
and Professions Code and my license is in full force and effect Power Apparatus 8 Large Appliances C U +� i 6
Size 8 Type HP KW, KVA, or KVAR c� z CJ O
License umber Loc Cloy Up to 1 Ind FINAL U
fOver 1 to 10 Incl DATE VALIDATION
Conir0 to Over 10 to 50 Ind FINAL
ElIF of
am exempt under Sec Over 50 to 100 Inc BY W� d
B 8P C for this reason Over 100 4101Z
Dote Services, Swbd, MCC 8 Ponelboards ►
0 -200 Amp Under 600 V
Signature 201 1000 Amp Under 600V r �j
❑ Exemption fee Reg Mamt Elect Over 1000 Amp or Over 600 V O
SINGLE FAMILY Temp Power Pole 8 Appurtenanroeii— K f 2 2 3 9 A
HOME OWNER-BUILDER DECLARATION Sign with One Branch CircuitI hereby affirm that I am exempt from the Contractor's License # • • • • • 2
Law for the following reason (Section 7031 5 Business and Additional Sign Branch Circuits
Professions Code)
Misc Conduits 8 Conductors
❑ 1, as owner of the property will do the work and the i 2 • • 2550-
structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ 1 t
7044, Business and Professions Code) ► ,• • • 2 a 5 d u
CONSTRUCTION LENDING AGENCY - 6i2 5.-84
I hereby off rim that there is a construction lending agency for J.
the performance of the work for which this permit is issued PERMIT FEE (Sub Total) h�
(Sec 3097 Civ C )
PLAN CHECKING FEE
Lenders Name
PERMIT ISSUING FEE O _
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 State jaws regulating Electrical wiring and p J) --//__
hereby authorize representatives of this County to enter upon 1 ;p , e;, r.G+�/.2�i d U/���1—!J/`" -j vw�
the ab e-mentic, � property fo inspection purposes '
VIII SEE REVERSE FOR EXPLANATORY LANGUAGE i
aurezf er ntee J Date i
WORKER S COMPENSATION DECLARATION 20-0019 DPW 9/89
I hereby affirm that I have a certificate of consent to self Insure 76AM APPLICATION FOR ELECTRICAL PERMIT
or a certificate of Worker a Compensation Insurance or a certified COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV
copy thereof(Sec 3800 Lab C) - r ,_ , , ,
❑�No Company r POR APPLICANT TD Rl1 a �� QL
CeN furnished EACH NO FEE 8
New Resitlenttul BNpe i Poole
VD
❑ C.m led
wit
the county building kmpectbn n 1 8 2 Family Sq Ft i — $ LOCALITY �� I�F G L
d r Muth fl mitt'Sq Ft — tR <F2U&.4
Date Applicant' 1''a Residential Swimming Pools AgSEq,.�R
11AP BO01f PM1E PA11L8
CERTIFICATE OF EXEMPTION FROM WORKERS OuUm Roc _Light_Sw _ FIRM�NAME �; QE L�"Y�6
..COMPENSATION INSURANCE ,
(This section need not be completed It the work involved by the Flint io MNL
permit Is for aria hundred dollars($100)a 10" Total No Atldltlmel - � �� 1"11 �I�t�X � 8
I cenity that In the performance of the war for which this permit //�y�/��y��(il/Q s CITY - Agp-c -ry��, T« Na g/g yZ- 0
is issued I shell no employ any person any manner s ea to • 7TA�,J' t, 1 PLM CHECK
become eu )act to a Workers Compen on Le LlgMing Fixtures First 20
/S i, Total No Atltlhbnel
Data APPltralt 81/CZ 7�1/L�5 ADDRESS
15 OR 20A 12011 BRANCH CIRCUITS
NOT I E T PPLICANT If eft m nehlart Htceta of CITY Tel W
Exem Von you should become subject to theCompensetbn 1 TO 10 INCLUSIVE EACH
provisions of the Labor Code you must forthwith comply with such 11 TO 40 OICLUSIVE EACH - PERuffTT ,4Sd
provisions lir this
IC permit shell be deemed ECLA tl 41 OR MORE BRANCH CIRCUITS EACH s O
LICENSED CONTRACTORS DECLARATION + ADDRESS G
I hereby affirm that 1 em licensed under provisions of Chapter B 15 OR 20A 20911 T027N LIGHTING EACH
(commencing with Section 7000) of Division 3 0l the Business and - _ CfT— 40 TY V
Professions Code end my license is In full farce and effect RESIDENTIAL APPLIANCES Up TO 3HP
Parisi Apparatus i Large ApOsslaes t WAGERV&Vgr pm r-
FfLicense Number Lk, Clens Sim 8 Type HP KW KVA lir KVAR - - _ M DISTRICT NO (/ ED ev F-
A - Up to 3Incl -- Op W
Con Date 72 Over 3 to 101rxi MTE CID
❑ '�— Ovx 10 to 50 Ind / � 1�Z Z
I am ex m antler Sec Over 50 to 100 Incl tv VALIDATION
B$P C for this reason Over 100 �
Bv
Date SerNcee SwartMCC&Pareboards _ _ _
0-20D Amp Under 800 V
Signature - 201-1 OOO Amp Under BOIL V_ _
❑
Over 1000 Amp or Over 800 V
Exemption far Reg Maim Elect -
SINGLE FAMILY Temp Power Pole&Apgatenmlcov _ lir•` f •'
HOME OWNER-BUILDER DECLARATION S�1v1111 One Branch Circuit f f1
I hereby o irm that I am exempt from the Contractor a License Lew 73P '°r•--
for the following reason (Sgggctron 7031 5 Business and Professions Additional Sign Branch Circuits
Code) , /
❑
:.7../
as or/oft will do the work entl the structure Mac COnduhs 8 Conductors TOTAL a j-�
Ie no d o listed lar sale(Section 7044 Business Other(See Cortplete Fee Schedule)—
entl rolesemns Code) - - - CHECK
and
CONSTRUCTION LENDING AGENCY
I hereby affirm that there Is a construction lending agency for the
performance of the work lar which this permit is issued(Sec 3097 PERMIT FEE _ _ . SubT
CIV C) (
/pL PLAN CHECKING FEE _ ,ii.�p 1I 7:4A
Lenders
1 V PERMIT ISSUING FEE a�
Lender's Address
I unity 1hat I have read this application and stale that the above I TOTAL FEE D
informs n Is correct 1 agree to comply with all 00.111,ortlmences
and at a laws regulating Electrical wiring and hereby authorize
repro motives of this Cou y to enter upon the above mentioned
pro for Inepec n p se SEE REVERSE FOR EXPLANATORY LANGUAGE
UA
i
TION
WORKER I have
DECLARATION 76AM DPW„2 91) APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I have a cendmate o/ consent to self insure ��
or a certificate
e of Worker
�a Compensation Insurance or a certified COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV
Popy4No, �K,- a 381 tab.
If',p _ \ 440
' /` / .may
Policy No Company � d��Oh FOR APPLICANT TO FlLL M - ADDRESS T \� 1�.J�t
❑ Certified copy is hereby furnished New Residential Burge d Pods NO EACH FEE LOCALITY
EKCertified copy is filed with the county building uutpeclwn 1 8 2 Family Sq Ft — $ 8
department Mulls family Sq Fl — NEAREST ^ ,
tt u �.�n�� mmsT
Date p�Z { -- ApphcsntAA:oAQ(A AXcIQI-` Residential Swimming Pods �ASSESSOR
BOCK
PAGE PARCEL
CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rao Ught_SW FlO�E
_ �E
COMPENSATION INSURANCE F rst 20 "✓
(This action need not be completed If the work Involved by the
permit Is for one hundred dollen(8100)or lees) Total No AdditionalAVOOORESs
I certify that in the performance of the work for which this permit CITY Tel No
is issued I shall not employ any person In any manner so as to
become subject to the Workers Compensation Lam ' Lighting Fonuree Feat 20 LIC�
Total No Aciddiunal
ADDRESS
Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP
NOTICE TO APPLICANT If alter making this Certificate of CITY Tel w
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 �� Ece�� t C
provisions or this permit shall be deemed revoked Power Apparatus A Lenge Applumcee APPLICANT
LICENSED CONTRACTORS DECLARATION Size a Type HP KW KVA or KVAR ADDRESS
I hereby affirm that I am licensed under provisions of Chapter 9
(commencing with Section 7000)of Division 3 of the Business and Over 3 to ID Ind CITY CA19(A Tel No
Professions Code and my license is in full force and effect Over 10 to 501nc1 }
Over 50 to 100 Incl L.IMENrq M, 'L,7 8 ro Clm �—(Q a
License Nummbye�r,325D Lc Class �%t D Swrbd1�jQ/(O��ve(,r/p100 i� wSrnICT NO BY 0
Camractor�""��� r,D set • _ _� Services lZ
0 399Mny UMer 800 V ✓ FI 0
❑ I am exempt untler Sec 400 1000 Amp Untlor 600 V VALIDATION
Over 1000 Amp or Over 800 V FINAL UU
G.
B 8P C for this reason BRANCH CIRCUIT FEES BY Tit
Date 15A or 20 120V Lighting a Recept 1 ,4 p Z
Signature 1 To 10 Branch Circuits i G
11 To 40 Branch Carte
_ 41 Or More Branch Ckcurts
Exemption for Rep Mehl Elect15A 20A 209V To 277V Lighting Br Cacurts
SINGLE FAMILY Temp Power Polo A Appurtenances 2
HOME OWNER BUILDER DECLARATION Sign with One Branch Circuit ACCT.AV
I hereby affirm that I am exempt from the Contractors License Law ��i�i�
for the following reason (Section 7031 5 Business and Professions Additional Sign Branch Circuits .7JLh] 134.00
Code)
❑ I as owner of the pro Mac Conduits 8 Conductors 1 ITM party will do the work end the structure
is not intended or offered for sale(Section 7044 Burliness Other(See Complete Fee Schedule)_ ► TOTAL 134. 00
and Professions Code) _ U�LE��C�K� 134.90
CONSTRUCTION LENDING AGENCY A.f3II1VG .00
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) 0 ,
Civ C)
PLAN CHECKING FEE _ O1 6/24/96
Lender a Name PERMIT ISSUING FEE 7079 1 PM 5:10
Lander a Address
I cerbty and I have read this application aunder penalty of purryry state TOTAL FEE X�
that the above information I9 carred I agree to comply with an County
ordinances and State laws regulating Electrical wiring and hereby authonze _
reprea haives of this County to enter upon the above-mentioned property
la I ion pts 6 6 SEE REVERSE FOR EXPLANATORY LANGUAGE
�
BIO TORE R PERMITTEE DATE
WORKERS CI have COMPENSATION DECLARATION a806 ,oiBl APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I have a certificate of consent to self CE BSG
insure or a certificate of Workers Compensation Insurance COUNTY OF LOS ANGELES BUILDING AND SAFETY
or a certified copy thereof (Sec 3800 Lob C )
Policy No Company FOR APRICANT TO FILL IN � LE �, QL✓
Certified copy is hereby furnished New Residential Bldgs 8 Pools EACH NO FEE
❑ — A
Certified copy Is filed with the county budding Im18 2 Family,omtly, Sq Ft $ S LOCALITY
bon department Multi-family Sq FI — NEAREST
CROSS ST
Residential Swimming Pools
Dote Applicant OWNER
FIRM NAME
CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL
section
INSURANCE Outlets Rec_Llght_Sw ; \ \ ,- s ``l1, - sl ADDRESS
(This sion need not be completed If the work Irtsolved by First 20
the perni Is for one hundred dollars($100)or less ) Total No Addrbonoly CITY Tel No
PIAN CHECK
I certify that In the performance of the work for which this APPLICANT
permit Is Issued I shall not employ any person In any manner
so as to become subject to the Wori Co onset. n Laws Lighting Fixtures First 20 ADDRESS
Total No Additional
-A y$� A s..,., CITY Tel No
Date pIf aft Fixed Appliances Not Over I HP PERMIT
NOTICE TO APPLICANT If cher making this the the to of 12 n
APPLICANT ONJ
Exemption you should become subject to Workeri Range_ Hooter_D WW.
Compensation provisions of the Labor Code you must forth- Oven _ Dryer _ W M — ADDRESS yr3TWq. Vt
with comply with such provisions or this permit shall be Top — FAU _WH _
deemed revoked Hood _ Fon _Other_ CITY ( 'r Tel No 41 lil,q 31741
LICENSED CONTRACTORS DECLARATION LICENSE OR
I hereby affirm that I am licensed under provisions of Chapter 9 Dlsp _ Room Air Cord REG NUMBER
(commencing with Section 7ODD)of Division 3 of the Business Power Apparatus IS Large Appliances DISTRICT NO O V BY 11.
and Professions Code and my license Is In full force and effect Oy C8
Size 8 Type HP KW KVA, or KVAR 5
License Number Lic ClassUp to I Incl FINAL O
Over 1 to 10 Incl DATE
V IDATION
Contractor Date Over 10 to 50 Incl FIN W
I am exempt under Sec Over 50 to 100 Inc BY
El
B 8P C for this reason Over 100 Z
Dote Senesces Swbd MCC&Portelboards ,
0 -200 Amp Under 600 V
Signature 201 - 1000 Amp Under 600 V
❑ Exemption for Reg Moint Elect Over 1000 Amp or Over 600 V
SINGLE FAMILY Temp Power Pole 8 Appurtenances - A 4 8 9.3 A
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit e a a e * 2
I hereby affirm that I am exempt from the Contractors License Additional Sign Branch Circuits Law for the following reason (Section 7031 5 Business and ( - -,1 550
Professions Code)
❑ I as owner of the property will do the work and the MIu Conduits&Conductors a a 915505
structure is not Intended or offered for sale (Section Other (See Complete Fee Schedule)_
44 , o&26-86
70Business and Professions Code)
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
ordinances and State jaws regulating Electrical wiring and
hereby authorize repr tative f this County to enter upon
thep v� a tion opo or Inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Permittee Date
WORKERS COMPENSATION DECLARATION 76A663 10/B1 APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm„ihot I have'a certificate of conseni CE self 806r,
insure or,4 certoscate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY
or a certified copy thereof (Sec 3800 Lob C )
Pal iicy No Company FOR APPUIC"TO FILL IN
❑ aEss N YM C T BLJD
Certified copy is hereby furnished New Residential Bldgs 8 Pools EACH NO FEE
❑ Certified copy is filed with the county bwldmg nspec 1 8 2 Family Sq Ft S — f LOCALITYCopkIggjuxaEZ A7 t Fix
hon department Multi-family Sq Ft — NEAREST
G
Residential Swimming Pools
CROSS ST TEWL�e
Date—Applicant t OWNER OR
CERTIFICATE OF EXEMPTION FROM WORKERS FIRM NAME KARE
YociTH Outlets Rec_Light_Sw= MAIL
COMPENSATION INSURANCE ADDRESS
(help stolon need rrof n red dolls If pito work less
) rd by First 20
the patrols b for ono hundred dollen (f100)or loss) I Total No Additional CITY Tel No f219 2-/1b
I certify that in the performance of the work for which this - PLAN CHECK
permit is issued I shall not employ any person in any manner APPLICANT
so as to become subject to the Worke m do ws Lighting Fixtures Fist 20 ADDRESS '
Total No Additional
6���Q� CIN Tel No
Dote T if and Fixed Appliances Not Over 1 HP
NOTICE TO APPLICANT If a r making this Certificate of �R'WT
Exemption you should become subject to the'Workers Range—,Heater—DW — APPLICANT
Compensation provisions of the Labor Code you must forth- Oven Dryer _W M _ ADDRESS /
with comply with such provisions or this permit shall be Top _ FAU _WH _ `� N. /Q Nor ,ora.
deemed revokedfi
Hood _ Fan _Other— CI 4 C; Tel Noy 3!Z P
LICENSED CONTRACTORS DECLARATION
Disp _ Room Air Cond LICENSE OR
I hereby affem that I am licensed under provisions of Chapter 9 REG NUMBER O S Class 3 e-/D
(commencing with Section 7000) of Division 3 of the Business power Apparatus 8 Large Applioncep DISTRICT NO D B
and Professions Code and my license is in full face and effect
—10 Size &Type HP KW KVA c KVAR s,
License Number Uc Class C+/^t�/O Up to 1 Incl FINAL d'
6 1Y-PY Over 1 to 10 Ind DATE ALIDATroN
Contracto ate❑ Over 10 to 50 Incl FI W
I am exempt under Sec Over 50 to 100 Inc B a.
B 8P C for this reason Over 100 z
Services Swbd MCC 8 Ponelboards I
Date 0 0 0 9 A
0 -200 Amp Under 600 V
Signature 201 100D Amp Under 600 V #i• is is Is 2
❑ Exemption for Reg Mamt Elect Over 1000 Amp or Over 600 V
SINGLE FAMILY Tem Power Pole 8 ( • ' 1 5 5 0
P Appurtenances psi• sit 550
HOME OWNER BUILDER DECLARATION Sign with One Branch Circuit
I hereby affirm that j g r exempt son ( from the Contractor Busi s ss nd Additional Sign Branch Circuits
13
Low for the following reason (Section 7031 5, Business and
Professions Code) 0628.!,88
❑ I as owner of the property will do the work and the Misc Conduits 8 Conductors
. structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ ,
7044 Business and Professions Code)
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, Cry C )
PLAN CHECKING FEE Als,Lender s NamePERMIT ISSUING FEE
Lendera AddressI 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 jaws regulating Electrical wiring and
hereby authorize reprep atives of Pis County to enter upon
t ov n pr erty to specrion purposes
SEE REVERSE FOR EXPLANATORY LANGUAGE
S gnature of Permittee Date
DEC
TION
v--sit WORKERS
that
COMPENSATION cafe of corse l a. 10/81 APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm shot I hove a certificate of consent to sell a'�
insure or a certificate of Workers Compensation Insurance COUNTY OF LOS ANGELES � G � BUILDING AND SAFETY
a certified copy thereof (Sec 3800 Lab C ) /
,j� 1 r 4l G 4/
Policy No W 14 aoa(?C mpany 4 1 A F TV Alf Q 72 ` FOR APPLICANT TO FILL IN J08 [7�
Certified copy is hereby furnished New Residential Bldgs 8 Pools EACH NO FEE ADDRESS tt9 Lf CL Ty /JL(��
Certified copy is filed wi&1hetWybudding mspec 18 2-Family Sq Ft f — s LOCALITY L� e.[ Ty
hon department sMultifamily Sq Ft — NEAREST
L/—1 LIT � Residential Swimming Pools CROSSST W IC Date Applica fFIIRM ROR
NAMECERTIFICATE OF EXEMPORKERS - MAIL
COMPENSATIOE Outleh Rec_Lipht_Sw= ADDRESS Lif Ci OkE GIs stolon need nos be mmwork Involved b First 20 it
P Y CITY 1 �,y Tel No
fM permit b for one hundred dollen($lop)x less ) Tonal No Additional PLAN CHECK
� `f C:v/ /
I certify that in the performance of the work for which this PLANAPPLICAM
permit is issued I shall not employ any person in any manner
so as to become subject to the Workers'Compensation Laws Lighting Fixtures First 20 ADDRESS
Total No Additional
CITU Tel No
Dare Applicant _ Fixed Appliances Not Over 1 HP PERMIT
NOTICE TO APPLICANT If after making this Certificate of S 6EL£S
Exemption you should become subject to the Workers I Range_ Heater_D W APPLICANT £LI t tl �
Compensation provisions of the Labor Code, you must forth- Oven _ Dryer — W M — ADDRESS 3 /u0CIii
with comply with such provisions or this permit shall be Top _ FAU —W H
deemed revoked Hood _ Fan _ Other CITY /,0S 'Tel No;ESS ��
LICENSED CONTRACTORS DECLARATION LICENSE OR
1 hereby affirm that I am licensed under provisions of Chapter 9 Dap _ Room Au Cond REG NUMBER 7 / Cbsa G—
se0
(commencing with Section 7000)of Division 3 of the BusinessDISTRICT NO D V
and Professions Cade,and my license is in full force and effect Power Apparatus 8 Large Appliances
Size 8 Type HP KW KVA or KVAR "o O O
Lice Numb s Uc Class G� I Up to I Incl y D \ O FINAL - V
c ,y,1��tf Over I to 10 Ind DATE '� � VALIDATION
Conhact Dote OOC
Over 10 to 50 Incl
❑ 10 xem under Sec Over 50 to 100 Inc BY
�L
B 8P C or this reason Over 100 11ge =
Dote Services, Swbd , MCC 8 Ponelboards ► -
0 -200 Amp Under 600 V
Signature 201 1000 Amp Under 600V
❑ Exemption for Reg MOver 1000 Amp or Over 600 V
mnt Elect
SINGLE FAMILY Temp Power Pole 8 Appurtenances _
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit •1 43 Y
I hereby affirm that I am exempt from the Contractor s License Additional Sig n Branch Cucuits �a�5
Law for the following reason (Section 7031 5 Business and 2
Professions Code) v Is rs ) &5o6
❑ as owner of the property will do the work and the M sc Conduits 8 Conductors
s
structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ pop. 5 7—$4
7044 Business and Professions Code)
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 Nome
PERMIT ISSUING FEE fa -
Lender s Address ,
I certify that I have read this application and statethat the TOTAL FEE d
above information a correct 1 agree to comply weh all County
ordinances and State lows regulating Electrical wiring and -
M��n
es of this County to enter upon
for inspection purposes
SEE REVERSE FOR EXPLANATORY LANGUAGE
/
5 f PermNee
tune / Dote
DEC
TION
WORKERS
that
COMPENSATION cafe of corse CE-OD6 ,a,et APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I have o certificate of convent to self jCE_BDb('
insure or o certificate of Workers'Compensation Insurance COUNTY OF LOS ANGELES 'BUILDING AND SAFETY
or a certified copy thereof(Sec 3BO0 Lob C ) /
Policy No Company FOR APPLICANT TO FILL IN JOB
ADDRESS
A
Certified copy is hereby furnished New Residential Bldgs 8 Pools EACH NO FEE
❑ Certified copy is filed with the county building inspec- 1 &2 Family, Sq Ft f — $ LOCALITY
hon deportment Multi-family Sq Ft — NEAREST
Residential Swimming Pools CROSS ST
Date Applicant OWNER
OR
FIRM NAME for
CERTIFICATE OF EXEMPTION FROM WORKERSOutlOutlets RecLight_Sw MAIL
_
COMPENSATION INSURANCE First 20 ADDRESS
(This ioctlon no"not be completed if the work involved by Total NoCITY Cly( Tel No
the permit Is for one hundred dollen Additional 4(5100)or Ins ) PLAN CHECK
I certify that m the performance o4 the work for which this APPLICANT
permit is issued I shall not employ any penton in any manner
so as to become subject to the Workers'Compensation Laws Lighting Fixtures First 20 ADDRESS
Total No Additional
DatVApplicon � CITY Tel No
e/G -
NOTICE TO APPLICANT If after making this Certificate of Fixed Appliances Not Over I HP PERMIT
Exemption you should become subject to the Worker Range_ Heater—D W _ APPLICANT
Compensation provisions of the Labor Code you must forth Oven _ Dryer —W M — ADDRESS
with comply with such provisions or this permit shall be Top _ FAU —W H —
deemed revoked Hood _ Fan _ Other-2s, CI Tel No
LICENSED CONTRACTORS DECLARATION affirm that I am licensed under provisions of Chapter 9 REG NU Disp _ Room Air Cond rQ LICENSE OR /y�.a" Clow
I hereby aR-IA
(commencing with Section 7000) of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NO Sod' PROCE D BY L
and Professions Code and m license is in full force and effect
��7.�Y' Size 8 Type HP KW, KVA or KVAR Q
License Number V15`- if- Lc Clan T Up to 1 Incl FIN � U
Contracts/�� Or Date J/7 T
Over 1 to 10 Incl DAA — VALIDATION QFF
.--- Over 10 to 50 Incl FI V
I am exempt under Sec Over 50 to 100 Inc B W
CL
B 8P C for this reason Over I W / Z
at Services Swbd , MCC 8 Ponelboards ► �/ ���
0 -200 Amp Under 60D V -
Signature 201 1000 Amp Urfder 600 V -
❑ Over 1000 Amp or Over 600 V
Exemption for Reg Momt Elect
SINGLE FAMILY Temp Power Pale 8 Appurtenances
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit # ;91 .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 "
Professions Cade) 12.-.. 3500
❑ I, as owner of the property will do the work and the Mrsc Conduits&Conductor • • • 3 S 0 0=
om _
structure is not intended or offered for toOther Complete Fee Schedule)—
)—
P
le (Section ►
7044 Business and Professions Code) 05,1 ,6-8 CL
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for ti
the performance of the work for which this permit is issued PERMIT FEE (Sub Total) S
(Sec 3097 Civ C )
PLAN CHECKING FEE
Lender's Name
PERMIT ISSUING FEE Q ,
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 State laws regulating Electrical wiring and
hereby o4 ¢e repro rativn of this County to enter upon
the ob / entione pr pert for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE
7
ig re of Per ittee Date
WORK COMPENSATION DECLARATION 0-001 6AOM DPW(12 a„ APPLICATION FOR ELECTRICAL PERMIT
7
1 hereby affirm thatt I havehove a certificate of Consent to Bell insure 7
or a certificate of Worker a Compensation Insurance or a cenified COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV
copy thereof(Sec 3800 ab lC)t- 1i i
Policy No • Company POR APPDCANT TO P IN ADOREss -
'Cemfled m furnished New Flasitlenbal Ridge d Pools NO EACH FEE
❑ Camhed u ik the county builtling inspection 1 8 2 FemiN Sq Ft
— S 8 %PtLOCALITY L.
tlepertm MuIU/einiN SQ FI CROSS sT I L
Date plicant I' Residential Swimming Pools ASSESSOR '
MAP BOOK PILE PARCH
CERTIFICAT OF EXEMPTION FROM WORKERS Outlets Rec —Light_Sw Fl�RM NROM�E
PENSATION INSURANCE
(ihh secllon need not be completed It the work Involved by the Fret 20 MNL
permit Is for one hundred dollars($100)or leve) tI �
i T«BI No Additional ADMESS
I certify that in the performance of the work for which this permit CITY IQO� Tei No 1-11
is Issued I shell not employ any person in any manner so as to -
become subject to the Workers Compens Ion Laws UgMmg Fixtures First 20 PlAll CHECx
APPLICAM
Total No Additional ADDRESS
Date ZB Applicant
NOTI 1T0 APPLICANT ,If alter maZingA his Certificate of RESIDENTIAL APPLIANCES NOT OVER 3 HP CITY Tel W
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 KRMPIT
provisions«this Permit shell be deemed revoked Power Apparatus 6 Large Applianws
LICENSED CONTRACTORS DECLARATION Sue 8 Type HP KW KVA or KVAR ADDRESS OZ Q�V
I hereby affirm that I am Iicensed under provisions of Chapter B Over 3 to 10 Incl(commencing with Section 7000) of Division 3 of the Business and CITYN Tia W 7
Professions Code and my license is in full force and effect Over 10 to 50 Inc] ucENSE OR }
4 1 /^ a / Over 60 to 100 Ind REO NUMBER 7 CMaa C�� d
License Number ` `q v q e LIC Cf. `-'—�� Over 100 pig1111�NO /�,{� 99ED BV 0
Semces SWbd MCC 8 Panelboerds �`'V Q
Conuectar Date__V24/
? 9_S 0 399 Amp Under 800 V _ FINAL
400 1000 Amp Under 800 V 30 44V
❑ I am exempt untler Sec VALIDATION W
Over 1000 Amp or Over 800 V FINAL Il
B 8P C for this reason BRANCH CIRCUIT FEES
Date 15A or 20A 120V Lighting or Rmept ?
1 To 10 Branch Circuits
Signature 11 To 40 Branch Circuits
— 41 Or More Branch Cacti
❑ Exemption for Reg Meint Elect - 15A,20A 20BV To 277V Ughting Sr Canes us -
SINGLE FAMILY Temp Power Pole d Appurtenances
HOME OWNER BUILDER DECLARATION 2I hereby affirm the I em exempt from the Contractors License Lew Sign with One Branch Circuit
for the following r on (Section 7031 5 Business and Professions Additional Sign Branch Circulls AC T.e'
T
Code) 3303 47.35
❑ I er of a property will do the work and the structure Mies Conduits 6 Conductore
ie t i le r offered for sale (Section 7044 Business Other(See Complete Fee Schedule)
en r s Code) (�Il, xO`bQ1t91O@
STRUCTION LENDING AGENCY
I hereby affirm t et there ie a conslr uclion lending agency for the
performance of the work for which this permit is issued (Sec 3097 PERMIT FEE (Sub-Tots])
Civ C)
1 PLAN CHECKING FEE
Lender a Name
PERMIT ISSUING FEE �!p
Lender a Addrem p`
I certify that I have reed this application antl under penally of purjury state TOTAL FEE O:l
that the above information is correct I agree to comply with all County
ordinances and State lawn regulating Electrical wiring endherebyauthonze
repress lives of this County to ant"upon the abovamenb ned property - -
f«i olion purySEE REVERSE FOR EXPLANATORY LANGUAGE
NATtI OF P am a Trim TZ�,.�
\ `
� WORKERS COMPENSATION DECLARATION 10,91 APPLICATION FOR ELECTRICAL PERMIT
I heremv affirm that I have a certificate of consent to self CE CE WBO6G
'insure 3t a certificate of Workers Compensation Insurance COUNTY OF LOS ANGELES BUILDING AND SAFETY
or a certified copy thereof(Sec 3800 Lob C )
P❑alicy No Compony FOR APPLICANT TO FILL IN ADDRESS y$1Q TF_YMPLE C BLVD
Certified copy is hereby furnished New Residential Bldgs 8 Pools EACH NO FEE
❑ Certified copy is filed with the county building mspec 1 8 2 Family Sq Ft T — $ LOCALITY N W CO P4M COW[e A2WSA$7Z-
hon deportment Multifamily Sq Ft — NEAREST
Residential Swimming Pools CROSS ST 7fri"PLC C/ BL VA $' Ld'/6R AZKSA
Date Applicont I ` OWNER OR
CERTIFICATE OF EXEMPTION FROM WORKERS' `J �t . 1 FIWIF
RM NAME
COMPENSATION INSURANCE Outlets Rec_Ught_Sw(` `, �} J ` ` ADDRESS
(This section nand not be completed If the work involved by First 20
the permit is for one hundred dollars($100)or leu) Total No Additional CITY -- — Tel No
I certify that in the performance of the work for which this i - PLAN CHECK
permit is become
I shall not employ 6ny person in any manner APPLICANT
so as to become sublect to the Worker Com ns n Laws Lighting Fixtures Fust 20 ADDRESS
Total No Additional
�_2t_f7�A CITY Tel No
Dote pIf aft sed Appliances Not Over I HP
NOTICE TO APPLICANT If after making this Certificate of 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 ADDRESS
with comply with such provisions or this permit shall be Top FAU _WH _
,/
deemed revoked Hood _ Fon _Other— CITY Tel No fl'frT 3/Z'
LICENSED CONTRACTORS DECLARATION D�sp _ Room Au Cord LICENSE OR
m _ CIou GI_
I hereby off ethat I am licensed under provisions of Chapter 9 REG NUMBER
(commencing with Section 7000) of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NO P S BY T
and Professions Cade and my license is in full force and effect ppa g pP _ 6
Size 8 Type HP KW, KVA or KVAR 57, Q O
License Number L,c ClassUp to 1 Incl FINAL V
Over 1 to 10 Incl _ DAA / VALIDATION ad
Contractor Date Over 10 to 50 Incl FI G
❑ I am exempt under Sec - Over 50 to 100 Inc BY sy
8 8P C for this reason Over 100 y
Services, Swbd , MCC 8 Ponelboords ?
Dote 0 -200 Amp Under 600 V
Signature 201 - 1000 Amp Under 600 V
❑
Exemption for Reg MoOver 1000 Amp or Over 600 V
Mont Elect
SINGLE FAMILY Tamp Power Pole 8 Appurtenances
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit
-1 hereby affum that I am exempt from the Contractor s License Additional Sign Branch Grcmts-
Law for the following reason (Section 7031 5 Business and
Professions Code)
❑ -
I as owner of the property will do the work and the Misc Conduits 8 Conductors ;22329A
structure is not intended or offered for sale (Section Other a Complete Fee Schedule)_
7044, Busmen and Professions Code) -# • • 0.9 a 2
CONSTRUCTION LENDING AGENCY ( a • ) 5 5 0
1 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) a 0021 S5 0 Z
(Sec 3097 Cw C ) 0b6-85
PLAN CHECKING FEE -- - - _
Lender s Name '
PERMIT ISSUING FEE _
Lenders Address -
I certify that I have read this application and state that the TOTAL FEE 5
above information is correct I agree to comply with all County -
ordinances and State low regulating Electrical wiring and
hereby authaa a repres lives of the County to enter upon
the o - nti ed r airy for P clan purposes SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Permittee Date
WORKER'S
have a certificate
DECLARATION MI DPW(tz 31) APPLICATION FOR ELECTRICAL PERMIT
]OM1
I hereby affirm that I have a cerltrcate of consent to Bell insure
or a certificate of Worker a Compensation Insurance or a certified COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV
copy thereof(Sec 3800 Lab C)•�- I t
Policy No Company FOR AP cMfr TO RLL IN
1Ceru8ed copy is hereby furnished _ New Residential Bldgs 6 Pods NO EACH FEE `G
❑' — S $
LOCALITY
a
Confined copy filed with the county building Inspection 1 S 2 Family Sit Ft NEAREST
depenmerrt y - Mulb family Sp Ft — CROSS ST
Date - Applicant Residential Swimming Poole ASSESSOR
` _ MAP BOOK I PAGE PARCEL
CERTIFICATE OF EXEMPTION FROM WORKERS pullala Ret —Light_S. ,1/I
COMPENSATION INSURANCE I I^WIEN,WE
(This section need not be complNed 11 the work Involved by the Total No FAdditi nal ADDirst 20 LRESS n- -
permit Is for one hundred dollars(5100)or leu)
I certify that In the performance of the work for which this permit CITU r P*7D rd _ TO No
Is issued I shell not employ any perso In any manner so as to
become sub to the Workers Compen son Lawn Lighting Futures Fist 20 PUN CHECK
APPLICANT
t- Total No Additional
Date• 27 Applicant ADDRESS
NOTICV TOAPPLICANT II el a mak g Me Carlif.cate of RESIDENTIAL APPLIANCES NOT OVER 3 HP 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 au
provisions or this permit shall be deemed revoked Power Apparetus 8 Large Appliances APPLICANT
14a firg M—
LICENSED CONTRACTORS DECLARATION y Sue d Type HP KW KVA or KVAR ADDRESS.Qrt aOr
I hereby affirm that I em licensed under provisions of Chapter S Over 3 to t0 incl
(commencing with Section 7000)of DIvIalon 3 of the Business and C y Tel No
Professions Code and my license is In full force and effect Over 10 to 50 Ind
/� (� Over 5010 1001nc1 RED NUMBER
License NUm LIC GBes Over 100 DISTRICT NO ,['�yP Pp{,Qg[�SSED'B'Y �" O
-- Services Swbd MCC 8 Panelbcorda �J� v` ` �� C-r(�l Gc��vcivv Ur
Canuactor Daze (C70 303 Amp Under 800 V _ OA�TE 0
❑ I snit exempt under Sec 400 1000 Amp Under 800 V r ~
Over 1000 Amp or Over 600 V FWAL VALIDATION W
- B AP C-for ihl9 reason - BRANCH CIRCUIT FEES BY �
Dole 15A or 20A 120V Lighting or Recap) Z
1 To 10 Branch Circuits
Signature 11 To 40 Branch Cumits
❑ _ 41 Or More Branch Circuits
Exemption for Reg Main Elect 15A 2DA 208V To 277V Ughlong Br Cucuta _
SINGLE FAMILY ' Temp Power Pole 8 Appurtenances
HOME OWNER BUILDER DECLARATION
I hereby affirm that I errs exempt from the Contractor s License Lew SIg^w^h Of1e Branch Clrcun pC�) .v
for the following reason (Section 7031 5 Business and Professions Additional Sign Branch Circuits 6zIh 47.10
Code)
❑ I as owner of the property will do the work and the structure Mau: CondwM 8 Conductom _ _ 1 UWE'
Is not intended or offered for sale (Section 7044 Business Other(Sea mplete F Schedule) , TOTAL 47 - 10
and Professions Code) CHECK Ar7 10
CONSTRUCTION LENDING AGENCY
I hereby affirm that there Is a construction Iendlng agency for the lHANGE .()I]
performance of the work for which this permit is issued(Sec 3007 PERMIT FEE (Sub Total)
Cm C)
PLAN CHECKING FEE DOW-0001 -6/29/94
Lender s Noma
PERMIT ISSUING FEE j•�'OL.^j 1 AI110.1k
Lenders Address,
I certify that I have reed this application and under penalty of purlury state TOTAL FEE
that the above Information Is correct I agree to comply with all County -
ordiname and Stetelawaregulating Eledncelmnng and hereby authorize -
represeldivea of this County totnter upon the above mentioned property -
far m on purposeg
sSEE REVERSE FOR EXPLANATORY LANGUAGE
- of 1 7TE9
WORKERS CI hove COMPENSATION DECLARATION CE 806 tD,B, APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I hove a certificate of consent to self �B06G
insure or a certificate of Workers Compensation Insurance COUNTY OF LOS ANGELES �� BUILDING AND SAFETY
or r i eof (Sec 3800 Lab C )
Policy No �� Company M I SS I OD 105, CO. FOR APPLICANT TO Flu w JOB
Certified co ts hereby furnished EACH NO FEE ADDRESS a Imo! t (K C-f r piaci
PY v New Residential Bldgs 8 Pools
® Certified copy is filed with the county budding mspec 1 8 2-Family Sci Ft 3 — S LOCALITY
hon departmentMultifamily Sci Ft — NEAREST
/ Applicant - Residential Swimming Pools p�T 6 ,/0 Zs+�Yy
6,1
84
Date 4 Ol
CERTIFICATE OF EXEMPTION FROM WORKERS h FAL NAME /Y!2L-f.N�+
COMPENSATION INSURANCE Outlets Rec�Light S. r/ � D AD&ESS S,4--
(This section need not be complMad R the work Involved by /i First 20
n
the ponit Is for one hundred dollars(5100)or less) Total No AL Additional r CITY Tel No
PIAN CHECK
I certify that in the performance of the'work far which this APPLICANT
permit is issued I shall not employ any person in any manner
so as to become subject to the Workers'Co sal, n Laws Lighting Fixtures First 20 , S ADDRESS
h Total No Additional
DatA °�r�.�l nppl CITU Tel No
Fixed Appliances Not Over I HP PERMIT
the W
NOTICE TO APPLICANT If come making this of APPLIcANTCobine Electric Co., Inc.
Exemption you should become subject to the Workers Range_ Heater_D W
Compensation provisions of the Labor Code you must forth Oven _Dryer _W M _ ADDRESS
with comply with such provisions or this permit shall be To _ FAU —W'H 1607 Chestnut $t.
deemed revoked p CITU A I hBNbra Tel Na 282_0315
LICENSED CONTRACTORS DECLARATION 'Hood _ Fan _Other_
Dup _ Room Air Cord LICENSE OR Class
C I O
(commencing with Section 7000) of Division 3 of the Business DISTRICT NO PROCE D BY
and Professions Code and my license is in full force and effect Power Apparatus 8 Large Appliances d
Sizer HP, to I Ind or KVAR
License Number 229847 Lic Class C10 Up to 1 Incl FINAL V
11 /30/85 — -- Over I to 10 Incl O DATE —Zits VALIDATION 0
C❑ontro<p�r to Over 10 to 50 Incl FINAL Lr�/ y~~
I cm exempt under Sec Over 50 to 100 Inc BY 6
as
B 8P C for this reon Over 100 -�7 8�' G A 44
Z
Date Services, Swbd , MCC d Ponelboards ► C' ,
0 - 200 Amp Under 600 V 11 `` 9 is • • e . 2
Signature 201 - 1000 Amp Under 600 V �j� !�
r_1 Exemption for Reg Mont Elect Over 1000 Amp or Over 600 V A J 2 • • 9 3 Q Q
SINGLE FAMILY Temp Power Pole 8 Appurtenances • ^ • 9 3 Q Q
HOME OWNER-BUILDER DECLARATION One Branch Circuit 12 2 S 3
h 9—
I hereby affirm that I am exempt from the Contractor s License Sign with
Sign Branch Circuits _ j
Low for the following reason (Section 7031 5 Business and
Professio®Code)
Misc Conduits 8 Conductors -
I os owner of the property will do the work and the Other (See Complete Fee Schedule)_ ,
structure is not intended or offered for sale (Section
7044 Business and Professions Code)
CONSTRUCTION LENDING AGENCY
I herebyaffirm that there iso construction lending agency for
the performance of the work for which this permit is issued PERMIT FEE (Sub-Totol) S _ _
(Sec 3097 Civ C )
PLAN CHECKING FEE - _ -
Lenders Name
PERMIT ISSUING FEE D _
Lender s Address
I certify that I have rood this application and state that the TOTAL FEE
above information is correct I agree to comply with all Count' - - -
ordinances and State jaws regulating Electrical wiring and
hereby authorize representatives of this County to enter upon
the above-mentioned property for inspection purposes
� SEE REVERSE FOR EXPLANATORY LANGUAGE -
499 �� �— 12/29/83
Signature of Permittee Date
COUNTY OF IAS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1207120009
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID FEES PAID I BUILDING ADDRESS 1
ITR 14647 LT 35 6 BL 3 1 14619 TEMPLE CITY BL
IFEE DESCRIPTION QUANTITY UOM AMOUNT I TEMP CA 91780
(ASSESSOR INFORMATION NUMBER I INEAREST CROSS STREET
18590-017-029 1A1 PERMIT ISSUANCE FEE 27 80 I THOMAS PAGE 597 GRID AS IACALITY TEMPLE CITY Cl
K1 SIGNS, OUTLINE IGT 1 00 SIG 38 90 I 1
TENANT I TOTAL FEES 66 70 TISSUED ON PROCESSED BY PLAN BY
107/12/12 SR 1
(OWNER TEL NO FP-0
�1AIy DATE FINAL $$$Y CODE I
148 YANG 626) 618-3698- ///�/j�
4819 TEMPLE CITY BL (•r"�_I -/
1TEMPLE CITY CA 91780
I IDfi
DESCRIPTION OF (YORK I
(CHANNEL LETTER SIGN 6 ONE FACE FOR EXISTING CABENIT SIGN
APPLICANT TEL NO
JIN CHENG YU (626) 497-6453- 1
19363 LOWER AZUSA RD i SPECIAL CONDITIONS
ITEMPLE CITY CA 91780
I
1 1 I
ICONTRACIOR TEL NO (APPROVALS DATE INSPECTOR SIGNATURE 1
INEW SIGNS AND PRINTING (626) 571-9288- 1
18902 GARVEY AVENUE LIC NO ]TEMPORARY POWER POLE
IROSEMEAD CA 91770 956512-C45 •I
(UNDERGROUND CONDUIT
1ARCHITECT OR ENGINEER TEL NO 1 .. 1UFER GROUND I -
1 LIC NO IROUGH CONDUIT
1ROUGH WIRING
IMAIN WATER LINE 1
PLASTIC YIN METAL YIN
1 10TIL TTY COMPANY NOTIFIED I
I
I I I I I
I I I I I
I - -
I '
) I I I
I I I 1
I I
1 I I I
I
I
ADDITIONAL DATA ON FILE I 1
1 IREPORT ID DPR265 ROUTE TO BS0508 1
I I I
COUNTY OF LOS ANGELES T LF_ CITY # 0508 ELECTRICAL PERMIT)
DEPARTMENT OF PUBLIC WORKS 90 LAS TUNAS EL-0508-9806260029
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA
PHONE (818) 285-0488 EXT
LEGAL TO FEES PAID BUILDING ADDRESS
TR 14647 LT 33 �T/lf 4M-TEMPLE-CITY BL,ASSESSOR INFORMATION NUMBER
FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP-CA-917804236 'C
NEAREST CROSS STREET LOWER AZUSA
8590-017-027 Al PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID A5 LOCALITY TEMPLE CITY
ID3 BOOTH LGT, SYSTEM 1 00 B00 16 35
TENANT TOTAL FEES 44 10 .
06/26/98 UT TEL NO FINAL DATE FINAL BYq 06/26/99
OWNERCODE
YOUNG'
DAVID,SUSIE (818) 797-1530- / n QQ (����
2260 WODDLYN RD (D /+ " T� s -
/
PASO 911043337 ULSLKIF9 lUN--6F-
FIREWORKS-STAND-ELECTRICAL
APPLICANT
G G HESTER 6 SON (626) 287-4755-
9024 E GREENWOOD SPECIAL CONDITIONS
SAN GABRIEL
GELES C0CONTRACTOR TEL NO
APPROVALS DATE iNsPnT6W-9TUWATUWF—
\
G G HESTER 8 SON - / /"1.)� �I
9024E GREENWOOD LIC NO , TEMPORARY POWER POLE
SAM GABRIELIEL, CCA 91775 NONE
ARCHITECT OR ENGINEER TEL NU UFFR GROLND
LIC NO 1111171
ROUGH WIRING
MAIN WATER LINE
Li U O L G]�J� �j PLASTIC Y/N METAL Y/N
O 0 _
0
ILL\Ir1
n �5
Gb/�Q Sery cle iha��o`
�\ ` REPORT ID DPR265 ROUTE TO BS0508
COUNTY OF LOS ANGELES TEMPLE CITY 9 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 9906280033
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE (626) 28510488 EXT
LEGAL ID- FEES PAID BUILDING
TR- 14647 LT: 35 BL 001 4819 TEMPLE CITY ADDRESSSBL
FEE DESCRIPTION QUANTITY UOM ANOINT TEMP CA 917804236
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET LOWER AZUSA RD
8590-017-029 Al PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID A5 LOCALITY TEMPLE CITY
D3 BOOTH LOT, SYSTEM 1 00 BOO 16.20
TOTAL FEES 43.95 ISSUED ON: PROCESSED BY: PLAN BY FXPIRES ON
KARE YOUTH LEAGUE 06/28/99 UT 12/25/99
OWNER FINAL DATE FINAL PY CODE
YOUNG DAVID SUSIE (818) 797-1530-2260
YA RD
PASO 9L3337 1StS KA6TRYH ]OF 46RR-
BOOTH LIGHTING FOR FIREWORKS STAND-1999
APPLIrANT TEL NO-
G G NESTER (626) 287-4755-
SPECIAL )NDITIONS
5 PNGELES CoCONTRACTOR: lEL NO APPROVALS DATE INSPECTOR SIGNATURE
G G HESTER AND SON ELECTRIC (818) 287-4755- .0 �Tj-
9024 E GREENWOOD AVENUE LIC NO TEMPORARY POWER POLE
SAN GABRIEL, CA 91775 474648/C10
TEL NO UNDER I GROUND CONDUIT
LIC 'NO� 7111111ROUGH CONDUIT
ROUGH WIRING
MAIN WATER LINE
I U B L I C WORKS PLASTIC Y/N METAL Y/N
/c Service That
i
REPORT ID DPR265 ROUTE TO- SS0508
i
I ��
COUNTY OF LOS ANGELES TEMPLE CITY N 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC LARKS 9701 LAS TUNAS EL 0508 0401050008
_BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID FEES PAID UUILDING ADDRESS.
TR- 14647 LT 35 BL. 001 4819 TEMPLE CITY SL
FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917804236
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET: LOWER AZUSA
8590-017-029 Al PERMIT ISSUANCEJEE 27 75 THOMAS PAGE 597 GRID A5 LOCALITY TEMPLE CITY
K1,SIGNS, OUTLINE LGT 1 00 SIG -, 38 85
TENANTTOTAL FEES 66 60 issuEo ON PROCESSED BY' PLAN BY EXPIRES ON
TEMPLE CITY RANCH MARKET 01/05/04 VG 07/03/04
YOUNG DAVID,SUSIE (818) 797-1530-
2260 NOODLYN RD
PASD 911043337
ELECTRICAL FOR S1 GI
SIGNS EXPRESS MFG CO (626) 443-3333-
SPECIAL CONDITIONS
WNTRAC
SIGNS EXPRESS MFG CO (626) 443-3333- t
APPROVALS DATE I NSFnT6W-fr&Xl9kF-
2446 MERCED AVE LIC NO TEMPORARY POWER POLE
SOUTH EL MONTE, CA 91733 552097 C45
UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER UFFR GROUND
LIC. NO ROUGH CONDUIT
ROUGH WIRING
MAIN WATER LINE
PLASTIC Y/N METAL Y/N
UTILITY COMPANY NOTIFM
i
,
REPORT ID DPR265 ROUTE TO BS0508
I
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 IAS TUNAS EL 0508 0706120039
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID FEES PAID BUILDING ADDRESS
TR 14647 LT 35 6 BL 3 4819 TEMPLE CITY BL
IEEE DESCRIPTION QUANTITY Oom AMOUNT I TEMP CA 91780
(ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET 1
8590-017-029 AI PERMIT ISSUANCE FEE 27 75 I THOMAS PAGE 597 GRID AS LOCALITY TEMPLE CITY, C
D3 BOOTH LOT SYSTEM 1 00 BOO 16 20 I
TENANT TOTAL FEES 43 95 ISSUED ON PROCESSED BY PIAN BY EXPIRES ON
KNIGHTS OF COLUM13US 06/13/07 SR 12/10/07
OWNER TEL NO FnZ DA 0:27i FIL Y CODE 1
YOUNG, DAVIDLSUSIE (818) 797-1530-
12260 WOODLYN RD I 1
(PASADENA• CA I (DESCRIPTION OF WORE
I 113OMH LIGHTING FOR FIREWORKS STAND 2007
JATEL IME NEVAREZ (56867-4447-
I ,
2) 867-7-9997-
16509 GLORY WHITE ST 1SPECIAL CONDITIONS
I LAR£M1Q70D, CA 90713
CONTRACTOR TEL NO IAPPPOVAIS DATE INSPECTOR SIGNATURE
IK C ELECTRIC (310) 505-0444- 1 1
16509 GLORY WHITE ST LIC NO (TEMPORARY POWER POLE 1
LAKEWOOD CA 90713 699521 CIO
I (UNDERGROUND CONDUIT
ARCHITECT OR ENGINEfiRTEL NO vFER GROUND
LIC NO ROUGH CONDUIT
ROUGH WIRING
MAIN WATER LINE
IPLASTIC Y/N METAL Y/N
UTILITY COMPANY NOTIFIED
I I I
1 I I I
I I I
I I ( I I
I I I I
I
I I ) I
I
I
ti I
I
I I
,- (REPORT ID DPR265 ROME TO 850508 I
I I I I I
COUNTY OF IAS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 IAS TUNAS EL 0508 1011090025
BUILDING AND SAFETY / SAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID FEES PAID BUILDING ADDRESS
ITR 14647 LT 35 BL 001 _ 4819 A TEMPLE CITY BL
I FEE DESCRIPTION QUANTITY DOM AMOUNT TEMP CA 917804236
1 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET LOWER AZUSA
18590-017-029 IA1 PERMIT ISSUANCE FEE 27 80 1 THOMAS PAGE 597 GRID AS LOCALITY TEMPLE CITY Cl
I F1 120V 15/20A BR CKTS 3 00 BR 51 90 1 1
TENANT G1 OUTLETS-L,3T,SW RECP 5 00 OUT 9 70 ISSUED ON PROCESSED BY PLAN BY
TOTAL FEES 89 40 11/09/10 SR
(OWNER TEL NO )FINAL DATE FIN��A��L BY CODE
(YOUNG DAVID,SUSIE (626) 797-1530- 1
12260 WOODLYN RD 1V Y
IPASD 911043337 (DESCRIPTION OF WORK
(ELECTRICAL FOR SERVICE COUNTER
(APPLICANT TEL NO
JENG MATT (998) 765-8982-
ISPECIAL CONDITIONS
(CONTRACTOR TEL NO (APPROVALS DATE INSPECTOR SIGNATURE
IXIN YUAN CONSTRUCTION INC (626) 579-9898-
11718 CHICO AVENUE LIC NO (TEMPORARY POWER POLE
B EL MONTE, CA 91733 899026 B UNDERGROUND CONDUIT
(ARCHITECT OR ENGINEER TEL NO iUFER GROUND
IJENG, MATT (626) 222-0621-
1713 W DUARTE RD, #G303 LIC NO IROUGH CONDUIT I
ARCADIA CA 91007 NONE ROUGH WIRING I
r MAIN WATER LINE
PLASTIC Y/N METAL Y/N
UTILITY COMPANY NOTIFIED I r
I I I I
I I I
I I I
I
I I I
I I I I
I I
I I
I
I
I
I I
I
I
REPORT ID DPR265 RO[TTE TO 850508 I
I I I
COUNTY OF LOS ANGELES TEMPLE CITY K 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC MORKS 9701 LAS TUNAS EL 0508 0506200030
BUILDING AND SAFETY / LAND DEVELOPM TEMPLE CITY CA 91780
PHONE (636) 2B5-0488 EXT
LEGAL ZD PEES PAID BUILDING ADDRESS
TR 14647 LT 35 G BL 3 " 4819 TEMPLE CITY BL
FEE DESCRIPTION QUANTITY DOM AMOUNT TEMP CA 91780
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET
8590-017-029 Al PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID AS LOCALITY TEMPLE CITY C
D3 BOOTS LOT, SYSTEM 1 00 BOO 16 20
TENANT TOTAL PEES 43 95 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON
KNIGHTS OF COLUMBUS 06/20/05 JX 12/17/05
OWNER TEL NO FINAL Di BY CODE
YOUNG DAVIDLSUSIE (818) 797-1530-
2260 WOODLYN RD
PASADENA, CA DESCRIPTION OF WORK
HGOK-UP ELECTRICAL FOR FIREWORKS STAND 2005
APPLICANT TEL NO
SAME AS OWNER -
SPE(.IAL CONDITIONS
CONTRACTOR TEL NO _ _ ` APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER
LIC NO TEMPORARY POWER POLE
1 UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER TEL NO UPER GROUND
_ I
LIC NO ROUGH CONDUIT
ROUGH MZRIHG
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U MAIN NATER LINE
PLASTIC Y/N METAL Y/N
UTILITY COMPANY NOTIFIED
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REPORT ID DPR265 ROUTS TO BS0508
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COUNTY OF LOS ANGELES '' TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1210040081
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID - FEES PAID BUILDING ADDRESS
ITR 14647 LT 35 6 BL 3 4819 TEMPLE CITY BL
IFEE DESCRIPTION QUANTITY UOM AMOUNT TRMP CA 91780
ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET 1
8590-017-029 1A1 PERMIT ISSUANCE FEE . 27 80 I THOMAS PAGE 597 GRID AS LOCALITY TEMPLE CITY Cl
I F1 120V, 15/20A BR CKTS 30 00 BR 461 90 1
TENANT F2 206 277V LGT BR CRT 10 00 BR 273 00 ISSUED ON PROCESSED BY PLAN BY 1
SHENG MEN TANp J AC UNITS .3-10HP 1 00 AC 19 70 110/04/12 SR I
I� MOTORS, LT 3 HP 1 00 MOT 15 30 I I
OWNER - TELNO TOTAL FEES 797 70 iF DATE FINAy�BY CODE
YANG, DAVID/SUSIE (626) 864-4878-
12260 WOODLYN RD
IPASADENA CA _ � 1 OF WORK
ELECTRICCALNI I FOR MARKET 6 FOOD TO GO RESTAURANT
APPLICANT -
TEL NO
CAMACHO TITO C (323) 775-2515- I
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SPECIAL CONDITIONS
CONTRACTOR -
TEL NO (APPROVALS DATE INSPECTOR SIGNATURE
LAMS COOLING INC (323) 578-2250- 1 _
14206 WHITESIDE ST LIC NO 1 ITEMPORARY POWER POLE
ILOS ANGELES, CA 90063 946097 B
(UNDERGROUND CONDUIT 1
1ARCHITECT OR ENGINEER TEL NO UFER GROUND
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LIC NO ROUGH CONDDIT I
�
�ROUGH WIRINp
MAIN WATER LINE
PLASTIC Y/N METAL Y/N
UTILITY COMPANY NOTIFIED(
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REPORT ID DPR265 ROUTE TO 850508
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