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HomeMy Public PortalAbout5271 1/2-23-23 1/4-23 1/2-25-25 1/2 TEMPLE CITY BLVD_Electrical__ v.�w aXt eA �,ra APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES ELECTRIC 1 WILLIAM J. FOX, CHI[r ENGINEER FOR APPLICANT TO FILL IN , DISTRICT NO. GROUP I ZONE PERMIT NO. r369� ELECTRICIA lgljj ty R [ o er READY ran DA to ADDRESS r ro FIRST INSPECTION CITY T[L NO DOUPMY LICENSE NO rXPIRKSBUILDING �J/� I PERMIT PEES ADONE m / NUMBER OUTLETS EACH F[[ LOCALITY LIGHT M NEAREST OROBB ST RECEPTACLES B L4 4 FIXTURES s 0 OWNER WALL SWITCHES S MAIL [LEO RANGES 13 ADDRESS ELEO. HEATERS IIS CITY TEL No MISC 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS NUMBER or CIRCUITS INSTALLEDJ O /♦_a Tar I `I APPLICATION AND STATE THAT THE ABOVE IB CORRECT LRECEPTACLES AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES MOTORS AND STATE LAWS REGULATING ELECTRICAL WIRING NuwrEX HORSEPOWER FEE 1 CERTIFY THAT 1 PO®ESS THE ABOVE VALID LOS NEw MVa. HP Ova. i No [AOFI ANGELES COUNTY LIQ[NBE, OR I AM THE LEGAL OWNER Or THE RESIDENTIAL PROPERTY DEBCR [D ABOVE 1 V2 • LEa 13 4 SO BIGNATUR[ Or 1 S 100 PERMITTKN s is I so INSPECTION RECORD i s so 4 so so BOO Goo "6`� 4 z 400 SaG 14DD BOD 1000 10 DO Cy p p U J OVER IOM 44OD _ M G BET FR CHANGER-HP �d 4 C Y�Feq wcLDenelwo-KVA ¢ GENERATORS - KW O TRANSrORMERS - KVA TEMP MOTORS (76 or DK,a) r MOVED MOTORS (76 or often) MIs6 SIGNS TYPE. N4 TRANS TYPE No LAMPS APPROVALS FOR EACH PERMIT DAT[ INSPEOTOWS NAM[ WIRING elm lj0 CONDUIT FIXTURES e/ 00 WIRING SUPPLEMENTARY 60 FIXTURES POWER TOTAL FEE e / t� UTILITYCO NOTI►IED FINAL / WORKER'S hveacertificate COMPENSATION DECLARATION 26G01s DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT ]0AfiB3 I hereby affirm that I have a certificate of consent to self Insure, or a certificate of Worker's 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 APPLICANT TO FILL IN JOB ADDRESS Certified copy is hereby furnished. New Residential Bidgs.&Pools NO. EACH FEE ❑ _ $ $ LOCALITY Certified copy is filed with the county building inspection 1 ul i--Family,Sq.Ft. department. Multi-family Sq.Ft. — �gp�ysT-r, Residential Swimming Pools ASSESSOR Date Applicant MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Else.—Light_Sw._ OWNER OR COMPENSATION INSURANCEFIRM NAME (This section need not be completed It the work Involved by the First 20 MAIL Additional ADDRESS permit Is for one hundred dollars($100)or leas.) Total No. - 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 eb as tar PLAN CHECK become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANT Total No. Additional ADDRESS Date - I, L- Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: If, after making this Certificate of CITU T.I.No. Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Cade, you must forthwith comply with such PERMIT provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances APPLICANT / LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS /.. I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. } (commencing with Section 7000) of Division 3 of the Business and CITU T.I.No. EL Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. - 0 Over 50 to 100 Incl. LICENSE OR s Class. /r REG.NUMBER i- 0 License Number ^.4- Lie.Class +/'T Over 100 DISTRICT NO. PROCESSED BY W J _ Services,Swbd.,MCC&Panelboards lL C 0-399 Amp.Under 600 V FINAL } Contractor - Date DATE LJ I am exempt under Sac - y� 3 9 ~ 400-1000 Amp. Under 600 V /,- VALIDATION Q Over 1000 Amp.Or Over 600 V FINAL Cr B.&P.C.for this reasonBRANCH CIRCUIT FEES By d Date: r 15A,or 20A,120V,Lighting or Recept. /� 1 To 10 Branch Circuits W Signature - it To 40 Branch Circuits H ❑ -" ''r 41 Or More Branch Circuits Exemption for Reg.Maint."Elect. 16A.20A,20 VV To 277V Lighting Br.Circuits SINGLE FAMILY Temp.Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law for the fallowing reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits Cyode): ❑ I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) 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(Sec. 3097, PERMIT FEE (Sub-Total) Civ.C.) PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address I certify that I have read this application and under penalty of purjury state TOTAL FEE that the above information is correct. I agree to comply with all County ordinances and State laws 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 s, SIGNATURE OF PERMITTEE DATE COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0904290003 BUILDING AND SAFFTY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT LEGAL ID FEES PAID BUILDING ADDRESS ITR 6561 LT 606 ON 0025721 1/2 TEMPLE CITY-BL FEE DESCRIPTION QUANTITY UOM AMOUNT I TEMP CA 917802510 IASSESSOA INFORMATION NUMBER I NEAREST CR095 STREET LIVE OAR 8587-016-005Al PERMIT ISSUANCE FEE 27 75 1 THOMA9 PAGE 596 ARID J3 LOCALITY TEMPLE CITY Cl TF1 120V 15/20A BR CM 3 00 BR 51 75 1 TENANT F2 208, 277V LGT BR CKT 2 00 BR 54 60 ISSUED ON PROCESSED BY PIAN BY EXPIRES ON c G1 OUTLETS-LOT,SW,RECP 4 00 OUT 7 80 04/29/09 SR 10/26/09 IG2 LIGHTING FIXTURES 2 00 LOT 3 90 �p�, �9'f� OWNER TEL 9- IHS RES AMP MACH LT 3HP 4 00 MAS 43 80 �PV / I I FINAL Y CODE IPUERTAS ANGELO (626) 319-3406- IIA 100 AMP PANELS, MCC 1 00 PAN 38 85 bi 129 WINNIE F TOTAL FEES 228 45 ARCO 910064672 _ IDESCR IOIlOFWOR— K INSTALL (1) 100 AMP PANEL 4 OUTLETS FOR LAUNDRY MACHINES, APPLICANT TEL NO (2) LIGHT FIXTURES JACK T Y FAN (626) 202-4762- 426 A SOUTH ORANGE ISPECIAL CONDITIONS MONTEREY PARR 91754 CONTRACTOR TEL NO I IAPPROVAL9 DAM INSPECTOR SIGNATURE JAGR•$ fiLECTRIC (626) 202-4762- 426 A SOUTH ORANGE AVENUE LIC NO [TEMPORARY POWER POLE MONTEREY PARR, CA 91754 383529 CIO UNDERGROUND CONDUIT I ARCHITECT OR ENGINEER TEL NO UFER GROUND LIC NO ROUGH CONDUIT _ IROUGH WIRING I MAIN WATER LINE - i PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED[ d-1 I I IRBPORT ID DPR265 ROUTE TO DS0508 I � I