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Home My Public Portal About5828 TEMPLE CITY BLVD_Electrical__ 76A663-CE606 10%2 'APPLICATION F It ELECTRICAL PE IT ��"� �• COUNTY OF LOS ANGELES n DEPARTMENT OF COUNTY ENGINEER ADDRESS '�j `�$ b'1'i'L IV r,,c� d� BUILDING AND SAFETY DIVISION LOCALITY (Qq- a e f cn NEAREST j N } FOR APPLICANT TO FILL IN CROSS ST. OUTLETS NO. EACH FEE OWNER OR- RECEPT. $ $ FIRM NAME /r �` R✓�o� MAIL LIGHT TOTAL FIRST 20 25 ADDRESS CITY TEL. N0. SWITCH GO OVER 20 10 PLAN CHECK P �^ FIRST 20 .25 APPLICANT L11 dUii/ LIGHTING TOTAL OVER 20 ADDRESS q 1�0 � L A3 FIXTURES .10 RESIDENTIAL APPLIANCESCITY //++ TEL. NO.QS ,p RANGE, DRYER_WTR. HTR. APPLI ANT GLI �L6'e rjS T Ca STA. COOK DISP. F.A.U. ADDRESS (OU, SPACE HTR. AIR COND. CITY M&Mg - L104 TEL. NO.bb'f-2773 CLOTHES WASH. DISHWASH. LICENSE OR CLASS.�'�� REG.NUMBER UID szk FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE.THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 - 1 1.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF' CALIFORNIA OR THAI" I AM THE LEGAL OWNER OF THE ABOVE - 10 3.00 DESCRIBED RESIDENTIAL PROPERT C PERMITEE V 1 . 10 - 50 5.00 SIGNATURE CD 50 - 100 10.00 DISTRICT NO. PROCES D BY t3 100 - S00 15.00 /y Q SIGN, GAS=Sr ONE CIRCUIT 5.00 APPROVALS DATE INSPEC R'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE SERVI CENOT OVER 600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK SERVICE OVER 600 VOLTS OR.200 AMP 10.00 ROUGH CONDUIT TEMP SERVICE,POLE,&APPURTENANCES 5.00 WIRING Q TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL �• G PERMIT FEE (SUB TOTAL) SO NOTES; PLAN CHECK FEE PERMIT ISSUING FEE 3.00 3 TOTAL FEE PLAN CHECK VALIDATION CK. M.O. CASH . PERMIT VALIDATION M.O. CASH ' 0 2 8 073 mAR 3 0 2 U -" SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE OHS S-A 2-46 DEPARTMENT OF BUILDING •AND .APPLICATION FOR PERMIT COUNTY OF LOS ANGELES ELECTRIC WM. J.-FOXCHIEF ENGINEER a NnME , DISTRICT NO. GROUP ZONE PERMIT NO. �• ADDRESS 7 1 � a RECEIVED BY -READY FOR DATE ISSUED U CITY TEL.NO. FIRST INSPECTION' / NI COUNTY /y L2 �-�, d�C Iw W CERT.NO. - EXPIRES APPLICANT'.FILL IN HEAVILY OUTLINED PORTION ONLY DESCRIPTION 'OF. WORK ADDRESS I" NUMBER OF OUTLETS ON"CIRCUITS ' JFIXT LOCALITY est LOCATION BY�iQDMB'�'`�' S NEAREST LIGHT.OUTLETS SW. PLUGS CROSS ST. CIRCUIT A .B: G D .E F. G H ' W NAME S MAIL 3 ADDRESS CITY TEL.NO. 1 AM THE LEGAL POSSESSOR OF. THE ABOVE LOS ANGF"J..P.S COUNTY CERTIFICATE OF QUALIFICATION.. • - ELECTRICIAN.- t AN ABOVE LUGAL OWNER OF THE PROPAIrrY DESCRIBED OWNER. a CORRECTIONS J Z TOTAL- j.2 .7 NO. OF OUTLETS �,I $ ir APPROVALS NO. OF FIXTURES S DATE INSPECTOR' NAME •NO. OF MOTORS H.P. ffi CONDUIT C NO. OF SIGNS TRANS. $ WIRING LTZTAL RANGES OR HEATERS 8 _ FIXTURES - r LANEOUS /\ 1L'�" $ ►� POWER FEE „. /P G A, UTILITYCO.NOTIFIEFEE � � ` I` /t FINAL �U 3 DES-5-A 2-46 ' APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFE'M I COUNTY OF LOS ANGELES ELECTRIC mosommummmomommWM. J. FOX CHIEF ENGINEER f r — DISTRICT NO. GROUP ZONE PERMIT NO. NAME .,4' r_ e. c ? •. , . , �— lj ADDRESS �y 1 `�.•2•. ,�' f ��•v�_ / a G��-C% RECEIVED BY READY FOR DATE ISSUED N CITY /?, i'.. -TEL.NO. I FIRST INSPECTION / .t COUNTY '�' 4 r -°�1�•'�J "-/ ul CERT.NO. EXPIRES :4,//,1 APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY f DESCRIPTION OF WORKdF./lft ADDRESS _ NUMBER.OF OUTLETS ON CIRCUITSLOCALITY /' 4 �! LOCATION BY ROOMS r NEAREST LIGHT OUTLETS SW. PLUGS CROSS ST. 1..J1_ ✓ i / t i e '� " CIRCUIT A B C D E F G N NAME Z MAIL ADDRESS CITY TELHO. 1 AM THE THE LEGAL POSSESSOR OF THE ABOVE LOS y ANGELES COUNTY CERTIFI JJTB OF QUALIFICATION.. , % RL,CCTRICIAN. - i AM WE LEML OWNER OF THE PROPWY DESCRIBED ABOVE OWNER. CORRECTIONS J Q Z_ L7 a a 'DOTAL f. � ' �• NO. OF OUTLETS $� ffi 'V�` APPROVALS NO. OF FIXTURES 'jam'' ffi DATE INSPECTOR'S NAME NO. OF MOTORS H.P. ffi CONDUIT NO. OF SIGNS TRANS. ffi WIRING NO. OF RANGES OR HEATERS $ FIXTURES O d rl MISCELLANEOUS ffi POWER PERMIT FEE ffi f UTILITY CO.NOTIFIED it =� TOTAL FEE �` ' �� I FINAL D88,5-A 2-46 "IMPARTMENT OF BUILDING AND SAFIr`1'Y_. APPLICATION FOR PERMIT DEI COUNTY OF LOS ANGELES ELECTRIC WM. J. FOX CHIEF ENGINEER _z NAME DISTRICT NO. _ GROUP I ZONE PERMIT NO. U ADDRESS �. RECEIVED BY READY FOR DATE ISSUED W CITY -f _ FIRST INSPECTION .1 COUNTY /� / C:/ W CERT.NO. y EXPIRES L- APPLICANT FILL IN HEAVILY OUTLINED PORT/BION ONLY DESCRIPTION OF WORK ADDRESS ` >� d"s// ,,ee1��1.=� ' NUMBER OF OUTLETS ON CIRCUITS LOCALITY .C:1 'f�7".f et_4 f LOCATION BY ROOMS "i NEAREST ! LIGHT OUTLETS ISW. PLUGS FI CROSS ST. �..�•�L—J \.r {.-L, s:'� r F" - CIRCUIT A 113 C DI El F G H X NAME 6L 4--t C 2 MAIL �� ,.��• ADDRESS O CITY TEL.NO. L� ! i iJ^ 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGFLE6 COUNTY CERTIFICATE OF QUALIFICATION.. ELECTRICIAN. ABOVEM T=19"L OWNER OF THE PROPERTY DESCRIBED OWNER. CORRECTIONS J Q Z t7 a 0 TOTAL � Z z-. NO. OF OUTLETS $ SSC APPROVALS NO. OF FIXTURES $ « DATE INSPECTOR'S NAME NO. OF MOTORS H.P. $ CONDUIT NO. OF SIGNS TRANS. $ WIRING NO. OF RANGES OR.HEATERS $ FIXTURES MISCELLANEOUS $ POWER PERMIT FEE J- r� UTILITY CO.NOTIFIED TOTAL FE �l i 7 FINAL WORKERS'COMPENSATION DECLARATION 76-8 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self insure, CE-806G 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. Company FOR APPLICANT TO FILL IN JOB -DDR S �� - ,� r �V Certified copy is hereby furnished. New Residential Bldgs.&Pools EACH NO. FEE$ _ $ LOCALT S ily, q.Ft. r&/,V ` e _ Certified copy is filed with the county building inspection 1 & 2-FamNE-REST department. Multi-family Sq.Ft. CROSS ST. b � Date Applicant Residential Swimming Pools OWNER FIRM El G CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:RLight_Sw. MAIL a COMPENSATION INSURANCE ec— ,_ ADD t (This section need not be completed if the work involved by the First 20 r permit is for one hundred dollars($100)or less.) Total No. Additional I Y O _ 69 PI AN I certify that in the performance of the work for which this permit APPLICANT CHECK 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 � Additional Total No. CITY Tel.No. Date - Applican Fixed Appliances Not Over 1 HP PER T NOT E TO APPLICANT:. If, after making this-Certificate of APee /G Exemption,you should become subject to the Workers'Compensation Range_ Heater D.W. provisions of the Labor Code,you must forthwith comply with such Oven _ Dryer_ W.M._ AD If G provisions or LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other_ At /Zo c /c G!� T 4�-y a/tS 7 I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. LICENSE OR (commencing with Section 7000) of Division 3 of the Business and REG.NUMB 13 Class O Professions Code,and my license is in full force and effect. Power Apparatus&Large Appliances DISTRICT NO. PROCESSED BY y` Size&Type HP,KW,KVA,or KVAR S t VQ License Numb ��9i7 / Lic.ClassUp to 1 Incl. FINAL /1 0 er��F41fe e -�l e cT d Over 1 to 10 Incl. DATE C /, V DATION 0= ❑ Over 10 to 50 Incl. FINAL I am exempt under Sec. Over 50 to-100 Inc. BY ; B.&P.C.for this reason Over 100 Service bd.,MCC&Panelboards ® 0 0 6 3 A Z� Date: =20 Amp.Under 600 V Signature 20 00 Amp.Under 600 V 0 0 0 0 0 2 Over 1000 Amp.or Over 600 V Exemption for Reg.Maint.Elect. I o - 25.50 SINGLE FAMILY • Temp.Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ° ° ° i ��0 I hereby affirm that I am exempt from the Contractor's License Law Additional Sign Branch Circuits for the following reason(Section 7031.5,Business and Professions Code): S, Misc.Conduits&Conductors 7.01 `� I,as owner of the property,will do the work and the structure Other(See Complete Fee Schedule) is not intended or offered for sale (Section 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(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 state that the above TOTAL FEE information is correct.I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize 4SIgrn tatives of this County to en er upon the above-mentioned for' spection purp es. SEE REVERSE FOR EXPLANATORY LANGUAGE �'e of Permitt Date WORKERS'COMPENSATION DECLARATION 20-0019 DPW 3/87 APPLICATION FOR ELECTRICAL PERMIT u Al"hereby affirm that I have a certificate of consent to self 7°E^ insure, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS �/�j/ �V or a certified copy thereof(Sec. 3800, Lab. C.) ' Policy No. Company FOR APPLICANT TO FILL IN JOB C % e G ❑Certified copy is hereby furnished. I New Residential Bldgs. &Pools EACH. NO. FEE ADDRES ...� , ❑Certified co is filed with the count building inspec- 1 &2-Family, S Ft. $ — $ LOCALITY�e PY � Y 9 � P Y� q• tion department. Multi-family Sq. Ft.— NEARESTCROSS ' 1 Residential Swimming Pools OWNERR us ✓/� s Date Applicant FIRM NAM G s CERTIFICATE OF EXEMPTION FROM WORKERS' 1 Outlets: Rec Li ht Sw._ MAIL COMPENSATION INSURANCE g SS � O L;,V First 20 ADDRE (This section need not be completed If the work Involved by CIT the permit is for one hundred dollars($100)or less.) Total No. Additional Al7/92-9.2/(575— PLAN 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 Work Com ensatio Laws. Lighting Fixtures First 20 ADDRESS Additional Total No. CITY Tel. No. D pelican Fixed Appliances Not Over 1 HP NOTICE TO APPLICANT: If, after making this Certificate of A PILIC LIcea /_e G Exemption, you should become subject to the Workers' Range— Heater—D.W. — Compensation provisions of the Labor Code, you must forthi Oven — Dryer —W.M.— ADDW !/ with comply with such provisions or this permit shall bei Top — FAU —W.H. _ deemed revoked. CITY5Z k EL -C gf�INo�j' _ Hood — Fan —Other Af LICENSED CONTRACTORS DECLARATION LICENSE OR 9 I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. REG. NUMBE S v Class.0 As (commencing with Section 7000)of Division 3 of the Business Power Apparatus&Large Appliances DISTRICT NO. PROCE D BY D}.. and Professions Code,and my license is in full force and effect. _ �►I Size&Type HP, KW, KVA, or KVAR O License Number � 9.3 Lic.Classes—L— V �r � ,/T �— Q Up to 1 Incl. FINAL 0 6-^�'il�Y e� Date � �O ' U� Over 1 to 10 Incl. DATE � �� LIDATION � C ntr Over 10 to 50,4=1. 0 c� �� FINA ❑ e pl� e c. ao �fPS'ver to } •� BY w B.&P.C. for this reason Over 100 / 5 9 9 a O R � Services, Swbd., MCC&Panelboards # 0 0 0 0 0 2 Z �' 0-200 Amp. Under 600 V Signature 201 - 1400 1000 Amp. Under 600 V ( ° ° ❑ Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V o 'o 0 1 4.0 Q c=i SINGLE FAMILY Temp. Power Pole&Appurtenances $$ HOME OWNER-BUILDER DECLARATION O i&2 O I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits Professions Code): ❑ I, as owner of the property, will do the work and the Misc. Conduits&Conductors structure is not intended or offered for sale(Section 7044, Other(See Complete Fee Schedule)— 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 Name PERMIT ISSUING FEE 14 Lender's Address TOTAL FEE I certify that I have read this application and state 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. AE:Io�ve- entloed propert for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE rd0 —(SIS —S (j Signature of Per ttee Date (� ®' AV ` COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1001050017 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: I FEES PAID I BUILDING ADDRESS: 1 1TR: 6561 LT: 585 BL: .001 1 5828 TEMPLE CITY BL I (FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:1 TEMP CA 917802112 1 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: LAS TUNAS 18587-018-022 1A1 PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, Cl 1K1 SIGNS, OUTLINE LGT 1.00 SIG 38.85 ITENANT: I TOTAL FEES 66.60 (ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: ] [DR. PETER CHI M.D. 1 101/05/10 SR 01/05/11 I OWNER: TEL. NO: ] IFINAL DATE FI BY: CODE: 1 ]CHI, PETER (626) 285-1154- 5828 TEMPLE CITY BL ] ITEMP 917802112 I IDESCRIPTION OF WORK I 1 I 1ELECTRICAL FOR SIGN 1 (APPLICANT: TEL. NO: 1 ISUCCESS SIGN GROUP (626) 444-8181- 1 1 1 12812 PECK RD. 1 ISPECIAL CONDITIONS: IEL MONTE, CA 91731 1 1 I I ] 1 CONTRACTOR: TEL. NO: ] ]APPROVALS DATE INSPECTOR SIGNATURE I ISUCCESS SIGN GROUP (626) 444-8181- 1 1 1 12812 PECK RD LIC. NO 1 ITEMPORARY POWER POLE I I ] �EL MONTB CA 91776 896068 C45 I (UNDERGROUND CONDUIT I I I I I I (ARCHITECT OR ENGINEER: TEL. NO: 1 IUFER GROUND I I I 1 LIC. N0: I IROUGH CONDUIT I I ] I 1 IROUGH WIRING I I I I I I I ] (MAIN WATER LINE I I I (PLASTIC Y/N METAL Y/N I I I (UTILITY COMPANY NOTIFIED( I I I I ] I I I 1 I I I I I I I I I I ] I I I I I I I I ] ] I I I I I I 1REPORT ID: DPR265 ROUTE TO: BS0508 1