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HomeMy Public PortalAbout5837-5839 TEMPLE CITY BLVD_Electrical__ TEMPLES Cid T V lease-oesoae-eo APPLICATION .FOR ELECTRICAL PERMIT. 1 COUNTY OF LOS.ANGELES" • DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS `i T n -ir MIT JOHN A.LAMBIE,COUNTY ENGINEER WILLIAM A.JENSEN. SUP'TOF BUILDING LOCALITY Tempi Cit FOR APPLICANT TO FILL IN NEAREST CROSS 8T. PERMIT FEES OWNER Libert National Ins. Co ITEM NUMBER 'EACH FEE MAIL OUTLETS: $ S ADDRESS 5839 Temple Cit, Blvd. LIGHTS RECEPT. SW. .fO empl E 'it y TEL.NO LIGHTING FIXTURES ,10 CITY /� ELM.RANGES CLO.DRYERS ELECTRICIAN -Air C on Electric WATER HEATERS .50 ADDRESS I- 3 6 . Florence Ave. ELEC.SPACE HTRS. DISHWASHERS cITy Los ngele S TEL.NO. PL -1161 GARBAGE DISPOSERS AUTO.. STATE �190742 WASHERS STA.COOKING UNITS. ,2$ LICENSE NO. MOTORS: OVER INC. H.P. 25 DISTRICT GROUP ZONE. P SSED BY O — 1/2 25 Va _ 2 .50 50 ` IIsj§PECTION RfOCQRD d 2 — 5 1.007 !� �j �0� O. $ IS' 1.50 4C. arJ — U .Is — BO 2.50 O so — 200 5.00 W SIGNS: NO TRANS.' N NO.LAMPS Z SERVICE O.000V 1.00 SERVICE OVER GOOV 5.00 MISC. WIRING PERMIT 1.00 FIXTURE PERMIT i:00 SUPPLEMENTARY PERMIT ,$O 0 TOTAL FEE S 1 2 _ [_HEREBY ACKNOWLEDGE THAT"[ HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATIC-THAT.THE ABOVE"I8.CORRECT AND AGREE TO COMPLY WITH AL4 COUNTY ORDINAN"S AND STATE LAWS REGULATING CONDUIT ELECTRICAL.WIRING. WIRING 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT 1 AM E LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL P ERTY. POWER SIGNATURE u UTILITY CO.NOTIFIED I i e/. OF PERMIT TE FINA VALIDATION S HU C.VETT, Mo CASH SU ERV,ISING ELECTRICAL ENGINEER. [&7482% Jlul26 2 0 1 .25 19 78A66C-CE#'808 5-61 APPLICATION FOR ELECTRICAL PERMIT u COUNTY OF LOS ANGELES DEPARMENT OF COUNTY ENGINEER BUILDING 1 BUILDING AND SAFETY DIVISION ADDRESS �t JOHN A. LAMBIE. COUNTY ENGINEER �a WILLIAM A.JENSEN.SUPT OF BUILDING LOCALITY `i NEAREST FOR APPLICANT TO FILL IN CROSS ST. PERMIT FEES OWNER i ITEM NUMBER EACH I FEE MAIL �/ y— OUTLETSI $ s s ADDRESS �r LIGHTS RECEPT. SW. .10 CITY \ �+ TEL.NO. LIGHTING FIXTURES .10 ELEC.RANGES CLO.DRYERS ELECTRICIAN C9 WATER HEATERS :50 'ADDRESS ELEC.SPACE HTRS. DISHWASHERS CITY 5540OP TEL NO /��' GARBAGE DISPOSERS AUTO.- ,STATE WASHERS STA.COOKING UNITS .25 LICENSE NO. ��g7 MOTORS: OVER INC. H.P. DISTRICT O. GROUPZiON�(E PROCESSED BY 0— 1/2 .25 G. OLG✓! I/a— 2 650 INS P ION RECORD 2— 5 1.00 5— 18 1.50 V Is— SO 2.50 8 50— 200• 5.00 V W SI N NO TRANS. N NO.LAMPS SERVICE 0-600V 1.00 v SERVICE OVER 600V 5.00 MISC. WIRING PERMIT 1.00 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .SO TOTAL FEE -S I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE 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 I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR /% LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PR PERTY. POWER SIGNATURE UTILITY CO.NOTIFIED OF PERMITTE FINAL w/ v% ^LIDATION ARTHUC.VEIT CK MO CASH SUP RV SING ELECTRICAL ENGINEER LKI,, g 4 7 7 2 D 2.0 0 76'A66C-CE#606 5-61 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARMENT OF COUNTY ENGINEER BUILDING g Tem le Cit Blvd, BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE.COUNTY ENGINEER WILLIAM A.JENSEN,SUPT OP BUILDING LOCALITY Tern-ole Cit NEAREST FOR APPLICANT TO FILL IN CROSS sr. PERMIT FEES OWNER Liberty National Ins. Co. ITEM NUMBER EACH FEE MAIL 5839 Temple Cit ^ Blvd. , °eHTSL__),RECEPT. 6 SW. 2 23 s10 $ 2 30 'CITY Temple City TEL.NO. LIGHTING FIXTURES l ELfiC.RANGSS CLO.DRYERS .10 1 90 ELECTRICIAN .Air Con Electric WATER HEATERS .150 ADDRESS 1736 W. Florence Avenue ELEC.SPACE HTRS. DISHWASHERS CITY Lo s An el e S TEL NO. PL -1161 GARBAGE DISPOSERS AUTO.- STATE WASHERS STA.COOKING UNITS .25 LICENSE NO. 190742 MOTORS: OVER INC. H..P.. DISTRICT. G UP O P D rG 0— va1 AS 2 1/2— Z ,50 / IN/SPEC/TION RECORD 2— 5 1.00 I .?4�L•'1//0/ F/f%l !4� s s— Is 1.50 is— so 2.50 a SO— Zoo 5.00 ,-q S�s:�✓ �`'l''; , c l d SIGNS: NO TRANS.. H NO.LAMPS ^z SERVICE 0-600V 1.00 jr U SERVICE OVER 600k s.00 ^ M ISC. WIRING PERMIT1.00 1 CO fr ^��-�`� -AW FIXTURE PERMIT 1.00 1 00 SUPPLEMENTARY PERMIT 50 TOTAL FEE s 6 05 1HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURZ AND STATS THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT A WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. ' WIRING 1 HEREBY CERTIFY THAT t AM PROPERLY REGISTERED AND/OR LI / /� �� '• � fr�� CENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT i AM TAa WN F THEDESCRIBED RESIDENT L P OPEP POWER SIGNATURE UTILITY CO.NOTIFIED eta OF PERMITTE / y 1-al tllllr� VALIDAT H AR ERVIS C.VETT CK mo cwsH SUPERVISING ELECTRICAL ENGINEER 6 2 9 24- DEC-19 2 D 6.0 5 e9.a- e BAGGS.CESGG.10.56 APPLICATION FOR ELECTRIC PERMIT 1 BUILDING AND SAFETY DIVISION Department of County Engineer BUILDING r County of LOS Angeles A13DRF-Ss� . JOHN A.LAMBIE.COUNTY ENGINEER CASSATT D. GRIFFIN.SUPT OF BUILOINe LOCALITY p NEAREST FOR APPLICANT TO FILL IN ceoss s PMIM FEES (�- OWNER *j �JLd-� C . /✓J LIGHTS RECEPTACLES SWITCHES NUNSERI I T E M EACH FEE MAIL ADDRESS If TOTAL OUTLETS $ .10 $ ELEC. RANGES, WATER HEATERS, CITYTEL.NO CLOTHES DRYERS . .SO TIAELECTRI IAN ELEC. SPACE HEATERS, BTAT'Y. COOK- /. ING UNITS, GARBAGE DISPOSERS, ADDRESS Q AUTO WASHERS. DISHWASHER .28 LIGHTING FIXTURES .10 CITY TEL.NoA7. 61SAO MOTORS STATE LICENSE NO. HORSEPOWER H.P. OVER INC: DISTRIC6T-WO. GROUP ZONE READY FOR INSPECTION V2&LESS .25 2 .so INSPECTION Mc&D 2 5 1.00 S — 18 1.80 18 SO 2.80 SO 200 5:00 MiSC. SIGNS NO.TRANS NO.LAMPS SERVICE O-GOOV 1:00 SERVICE OVER GOOV 5.00 WIRING PERMIT 1.00. FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT_ .SO APPROVALS TOTAL FEE $ DATE INSPECTORS SIGNATURE I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATIUR AND. STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING IS15 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AN THE LEGAL OWNER OF THE ABOVE POWER DESCRIBED RESIDENTIAL PROP Y. SIGNATURE UTILITY CO.NOTIFIED OF PERMITTEE FINAI CRI IS1 Std r 5(LL...ea.. OHN A. LAMBIE. MATION AR1rHuR C.VEIT, :OUNTY ENGINEER /c MO CASH SUFERVISIN6 ELECTRICAL ENGINEER LAC01 14 19 MAY 22 2 A 2.4 0 � 76AA63 SA 15N SETS 7-45 APPLICATION FOR PER= �. DEPARTMENT OF svlLnnvc AM sAFErY ELECTRIC � COUNTY OF LOS ANGELES $ WM. J FO CHIEF EN7i1NEE // DISTRICTNO. GROUP ZONE PERMIT NO. NAME , 7' !i t6li.l'. i. v ADDRESS „1 r•r fJ �! �• i RECEIVED BY READY FOR DATE ISSUED TEL.NO.=' • ` ? FIRST INSPECTION L CEN END. �! 6 Y. EXPIRES / i' / J APPLICANT FILL IN MAVMY OUTIME'D/PORTION ONL. DESCRIPTION OF WORK ADDRESS ! ! � ,f; .L�•s / J= NUMBER OF OUTLETS ON CIRCUITS LOCALITY /Z i^� _ LOCATION BY ROOMS LIGHT OUTLETS SW. PLUGS NEAREST i?/s / ! 7 CIRCUIT A B C D E F G EI m NAME A�f'-� - - z MAIL ADDRESS CITY TEL NO. 1 AN THE LEGAL POSSESSOR- OF,THE ABOVE LOS, ANGS.ES COUNTY CERT/FICATIZ OF QUALIFICATION.. �✓ SLSCTRICIAN. AI AN THB JXGAL OWNER OF'THE MWPQRTY DESCRIBED ��p���v�pn7�Q OWNER. CORRECTHONS t Z IC .0 NO. OF OUTLEM S APPROVALS NO. OF FIXTURES B DATE INSPECTOR'S NAME NO. OR MOTORS H.P. B CONDUIT NO. OF SIGNS I TRANS. owl WIRING NO. OF RANGES OR HEATERS R FIXTURES NI ALNFAUS B POWER PERMIT FEE S o1v UTILITYCO.NOTIFIED 78A663 CE�BOBR f0�77 �;. APPLICATION FOR ELECTRICAL PERMIT V ' COUNT)/OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER JOBS� �. 4 BUILDING AND SAFETY DIVISION ADDRESS l.7 Tke FOR APPLICANT TO FILL IN LOCALITY New Residential Bldgs.&Pools EACH NO. FEE NEAREST 1 &2-Family,Sq.Ft. $ .025 — $ CROSS ST. QS OWNER OR 1*0 Multi-family Sq.Ft. •02 — FIRM NAME Residential Swimming Pools 25.00 ADDRESS C Outlets:RecLight_Sw. CITY el.No. First 20' 50 PLAN CHECK Total No. Additional .30 APPLICANT ADDRESS Lighting Fixtures First 20 .50 -CITY Tel.No. Additional .30 - PERMIT Total No. APPLICANT L' Fixed Appliances Not Over 1 HP ADDR �� 1 . Range_Heater_D.W._ CITY,9AIN j CjA 15 12 1 e.jNo. Oven_Dryer—W.M._ LICENSE OR Top —FAU —W.H. REG.NUMBER Class. Hood_Fait —OII1ef— I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE D'Isp. — Room Air Cond. 2.50 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'a Type HP,KW,KVA,or KVAR I:HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS 2.50 REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM IZ7Up to 1 Ir1CI. THE LEGAL OWNER OF THE ABOVE BED RESIDENTIALPROPERTY. Over 1 to 10 Incl. 5.00 Over 10 to 50 Incl. 12.50 PERMITTEe Over 50 to 100 Inc. 25.00 SIGNATURE t� Over 100 40.00 DISTRICT NO. PROCESSED BY d r� � ti Services 0-200 Amp.Under 600 V 12.50 ( INSPECTOR'S 201.1000 Amp.Under 600 V 25.00 APPROVALS DATE SIGNATURE Over 1000 Amp.or Over 600 V 50.00 TEMP.POWER POLE Temp.Power Pole&Appurtenances 10.00 UNDERSLAB WORK Sign with One Branch Circuit 10.00 ROUGH CONDUIT - Additional Sign Branch Circuits 2.00 WIRING Misc.Conduits&•Conductors 10.00 . FIXTURES Other(See Complete Fee Schedule) POWER AUTHORIZED UTILITY CO.NOTI FI ED FINAL PERMIT FEE (Sub-Total) NOTES. PLAN CHECKING FEE [One-Fourth Permit Feel PERMIT ISSUING FEE $7.00 TOTAL FEE -� PLAN CHECK VALIDATION CK. M.b. IV VASH PERMIT VALIDATION , CK. M.O. CASH a a o N a o o .+ �7 CN C.4 o N N ' o to SEE BACK OF APPLICATION FOR COMPLETECLC'•EDU& .N n- CH RM ' DES �yS-A .12D-r44�� 7T *� ypTg�1 �p�� DEPAIILIll,Y�Y�ENT OF BUILLQDYlA�1NG AND SAFETY I ��®� �� ��/y NTY.OF GELES WM. J. FOX •CHIEF ENGINEER NAME :TZ /�l�J,f w DISTRICT NO. GROUP ZONE PERMITNO. ADDRESS-ILZ (L f j��Pao. {lLAi1�t :` oi � '�f + COUNTY Fl. RECEIVED B$ READY FOR DATEISSUED CITY �f�A TEL.NO '�/1 f �s FIRST INSPECTION e CERT.NO. d !a EXPIRES APPLICANT FILL IN 1SWEAVELY, JOB DESCRIPTION OF WORK. ADDRESS AIL 6 p NUMBER OF OUTLETS ON CIRCUITS LOCALITY LOCATION BY ROOMS NEAREST LIGHT OUTLETS SW. PLUGS FI)CT CROSS ST. CIRCUIT A B C D . E F 10 Hm NAME. Z MAIL J� 3 ADDRESS O CITY TEL.NO. 1 AM THE. LEGAL POSSESSOR 'OF THE ABOVE LOS ANGELES COUNTY CERTCAAs66 SOF •QU IFICATION.. ELECTRICIAN. I AM THE LXCAL OWNEROF TIIE PROPF,RTY DESCRIBED ABOVE OWNER. CO MONS Z_ •L7 .E 1] TOTAL yy�� NO. OF OUTLETS d� ffi /0 APPROVALS I NO. OF'FIXTURES ffi' DATE 'INSPECTOR'S NAME NO. OF MOTORS H.P. $ CONDUIT NO. OF SIGNS TRANS. S WIRING NO. OF RANGES OR HEATERS S_ FIXTURES MISCELLANEOUS ffi POWER PERMIT FEE o 1019:1NAL � UTILITYCO.NOTIFIED �v-. ...... 3i .� '/- D13YLGk�tLifE ll 1YR�1®8 ®L' J�611II�9DY1`fG AAND .7Ai io i 1 ��41i11O1\ FOR lC IT+1�31V+11111 COUNTY OF LOS ANGELES WM. J. FOX CHIEF ENOINEFR �������� Z DISTRICT NO. GROUP I ZONE PERMIT NO. Q NAM_L*! U ADDRESS H RECEIVED BY READY FOR DATE IESSUGD 0 CITY TEL.NO. FIRST INSPECTION i COUNTY N CERT.NO. EXPIRES APPLICANT FILL IN HEAVILY OUTLUNE®PORTION ONLY JOB DESCRIMON OF WORK ADDRESS NUMBER OF OUTLETS ON CIRCUITS LOCALITY LOCATION BY ROOMS NEAREST LIGHT OUTLETS SW. PLUGS FAIT CR SS 9T CIRCUIT A I m C D E F IG IH X NAME Z MAIL 3 ADDRESS CITY TEL.NO. I AM THE LEGAL POSSESSOR OF THE ABOVE LOO ANGELES COUNTY CERTIFICATE OF QUALIFICATION.. 13LECTRICIAN. AI AN TM LWAL OWNER OF TM PROPARTY DESCRIBED OWNER. WMM RRF=ON QQ 7 J Q Z 0 TOTAL NO. OF OUTLET'S O APPROVALS NO. OR FQXTURES O DATE INSPECTOR'S NAME NO. OF MOTORS H.P. - CONDUIT NO. OF SIGNS TRANS. WIRING NO. OF RANGES OR HEATFRS f3 FIXTURES MISCELLANEOUS O POWER PERMIT FEC B UTILITYCO.NOTIFIGD TOTAL A FINAL I le, WORKERS'COMPENSATION DECLARATION 26A663 DPW 3/87 APPLICATION FOR E 1ECTRICAL PERMIT J hereby affirm that I have a certificate of consent to self I cE-6WG Q in re, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES � DEPT. OF PUBLIC WORKS ox certified copy thereof(Sec. 3800, Lab. C.) Policy No. Company. FOR APPLICANT TO FILL IN JOB '] . J ❑Certified co is hereby furnished. EACH NO. FEE ADDRESS;5 3 '�//JO �'� ���(/ copy y New Residential Bldgs. &Pools ❑Certified co is filed with the count buildinginspec- 1 &2-Family, S Ft. $ — $ LOCALITY copy y P y . I NEAREST tion department. Multi-family Sq. Ft. I CROSS ST. Date Applicant Residential Swimming Pools OWNER OR I FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw.— MAIL COMPENSATION INSURANCE I ADDRESS S (This section need not be completed if the work involved by First i CITY Tel. No. the permit is for one hundred dollars($100)or less.) Total No. Additional i PLAN CHECK I certify that in the performance of the work for which this I APPLICANT permit is issued, I shall not employ any person in any manner Lighting Fixtures First 20 I ADDRESS so as to become subject to the Wor ompensation La S. g g � Additional Date Applicant �� Total No. i CITY Tel. No. NOTICE TO APPLICANT: If, after making this ertificate of I Fixed Appliances Not Over 1 HP PERMIT Exemption, you should become subject to the Workers' Range— Heater—D.W. — i APPLICATION , y+Z -t 1QV o� Compensation provisions of the Labor Code, you must forth- Oven — Dryer —W.M.— i ADDRESS with comply with such provisions or this permit shall be Top — FAU —W.H. — deemed revoked. I Hood — Fan —Other— CITY ip ro Tel. No.1 7--;235' LICENSED CONTRACTORS DECLARATION LICENSE OR Disp. — Room Air Cond. REG.NUMBER / �� Class.C 0I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business Power Apparatus&Large Appliances DISTRICT NO. PRO SSED BY a and Professions Code,and my license is in full force and effect. �l7 y ell) 11 Size 8 Type HP, KW, KVA, or KVAR I i� ��G� -� 7 O License Number�t / Lic. Class Up to 1 Incl. FINAL <g> u� � r•-�y1 Over 1 to 10 Incl. j DATE /17- 71 VALIDATION Contractor! Date Over 10 to 50 Incl. I FINAL �s 1-- I I am exempt under Sec. Over 50 to 100 Inc. BY B.&P.C. for this reason Over 100 ' d D _ Services, Swbd.., MCC&Panelboards � N� z 0-200 Amp. Under 600 V Signatur ' 201 - 1000 Amp. Under 600 V ❑ Exemption for Reg. Mai Over 1000 Amp. or Over 600 V . Elect. SINGLE FAMILY Temp. Power Pole&Appurtenances 2 HOME OWNER-BUILDER DECLARATION 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 7�f-, ii Professions Code): 33�' 31.11- ID I, as owner of the property, will do the work and the i Misc. Conduits&Conductors 1 I,111 structure is not intended or offered for sale(Section 7044, Other(See Complete Fee Schedule)_ 10I HL 3,i i--�=t t .t_ Business and Professions Code). 7.1 CHECK CONSTRUCTION LENDING AGENCY -HECK I hereby affirm that there is a construction lending agency for CHANGE the performance of the work for which this permit is issued i PERMIT FEE (Sub-Total) 1 (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name iPERMIT ISSUING FEE � -r �h r .1 Lender's Address ����� .i H'"`�'`1-1 I certify that I have read this application and state that the I TOTAL FEE above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and herets au rize representatives of this County to enter upon f(7e ab ve- ntioned property f inspection purposes. 1 � SEE REVERSE FOR EXPLANATORY LANGUAGE r Sigriature of Permittr Date ®� WORKERS'COMPENSATION DECLARATION CE-806 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have o certificate of consent to self CE-8066 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 New Residential Bldgs. 8 Pools FOR APPLICANT TO FILL IN JOB ADDRESS t L•�• a'�� Certified copy is hereby furnished. EACH NO. FEE J Certified copy is filed with the co t build' i ec- 1 &2-Family, Sq. Ft. $ _ $ LOCALITY !!� tion department. Multi-family Sq. Ft. NEAREST S- ,%denlail Swimming Pools CROSS ST, Date Applicant 9 OWNER OR CERTIFICATE OF EXEMPTION FROM WORKERS' FIRM NAME c Light Sw._ MAIL COMPENSATION INSURANCE o First 20 ADDRESS c• �. (This section need not be completed if the work Involved by Total No. CITY ��"�- Tel. No. the permit is for one hundred dollars($100)or less.) Additional N,•r+ PLAN CHECK ,f, I J` I certify that in the performance of the work for which this APPLICANT di N ���, 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 Date Qpplicanf Tocol No. Additional No. CITY C Tel. N�� f•'I�4�•°I� �• NOTICE TO APPLICANT: If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT Exemption, you should become subject to the Workers' Range_ Heater_D.W. APPLICANT _ Compensation provisions of the Labor Code, you must forth- Oven —Dryer —W.M. ADDRESS with comply with such provisions or this permit shall be Top _ FAU —W.H. — deemed revoked. CITYTel. No. LICENSED CONTRACTORS DECLARATION Hood _ Fan _Other_— c . Dis _ Room Air Cond. LICENSE OR C�L I hereby affirm that I am licensed under provisions of Chapter 9 p' REG.NUMBER @ Ca Class. Q-Q(gyp (commencing with Section 7000)of Division 3 of the BusinessDISTRICT NO. PROCESSED BY and Professions Code,and my license is in full force and effect. Power Apparatus&Large Appliances Size&Type HP, KW, KVA, or KVAR 5Ga License Number 36�0 Lic.Class u 1�.�O ' Up to 1 Incl. JFIN� L /' (1; 1� _ O Over 1 to 10 Incl. E '� /_ VAL ATION Contractor Date Over 10 to 50 Incl. / SP W' I am exempt under Sec. Over 50 to 100 Inc. p,• B.&P.0. for this reason Over 100 _ Date: :es, =Amp�Uncler CC&Panelboards 0 600 V Signature Ol - p. Under 600 V ❑ Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY Temp. Power Pole&Appurtenances4 9 21 A HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits # 0 0 0 0 0 2 Law for the following reason (Section 7031.5, Business and Professions Code): 1 0 - 3250 ❑ I, as owner of the property, will do the work and the Misc. Conduits&Conductors structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)_ , o o o 3 2 rj 0 7044, Business and Professions Code). 0630-86 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 1 certify that I have.read this application and state that the TOTAL FEE �d above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and her a t orize re a tive of this County to enter u on the ention d r erty r inspection purpg7 � SEE REVERSE FOR EXPLANATORY LANGUAGE Si a ure of ermitt a Date WORKERS'COMPENSATION DECLARATION CE-806 10181 APPLICATIOIN FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self CE-806G 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 FILL IN JOB EACH I NO. FEE ADDRESS Certified copy is hereby furnished. New Residential Bldgs. & Pools LOCALITY Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. $ _ $ NEAREST tion department. Multi-family Sq. Ft. CROSS ST. i1 Date Applicant Residential Swimming Pools OWNER OR FIRM NAME t CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec-LLight�Sw—L IL COMPENSATION INSURANCE ADDRESS First 20 (This section nood not be eomploted if the work involved by Total No. Additional CITY , ' Tel. No. tho permit is for one hundrod dollars($100)or less.) PLAN CHECK I certify that in the performance of the work for which this APPLICANT permit is issued, I shall not employ any pern in any manner so as to become subject to the Work pe do Lgws. Lighting Fixtures First 20 DDRESS tI Total No. Additional CITY Pi No. Date r pplicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making thi ertificate of APPLICANT 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 XN with comply with such provisions or this permit shall be Top FAU —W.H. — CIN Tel. No. deemed revoked. Hood _ Fan _Other_ LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. _ Room Air Cond. REG. NUMBER Class. (commencing with Section 7000)of Division 3 of the BusinessDISTRICT NO. PROC ED Y and Professions Code,and m license is in full force and effect. Power Apparatus& Large Appliances Zio Size&Type HP, KW, KVA, or KVAR �i O (�Q O License Number-40 Lic. Class Up to 1 Incl. FINAL %P Over 1 to 10 Incl. DATE V (DATION cc Contractor Date Over 10 to 50 Incl. � ❑ FINAL LU I am exempt under Sec. Over 50 to 100 Inc. BY B.&P.C. for this reason Over 100 Services, Swbd., MCC&Panelboards Date: 0 -200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V ' #c 7 2 b'9 Over 1000 Amp. or Over 600 V Exemption for Reg. Mains. Elect. c o l 3 5 0 SINGLE FAMILY Temp. Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit o 0 0 1 350'o 1 hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits 1.04-87 Law for the following reason (Section 7031.5, Business and Rpsions Code): Misc. Conduits&Conductors I, as owner of the property, will do the work and the 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 fdr the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) Q (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE C Lender's Address �\ 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 ordinances and State laws regulating Electrical wiring, and Aignature ze r resent ti es of this County to enter upon nti pro ray�or inspection purposes. SEE REVERSE POE! EXPLANATORY LANGUAGE ittee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1205030054 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: ITR: 6561 IT: 624 BL: .001 5839 TEMPLE CITY BL I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:I TEMP CA 917802113 ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: LAS TUNAS 18587-015-010 IA1 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, Cl I IK1 SIGNS, OUTLINE LGT 1.00 SIG 38.90 [TENANT: I TOTAL FEES 66.70 JISSUED ON: PROCESSED BY: PLAN BY: 105/03/12 SR TOWNER: TEL. 15839 TEMPLE CITY BL I TEMP 917802113 IDESCRIP ION OF WORK (ELECTRICAL FOR ONE SIGN APPLICANT: TEL. NO: SIGNS EXPRESS (626) 443-3333- 11438 SANTA ANITA ISPECIAL CONDITIONS: I SOUTH EL MONTE 91733 CONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE SIGNS EXPRESS (626) 443-3333- 1438 SANTA ANITA AVE. LIC. NO ]TEMPORARY POWER POLE S. EL MONTE, CA 91733 C45552097 UNDERGROUND CONDUIT I I I I � I ARCHITECT OR ENGINEER: TEL. NO: IUFER GROUND I I LIC. NO: I [ROUGH CONDUIT IROUGH WIRING IMAIN WATER LINE I I [ (PLASTIC YIN METAL YIN (UTILITY COMPANY NOTIFIEDI I [ I I I I I [ I I I I I I [REPORT ID: DPR265 ROUTE TO: BS0508 S 0-A 4-31 YM APPLICATION FOR PERMIT DEPARTMENT OF MM MING AND SAFETY ,.%,,COUNTY OF LOS ANGELES ELEMC WM. J. FOX. cN1Q BNalar�t NATURE OF INSTALLATION DISTRICT NO. GRourZJONE PERMR No. WIRING FIXTURES SERVICE r. I 4 A_ FO r g READY FOR RECEIVED DATE ISSUED RANGE HEATER POWER FIRST INSPECTION AN �� i1GNf MIBCEIEOUf P T FILL IN HEAVILY OUTLINED PORTION ONLY JOB NAME ADDRESS Iwo U ADOR , LOCALITY p NEAREfT CI TE. M. j CROSS MIT.COU / + REG.NO. D EIPIRES Y I NAME DESCRIPTION OF WORK4 MAIL NUMBER OF OUTLETS ON CIRCUITS S ADDRESS LOCATION BY ROOM CITY TE. No. LIGHT OUTN.ETf I S1AI. PLUGS Irlmr. CORRECTIONS RC B O D E I R I G H N �— N �— BR J mc Z FRONT PORCH O CLOfET �— Bella. NO. I . CLOSET APPROVALS IJlf -- DATE INSPEC7O11'll NAME I -- CONDUIT1T �z _ WIRING TO TA FIXTURES NO. OP OUTLETS i POWER NO. OP FIXTURES i UTILITY CO.N 'NO. OR MOTORS N. P. i FINALam 4' ~ NO. OF SIGNS TRANS. i 1 AM THE LEGAL OWN H E LOS ANGELES COUNTY REGISTRATION n / NO. OF RANGES OR MATURE f (' t� �G.!I� MINCENJ�NEOUf i •■EC'MICIAN. 1 AN THE LEGAL OWNER OF THE PROPERTY DESCRIBED PERMIT FEE Zjj ABOVE. TOTAL FES 70 OWN=. oee S-A ia-aa AP* CATION FOR PERWr DEP1 MMM OF BUIL. ING AMD �,' �aicsa.s . COUNTY OF LOS ANGEMS ELECTRIC WM. J. OX H EF ENGINEER Fj! A AME bkfv. r DISTRICT NO. GROUP ZONE PERMITNO. DDRESS C � 79 3��r RECEIVED BY READY FOR DATE ISSUEDITY TEL.NO. �s I E FIRST INSPECTION ��ERT.NO. .t7 Z EXPIRES /Q r 3� ""- n -�U`t'=°� s'f APPLICANT FHL IN IEAVILY OUTLINEHD-PORTION ONLY JOB DESCHE TION OF YORK ADDRESS NUMBER OF OUTLETS ON CIRCUITS LOCALITY LOCATION BY ROOMS NEAREST LIGHT OUTLETS, SW. PLUGS FdT CROSS ST. ° gRCUrr A' B C 13 E F G 'I•'I W, NAME Z MAIL 3- . 3 °�. �^ ADDRESS ^ O CITY TEL-NO. 1 AC,M�THE LEGAL POSSESSOR OF THE A13OVE LOS ANGF�S COUNTY Tl.ICATE F . IFICATION.. R �' - ° ELECTRICIAN. I a THU 1i.mCmL OWNER.OIs'7HE PROPERTY 1]F.SCRIBED AS a OWNER. -CORRECTIONS Z. Q LF ` TLETS S APPROVALS TURES III DATE Ire i PECTOR'S NAME/ NO., TORS H.P. $ CONDUIT NS. TRANS. S 'WIRING • NGES OR HEATERS. FIXTURES EOUS POWER �, PERMIT-FEE rdJ �i '� �+ S IJTILiTYCO.NOTIFIED '