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 '