The URL can be used to link to this page

Home My Public Portal About5911 TEMPLE CITY BLVD_Electrical__ ` TEMPLE CITY Y , f '"N-an0Bd APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER 8t11LotNG �^ f! T {O BUILDING AND SAFETY DIVISION ADDRESS' !! / Cr JOHN A.LAMBIE,Couwrsr ENGI mit WILLIAM A.JENSEN.SUP-TOP BUILDING LOCALITY FOR APPLICANTTO FILL IN . NEAREST PERMIT PEES CROSS Sr Ali n ITEM NUMBOWNER ER EACH Ffifi MAIL OUTLETS: $ ADDRESS LIGHTS RECEPT. SW. .10 LIGHTING FIXTURES .to CI ELEC.RANGES CLO.DRYERS ELECTRICIAN WATER HEATERS .80 ADDRESS SO ELEC.SPACE HTRS. DISHWASHERS' CITY ! TEL.NO. GARBAGE DISPOSERS AUTO.. STATE �'�J WASHERS STA.COOKING UNITS ,QS LICENSE NO. 4/ Al MOTORS: OVER INC. H.P. DIST .ICT ROU ONE [Pft?ffCEED Y O %s .28 a �• V_ —' 2 .80 INSPECTI N CARD 2 — a i.00 a t.50 U Is - 80 22.130 06 $O 200 8.00 SIGNS: NO TRANS. Lu NO.LAMPS SERVICE 0.800V 1.00 SERVICE OVER GOOV 8.00 MISC. 0 WIRING PERMIT 3.00 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .80 TOTAL FEE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVAL$ DATA INSPECTOR'S-SIGNATURE : AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAW$ REGULATING CONDUIT !. I { ,-"j 1••�r! ELECTRICAL WIRING. VV / T HEREBY CERTIFY THAT i AN PROPERLY REGISTERED AND/OR WIRING LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT !AM THE GAL NER OF THE ABOVE DESCRIBED RESID POWER f j., SIGNATURE : UTILITY CO.NOTIFIED !!/. OF PERMITT /VXjC $UPERYISINCV��17AUR C/ELECTRICAL ENGINEER ! it 4-��,yntO cASi►Bx [AC05 2 8 8 w NOV 2 0 2 0 2.0 0 9 T [7Vt1II L +- CHTY, MA663-CE806 8-62 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING. BUILDING AND SAFETY DIVISION ADDRESS PI JOHN A. LAMBIE, COUNTY ENGINEER ^7� WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY / ( NEAREST FOR APPLICANT TO FILL IN CROSS ST.. RECEPT. TOTAL NO. EACH FEE OUTLETS FIRST 20 $.20 $ OWNER zc LIGHT - MAIL ADO'L .10 ADDRESS SWITCH. OVER 20 LIGHTING TOTAL FIRST .20 CITY TEL.NO. � 0 FIXTURES A00'L ELECTRICIAN .� ovlEn 20 .10 RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS GARB.DISP. STA.COOK CITY TEL.NO. DISHWASH. AUTO.-WASH. STATE Gl SPACE HTRS. BTA.APP.(Vit.H.P.MAX.) .50 LICENSE NO. _/ cl MOTORS, OVER NOT OVER H.P. DISTRI T NO. GROUP ZONE P CESSED BY O 1 1.00 z 1 s 1.50 I SPECTION RECORD 8 B 2.00 B 1s 2.80 i5 so r 3.00 �. s0 100 5.00• O SIGNS, NO.TRANS. NO.LAMPS O SERVICE 0.600V-NOT OVER 200A 1.00 13 W SERVICE 0.60OV-OVER 200 A. 2.00 H SERVICE OVER 600V 5.00 ? MISC. U PERMIT ISSUING FEE 2.00 Z O SUPPLEMENTARY PERMIT ISSUING FEB 1.00. TOTAL FEE $ UG 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS ...DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY CONDUIT t — I WITH ALL•COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING , 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOB ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT 1 AM THE EGAL ER OF THE ABOVE DESCRIBED RESIDENTIA OPERT POWER SIGNATURE UTILITY CO.NOTIFIED / OF PERMITTEE FINAL - -G' IDATION ARTHUR C. VEIT CK MO CASH SUPERVISING ELECTRICAL ENGINEER 2 8 0 4 G) NOV 21 2 D 4.00- ccl - V � Temple City Chamber of 'Commerce Christmas Lights 76A663-CE606 468 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEERJBUILDING BUILDING AND SAFETY DIVISIONDDRESS 11 Temple City Blvd. ` JOHN A. LAMBIE. COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUIOCALITY EAREST FOR APPLICANT TO FILL INROSS ST. Las Tunas Drive NO. AC RECEPT._ $ $ OWNER Temple City (;hamber of Commerc .MAIL LIGHT TOTAL FIRST 20 .20 ADDRESS $ Te le City Blvd. SWITCH_ OVER 20 .10 CITY Temple City 'TEL. NO. 286-3101 PLAN CHECK LIGHTING �TOTALFIRST 20 .20 APPLICANT FIXTURES OVER 20 .10 ADDRESS RANGE_DRYER—WTR.HTR._ CITY TEL. NO. STA.COOK_DISP._F.A.U._ CONTRACTOR R. P. HOrstmann SPACE HTR.-7—AIR GOND. ADDRESS 4835 N. Ryland Ave. CLOTHES WASH._DISHWASH._ CITY Temple City TEL. NO. FAN—OTHER 11.00 LICENSE IJO. 161053 CLASS. MOTORS,TRANSFORMERS RATING IND. HEATERS, ETC. HP. KW. KVA. I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION SIZE & TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING 1.00 ELECTRICAL WIRING. 0 - 1 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR 1 - 10 3.00 LICENSED AS REQUIRED BY LOS ANGELES TY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OW V-9,, AND I TEND TO 10 - 50 5.00 RESIDE IN, T VE P,ED E ENTIAL ROPERTY. O 50 - 10010.00 SIGNATURE OF PERMITTEE CD 100 - SOO 15.00 SIGNGAS SIGN AND ONE CIRCUIT 3.00 DISTRICT NO. GROUP ZONE PROCESSED BY , TUBE, OR y MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES: SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 09 SERVICE OVER 600 VOLTS OR 200 AMP 5.00 TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP. POWER POLE UNDERSLAB WORK ROUGH CONDUIT PERMIT FEE (SUB TOTAL) WIRING FIXTURES PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED PERMIT ISSUING FEE 2..00 UTILITY CO.NOTIFIED SUPPLEMENTARY PERMIT ISSUING FEEI 1.00 FINAL TOTAL FEE JO E H C. R OHAN SUPERVISING ELECTRICAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION LAP- 7 5 2 9- DSD 5 40 DM nuu .Q EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULEze 3A663-CES06 5-62 APPLICATION FO ELECTRICAL PERMIT T Z, rNi COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY c NEAREST FOR APPLICANT TO FILL IN CROSS ST. RECEPT. TOTAL NO. EACH FEE OUTLETS FIRST 20 $.20 OWNER' 1 LIGHT MAIL ADD'L 10 ADDRESS SWITCH. I_ .lovER 20 TOTAL Y EL O. LIGHTING 1 F1R.sr 20 .20 CITT _• FIXTURES 1 ADD'L 10 ELECTRICIAN OV R 20 G RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS Q 0 GARB.DISP. STA.COOK - tDIIURICT C TEL.NO. DISHWASH. AUTO.-WASH. SPACE HTRS. STA.APP.(Vs H.P.MAX.) ,30 MOTORS, OVER NOT.OVER H.P. ZONE P ESSED BO 1 1.00 t 3 1.50 INSPECTION RECORD 3 s 2.00 6 is 2.50 0 is so 3.00 U s0 100 1 15.00 .' O NO.TRANS. (� 81GN8, NO:LAMPS ;' W �k H SERVICE 0.600V-Nor OVER 200A 1.00 Z SERVICE 0.60OV-OVER 200 A. 2.00 SERVICE OVER 600V 5.00 MISC. :.;. PERMIT ISSUING FEE 2.00 =s SUPPLEMENTARY PERMIT ISSUING FEE 1.00 ' TOTAL FEE C] 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE. INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORIMCT AND AGREE TO COMPLY CONDUIT WITH ALL-COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS A ELES LINTY AND STATE OF _:`. FIXTURES CALIFORNIA OR THAT THE G NER OF THE ABOVE 1" DESCRIBED on THAT R E POWER SIGNATURE UTILITY CO.NOTIFIED OF PERMITT FINAL /-V)SLIDATION ARTHUR C. VEIT I CKf MO CASH SUPERVISING ELECTRICAL ENGINEER \•./ LAU)7.1 .6 2 QI NOV 2 0 2 D 4.0 0- v 78.0863-CE808 8-89 � APPLICATION FOR ELECTRICAL PERMIT �J COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS 6 ( �r JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY I FOR APPLICANT TO FILL IN NEAREST U CROSS ST. NO. EACH FEE $ $ OWNER r RECEIPT._ LIGHT TOTAL FIRST 20 ,20 ADDRESS 'Z C CITY TEL.N0. SWITCH OVER 20 10 PLAN CHECK LIGHTING TOTAL FIRST 20 •20 APPLICANT FIXTURES ) OVER 20 •10 ADDRESS RANGE_DRYER_WTR. HTR. CITY TEL.NO. STA. COOK_DISID._F.A.U. CONTRACTOR SPACE HTR. AIR COND. ADDRESS CLOTHES WASH._DISHWASH. CITY TEL.NO. FAN_OTHER 1.00 LICENSE NO. CLASS. MOTORS,TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION IND. HEATERS, ETC. HP. KW. KVA. AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY SIZE @ TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. 0 - 1 1.00 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF I - 10 3.00 CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF, AND INTEND TO RESIDE IN, THE ABOVE DESCRIBED R IDENTIAL PROPERTY. / 10 — so 5.00 \( SIGNATURE 50 — 100 10.00 OF PERMITTEE 100 — 500 15.00 DI T NO GROUP ZONE RO SSED BY L LI SIGN GAS SIGN AND ONE CIRCUIT 3.00 O v TUBE, OR � MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES: SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 SERVICE OVER 600 VOLTS OR 200 AMP 5.00 TEMP SERVICE, POLE, &APPURTE CES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP. POWER POLE UNDERSLAB WORK ROUGH CONDUIT WIRING PERMIT FEE (SUB TOTAL) FIXTURES POWER AUTHORIZED PLAN CHECK FEE (50% PERMIT FEE) PERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL TOTAL FEE Free waived: JOSEPH C. ROOHAN SUPERVISING ELECTRICAL ENGINEER PLAN CHECK VALIDATIO7cK. � M.o cA PERMIT VALIDATION cQ SEE BACK OF APPLICATION FOR COMPLETE FEE PCHEDULF. �� 76A563-CEB06.10/72 APPLIC TION OR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER 7DRS T BUILDING AND SAFETY DIVISION 77 TY Temple Clt NEAREFOR APPLICANT TO FILL IN S T. Las Tums Dr. OUTLETS NO. EACH FEE FIRM AR C $ $ RECEPT._ MAIL LIGHT TOTAL FIRST 20 25 ADDRESS CITY TEL. NO. SWITCH OVER 20 .10 PLAN CHECK LIGHTING TOTAL FIRST 20 .25 APPLICANT FIXTURES OVER 20 .101 ADDRESS RESIDENTIAL APPLIANCES CITY ,�t vTEL. NO. PERMIT , RANGE DRYER_WTR. HTR. APPLICAN , Cf STA. COOK DISP. F.A.U. ADDRESS ;X, 8 � SPACE HTR, AIR COND. CITY // TEL. N 6 f CLOTHES WASH. DISHWASH. REG NNUM9E ¢ O p CLASS.0/Q FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS 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 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/Op 0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF' CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE y.. 1 - 10 9.00 DESCRIBED RE NTIAL PROPE Y. C PERMITEE v 10 — 50 5.00 SIGNATURE CD 50 — 100 10.00 DISTRICI Np. ED BY LLL 100 — SOO 15.00 cn SIGN, GAS=SC ONE CIRCUIT 5.00 APPROVALS DATE INSPECTOR'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE SERVI CENOT OVER 600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK SERVI CEOVER 600 VOLTS OR 200 AMP 10.00 ROUGH CONDUIT TEMPSERVICE,POLE, &APPURTENANCES 5.00 WIRING TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES Xmas Street TAgb±,jnjZ POWER AUTHORIZED 25 sockets UTILITY CO. NOTIFIED FINAL PERMIT FEE (SUB TOTAL) NOTES: PLAN CHECK FEE PERMIT ISSUING FEE 3.00 TOTAL FEE PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION CK. M.O. CASH DECta Fee Waived• EC 5 4 0 D •C 0 City Manager SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 76A663-CE80611-71 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS 5911Temple Cit Blvd® LOCALITY Tem le Cit T NEARES FOR APPLICANT TO FILL IN CROSS ST. Las Tunas Dro OUTLETS NO. EACH FEE $ $ owNER Tem le Cat Chamber of Commerce RECEPT._ MAIL LIGHT TOTAL FIRST 20 25 ADDRESS CITY TEL. NO. SWITCH OVER 20 .10 PLAN CHECK LIGHTING TOTAL FIRST 20 25 APPLICANT FIXTURES OVER 20 .10 ADDRESS RESIDENTIAL APPLIANCES CITY TE 0. PERMIT RANGE DRYER_WTR. HTR. APPLICAN STA. COOK DISP. F.A.U. ADDRESS,. SPACE HTR. AIR COND. CITY LU EL. NO. CLOTHES WASH. DISHWASH. LICENSE NO. CLASS. FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS 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 IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 - 1 1.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF a CALIFORNIA OR THAT I A LEGAL WNEX. AINTEND TO 1 - 10 3.00 RESIDE IN, THE AB D SORE R PROPERTY. V SIGNATURE 10 - 50 5.00 OF PERMITTEE 50- 100 10.00 b DISTRIC CLASS ZONE ED BY 100 - 500 15.00 L� Luh SIGN, GAS SIGN AND ONE CIRCUIT 5.00 NOTES: ? TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 SERVICENOTOVER 600 VOLTS OR 200AMP 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE SERVICEOVER 600 VOLTS OR200AMP 10.00 TEMP.POWER POLE TEMP SERVICE,POLE,&APPURTENANCES 5.00 UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM 3.00 ROUGH CONDIUT Xmas Street Lighting WIRING 25 sockets FIXTURES POWER AUTHORIZED PERMIT FEE (SUB TOTAL) UTILITY CO. NOTIFIED PLAN CHECK FEE rL 7 PERMIT ISSUING'FEE 3.00• FINAL TOTAL FEE ') PLAN CHECK VALIDATI N CK. M.O. CAS PERMIT VALIDATION CK. M.O. CASH, Fee Waived: Dg� 4 0 D .0 0- 'Clty Manager Chao •- �' SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 76A663-CEB061/70 APPLICATION FOR ELECTRICAL PERMIT LI COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS 75911 Tem le Cit $JOHN A. LAMBIE, COUNTY ENGINEER LOCALITYTemple City COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING NEAREST FOR APPLICANT TO FILL IN CROSS ST. y�S/�T�7 Ts p /� OUTLETS N0. $ACH s FEE OWNER Tl[S1L•E CITY CHAMBER OF C�l L RECEPT._ MAIL LIGHT TOTAL FIRST 20 .20 ADDRESS CITY TEL. NO. SWITCH OVER 20 .10 PLAN CHECK LIGHTING TOTAL FIRST 20 .20 APPLICANT FIXTURES OVER 20 .10 ADDRESS APPLIANCES CITY TEL. NO. PERMIT RANGE DRYER_WTR. HTR. APPLICANT .0 9V-4/1' STA. COOK DISP. F.A.U. ADDRESS r,000jr ,4e *4'_/2 SPACE HTR. AIR COND. CITY 7'0 EL. N0. 3 CLOTHES WASH. DISHWASH. LICENSE NO. OS.3 CLASS.e-19) FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS 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 THAT I AM THE LEGAL OW OF, AND INTEND TO 1 - 10 8.00 RESIDE IN, THE ABOV ESCR IBED ESI�IPROPERTY. SIGNATURE n 10 - 50 5.00 OF PERMITTEE 50 - 100 10.00 DISTRICT NGRO 0 PR C 0 100 - 500 15.00 O 07 I- V SIGN, GAS=SIGN ONE CIRCUIT 3.00 NOTES: a TUBE, OR N MARQUEE ADDITIONAL CIRCUITS 1.00 ? SERVI CENOTOVER 600 VOLTS OR 200 AMP 2.00 APPROVALS DATE INSPECTOR'S SIGNATURE SERVICEOVER 600 VOLTS OR 200 AMP 5.00 TEMP.POWER POLE TEMP SERVICE,POLE,B:APPURTENANCES 3.00 UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM 3.00 ROUGH CONDIUT Xmas Street Lighting WIRING 25 sockets FIXTURES PERMIT FEE (SUB TOTAL) POWER AUTHORIZED PLAN CHECK FEE (50% PERMIT FEE) UTILITY CO. NOTIFIED f PERMIT ISSUING FEE 2.00 FINAL �/ d/�Q � SUPPLEMENTARY PERMIT ISSUING FEE 1.00 JO PH C. ROOHAN TOTAL FEE SUPERVISING ELECTRICAL ENGINEER. PLAN CHECK VALIDATION CK. M.O. • CASH PERMIT VALIDATION CK. M.O. CASH I YAP,,, 6 8 zz LOV18 2 D .00-Fee waived: ity Manager SEE BACK OF APPLICATION.FOR COMPLETE SCHEDULE 76AG63-CES0611/70 APPLICATION FOR ELECTRICAL(PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER FADDRE BUILDING AND SAFETY DIVISION 11 Temple City Blvd. COLEMAN W. JENKINS SUPERINTENDENT OF BUILDING Temple City as Tunas Dr. FOR APPLICANT TO FILL IN OUTLETS N0. EACH FEE77 OWNER TEMPLE CITY CHAMBER OF CORE CE S S RECEPT._ MAIL LIGHT TOTAL FIRST 20 25 ADDRESS CITY TEL,. NO. OVER 20 'SWITCH .10 PLAN CHECK LIGHTING TOTAL FIRST 20 25 APPLICANT OVER 20 ADDRESS FIXTURES f0 APPLIANCES CITY 4 TEL. NO. PERMIT RANGE DRYER_WTR. HTR. APPLI N STA. COOK DISP. F.A.U. ADDRESS Q SPACE HTR. AIR COND.-------., CITY t.,(, TEL. NO.3.3 9-—2,2,3 CLOTHES WASH. DISHWASH. LICENSE NO. CLASS.Ll1;j` FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS 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 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF, AND INTEND TO >_ 1 - 10 3.00 RESIDE IN, THE ABOVE DESC EED FXSIDE TIAL PROPERTY. Q 10 - 50 5.00 SIGNATURE / U OF PERMITTEE G Cr 50 - 100 10.000 DIBTRICT NO. CLASS ZONE OCESS BY 100 - 600 15.00CL -'Z (�,�,�_ w SIGN, GAS SIGN AND ONE CIRCUIT 5.00 NOTES: �6 Z TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 SERVICENOT OVER 600 VOLTS OR 200AMP 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE SERVICEOVER600VOLTSOR200AMP 10.00 TEMP.POWER POLE TEM P SERVI CE,POLE,&APPU RTENAN CES 5.00 UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM 3.00 Xmas Street Lighting ROUGH CONDIUT WIRING 25 sockets FIXTUROP POWER AUTHORIZED PERMIT FEE (SUB TOTAL) UTILITY CO. NOTIFIED PLAN CHECK FEE FINAL PERMIT ISSUING FEE 9.00 JOSEPH C. ROOHAN TOTAL FEE SUPERVISING ELECTRICAL ENGINEER. PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION CK. M.O. CASH FEE WAIVED: ujuo 3 6 4 NOV 2 2 4 0 D .0 0- V itManaer� SEE B CK OF APPLI TION FOR COMPLETE SCHEDULE WORKERS'COMPENSATIONDECLARATION OE-806G (2-80) �APPLICATION FOR, ELE.CTRI;CAL PERMIT ' E,806 I hereby affirm'that I have a certificate of consent to self COUNTY OF LOS ANGELES B AFETY insure,or a certificate of Workers'Compensation Insurance,or a certified copy+thereof(Sec.3800,Lab.C.) I FOR APPLICANT TO FILL IN JOB �. Policy No. Company EACH NO. FEE ADDRESS New Residential Bldgs.&Pools Certified:bopy;is hereby furnished. 1 &2-Family,Sq. Ft. $ $ LOCALITY ❑ iMulti-family Sq. Ft. — .NEAREST Certified copy is filed with the county building inspection CROSS ST 1t department. Residential Swimming Pools OWNER OR FIRM NAME Date Applicant Outlets: Rec.—Light Sw. ADDRESS First 20 -CE TIFICATEO.F.EXEMPTION FROM WORKERS' CITY Tel No.. Total No. Additional /gyp COMPENSATION INStIRANCE M V� PLAN CHECK 0. (This sectionAPPLICANT O. need not be completed it the work involved � by the. permit• is for one hundred dollars ($1.00) or less.) Lighting Fixtures First 20 ADDRESS Additional Total No. fy that in the performance of the:work for which this CITY Tel No. I certi permit is-issued, I shall.not employ person in an Fixed Appliances Not Over 1 HP O p p y an y p y�manner PERMIT so as to become subject to the Wor s' Compensation.Laws. Range_Heater W NT D.W._ APPLICAd Oven _ Dryer_W.M._ ADDRESS rn Date�'� /Applicant Top _FAU —W.H.•_ `, Hood — Fan _Other_ CITYiLO Tel N-12 04om 76 NOTICE TO APPLICANT: If, after making is Certificate of Disp. _Room Air Cond.— LICENS OR ' "� Exemption, you should become subject to the Workers' REG.NUMBER 7Z-5-/ Class _ Compensation provisions of the Labor Code, you must forth- Power Apparatus&Large Appliances DISTRICT NO. PR D BY with comply with such provisions or this permit shall be deemed revoked. Size&Type HP,KW,KVA,or KVAR Up to 1 Incl. d FINAL �" ' ® f LICENSED CONTRACTORS DECLARATION Over 1 to 10"Incl. DATE ,Over 10 to 50 Incl. VALIDATI N' I.hereby affirm that I.am licensed.under provisions of Chapter Over 50 to 100 Inc. FINAL / 9 (commencing with Section.7000)of Division 3:of the.Susi= Over 100 ness and Professions.Code, and my license is in full force and. effect. Services ®®Apw;r—> License Number Lic.Class- �_ l� 0-200 Amp.Under 00 V �- 201-1000•.Amp.Under 600-V Contractor Date $7 Over 1000 Amp,or Over 600 V 7 40 HOME OWNER-BUILDER DECLARATION. Temp.Power Pole&Appurtenances �� I hereby affirm ttiat I am exempt from the Contractor's Sign with One Branch Circuit License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits nese and Professions Code): Misc.Conduits&Conductors I, as owner of the property; will do the work and the Other(See Complete Fee Schedule)— 2 5 2 9,8 A structure is not intended or offered. for said (Section 7044,Business and Professions Code). o o'o o a 2 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency 21- 0 19.5. 0 for the performance,of the work for which this permit is PERMIT FEE (Sub-Total) issued(Sec.3097,Civ.C.). - 0 0 0 1 g 0Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) • 50 0518-81 Lender's Address PERMIT ISSUING FEE I certify that I have read this epplibation 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 au horize representatives of this County to enter upon ` the abo -mentio d property for i action purposes. I SEE'REVERSE FOR.EXPLAN.ATORY.LANGUAGE ignature of P ittee Date