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Home My Public Portal About5935 TEMPLE CITY BLVD_Electrical__ A663-CU06 4-00 APPLICATION FOR ELECTRI• AL PERMIT ' COUNTY OF LOS ANGELES- DEPARTMENT OF COUNTY ENGINEER eUILDliqG BUILDING AND SAFETY DIVISION ADDRESS �� .41 /J C'! t •�J JOHN A.LAMBIE,COUNTY ENGINEER WILLIAM A.JENSEN. SUP'TOF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS T-.. ''`..'-^-'' --+vC' PERMIT FEES OWNER AA I-)I ,'L--7_Ar -T NUMBER EACH FEE MAIL OUTLETS: J, $ S ADDRESS LIGHTS 3� REcEPT,/' SW.= 5r Ali .to Lr_? . . . LIGHTING FIXTURES .10 CITY r TE NO EL'EC.GANGES . CLO.DRYERS ELECTRICIAN A,e, WATER HEATERS .50 ADDRE,S,S/'Fr' n! r./ f' . ELEC.SPACE HTRS. DISHWASHERS •• CITY /i*+-+i�•!: e,-Y4 TEL.NO. GARBAG8 DISPOSERS AUTO.- �jSTATE WASHERS STA.COOKING UNITS / .25 +z. .,,Ji•' LICENSE NO', rJ MOTORS: OVER INC. H.P. DI§XRICT NO. .GF10UP 'ZONE PROCESSED BY* y ?• .r vs — 2 .so „n INSPECTION RECORD O 2— 15 IJ 1.00 ,3 i! 0 V ILI 5 --- i8 1.80' ri. �f a LL Is — 50 2.50 S d } OC SO — 200 5.00 9 SIGNS: NO TRANS. • OOH. NO.LAMPS - SERVICE 0.800V r.00 SERVICE OVER'SOOV 5.00 MISC. WIRING PERMIT i.00 1 FIXTURE PERMIT 1.00 `F) SUPPLEMENTARY PERMIT ;8O TOTAL FEE v 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIONATURE AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE' LAWS REGULATING _ - ELF=RICAL WIRING. :WIRING I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND'STATE OF FIXTURES. _ CALIFORNIA OR THAT I THE LEGAL OWNER OF THE A Ova ' DESCRIBED RESIDEN IA (9PBRYY. POWER . .UTILITY SIGNATURE / ,' ��• �.y/ ..P/� +)' OF PERMI. FINA / LIDATION ARTHUR C.VETT. • CK MO CASH SUPERVISING ELECTRICAL ENGINEER -< rj rw �o, 76A663 CE60612-58 APPLICATION FOR ELECTRIC PERMIT 4 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION _ADDRESS JOHN A.LAMBIE,COUNTY ENGINEER CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN cRoss sr. PERMIT FEES OWNER ITEM NUMBER EACH FEE OUTLETS: $ s MAIL LIGHTS RECEPT. SW. ,10 ADDRESS LIGHTING FIXTURES .10 CITY TEL.NO. ELEC.RANGES CLO.DRYERS ELECTRICIAN WATER HEATERS .50 ADDRESS ELEC.SPACE HTRS. DISHWASHERS CITY TEL.NO. GARBAGE DISPOSERS AUTO.- STATE WASHERS STA.COOKING UNITS .25 LICENSE NO. MOTORS: OVER INC. H.P. DISTRICT NO. IGROUP ZONE PROCESSED BY O— 1/2 .25 f _ � I / I ,n�, .1•t 1/2- 2 .50 INSPECTION RECORD 2— 5 1.00 5— 15 1.50 15— 50 2.50 50-200 5.00 SIGNS: NO.TRANS. NO. LAMPS SERVICE 0-600V 1.00 SERVICE OVER 600V 5.00 MISC. WIRING PERMIT 1.00 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .50 TOTAL FEE $ 7 j v) APPROVALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT 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 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. ` POWER SIGNATURE UTILITY CO.NOTIFIED OF PERMITTEE FINAL DF VALIDATION-,, ARTHUR C. V EIT, J CK MO CASH SUPERVISING ELECTRICAL ENGINEER 6A668-CE8064-60 APPLICATION FOR ELECTRICAL PERMIT 4 CO)NTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER 7EAREST BUILDING AND SAFETY DIVISION JOHN A.LAMBIE. COUNTY ENGINEER WILLIAM A. JENSEN• SUP'TOF BUILDING FOR APPLICANT TO FILL IN PERMIT FEES OWNER t TE M NUMBER EACH FEE MAIL OUTLETS: $ •i0 $ ADDRESS LIGHTS RECEPT. SW. LIGHTING FIXTURES ,10 CITY TEL.NO. ELEC. RANGES CLO. DRYERS ELECTRICIAN WATER H EATERS .50 ADDRESS '" `'f ELEC.SPACE HTRS. DISHWASHERS CITY TEL.NO. GARBAG5..01SPOSERS AUTO.- STATE . LICENSE NO. WASHERS STA, COOKING UNITS .25 MOTORS: OVER INC. H.P. DIS H 4 CTN ! ,GROUFj ZOI 4 PF O '/z ZOCE5S IIIBY - o✓ /_ �.. 2 ,50 INSPECTION RECORD CL 2 5 1.00 0 5 - 15 1.50 W J_ 15 50 F, 2.50 50 - 200 5.00 SIGNS:/ NO TRANS, Y O NO. LAMPS CG. SERVICE 0.600V 1.00 LU SERVICE OVER 600V 5.00 MISC. WIRING PERMIT 1.00 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT ,50 TOTAL FEE $ 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE 1 CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINA S AND STATE LAWS REGULATING ELECTRICAL WIRING, WIRING I HEREBY CERTIFY T AM ROPERLY REGIS ED /OR LICENSED AS REQUI D LOS NGELES COUN ANg, ATE FIXTURES CALIFORNIA OR T T M T LEG OW Q HE DESCRIBED RESI NT PR POWER SIGNATURE ILITY CO. NOTIFIED OF PERM ITT FINAL VALIDATION ARTHUR C.VEI SUPERVISING ELECTRICAL ENGINEER CK- MO CASH 2 ,.76AS63-CEBOS 10/74 APPLICAT16VFO ELECT M CAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER ADDRES �� (! IV BUILDING AND SAFETY DIVISION LOCALITY e 1 FOR APPLICANT TO FILL IN NEAREST CROSS ST. (i{J OUTLETS NO. EACH FEE OWNER OR `-_^ -I I FIRM NAME 1.(/()yYV!WtZ0 RECEPT._ S $ MAIL FIRST 20 25 ADDRESS LIGHT TOTAL CITY E G C} TEL. NO "(p SWITCH OVER 20 Ip PLAN CHECK LIGHTING TOTAL FIRST 20 .25 APPLICANT FIXTURES OVER 20 10 ADDRESS RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT RANGE-DRYER WTR. HTR. APPLICANT GG `� C 5 STA. COOK DISP. F.A.U. ADDRESS Sit w N/7 SPACE HTR. AIR COND. CITY -TEL. N0. O 36Y CLOTHES WASH. DISHWASH. LICENSE OR C.,�/ REG. NUMBERa7c CLASS. 0 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. 512E & 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 OWNER OF THE ABOVE 1 - 10 3.00 DESCRIBED RES/IDDE N-T II L- PROPERTY 6.7 PERMITEE „/IJ�II Y U � 10 - 50 5.00 SIGNATURE(��/IIIi�I�MMM � 50 - 100 10.00 DISTRICT NO. R SSED BY Cl- 100 100 - 500 15.00 !, Z � V . SIGN, GAS=SIGN ONE CIRCUIT 5.00 APPROVALS DATE INSPECTOR'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE SERVICENOTOVER 600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK SERVICE OVER 600 VOLTS OR 200 AMP 10.00 ROUGH CONDUIT TEMPSERVICE,POLE,&APPURTENANCES 5.00 WIRING TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES JF UTHORIZED CO. NOTIFIED FINAL PERMIT FEE (SUB TOTAL) ^ i �Y' '�PLAN CHECK FEE Gia'p-<q ovc-rPERMIT ISSUING FEE 3.00 f.( ItTOTAL FEE PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH Aye SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE AD - IJI 76A663-CE8061-68 APPLICATION. FOR ELECTRICAL PERMIT COUNTY-OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING �/ y- BUILDING AND SAFETY DIVISION ADDRESS � 3� /(O JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT-OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST.. NO. EACH FEE �y S $ OWNER C. Ci/7/4 E � om RECEPT._ MAIL • LIGHT TOTAL FIRST 20 .20 Cfo ADDRESS SWITCH_ OVER 20 .10 CITY TEL. NO. PLAN CHECK LIGHTING TOTAL FIRST 20 .20 K APPLICANT FIXTURESJOVER 20 .10 U-U ADDRESS RANGE_DRYER—WTR.HTR._ CITY TEL. NO. STA.COOK_DISP.—F.A.U._ CONTRACTOR SPACE HTR. AIR COND. ADDRESS CLOTHES WASH._DISHWASH.— �,/ CITY CiI TEL. NO. —Ow' FAN—OTHER 1.00 LICENSE WO. Z CLASS. U MOTORS,TRANSFORMERS RATING IND. HEATERS, ETC. HP. KW. KVA. .1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION SIZE & TYPE OVER TO AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. , 0 - 1 1.00 1 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR I - 10 3.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO 10 - 505.00 RESIDE IN, THE ABOVE +ESC BED RESIDENTIAL P OPERTY. 0 SIGNATURE . 50 - 100 10.•00 OF PERMITTEE L7 Of 100 - soo 15.00 (STRICT NO. G OUP ZONE P . SSED BY G TUBE,SIGN,GAS ORSIGN,GAS SIGN AND ONE CIRCUIT 3.00 i W O. MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES: Z SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 SERVICE OVER 600 VOLTS.OR 200 AMP 5.00 TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP. POWER POLE UNDERSLAS WORK ROUGH CONDUIT PERMIT FEE (SUB TOTAL) WIRING FIXTURES PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED PERMIT ISSUING FEE 12.00. ]UTILITY CO.NOTIF19D SUPPLEMENTARY PERMIT ISSUING FEE 1.00 IFINAL G, r TOTAL FEE 10 .001 JO PH C. ROOHAN SUPERVISING ELECT ICAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH L&O-5 2 6 IN JUH28 2 D 10.0 0 Q EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE V APPLICATION 1FOR� ELECTRICAL PERMIT 76A.663-CEB06 10/72 ' COUNTY OF LOS ANGELES �^ DEPARTMENT OF COUNTY ENGINEER 7ADRE 3� (� u BUILDING AND SAFETY DIVISION S 'v ITY y� O STFOR APPLICANT TOFILL IN ST. WoAto OUTLETS NO. EACH FEE OWNER OR FIRM NAME wO S$ EWE S S RECEPT._ MAIL 4 LIGHT TOTAL FIRST 20 25 ADDRESS OVER 20 CITY ,Mo b TEL. NO. at- 1s SWITCH___ 10 PLAN CHECK FI .10 RST 20 25 FIXTURES APPLICANT LIGHTING TOTAL OVER 20 ADDRESS RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT RANGE DRYER_WTR. HTR._ APPLICANT \� STA. COOK DISP. F.A.U. ADDRESS YQ8 f O lArti2 SPACE HTR. AIR GOND. CITY o S' EL. NO. I��l� •3LJ $)' CLOTHES WASH. DISHWASH. LICENSE R1/ REG. NUMBER CLASS.C 10 FAN OTHER 1.00 I HEREBY ACKNOWLEDGE THAT 1 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 1 AM PROPERLY REGISTERED AND/OR 0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAI I AM THE LEGAL OWNER OF THE ABOVE 1 - 10 300 DESCR IF.ED RESIDENTIAL PROPERTY. PERMITEE � C.') 10 - 50 5.00 SIGNATURE + • •��i O 50 - 100 IOAO DISTRICT NO. P. CES ED BY W 100 - 500 15.00 , n SIGN, GASSIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTO SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.A0 TEMP. POWER POLE SERVICENOTOVER600VOLTS OR200AMP 3.00 IR DERSLAB WORK SERVICEOVER 600 VOLTS OR 200AMP 10.00 UGH CONDUIT. TEMP SERVICE,POLE,&APPURTENANCES 5.00 RING , 1'I TEMP LIGHT OR RECEPT. SYSTEM 3.00 TURES Q, s .360WER AUTHORIZED ILITY CO. NOTIFIED AL PERMIT FEE (SUB TOTAL) TES: PLAN CHECK FEE PERMIT ISSUING FEE 3.00 TOTAL FEE Co U PLAN CHECK VALIDATION CK. M.0. CASH PERMI V LIDATIONM.O. CASH 6 1 9 r")'JUN tQ G V o.V U nl0 SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE ' 76AG63 SA 8SM SETS 7-48 AYMUTION FOR PEOW DEPARTMENT OF BUMNTG AND sAFM ELECTRIC SIC COUNTY OF LOS ANGELES WM. J. FOX CHIEF ENGINEER _ NAME Electrical Products Corp. DISTRICT NO. GROUP ZONE PERMIT NO./ U ADDRESS 1100 NoMain St, JL r� / CITY L A TEL.NO. �EIVE BY READY FOR DATE ISSUED FIRST INSPECTION W COUNTY LICENSE NO. 556®B EXPIRES 6=30-49 APPLICANT FILL IN HEAV.Y OUTLINED PORnON ONLY JOB DESCRMMON OF WORK ADDRESS 201 North Sunset Blvd, NUMBER OF OUTLETS ON CIRCUITS LOCALITY Temple Cit LOCATION BY ROOMS NEAREST LIGHT OUTLETS SW. PLUGS FIItT CROSS ST. Q CIRCUIT A B C D E F G H le NAME Danish Maid Balae ZMAIL lo: ADDRESS 2409 Southwest Dr. CITY L.& =IQ IML-NO. Ii AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANS_ NT1fIIFICAT OF QUALIFIICAT[ON.. DUBE AC BRIO AL NEN 8 AN THE�C,EC3AlE. OR THE P$R7'Y DESCRIBED ABOVB ' OWNER. 1 3 t an f o C� Q, ®ICii.�3 = tam tan 1= S L F CE HO IZ NT S N G D IS ID o. J Z _O 1p O TOTAL NO. OF OUTLETS s APPROVALS NO. OF FIXTURES Q DATE INSPECTOR'S NAME NO. OF MOTORS H.P. E [FINAL UIT NO. OF SIGNS 2 TRANS. e 2 PONG NO. OF RANGES OR HEATERS RES MISCELLANEOUS !$ R PERMIT FEE Q 1® 00TYCO.NCMFIED AL FEE (.J i•/F /� s DEPARTMENT OF BU"ING AND SAFAPPLICATIOI�T FOR YL�R1Vi1T ETY COUNTY OF LOS ANGELES ELECT-RIC WM. J. FOX CHIEF ENGINEER NAME I ,0 }r'na4V r� ;� DISTRICT NO. GROUP ZONE PERMIT NO. ADDRESS -31 ►'+ .�sl�L:!A,.fi�.�. ,` '�' ,�� ' �-- -'�•Z�Z 1f�� CITY -•�til� TEL.NO. (VED BY READY FOR DATE ISSUED ll //��ee,, � ,�+J FIRST INSPECTION / CO. `�''�'"�/ EXPIRES �`'�,✓` rte /�� ERT.N APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY (DESCRIPTION OF WORD. ADDRESS 2,0 � � :! ,.I tl 11' R'��• NUMBER OF OUTLETS ON CIRCUITS LOCALITYI�;�• L IfILY-tr LOCATION BY ROOMS y NEAREST •yam LIGHT OUTLETS SW. PLUGS ml* CROSS ST. �� N CIRCUIT A I B C D I E F IG JH E NAME &A;4 tr •f/ 4e/ci Z MAIL r TU ADDRESS O CITY TEL.NO. 1 AN THE LEGAL POSSES OF THE ABOVE LOS ANGELES COUNTY CERTIF-17-T OF UALIFICATION.. % �i OF /J ELECTRICIANV/ I AM TM LOML.OWNER 010MO E PROPEkrY DESCRIBED ABOVE OWNER. CORREC�.'IONS, �JlYI.rlJ /�.t_r�•� .rte /�,.. /9'� _ [rOTAL S d� 44 A� j!OUTLETS ' S ` APPROVALS FIXTURESDATE INSPECTOR'S NAME MOTORS H.P. $ D CJ CONDUIT NO. OF SIGNS TRANS. ffi WIRING NO. OF RANGES OR HEATERS $ FIXTURES ^ MISCELLANEOUSffi ,r� POWER PERMIT FEE E 2, UTILITY CO.NOTIFIED TOTAL FEJE FINAL C°/lUv, 7GA663 CE-806R 9/76 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER FADDRESS BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN Y New Residential Bldgs.&Pools EACH NO. FEE CROSS ST. /� 1 &2-Family,Sq.Ft. $ '025 = $ OWNER T. �.r' Multi-family Sq.Ft. .02 — FIRM NAM (4- Cif �p�7E Residential Swimming Pools 20.00 ADD ES 't/)m Outlets:Rec Light_Sw. CITY f�j; JI c Tel.No. First 20 .50 1 PLAN CHECK Total No.- Additional .30 APPLICANT ADDRESS Lighting Fixtures First 20 .50 CITY Tel.No. Additional .30 PERMIT Total No. APPLICANT Fixed Appliances Not Over 1 HP ADDRESSo, Range_Heater_D.W._ CITY s�fin ` Tel.N �� Oven—Dryer_W.M. LICENSE OR Top —FAU —W.H. REG.NUMBER Class. Hood—FOA —Other— I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE Disp. _ Room Air Cond. 2.00 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&Type HP,KW,KVA,or KVAR I HEREBY CERTIFY THAT.I AM.PROPERLY EGISTERED AND/OR LICENSED AS Up t0 1 Ind. 2 00 THE LEGALOWNEUIRED R OF TEL COVE TYS R B TE ONTIALIPROPE RNIA OR THAT I AM Y. Over 1 to 10 Incl. 5.00 m Over 10 to 50 Incl. 10.00 PERMITTEE 0 20.00 SIGNATURE V Over 50 to 100 Inc. � Over, 100 30.00 DISTRICT N PROCESSE Y - Services f 0 g 0-200 Amp.Under 600 V 12.50 INSPECTOR'S Vii 201.1000 Amp.Under 600 V 25.00 APPROVALS DATE SIGNATURE g Over 1000 Amp.or Over 600 V 50.00 TEMP.POWER POLE Temp.Power Pale&Appurtenances 10.00 UNDERSLAB WORK Sign with One Branch Circuit 10.00 ROUGH CONDUIT 2.00 WIRING Additional Sign Branch Circuits Misc.Conduits&Conductors 15.00 FIXTURES Other(See Complete Fee Schedule) POWER AUTHORIZED UTILITY CO.NOTIFIED FINAL PERMIT FEE (Sub-Total) NOTES PLAN CHECKING FEE (One-Fourth Permit Fee) PERMIT ISSUING FEE -56.90 TOTAL FEE /. O e PLAN CHECK VALIDATION CK. M.O. CASH ' PERMIT VALIDATION CK M.O. CASH 0 7.2 fi JUN 1.7 . 2 0 9.0 0 SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE ®s 7&AGW DBS SA 3-SO APPLICATION FOR PERMIT DEPARTMENT OF BUMDING AND SAFETY COUNTY OF LOS ANGELES ,�,� �:F ELECTRIC i WILLIAM J. FOX, CHIEF ENGINEER 7s+�EI�{ ' FOR APPLICANT TO FILL IN �'' DISTRICT_ NO. GROUP ZONE PERMIT NO. ELECTRICIAN + , (z x RECEIVED BY READY FOR DATE ISSUED ADDRESS n ^ FIRST INSPECTION CITY11. TEL.NO. i- yjt - `1(`• COUNTY LICENSE NO. I EXPIRES I- LDING PERMIT FEES "ADFEE DRESS NUMBER EACH LOCALITY n/9 ll t it CI 3� LIGHT OUTLETS NEAREST RECEPTACLES GROSS ST. WALL SWITCHES OWNER /��/./C✓T.�e k �l i\ I'� t^•'Lc.f TOTAL OUTLETS 60 - MAIL ADDRESS r ELEC. RANGES 25 ELEC. HEATERS 25 CITY NO. 'd d FIXTURES 5 ¢ _ 1 HEREBY ACKNOWLEDGE ITHAT 1 HAVE READ THIS (b MISC. APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDJNANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOB NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER NEw MVC. HP OVER INC. EACH OF THE REBIDENTIAh PROPERTY DESCRIBED ABOVE. %2 & LESS 111 .85 SIGNATURE OF I/2 z .50 PERMITTEE z s t.oD INSPECTION RECORD 5 1S 1.50 15 50 8.50 50 800 5.00 800 500 10.00 JQ 600 1000 15.00 Z OVER 1000 80.00 0 M.G. BET/FREq. CHANGER-HP Q' WELDERS.AC-KVA O GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% or CRIB.) movcp MOTORS (75% DF DRIB.) M19C. SIGNS NO. NO.TRANEL APPROVALS NO. NO.LAMPS • FOR EACH PERMIT: DATE INSPECTORS NAME WIRING $1.00 CONDUIT FIXTURES f$1.00 WIRING SUPPLEMENTARY .50 FIXTURES POWER TOTAL FEE �� UTILI4TJrJ FINAL IYIMAIIYIUIYI 76A663-CE60616/72 APPLICATI N F EL AL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER JOB BUILDING AND SAFETY DIVISION ADDRESSEC1 LOCALITY c� NEAREST woo'. v FOR APPLICANT TO FILL IN CROSS ST, W OUTLETS NO. EACH FEE OWNEROR (y1JaYNQrK� $ $ FIRM NAME41 �j RECEPT._ MAIL ADDRESS n EI 'I• n LIGHT TOTAL FIRST 20 25. SWITCH OVER 20 10 PLAN CHECK LIGHTING TOTAL FIRST 20 .25APPLICANT FIXTURES OVER 20 .10 ADDRESS RESIDENTIAL APPLIANCES CITY TEL. NO. PERIT RANGE DRYER_WTR. HTR. APPLI ANT /s El kt eL STA. COOK DI SP. F.A.U. ADDRESS �� `r✓Q /y� SPACE HTR. AIR COND. CITY • O CLOTHES WASH. DISHWASH. LICENSE OR CLASS'.C� REG. NUMBER 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 1 AM PROPERLY REGISTERED AND/OR 0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAI' I AM THE LEGAL OWNER OF T E ABOVE It 1 - 10 3.00 DESCRIBED PERMITEE RE REST ENT PRf�� O V 10 - 50 5.00 SIGNATUp F- 50 - 100 1040 DISTRICT NO. PROC SED BY a 100 - 500 15.00r/? y `/•CJ SIGN, GASSIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTOR'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE SERVICENOTOVER 600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK SERVICE OVER 600 VOLTS.OR 200 AMP 10.001 1 ROUGH CONDUIT TEMP SERVICE,POLE,IN APPURTENANCES 5.00 WIRING TEMP LIGHT OR RECEPT. SYSTEM 9.00 3 FIXTURES POWER AUTHORIZED .UTILITY CO. NOTIFIED FINAL PERMIT FEE (SUB TOTAL) NOTES: PLAN CHECK FEE PERMIT ISSUING FEE 3.00 a Q TOTAL FEE PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION CK. M.0. CASH 6 3 stiiuN 2Q 2 0 6.0 0 AW SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 76AS63-CESOG 9-69 APPLICATION FOR ELECTRICAL PERMIT ch COUNTY OF LOS ANGELES DEPARTMENT.OF COUNTY ENGINEER FEA G .-� BUILDING AND SAFETY DIVISION S 3S e ,�l �, I JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDINGY FOR APPLICANT TO FILL IN T U T. NO. EACH FEE $ $ OWNER RECEIPT._ AMAIL DDRESS LIGHT TOTAL FIRST 20 .20 SWITCH OVER 20 10 CITY T.G TEL.N0. -S1a0 PLAN CHECK LIGHTING TOTALFIRST 20 ,20 APPLICANT FIXTURES } OVER 20 .10 ADDRESS RANGE DRYER_WTR. HTR. CITY TEL.N0. STA. COOK_DISP._F.A.U. CONTRACTOR SPACE HTR. AIR COND. ADDRESS CLOTHES WASH._DISHWASH. CITY TEL.N0. FAN OTHER 1.00 LICENSE NO. CLASS. 10 MOTORS,TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION IND. HEATERS, ETC. HP. KW. KVA. AND STATE THAT THE ABOVE IS 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 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATEOF 1 — 10 3.00 CALIFORNIA OR THAT 1 AM THE L AL OWNER OF, AND INTEND TO t RESIDE IN, THE ABOVE CRI D RESIDENTI OPE TY. 10 — 50 5.00 C SIGNATURE F 50 - 100 10DO OF PERMITTEE u 100 — 500 15.00 DISTRICT NO. GROUP ZON PROCESSED BY IV SIGN GAS SIGN AND ONE CIRCUIT 3.00 �� e TUBW, 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, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP. POWER POLE UNDERSLAB WORK ROUGH CONDUIT WIRING PERMIT FEE (SUB TOTAL) FIXTURES PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED PERMIT ISSUING FEE 2.00UTILITY CO.NOTIFIED SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL TOTAL FEE ,r��y JOSE H C. ROOHAN SUPERVISING ELECTRICAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. As 6 61 JuN3 0 2 D 5.0 0- SEE BACK OF APPLICATInN FOR COMPLETE FEE SCHEDULE �.A B.BB_qQBQB 3_69 APPLICATION FOR ELECTRICAL PERMW COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER n BUILDING AND SAFETY DIVISION BUILDING �r+� Y %T JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITYFOR APPLICANT TO FILL IN NEARES /W CROSS ST. NO. EACH FEE $ $ OWNER RECEIPT. MAIL LIGHT TOTAL FIRST 20 ,20 ADDRESS s SWITCH OVER 20 ,10 CITY TEL.N0. PLAN CHECK LIGHTING TOTAL RST 20 ,20 APPLICANT FIXTURES )—��ov"ER 20 ,10 ADDRESS RANGE_DRYER_WTR. HTR. CITY TEL.NO. STA. COOK_DISP._F.A.U. CONTRACTOR SPACE HTR. AIR COND. ADDRESS g CLOTHES WASH._DISHWASH. CITY — -'LA TEL.N0.. r- FAN_OTHER 1.00 LICENSE N0. 7& :Z CLASS. MOTORS,TRANSFORMERS RATING 1 HEREBY ACKNOWLEDGE THAT 1HAVE READ THIS APPLICATION IND. HEATERS, ETC. HP. KW. KVA. AND STATE THAT THE ABOVE IS 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 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF I - 10 3.00 CALIFORNIA OR THAT i AM THE LEGAL OWNER OF, ND INTEND TO RESIDE IN, THE ABOVE DESCRIBED R DE TIAL OP ERTY. c Jo 10 - 50 5.00 L SIGNATURE O 50 - 100 10A0 OF PERMITTEE 92 100 - 500 15.00 DISTRICT NO GROUP ZONEPROC D t SIGN GAS SIGN AND ONE CIRCUIT 3.00 '� I TUB , OR MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES: SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 SERVICE OVER 600 VOLTS OR 200 AMP [2.00 TEMP SERVICE, POLE, &APPURTENANCES APPROVALS DATE INSPECTOR'S SIGNATURE TEMP. POWER POLE L UNDERSLAB WORK ROUGH CONDUIT WIRING �'j 7- 7Arse PERMIT FEE (SUB TOTAL) FIXTURES POWER AUTHORIZED PLAN CHECK FEE (50% PERMIT FEE) PERMIT ISSUING FEE UTILITY CO.NOTIFIEDSUPPLEMENTARY PERMIT ISSUING FEE FINAL TOTAL FEE ✓� JOSEPH C. ROOHAN SUPERVISING ELECTRICAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH SDa7Yf9PERMIT��gG VALIDATION CK, M.O. CASH .Q{ r,, V,.5 5 4n 26 O 5.00— a SEE BACK OF APPLIfATION EOR COMPLETE FEE SCHEDULE L 7BA583-CE806I1/70 APPLICATION .FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING / ifE� GJr1 A— BUILDING AND SAFETY DIVISION ADDRESS J !! 11 a COLEMAN W. JENKINS SUPERINTENDENT OF BUILDING LOCALITY y .{. FOR APPLICANT TO FILL:INMIIIIIIIIIIIIIIIIIIIIII OROSSSST ? Q 1 OUTLETS NO. EACH I FEE OWNER RECEPT._ $ $ AV C AIL F LIGHT TOTAL FIRST 20 25 DDRESSS' SWITCH OVER 20 ,Ip CIT . �m Iec1 TEL. NO.2X-6-3- /s PLAN CHEC LIGHTING TOTALI FIRST 20 25 APPLICANT OVER 20 ADDRESS FIXTURES_ .IO, APPLIANCES CITY / yy�� +TEEyL.. NO. PERITRANGE DRYER_WTR. HTR. APPLICANT {��/i �I EC1 l� rc STA. COOK DISP. F.A.U. ADDRESS )C). - 0 SPACE HTR. AIR COND. CITY TEL. N0.2oraF CLOTHES WASH.' DISHWASH. LICENSE NO. ,S77 CLASS.C-/ 0 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 04tDINANCES 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 I AM THE LEGAL OWNER OF, AND INTEND TO >. 1 - 10 3,00 RESIDE IN, THE ROVE SCRIBED WAL PROPERTY. IL 0 SIGNATURE O 10 - 50 5.00 OF PERMITTEE _ -` Cd 50 - 100 10.00 DISTRICTNO. CLASS ZONE PROCESSED BY 100 - 500 15.00 5,710 �' W O. SIGN, GAS =SIGN ONE CIRCUIT 5.00 NOTES; jjE 0JbjL z TUBE, OR MARQUEE ADDITIONAL CIRCUITS . 1.00 SERVICENOTOVER 600 VOLTS OR 200AMP 3.00 SERVICE OVER 600 VOLTS OR 200 AMP 10.00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP.POWER POLE TEMP SERVICE,POLE, &APPURTENANCES 5.00 UNDERSLAB WORK TEMP LIGHT OR RECEPT, SYSTEM 3.00 ROUGH CONDIUT WIRING n--2-1 -71r FIXTURES PERMI`f FEE (SUB TOTAL) POWER AUTHORI71ED UTILITY CO. NOTIFIED PLAN CHECK FEE y FINAL / PERMIT ISSUING FEE 3.00 3 Qj JO ROOHAN . TOTAL FEE �.�p SUP RVI ING ELECT. AL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VAL�I TON' CK. M.0. CASH 6.5 '1 s;s 12 2 'D 6.0 0' SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 76A668 CH 806R 10/77 APPLICATION FOR ELECTRICAL'PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER ADDRESS 5935 N. Temple City Blvd, BUILDING AND SAFETY DIVISION p FOR APPLICANT TO FILL IN LOCALITY Templer City New Residential Bldgs.&Pools EACH NO. FEE CROSS STWO:rkmam . 1 &2-Family,Sq.Ft. $ .025 — $ OWNER OR 02 _ ORP_C._ Republican Womens 01. 1 b. Multi-family Sq.Ft. FIRM NAM Residential Swimming Pools 25.00 MAILSS 8 ADDRES `t0, N. Camellia AVe., Outlets:Rec Light_Sw. CITY Temple: City Tel.No. 917801 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 Dales Electric Fixed Appliances Not Over 1 HP ADDRESS 1668 San Dia Range_Heater_D.W. CITYWest COVi17:a Tel.No338-8202. Oven_Dryer_W.M. LICENSE OR' 2716-2-1-8- c"1 0 Top —FAU —W.H._ REG.NUMBERClgss. Hood_Fan _Other— P HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE Disp. — 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&Type HP,KW,KVA,or KVAR I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES.COUNTY A STATE OF RNIA OR THAT I AM Up to l Incl. 2.50 THE LEGALOWNE. FT EA DI RESID P Y. Over 1 to 10 Ind. 5.00 C3 Over 10 to 50 Incl. 12.50 PERMITTEE CD Over 50 to 100 Inc. 25.00 SIGNATURE Over 100 40.00 DISTRICT NO. I PROMSED BY nW. Services 15. U C/ z 0.200 Amp.Under 600 V 12.50 1 ECTO 'S 201-1000 Amp.Under 600.V 25.00 APPROVALS DATE GNATURE Over 1000 Amp.or Over 600 V 50.00 'TEMP.POWER POLE Tem Power Pole&A 10.00 JIXTURES NDERSLAB WORK Temp. Appurtenances Sign with One Branch Circuit 10:00 OUGH CONDUIT 2.00' IRING Additional Sign Branch Circuits Misc.Conduits&Conductors 10.00 Other(See Complete Fee Schedule) OWERAUTHORIZED TILITY CO.NOTIFIEDINAL PERMIT FEEFirew=ks: Stand (Sub-Totoll NOTES Tempowary Fireworks.- Stand PLAN CHECKING FEE (One-Fourth Permit Feel Approved By Temple City Counci PERMIT ISSUING FEE $7.00' 7!0. Wired-,, to) Alpha Beta: Pk. . Lot TOTAL FEE �Q Lowe N •s#gn Main Panes. PLAN CHECK VALIDATION CK. M.O. CASH _. BERIIQJT V9LIDA_ION CK. M.O. CASH 00 r O �O -I, Q . O P` 4 O O O U 10 O O IV DZI SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE CH I 7GA663 CIF8061t`10/77 APPLICATION FOR ELECTRICAL PERMIT -a COUNTY OF LOS ANGELES 1 DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION 41 FOR APPLICANTTO FILL IN LOCALITY ,,� Ar C New Residential Bldgs.&Pools EACH NO.. FEE CROSS ST. W� /�/ 1 &2-Family,-Sq.Ft. $ '025 — $ OWNER T. � l Multi-.family Sq.Ft. 02 — FIRM NAME � C 1 Residential Swimming Pools 25.00 MAIL �q C� I ADDRESS TT��++ Outlets:Rec Light_Sw. CITYC�1 Tel.No. 73?/� First 20 50 PLAN CHECK Zd Total No. Additional .30 APPLICANT ADDRESS Lighting Fixtures First 20 .50 CITY Tel.No. Additional . 30 No. 30 APPLICANT A019 Fixed Appliances Not Over 1HP ADDRESS f.0 . J?Q fi +2, Range—Heater_D.W._ CITY CC Tel.No b ^ p Oven_Dryer_W.M. J /� `� �i LICENSE OR �j// �� p Top —FAU —W.H.: "• REG.NUMBER /lode IO 'c-, . 8s Class-c- v Hood—.Fan _other_ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION.AND STATE Disp. _ 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&Type HP,KW,KVA,or KVAR I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS Up to 1 Incl. 2.50 REQ LEGAL OWBY NER OF THANGELA COVE TY AND RISE STATE ID F CALIFORNIA CD Over THAT I AM. Over 1 to 10 Incl. 5.00 � Over 10 to 50 Incl. 12.50 PERMITTEE j CD SIGNATURE Over 50 to 100 Inc. 25.00 Over 100 40.00 DISTRICT NO. ROC ED BY y Services a� 0-200 Amp.Under 600 V 12.50 IN ECTOR'S 201-1000 Amp.Under 600 V 25.00 APPROVALS DATE SI NATURE Over 1000 Amp.or Over 600 V 50.00 ]TEMP.POWER POLE UNDERSLAB WORK Temp.Power Pole&Appurtenances 10.00 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 012 UTILITY CO.NOTIFIED 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.O. CASH PERMIT VALIDATION Cn 4M.0. CASH I .3'7�JUIU 23 2 D �.h- 0.4 0 ©56 SiE BACK OF APPLICATION FOR COMPLETE SCHEDULE COUNTY OF LOS ANGELES - APPLICATION FOR PERM DEPARTMENT OF COUNTY ENGINEER ELECTRIC 1 DIVISION OF BUILDING & SAFETY WILLIAM 1. FOL COUNTY ENGIRM FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRICIAN C ADDRESS f RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION CITY X7TEL. NO Z COUNTY LICENSE NO. EXPIRES 13 PE UM FEES 6�9 NUMBER EACH FEE - LOCALITY LIGHT OUTLETS NEAREST RECEPTACLES CROSS ST. ZZ WALL SWITCHES OWNER TOTAL OUTLETS SC $ MAIL ELEC. RANGES 23 ADDRESS ELEC. HEATERS 25 FIXTURES 5 CITY TEL. NO. MI C. 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS NUMBER OF LIGHT CIRCUITS APPLICATION AND STATE THAT THE ABOVE 1S CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES -NUMBER OF RECEPTACLE clirm AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER NEW MVD. HP oven I lice. EACH OF THE RESIDENTIAL PROP TY DESCRIBED ABOVE. Y2 a LEBB $ .25 - �SIGNATURE OF ` Va 2 .50 PERM17TE 2 5 1.00 II�iSPECTION RECORD 5 15 1.50 15 50 2.50 SO 200 5.00 200 500 10.00 A 500 1000 15.00 a OVER 1000 20.00 ZZ M.G. SET/FREQ. CHANGER-HP a WELDERS:•AC-KVA 0 GENERATORS-KW TRANSFORMERS-KVA TEMP. MOTORS (75% DF oRIG.) MOVED MOTORS (75% OF ORIG.) MISC. SIGNS NO. NO.TRANS. APPROVALS NO. NO. LAMPS I L FOR EACH PERMIT: DATE INSPECTOR'S NAME WIRING $1.00_�OQ CONDUIT --------- FIXTURES $1.00 elf WIRING SUPPLEMENTARY ,90 FIXTURES ,� POWER TOTAL FEE $ 0c; UTILITY CO. NOTIFIED FINAL 79A 668 Dead BA. 4-82 76A663 5A 25M BETS 7-49 APMUTION FOR P FMai DEPARTMEI T OF BUI M(; AND SAFETY ' ��((``�� ``11 COUNTY OF LOS ANGELES Egg�.SEVI6� WM. J.-FOX CHIEF ENGINEER z NAME Ruebel- Xle.Ctrio • -DISTRICT NO. GROUP ZONE PERMIT NO. -s - ®ys ADDRESS - 6. 01 S. Palm St. E-' `3 CITY lha r TEL.NO.AT 2 318 REc�IVED FIRST DY PORION. DATE ISSUED .1 COUNTY t1 W LICENSE NO. EXPIRES 50 r APPLICANT FILL IN HEAVILY; UTLINED PORTION ONLY IDESCHEMON OF WORK JOB 20'1 N. sunset t NUMBER OF OUTLETS ON CIRCUITS LOCALITY., Temple LOCATION BY ROOMS ' NEAREST LOS, Tuna�o LIGHT OUTLETS SW. PLUGS FIXr CROSS ST. CIRCUIT A B C D E F G H N NAME Danish Maid, Bakery,.* ., Z MAIL 201 N. Sunset S.t ADDRESS CITY Temple. TEL.NO. 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGE -COUNTY CERTIFI TE OF Q IFICATIO ' �ELECTRIc1 'k Y AM THR LXGAL OWNER OF THEN PROPERTY DESCRIBED ABOVE v _ OWNER. -1 Bakew Eil CORREMONS SLamr Urcuit 2zl ' 0 o TOTAL -No. OF OUTLETS t f APPROVALS NO. OF FIXTURES S DATE INSPECTOR'S NAME -ANO. OR MOTORS H.P.. CONDUIT. NO. OR SIGNS 2 TRANS.. WIRING_ (� NO. OF RANGES OR HEATERS FIXTURES Gj / MISCELLANEOUS S POWER t PERMIT FEE $ m .b UTILITY CO.NOTIFIED ZgM FEE 0� FINA16 DEPARTMENT OF BUHI.DING AND SAF, 1�rr� riV1•I MK r�r<una�; COUNTY OF LOS ANGELES ELECTRIC WM. J. FOX CHIEF ENGINEER NAME , DISTRICT NO. GROUP ZONE PE�yR y�MIT NO. U ADDRESS ��® n 57- 20:tj REC l BY READY FOR DATE ISSUED CITY L NO. tS � FIRST INSPECTION � 2--d CE O. EXPIRES APPLICANT FILL IN MAVMY OUTLINED PORTION ONLY DESCRIPTION OF WORK ADDRESS NUMBER OF OUTLETS ON CIRCUITS LOCALITY LOCATION BY ROOMS NEAREST LIGHT OU Ism I PLUGS F13ft CROSS ST CIRCUIT' A B C D I E F JG I H IC NAMEki,;ea ' W MAIL ADDRESS ' - O CITY ' TEL NO. 1 AM THE LEGAL POSE R OF THE ABOVE LOS ANO LE6 COUNTY EMIR WE OF U IF ON.. I AM CiR1C1AN. ABOVE THE LEGAL OWNER OF THE PROPERTY DESCRIBED OWNER. Cohn TIONS I A ten ld�e, -lw J — Q Z_ 19 O TOTAL �j NO. OF OUTLETS S APPROVALS 0 1 NO. OF FIXTURES E DATE INSPECTOR'S NAME NO. OF MOTORS H.P. 6 CONDUIT NO. OF SIGNS TRANS. $ WIRING NO. OF RANGES OR HEATERS E FIXTURES M183CELLANEOUS E POWER J PERMIT FEEE UTILITYCO.NOTIFIED il / TOTAL FE RINAL DEPARTMENT OF BUILDING. AND SAFE'1 Y ; ELECTRIC COUNTY OF LOS ANGELES �eLEC�+MIC M. J. FOX. CHIEF ENGINEER NAME y gg ..gy —DISTRICT NO. GROUP ZONE PERMIT NO. ADDRESS 1136C7 .—I'4 7JI /7my DY FOISSUED CITY - TEL.NOJffl El�j� FIRST INSPECTION p ATIC ERS T.NOEXPIRES' �: APPLICANT FILLA 19 VILY OUTLINED PORTION O Y DESCRIPTION OF WORK ADDRESS NUMBER OF OUTLETS ON CIRCUITS LOCALITY , LOCATION BY ROOMSNEAREST LIGHT OUTLETS SW. PLUGS . rl CROSS CIRCUIT A B C D E F G H E NAME a 3 MAIIL ADDRESS 0 CITY TEL.NO. ANG �HE OERT ES OP F TALI ION.IAS l�FM 6 RICIAN. AI Alk BOYE THE LEQJIL OWNER OF THE PROPERTY DESCRIBED a OWNER. � � CORRECTIONS � J Q _Z 17 ' O TOTAL NO. of OuTLETs B APPROVALS NO. OF FIXTURES g:I $ DATE' INSPECTOR'S NAME NO. OR MOTOR. H.P. S CONDUIT NO. OF SIGNS TRANS: $ WIRING NO. OF RANGES OR HEATERS S FIXTURES MISCELLANEOUS S POWER PERMIT FEE s / UTILITY CO.NOTIFIED TOTAL FEE + FINAL -7- oti DB 5-A 4-89 29M APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY ELECTRIC COUNTY OF LOS ANGELES WM J. FOX. CHIEF ENGINEER NATUR"F INSTALLATION DISTRICT NO. GROUP ZONE PERMIT No. WIRING FIXTURES SERVICE 0 � 9 READY FOR RECEIVED BY DATE ISSUED RANGE HEATER POWER __t_!!f FIRST INSPECTION SIGNS MISCELLANEOUS �%`�� `j I e`) APPLICANT FILL IN HEAVILY OUTLINED PORTON ONLY Z JOB a NAME ADDRESS U ADDRESS �� - IC 1a � LOCALITY V !1` � NEAREST / � J CITY ,•/ TEL No. CROSS ST. (i'f�"ci Id COUNTY U' REG. NO. EXPIRES 5: NAME DESCRIPTION OF WORK z MAIL y^; 3 NUMBER OF OUTLETS ON CIRCUITS ADDRESS LOCATION BY ROOMS 0 CITY I LIGHT OUTLETS I SW.I PLUG 6 IPIXT. CORRECTIONS CIRCUIT I A 1 B 1 C I D E FIG H LIVING ROOM y--� � DINING ROOM BRFST. RM. BATH ENT. HALL I -- J a HALL NO. I __ Z FRONT PORCH OUTSIDE KITCHEN �_- SERV. PCH. BORN. NO. �— CLOSET' BDRM. NO. CLOSET I — APPROVALS -I� DATE INSPECTOR'S NAME i I CONDUIT WIRING I TT TOTAL I-I-I I I I FIXTURES �l NO. OF OUTLETS :S e B S n`- I POWER ` NO. OF FIXTURES S r/ UTILITY CO.NOTIFIED /L NO. OF MOTORS I H. P. .� B !5 FINAL I �d{�-,d L'I T 'L NO. OF SIGNS TRANS. $ I AM THE LEGAL OWNER OF THE ABOVE LOS ANGELES COUNTY REGISTRATION NUMBER. NO. OF RANGES OR HEATERS >$ MISCELLANEOUS $ ELECTRICIAN. 1 AM THE LEGAL DINER F THE,PROPE T,Yi�ESCRIBEP PERMIT FEE $ J ABOVE. 7�� ®b �.}d� �j . /�b.0i.'j F%�e`i.@ TOTAL FEE I S I < i "nn !'rr'- r'�"� OWNER. 76A563-CESO6 14-68 APPLICATION FOR ELECTRICAL E IT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING tf BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE. COUNTY ENGINEER COLEMAN fN. JENKINS, SUPERINTENDENT OF 13UILDING LOCALITY calafi-ki Y-77.--,(,, NEAREST CROSS ST dI FOR APPLICANT TO FILL IN O. EAC FEE IP ERM IT ADDRESS LOCALITY NEAREST c7Oss sT, OWNER 21 'v— RECEPT— MAIL S LIGHT TOTAL FIRST 20 .20 ADDRES X &Z el SWITCH TEL: N06 OVER 20 .10 CIT oily PLAN GH Ky f LIGHTING JTCITAL FIRST 20 .20 APPLICANT T� -7 FIXTURES .10 ADDRESS R;NGE—DRYER—WTR.HTR.— CITY TEL. NO. STA.COOK—DISP.—F.A.U.— CONTRACTOR 1/- %�- 7IV SPACE HTR. AIR COND.— ADDRESV' A-4—Y Z "t CLOTHES WASH.—DISHWASH.— clT42d Af C—A,&4'1,A—'TEL. N FAN—OTHER THER ' I.00 LICENSE No., CLASS. MOTORS,TRANSFORMERS RATING IND. HEATERS, ETC. HIP. KW. KVA. IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY SIZE IN TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIR,ING. 0 — 1.00 1 HEREBY CERTIFY THAI—t\AM PWPERLY REGISTERED AND/OR 3.00 LICENSED A$ RIIU.lEo Y LO A LE COUNTY AND STATE.OF I — to CALIFORNIA OR THAT I THE L HER or, AND INTEND TO RESIDE IN, THE A VE E RESIDENTIAL PROPERTY. to — so 15.00 .1.1 COMPLY REGULATING �R 6E LO A LE COUNTY 'OF - Y I T Al THE L HER 0' 0 A 0 IE RESIDENTIAL Ty SIGNATURE. .1 50 - 100 10.00 OF PERMITTEE C" 100 - Soo 15.00 DISTRICT NO. GRO P ZONE P OC SED BY p SIGN,GAS SIGN AND ONE CIRCUIT 3= --w TUBE, OR MARQUEECL. ADDITIONAL CIRCUITS 1.00 NOTES., cn SERVICE SERVM CZ HOT OVER 600 VOLTS OR 200 AMP 2.00 SERVICE OVER 600 VOLTS OR 200 AMP 5.00 TEMP SERVICE, POLE, &APPURTENANCES 3.001 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP. POWER POLE UNDERSLAB WORK ROUGH CONDUIT WIRING PERMIT FEE (SUB TOTAL). FIXTURES PLAN CHECK FEE (SO% PERMIT FEE) POWER AUTHORIZED PERMIT ISSUING FEE 2-00 UTILITY CO.NOTIFIED 'ol SUPPLEMENTARY PERMIT ISSUING FEE 1,40 NFINAL TOTAL FEE dJ0tEPA C. R06HAN SUPERVISING ELECT CAL ENGINEER 5 PLAN CHECK VALIDATION CK. M6.0. CASH PERMIT VALIDATION0 I.Q.0CASH -7 D cc, .0 -'�- 0 5 iE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE OBSAPPLYCA'IIION FOR PERMIT DEPARTMENT OF BUILDING AND SAE= COUNTY OF LOS ANGELES ELECTRICWM. J. FOX CHIEF ENGINEER a NAME Keeley Electric 'Coe Inc. DISTRICT NO, GROUP ZONE PERMIT NO. U ADDRE88315 E. Whittier Blvde s~ //// ✓ ~ CITY Q TEL.NO.G4�220 RECEIVED BY READY FOR DATE ISSUED I / r ,r FIRST INSPECTION /- �� W CERT.NO. 245®A COUNTY EXPIRES 1 3147 y//Ly ✓7C7 �f APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY JOB DESCRIPTION OF WORK DDRESS 1 6 5I-JV.1 -A 1 Bea eS P '_Y �ill V LD NUMBER OF OUTLETS ON CIRCUITS LOCALITY L ni �/1 LOCATION BY ROOMS NEAREST LIGHT OUTLETS SW. PLUGS FIXT CROSS ST. C_71&,A1 J.S- tl V CIRCUPI' A B C D E F Jr. H N NAM 1 ,5`T 1� IVa�9 hLp �9-C�u l=1 MAIL 1 ADDRESS `, 1177AM. f JI VP at O CITY *) /,A TEL.NO. 1 AM THE LEGAL POSSESSOItI OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE/((O��F QU FICATI,(ON..^. ti LCL� N/I �L C•f:,��r� ELECTRICIAN. I AM TM LEGAL OWNER OF TAX PRoPFItTY DF-Sc ABOVX OWNER. CORRECTIONS J — Q Z_ [7 ' E O bOF S ffi APPROVALS ES ffi DATE INSPECTOR'S NAME r NO. OF MOTORS H.P. ffi CONDUIT NO. OF SIGNS TRANS. $ WIRING NO. OF RANGES OR HEATERS ffi FIXTURES MISCELLANEOUS ffi POWER PERMIT FEE ffi (f ® UTILITY CO.NOTIFIED TOTAL FEE 1 FINAL O t `E '(fi/n' APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN JOB /— New Resideritial Bldgs.&Pools EACH NO, FEE ADDRESS.. 1&2--Family,Sq.Ft. $ .025 — $ LOCALITYC ' .Multi-fam'ilySq.Ft. •02 — NEAREST jf y o �,9 25.00. CROSS ST. GN V Res[dential Swimming,Pools OWNER OR r•- FIRMNAME .G Outlets:Rec Light Sw. MAIL E/ 'First 20 •50 ADDRE S. qQ Total No. Additional' .30 CITY E.C' Tel.'N PLAN CHECK APPLICANT Lighting.Fixtures First 20 .50 ADDRESS Additional ..30 Toto)No. CITY r TeL No. Fixed Appliances Not Over 1 HP PERMIT APPLICANT El 1 i L Range_Heater_D.W. Oven_ ADDRESSDryer_W.M. Top. _FAU _.W.H..— CITY (rfA/b}_ Tel._No,• 3 - . Hood Fan —Other—. LICENSE.OR / Disp._Room Air Cond. 2.50 REG;,N.UMBER 2 .(7 Closs.cl.0 I HEREBY.ACKNOWLEDGE THAT I HAVE READ THIS APPLICA- Power Apparatus&L-arge Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY'ORDINANCES AND 'STATE LAWS' Size&Type HP,K.W;KVA,or KVAR 2.50 REGULATING ELECTRICAL WIRING. � Up to 1 Incl (:,HEREBY CERTIFY THAT I'AM PROPERLY REGISTERED AND/OR ty Over 11to 10 Incl. 5:00 LICENSED:AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF p3 Over•10 to 50 Incl. 12.50 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF.THE ABOVE __. 25.00 DESCRIBED RESIDETIAL ROPE T C Over 50 to 100 Inc. PERMITEE & /� Over 100 40:00 SIGNATURE V5 Services, 'DISTRICT'DISTRICT NO.' "• PROCESSED 13YK " v 0-200 Amp.Under 600 V 12.50 i f/ 201-1000'Amp. Under 600 V 25.00Over 1000 Amp.or Over'60.0 V 50.00 ' Z Temp.Power Pole&Appurtenances 10.00 Sign with One Branch-Circuit 10.00 t o Additional Sign Branch Circuits 2'00 INSPECTION > 0 7.8 5 A INFORMATION Misc.Conduits.8 Conductors 10:00 ON REVERSE _ # o 0 0 0 o 2 Ot er iSee Compl to Fie Schedule) ' SIDE Z z o o 1 GOOg PERMIT FEE (Sub-Total) 061 '.6-80 PLAN CHECKING.FEE- (One-Fourth Permit Feel _ 'O PERMIT ISSUING FEE $7.00 TOTAL FEE INSPECTI FINALE D W date: F�� By C«ww� as 762p53.CE0051/70 APPLICATION OR ELE ICAL PERMIT u COUNTY OF LOS ANGELES �, n DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS SUPERINTENDENT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. CI U OUTLETS NO. EA H FEE owNE .C• ,lQ�/�h, 6[/ONtE/�f' vb RECEPT._ $ $ DDRESS 6� �Ji// LIGHT TOTAL FIRST 20 .20 OVER 20 CITY g- C( TEL. NO -3!n T- SWITCH_ Ip PLAN CHECK LIGHTINGTOTAL FIRST 20 2p APPLICANT FIXTURES OVER 20 ADDRESS •10 APPLIANCES CITY TELj No, PRMIT RANGE DRYER_WTR. HTR. APPLICANT AElq C STA. COOK DISP. F.A.U. ADDRESS t2LAV04-1cx'4 V SPACE HTR. AIR COND. CITY M 0'AA&WQf EL. NO,;Lt-JAMI CLOTHES WASH. DISHWASH. LICENSE N0. Zf CLASS.0 0 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, TRAN9FORMER9 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 OWNER OF, AND INTEND TO 1 - 10 3.00 RESIDE IN, THE ABOVE DES IPED RE 9 L PROPERTY. O. SIGNATURE 0 10 - 50 5.00 OF PERMITTEE' 'SYS V 50 - 100 10.00 IY ____ADISTRICTNO. ICLASO 1GROUFa,lZONE RO E SED BY 0 100 - 500 15.00 Q C-L SIGN, GAS SIGN AND ONE CIRCUIT 3.00 NOTES; h TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 ? SERVI CENOT OVER 600 VOLTS OR 200 AMP 2.00 APPROVALS DATE INSPECTOR'S SIGNATURE SERVI CE OVER 600 VOLTS OR 200 AMP 5.00 TEMP.POWER POLE TEMP SERVICE,POLE,&APPURTENANCES UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM 3.00 n ROUGH CONDI UT WIRING PERMIT FEE (SUB TOTAL) FIXTURES PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED UTILITY CO. NOTIFIED PERMIT ISSUING FEE 2.00 FINAL SUPPLEMENTARY PERMIT ISSUING FEE 1.00 JOSIEPK C. R0014AN TOTAL FEE jVISING ELE L ENGINEEP. PLAN CHECK VALIDATION CK. M.O. CASH PERMATION CK. M.O. CASH 8 8 473 JUIN 27 2 D 6.0 0- 0. SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE RKERS'COMPENSATION`DECLARATION CE.80 G (280) A.PPLI.CATIO:N� FOR EIEC PER,MIT.Coog—: r1ihereby'affirm that d. have 'a certificate of consent: tb self COUNTY OF LOS AN ELES� BUILDING AND SAFETY `) insure, or a certificate of Workers'Compensation Insurance,or �. Y a certified copy thereof(Sec.3800,Lab.G.) I Q E, FOR APPLICANT TO FILL IN JO.B. ( d . Policy No. Company AD ES I� New Residential Bldgs.&'Pools EACH N.O. FEE �� C/' - �Il a Certified copy is hereby furnished. 1.&2-Family,Sq:Ft. $- — $. LOCALITY- Multi-family Sq.ft: — NEAREST ST DCertified copy is filed with.the ty building inspection 'CROSS ST {�,Is department. Residential Swimming Pools OWNER OR I FIRM NAME CI Date ApplicadfM j Outlets•:.Rec._Light Sw, MAIL a .First 20 ADDRESS.. • ellZ9 CERTIFICATE OF EXEMPTION FROM WORKERS' I Total No... Additional;; ` CITY �,' Tel IN ; ' — COMPENSATION INSU.R'ANCE E I d i PLAN CHECK APPLICANT r O (This section need not be completed if the work involved V Lighting Fixtures First 20 b the permit is for .one hundred dollars $.1.00) or less. Z ADDRESS y p ( ) Additional Total'No. p I certify that in the performance of the work for which this i CITY Tel No. Fixed Appliances'Not Over 1 HP :permit is issued,i.shall not'employ.any arson in..any manner PERMIT W so as to become qubject'to the.W. er nation. ws. ( Range_Heater..D.W._ APPLICANT G &�,etklc a Date. /I� a y Ir Oven _'Dryer_W.M._ ADDRESS 6 CO) Z Applicant 4 Top _ FAIJ. _W.Fi. Hood _ Fan _Other_ CITY rjfFXI* &jf**el.No. 3§L NOTICE TO APPLICANT: If,'after making this Certificate of D.isp. .LICENSE Room.Air Cond— (� Exerription, you should become subject to the Workers' REG.NUMBER L+ G Class C Compensation provisions of the Labor Code, you'must forth- i Power.Apparatus:&Large Appliances DISTRICT NO. S D BY t With comply;with such provisions or tliis permit shall be Size.&Type.HP.,KW�KVA,or. KVAR deemed revoked Up to 1 Incl. FINAL Over 1to 10 Incl. DATE _ LIGEN.SED CONTRACTORS DECLARATION '1 VALIDATION ; I _ Over 10'to'50 ncl. . I'hereby affirm that I amlicensed under provisions of Chapter Over 50 to 100 Inc. L 9, (commencing with Section 7000)of Division 3 of the.Busi- ness and Profes"sWions.Code,,and.my•license is in fuOver 1.00Vr"""" ll force and " effect. Servicds 0-200 Amp.Under 600 V License Number- .Lic..Class-�' ' �� 201-1000 Amp..Under 600 V Contractor ate. Over,1000.Amp,or Over 600 V + HOME OWNER=B_UILDER DECLARATION , Temp:Power Pole&Appurtenances • I hereby affirm .that. I am exempt from. the Contractor's. Sign with One Branch Circuit 01 .5 A License Law for the following reason (Section 7031:5, Busi- Additional Sign Branch Circuits Hess and Professions Code): .. ' ° ° ° ° ° 2 Misc.Conduits&Conductors 13 I, as owner, of the property, will do the work and the Other(See Complete Fee Schedule)— 2 ° 'O 1 0,00 structure. is not .intended or offered for sale. (Section 7044,1 Business•and'Professions Code). 1 0.0 0'1. Q CONSTRUCTION LENDING AGENCY I hereby .affirm that there is a construction lending agency 0615-8-1 for the performance of the work for which this permit .is PERMIT FEE issued(Sec.3097,Civ.C.). ;.[Sub-Total) Lender's Name. PLAN•CHECKING FEE (One-Fouifh:Permit Fee) Lender's Address - PERMIT ISSUING FEE I certify that I have read this application and state that the. TOTAL FEE above information is correct.+I agree to comply with all County , r -ordinances and State laws regulating Electrical wiring, and hereby.authorize Zeprespntatives.of this County to enter upon the ab ti. a propert r inspection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE. ` rgnature of P rmittee Date t WORKERS'GOMPENSATIO.N DECLARATION CE-806G (2=80) ESAPPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BULLDING AND SAFETY insure,or a certificate of Workers'Compensation Insurance,of a certified c thereof Sec. S 0,Lab.C I I_� z� ,7�60- W � � FOR APPLICANT TO FILL IN JOB 59.35 r PLS Gi' Policy No. Company /�Li.rr�� EACH NO. FEE ADDRESS '-BL.1f 10 ' New Residential Bldgs.&Pools ' ❑ Certified copy is'hereby furnished. 1 &2-Faniily,Sq. Ft. $ — $ ` LOCALITY L Multi-family Sq.Ft. NEAREST ,! (� Certified copy is filed with the county building inspecti CROSS ST oneu FF AY67 7+� departure t., r Residential Swimming Pools OWNER OR nLp� AA d FIRM NAMEn �/1 Date _�y�% Applicant Outlets.: Rec.LLight Sw. � Y MAIL-S5. J��Al . I•Gl•1I'�i� �i� 8� ' First 20 CERTIFICATE OF EXEMPTION FROM WORKERS' TotalNo. Additional CITY -TQq1P1,67 G/ Tel,No.2&&_ COMPENSATION INSURANCE PLAN CHECK APPLICANT (This section need not be completed if the work involved Lighting Fixtures First 20 V by the permit is for one hundred dollars ($100) or less.) ADDRESS � Total No. Additional W I certify that in the performance of the work for which-this CITY Tel No. permit'is issued, I shall not employ any person in any manner Fixed,APpliances-Not Over 1 HP PERMIT W so as to become subject to the Workers'Compensation Laws: Range_Heater D.W._ APPL'ICANT (7� p, Oven _ Dryer_W.M._ ADDRESS ,�S }6L& R,aC�2. � W Date !Applicant Top _ FAU _W.H.._ Hood _ Fan _Other_ CITY Tel No. 6-'7I If/ NOTICE TO APPLICANT: If, after making this Certificate of Disp. _Room Air Cond.— LICENSE OR )"H C� Exemption, 'you should become subject to the Workers' REG.NUMBER /• /l /�� Class Q/O Compensation provisions of the Labor Code,you must forth- Power Apparatus&Large Appliances DISTRICT NO. OCES ED BY with comply with such provisions or 'this permit shall be ' ©� t deemed revoked. Size&Type HP,KW,KVA,or KVAR Up to 1 Incl. ` • � FINAL Over 1 to 10 Incl. DATE f VALIDATIO LICENSED CONTRACTORS DECLARATION + m Over 10 to 50 Incl. 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 Busi- Over 100. BY ness and Professiotis.Code, and my license.is in full force and effect. - Services License Number Lic.Class C—/ C7 0-200 Amp.Under 600 V 201-1000 Amp.Under 600 V Contractor,/7'L L Date Over 1000 Amp.or Over 600•V HOME OWNER-BUILDER DECLARATION Temp.Power Pole&Appurtenances I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit 1 License Law for the following reason (Section 7031:5, Busi- Additional Sign Branch Circuits ness and Professions Code): ' Misc.Conduits&Conductors ❑ I, air•owner mf the property, will do the work and the Other(See Complete Fee Schedule)— structure is not intended• or offered for sale (Section] 7044,Business and Professions Code). A, CONSTRUCTION LENDING AGENCY `2 7,Q A I hereby affirm that there is a construction lending agency t o o o•o o 2 for the performance of the work for which this permit is PERMIT FEE (Sub-Total) Issued(Sec.3097,Civ.C.). Lender's Name • PLAN CHECKING FEE (One-Fourth Permit Fee) 2 0 o'o47 5 0 Lender's Addressd o 0 a'- 7.5 0 5 � PERMIT ISSUING FEE -0180 I certify that I have read this application and state that the, TOTAL FEE � Z 9' 8— 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 proper, for i pection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE ignature of Permittee at i WORKERS?COMPENSATION DECLARATION j�Eo 120; APPLICATION FOR 'E.L�ECTRIC.AL PERMIT- I hereby affirm that I 'havea certificate of consent to self I� COUNTY OF LOS.ANG LES f BUILDING AND SAFETY insure,or a certificate of Workers'Compensation Insurance,or, f �. a certified copy thereof(Sec.3800,Lab.C.) v' FOR APPLICANT TO.p.ILL 114 SOB Policy No. ADDRES 1 Company .'New Residential Bldgs.&Pools .EACH No... FEE �'.. 0 .Certified copy is:hereby furnished: 1 &2-Family,Sq..Ft.,. $ $ LOCAOTY e,, OMulti-.family Sq. Ft..- NEAREST Certified copy is.filed with the county building inspection CROSS ST Ls. . . department: "Residential Swimming Pools OWNER 0.R FIRM NAME �, Date Applicant, Outlets: Rec.._L'ight Sw•. ' MAIL t�� First 20 ADD AEBB .��t `• CERTIFICATE OF EXEMPTION FROM WORKER'S' Total.No.. Additional- INSURANCE a PLAN CHECKCL APPLICANT (This. section need not be completbd if the work involved V 2 First Fixtures i h by the permit 'is foLighting xtures rst 0r. one 'hundred dollars ($100) 'or less.) LigADDRESS Total No. Additional O I certify that in the performance of the work for which this CITY Tel.-No.. • Fixed Appliances Not Over'1 HR permit'is issued,I.shall not.emplo any person in any manner " PERMIT \� W so as to become subject to.the rk..e. Compensa 'on Law Range_Heater`D..W._ APPLICANT �r�S ` d j Oven _ Dryer_W.M. ADDRESS �( Z' Datpplicant Top _ FAU _'W.H.._ `�� — Hood — Fan _Other._ CIT �•.� Tel No. .. NOTICE TO APPLICANT: If, after making this Certificate of ` Disp. _Room Air Cond,_ LI.CENS.E 0" ��yy Exemption, you should become subject .to the Workers' R.EG:NU.MBE.R. Class Compensation provisions of.the Labor Code;you must forth= c Power Apparatus&Large.Appliances DISTRICT,NO. PRS BY with comply with such provisions or this .permit shall -be deemed revoked. Size&Type Ii P.,KW,kVA,or KVAR Up to 1 Incl. FINAL Over 1 t.5 Incl. DATE VALIDATION LICENSED CONTRACTORS DECLARATION Over 10 to.50 Incl, rBY' � '�Q�J I hereby affirm that I am licensed under provisions of.Chapter Over,50 to 100 Inc, 9 .(commencing with Section 7000)df Division 3 of the Basi- Over 100 ,ness and'Professioris,Code,-and my license is in:full force and effect. Services 0-200 Amp.Under 600 V - License Number Lic.Class 201-1.000 Amp.Under 600 V Contractor .. Date Over 1000 Amp.or Over 6.00 V .. A439.3A ROME OWNER-BUILDER DECLARATION Temp.'Power Pole,&Appurtenances o 0 0 0 0.2 I' hereby affirm that 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 2,b o 1 2,50 ness and Professions Code): Misc.Conduits&Conductors i• ° °'° 25 0 3: I, as owner of the property, will do the,work and the Other'(See Complete Fee•Schedule)— structure 'is not intended or offered for sale (Section 0'6 1 7-82 7044,.:Business and Professions Code). CONSTRUCTION LENDING AGENCYWe I hereby affirm that there is a construction lending agency 4L4 U for the .performance of the work for which this permit is I PERMIT FEE (Sub-Total) issued(Sec.,90.97,Civ,C.). If Lender's.Name (PLAN CHECKING FEE (One-Fourth Permit Fee) Lender's Address. PERMIT ISSUING FEE I certify that I.have read this application and state that the 'TOTAL FEE above information is correct..I agree to comply with all County ordinances an State laws. regulating,Electrical wiring, and Here th r reseritatives o this County to enter upon the b e- o perty fc pection purposes.�y SEE'REVERSE.FOR EXP.LANA7ORY LANGUAGE 6� Signature of Permittee , Date I WORKERS'COMPENSATIONDECLARATION CE-806G.(2-SO) APPLICATION FOR ELECTRICAL PERMIT s E-SO6i I hereby affirm that I have a .certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY insure,or a certificate of Workers'Compensation Insurance,or 7 �� ; a certified copy thereof(Sec.3809,Lab.C.) FOR APPLICANT TO FILL IN JOB Policy No. Company._' New Residential Bidgs.-&Pools EACH NO. FEE ADDRESS Temle' Cit B1 0 Certified copy is.hereby furnished. 1 &2-Family.Sq.Ft. $ — $ LOCALITY Temple. City ❑ Ft. — N Certified copy is filed with the county-building inspection Multi-family Sq. CROSSEARESST T Woodrurr department. Residential.Swimming Pools OWNER O:R FIRM NAMETeCe Republican women Date Applicant Outlets: Rec.-_.Light Sw. MAIL 009 Camellia First 20 ADDRESS CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY Temple City Tel N.. 286— COMPENSATION INSURANCE PLAN CHECK Q_ (This section need not be completed if the work involved APPLICANT 0 Fixtures First 20 Lighting by the permit is for 'one hundred g dollars ($100) or less.) LigADDRESS Total No. Additional 0 I cgrtify that in the performance of the work for which this .Fixed Appliances Not Over 1 HP CITY Tel No. U permit is issued, I shall not employ any person in any manner PERMITD� S ELECTRIC so as to become subject to the:. ork 'Com ens ion L s. Range_Heater D.W. _ APPLICANT aW. Oven _ Dryer_W.M._ ADDRESS 1665' Sandia S.t0 2 Datejiplican. Top _•FAU _W.H. Hood — Fan _Other_ CITYWeSt Covina Tel No.33 —9368 NOTICE TO APPLICANT: a Disp. —Room Air Cond— LICENSE OR C+o I Exemption, you shoul to the orkers' REG.NUMBER Class Compensation provisions t e a r Code,you must forth- Power Apparatus& Large.Appliances DISTRICT O. PROCESSED BY with comply .with such provisions or this permit shall be deemed revoked. Size&Type HP,.KW,KVA,or KVAR Up to 1 Incl. 10 FINAL LICENSED CONTRACTORS DECLARATION Over 1 to 1.0 Incl. DATE —17, VALIDATION. Over 10 to 50 Incl. NAL /+ I hereby affirm that I am.licensed under provisions of'Chapter l Over 50 to 100 Inc. FIFI �vl( 9 (commencing with Section 7000)of Divisionof the Busi- I � :�3 BY ness and Professions.Code, and my-license is in full force and Over 100 effect. Services 0-200 Amp.Under 600 Vs,� � � License Number Lic.Class 201-1000.Amp..Under 600 V. Contractor Date l Over 1000 Amp.or Over 600 V HOME OWNER-BUILDER DECLARATION II Temp.Power Pole&Appurtenances ` 2 7 5 9 A I hereby affirm that I am exempt from the'• Contractor's f Sign with One Branch Circuit ;? 0 0 0 0 0 License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits ness and Professions Code): 2•° ° 1 650 Misc.Conduits&Conductors Ell, as owner of the property, will do.the work and the Other(See Complete Fee Schedule)— c` (% structure is not intended or offered for sale (Section 7044,Business and Professions Code). !?6 1,4—P v CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency Goof ,for the performance of the'work for which this permit is PERMIT FEE (Sub-Total) issued(Sec.3097,Civ.C.). Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) , Lender's Address PERMIT ISSUING FEE I certify that I have read this application and state that the TOTAL FEE r above information is correct.I agree to comply with all.County ' ordinances and tate laws regulating Electrical wiring, and ! here suth z. a sentatfv f this County to enter upon th a ov t e ropert his purposes. l SEE'REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Dae WORKERS'COMPENSATIONDECLARATION CE-806G (2-80) APPLICATION FOR E IECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY �. insure,or a certificate of Workers'Compensation Insurance,or C I a certified copy thereof(Sec.3800,Lab.C.) Alpha Beta Ilk. Last Policy No. Company - FOR APPLICANT TO FILL IN JOB New Residential Bldgs.&Pools EACH NO. FEE ADDRESS No Tem le Cit i ❑ Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ — $ LOCALITY Temple, Cit i Multi-family SqFt — + NEAREST WOAX3;rUff ❑ Certified copy . .is filed with the county building.inspection CROSS ST department. Residential Swimming Pools OWNER OR FIRM NAME To Co Republican As.semb y Date Applicant Outlets: Rec.—Light Sw. MAIL •J First 20 ADDRESSOQ Ne Cam'e'llia CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional ! CITY Temple: City Tel No2.86�3766 } COMPENSATION INSURANCE PLAN CHECK 0' APPLICANT V (This section need not be completed if the work involved' Lighting Fixtures First 20 by the permit is for one hundred dollars ($100) or less.)' g ADDRESS cc Total No. Additional O I certify that in the performance of the work for which'this I CITY Tel No. permit is issued I shall not em to an Fixed Appliances Not Over 1 HP p' p any,person 1n any manner i PERMIT, so as to become subject to the rk 'Compens 'on Laws. I Range_Heater D.W._ APPLICANT Dale li 8. Electrid rn Oven Dryer_W.M._ ADDRESS 6.68 Sandia. Ste Date/( �[Y��+pplican Top _ FAU —W.H. 33 986 -/ , Hood _ Fan —Other CITY eS t �i0.V1Yla Tel No. m NOTICE TO APPLICANT: If, after making this Certificate of Disp. _Room Air Cond— LICENSE OR Exemption, you should become. subject- to the Workers' REG.NUMBEE- 62 Class Compensation provisions of the Labor Code,you must forth- Power Apparatus&.Large Appliances DISTRICT NO. PROC SED BY with comply with such 'provisions or this permit shall be deemed revoked. y Size&Type HP,KW,KVA,or KVAR , , Sj Q JV .�r Up to.1 Incl. FINAL P LICENSED CONTRACTORS DECLARATION Over 1 to 10 Incl. DATE VALIDATION Over 10 to 50 Incl•. 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 Busi- Over 100 BY ness and Professions.Code, and my license is in full force and effect. j ServicesP ,�� \ P / o 0-200 Am Under 600V,' License Numb s Lic.Class � I 201-1000 Amp.Under 600 V Contracto t, Date /E "'r+ — 3 Over 1000 Amp.or Over 600 V HOME OWNER-BUILDER DECLARATION i Temp.Power Pole&Appurtenances I hereby affirm that 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 o 0 0 0 0 Hess and.Professions Code).: Misc.Conduits&Conductors ❑ I, as owner of the property, will do the work and the °` er(See Complete Fee Schedule)— structure is not intended or offered for sale (Section m. opr r „+,, 1 l, N 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.,Civ.C.). PERMIT FEE (Sub-Total) Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) Lender's Address ` PERMIT ISSUING FEE O jo I certify that I have read this application and state that the TOTAL FEE S� above information is correct.I agree to comply with all County ordinances and ,State laws regulating Electrical wiring, and hereby uth 'ze r presentatives of this County to enter upon the e- a do d roperty inspection purposes. . SEE`REVERSE FOR EXPLANATORY LANGUAGE Signa ure of Permittee Date - ��,y'' Ir 11VORIl1`R$'COMPEN.SATIONDECLARATION `� CE-866G 10'8' APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I' '�I a certificate of consent to self insure, or aacertificate of Worker's' Compensation Insurance,.or a certified COUNTY OF LOS ANGELES ( BUILDING AND SAFETY copy thereof(Sea 3600,Lab.C.) Policy No. Company FOR APPLICANT TO FILL IN JOB ❑ Certified copy is hereby furn'ished.. EACH. NO. FEE ADDRESS F New Residential Bldgs.&Pools ❑ Certified copy is filed with;the county building inspection 1 &2-Family,Sq.Ft. $ _ $ LOCALITY department. ' Multi-family'Sq.Ft.. NEARESTCROSS ST. W06dr Date . Applicant Residential Swimming Pools OWNER OR FIRM NAME 2 e CERTIFICATE OF COMPENSATION INSURANCEPTION FROM WORKERS' Outlets:Rec—Light_Sw. ADDRESS ?3S 1• TCMPI C�Fb�tl (This section need not be completed if the work involved by'theFirst 20 4 CITY '. permit Is for one hundred dollars($100)or less.) Total No. Tel.No Additional ' 30 /3 I certify that in the performance of the rk for which'this permit PLAN CHECK f AF.RLICANT is issued, I shall not employ any perso any manner as to; become subject to the Workers'Comp s ion Laws. fighting Fixtures First 20 ADDRESS ` Additional PIZ Total No. CITY No. Date Applicant Fixed Applianever 1 HP -NOTICE TO APPLICANT: If; after.. *,n,..th is .Certificate of PERMIT Exemption,you should become.subject-to the Workers'Compensation Range_ Heater_ D.W. APPLICANT provisions of the,Labor Code,you must forthwith comply with such Oven — Dryer_ W.M._ ADDRESS' a provisions or this permit shall be,.deemed.revoked., l Top FAU — W:H. _ LICENSED CONTRACTORS DECLARATION CITY Tel.No. Hood-- Fan Other_ .I hereby affirm that I am licensed under provisions of, Chapter 0LICENSE OR Disp. Room Air Cond. REG.NUMBER Class. (commencing with Section 7000)of Diviston•3 of the Business'•and Professions Code,and my license-is in,full force and effect. ° DISTRICT NO. PROCESSED BY Power Apparatus&Large Appliances 1 Size&'Type HP,KW,KVA,or KVAR '. �� 'License Number Lic.Class Up to 1 Incl. FINAL Over 1 to 10 Incl. DATE / — 0 • � v !j V IDATION 0 Contractor Date Over 10 to 50 Incl. FIf;JA ' ❑ _I am exempt under Sec! ++ 'Over 50 to 100 Inc. By' W B.&P.C.for this reason I Over 100 " N Services,Swbd.,MCC&Paneiboards Z Date: 0-200 Amp.Under 600 V Signature 201 1000 Amp.Under 600 V Over 1000 Amp.or Over 600 V ❑ 'Exemption for Reg.Maint.Elect. 9-81 9 O A SINGLE FAMILY Temp.Power Pole$Appurtenances # o '0 0 0 0 'L HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 1 hereby affirm that I.am exempt from the Contractor's License Law for the following reason(Section.70 31.5,Business and Professions. Additional Sign Branch Circuits o o 1 1.25 Code): o o o 1 1,250 Vy/, Misc.Conduits&Conductors "as owner of the property,will do the work'and the structure is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) _ 0,26-87 and Professions Code). 1 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.3087, 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 tnformatto is correct.I agree to comply with all County ordinances and.St laws regulating Electrical -wiring, an hereby authorize re.res fives of this my to nter upon t above-mentioned P t for inspe 'o. urposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Si nature o rmittee Date - WORKERS'COMPENSATION DECLARATION a3 DPW 3/87 76M63 APPLICATION FOR ELECTRICAL PERMIT O I heYe�11'bffirm that I have a certificate of consent to self insure, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certified copy thereof(Sec. 3800, Lab. C.) ; Policy No. Company FOR APPLICANT TO FILL IN JOB ❑Certified copy is hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE I ADDRESS 5935 R• MMPLE CITY BL. ❑Certified co ;s filed with the count building inspec- 1 &2-Family, S Ft. $ .— $ LOCALITY TEMPLE CITY PY � Y 9 � P Y. q• tion department. Multi-family Sq. Ft. — I NEAREST Residential Swimming Pools CROSS ST. • WOODRUFF DateWNER OR Applicant FFIIRM NAME PONY BASEBALL INC.. . CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: w. Rec Li ht S _ MAIL A COMPENSATION INSURANCE g I ADDRES9522 E. WEDGEWOOD (This section need not be completed if the work involved by First 20 I CITY TEMPLE CITY Tel. No285-2588 f 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 APPLICANT permit is issued,`I shall not employ any person in any manner 1, so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS. Additional Date I Date 5-25-92 Applicant DALES ELECTRIC Total No. CITY Tel. No. NOTICE TO APPLICANT: If,. aftermaking this Certificate of Fixed Appliances Not Over 1 HP I PERMIT Exemption, you should become subject to the Workers' Range.--_ Heater—D.W. — APPLICATION DA ES ELECTRIC 1 Compensation provisions of the Labor Code, you must forth- Oven — Dryer —W.M.— ADDRESS 9923 E. LIVE OAK I with comply with such provisions or this permit shall be Top — FAU —W.H. — f deemed revoked. Hood — Fan —Other— CITY ' i'M CIS Tel. N0287-8627 LICENSED CONTRACTORS DECLARATION I LICENSE OR Disp. — Room Air Cond. — 0'7618 Class. — I hereby affirm that I am licensed under provisions of Chapter 9 REG. NUMBER 7 C 0 (commencing with Section 7000)of Division 3 of the Business power Apparatus&Large Appliances I DISTRICT NO. P OCESSED BY >- and Professions Code,and my license is in full force and effect. d j Size&Type HP, KW, KVA, or KVAR O I License Number �7618 Lic..Class C-1 f0 Up to 1 Incl. FINAL r DALES ELECTRIC 5-25-92 Over 1,to 10 Incl. DATEVALIDATION Erp Contractor. ate Over 10 to 50 Incl. 0 ❑ _ FINAL I am exempt"under Sec. Over 50 to 100 Inc. :All gY U B.&P.C. for this reason Over 100 l Ow fn Services, Swbd., MCC&Panelboards Z Date: 0-200 Amp. Under 600 V _4 Signature _^ Z!== 201 - 1000.Amp. Under 600 V Over 1000 Amp. oP Over 600-V - ❑ Exemption for Reg. Maint, Elect., ;+ SINGLE FAMILY Temp. Power Pole&Appurtenances ' HOME OWNER-BUILDER DECLARATION 1 I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuits- :. g Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits _ Professions Code): '='r'7 I"•' i- { '❑ 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)_ i - Business and Professions Code). `-i- 1 fDr CONSTRUCTION LENDING AGENCY j . ''.-.'. ;fir-'- UTAND' I hereby affirm that there is,a construction lending agency for I - • : _',; I the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) j (Sec. 3097, Civ. C.). 'PLAN CHECKING FEE `�:+�,'+moi Lender's Name PERMIT ISSUING FEE16 Lender's Address " ` 'q - I certify that I have read this application 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 authorize representatives of this County to enter upon t I \ the a -m ione r party for' pection purposes. I, SEE REVERSE FOR EXPLANATORY LANGUAGE 5-25-92 a Signature of PermitteeDate ,, ®s 1; WORKERS'COMPENSATION DECLARATION '76ft3 DPW 3/87 APPLICATION FOR ELECTRICAL PERMIT O 1 hereby affirm that I have a certificate of consent to self Ce MG insure, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES I DEPT. OF PUBLIC WORKS or a certified copy thereof(Sec. 3600,Lab. C:) Policy No. Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished. [Total w Residential Bldgs. &Pools EACH NO. FEE ADDRESS 5935 N. TEMPLE CITY BL . _ $ LOCALITY TEMPLE CITY Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. _ tion department. Multi-family Sq. Ft. I NEAREST Residential Swimming Pools CROSS ST. WOODRUFF Date Applicant ", WNER OR FFIIRM NAME PONY BASEBALL INC. CERTIFICATE OF EXEMPTION FROM WORKERS' Cutlets: Rec Light Sw.— I MAIL COMPENSATION INSURANCE ADDRESS9578 PENTLAND (This section need not be completed if the work involved byFirst 20 CITY Tel. N the permit Is for•one hundred dollars(:100)or less.) No. Additional TEMPLE CITY �.A. �$6-6 I certify that in the performance of the work for which this PLAN CHECK permit is issued, I shall not employ any person in any manner APPLICANT Li so as to become subject to the Workers'Compensation Laws.. hting Fixtures First 20 ADDRESS Additional Date' 4-23"90Applicant DALES ELECT�IC Total No. I CITY Te(. No. NOTICE TO APPLICANT: If, after making this-Certificate of Fi ed Appliances Not Over 1• HP PERMIT Exemption, you should become subject to the Workers" Range— Heater—D.W. _ APPLICATION DALES ELECTRIC Compensation provisions of the Labor Code, you must forth- Oven — Dryer —W.M.— I ADDRESS 672 ARDILLA. ST. with comply with such provisions or this permit shall be Top — FAU —W.H. — deemed revoked. f Hood — Fan —Other— CITY I A PUENTE 9 CA. Tel. No287-8627 LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm than Iam licensed under provisions of Chapter 9 1 Disp: — Room Air Cond. — REG. NUMBER !•2 6218 class,_C-10 . (commencing.with Section 7000)'of Division 3 of'the Business Pc wer Apparatus&Large Appliances .+ 4INALr , ISTRICT NO. PROCE. D BY >_ and Professions Code,and my license is in full force and.effect. 1 � �� a- Q Size&Type HP, KW, KVA, or KVAR ti 0 License Number �7621 8 Lic. Clads' C'-10' Up to 1 Incl. '+ 0000DALES ELECTRIP 4--23-.90 Over 1 to 10 Incl. iATEVALIDATIONContractor ate Over 10 to 50 Incl'. INAL Iamexempt underSec. Over 50 to 100 Inc. Y.' i r B.&P.C. for this reason i Over 100 d S rvices, Swbd.., MCC&Panelboards + poll. Z CD Date: ' 0-200 Amp. Under 600 V r Z Signature 201 - 1000 Arrip. Under 600 V Over 1000 Amp. or Over 600 V Exemption for Reg. Maint. Elect. ( `_ SINGLE FAMILY Temp. Power Pole&Appurtenances i \ HOME OWNER_BUILDER DECLARATION I herebyaffirm that I am exempt from the Contractor's License Sign.with One Branch Circuit y P I ACCT a s Law for the following reason (Section 7031.5, Business and ditional Sign Branch Circuits Professions Code): I 330 1181.00 ❑ I, as owner of the property, will do the work and theu. AI'isc. Conduits&Conductors 1 ITEMS structure is not intended or offered for sale(Section 7044, Other(See Complete Fee Schedule)_ TOTAL 00 Business and Professions Code). � . CONSTR.0I TEMPORARY,CTION LENDING AGENCY j L. -- CHECKCHECK . I 1 hereby affirm that.there is a construction lending agency for CHANGE .00the performance of the work for which this permit is issued PIRM1T FEE (Sub-Total) fSec. 3097, Civ. C.), I " I P N CHECKING FEE j Lender.'s Name l30Ql—IQI]1 5/23/050P RMIT ISSUING FEE Lender's Address . . 0°1 10016`5 1 AM 8a36 I certify that I have read this. application and state,that the TTAL FEE' 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 ab me ned o erty for 16sp tion purposes. kr SEE REVERSE FOR EXPLANATORY LANGUAGE rjU 4-2 - 0 �, 05 Signafu of, ermitt e � Date , 'UWORKERS'COMPENSATION DECLARATION 76AM3 10/81 I .hereby affirm that,l have a certificate of consent to self CE_eo6G APPLICATION FOR ELECTRICAL PERMIT insure, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES I BUILDING AND SAFETY or a certified copy thereof(Sec.'3800, Lab. C.,) Policy No. ' Company FOR APPLICANT TO FILL IN I JOB Certified copy is hereby furnished. II New Residential Bldgs. &Pools EACH NO. FEE I ADDRESS ,935' TEMPLE CITY BLVD. ❑ Certified copy is filed with the county building inspec- 1 1 &2-Family, Sq. Ft. $ .. — $ I LOCALITY T MPLE CITY' CA.v tion department. Multi-family Sq..Ft. — I 'NEAREST Residential Swimming Pools j CROSS ST. R Date Applicant FIM NA a DgD S COMMITTEE CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec LightMAIL COMPENSATION INSURANCE Sw._ ADDRE BROADWAY ST Y,UKES CH CH (This section need not be completed if the work involved by i Total NoFirst ti 'l CITY °TEMPLE CITY ffAe1. No286-.0163 the permit Is for one hundred dollars(;100)or less.) . Additional I HECK I certify that in the,performance of the work for which this A PPLALICK ANT permit is issued, I shall not employ any person in any miL, so as to become subject to the Work rs'Co pensation Laws. Lighting Fixtures First 20 ADDRESS Additional 6.1"O/A I Total No. I CITY Tel. No. Date CC77 pplieant Fixed Appliances Not Over 1 HP I� PERMIT NOTICE TO APPLICANT: If, after making this ertificat of APPLICANT DALES ELECTRIC Exemption, you should become subject to the Workers' Range_ Heater_D.W. _ I Compensation.provisions of the Labor Code, you must forth- ; Oven —Dryer —W.M._ I ADDRESS - P.O. B0X `t 2. with comply with such provisions or this permit shall be Top _ FAU —W.H. — CITY SAN GABBOL 1291. Ivo2$ —862 deemed revoked. j I 7. 7 LICENSED CONTRACTORS DECLARATION Hood _ Fan _Other— LICENSE OR 1 hereby affirm that I am,licensed under provisions of Chapter 9 Disp. _ Room Air Cond. REG.NUMBER 2. 62 Class.. (�.. 0 (commencing with Section 7000)of.Division 3 of the Business �. Power Apparatus&Large Appliances ,�` DISTRICT NO. P ESS BY i and Professions Code,and my license is in full force and effect. .�� 00 Q gb Size&Type HP, KW., KVA, or.KVAR' I �J r/ . . License Numbe Lic. Class i .Up to 1 Incl. FINAL �' �,./ " 1119 Over 1 to 10 Incl.. DATE _ VALIDATION Contractor Date l��V g ., Over 10 to 50 Incl. �' ❑ FINAL 11111 I am exempt under Sec. Over 50 to 100 Inc. BY f, OU-1 B.&P.C. for this reason Over 100 en Date: Services, Swbd., MCC&Panelboards I , Z 0 -200 Amp. Under 600 V Signature ezv201 - 1000 Amp. Under 600 V !. .Over 1000 Amp. or Over 600 V � Exemption for Reg. Maint. Eject. .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 ' Additional Sign Branch Circuits Low for the following reason (Section 7031.5, Business and Professions Code): i ❑ I, as owner of the property,will do the work and the 'I. Misc. Conduits&Conductors structure is not intended or offered for sale (Section Ot ft(5Feb Schedule)_ , 7044, Business and Professions Code). I �7 2 9.4 A CONSTRUCTION LENDING AGENCY FEMWOM STAND 1 hereby affirm that there is a construction lending agency for I # 0 0 0 0 0 2 the performance of the work for which this permit is issued i PERMIT FEE (Sub-Total) t( 15,50 (Sec. 3097, Civ. C.). I PLAN CHECKING FEE o -'o 15505 Lender's Name I PERMIT ISSUING FEE0622-87 O Lender's Address I certify that I have read this application and state that the't TOTAL FEE /_,!5-5V 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 t ab e- ntioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE p � d I: Signature of ermitt a Date WORKERS COMPENSATION DECLARATIONf 7BA663 10/81 CE-806G APPLICATION FOR ELECTRICAL PERMIT {� I hereby affirm that I have a certificate of.consent to self insure, I Ll or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING,AND SAFETY copy thereof(Sec.3800iLab.C.) III Policy No. Company i FOR.APPLICANT TO'FILL IN ADDRESS 5935 Ne TEMPLE CITY BLVD. ❑ Certified copy is her furnished.. New.Residential Bldgs.&:Pools EACH NO. -FEE ❑ 1 &2-Family,Sq.Ft. $ —Is I LOCALITY PLE CITY CA. Certified copy is filed with the county building inspection NEAREST department. f Multi-family Sq.Ft. — CROSS ST. WOODIUM Date Applicant Residential Swimming Pools F,°M R ORNAMEPONY BASEBALL INC CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:.Roo Light Sw. MAIL ' COMPENSATION INSURANCE �. ADDRESS102.1RANDWICK (This section need.not:be completed if the work Involved by tl�e Firrst.20 Total No. Additional 4 CITY TEMPLE CITY C Tes No _ .6 permit is for one hundred dollars($100).or less.) 1 certify that in the performance of the work for which this per 1 �. PLAN CHECK is issued, I shall not employ any person in any manner so a �' PPPLICANT become subject to the Workers'Cc nsati Lauds. YYY��• Lighting Fixtures First 20 I ADDRESS ++ Additional Date 6—i3;-88 Applica Total No. CITY Tel.No. NOTICE TO APPLICANT: If, after making this. Certificate of Fixed Appliances Not Over 1-HP I PERMIT pange— Heater oW. _ APPLICANT DALES ELECTRIC Exemption,you should become subject to the Workers'Compensation c provisions of the:Labor,Code,you must forthwith comply with'.such Oven _ Dryer_ W.M.— ADDRESS P.0 BDx provisions or this permit shall be deemed revoked. Top _ FAU — W.H. _ 1 CITY SAN GABRIEL CSI Nd�B ..,862 LICENSED CONTRACTORS DECLARATION Hood — Fan Other_ + I hereby affirm that.l am licensed under provisions of Chapter 9 Dis p. Room Air Cond. REGLICE.NU OR (commencing with Section 7000)of Division 3 of the Business and REG.NUMBER 276218 Class Cr Professions Code,and my license is in full'force and effect. Power Apparatus&Large Appliances r DISTRICT NO. //J�x/ PROCESSED_Y�/ Size&Type HP,KW,KVA,or KVAR V 276218 C-10 ,,. Q Licenle Nunwkn� Lic.Class' I Up'to.T Incl. FINAL / O' 6-13-8 Over 1 to 10 Incl. DATEl w VALID ONContractor 007 Over 10 to 50 Incl. �1 ' FINAL ❑ I am exempt under Sec. Over 50 to 100 Inc. BY a B.&P.C.for this on Over 100 Services,Swbd.,MCC&Panelboards Z a 0-200 Amp.Under 600 V IonSignature 201 -1000 Amp.Under 600 V ❑ Over 1.000 Amp.or Over 600 V Exemption for Reg.Maint.Elect. SINGLE FAMILY Temp.Power Pole&Appurtenances HOME OWNER-BUILDER.DECLARATION Sign with One Branch Circuit I`• 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): 0. I,as owner of thea property,will.do the work and the structure . Misc.Conduits&Conductors r �'9 8 a 9 A is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) _ ► #.000002 and Professions Code). O Y, I o 0 3 Q 5 0 CONSTRUCTION LENDING AGENCY TEMPi o 0 o 3 Q 5 0 c=+ I hereby affirm.that there is a construction lending agency for the performance of the work for which this.pejmit is issued(Sec.3097, PERMIT FEE (Sub Total) Civ.C.): 0615-88 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 ancj State laws regulating Electrical wiring, and hereby authorize rilmsentatives of this County to a IVt :r upon the above=mentioned Zigna eforn p . SEE REVERSE FOR EXPLANATORY LANGUAGE A—ture o rmittee Date 1 ; WORKERS'COMPENSATION DECLARATION 76A663 10761 l' " I hereby affirm`yat I have a certificate of conserit to self insure, CE-806G APPLICATION FOR ELECTRICAL PER; IT or a.certificatelo Workers' Compensation Insurance;or a certified COUNTY OF LOS ANGELES �. BUILDING AND SAFETY IBJ copy th of 1Se3800,Lab:•C.) o FOR APPLICANT TO FILL IN i JOBPolicy Certified copy:Is herebyrfurnished I� t ['New•Residential Bldgs.:&Pools '' EA ADDRESS.CH NO.. FEE. .� LOCALITY rtifi,°cJ copy is filed with the county building inspection: 1' 1 &2=Family,Sq.Ft. $ : _ $ C depar''nen't. Multi-family Sq.Ft: I NEAREST � CROSS ST00, . Date. '` Applicant Residential Swimming Pools i. OWNER OR FIRM NAME CEi##.fIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec.—Light=Sw.— j. MAIL COMPENSATION INSURANCE I ADDRESS (This.section need not be completed:If'.the work involved'by'.the I' First 20 ; Total No.. Additional 'CITY Tel:No. permit Is for one hundred dollars $100)or less.) ( PLAN CHECK I certify that in,the performance of the work for.which this:permit f APPLICANT '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 _ ?ppiicant . . A anc „ NOTICE TO APPLICANT: If,, after making this Certificate .of Fixed_.ppli es Not Over,i MP PERMIT Exemption.,you should become subject to the Workers',Corn enation. Range_ Heater. D.W. APPLICANT'' provisions'of the Labor Code,.you must forthwith comply with such Oven _ Dryer— W.M._ ADDRESS provisions.or this permit shall be deemed'revoked. Top _ FAU W.H. _ CITY Tel.No. LICENSED CONTRACTORS-DECLARATION Hood — Fan Other_ 1 hereby affirm that I'''am licensed ender provisions'of Chapter 9 1 D(sp. Room Air Cond. LICENSE OR Class (commencing with.Section 7000).of Division 3 of the Business and I' REG.NUMBER ��. .G .. 'Professions Code,and my license is.in full'force and effect. IN DISTRICT NO. PROC D BY Power. Apparatus&.Large Appliances Size&Type HP,KW.'KVA,or KVAR, e / / p License Numbe Lic.Class. Up to 1 Incl. 1, FINAL (� r. DATE:+ "' LL Over 1.to 1.03ncl.. r VALIDATION Contractor.' Date -• Over 10 to,50 Incl. F Q i aril exempt uniier'Sec. Over 50 to 100 Inc, BY AL L1 B.&P:C.for this reason Over"IOQ ' CLN Services;Swbd.,MCC&Panelboards res Date: �, 0-200 Amp. .Under 800 V Signature I . 201 -'1000 Amp.Under 600 V r Over 1000.Amp.or Over'600 V At. ' . Ezemption'.for Reg.'Maint..Elect. r, "� , SINGLE FAMILY Temp.Power Pole&.Appurtenances ��fy HOME OWNER-BUILDER DECLARATION 1 'Sign.with One Branch Circuit 3307"""'"'"" i�o•.✓V ' I'hereby.affirm that I.am exempt from the Contractor's License Law I. .Branch for the:following reason(Section 7.031.5,Business additional Sign Circuits and Professions II 1. ITEMS : Code): I Tr Misc.Conduits&Conductors F � !` © � ' 0 I,.as owner:of the property;will do the work.and the structure is'not'Intended or offered-for.sale (Section 7044., Business Other(SeeComplete Fee Schedule) _ � [ CHECK 10.50. Q. and Professions Code). ®, CHANGE c00 CONSTRUCTION LENDING AGENCY f ; I hereby affirm that there is a construction,lending:agency for..the IAyW - performance.of the work for which this permit is issued(See:3097, 1 PERMIT FEE (Sub-Total) I, J ��1 Civ.C.). , ma PLAN CHECKING FEE 6497 1 AM 9°o32 Lender's Name 1 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 i and State;laws regulating Electrical wiring, and,hereby authorize representatives of this County'to enter:upon the above-mentioned f party for in ction p "poses. I SEE REVERSE FOR EXPLANATORY LANGUAGE ature of rmit Dat 1 WORKERS'CI hay..Na seri DECLARATION C&863 10/81 APPLICATION .FOR .EiECTRIC'AL PERMIT �'. hereby affirm that I have a certificate of consent to self CE•806G insure,, or a.certificate of Workers'Compensation Insurance; COUNTY OF L.OS ANGELES BU.IL•DING',AND SAFETY or a certified copy thereof(Sec..3800,'Lab. C.) HA BETA PK. LOT Policy.No. Company FOR APPLICANT TO FILL IN 2% f 'OB Certified copy Is•hereby furnished. s New Residenfial Bldgs. &Pools EACH NO. 'FEE ESS 5935 N. TEMPLE DDR CITY Certified copy is:filed with the county,building fnspec- 1 &2-Family, Sq. Ft. $ _ $ I LOCALITY 9TEMPLE CITY tion department. Multi-family Sq. Ft. 1 NEAREST Residential Swimming Pools CROSS ST. 'WOODRUFF- Date Applicant ! �. OWNER OR i FIRM NAME 692 4121 CERTIFICATE OF EXEMPTION FROM WORKERS' M/lfL Outlets: Rec Light Sw._ COMPENSATION INSURANCE I ADDRESS Q E. LAS TUNAS DRs First 20 (This section need not be completed if the work involved byrTotal No. Additional CITY!T�' PLE CITY Tel No. 286-968 the permit Is for one hundred dollars..($100)or less.) r PLAN CHECK 'I certify that in the performance of the work for which this APPLICANT permit is'issued, 1{shall,not employ any person in any.manner, i so as to become subject to the WorkeAs,C pensation aws.' . Lighting Fixtures First 20 ADDRESS • c.� Total No. Additional 6,=1.Q-8 S ` CITY Tel. No. Date ApplicantA Iva PC— NOTICE TO APPLICANT: If; after makin this Certificate of i1 Fixed App.l.iances Not:Over 1 HP PERMIT r 9 APPLICANT.. DALES ELECTRIC Exemption, you should become subject to thWorkers'1% Range_ Heater_D.W. — e Compensation provisions of the Labor Code, you must forth- Oven _•D.ryer _W.M.— ADDRESS P.O. BQX Zi-2 with comply. with.such provisions or'this ;permit shall :be,, Top — FA.0 —W.H. — Q . deemed revoked. ' Hood ._'Fan —Other.._ I' CITY SAN GABRIEL 8469-287-8627 LICENSED CONTRACTORS DECLARATION LICENSE ORr7 I Disp. ..Room Air Cond. REG.NUMBER 'D!.62.18 Class. C-�10. I'hereby affirm that I am licensed.undei provisions.of Chapter 9 i (commencing with Section.7000) of-Division 3 of the Business, DISTRICT NO. PROCESSED BY and-Professions Code,and my license is in full force and effect:�. Pow...P.paratus.8 Large Appliances r I Size&Type HP, KW, KVA, or KVAR' _(,j O C— G License Number 276218 Lic. Class , � _ -Up to 1 Incl. FINAL k) r Over 1 to 10 Incl. DATE VALIDATION Contractor Date I Over 10 to 50 Incl. FIN El I din exempt under Sec. Over 50 to 100 Inc. BY � - B:&P.C. for this reason I Over 100 I' Services, Swbd., MCC&Panelboards °}e' ` 0:-.200 Amp. Under 600 V ` X1,5 Signature 20:1 -1'000 Amp. Under 600 V ❑ IF Over 1000 Amp. or Over 600 V #Exemption for Reg. Maint. Elect. SINGLE FAMILY Temp. Power Pole&AppurtenancesHOMEOWNER-BUILDER DECLARATION Sign with One Branch Circuit1 hereby affirm that:I am exempt from the Contractor's License + Law for the following reason (Section 7031•.5, Business and;. Additional Sign Branch Circuits Professions Code)- ElI, 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.Co.mp(ele FeeSched-u:le)_ Y 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for; 10,01550 the performance of"the work for which this permit is issuedi PERMITTEE (Sub-Total) (Sec. 3097, Civ,.C.). ° 01° 1 5 5 0 M PLAN CHECKING FEE. 0690-85 2 0 $5 Lender's Name. PERMIT ISSUING FEE Lender's Address I:certify that I have read this application and state that the TOTAL FEE J5,. above information is correct. I agree to comply with-all County I ordinances and State laws regulating Electrical wiring, and, . hereby authorize representatives of this County to-enter upon ' the ab - ntio property JJ inspection.purposes.. SEE REVERSE FOR EXPLANATORY LANGUAGE 6410-85 S ature.of Permittee Date ,_ i 1. • WORKERS'COMPENSATION DECLARATION 1 bt-866 ,a,8, APPLICATION FOR ELECTRICAL PERMIT ,I,liereby affirm that I have a certificate of consent to. self insult , CE-aoeG r ar a certitiaate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES l BUILDING AND SAFETY copy thereof(Sea 3800,Lab.C.) l Policy No. ' Company I FOR APPLICANT TO FILL IN i JOB � � L E] Certified copy is hereby furnished. New Residential Bldgs.&Pools EACH NO. FEE ADDRES . $ — $ ! LOCA 1 &2-Family,Sq.Ft. LITY ❑ Certified copy is filed with the county building inspection _ NEAREST department, , Multi-family Sq.Ft. CROSS ST Date Applicant I Residential Swimming Pools OWNER O r I FIRM NAME DID' L , CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec—Light—.Sw.— i , MAIL First20 COMPENSATION INSURANCE I ADDRESS completed if the work involved bt►the (� (This section need not be com ' . p CITY ,NoffR permit is for one hundred dollars($100).or less.) Total No. Additional I G' Tel �'7/ I certify that in the performance of the work for which this permit PLAN HE CK is issued,'I,-shall not employ any person in any manner so as F APPLICANT become subject to.the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS Additional l Total'No. ` CITY Tel..No. Date Applicant , Fixed Appliances Not Over 1 HIP II NOTICE TO APPLICANT, If, after Maki this Cert'Ificate of PERMIT J )AL El .—C„ OZ Exemption,you should become subject to the orkers'Compensation Range_ Heater. D.W. _ APPLICANT provisions of the Labor Code,you,must forthwith comply with such Oven,_ Dryer.— W.M._ II ADDRES provisions or this permit shall be deemed revoked. Top FAU W.H. _ CITY1 T . LICENSED CONTRACTORS DECLARATION i Hood — Fan Other_ .hereby affirm that I am licensed upder provisions of Chapter,9 Disp. Room Air.Gond. I UCENSE OR (commencing with Section 7000).of Division.3 of the Business and REG.NUMBER ,�� Class.C'�-7 O• Professions Code,and my license is in full force and effect. Power Apparatus&Large Appliances. DISTRICT NO. PROCESSED BY Size&Type HP,KW,KVA,or KVAR V •0� Q� License Number y. Li..Class '—� ', Up to 1 Incl. FINAL v Over 1 to 10 Incl. l' DA1 E �dd� VAL ON Contractor Date Over 10 to 50 Incl. FINA . 0 I am exempt under Sec. Over 50 to 100 Inc. BY B.&P.C.for this reason Over 100 i N Services,Swbd.,MCC&Panelboards i Z Date: 0-200 Amp.Under.600 V Signature 201 - 1000 Amp.Under 600 V Over 1000 Amp.or Over 600 V i ❑ Exemption for Reg.Maint:Elect. l 1, SINGLE FAMILY Temp.Power Pole&.Appurtenances �1 # Q HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 1, I o 0 2'5 50 I.hereby affirm thatkl am exempt from the Contractor`s License Law additional Sign Branch Circuitsl' for the following reason(Section 7031.5,Business and Professidns Code): I ° c ° 2 a 5 Q U Misc.Conduits&Conductors 0 51 0"818r ❑ 1,as owner of the property,will do the work and the structure is not intended or offered for sale(Section 7044.,Business . Other(See Complete Fee Schedule)._, ► r and Professions Code). CONSTRUCTION LENDING AGENCY ,hereby affirm that there is a construction lending agency for the ; performance of the work for which this permit is issued(Sec.3097, I 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 j TOTAL FEE o2U r information-is correct.I agree to comply with all County ordinances 4 and State laws regulating Electrical wiring, and hereby authorize i representatives of this County„to enter upon the above-mentioned r property for inspection purpos SEE REVERSE FOR EXPLANATORY LANGUAGE 4�311ffnature oT ittelf Date 4. 1 WORKERS'COMPENSATION DECLARATION CEnss3 �o/a� APPLICATION FOR-ELECTRICAL PERMIT I here CE-BoeG F�„affirm that I have a certificate of consent to self insure, r COUNTY OF LOS ANGELES BUILDING AND SAFETY . "d r;or a_ct.rtificate of Workers'Compensation Insurance, or a certified copy thereof T,,_,,3800;Lab.C.) i ri Policy N9k.•` ` Company FOB APPLICANT TO FILL IN JOB EACH NO. FEE ADDRESS 5935 N. Temple Cit Blvd. ❑ Certified copy'is hereby furnished. I., New Residential Bldgs.&Pools $ _ $ 'LOCALITY Temple City, CA' ❑ t 1 &2=Family,Sq.Ft. — Certified copy is filed with the county building inspection ! NEAREST deliartmenf. Multi-family Sq.Ft. CROSS ST. Woodruff Date Applicant Residential Swimming Pools OVVNER OR FIRM NAME Pony Baseball Tna- CERTIFICATE OF EXEMPTION FROM WORKERS' fOutlets-Rec=Light Sw. . MAIL — — , COMPENSATION INSURANCE ` ADDRESS 10217 Randwl.c3,: First 20• (This section need not be completed if the work involved by the Total No. Additional CITY Temple City CA Tel.No.579-7865 permit is for one hundred dollars($100)or less.) I PLAN CHECK I certify that in the perforinance of the work for which this permit APPLICANT Is issued, I shall not employ any person in any manner to as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS Additional Total No. CITY Tel.No. Date 4-11—R9 -Applicant- T)a3 elrla M ectri-Q I NOTICE TO APPLICANT: If, after making .this Certificate of Fixed Appliances Not Over 1 HP I PERMIT Exemption,you should become subject to the Workers'Compensation r Range—. Heater D.W. _ ' APPLICANT Dales Electric .provisions of the Labor-Code,you must forthwith.comply with such Oven — Dryer— W.M.— I ADDRESS 672 Ardilla :Street provisions or this permit shall be deemed revoked. Top — FAU — W.H. . LICENSED CONTRACTORS DECLARATION, Hood — Fan _: Other_ CITY La Puente Tel.No. 287=8627 1 hereby affirm that I am licensed under provisions of Chapter 9Disp..— 'Room Air Cond. LICENSE OR 27621,8 Clara C- C (commencing with Section 7000)of Division 3 of the Business and C. REG.NUMBER Professions Code,and my license is in full force and effect.. Appliances DISTRICT NO PROC E � .Power Apparatus.&Large Size&Type.HP,KW,KVA,or KVAR 8. License Number276218 Lic.Class r=-1 n Up to 1 Incl, FINAL. Contractor Date —11-.89 Over 1 to 10 Incl. DATE VALIDATION 0: Over 10 to 50 Incl. FINAL ❑ I am exempt under Sec. .Over 50 to 100 Inc.• BY W B.&P:C.for this reason ,. Over 100 N t Services,Swbd.,MCC&Panelboards , Z Date: _ 0-200 Amp.Under 600 V Signature 201- 1000 Amp.Under 600 V ❑ Over'1.0bO Amp.or*Over 600 V . Exemption for Reg.Maint Elect SINGLE FAMILY Temp.Power Pole&Appurtenances C7 ` HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 1 hereby affirm that I am exempt from the.Contractor's License Law +. n for the following reason(Section 7031.5,Business and Professions , Additional Sign Branch Circuits ACCT p Code): 07 15.50 ❑ I,as owner of the roe Misc.Conduits&Conductors property,will.do the work and the structure Other See Complete Fee Schedule 1 ITEMS is not intended or offered for.sale (Section 7044, Business ( Schedule)._ land Professions Code). TOTAL �5 c 50 Fireworks- CONSTRUCTION LENDING AGENCY �'� 15.50 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) , (:HflNjjE .00 Civ.C.). PLAN CHECKING FEE O Lender's Name PERMIT ISSUING FEE ~` 0 m-Qo01 5/man Lender's Addressi / 3295 1 A 4 n° �' 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 - representatives of this County to enter upon the above-mentioned property or,'n ectionpurposes. �� SEE REVERSE FORERY LANPUAME !CJ t Ctlr C[rO a 0 F Sig of ee Date . .p C+ WORKER'S COMPENSATION DECLARATION I20-0019 DPW(12.91) APPLICATION FOR ELECTRICAL PERMIT LI 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.) I ' Policy No. Company FOR APPLICANT TO FILL IN JOB - ADDRESS Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EAC FEE LOCALITY ❑ l 1 &2-Family,Sq.Ft. — $ $ Certified copy is filed with the county building inspection _ NEAREST � department. Multi-family Sq.Ff. CROSS ST. &J . rte{ Date Applicant Residential Swimming Pools ASSESSOR MAP BOOK PAGE PA EL CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER OR f�-in � ti COMPENSATION INSURANCE Outlets:Rec._Light SW. FIRM NAME First 20 MAIL (This section need not be completed If the work involved by.the Total.No. Additional ADDRESS permit 1s for one hundred dollars($100)or less.) I certify that in the performance of the work for which this permit CITY Ie� /�.y-_.� 4�1^ • j Is issued, I shall not employ any person in any manner'so as to PLAN CHECK l become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANT Total No. Additional ADDRESS Date• Applicant RESIDENTIAL APPLIANCES NOT OVER:3 HP. NOTICE TO APPLICANT: If, after making this Certificate. of CITY Tel.No. Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions•of'the Labor Code,you must forthwith comply with suchPERMIT provisidns or this permit shall be deemed revoked. Power Apparatus&Large Appl'iahces APPLICANT LICENSED CONTRACTORS DECLARATION Size&Type HP •KW,KVA,or KAR•- - ADDRESS I hereby affirm that I am licensed under provisions of Chapter 9 e,KOver3 to 10 Incl. (commencing with Section.7000)of Division 3 of the Business and CITY Tel.No.. Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. LICENSE OR Clew. Over 50 t0 100 Incl. .- REG.NUMBER d License Number Lic.Class Over 100 DISTRICT NO. R SSED BY V p Services,Swbd.,MCC&Panelboards , v cc Contractor Date .0-399 Amp.Under 600 V FINAL ❑ 400-1000 Amp.Under 600 V DATE I-- 'Iarn exempt under.Sec. VALIDATION V Over 1000 Amp.or Over 600 V FINALd -B.&P.C.for this reason BRANCH CIRCUIT FEES BY N Date: 1.5A,or 20A,120V,Lighting or Recept. Z_ 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits Exemption for Reg.Mairit.Elect. 15A,20A,20 VV To 277V Lighting Br.Circuits SINGLE FAMILY Temp.Power Pole&Appurtenances 2 HOME OWNER-BUILDER DECLARATION �+.•� t I-hereby affirm that I am exempt from the Contractor's License LAIw Sign with Oqe Branch Circuit �r�;=e 46.90 for the following reason'(Section 7031.5, Business and Professions Additional Sign Branch Circuits U�7 Code): ❑ I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors I ITEMS Is not Intended or offered for sale(Section 7044, Business O or(See Complete Fee Schedule) I 4 ,-� and Professions Code). y- 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 p;�pAr 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 SA9(/9 y SEE REVERSE FOR EXPLANATORY LANGUAGE ; i SIGNATURE OF PERMITTEE-0 DATE , i WORKERS'COMPENSATION DECLARATION 7&MO D 3/87 APPLICATION FOR EL CTRICAL PERMIT Q I hereby affirm that I have a certificate of consent to self insure,, it ficate of.Workers'-Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certified copy thereof(Sec. 3800, Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN .JOB 5935 N TEMPLE' CITY BI, Certified co is hereby furnished. EACH NO. FEE ADDRESS N. • i ❑ PY Y New Residential Bldgs. 8 Pools � Certified co is filed with the count building inspec- 1 &2-Family, S Ft. $ — $ LOCALITY TEMPLE CITY PY Y g P y' •q' � tion department. Multi-family Sq. Ft. NEAREST Date Applicant Residential Swimming Pools j owl ST WOODRUFF OR FIRM NAME PONY BASEBALL INC. CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL COMPENSATION INSURANCE OutRee Light Sw._ i First ADDRESS 6043 N. HART 282-7572 Total (This section need not be completed if the work Involved by Noi CITYT 'MPLE CITY Ckgl. Nr >� the permit is for one hundred dollars($100)or less.) . Additional l ona11 I certifythat in the performance of the work for which this PLAN CHECK P t APPLICANT permit is issued, I shall not employ any person in any manner { so as to become subject to the Workers'Compensation Lbws. Lighting Fixtures First.20 ADDRESS 8®91 DALES ELECTRIC Additional « Total No. CITY Tel. No. Date � Applicant ! NOTICE TO APPLICANT: If, after.making this Certificate of Fixed Appliances Not Over 1 HP PERMIT( APPLICATIONDALES ELECTRIC Exemption, you should become subject to the Workers' Range— Heater—D.W. — Compensation provisions of the Labor Code, you must forth- Oven — Dryer —W.M.— ADDRESS9923 E• LIVE OAK with comply with such provisions or :this permit shall be Top — FAIL —W.H. — deemed revoked. HoodFan —Other— CITY TEMPLE CITY, CAal. No287-8627 • : — i LICENSED CONTRACTORS DECLARATION LICENSE OR Disp. _ Room Air Cond. — �' 27618 Class. C-10 NUMBER (commencing with Section 7Z)00):of Division 3 of the Business Power Apparatus&Large Appliances DISTRICT NO. P O ESSED BY >_ and Professions Code,and,my license is in full.force and'effect. tl Size&Type HP, KW, KVA,.or KVAR � [ '�=�'= O License Number 27621$• Lic. Class C-10 f U Up to 1 Incl. FINAL n DALES ELECTRIC 5-8-91 Over 1 to l0,lncl. ; DATE /1 VALIDATION 0 Contractor ate Over 10.to.50 Incl. I FINAL VVV U ❑ I am exempt under Sec. Over 50 to 100 Inc. BY W BAP.C. for this reason Over 100 a, Z Services, Swbd., MCC&Ponelboards 41 Z 0-200 Amp. Under 600 V , Signature 201 1000 Amp: Under 600 V j Over 1000 Amp..or Over 600 V Exemption fo_r Reg. Maint. Elect. SINGLE FAMILY Tem Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION p' :r � Sign with One Branch Circuit i fls.y. i o s I I hereby affirm that I am exempt from'the Contractor's License __- Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits ,,.1 ; 'j . Professions Code): • • .44-.jjj r• I Misc. Conduits 8 Conductors j 1 1`rE�= ❑ I, as owner of the property, will do the work and the tai structure is not intended or offered for sale(Section 7044, Other.(See Complete Fee Scheduled ® !{E; Business and Professions Code). , TEMPORKRY j� L �e CONSTRUCTION LENDING AGENCY 0 (-,HEC.-,r =CI`I CITAM 1 1 hereby affirm that there is a construction.lending agency for I CHANGE /.. the performance of the work for which.this permit is issued PERMIT FEE (Sub-Total;) I 1 (Sec. 3097, Civ. C.). PLAN CHECKING FEE LI(iSJti– I�ISJ PERMIT ISSUING FEEJ? 1 } Lender's Name I ` I Lender's Address 1 certify that I have read this application and state that the TOTAL FEE ' above information is correct. I agree to comply with all County Iordinances and State laws regulating Electrical wiring, and hereby authorize representatives of this County to.enter upon �hea bo me ne r er�Ior ;eclion purposes. S SEE REVERSE FOR EXPLANATORY LANGUAGE 03 Signatu.a Permitt a Date ;3 .,7i.WORKER a•CO�VIPENSPITId�1PECILgRATION 76-906 70/81 APPLICATION FOR ELECTRICAL PERMIT .. a �s, i''".�. E's• '1 CE-606G e,y�affir�n t1Aat I have a certificate'bf consent to self insure, or a ertificate of Worltere' Compensation Insurahce, or a Certified COUNTY OF LOS ANGELES / BUILDING AND SAFETY copy thereof(Sec.3800,Lab.C.) ' i Policy No.&9871?0 Company i�f'26"c. t MPd*f r' FOR APPLICANT TO FILL IN JOB ❑ Certified copy is hereby furnished. EACH NO. FEE' ADDRESS ,5cro 7c,"Pt-E Gi (�'�'`�+ i Y New Residential Bldgs.&Pools 1 &2=Family,'Sq.Ft. $ — $ LOCALITY Certified copy is filed with the county building inspectidn — department. Multi-family Sq.Ft. NEAREST CROSS ST, Date. 113 g Applicant Residential Swimming Pools OWNER OR -FIRM NAME Oma ( 2 CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL Q COMPENSATION INSURANCE Outlets:Ree Light _Sw._ ADDRESS (This.section need not be completed if the work involved by t le First 20 CITY mow%VPC.E C I Tel.No. permit is for one hundred dollars($100)or less.) �i Total No.. Additional t PLAN I certify that in the performance.of the work for which this permit APPLICANT CHECK is issued, I shall not employ any person. in any manner.so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS I' 'Total No. Additional CITY Tel.No. Date - Applicant Fixed Appliances Not Over 1 FTP PERMIT 4 VL5 C-0�? NOTICE TO APPLICANT: If,. after making this Certificate of APPLICANT � Exemption,you should become subject to the Workers'Compensation Range_ Heater D.W. provisions of the Labor Code,you must forthwith comply with such Oven r— Dryer_ W.M._ ADDRESS t<% "LO T'0 9 AJ G 4 U S 1 provisions or this permit•shall be deemed revoked. ` Top '— FAU _ W.H. _ LICENSED CONTRACTORS DECLARATION i, CITY),.p g �}.,f�,f LAS Tel.No.t� ZZ3 Hood — Fan _ Other_ I hereby affirm that I am licensed under provisions of Chapter 9 LICENSE OR Disp. — Room Air Cond. O 27 9 Z- Class. G'f .(commencing with Section 7000)of Division 3 of the Business and REG.NUMBER Professions Code,and my license is in full force and effect. DISTRICT NO. PROCESSE. Power Apparatus&'targe Appliances �{ a �! 'Size&Type HP,KW,KVA,or KVAR �5 lJ� Q License Number ©Z�9 O "f` .Lic.Class C Up to 1 Incl: FINAL. V f Over 1 to 10 Incl., DATES ,�� VTION Ix Contractor ns Go R p' Date S 2$ 8 I: Over 10 to 50 Incl. FINAL' (~j ❑ I am exempt under Sec. Over 50 to 100 Inc. BY W Over 100 a B.&P.C.for this reason it Z Services,Swbd.,MCC&Panelboerds Date:. 0'-200 Amp.Under 600 V ;271 2 2 A Signature r 201 - 1000 Amp.Under 600 V ❑ Over 1000 Amp.or Over 600 V # 0 0 0 0 0 2. Exemption for Reg:Maint.Elect. 11 °t1 3 Q 5 SINGLE FAMILY Temp.Power Pole&Appurtenances HOME OWNSign with One Branch Circuit ER-BUILDER DECLARATION o,o = I hereby affirm that I am.exeYnpt from the Contractor's License Law 1 3 Q 5.O 5 for the following reason.(Section 7031.5,Business and Professions Additional Sign Branch Circuits Code): 0528587 ❑ 4 Misc.Conduits&Conductors .I,as owner of the property,will do the work and the structure + is not intended or offered for sale (Section 7044, Business Other-(See Complete Fee Schedule) _ 1 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 �jSG 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 5!gpna' for inspe ilarposes• SEE REVERSE FOR EXPLANATORY LANGUAGE ture of rmittee Dat ti WORKER'S COMPENSATION DECLARATION 9 DPW(12-91) 7MG63 APPLICATION FOR EL . 'TRICAL. PERMIT fjJl 76A66 I hereby affirm that I have a certlf t*te of consent to self insure, or a certificate of Worker's'G'ompensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC ORKS BUILDING AND SAFETY DIV. Copy thereof(Sec.3800 Lab.C.) JOB FOR APPLICANT TO FILL IN Policy No. Company ADDRES Certified copy is herebyfurnished. 1 New Residential Bldgs.&Pools NO. EACH FEE I LOCALITY ❑ i 1&2-Family,Sq.Ft. _ $ $ Certified copy is filed with the county building Inspection NEAREST department. Multi-family Sq.Ft. CROSSS S ST. Date Applicant Residential Swimming Pools ASSESSOR 1 MAP BOOK .AGE PARCEL CERTIFICATE OF EXEMPTION.FROM WORKERS' Outlets:Rec._Light} Sw. I OWNER OR 1r. COMPENSATION INSURANCE 1 FIRM NAME First 20 `, MAIL ,/� (This section need not be completed If.the work Involved by the Total No. Additional ADDRESS ' /� permit Is for one hundred dollars($100)or less.) I certify that in the performance of the work for which this permit CI Tel.N is issued, I shall not employ an person in an manner so as to P Y Y P Y PLAN CHECK become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANT ( Total No. Additional ADDRESS Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE.TO APPLICANT: If, after.making. this Certificate of •. CITY TeL No. Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code,you must forthwith comply with such I AEP CANT provisions or this permit shall be deemed revoked. I. Power Apparatus&Large Appliances f LICENSED CONTRACTORS DECLARATION Type HP KW, r V R ! ADDRESS I hereby affirm that I am licensed under provisions CITY Tel.No. of Chapter 9 er Z �% (commencing with Section 7000)of Division 3 of the'Business and j Incl.Professions Code,and my license is in full force and effect. Over 10 to 50 Inc { iICENSE OR Over Over 50 to 100 Incl. REG.NUMBER Claes. G I Over 100 DISTRICT NO. R EBBED BY 0V License Number Lic.Class p Services,Swbd.,MCC&Panelboards s Q Contractor Date j 0-399 Amp.Under 600 V FINAL DATE O I❑ 400-1000 Amp.Under 600 V I VALIDATION V I am.exempt under Sec: i Over 1000 Amp.or Over 600 V I FINAL IL B.&P.C.for this reason i BRANCH CIRCUIT FEES 1 BY Date: f 15A,or 20A,120V,Lighting or Recept. z I 1 To 10 Branch Circuits Signature 1 11 To 40 Branch Circuits a ❑ ! 41 Or More Branch Circuits +' Exemption for Reg.Maint.Elect. 15A,20A,20 VV To 277V Lighting Br.Circuits I SINGLE FAMILY 1, Temp:Power Pole&Appurtenances I 2 HOME OWNER-BUILDER DECLARATION JL One I hereby affirm that I'am exempt from the Contractor's License Law Sign with One Branch Circuit i ACCT.T for the following reason(Section 7031.5, Business and Professions Additional Sign Branch Circuits 3303 46.70 Code): 1 El 1, Misc.Conduits&Conductors 1 ITEMS I,as owner of the property,will do the work and the structure I is not intended or offered for sale(Section 7044, Business ) Other(See Complete Fee Schedule) TOTAL 46.70 and Professions Code). I , CONSTRUCTION LENDING AGENCY CHECK 46.70 1 hereby affirm that there is a construction lending agency for the ( I CHANGE °00 performance of the work for which this permit is issued(Sec. 3097, PERMIT FEE (Sub-Total) /J Civ.C.) PLAN CHECKING FEE ! 0000-0001 6/275/96 Lender's Name i t PERMIT ISSUING FEE 7115 1 PM JC 11 Lender's Address ' I certify that I have read this application and under penalty of purlury state I 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 'I for' spectlon purposes. ` SEE REVERSE FOR EXPLANATORY LANGUAGE 0. 1 SIGNATURE OF PERMIrrEE DATE