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Home My Public Portal About6058 TEMPLE CITY BLVD_Electrical__ COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer J)IVISION OF BUILDING Bic SAFETY ECTRIC 1 WILLIAM J. FOX, County Engineer FOR APPLICANT TO FILL IN DISTRICT NO. BROUP Z N5 PERMIT NO. ELECTRICIAN n 'j `o EIVED BY r READY FOR_ /D�AFT._E�ISSUED ADDRESS a FIRST INSPECTJON ally TEL NO. IN ;4-/J T LICENBE NO. A �PERMIT ES ADDRESS � NUMBER EACH FEE LOCALITY L1014T OUTLETS NEAREST RECEPTACLES CROBS ST. A =� �u� _t ! r�• WALL SWITCHES OWNER +� . I/ TOTAL OUTLETS / 5C S Q Z j;r MAIL / J CLEC. RANGES 25 ADDREBB P: ;4 I�' GG9,�f�' F, / VQ CLEC. HEATERS 21; r '� FIXTURES B CITY Zmefj,? 'p "- /z7,-/TEL. NO. 1 HEREBYACKNOWLEDGIV THAT I HAVE READ THIS MIBC -Q , APPLICATION AND STATE THAT THE ABOVE IB CORRECT NUM ER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOB NUMBER HORSEPOWER FEE ANGELES COUNTY LICO ENSE, OR 1 AM THE LEGAL WNER NEW MVO. HP OVER INC. EACH OF THE RESIDENTIAL' ROPERTY DESCRIBE/;A OVE. y2 A LESS S .25 • ' / SIGNATURE OR %2 2 .513 PERMITTE 2 S 1'130 INSPECTfON RECORD 5 19 1.50 TB BO 2.50 :SO 200 5.00 21313; 1 . 5160 10.130 J 5130 1 1000 15.00 Z OVER 1000 20.130 D __MOVED_MOTORS (75% OF CRtn.) Q M.G. BET FREM CHANGER-HP O WELDERS-AC-KVA GENERATORS - KW TRANSFORMERS - KVA MIBC. - SIGNS NO. NO.TRANS. NO. NO.LAMPS APPROVALS FOR EACH PERMIT? DATE INBPECTORPB NAME WIRING $1.00 CONDUIT ��✓.+ B'IXTURES 01.00 WIRING INUPPLEM ENTARY ,BO FIXTURES POWER TOTAL FEE UTILITY CO.NOTIFIED FINAL 7BAss3 DBS#8A Cdb 12.53 76A663—CES06 3-64 APPLICATION FR ELECTRI AL PERMIT COUNTY OF LOS ANGELES. DEPARTMENT OF COUNTY ENGINEER 7CR G BUILDING AND SAFETY DIVISION d . JOHN A. LAMBIE. COUNTY ENGINEER WILLIAM A.JENSEN,SUPT OF BUILDING Y FOR APPLICANT TO FILL IN T. RECEPT. TOTALNO. EACH FEE OUTLETS FIRST 20 6.20 $ ` . .OWNER LIGHT MAIL ADO'L 10 ADDRESS SWITCH. OVER 20 TOTAL J/a CITY TEL.NO. LIGHTING FIRST 20 .20 X FIXTURES }_� ADD'L OVFR 20 .10 ELECTRICIAN �. ^^ RANGER CLO.DRYERS WTR.HTRS. 1.00 AlO13RESSjQt3L GARB.DISP. STA.COOK jl �� ! >CITY TEL.NOl/ 4 . DISHWASH. AUTO.-WASH. STATE C� g SPACE HTRS. STA.App.(V.H.P.MAX.) � .50 Q LICENSE NO. 3 ✓ � 3 MOTORSs OVER NOT OVER H.P. DISTRICT O. UP ZON P EBBED BY 0 1 1.00 I 3 1.60 INSPECTION RECORD s 6 2.00 V S Is 2.50 D: 1s so 3.00 so loo 5.00 NO.TRANS. - Z SIGNSs NO.LAMPS SERVICE 0.600V-NOT OVER 200A 1.00 SERVICE 0.600V-OvER 200 A. 2.00 SERVICE OVER 600V 5.00 MISC. PERMIT ISSUING FEE 2.00 Q SUPPLEMENTARY PERMIT ISSUING FEE 1.60 TOTAL FEE 6 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI ATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT / r3 WITH ALL'COUNTY ORDINANCEB'AND STATE LAWS REGULATING / ELECTRICAL WIRING. ��/[[[ WIRING 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTER AND/OR LICENSED AB REQUIRED BY.LOS ANGELES COUNTY AN STATE OF r.FIXTURES W31 - CALIFORNIA OR THAT I AM THE LEGAL OWNER OF TUE ABOVE DESCRIBED RESIDENTI .PROPERTY. POWER SIGNATURE UTILITY CO.NOTIFIED �� 0 OF PERMITTEEinn FINAL i ��tR IDATION ARTHUR C. VEIT CK MO CASH SUPERVISING ELECTRICAL ENGINEER LliUo 6 6 5 6 DEC 10 2 D 43 0 WORKERS'COMPENSATION DECLARATION .076AB63806 10/87 APPLICATION FOR ELECTRICAL PERMIT p. .I.hereby. ffirm that I have a certificate of consent to self insure, CE-9oaG or-a dgrti�fcate of•Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec.3800,Lab.C.) Policy No. Company FOR APPLICANT TO FILL IN JOB ,-e � �c AA t r 6LL ❑ Certified co is here furnished. EACH. NO. FEE ADDRESS C �av��/l.)'V7 copy � ', New Residential Bldgs.&Pools LOCALITY ❑ Certified copy is filed with the county building inspedtion 1 &2-Family,Sq.Ft. $ _ $ department. Multi-family Sq.Ft. NEAREST S ` Date Residential Swimming Pools CROSS ST.OWNER R Applicant .FIRM NAME (,5 �� CERTIFIC COMPENSATIONON FROM WINSURANCE ORKERS' Outlets;Rec•�.Light Sw.�. / ADDRESSLA (p =1(This,section need not be cFirs!20 ompleted if the work involved by the CITY iu Tel,No. permit is for,one hundred dollars($100)or less.). Total No.�. Additional • p� 'I'certify.that in the performance of the work for which this permit PLAN CHECK APPLICANT ItlK-�JIf=- V is issued, I shall not employ;any person in any.manner so as to .become sled to,the Workers'Compensation Laws. Lighting Fixtures First.20 �• ADDRESS 6 (, Additional w' /Date •Applicant Total No. CITY ' ¢ Tel.No: 9 NOTICE TO APPLICANT: If, after making this Certifi to of Fixed Appliances Not.Over'1 HP PERMIT „Exemption,you should become subject to the-Workers'Compddsation Range_ Heater D.W. APPLICANT . Q Lg�-- provisions.of the•Labor,Code;you must forthwith comply With such Oven Dryer_ W.M._ ADDRESS 69C-)f OW46 404 provisions or this permit shall be deemed revoked. Top • _ FAU W.H. _ CITY Tel.No. c� LICENSED CONTRACTORS DECLARATION- Hood — Fan' Other_ 7� I hereby affirm that.I am licensed 'under provisions of Chapter 9• LICENSE OR ; (commencing with Section 7000)of Division 3 of the Business and Disp. — Room Air Cond. REG.NUMBER Class. Professions Code,and my license is in full force and effect.. . DISTRICT.NOPROCESSED BY } Power Apparatus&Large Appliances q A q Size A Type HP,KW,KVA,or KVAJR Q License Number S4-1 75 7 1 Lic.Class Up to 1'Incl. FINAL �+ "�w��f ' =61 Over 1 to 10 Incl. DATEVALIDATION ContragtorNt/�+i+�-t= VkU�5Date L Over 10 to 50 Incl. FINAL J 0 ❑' .I am exempt under Sec. Over 50 to 100 Inc. BY LLI d B.&P.C.for this reason Over 100 to Date: Services,Swbd.,MCC&Panelboards ® Z ' 0-200 Amp.Under 600 V Signature 201 - 1000 Amp.Under 600 V ❑ . Exemption for Reg.Maint.Elect: Over 1000 Amp.or Over 600 V SINGLE FAMILY Temp.Power Pole&Appurtenances - HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ' hereby affirm that I am exempt from the Contractor's License Law for the following reason(Section 7031.5,Business and Professions Additional Sign Branch Circuits Code): 7-_r ' Misc.Conduits&Conductors •• ❑• I,,as owner of the property,will do the work and the structure Other See Complete Fee Schedule) is not intended or offered for sale (Section 7044, Business and Professions Codej. , I i�l AL . 41 CONSTRUCTION LENDING AGENCY .�� ,� • -'; I hereby affirm that thereds 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'$Name 7;>- PERMIT ISSUING FEE / UJA'-'jicif I az ?JA,A Lender's Address �.O 8 I certify that I have read this application and state that the above TOTAL FEE �. Lf, �,l - i 9'e 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 in pection purposes:' SEE REVERSE FOR EXPLANATORY LANGUAGE Signaturd of Permittee LLae/a/—. WORKERS'COMPENSATION cafe of 120.Op19DPYY3/87 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that 'I have a certificate of consent .to self (CE� O 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... I FOR APPLICANT TO FILL IN JOB ❑Certified copy is-hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE ADDRESS ff— Fl Certified copy is filed with the county building inspec- .1 &2-Family, Sq. Ft. $ $ LOCALITY tion department. Multi-family Sq. Ft. NEAREST Residential.Swimming Pools CROSS ST. � 6 Date Applicant FIRM NAME IGAW/-S 4006--s CERTIFICATE OF EXEMPTION FROM WORKERS' I Outlets: Rec Light Sw._ MAIL �., COMPENSATION INSURANCEADDRESS hhis section need not be completed if the work Involved b First'20 CITY j�,�,M� Tel. No. e permit Is for one hundred dollars($100)or less.) Y 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 mariner Lighting Fixtures First 20 ADDRESS so as to become'subject-to the Workers'Compensation Laws. Additional Date l2-16-1 I Applicant I Total No. CITY Tel. No. Fixed Appliances Not Over 1 HP PERMIT YV� NOTICE TO APPLICANT:. If, after making,this Certificat of APPLICATION Ay— J �5 Exemption, you should become subject. to the Work rs' Range— Heater—D.W. — Compensation provisions of the Labor Code, you must forth- Oven — Dryer —W.M.— ADDRESS 64)! Cowo el*6 with comply with such provisions .or this permit shall be Top — FAU —W.H. — deemed revoked. Hood — Fan —Other— CITY &A. VggA - Tel. No.2,27-2-b') LICENSED CONTRACTORS DECLARATION LICENSE OR Q Disp. — Room Air Cond. — REG.NUMBER Zi[ 8 Class. I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business Power Apparatus&Large Appliances DISTRICT N_O: PROCE d and Professions Code,and-my-license is in full force and effect. y� $7 Size&Type HP, KW, KVA, or KVAR ( U U License Number Jr21 Lic. Class �� Up to 1 'Incl. ;FINAL I Z_.� Over 1 to 10 Incl. DATE Z-�v1 -f/ VALIDATION cc Contractor., �Lcc``Date Over 1.0 to 50'.Incl. 'FINAL U • I am exempt under Sec. Over 50 to 100 Inc. I;BY W B..&P.C. for this reason ' Over 100 U) Services, Swbd., MCC&Panelboords Z Date: 0-200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V El r ExemptionOver 1.000 Amp, or Over 600 V for Reg. Maint. Elect: _ SINGLE FAMILY ; HOME OWNER-BUILDER DECLARATION Temp. Power Pole&Appurtenances .'� '7,Cc_ Sign with One Branch Circuit L=` 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 Professions Code): ,r_.,;, •••; j ill i� ` -- �' _ -- I, as owner of the property, will do the work and the• Misc. Conduits&Conductors r: ' --oi-..� 155 55 -,.x , ' structure is not intended or offered for sale(Section 7044, j Other(See Complete Fee Schedule)_ ® i«.+:•,. :r;5 Business and Professions Code). ''--}}""',may: CONSTRUCTION LENDING AGENCY i I hereby affirm that there is a construction lending agency for �. GtIl �f•3 a - the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) (Sec. 3097,'Civ. C.). i PLAN CHECKING FEE -" 's� _'„l '_` i ,i` Lender's Name I PERMIT ISSUING FEE Lender's Address t'2l: I certify that I have read this application and state that the TOTAL FEE above information is correct. 1 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 above-mentioned prop. y for inspection purposes. SEE REVERSE FOR.EXPLANATORY LANGUAGE V 12 ?_J6:3 1 1 Signat a of Permittee Date I' ®s