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Home My Public Portal About6203 A & B TEMPLE CITY BLVD_Electrical__ 76A669-CE906 4-68 APPLICATION FOR EiECTRICA PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS Z� GCs Y cl JOHN A. LAMBIE. COUNTY ENGINEER �. COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING .LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS.ST. NO. EA-C FEE $ $ RECEPT._ ' OWNER ' MAIL LIGHT TOTAL FIRST 20 .20 ADDRESS SWITCH_ OVER 20 .10 CITY TEL. NO. PLAN CHECK LIGHTING TOTAL FIRST 20 .201 APPLICANT FIXTURES OVER 20 .10 .ADDRESS RANGE_DRYER_WTR.HTR. CITY TEL. NO. STA.COOK_DISP._F.A.U._ CONTRACTOR `tl'j(, j W.L, SPACE HTR. AIR COND. ADDRESS se wo mw In !1 CLOTHES WASH._D:ISHWASH._ CITY TEL. N FAN-OTHER 1.00 LICENSE WO. CLASS. MOTORS,TRANSFORMERS RATING IND. HEATERS, ETC. HP. KW. KVA. IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION SIZE & TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING 0 1 1.00 ELECTRICAL WIRING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 1 - 10 3.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ,CAL;FORN.IA OR THAT I AM THE LESAL OWNER OF, AND INTEND TO 10 - 50 5.00 RESIDE IN, THE ABOVE GESCR.ISED RESIDENTIAL PROPERTY. SI.GNATU.R. V 50 - 100 10.00 OF PERMIT 1d�`�J 100 - 500 15.00 DI�gjRI NO. UP OIV� PR ESSED BY w TUBE, OR SIGN AND ONE CIRCUIT - 3.00 7`0 3 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 MP. POWER POLE DERSLAB.WORK UGH CONDUIT PERMIT FEE (S,U.B TOTAL) WIRING FIXTURES PLAN CHECK FEE (50%, PERMIT FEE) POWER AUTHORIZED PERMIT ISSUING FEE 2.00. 2 ]FINAL UTILITY CO.NOTIFIED 1 _ SUPPLEMENTARY PERMIT ISSUING FEE 1.00 C /y TOTAL FEE JOSEPH.C. ROOHA:N SUPERVISING ELEC CAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK'. M'.O. CASH [pr%- aa59 -UL 9 2 D 4.00tv -E BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE 78A889-CESOB-It-W/,.APPLICATION FOR "ELECTRIC PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER 13UILDINIG o BURDING AND SAFETY DMSION ADDRESS CW A.LANIDIB. ?a,*EnaiaeU LOCALITY TP D. GSIIrFII�i.Supt $ NEAREST FOR APPLICANT TO FILL IN CROss ST. PFJM FEES ITEM NUMBER EACH FEE OWNER OaAdgolm OUTLE $ $ ty q MAIL LIGHTS•ORECEPT. O SW.2 .10 / i R-dP ADDRESS ' LIGHTING FIXTURES Ae) lo �y e9do CITY TEL:NO. ELEC.RANGES CLO.DRYERS ELECTRICIAN a WATER HEATERS .SOADDRESS 9 ELEC.SPACE HTRS. DISHWASHERS ,GARBAGE DISPOSERS AUTO.- qq CITYdf TEL.NO. WASHERS BTA.COOKING UNITS •Q$ 6.� STATE ® /9 LICENSE NO. Q 7 �✓' MOTORS: OVER INC. H.P. o— 1/a Q$ ,DIS RICTNO. 1GROUIll ZUNE I READY FOR INSPECTION 1/2 — 2 .$'O 2 — 5 1.0o INSPECTION O RD 5 — Is 1.50 1s — so 2.60 50— 200 s.00 SIGNS: NO.TRANS. I "P• X1,5 t i o P L rev- 1 s NO.LAMPS SERVICE O-$OOV 1.00010 `t J }, SERVICE OVER 600V 5.00 ' r• ��5�12xf is X97 WIRING PERMIT 1.00 QI® —7 lla f o FIXTURE PERMIT 1.00 /� r?' F SUPPLEMENTARY PERMIT .50 -93-119d1til PZ06 DO LET IV TOTAL FEE $�,Za �t� ,: BATHRaa APPROVALS—LooJE"rm&ALL I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS.APPLICATION DATE INS/P�EC/TOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT �P WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING D 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES /g07/F S �2 S LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF �� CALIFORNIA S THAT M LEGAL OWNER OF THE ABOVE POWER DESCRIBED RESIDENTI 0 SIGNATURE OF PERM17 TE tAll FINAL UTILITY CO.NOTIFIED J10��.,;A? .5• n�fr f' .IDATION ARTHURN FMLX �(CIS Mo CASH SUPERVISING ELECTRICAL ENGINEER; 2 2 �. 2 2 A 12.45 R 76A663 CE-806(11 /78) APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY t FOR APPLICANT TO FILL IN JOB ADDRESS New Residential Bldgs.&Pools EACH NO. FEE LOCALITY 1 &2-Family,Sq.Ft. $ .025 — $ Multi-family Sq.Ft. .02 — NEAREST CROSS ST. Residential Swimming g Pools OWNER OR FIRM NAME Outlets:Rec Light Sw. MAIL First 20 .50 ADDRESS Total No. Additional .30 CITY Tel.No. PLAN CHECK APPLICANT Lighting Fixtures First 20 :50 ADDRESS Additional .30 Tocol No. CITY Tel.No. Fixed Appliances Not Over 1 HP PERMIT Range_Heater_D.W.— APPLICANT ADDRESS Oven—Dryer_W.M. Top _FAU —W.H. Hood—Fan _Other_ Disp._Room Air Cond. 2.50 REGNNUMBER \ ��jr 7�j Class. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA• Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO Size&Type HP,KW,KVA,or KVAR COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS 2.50 1 REGULATING ELECTRICAL WIRING. Up to 1 Incl. .Over 1 to 10 IncI.A1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 1j 5.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF M Over-10 to 50 Incl. 12.50 CALIFORNIA OR THAT I AMLEGAL OWNER OF THE ABOVE p Over 50 to 100 Inc. 25.00 DESCRIBED RESIDEN PR PAZ T (WF,Over 100 40.00 PERMITEEFINFORI'MATION IA Services � PRO $ 0.200 Amp.Under 600 V 12.50 201.1000 Amp. Under 600 V 25.00 Over 1000 Amp.or Over 600 V 50.00 Z O Temp.Power Pole&Appurtenances 10.00 Sign with One Branch Circuit 10.00 Additional Sign Branch Circuits 2'00 CTION lo.00 Misc.Conduits&Conductors EVERSEOther(See Complete Fee Schedule) IDE v Z PERMIT FEE (Sub-Total( PLAN CHECKING FEE (One-Fourth Permit Fee) O PERMIT ISSUING FEE $7.00 ; G TOTAL FEE �� > INSPECTION FINALED W date:(�– `?_�p By 6 ®s •• WORKERS'COMPENSATIONDECI:ARATION fOG CEI APPLICATION .FOR ELECTRICAL PERMIT O6G (2-80) Iyhereby 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 a certifi f opy thereof(Sec.3800;Lab C.) ' S� FOR APPLICANT TO FILL IN JOB PdIky.No. Company i ADDRESS I New Residential Bldgs.&Pools EACH NO. FEE [DI Certified copy is hereby furnished.• 1 &2-Family,Sq.Ft. $ — $ LOCALITY �"� /f Multi-family Sq. Ft, NhAREST d' Certified copy is filed with the county building inspection Residential Swimming Pools CROSS ST ) department. g � 45 FIRM NAIME �G' --�"�.� d Date f Applicant ` VS420-`1 "" Outlets: Rec.._-Light Sw. MAIL. First 20 ADDRESS CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY Tel No. LU COMPENSATION INSURANCE PLAN CHECK :L (This section need not be completed if the work involved Lighting Fixtures Firsf 20 APPLICANT by'the permit is for one hundred dollars ($100) or less.) ADDRESS cc Total No. Additional Q I certify that in the .performance of.'the work for which thisCITY Tel No. (r Fixed Appliances Not Over 1 HP permit is issued, I shall'not employ any person in any manner PERMIT O so as to become subject to.the Workers'Compensation Laws. Range_Heater D.W. _ APPLICANT fJ��.ry r;��-� 0- Oven _ Dryer_W.M._ ADDRESS��,r ,7- f Date Applicant U Hood _ Fan .. —Other CITY ��7/ f Tel Nom -XW 7 ` NOTICE TO APPLICANT: If; after making this Certificate.of Disp. _Room Air Condom LICENSE.OR Exemption, you should become subject,to the Workers' REG.NUMBER- We .•4`Class Compensation, provisions of the Labor Code,you must forth- Power Apparatus&Large Appliances DISTRICT NO. PROC SEq BY with .comply with such. provisions or this"permit shall be Size&Type HP;KW,KVA,or KVAR Id deemed revoked. Up•to 1 Incl. FINAL LICENSED Over 1 to 10 Incl. DATE LICENSED CONTRACTORS DECLARATION -9 Over 10 to 50 Incl. VALIDATION 4 I herebyaffirm that I am licensed under p FINAL provisions of Chapter Over 50 to 100 Inc. 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. �K Services 1 a -License Number Lic.'Class ' 0 200 Amp.Under 600 V 201-1000 Amp.Under 600 V 3 Contractor ai'% Date f� a � Over 1000 Amp.or Over 600 V HOME OWNER-BUILDER DECLARATION Temp.Power Pole&Appurtenances t 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 ness and Professions Code)_: Misc.Conduits&Conductors Ell, 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 ' A�,�; • 7044,Business and Professions Code). CONSTRUCTION.LENDING AGENCY � J4?o o�o 0"G 1 hereby affirm that, there! is a construction lending agency for the'performance of the work for which this permit' is PERMIT FEE (Sub-Total)' issued(Sec.30.97,Civ.C.). i Lender'sName I PLAN CHECKING FEE •(One-Fourth Permit Feel Lender's;Address PERMIT ISSUING FEE, I certify that I have read .this application and state that the TOTAL FEE U above information is correct.I agree to comply with all County ordinances and State laws regulating Electrical wiring,, and hereby adthorize representatives of-this County to enter upon the above,mentioned prop rty foe:n§pec ion purposes. ,- SEE'REVERSE FOR EXPLANATORY LANGUAGE , Signat-.{ of Permittee Date