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Home My Public Portal About6243 TEMPLE CITY BLVD_Electrical__ I P.a Ike:I I 1 1 1 ' 1 ; 1 1 I ®� eta■■.■■.w...w 75AE03 CES06 1 66 / COUNTYAPPLICATION FOR ELECTRICAL PERMIl OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING BUILDING AND SAFETY DIVISION ADORESS 7 JOHN A LAMBIE COUNTY ENGINiER COLEMAN JENKINS, SUKRINTENDIINT OR BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST --/A-<9 C F RECEPT _ 5 S OWNER MAIL _ LIGHT TOTALEFIRST 20 20 O ADDRESS O V SWITCH_ J20 10 CITY UI TEL NO 3T7-32ry PLAN CHECK LIGHTING TOTAL20 20 APPLICANT FIXTURES 20 10 ADDRESS RANGE—DRYER—WTR HTR — CITY TEL NO STA COOK_DISP F A U CONTRAC TOR J SPACE HTR _AIR CONE) _ ADDRESS 2f/ tYJ9 -C BLr/9 CLOTHES WASH -DISHWASH CITY C'7� u� ` TEL NO FAN-OTHER 1 00 LICENSE NO CLASS MOTORS TRANSFORMERS RATING IND HEATERS ETC HP KW KVA I HEREBY ACKNOWLEDGE THAT I 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 ELECTRICAL WIRING 0 - 1 1 00 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR I - 10 3 00 LICENSED AS REOUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND T 10 - $0 $ 00 RESIDE IM THE A pE SCR RED RE IDEM IAL Pq OPERT Q 50 - 100 UOO SIGNATURE V OF P7POIERPOLE 100 - $00 DISN P O SSED Y 0 SIGN GAS SIGN AHD ONE CIRCUIT IY� TUBE OR a MARQUEE ADDITIONAL CIRCUITS NOZ SERVICE NOT OVER 600 VOLTS OR 200 AMP SERVICE OVER 600 VOLTS OR 200 AMP TEMP SERVICE POLE &APPURTENANCES DATE INSPECTOR 9 SIGNATURE TE UNDERSLAS WORK ROUGH CONDUIT PERMIT FEE (SUB TOTAL) WIRING FIXTURES PLAN CHECK FEE (60% PERMIT FEE) POWER AUTHORIZED PERMIT ISSUING FEE 200 UTILITY CO NOTIFIED SUPPLEMENTARY PERMIT ISSUING FEE 1 00 FINAL TOTAL FEE JOSE H C ROOHAN SUPERVISING ELECT ICAL ENGINEER PLAN CHECK VALIDATION CK M o CASH PERMIT VALIDATION CK M o CASH LP-04 3 3 82 APR1g 2 0 220- IEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE oe a-A 4-40 ION APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND ES �1 SAFETY *� COUNTY OF LOS ANGEL WM J FOX CHIEF ENGINEER NATURE OF INSTALLATION DIST�f.MQ� T NO OR UP Z Em WIRING FIXTURES SERVICE V 'VED BY EADY FORRANGE HEATER POWER FIRST INSPECTION81GN8 M BCELLAN UB APPLICANT Eq,441N HEAVILY OUTLINED PORTION ONLY Job NAME A ADDRESS U K ADDRESS Ao; Ze LOCALITY UFp CITY AV, TEL No r7 gyri' CROSS ST d COUNTY , O EXPIRES 12/ / CHET NO NAME DESCRIPTION OF WORK MAIL NUMBER OF OUTLETS ON CIRCUITS ADDRESS LOCATION BY ROOMS O CITY TEL No LIGHT OUTLETS SW PLUGS nn 1 AM THE EGAL POSSESSOR T THE ASOVE LOS CIRCUIT A B C D E F 6 H ANOELEB CO TM C_Sp o QUIWIPI ATION LIVING ROOM DINING ROOM Ic1AN 1 AM THE LEGAL OWNER OF THE PROPS DESCRIBED BRPBT RM ABOVE OWNER BATH _ CORRECTIONS ENT HALL HALL NO FRONT PORCH OUTSIDE _KITCHEN SERV PCH / Q Z BORN No CLOSET BORN No CLOSET TOTAL NO OF OUTLETS t OS APPROVALS NO OF FIXTURES DATE llfsm OR R NAME NO OF MOTORS H P 6 CONDUIT NO OF SIGNS TRANS S WIRING NO OF RANGES OR HEATERS t FIXTURES MISCELLANEOUS S POWER PERMIT FEE S UTILITYCO NOTIFIED TOTAL FEE $ FINAL J o 11 '�M TeAeea-cfeoe G-eT APPLICATION;;F R ECT CfAL RMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS �rMJA JOHN A LAMBIE, COUNTY ENGINEER COLEMAN W JENKINS, SUP'ERINTENCIENTO'BUILDING LOCALITY AREST FOR APPLICANT TO FILL INCROSSST RECEPT OWNER .�MAILLIGHTTOTAL FIRST 20 20ADDRESSSWITCH_ OVER20 10 CITY TEL NO LIGHTING iTOTAL FIRST 20 20 CONTRACTOR FIXTURES /( OVER 20 10 ADDRESS apleRANGE_DRYER_WTR HTR — CITY NOZSTA COOK_DISP F A U LICENSE NO �7SPACE HTR _AIR COND I HEREBY ACKNOWLEDGE THAT I HAV[ REAPLICATIONANOSTATE THAT THE A{OVE19 CORRECT ANO COMPLYCLOTHES WASH _DISHWASH WITH ALL COUNTY ORDINANCE{ AND STATEGULATINGELECTRICAL WIRING FAN_OTHER 1 DO I HEREBY CERTIFY THAT I AM PROPERLYED AND"MOTORS TRANSFORMERS BATING LICCNSED ABRCOUIR DBYLOS ANGEL[{ COSTATE OF4LIFORMIA OR TXf LEGAL OWNERINTEND TOIND HEATERS ETC HP KW KVA RESIDE IN [ ABOV DESCRIBED RESIPROPERTY SIZE 8 TYPE OVER TO SIGNATURE 0 - 1 1 00 OF PERMITTEE 1 — to 3 00 tD�lST_aLCb5fGrPP!T P EDO1O 50 S 00_50 - 100 1000 �1oo - Soo 16 00SIGN GAS SIGN ANO ONE CIRCUIT 3 00 TUBE ORMARQUEE AOOITIONAL CIRCUITS 1 00 SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 DO SERVICE OVER 600 VOLTS OR 200 AMP S 00 TEMP SERVICE POLE B APPURTENANCES 3 00 APPROVAL{ DATE INSPECTOR'S SIUNATMIK TEMP POWER POLE UNDERSLAB WORK ROUGH CONDUIT WIRING ISSUING FEE 2 00 D FIXTURES SUPPLEMENTARY ISSUING FEE 1 00 POWER AUTHORIZED PERMIT FEE UTILITY CO NOTIFIED PLAN CHECK FEE ISO% PERMIT FEE) FINAL TOTAL FEE JOSEPH C ROOHAN SUPERVISING ELECT AL ENGINEER PLAN CHECK VALIDATION CK M o CASH PERMIT VALIDATION cK M o CASH IAf'„ 1 0 3 3- JUL 1 8 2 D 4.0 Q~ s WE BACK OF APPLICATION FOR COMitETE FEE SCHEDULE I 7aA6e3-CEaO611/70 APPLICATION FOR 4MMeAL P IT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS COLEMAN W JENKINS, SUPIMIRINTIENORNT OF BUILDINGLOCALITY NEAREST FOR APPLICANT TO FILL IN CR OS$ ST OUTLETS NO • E OWNER RECEPT S S MAIL FIRST 20 25 ADDRESS LIGHT TOTAL CITY TEL NO QD SWITCH 2 OVER 20 10 PLANCHECK TOTAL LIGHTING FIRST 20 25 APPLICANT FI%TURES d 10 OVER 20 ADDRESS APPLIANCES I CITY TEL NO PERMIT RANGE_DRYER_WTR HTR_ APPLICANT STA COOK_DISP LF A U _ ADDRESS SPACE HTR AIR CONO CITY TEL NO CLOTHES WASH DISHWASH LICENSE NO CLASS FAN—OTHER 100 O I HERESY ACKNOWLEDOE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE la CORRECT AND AGREE TD COMPLY MOTORS TRANSFORMERS RATINo WITH ALL COUNTY ORDINANCES AND STATE LAWS REOULATING IND HEATERS ETC HP KW KVA ELECTRICAL WIRING SIZE a TYRE OVER To I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR 0 — 1 100 LICENSED AS REOUIREO BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO r 1 — 10 3 G RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY 0 10 — SO ppp SIGNATURE _^ U OF PERMITTEE K SO — 100 1000 DISTRICTNO CLASS ZO PROLES ED BY O 100 — 500 1700 SQ V h �� 111(�LLLJ SIGN GAS SIGN AND ONE CIRCUIT 500 NOTES �� Z TUBE OR — MAROUEE ADDITIONAL CIRCUITS 100 SERVI CENOTOVER 600 VOLTS OR 200 AMP 300 D Q S ERVI CE OV ER 600 VOLTS OR 200 AM P 1000 APPROVALS DATE IMAEC1gYa SIGNATURE TEMP ROWER POLE TEMP SERVICE,POLE &APPURTENANCES 500 UNDERSLAB WORK TEMP LIGHT OR RECEPT SYSTEM SOD ROUGH CONDIUT WIRING FIXTURES POWER AUTHORIZED PERMIT FEE (SUB TOTAL) UTILITY CO NOTIFIED PLAN CHECK FEE FINAL PERMIT ISSUING FEE 300 00 JOSEPH C ROONAN TOTAL FEE O SUPERVISING ELECTRICAL EN EER PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK M o cAe L," 7 1 9 9'1 NDV23 2 n 9.60 Q SEE SACK OF APPLICATION FOR COMPLETE SCHEDULE WORKERS COMPENSATION DECLARATION CE-806 islet APPLICATION FOR ELECTRICAL PERMIT I hereby offum that I have a certificate of consem to self - ' insure or a certificate of Workers Compensation Insurance COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec 3800 Lab C ) Policy No Company FOR APPLICANT TO FILL IN rNEAREST E55 Certified copy is hereby furnished Now Residential Bldgs 8 Pools EACH NO FEE Certified copy is filed with the county building mspec- I 0 2 Family Sq Ft f — f LITY E Q tion department Multi family Sq Ft — Residential Swimming Pools Date Applicant ER NAMECERTIFICATE OF EXEMPTION FROM WORKERS' � � 4 COMPENSATION INSURANCE Outlets Rec Light SwFirst 20 (This section need not be completed If the work Involved by Total No Additional Tel No the permit Is for one hundred do 1100)or I ) MN HEC I certify that in the performs a of the ark ich this APPLICANT permit is issued 1 shall not ploy any p-so y manner so as to become su ticthe r era Com hon Laws Lighting Futures Fust 20 r 1" Q ADDRESS r Additional d Total No CIN Tel Na ° p Fixed Appliances Not Over I HP PERMIT NOTICE TO you sh I after king t o t to of Exemption you shout become sublets to th orkers Range_ Heater_D W 'APPLICANT Compensation provisions of the Labor Code you must forth Oven — Dryer — W M — ADDRESS with comply with such provisions or this permit shall be Top ,_ FAU —W H — deemed revoked CITY Tel No LICENSED CONTRACTORS DECLARATION Hood _ Fan —Other_ I hereby offum that I am licensed under provisions of Chapter 9 Disp — Room Au Cond REG NU6MBER OR Class (commencing with Section 7000) of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NO PROLE E4 E6Y Y and Profe om Code,and my license is in full force and effect 7 Q Q .1. t�'F'✓ d Size 8 Type HP, KW KVA or KVAR ♦ (.l ►V(� O License Number Lic Class Up to 1 In FINAL V Over 1 to 10 Incl DATE 6—/ Q- VALIDATION 0 Contractor Date O 10 to 50 Incl T OOver FINAL I am exempt under Sec Over 50 to 100 Inc BY B 8P C for this reason Over 100 1N Date Services Swbd MCC B Ponelboorcis ► _ 0 -200 Amp Under 600 V Signature 201 - 1000 Amp Under 600 V ❑ Exemption for Reg MaiOver 1000 Amp cr Over 600 V Maim Elea ' 0762A SINGLE FAMILY Temp Power Pole 8 Appurtenances HOME OWNER BUILDER DECLARATION Sign with One Branch Circuit s s e e e 2 1 hereby offum that I am exempt from the Contractor's License Additional Sign Branch Circuits Law for the following reason (Section 7031 5 Business and � s e 1 725 Professions Code) e e's )Misc Conduits 8 Conductors 7255 I s owner of the property will do the work and the 0 Q 2 6—8-� structure is not intended or offered for sale (Section Other (Sea Complete Fee Schedule)— ► 70" Business and Professions Code) CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency far the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) (Sec 3097, Civ C ) PIAN CHECKING FEE Lender s Name O PERMIT ISSUING FEE Lenders Address I certify that I have reyl this application and state that the TOTAL FEE 1-7,151 X ahon P e to comply with oil County nd Stting Electrical wrong and rizef this County to enter upon ent n inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Dale ■ I affirmWQRKERS that COMPENSATION DECLARATION CE-w6 ,D,B, APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self �-�' insure w a certificate of Workers Compensation Insurance COUNTY OF LOS ANGELES �♦ BUILDING AND SAFETY or a certified copy thereof (Sec 3800 Lab C ) Policy NO Company FOR APRICANT TO RLL IN JOB�� Certified co is hereby furnished EACH NO FEE PY Y New Residential Bldgs 8 Pools ❑ Certified copy is filed w unty mg mspec 1 d 2-Family, Sq Ft $ — S LOCALITY // tto de rimgnt Multi-family Sq Ft — NEAREST 7�' Residential Swimming Pools OtO55 ST Dote OWNER OR k FIRM NAME CERTIFICATE OF PTION FROM WORK S' , MAILCOMPEN TION INSURANCE r Outten Recht_Sw A IL(This section need not be completed If the work Involved by First20 the posrrH Is for aro hundred dollars(3100)or less ) Additional CITY r Tel N v 1 certify that in the performance ofa PLAN CHECK the work for which this permit is issued I shall not employ any person in any manner APPLICANT so as to become subject to the Workers Compensation Laws Lighting Fixtur s First 20 ADDRESS Total No Additional Date Applicant f CITY Tel No NOTICE TO APPLICANT If after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT Exemption you should become subject to the Workers Range_ Heater_D W _ APPLICANT Compensation provisions of the Labor Code you must forth Oven _ Dryer _W M — ADDRESS with comply with such provisions or this permit shall be Top _ FAU _WH _ deemed revoked Hood _ Fan _Other_ CITY Tel No LICENSED CONTRACTORS DECLARATION Disp — Room Air Cond LICENSE OR Class (commencing with Section 7000) of Division 3 of the Business DISTRICT NO PROCESS BY and Professions Code and m license is in full face and effect Power Apparatus 8 Large Appliances �/ y/ ! Y Size 8 Type HP KW KVA, or KVAR , ' oil Q License Number L¢ ClassUp to 1 Incl FINAL V 4 / Over 1 to 10 Incl DATE _� VALIDATION Q Contractor Date Over 10 to 50 Incl H IDI am exempt under Sec Over 50 to 100 Inc BYE _ 6 B 8P C for this reason Over 100 41,011= Date Services Swbd MCC 8 Ponelboards 1101.0 -200 Amp Under 600 V Signature 201 - 1000 Amp Under 600 V ❑ Exemption for Reg MaOver 1000 Amp or Over 600 V mt Elect ' 31 Q b A SINGLE FAMILY Temp Power Pole 8 Appurtenances HOME OWNER BUILDER DECLARATION Sign with One Branch Circuit 1 hereby affirm that I am exempt from the Contractor s License Additional Sign Branch Circuits Law for the following reason (Section 7031 5 Business and Professions Code) /♦/ 2rCot IDI, as owner of the property will do the work and the Mau Conduits 8 Conductor 7 structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ , 7044, Business and Professions Code) CONSTRUCTION LENDING AGENCY I hereby affirm that there iso construction lending agency for the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) 3 (Sec 3097, Civ C ) PIAN CHECKING FEE _ Lenders Name PERMIT ISSUING FEE Ax Lenders Address 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 ordrn and Stote regulating Electrical wiring and e you nze r ntotnves of this County topp enter upon the abo mention roperty for i pection pur owns SEE REVERSE FOR EXPLANATORY LANGUAGE S nature of ittee Dale