HomeMy Public PortalAbout6244 TEMPLE CITY BLVD_Electrical__ 76A863-CED 06 I 1/7o 1
APPLICATION FOR ELECTRICAL 'PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEHBUILDING TC/r1 ! /'BUILDING AND SAFETY DIVISIOADDRESS C.COLEMAN W JENKINS IN NLOCALITYNEARESTFOR APPLICANT TO FILL INCR0955TOUTLETS OWNERRECEPT L - MAIL
LIGHT_ TOTALFIRST 20 ADDRESS
_
SWITCH OVER 20 10 CITY TEL NO
PLAN CHECK
HTING TOTAL
LFIRST 20 n APPLICANT
FIXTURES ID IGi
I OVER 20 ADDRESS
APPLIANCES CITY TEL No
PERMIT / T "16
//
RANGE_ORY ER_WTR HTR_ APPLICANT L C+
STA COOK_DISP_F A U _ ADDRESS12
c
SPACE HTR AIR GOND CITY 17R—ew*�t TEL NO -2
CLOTHES WASH DISHWASH _ LICENSE NO , CLASS 1Q
FAN-OTHER 100 1HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
ANO STATE THAT THE ABOVE IS CORRECT AND AOR[[ TO COMPLY
MOTORS TRANSFORMERS "TING WITH ALL COUNTY ORDINANCE! AND STATE LAWS REGULATING
IND HEATER! ETC XP KW KVA ELECTRICAL WIRING
DIZ[ 6 TYPE OVER TO
1 HERESY CERTIFY THAT I AN PROPERLY REGISTERED ANO/OR
O - 1 100 CALFLICE�NSED AS REHATI DT LOS ANGELES COUNTY ADD !TATE TOF
O
CESIDE MIA OR THAT AM THE L L OWNER DP AND INTEND TO Y
1 - 10 300 RESIDE IM THE ABOVE DE DED R DE MTIAL PROPERTY 0
10 - 50 5 D OF PERMRITTE
50 - 100 1000 DISTRICT NO LASS ZONE PR Cf SSf Y O
100 - 500 13 oO V 1(L)
d
SIGN GAS SIGN AND ONE CIRCUIT 5 D NOTES N
Z
TUBE OR
MARQUEE ADDITIONAL CIRCUITS 100
SERVICE NOT OVER 600 VOLTS OR 200AMP 300
APPROVAL$ DAT[ ' DISPECTOIYS SMKATIRf
S ERVI CE OVER 600 VOLTS OR 200 AM P 1000
TEMP POWER POLE
TEMPSERVICE POLE 6 APPURTENANCES SOO
UNDERSLAB WORK
TEMP LIGHT OR RECEPT SYSTEM 300
ROUGH CONDIUT '
WIRING
FIXTURES
POWER AUTHORIZED
PERMIT FEE (SUB TOTAL)
UTILITY CO NOTIFIED
PLAN CHECK FEE
FINAL
PERMIT ISSUING FEE 300
n /-- 1 )qltPH C ROOHA
TOTAL FEE A �{J SUPERVISING
,nAL FFN GINEER
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION cx CASH
X26229 U61 13 2 0 325-
SEE DAM OF APPLICATION FOR COMPLETE SCHEDULE
TEMPLE CITY
76AS63-CES06 a-62 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER rIO:DREQS
G
BUILDING AND SAFETY DIVISION JOHN A LAMBIE COUNTY ENGINEERWILLIAM A JENSEN BUR T OF SUILDING Y
NEAREST
\FO PLI N FILL CROSS ST
RECEPT I TOTAL No DCII IQ
1111{ OUTLETS FIRST 20 S 10 • OWNER
LIGHT MAIL
!WITCH ADD'L ADDRESS
OVLR 20 +0
LIGHTING TOTAL FIRST 20 10 CITY TEL NO
FIXTURES ADD'L to ELECTRICIAN
or R 20
RANG" CLO MnXII WTR HT" 100 ADDRESS
Mlm DISP RA COOK
CITY 0 NO
DIMWAM AVIO WASH STATE
YALE HTRS STA ARR ISS H P xAX 1 SO LICENSE NO
MOTORS, OVER Naravu H♦ DIS RICT GROUP NE PROCESSED BY
O I 100 I
+ — a 150 INSPECTION RECORD
g — S 200
S -- is 260
IS -- 50 goo }
a
so too goo O
V
NO TRANS
BIONS no uxF[ �
O
SERVICE D SOOV NOT Gr U+200A 0 WJ
SERVICE O SOOV OVSD 200 A 200 D.
WI
SERVICE OVER SOOV 000 Z
MISC
PERMIT ISSUING FEE 100
SUPPLEMENTARY PERMIT ISSUING FEE 100
TOTAL FEE V d
I N[ReFY AO NOWT[DO¢ THAT 1 HAT[ R[AD THIS APPuCATION APPROVALSDAn fwl►[ ci a GIFU ATumw
ANI "An THAT TH[ AEOV[ IS CCRR[CT AND AGRR TO COMPLY CONDUIT
WITH ALL COUNTY oMtHANw AND STATS uwa MOULATING
KLICOTAXAL WIRING WIRING
1 H[RYY CERTIFY THAT 1 AN FROP[RLY MG111nRID ANG/OR
LIC[H® All M UIR[D SY LO[ ANO[L6S COONTY AND RATE OF FIXTURES
CAU MIA O 1 AM TH[ L[GAL OWN" OF THE ABOVE
D[SCRIS[D RU I RTY POWER
SIGNATURE UTILITYCO NOTIFIED
OF PERMITTR
IV PINAL �
DATION ARTHUR C VETT
CE GASH SUPERVISING ELECTRICAL ENGINEER
p�_ 1 0 5 2-� ,.'UL22 2 D 4.0 0"
►1 1A 1 ' g:
WRR
APPLICANT FHJ IN .1 I OUTIEWD PORTION ONLY
DFSCRIPTION OF WORK
- 1 1
NUMBER OF OUTLrm ON CIRCU
V
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MWES■■ ■■■■■■■
MMMS...■.■..■.
MMMS■■■■■■■■■■
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MEMN■■■■■■■■.■. MEN
MMMI■.■.■...■ . MEN
MEMO■■■■■■.■■ ■
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MEN..l■■■■■■■■■
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MOM.■■■■■■■■.■. MEN
MEN
MOM.■■■■■■.■■.. MEN
RENEE
IN WERE
SIN ►�MMl NOMINEES
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✓/,4tilWj&ra6TN-
7a.� RBB a. APPLICATION FOR PERMIT
DEPARTMENT OFNG AND SAFETY COUNTY
ELECTRIC
COIINTY OFF LOS LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DIBTRICT�LF GROUP ZONE PERMIT NO.
Jr S�
ELECTRICIAN
RECEIVED BY
BY READY FOR DATE 1 ED
ADO EMS FIRST INSPECTION
CITYTEL NO
COUNTY LICENSE NO EXPIRES BUILDING""// (�
sljl
PERMIT FEES
ADDRESS /
NUMBER EACH FEE LOCALITY 00
LIGHT OUTLETS NEAREST
CROSS BT.
RECEPTACLES
WALL SWITCHEB DWNE
TOTAL OUTLETS Sc S MAIL /
ELEC RANGES 25 ADDRESS
ELEC HEATERS 23 ITy TEL. NO R T-
FIKTURES S 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
MISC APPLICATION AND STATE THAT THE ABOVE IB CORRECT
NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING
MOTORB 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOB
NummE HORBEPOW[R ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
FCE OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE
N[W Mw NP HOR Ino [AVN
Ike �eee S 29 SIGNATURE OF
8 60 PERMITTEE
2 S 1 DD INSPECTION RECORD
S 16 1 So
16 BO 250 _
SO 200 Sao
200 SOO 1000
SOO 1000 1500 Q
=
OVER 10130 1 20 DO 020�i
l/ Y/
M G SET/FREq CHANGER-HP �
WELDERS AO-KVA Tnm A,f vD
GENERATORS - KW r� r
TRANSFORMERS - KVA
TEMP MOTORS (76 of vaiu)
MOVED MOTORS (76 of RRIo)
MI00
SIONB
NO NO TRANS.
NC NO LAMPS APPROVALS
FOR EACH PERMIT- DATE INSPECTORIB NAME
WIRING Bloc CONDUIT -�—'�
FIXTURES Bl 00 In WIRING _
SUPPLEMENTARY SO FIXTURES
POWER
TOTAL FEE B f,/(/ UTILITYCO NOTIFIED
FINAL
76ASB3-CESOB 10.83 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING r
BUILDING AND SAFETY DIVISION ADDRESS S`
JOHN A. LAMBIE, COUNTY ENGINEER '�,
WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY + 46' le
NEAREST
FOR APPLICANT TO FILL IN a CROSS ST.
RECUT. TOTAL No. EACH PEE I
OUTLETS nRST 20 S2of OWNER ��/
LIGHT MAIL
SWITCH. AESS
DD' .10 ADD1
1
GA..'
ER ZO
LIGHTING 1 TOTAL FIRST 20 .20 CITY TEL.NO.
FIXTURES J{ ADD•L fO ELECTRICIAN O
OVER 20 J J
PANGEs CLO.DRYERS WTR.Mb. 1.00 ADDRES6 + ✓ 1 –e G
GARB.Dior. RA.COOK
CITY L L- + .(,/� -, TEL. NO.
DISHWASH. AUTO.-WASM. STATE
SPACE MTM. RA.APP.(K X.P.MA14) .50
LICENSE NO. i
MOTORS, OVER NOT OVER H.P. C/ DLSy1jiICTN P zr PROgE$5D
a
1 a 1.Bo INSPECTION RECORD O
a a 2.00 w
5 15 2.50 LL
t5 Bo 3.00
Bo 100 5.00 O
SIGNS, NO.TRANS. d
NO.LAMPS W
SERVICE O-600V.NOT OVER 200A f.00
SERVICE 0-600V-OVER 200 A. 2.00
SERVICE OVER BOOV 5.00
MISC.
PERMIT ISSUING FEE 2.00 '71
-
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INIP[ROR'BSIGNATURE
I AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FOCTURES
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
IIF DESCRIBED RESIDENTIAL PROPERTY. POWER
SIGNATURE UTILITY CO.NOTIFIED
OF PERMITTEE—
FINAL
VALIDATION ARTHUR C. VEIT
SUPERVISING ELECTRICAL ENGINEER
CK MO CASH
78A oBEaA O-Eo I APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY FO LOS ANGELES ELECTRIC , 1
WILLIAM J FOX CHIEF ENGINEER '
FOR APPLICANT TO FILL IN
DISTRICT NO Gppup Z NE PERMIT NO
�- C. R ��/
ELECTRICIAN 7A � 7 '
REC D HY READY POR DAT[ISSUED
ADDRESS / t FIRST INSPECTION _ ,Y i
CITY (^ fIATSARY
TEL N '"�^Y JJ7
COUNTY LICENSE BUILDING ./
PERM PEES AD.R 162 e
NUMNUM13SR EACHI "itLOCALITY C E
LIGHT OUTLETS NEAREST _
CROSS BTomr
REC¢PTACL[H
WALL SWITCHES OWNER
TOTAL OUTLET v Sc f MAIL ^1 /
ELEC RANGES IIS ADDRESS
ELEC HEATERS IIS
T¢
FIXTURES 6 /V
1 N[REBY ACKNOWLEDGE THAT 1 HAVE READ THIS
MISC APPLICATION AND STATE THAT THE ABOVE IS CORRECT
NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS AND STAT[ LAWS REGULATING ELECTRICAL WIRING
MOTORS 1 CERTIFY THAT 1 POSSESS THE ABOVE VAUD LDS
ANGELES COUNTY LICENSE OR I AM THE LEGAL OWNER
NUYEER HORHEPOWER F[[ OF THE RSHIDENTIAL PROP DlSppgglB[/D/ABOVE.
NEw Mvo HP OYER INC
EACH
� (/ I/�'?
1 e LEp ¢a SIGNATURE OF
J i[/
1 Y a0 PERMITTEE
II a 1 00 INSPECTION RECORD
a /a too
Ia ao II So
O 20Q S 00
IIoo Soo 1000 ,I
Soo 1000 1a DO Q
Z
OVER 1000 1000 5
M G SET/FREQ CHANGER-HP fY
WELDERS AC-KVA 0
GENERATORS-KW
TRANSFORMERS-KVA
TEMP MOTORS TS orORla
MOVED MOTORS TB° or ORIG
SC
SIGNS
No No TRANS APPROVALS
NO LAM
DATE INSPECTOR B NAME
FOR EACH PERMIT
WIRING 1 00 CONDUIT
FIXTURES 1 00 0 V WIRING �I
SUPPLEMENTARY SO FIXTURES —
POWER
TOTAL FEE aA� GD UTIUTYCO NOTIFIED J
L Q FINAL Z
WORKERS'COMPENSATION DECLARATION 806 ID,B, APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm
m that I have a certificate of consent to self CE 806r,
insure or a certificate of Workers Compensation Insurance COUNTY OF LOS ANGELES BUILDING AND SAFETY
+ or a certified copy thereof (Sec 3800 Lab C ) r
}
Policy Na Company FOR AFPUCANT TO RLL IN ADDRESS / Ir�''%Y / A• �� 't
Certified copy is hereby furnished New Residential Bldgs & Pools EACH NO FEE
i LOCALITY
❑
Certified copy is filed with the county building mspec- 1 8 2-Family Sq Ft S — S f
non department Muth family Sal Ft NEAREST
Residential Swimming Pools OWNER OR
Date Applicant
FIRM NAME �1i1 r r i.+lt/". •r! .•
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec_Light_Sw_ MAIL
COMPENSATION INSURANCE ADDRESS J Fi;L r+ /fi< . •t
(This section need not be completed If the work Involved by First 20 CITY.~ Tel No ,
r the permit is for one hundred dollars ($100)or Ins ) Total No Additional I,, o•V.
certify that in the performance of the work for which this PIAN CHECKAPPLICANT
permit is issued I shall not employ any person in any manner
so as to become subject to the Workers Compensation L wit Lighting Fixtures First 20 ADDRESS
Additional 1
J_ - A Total No CITY Tel No
Date?t a.. ePPhcant 'x !- -w Fixed Appliances Not Over 1 HP PERMIT
r NOTICE TO APPLICANT If, after making t Certificate of APPLICANT 7,J .,�f � 1' .G •✓
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 _ ADDRESS
with comply with such provisions or this permit shall be
deemed revoked Hoped _ Fan _Other_ I CITY, ,�.r Tel No
LICENSED CONTRACTORS DECLARATION LICENSEI hereby affirm that I am licensed under provisions of Chapter 9 Disp Room Air Cond Oft
REG NUMBER lft( ri l : Class �7
(commencing with Section 7000) of Division 3 of the Business DISTRICT NO PROCESSED BY
Power t8 Large Appliances d
and Professors Code and my license is m &Type H full force and effect `•-- O
Size 8 Type HP, KW KVA, or KVAR / _ /'�..• U
License Number. 7 r Lic Class 4f r Up to I Incl FINALW
DATE
Contractor r � '�.f �. v r !' pore •�•y+ Over I to 10 Incl < ( VALIDATION
❑ Over 10 to 50 Incl FINAL i Im
I am exempt under Sec Over 50 to 100 Inc BY Q
B 8P C for this reason Over 100 K
O
Dote Services Swbd PMCC 8 Panelboards ► d 1 - W
0 -200 Am Under 600 V r, u
Signature - 201 - 1000 Amp Under 600 V F
❑
Exemption for Reg MOver 1000 Amp or Over 600 V
mnr Elect
SINGLE FAMILY Temp Power Pole 8 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
for the following reason (Section 7031 5, Business and
Professions Code) _
❑ j, as owner of the property, will do the work and the Mnc Conduits&Conductor
structure is not intended or offered for sole (Section Other (See Complete Fee Schedule)— r t� r•
7044, Business and Professions Code) Poo j (e e,N t h
CONSTRUCTION LENDING AGENCY
1 hereby affirm that there is a construction lending agency for
the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) tel`w st �f
(Sec 3097 Civ C )
PLAN CHECKING FEE i l Q 0 n h
Lender s Name
PERMIT ISSUING FEE
Lender s 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
ordinances and State laws regulating Elecmcol wiring, and
hereb r uif) representatives of this County to enter upon
the a-me Honed prop for inspection purposes ,
F SEE REVERSE FOR EXPLANATORY LANGUAGE
nature of P rr6Htee Date ,