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Home My Public Portal About6341 TEMPLE CITY BLVD_Electrical__ t l Al 1 1 - A .Jti � A.. _ WWROM . i �- 1 7aAa67 OW BA RSM 111 B ll- APPLICATION FOR PERMIT DEPARTMENT OFNG AND SAFETY ELECTRIC 1 COUNTY OFF LOS LOS ANGELES WILLIAM J. FOX. 1 F EMpINEE DISTR15r ND. GR �FO �+UP ZONE PERMIT NO. FOR APPLICANT TO FILL IN ) / — S 5-c) ELECTRICIAN RECEIVED BY READY FOR DAT[ ISSUED /`J/� 1 / lj FIRST INSPECTION ?- ADDR[SB MO'�1/T` 3 CITY T[L NO BUILDING LICENSE NO O �I/ A "PIREQ DDRESS DESCRIPTION OF WORK NUMBER OUTLETS MACH Feld LOCALITY cgpee LIGHTS Se Ip RECEPTACLES B FIXTURES 6 OWN WALL SWITCHES 6 MAIL AODR [LEC RANGES 26 EL[C T[RS SS CITY / L' T[L NO IBC 6 I CERTIFY THATI POSSESS THE AS VA LOB NUMBER OF CIRCUITS INSTALLED ANGELES COUNTY LICENB LIONLIONTS RIECVPTACLEB MOTORS fted.RIOIAN MUM" HORSEPOWER F[[ N[w Mvo HP Rv[R INC EACH I AM THE L[OAL OWNER OF THE RESIDENTIAL PROP• I� a Lba B 13 KATY DESCRIBED ABOVE. 1/ R SO Z B 100 p ZR B 1B 1 SO INSPECTION RECORD 13 Bo a Bo BD wp 1 5013 lop BOO to OO 13 l 000 a0 600 'I a w1R 1 wD Zp w __ M G 5tTjFREq CHANG[R-HP a WELDERS ^C-"A D GENERATORB - K TRANSFORMERS - "A TEMP MOTORS (76 of oRIR) MOVED MOTORS (73 of oRIR) MISC SIGNS TYPE NO TRANS D LAMPS APPROVALS PERMIT FEE DATE INSPECTORIBNAME FOR ISSUING PERMIT CONDUIT WITHOUT FIXTURES B1dD WIRIND WITH FIXTURES1 ZS FIXTURES SUPPLE N A Y 30 POWER TOTAL FEE B / OO UTILITYCO NOTIFIED FINAL TEMPLE CITY 76AS53 CE305 4$B APPLICATION FOR ELECTRICAL PERMIT 63 yzl `l COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION AODgE55 Te le City Blvd. JOHN A LAMBIE, COUNTY ENGINEER COLEMAN W JENKINS, SUPRRINTtNOtNTOFBUILDING LOCALITY Temple Cit FOR APPLICANT TO FILL IN NEAREST CROSS ST Longden RECEPT _ 3 f OWNER Sacatie MAIL LIGHT_ TOTAL FIRST 20 20 ADDRESS 6361 Temple City Blvd. SWITCH_ OVER 20 10 CITY T C TEL NO 286-2020 PLAN CHECK LIGHTING TOTAL FIRST 20 20 APPLICANT FIXTURES OVER 20 10 ADDRESS RANGE_DRYER_WTR HTR _ CITY TEL NO STA COOK_DISP __F A U _ CONTRAC roR Conlee & Son Electric SPACE HTR __AIR COND _ ADDRESS1030 N. Grandview Ave. CLOTHES WASH _DISHWASH _ CITVS.San Gabriel TEL NO 280-2007 FAN—OTHER 100 LICENSE NO 242432 CLASS C 10 MOTORS TRANSFORMERS RATING IND HEATERS ETC HP KW KVA I NERDY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION $12E 4 TYPE OVER TO AND STATE THAT THE ABOVE 13 CORRECT AND AGREE TO COMPLY WIT ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WINING 0 1 1 00 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 1 10 3 00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND IN D TO ID 50 $ DD RESIDE IN THE ESCRRCD RESIDENTIAL PR Tl so $0 - 100 1000 SIGNATURE I S OF PERMITTEE U 100 - 500 15 00 DISTRICT N G P Z P E D SIGN GAS TUBE OR SIGN AND ONE CIRCUIT 3 00 U MARQUEE ADDITIONAL CIRCUITS 1 00 1 NOTES F . I , y SERVICE MOT OVER SOD VOLTS OR 200 AMP 2 00 T�f SERVICE OVER 500 VOLTS OR 200 AMP 5 00 ��v /� TEW SERVICE POLE h APPURTENANCES 3 00 Al VA DATE INSPECTOR'S SIGNATURE underground ullbox 2 00 TEMP POWER POLE FFINALI WORKUITPERMIT FEE (SUBTOTAL)PLAN CHECK FEE (50% PERMIT FEE) ORIZED �1PERMIT ISSUING FEE 200 2 OTI F IE t"SUPPLEMENTARY PERMIT ISSUING FEE 1 00 TOTAL FEE 4 JOSEPH C ROOHAN ' SUPERVISING ELEC ICAL ENGINEER PLAN CHECK VALIDATION CK M D CASH I PERMIT VALIDATION cK M 0 CASH I Ar,j 6 8 4c' JM2 6 2 D 4.00 f EE HACK OF APPLICATION FOR COMPLETE FEE SU EDULE .A!_� COIINTY OF LOS AIf=M — APPLICATION FOR PERMIT DEPARTMENTOF COUNTY ENGINE EII ELECTRIC 1 ' DIVISION ON OOF BUII.DING 6 SAFElY WILLIAM . FOX COUNTY ENQnMII FOR APPLICANT TO FILL IN DISTRICT NO GROUP ZONE PERMIT NO ELECTRICIAN J — / 926 q3 ADDRESS RECEIVED READY FOR DAT# I58 PIRSTINBPECTION / s^ CITY TEL NO 6 ✓f COUNTY LICENSE NO EXPIRES BUILDING PERM FEES ADDRESS �7 Y NUMBER G ?ANQw I ITY LIGHT OUTLETS BT uu N RECEPTACLES MI� (� Q 0 I` QQu - v WALL SWITCHES ER VSe tv it TOTAL OUTLETS Ec 3 I V ELEC RANGES Y6SS ELEC HEATERS E8 FIXTURES aCITY L ash TEL No Z.O1 MI HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS NUMBER OF LIGHT CIRCUITS ATION AND STATE THAT THE ABOVE 16 CORRECT ANDREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBS OF RECEPTACLE STATE LAWS REGULATING ELECTRICAL WIRING MOTORS ERTIFY THAT i POSSESS THE ABOVE VALID LOS NumRa HORSEPOWER PEES COUNTY LICENSE. OR I AM THE LEGAL OWN[ Nm Mvo HP ova I INCEACH OF THE RESIDENTIAL PROPERTY DMSCIVBKD ADOV •L s 4 28 BIGNATURB OF E 80 FERMICMA4a.4c s a 1 00 (INSPECTION RECORD E is 1 Eo 1E Bo s Eo 80 E00 8 00 goo BOO 1000 J eoo t000 1E 00 Z vER t000 20 00 V M G SET FREO CHANGER-HP K WELDERS AC-KVA GENERATORS KW TRANSFORMERS-KVA TEMP MOTORS I] OI ojpm MOVED MOTORS /7896 o RIa MISC IGNS NO NO TRANS APPROVALS NNO LAMPS FOR RAC14 PERMIT DATE INSPECTOR'S NAME WIRING $1 GO CONDUIT FIXTURES $1 00 LIRIN -SUPPLEMENTARY 80 TOTAL FEE E / NOTIFIED / TM� OEW M A 11& I �' 1 1 1 I I • I APPUCANT FUL INHEAVILY OUTLINED EMI 1 I ONLY i WORKERS COMPENSATIONIave DECLARATION peer°°°""� APPLICATION FOR ELECTRICAL PERMIT O .I hereby off irm that I hove a certificate of consent to self �� ` insure w a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS or a certified copy thereof (Sec 3800, Lob C ) P licy NoCom y FOR APPLICANT TO FILL IN JOB Certified copy s hereby furs shed New Residential Bldgs 8 Pools EACH NO FEE AWRESS Certified copy is filed with the county building mspec- 1 8 2-Family, Sq Ft $ = $ LOCALITY eon department Multi-family Sq Ft NEAREST Residential Swimming Pools CO ST Date Applicant FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec—Light_Sw— 'WAIL COMPENSATION INSURANCE ADDRESS.2 (This section need not be completed If the work Involved by First 20 Total No Additional" CITY ��// Tel No �� 9 the permit Is for one hundred dollars($100)or Ins) l t I'LAIJ 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 so os to become subject to the Workeri Compensation Laws Lighting Fixtures First 20 ADDRESS Additional Total No CITY Tel No Dote Applicant Fixed Appliances Not Over I HP PERMIT NOTICE TO APPLICANT If after making this Certificate of APPLICATION a 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 Top — FAU —WH — deemed revoked Hood — Fan —Other_ CIN Tel No LICENSED CONTRACTORS DECLARATION LICENSE OR Disp — Room Av Cond Class I hereby affnm that I am licensed under provisions of Chapter 9 REG NUMBER (commencing with Section 70DO)of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NO ED BY d and Professions Code and my license is in full force and effect [� Size 8 Type HP, KW, KVA or KVARD c) License Number Lic ClassUp to I Incl FINAL U Q Over I to 10 Incl DATE – 'l VALIDATION C) Contractor Date Over 10 to 50 Incl U ElFINAL I am exempt under Sec Over 50 to 100 Inc BY LU B 8P C for this reason Over 100 d ' Z Dote Services Swbd MCC&Ponelboords 010. z 0-100 Amp Under 600 V Signature 201 - 1000 Amp Under 600 V ❑ Cher 101X1 Amp or Over 600 V Exemption for Reg Mamt Elect SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Temp Power Pole 8 Appurtenances ' Sign with One Branch CircuitFp.l 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 3307 31,Q Professions Code) O-A I, as owner of the properly, will do the work and the Msc Conduits8 Conductor ITEM structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)— ► TiJ(jPL 31 - 00 Business and Professions Code) 1,IJIJ CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for CHANGE MLI the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) (Sec 3097 Civ C ) PLAN CHECKING FEE Lender s Name PERMIT ISSUING FEE J Lender s Address ul 1 9.5,' I cerl4y that I have rood this apphcmion and state that the TOTAL FEE -07 above information is correct I ogres to comply with all County ord,hances and State laws regulating Electrical wiring, and hereby authorue e fives of this County to enter upon the abov yyd For inspection purp s SEE REVERSE FOR EXPLANATORY LANGUAGE O�Sioncfture of PWyya to �s WORKERS COMPENSATION DECLARATION �aatga�=/® APPLICATION FOR ELECTRICAL PERMIT ' IJiereby affirm that Ihave ave 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 POR APPLICANT TO FILL IN lOB Certified copy is hereby furnished New Residential Bldgs 8 Pools EACH NO FEE � � Certified copy is filed with the county building mspec- 1 &2 Family Sq Ft $ — E LOCALITY eon department Multi-family Sq Ft — BAREST CROSS Si Residential Swimming Pools OWNS Dote Applicant FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec_Light_Sw ADDRESS COMPENSATION INSURANCE (This section need not be compleNd If the work Involved byFirst 20 CITY Tel Na p the permit Is for ono hundred dollars ({100)or less) Total No Additional 2 CS/1 certify that in m the performance of the work for which CHECK h this APPLICANT Permit is issued I shall not employ any person in any manner Lighting Fixtures First 20 ADDRESS so as to become subject to the Workers Compensation Lows Additional Date Applicant Total No CITY Tel No Fixed Appliances Not Over 1 HP PL NOTICE TO APPLICANT If, after making this Certificate of AAPPL PERMIT — Exemption you should become subject to the Workers Range— Heater—DW — Compensation provisions of the Labor Code you must forth- Coven _ Dryer _W M — ADDRESS with comply with such provisions or this permit shall be Top — FAU _WH — deemed revoked CITY Tel No Hood Fan —Other_ LICENSED CONTRACTORS DECLARATION LICENSE OR Dap _ Room Air Cond RE NUMBER 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 NO PIRZD BY d and Professions Code and my license is in full force and effect Q Size&Type HP, KW, KVA, or KVAR O License Number Lic Class— Up to 1 Incl CD FINAL Over 1 to 10 Incl DATE _ 6 Z VALIDATION 0 Contractor r>^te Over 10 to 50 Incl U F-1 FINAL I am exempt under Sec Over 50 to 100 Inc BY LU B 8P C for this reason Over 10D Dote Services, Swbd , MCC 8 Ponelboords ► Z 0 200 Amp Under 600 V Signature 201 1000 Amp Under 600 V El Exemption 1000 Amp or Over 600 V Exemption for Reg Moms Elect SINGLE FAMILY Tem Pole 8 HOME OWNER-BUILDER DECLARATION P Power Appurtenances I hereby affirm that I am exempt from the Contractor s License Sign with One Branch Circuit r}t„L T.4T Low for the following reason (Section 7031 5, Business and Additional Sign Branch Circuits ^ •h],i I_ "tons Code) ''3�1-•1 ` Prof os owner of the property, will do the work and the Mix Conduits 8 Conductors 1 1TEIME structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule}_ , TI ITf L. 20 • 00 Business and Professions Code) I a_H +Li.t'I_ CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for i_ ANGE Ni, the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) ho (Sec 3077 Civ C ) Lender s Name PLAN CHECKING FEE 13 13 fi/17ryi PERMIT ISSUING FEE 75S21 1 Lender s Address Ah 3CfI'7 1 certify that I have read this application and state that the TOTAL FEE r above information is correct I ogree to comply with all County ordinances and State jaws regulating Electrical wiring, and hereby authorize representatives of this County to enter upon the above tions r s ion Purpos1 �� 6 SEE REVERSE FOR EXPLANATORY LANGUAGE g azure of PermitJ__ ate ms ,t .by W�S'CI lave a TION DECLARATION 6AW APPLICATION FOR ELECTRICAL PERMIT ,. I Mereby affirm that I have a certificate of consent to self a-easa insure or a certificate of Workers Compensation Insurance COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a Artdied copy thereof (Sec 3800 Lab C ) Rolicy No Company FOR APPLKANT TO RRL IN JOB /3 Certified copy is hereby furnished New Residential Bldgs 8 Pools EACH NO FEE SS Certified copy is filed with the county building inspec 18 2-Family, Sq Ft $ — S LOCALITY lion department Multi family Sq Ft — :'JADDRESS REST SS ST Dote Applicant Residential Swimming Pools ` ER OR CERTIFICATE OF EXEMPTION FROM WORKERS' /0 NPJAE COMPENSATION INSURANCE Outlets Rec ight_Sw _ J(This sedlon need not bo completed if the work Involved by /_cFirst 20 L• Tel No the perrntlt Is for a"hundred dollen ($I00)or less ) Total No —LQ�J. Additional ` L 9� RAN CHECK I certify that in the performance of the work for which this APPLICAM permit 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 CITY Tel No Dote Applicant Total No Fixed Appliances Not Over 1 HP NOTICE TO APPLICANT If after making this Certificate of PERMIT Exemption, you should become subject to the Workers Range— Heater—DW — 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 Hood — Fan —Other— CITY Tel No LICENSED CONTRACTORS DECLARATION LICENSE OR hereby offum that I am licensed under prowstons of Chapter 9 Dtap — Room Air Cord NUMBER Clan (commencing with Section 7000)of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NO PRQgSSED BY d and Professions Code and my license is in full force and effect p Size 8 Type HP, KW, KVA or KVAR QQ 0 License Number Lic Clau Up to 1 Incl FINAL U Over I to 10 Incl DATE `— 1 6�R]� VALIDATION � Contractor rite Over 10 to 50 Incl U OFINAL am exempt under Sec Over 50 to 100 Inc BY UJ B BP C for this reason Over 100 a_ Dote Services, Swbd, MCC 8 Ponelboards ► Z 0-200 Amp Under 600 V Signature 201 - 1000 Amp Under 600 V Exemption far Reg Mamt Elect Over 1000 Amp or Over 600 V SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Temp Power Pole 8 Appurtenances I hereby affirm that I am exempt from the Contractor s License Sign with One Branch Circuit �I i Law for the following reason (Section 7031 5, Business and Additional Sign Branch Circuity , Professions Code) 6-5117 67.Ua ® I, as owner of the property, will do the work and the Misc Conduits&Conductor 2 1 I Ehh� structure is not intended or offered for sole(Section 7044 Other (See Complete Fee Schedule. ' TOTAL 67 _ �� Business and Professions Code) CONSTRUCTION LENDING AGENCY CHECK t7.lRJ I hereby affirm that there is a construction lending agency fa CHANGE .(li I the performance of the work fa which this permit is issued PERMIT FEE (Sub-Total) (Sec 3D97, Civ C ) PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE I3003-131301 6.1'il Lender s Address 7.7.166 i AN 4:L. 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 lows regulating Electrical wiring, and hereby authorize representatives of this County to enter upon , the abov -me do rbp or mspecaon rpos s / � 9� SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of er �y to 0i