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Home My Public Portal About6346 TEMPLE CITY BLVD_Electrical__ ]BAOBS CESDB 4-68 APPLICATION FOR ELECTRICAL P T � C6UNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION AD ESS JOHN A LAMBIE COUNTY ENGINEER COLEMAN JENKINS, SUPeRINTtNocNT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST ACH FE RECEPT_ S OWNER Ty NAIL LIGHT_ TOTAL FIRST 20 20 ADDRESS SWITCH_ OVER 20 10 CITY TEL NO PLAN CHECK LIGHTING iTOTAL FIRST 20 20 APPLICANT FIXTURES 7( OVER 20 10 ADDRESS RANGE—DRYER_WTR HTR _ CITY TEL N STA COOK_DISP _F A U _ CONTRAC iOR / SPACE HTR _AIR GOND ADDRESS CLOTHES WASH _DISHWASH _ CITY W, EL NO "�Zl FAN—OTHER-1100 LICENSE NO CLASS MOTORS TRANSFORMERS RATING IND HEATERS ETC HP KW KVA I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION SIZE 6 TYPE OVER TO ANO STATE THAT THE ABOVE If CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES ANO STATE LAWS REGULATING ELECTRICAL WIRING 0 - 1 1 00 I HERESY CERTIFY THAT I AM PROPERLY REGISTERED AMD/OR 1 10 3 00 LICENSED AS RECLINED BY LOS ANGELES COUNTY AND STATE OF CALI PORN IA OR THAT I AM THE LEO AL OWNER OF AND INTEND TO 10 SO S 00 RESIDE IN THE ABOVE DCS RIFE RESIDENTIAL PROPERTY - O_ IGNATU SO - 100 11000171 PERMITTEE TEE A �� C U 100 - 500 is 00RICT GROUP ZO E PROCESS BY c SIGN GAS SIGN AND ONE CIRCUIT 3 00 /TUBE ORQIaUMARQUEE AODITIOHAL CIRCUITS 1 DOSS�IVIOE NOT OVER BOD VOLT9 OR 200 AMP � 2 00SERVICE OVER 600 VOLTS OR 200 AMP b 00 TEMP SERVICE POLE 8 APPURTENANCES 3 00APPROYA Lf DATE INSKCT011 f fIG1YTUE POWER POLERSLAB WORKH CONDUITPERMIT FEE (SUB TOTAL) GRESPLAN CHECK FEE (SOX PERMIT FEE) R AUTHOR'ZED GPERMIT ISSUING FEE 200TY CO NOTI FIEDSUPPLEMENTARY PERMIT ISSUING FEE 1 00FINAL TOTAL FEE OO JOSEPH C ROOHAN SUPERVISING ELE ICAL ENGINEER PLAN CHECK VALIDATION CK M o CASH PERMIT VALIDATION cK M 0 CASH 0176� FAY 26 2 D 4.0 QM a EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE J/ 1V wQRImVBCOMPENSATION consATw001 w N DPye/ APPLICATION FOR ELECTRICAL PERMIT 7t I heraDy atilrm tbet I have a certlllcateete ofof consent to sell Insure 730M or a cytiflcate of Worker a Compensation Insurance or a certified COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV copy thereof(Sec 3800 Lab C) Polley No Company FOR APPUCG To FLLL IN ❑ CmOBed copy le hereby furnished New Residential Bldgs 8 Fools EACH NO FEE —TZ- -1!/• ❑ Cen fled copy Is filed with the county building Inspection 1 8 2 Family Sq Ft $ — $ LOCALITY department MURI family Sq Ft — NENRI�OCf� Data AFplicam Residential Swimming Poole ASSESSOR MAP BDOK PA PIF41 CERTIFICATE OF EXEMPTION FROM WORKERS OuSete Rec VS:Light !S S. IS �� PwAtov�O1 COMPENSATION INSURANCE kt,s� (This cation need not be completed If the wort involved by the First 20 ADO 3 .C gl..V permit is for one hundred dollars(0100)or Nu) Total No � Additional N v I certify that In the performance of the work for which this permit CITY I .. `( TW No Is Issued I shall not employ any person In any manner to as to Demme subject to the Workers C LphDng Fixtures Fkat 20 �� Data Total No 15 OR 20A 120V BRANCH CIRCUITS Addllfwrel ADDRESS ZO NOTICE TO APPLICANT If after making this Certificate of CITY Tet Ho Exemption You should became Subject W the Workers Compensation 1 TO 10 INCLUSIVE EACH provisions of the Labor Code you must forthwith comply with such 11 TO 40 INCLUSIVE EACH PERMIT prowislons or this permit shall be deemed revoked41 OR MORE BRANCH CIRCUITS EACH APPLICANT LICENSED CONTRACTORS DECLARATION ADDRESS4 I hereby affirm that I am licensed under provisions of Chapter B 15 OR 20A 209V TO 2T7V LIGHTING EACH (commencing with Section 7000)of Division 3 of the Business and _ C TM No Professions Code and my license is In lull force and effect RESIDENTIAL APPLIANCES UP TO 3HP UDENsE on 1 OI,y /s O �f�v Parer Apparatus 6 Lege Appliances REO NUMBER Vr/ License Number $�2 /e� L. Gem G 0 Sae 8 Type NP KW KVA or KVAR DISTRICT`ND p wq E Ep BY F Up to 3 Incl D/ W ContractorDate Over 3 m 10 Inc! CO DATE Over 10 to 50 Ind Z ❑ I am exempt untler Sec Over 50 to 100 Ind `C+ VALIDATION B AP C for this reason Over 100 FINAL BY Services Swbd MCC 8 P Dau o 20o amp under v � Signature 201 1000 Amp Under n ❑ Exemption for Reg Mem Elect Over 1000 Amp or Over 800 V JJV��n ` 7 179.5 . SINGLE FAMILY Temp Power Pole 8 Appurtenances Tom+ HOME OWNER BUILDER DECLARATION SM>"with One Branch Circuit 1 11 G11j I hereby affirm That I on exempt from the Business a s License rofLaw TOTAL 179.55 for the fdbwing reason(Section 7031 5 Business anti Professors Additional Sign Branch Grculm Code)❑ I as owner of the property will do the work and the structure MIS: Condu6 Concluctaa MICK 179.5E m Is not Intended or offered for eels(Section 7044 Business Other(See Complete Fee Schedule)_ , owa OL. and Professions Code) CONSTRUCDON LENDING AGENCY � en I hereby affirm that there is a construction lending agency for the 0000—M 1 8/20/92 performance of the work for which this permit Is Issued(Sec 3097 PERMIT FEE (Sub-Total) 5W1 �10:59 Civ C) 5 PLAN CHECKING FEE j Lenders Name PERMIT ISSUING FEE O' Lander s Address TOTAL FFA . I cartlty that 1 have read this application and state that the above Information is correct I agree to Comply with all County ordinances 1 and State laws regulating Electrical wiring and hereby authorize b h Dunt ter upon the above mentioned prop or In p em 5SEE REVERSE FOR EXPLANATORY LANGUAGE 20 4 I1 M