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HomeMy Public PortalAbout6424 TEMPLE CITY BLVD_Electrical__ 7GA663-CROOS ALN APPLICATION FOR ELECTRICAL"PERMIT U COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING Z �� - Vr BUILDING AND SAFETY DIVISION ADDRESS JOHN A LAMBIE COUNTY Em0IN[[R _ COLEMAN W JENKINS. SOPRRINT r'BNT OF BUILDING LOCALITY C//) FOR APPLICANT TO FILL IN NEAREST CROSS ST NO A RECEPT_ OWNER MAIL LIGHT_L L FIRST 20 20 ADDRESS SWITCH_ OVER 20 10 CITY TEL NO PLAN CHECK LIGHTING L FIRST 20 20 APPLICANT FI%TURESOVER 20 10 ADDRESS RANGE_DRYER_WTR HTR _ CITY TEL NO STA COOK_DISP _F A U _ QQIJTRAC iOR Q O SPACE HTR _,AIR COND ADDRESS i✓ JVD CLOTHES WASH _DISHWASH CIT O NrM TEL NOK- ON Z FAN_OTHER 1 00 LICENSE NO 1V SDI CLASS IO MOTORS TRANSFORMERS RATING IND HEATERS ETC HP KW KVA I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION SIZE 6 TYPE OV CR TO AND !TATE THAT TNC ABOVE 13 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY OROIMA MCE3 AND STATE LAW! REGULATING ELECTRICAL WIRING O - 1 1 00 HERESY CERTIFY REQUIR TNAT I AM PROPERLY IN Y AND ED AND/OR 1 - 10 3 00 LICENSED AS REQUIRED BY HE ANGELES OW ER OF AND STATE OF TO CALIFORNIA OR THAT 1 VE THE LEGAL OWNER OF AND INTEND TO T ID 5D 5 DD RERIDf THE ABOVE DE3[PIf CO Rf DC NT IAL PROPERTY O SIGNA I U 50 - 100 10 00 pF PERMI 5 O 100 - 500 1500 ~ DISS T N G OUP N� P CESSED BY w SIGN GAS A� TUBE OR SIGN AND ONE CIRCUIT 300 A y MARQUEE ADDITIONAL CIRCUITS 1 00 Z NOTES AA (! SERVICE NOT OVERNSOD VOLTS OR 200 AMP 12 00 2_ 00 SERVICE OVER 600 VOLTS OR 200 AMP 5 00 TEMP SERVICE POLE IN APPURTENANCES 3 00 APPROVAL! DATE 1N3PECTCR5 SIGNATURE ]ROUGH EMP POWER POLE NDERSLAB WORK CONDUIT PERMIT FEE (SUB TOTAL) IRING - IXTURES PLAN CHECK FEE (SO% PERMIT FEE) OWER AUTHORIZED PERMIT ISSUING FEE 2 00 2- UTILITYCO NOTIFIED �7 SUPPLEMENTARY PERMIT ISSUING FEE 1 00 FINAL TOTAL FEE Iry JOSEPH C ROOHAN SUPERVISING EL EC CAL ENGINEER PLAN CHECK VALIDATION CK M D CASH PERMIT VALIDATION CK M O CASH .00"Errr,,0 3 7 9 JUL 9 2 D 4.00- EE E BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE V/1. y�Yl'C�"✓E✓ COUNTY of LOB ANGELES APPLICATION FOR PERMIT Department of County Engineer ������'� DIVISION OF BUILDING & SAFETY WILLIAM 1 FOX, Gu[b EiFIaMT FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRICIAN L. rT A-1 <r3/Ci-8' RECEIVED BYREADY FOR DATE 1 ADCREBB /n rI RBTI NeP[OT ION GITY TEL N -Z� ✓5//V}•/ �, COUNTY LICENIIE NO E%PIR[B BUILDING PERMIT FEES ADDRESS TT ML• FEE NUMBER EACH LOCALITY LIGHT OUTLETS 16 NEAREST -4 kL-v--A RECEPTACLES CROSS ST �•O _ .— 1 WALL SWITCHES OWNER TOTAL OUTLETS Sc MAIL [LCC RANGES 25 ADDRESS [LEC HATERS SS y5 CITY TEL N FI%TUR[H S D I I HERE AGKNf] EDO THAT 1 HAVE READ THIS MISO APPLICATION AND STATE THAT THE ABOVE IB CORRECT NUMBER OF LIGHT CIRCUITS AND AOR[[ TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER Or RECEPTACLE CIRCUITS AND STAT[ LAWS REGULATING ELECTRICAL WIRING MOTORS 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOB NUMe[R HORSEPOWER FEE ANO[L= COUNTY LICENSE. OR 1 AM THE LEGAL OWNER N[w MVD MP o m ,ND EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE 3 . Lt" 25 SIGNATURE O►` dTf_ A V27 SO PERMITTE 2 ° ' OG INSPECTION RECORD S is 1 60 IS 50 250 IID 21m a o0 200 000 /0.013 J 500 1000 1500 IQ � PA Z EOVER lOOO 2000 � � O N O ST FR CHANGER-HP Tv Y EL WELDERS AO-KVA x — Ftp ) O GENERATORS - KW TRANSFORMERS - KVA TEMP MOTORS (75 or oERR) MOVED MOTORS 75 or Dele) misc SIGNS NO NO TRANS. APPROVALS N LA FOR EACH PERMITR DATE � INBP[CTOR'S NAM[ WIRING 91.00 O CONDUIT FIXTURES mica I WININGNUPPLKMKW TARY So rIKTUR[B POWER TOTAL rEE UTILITY CO.NCTm ED _ //-,r, FINAL 7Ma61 Dee#e11 1.61 WORKER 9avea ca8AT1ON of consent 7""3 DPyy9fee APPLICATION FOR ELECTRICAL PERMIT " I heroSY affirm iMl I have a certdice{e of convent to self Insure 78AeSs or e.cenlflcate of worker a bompeneation Insurance or a certified COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV copy thereof(Seo 3800 Lab C 1 _ • ) I _ Poky No 4/4Z" Company /" /'UN� FOR APPLICaNf To taLL IM O EWIrlmA,44211_ G ❑ Certdkd copy m hereby fumlehed New Residential Bldgs 6 Pods EACH NO FEE ❑ C(Niled copy la Bled with the county,building I 1&2 family SQ Ft S — LOCALITY ' department Mulct family So Fl NEA ST B ' Date 'Applicant Residential Swimming ee I A99ES90R ULAIR BOOK CERTIFICATE OF SATI N IN FROM WORKERS Ordlels R. Light FlrsSw L 70 7 0� q�RHI Ful COMPENSATION INSURANCE ',/ J (This section need not be completed If the work Involved by the tool No Addtional W'AODBEL 99 Et9 BG!/ permit Is for one hundred dollars($100)or lase) I certify that In the performance of the work for which this permit _ CITY v Tel No IS Issued I shall not employ any person in any manner so as to CHEM become subject to the Workers Compensation Laws r Lghlurg Fixtures Q Fast 20 O r Total No Additional ADDRESS Lt7 Date Applicant 4-=R 2DA,120V BRANCH CIRCUITS'— NOTICE TO APPLICANT If alter making this Certificate of CITY ��(a Tel No Exemgbn you should became subject to the Workers Compenaslion 1 TO 10 INCLUSIVE EACH provisions of the Labor Code you must forthwith comply with such 11 TOM INCLUSIVE EACH provisions or this permit Shell be deemed revoked n OR MORE BRANCH CIRCUITS EACH LICENSED CONTRACTORS DECLARATION 15 OR 20A 209V TO 277V LIGHTING EACH ADDRESS d I hereby affirm that 1 am licensed under provisions of Chapter 9 O (commencing with Section 7000) of Division 3 of the Business and CITY _ a TOW V Professions Cade and my[menu Is In full force and effect RESIDENTIAL APPLIANCES UP TO SHP LICENSE OR Own rr Power AppereNa A Large Appliances _ REO NUMBER O License Number 603 4,,LL// Lo Class Size&Type HP KW KVA or KVAR DISTRICT N`,0 F- '- Upto31rmI /•e8 1 W ContractorM FP GOd/ST Data to101nci RNA_ Over 130 W 50 Incl _ TE \\❑ I ern exempt under Sac Over SOW 100 Ind b-3o •./ VALIDATION B 8P C for this reason Ger 100 FINAL NAL Services Sw od MCC 6 Panemmrde Dale 0 200 Amp Under 800 V Signature 201 1000 Amp Under 800 V 2 E] _ Over 1000 Amp or G00 Over SV v t Exampaon for Reg Mamt Elect ACCT, SINGLE FAMILY Temp Power Pole 8 Appurtenances 99.97 HOME OWNER BUILDER DECLARATION Sign with One Brand)Circuit hereby affirm that I am exempt from the Contractor a License Law for the following reason (Section 7031 S Business and Profifulons Addbrwlal Sign Branch Circuits 1 ITEMS Code) ❑ I as owner d the property will do the work and the Structure Mae Conducts, e a DonducnorTOTAL '99 ;97 Is not intended or offered for Sale (Section 7044 Business Other(See Complete Fee Schedule)_ CHECK 79.97 and Professions Code) - - - ► CHANGE •Oil CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the performance of the work for which this permit is Issued (Sec 3097 PERMIT FEE _ _ _ _ (SubTWA Z Q9DU-rio0 i r •,n ' 7/92 CN C) PLAN CHECKING FEE 6094 i AMi[f'11 Lender a Name PERMIT ISSUING FEE Z Lander a Address TOTAL FFF I certify that I have read this application and stele that the above 1 •-1 information is c rract I agree to comply with all County ordinances and Stele Is regulating Iecirlcel wiring and hereby authorize repreaentet of ihi my to nter upon the above mentioned props 1 peal SEE REVERSE FOR EXPLANATORY LANGUAGE -7-imcm `�Z AOFHT DATE