HomeMy Public PortalAbout6431 TEMPLE CITY BLVD_Electrical__ 76A%.63-CEBOB-1-ee
COUNTYAPPLICATION FOR ELECTRI L PE
OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER rA
ILDING 3
BUILDING AND SAFETY DIVISION Da ESsJOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS, SUPERINTENDENTCP BUILDINGCALITY R
NEAREST
FOR APPLICANT TO PILL IN I CROSS ST
NO/j C
RECE Pt
S OWNER l+O
LIGHT TOTAL FIRST 20 RAD 20 " ADDRESS
SWITCH /11 OVER 20 10 CITY TEL NO
PLAN CHECK
LIGHTING TO�TIAAL FIRST 20 20 ED APPLICANT ,
FIXTURES �� OVER 20 10 ADDRESS
RANGE—DRYER—WT HTR CITY TEL NO /J
STA COOK—DIS P/LF A U CON TRAC r RR d W ,
SPACE HTR ��AIRR,CONO ADDRESS
� lX/ ark/
CLOTHHEE�4'WAS" LDISHWASH CITY d0 TEL NO T ^I 6
FAN(�OTHER 100 LICENSE NO -S'g 5p CLASS
MOTORS TRANSFORMERS RATING
IND HEATERS ETC HP KW KVA I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
SIZE 8 TYPE OVER TO AND STATE THAT THE ABOVE 1! CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND
STATE LAWS REGULATING
ELECTRICAL WIRING
O - 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 OP
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO 1
10 - SO S 00 IM THE ABOVE DClCRIPED RESIDENTIAL PROPERTY O
60 - 100 10 00 SIGNATURE V
OF PERMITTEE 09
too — Soo 15 00 jrR'S'DE
IST I T G P P D
SIGN GAS g$ON AND ONE CIRCUIT 3 00
TUBE OR
d
MAROUEE ADDITIONAL CIRCUITS 1 00 2
IROUGH
T ES
SERVICE NOT OVER BOO VOLTS OR 200 AMP 2 00 SERVICE WER 600 VOLTS OR 200 AMP 5 00TEMP SERVICE POLE &APPURTENANCES 3 00 APPROVALS DATE INSPECTOR S SIG"TURE
MP POWER POLE
DERSLA B WORK
CONDUIT
PERMIT FEE (SUB TOTAL) RING
FIXTURES / !
PLAN CHECK FEE ( lv
505 PERMIT FEE) POWER AUTHORIZED
PERMIT ISSUING FEE 200 UTILITY CO NOTIFIED 0 1
SUPPLEMENTARY PERMIT ISSUING FEE 1 00 AFINAL _144F
TOTAL FEE JOSEPH C ROOHAN
SUPERVISING ELE AL ENGINEER
PLAN CHECK VALIDATION CK M o cgsH PERMIT VALIDATION CK M o cgsH
.40;EI !Ar,4 7 3 89 AM30 2 0 2 1.40;-
EE
E BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE ��
WORKER I have a CNSATION DECLARATION 76AM DPW efw APPLICATION FOR ELECTRICAL PERMIT
I hereby-affirm that I have a cenHlcete of consent to Bell insure ��
or a cenlflpete of worker a Compensation Insurance or a certified COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV
copy thereof(Sao 3800 Lab C) ,
Policy No Company FOR APPL1CArIT TO FILL a JOB 6431 Temple City Blvd
❑ Certified copy is hereby furnished New Residential Bilge 8 Pods EACH NO FEE LOCALITY
❑ Certified copy 4 Ned wilh the county building.pecten 1 A 2 Family Sit Ft = — $
department Mufti family Sq Ft — CCRRO�S.S NEAREST
Dets Appl{pnl ' . Residential Swimming Poole ASR
- L, OWNER Nu,BOOn PAGE PARCEL
CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Ree Light_Sw 2 _
COMPENSATION INSURANCE First 201E
�D
(This eectlon need rot be completed If the work Involved by the Iwvl
Total No Additionalpeit Is for one hundred dollars($100)or leu)
permitAODriE89
I certify that in the performance of the work for which this permit CITY TO No
is Issued I shell not employ any person in any manner so as to PUN CHECK
become subject to the Workers Compensation Laws Lighting Fixtures Fleet 20 APPLICANT
Total No Additional
ADDRESS
Data 15 OR 20A 12DV BRANCH CIRCUITS
NOTICE TO APPLICANT If after making this Certificate of CRY Tel No
Exemption you should become Subject to the Workers Compensation I TO 10 INCLUSIVE EACH
provisions of the Labor Code you must forthwith comply with Such 11 TO/D INCLUSIVE EACH PERMrt
APPUCArrr Seymour L. Mecum
provisions or this permit shall be deemed revoked
11 OR MORE BRANCH CIRCUITS EACH
LICENSED CONTRACTORS DECLAFiARON ADDRESS }
I hereby affirm that I am licensed under provisions of Chapter g 15 OR 20A 208VTOZ7N LIGHTING EACH 6431 Temple Cit Blvd a
(commencing with Section 7000) of Division 3 of the Business and CITY Temple City Tel HP 818/447-9127
Professions Cadeend my license is in lull force and affect RESIDENTIAL APPLIANCES UP TO SHP LICENSE OR Ct® O
Power Apparatus$Large Appliances REO NUMBER
License Number LIc Clew Size 8 Type HP KW KVA or KVAR DISTRICT NO By
UP to 3 Incl
Contractorpejo Wer 3 to 10 Incl DAh N
Over 10 to 50 Ind Q�❑ Z I am exempt under Sec Over 60 to 100 Incl N —�Z VALIDATION
B$P C lar this reason Over 100 FINAL
By
Servkee Swbd MCC a Pendboerds
Date 0 200 Amp Under Boo V
Signature201 1000 AMP Under 800 V
❑ Exemption for Reg Maim Elect
Over 1000 Amp or Over 800 V _
SINGLE FAMILY
Temp Power Pde 8 Appunxiarices
HOME am exempt
from
DECLARATION sly„with One Branch Cecuit
I hereby affirm that I em exempt from the Contractors License Lew
for the following reason (Section 7031 6 Business and Profession Additional Sign Branch Gmulls _-407 74.Code' E j
I es owner of the property will do the work and the structureMlec Conduits$conductwe i 1 i END'
Is not intended or defor sale(Section 7011 Business Other(See Capbte Fee Schedule)_ , T t ITAL .. m j
and Pmfesabna Code)) m
CONSTRUCTION LENDING AGENCY
1 hereby affirm that there Is a construction lending agency for the CFAIGE .IIQ
performance of the Work for which this permit Is issued(Sec 3087 PERMfT FEE (Sub Total)
CW C)
Lender a Name PLAN CHECKING FFA _ (I'l'](I-(Ii.1 J i /!T57 92,
PERMIT ISSUING FEE d' �r 73 1 (:g'( 9.0513
lander.Address _ _ �7 7• 9.�J
I certlry that I have read this application and state that the above TOTAL FEE _
Information Is correct I agree to comply with all County ordinances
and Slate laws regulating Electrical wiring and hereby authorize
representatives of this County to enter upon the above mentioned
PrOpo for inspec lon purposes SEE REVERSE FOR EXPLANATORY LANGUAGE
slDi TUIE OFAPP moR Aoerrt DATE
COUNTY OF LOS ANGELES TEMPLE CITY q 0506 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1209170012
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID FEES PAID BUILDING ADDRESS
ON FILE I 6431 TEMPLE CITY BL
FEE DESCRIPTION QUANTITY UOM AMOUNT I TEMP CA 917801435
(ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET
15382-022-053 Al PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 596 GRID J1 LOCALITY TEMPLE CITY Cl
IP2 PC RES PV<10KW 153 90 I
(TENANT IP3 INVRTR RES PV<10KW TOTAL FEES 2027 90 9 60 109/1E/12N PROCESSSED BY PLAN BY
SR
OWNER TEL NO I (FINAL♦��DATE FINAL BY CODE
MECUM SEYMOUR L ISABEL (626) 447-9427- I �_n/I
6431 TEMPLE CITY BL /1 /"�/� 4 A/
(TEMP 917801435 I DDrSCCRIPTION OF WORK
(SOLAR PHOTOVOLTAIC SYSTEM ROOF MOUNTING 16 PANELS
(APPLICANT TEL NO
A-1 SOLAR POWER INC (855) 410-4700- I
5632 VAN NUYS BLVD (SPECIAL CONDITIONS
(VAN NUYS, CA 91401
I
ICONTRACIOR TEL NO I (APPROVALS DATE INSPECTOR SIGNATURE 1
IA-1 SOLAR POWER INC (855) 410-4700-
15632 VAN NUYS SL #36 LIC NO TEMPORARY POWER POLE
(VAN NUYS,CA 91401 493623C-10
(UNDERGROUND CONDUIT
I I
(ARCHITECT OR ENGINEER TEL NO iDFER GROUND
LIC NO IROUGH CONDUIT I
(ROUGH WIRING
I (MAIN WATER LINE
IPLASTIC Y/N METAL YIN
I (UTILITY COMPANY NOTIFIEDI
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I• ADDITIONAL DATA ON FILE
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I IRE PORT ID DPR265 ROUTE TO BSO508
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