HomeMy Public PortalAbout6444 TEMPLE CITY BLVD_Electrical__ 76ASGS Qa0610 aO APPLICATION FOR ELECTRICAL PERMIT 1
COUNTY OF LOS ANGELES
DEPARMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE, COUNTY EN UN¢ER
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
PERMIT FEES OWNER /
] TOM NUMBER EACH PE[ MAIL
OUTLET ' s ADDRESS
u6rrrR Racerr ew U v IO CITY f TEL NO
LIGHTING FIXTURES to
ELEG HARDER CLO DRYERS ELECTRICIAN
WATER HEATERG 50 ADDREISS
SLCC SPACE HTRS DISHWASHERS
oARBAG[DIEAOaERS�
AUTO- CT' F TCL NO
STATE /
WASHERS RTA COOKING UNA- 4L 2D I 'CBNHE NO b
MOTORS, OVER INC H r DIE?,Cr N GR Z P ED B
O` V228f
V.— 2 no INSPECTION RECORD
a
2— D 100 660 le.I y
1
D— ID 1O0 V
C.
ID-- DO 2w O✓< F / RGK �I / 0G
DO— 200 Boo �
SIGNS
NO TRANS
No LAMPS
SERVICE O 600V too Q /Q "fes Lead;.
SERVICE OVER 600Vc
D 00
MISC. r'
WIRING PERMIT too
FIXTURE PERMIT I pp
SUPPLEMENTARY PERM IT DO
TOTAL FEE 0S17,40
1HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR 5BIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT \
WITH ALL COUNTY ORDINANCES -
AND RTAT¢ "WE REGULATING
ELECTRICAL WIRING WIRING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OH
LICENSED AS REOUIRED BY LOS ANGELES COUNTY AND STATE OF- FIXTURES
CALIFORNIA OH TH AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED REBID IA ROP¢ POWER
810NATURE - UTILITYCO NOTIFIED
OP PERMITTE
FINAL j.
,YI�LI ARTHUR C VER
\/c1c ro CAS CARR SUPERVISING ELECTRICAL ENGINEER
✓LEC 0 4 2 4 JUL 2 4 2 D 1 2 .4 0In
]BARBS-CESOB 4-EB APPLICATION FOR ELECTRICAL�ERM
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS, SUPERINTKND.NT W BUILDING LLITY
FOR APPLICANT TO FILL IN NEAREOCAST
CROSS ST
F
S G�
RECEPT OWNER_ MAIL
LIGHT_ TOTAL FIRST 20 20 ADDRESS p�
SWITCH_ OVER 20 10 CITY TEL NO
PLAN CHECK
LIGHTING TOTAL FIRST 20 20 APPLICANT
FI%TURES OVER 20 10 ADDRESS
RANGE_DRYER_WTR HTR _ CITY TEL NO
STA COOK_DISP _F A U _ CONTRAC ioR 1fre,voloyE
SPACE HTR _AIR COND _ ADDRESS-24C I N S
CLOTHES WASH —DISHWASH _ CITY M TEL NSI jo
FAN—OTHER 100 LICENSE NO �3 CLASS
MOTORSTRANSFORMERS RATING
IND HEATERS ETC HP KW KVA I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
SIZE B TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WIT. ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING
0 - 1 1 00
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
1 10 3 00 LICENSED AS REOUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF AND INTEND TO
10 - SO 6 00 RESIDE IN TN ABOVE pESCRIFED R[ D[NTIAL PROPERTY
SO - 100 10 00 SIGNATURE
FPOWER
U
loo — soo IS oo OUP Z P CE ED BY z
0
SIGN GAS SIGN AND ONE CIRCUIT 300
TUBE OR
MARQUEE
ADDITIONAL CIRCUITS 100
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00 —
A.
SERVICE OVER 600 VOLTS OR 200 AMP S 00 If
TEMP SERVICE POLE 6 APPURTENANCES 3 00DATE INSPECTORS SIGNATURE
UNDERSLAB WORK
ROUGH CONDUIT
PERMIT FEE (SUB TOTAL) BE
WIRING
IFIN
I%TURES
PLAN CHECK FEE (60% PERMIT FEE)
OWER AUTHORIZED
PERMIT ISSUING FEE 200 TILITY CO NOTIFIEDSUPPLEMENTARY PERMIT ISSUING FEE 1 00 ALTOTAL FEE JOSEPH C ROOHAN
' SUPERVISING ELEC ICAL ENGINEER
PLAN CHECK VALIDATION CK M D CASH PERMIT VALIDATION cK M O CASH
r, osas� JUL 9 410 4.00 v
EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
7eAee3 CE eae 10/781 APPLICATION FOR ELECTRICAL PERMIT _
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL INp emp a City
ldgs
New Residential B &Pools - EACH, NO FEE ADDRESS "7
I &2 Family Sq F $
025 — $ LOCALITY
Multi family Sq Ft 02 — NEA ES - 'i,
Residennol$wimming Pools 2500 ST
FIRMNNAME Del ado Tmy
Outlets Rec__Light_Sw _ MAIL
First 20 50 ADDRESS'She' -
Total No Additional 30 CITY SSB _ Tel No ,
PLAN CHECK
APPLICANT
Lighting Fixtures First 20 50 ADDRESS
Total No Additional 30 _
CITY Tel No
Fixed Appliances Not Over 1 HP PERMIT __
Range—Heater_D W —
APPLICANT Trane
Oven—Dryer—W M— ADDRESS 2034 N Peck - -
Top _FAU X WH _ CITY South_ El H=te Tel N6797982
Hood_Fan _Other_
Disp —Room Air Cond 250 2. 0 LICENSE ORREG NUMBER265094 Class C-10
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA
Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO
Size&Type HP KW KVA or KVAR - COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
2 50 REGULATING ELECTRICAL WIRING
Up to 1 Incl I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
Over 1 to 10 Incl 5 00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
Over 10 to 50 Incl 12 50 CALIFORNIA OR THAT I AM THE LEGAL O ER OF THE ABOVE
25 00 DESCRIBED RESIDENTIAL PROPERTY -
Over 50to100Inc
Over 100 4000 PERMIT EE Gj/�CJ
SIGNATURE
Services DISTRICT NO
0 200 Amp Under 600V 12 50 .7� 0
201 1000 Amp Under 600 V 2500
Over 1000 Amp or Over 600 V 5000 Q_.A_t_&, ,-z(!,'
Temp Power Pole&Appurtenances I D DD
Sign with One Branch Circuit 10 00 C U J 9 O d Q 0
Additional Sign Branch Circuits - 2� 7�P�....
INSPECTION
3 8 7 1 A INFORMATION
Mx CSee Co &Conductors 10 0o
ON REVERSE x
Other(See Complete Fee Schedules_ � SIDE V
q 2
2,•,• 1 4.50
PERMIT FEE (Sub Totals 7 e • • 1 4,5 0 5
PLAN CHECKING FEE (One Fourth Permit Feel F _ 04. 1 9 -79
PERMIT ISSUING FEE b7 007• 9
TOTAL FEE > '
INSPECTION/FINALED ) _
date r"17 BY��1 -r—
r � -
74Aae9 CEBOe lD ED APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE. COUNTY ENGINEeR
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
PERMIT FEES OWNER /N
I T 6 X NUMBER EACH FEE MAIL
OUTLETS f S ADDRESS f
LIGHTS RECEPT ew 10 O CITY TEL NO .2
lov
LIGHTING FIXTURES 10
ELEC RANGES CLO DRYERS ELECTRICIAN t
WATER HEATERS 60 ADDRESS
ELEC EFACE Hi RB DISHWASHERS
CITY TEL NO
GARBAGE DISPOSERS` AUTO STATE
WASHw STA COOKING UNITE 26 LICENSE NO
MOTORS OVER INC. HP DI T ICT NO GR UP NE P OCESSE B
0— 'h 26 6
/•— 2 so INSPECTION RECORD
2— D 100 d
s— 16 1 so 0
1s— so 250
m
BO— 200 ppp G0
NO TRANS W
SIGNS NO LAMPS y6j
SERVICE O SOOV 1 pp
SERVICE OVER 600V Doo
MISE
WIRINGPERMIT 100
FIXTURE PERMIT 100
SUPPLEMENTARY PERMIT 60
TOTAL FEE $4-1
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIB APPLICATION APPROVALS DATE ' INSPECTOR S SIGNATURE
AND BTAT1 THAT THB ABOVE IS CORRECT AND AGREQ TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING WIRING
I HEREEY CERTIFY THAT 1 AM PROPERLY REGISTERED ANO/OR
LICENSED AB REQUIRED BY LOS AHOQLBS COUNTY AMD STATE OF FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL OWIRR OF THE
DESCRIBED RESIDENTI PIIOPBRTY POWER
SIGNATURE ✓ UTILITYCO NOTIFIED
OF PERMITTEU FINAL
T1 r- I (DATION
tlGASH SUPERVISING ELECTRICAL ENGINEER
. GK 0
M9 1 9 0 JLN 26 2 0 220
ION
WORKERS have
a certificate
of consent o CE B06 ,d,s, APPLICATION FOR ELECTRICAL PERMIT {1
I hereby affirm that 1 have a certifimte d consent to self Inatra ��� r 1 j
a a certificate of Workers Compereatbn Insurance or a certified COUNTY OF LdS ANGELES BUILDING AND SAFETY L
copy thereof(Sec 3800 Lab C)
Policy No i ' Company FOR APPLICANT TO FILL IN JOB 1 C
❑, Cerhhed copy a hereby fumahNew Residential Bldgs 8 Pods ad EACH NO FEE 'ADDRESS
LC C..
❑ Cerhfed copy a filed with the county Wilding nPeChon s1 8 2-Family Sq Ft $ = $ LOCAUTY
department Multi-family Sq Ft c NEAREST C
Date Applicant Residential Swsmmng Pods =ER OR
CERTIFICATE OF EXEMPTION FROM WORKERS /�, MAX b
Outlets Re v Light _ t 2 n // t j �O U
COMPENSATION INSURANCE � P(O AOORESS
First 20
, IThN section need not be completed H the work Involved by the Tidal No 12 Additional CITY l/
� Tel No
pormilt Is lor,one hundred dollars($100)a lees)
RAN C ECt
' I certify that in the partarranice of the work for which dus permit APPLIC-ANT '
is Issued I shall not employ arty person in any manner so es to
became whitedm the w rlrers pensatan Laws Lighting Flxturas 20 ADDRESS -
Total
Additional
No dtlitioral '
Date CIN Tel No
r• U If of
CANT M after v Ap Certd- Fixed Appliances Not Over 1 HP PERMIT
NOTICE TO, APPLIekirig this oete ofApP� f r / _�'G7/2/( ,
Exemption you should become subject to the Workers Compensation Range— eta— DW — [� ( '
Prowmons of the Labor Code,you must forthwith comply with such ' Oven _ Dryer — W M — ADDRESS (- �(�
IrOYisiorla
or t"permit shall be deemed revoked Top — FAU _ WH
CRY T25hpj.6Q/yN No V11-3W-_1`i5 PL
LICENSED CONTRACTORS DECLARATION Flood — Fen Other_
I hereby affum,that I am licensed under p. d Chapter 9 �p — Room Air Cord LCEN=OR Cws G io
(commencing mth Section 7000)d Denson 3 of the Business and REO NDMBER
Professors Code and my license a in full force and effect Power Apparatus 8 Large Appliances DISTRICT NO ESSED DY
va �O
License10 Number O ' / Lc Close G /O Size 8 Type HP KW,KVA KVAR
Up to t Incl FINAL O
C�
'Contract a`.�,/xt/�/�L L�u`4at0 � Over 1 to 10 Ind DATE gr- VALIDATION
Over 10 to SO Incl FINAL
❑ I am exempt under Sec Over 50 to 100 Inc BY Is1
BBPC for the reason Over 100 N
Data Services Swbd MCC 8 Panelboads
0- 200 Amp Under 800 V
Sgmature 201 - 1000 Amp Under 800 V
❑ - - _ Over 1000 Amp or Over 800 V
Exemption for Reg Maim Elect
- SINGLE FAMILY Temp Power Pole 8 Appurtenances _ 2
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit _ •
I hereby affirm that I am exempt hon the Contractee Licerrse Law Additional Sign Branch Circuits �ir.T.•
for the followeig reason(Section 7031 5 Business and Professions ' 3 r 53.30
Code)
❑ I as owmer of the property win do the work and the structure (Mao Conduits 8 Conductors - - 1 I I GI IJ -
is not intended or offered for sale (Section 7044 Business Oder(See Complete Fee Schedule) _ ► _ TOTAL 53 .30
and Profeseons Code) I OECK53.30CONSTRUCTION LENDING AGENCY r v�Lsvv�rv-C
1 hereby affirm that there is a coatrudon lending agency for the WIGS •00
Pent rortmnce of the work for which this permit is issued(Sec 3097 PERMIT FEE (Sub-Total)
PLAN CHECKING FEE - OOOD-0001 8/ 2M
Lenders Name - PERMIT ISSUING FEE r o� d 1666 1 , PM 4:54
Lenders Address
I certify that I have reed the applicator end state that the above TOTAL FEE '
Information u carat I agree to 00m* with all County ordinances
and State laws regulating Electrical mnng and hereby authorize
repreaentativos
of this County to enter upon the above-mentioned
rty fa inspection purposes -SEE REVERSE FOR EXPLANATORY LANGUAGESvrk'
x a=tee / Date_�
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 _ ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC FORKS 9701 IAS TUNAS EL 0508 0707190016
BUILDING AND SAFETY / IAM DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EKT
LEUAL ID FEES PAID BUILDING ADDRESS
ON PILE 6444 TEMPLE CITY BL
FEE DESCRIPTION QUANTITY DOM AMOUNT TEMP CA 917801436
A95ESSOA INFORMATION NUMBER NEAREST CROSS STREET
15383-013-019 Al PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID J1 LOCALITY TEMPLE CITY, Cl
1 01 OUTLETS-LAT SW RECP 1 00 OUT 1 95
TENANT TOTAL FEES 29 70 ISSUED ON PROCESSED BY PIAN BY EXPIRES ON
107/19/07 SR 01/15/08
DELGADO MARCO A JR,DE VONA L (626)L445---4168- F NAL 0 "�FIR�j�L BY CODE
6444 TEMPLE CITY BL I IRPIR U
�TLTP?LE CITY CA 91780 DESCRIPTION OF WORK
CHANGE 0 F I
(APPLICANT TEL NO
�NAVARRO (562) 587-3940-
16925 ADAMSON AVE SPECIAL CONDITIONS
BELL GARDENS 90201
CONTRACTOR TEL NO APPROVALS GATE INSPECTOR SIGNATURE
JVILIANUEVA CONSTRUCTION (562) 572-6405-
18413 CONKLIN STREET LIC NO TEMPORARY POWER POLE
DOWNEY CA 90242 820124 `
UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER TEL NO LIFER GROUND
LIC NO I ROUGH CONDUIT
ROUGH WIRING
MAIN WATER LINE
PLASTIC Y/N METAL Y/N
(UTILITY COMPANY NOTIFIED(
r
' REPORT ID DPR265 ROUTE TO BS0508