HomeMy Public PortalAbout5843 TREE ROSE TER_Electrical__ �APPLICA UILDING PERMIT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A LAMBIEI COUNTY ENGINEER NEAREST
COLEMAN W JENKINS, BUR T DF BDt LDIND CROSS ST
FOR APPLICANT TO FILL IN DISTRICT NO GROUP TYPE PROCESSED BY
CONST
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BUILDING`` STATISTICAL CLASSIFICATION SE R MAP
ADDRESS J ✓ G e CLASS NO 0 DWELL UNITS BK PG
LOT NO BLOCK USE ZONEI NO 12 O
TRACT SPECIAL _
NS /OT-r
(- NO OF BLDGS CONDITIOB /nS r r
SIZE OF LOT VASO NOW ON LOT
USED
EXISTING BLDG BLDG SETBACK FROM
TEL _ FRONTPROP LINEOF er C Its (STREET)
OWNER eY NO TYPO OF �(ISTING SETBACK HIGHWAY } YARD = TOTAL
ADDRESS � e�[Nl I /�� HIGHWAY WIDTH FROM C L
} 0
CITY e e `
BLDG SETBACK FR
ARCHITECT TEL SIDEPROP LINEOF (STREET)
ENGINEER NO TYPE OF EXISTING SETRACN HIGHWAY } YARD = TOTAL
ADDRESS
HI HWAY WIDTH FROM C L
TEL
} r
CONTRACTOR NOr4 4
O/RI IU , - /Uo
ADDRESS
NO Z CORNER CUTOFF YES ❑ NO L7 V
C
CITY CLASS — SEE REVERSE SIDE FOR SPECIAL APPROVALS
DESCRIPTION OF WORK
Ll
J6 z
NEW'ADD ALTER REPAIR DEMOLISH C H/T O
SO FT NO OF NO OF
SIZE STORIES I/ FAMILIES
r
USE
OF 21
STRUCTURE
Li-/R -L R :4F i/n/f
SIGNATURE OF 1 / n n, RE/I N'I.
APPLICANT i N
3SENSE -J
VALUATION APPROVALS DATE INSPECTOR'S SIGNATURE
P C PMTp� FOUNDATION LOCATION q�
FEES / FEE $q>.GG FORMS MATERIALS - 3" //i x
FRAME FIRE STOPS t
I HERESY ACKNOWL[DO! THAT I HAV[ RIA. TNI[ APPLICATION BRACING BOLTS O ��
ANO STAT[ THAT TH! AwV! I[ CORRECT AND AOR[[ To COMPLY FURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STAT! LAW[ R[OULATINO GAS VENT DUCTS
[UILDING CONSTRUCTION I CERTIFY THAT IN DOINO THE WORK
AUTHORIZED H!R[SY I WILL NOT EMPLOY ANYZL .
VIOLA LATH INT
TON OF THE LABOR CODE OF T�T[ OF
IMO TO WORKMEOOMI C / '� ^_LATH EXT r/SIGNATURE Or HOUSE NUMBER COR-
PERMITTEE RECT AND POSTEDADDRESSC Q ' FINAL //r �li Sjr
JOHN F LEWIS PRINCIPAL ST URAL ENGINEER
PLAN CHECK VALIDATION � M o CASH _ PERMT VALIDATION cK M o cABH
�5 a 6 ?� X16 2 3 A 5 1.00
Lijo56552 ,u,G12 1 A 85.00,
APPLICATION FOR BUILDING PERMIT
COUNTY OF L!OS ANGELES BUILDING AND SAFE Y
WORKERS COMPENSATION DECLARATION De�c3.�q FOR APPLICANT TO FILL IN BOLDING Ess
I hereby affirm that I have a certificate of corearm to self msure BUIL �p
or a certificated Workers Compensation Insurance or a certified o p
copy thereof(Sec 3800 Lab C) CITY ZIP �t7 d LOCALITY policy NO Company &44 1SIZE OF LOT NO OF Eft-DGSONW ON LOT
11 Certified copy a hereby furnished NEAREST CROSS ST 1 17
❑ Certified copy a filed with the county building Inspection TRACT BLOCK LOT NO
department I I USE ZONE MAP NO
Date Applicant ASSESSOR MAP BOOK PAGE PARCEL
I SPECIAL CONDITIONS
CERTIFICATE OF EXEMPTION FROM WORKERS re No
COMPENSATION INSURANCE 1p, WITHIN 1000 FT OF SCHOOL' YES NO
(This section need not be completed it the permit is fw one hundred ADDRESS r
dollars($100)or leas) �vyT L S DISTRICT GROUP TV CONST FIRE ZONE PROCESSED BY
I comfy that In the performance of the work for which the permit , - LP /f'Q /n1
is Issued I shall not employ arty Person In any manner so Be to
became subject to the Workers Compensation Laws ARCHITECT OR ENGINEER TEL NO
STATISTICAL 0LA951FICATgN PPT CONDO
Date Apphcam ADDRESS CUSS NO Q DyvELL UNITS
NOTICE TO APPLICANT If after making the Certificate of REOUIRED TOTAL SETBACK FROM EXIST
Exemption you should become subject to the Workers CONTRACTOR TEL NO SET BACK YARD HWY PROP LINE (MOTH
Compensation provlsorts of the Labor Code you must forttxAM
comply with such provara m
or the permit shall be desired revoked ADDRESS UC NO PANT
a
PL
LICENSED CONTRACTORS DECLARATION SIDE
CITY LIC CUSS PL
I hereby affirm that I am licensed urldwprovalora of Chapter 8yyEgp }
(Commencing with Section 7000)of Division 3 of the Business and SO FT SIZE NO OF STORES NO OF FAMIUEsPr d
professions Code and my,IKarae a In lull force and effect NEW eK PG ► Q
License Number Lx: Class DESCRW OF PPK ADD ❑ VALUATION V
Contractor Date ALTER ❑
R ❑
❑ 1 am exempt under Sec REPAI
a H
BSPC for the reason AL24 DEMOL ❑ W
LoruA P/C
Date USE OF EXISTING BLDG JIV URM ❑ rA
Signahua ?
APPLICANT(PFear) TEL NO LONA Perm
❑ 1 as owner of the Property or my employees with wages as = A C 1 .'r
their sole Compensation will do the work and the structure is ADDRESS Q
not intended or offered for sale (Section 7044 Busness and F ATE
�/ProfBaslGns Dade) WLL THE APRICMT oR FUTURE BUILDW OCGHNT IWDLE A HAZARpOAS xNTEPUL V i ITEMS,
g00 I as owner d Ure property am exclusneN contracting with OF� o A]T�HAZAACC)US VATE�s ECHO�i�TER rluN THE �Q
licensed contractors to construct the project (Sscbw 7044 RN9 By > TOTAL 165%
Business and Professor Code) YES❑ NG❑ L�.4Ir���(1L
wLL THE NTEIDED USE w THE BUID NG BY THE APHXlMT OR FUTURE BULEIr D CHECK 155.6[1
CONSTRUCTION LENDING AGENCY COOST AR recucRE A FEar IA FOR GOaTnl1CT1CN OR EE PIE TxxN CH TIE T FOR
GUCELINES ry wvu[ErnENT asrracr 1scAOMpI SEE FERAarnrq clEcxusT FOR
1 hereby affirm that there is a construction lending agency for vEs❑ No❑
the performance of the work for which the permit is Issued(Sec
3087 Qv C)
�T�DE�DW UX�E� E�� �000-�oa1 s�vs=
TRUE z CHAPTER]20SECTIONS 2 20 IM TSI Z 20140 CONGERA NG HAZAROMM
Lenders Name MATERIALS FEPORTNO MD FOR GBRlxNo A KelvinFRDv THE aGAwo
Lerldere Address
1515 1 AM 2:217
0 o+rc.w AorNr
1 certify that I have read the application and state under penalty
g Of perWy that the above Informalcn Is correct I agree to comply PC FEE PERMR FEE
R wit county ordinances and State laws relating to building
and hereby eN nBpreBLN1 ISSUANCE FEE —2e
fo r the nlenl Bion cry a
//( NyESTgAnON FEE TOTAL FEE
l` SEE REVERSE FOR EXPLANATORY LANGUAGE
WORKERS COMPENSATION DECLARATION
hereby affirm shot I have certificate of tion Insurance
,elf APPLICATION FOR BUILDING PERMIT
insure or a certificate of Workers Compensation Insurance
or otcertified copy thereof (Sec 3800, Lab C)
COUNTY Of LOS ANGELES BUILDING AND SAFETY
Policy No Company
❑ Certified copy is hereby furnished FORILDING APPLICANT TO FILL IN
EJ Certified y LG
ADDRESS
deportment copy a fled with the county building mspec- AAD
tion dRESS 3-Y11,3 s/ Sa FLS/
''7�
Date Applicant Utt ( / ZIP d LOCALITY
CERTIFICATE OF EXEMPTION FROM WORKERS SIZE OF LOT NO OF BL NEAREST NOW ON LOT CROSS ST117
COMPENSATION INSURANCE ASSESSOR
(This section need not be completed if the permit is for one TRACT BLOCK I LOT NO MAP BOOK PAGE PARCEL
hundred dollars ($10D) or less ) —�
OWNER 'NO'
USE ZONE MPP
y4
I certify that in the performance of the work for which this NO
permit is Issued, I shall not employ any person in any manner ADDRESS / C711641116'./ 0� CONDITIONS o.
so as to become subject to the Workers Compensation Lows '/ Q a / O
CITY ZIP
Date ARHITECT OR
Applicant CTEL
NOTICE TO APPLICANT If, after making this Certificate of ENGINEER NO DISTRICT I GROUP ITYPEIRE PROCESSED BY O
Exemption, yoshould become subject to
the Worken' �� (/ _2 CONST V1,
/ T
Compensation provisions of the Labor Code you must forth- ADDRESS l ✓ L� ✓•(
with comply with such provisions or this permit shall be TEL STATISTICAL CLASSIFICATION APT I CONDO N
deemed revoked I CONTRACTOR NO Z
LICENSED CONTRACTORS DECLARATION LIC CLASS NO DWELL UNITS_
I here offum that I am licensed under ADDRESS NO SEWER MAP
by pion Sof of Chapter 9 LIC
(commencing with Section 7000)of Division 3 of the Business
and Professions Code and my license is in full force and effect Cltt CLASS BK PG VALIDATION
CHECKSO FT NO OF NO OF CHECK
License Number Lic Class SIZE STORIES FAMILIES OrE
VALUATION
Contractor Date DESCRIPTION OF WORK NEW ❑
❑1 am exempt under Sec ADD ❑ Poo.
1:1
B&P C for this reason 4I $
REPAIR
Date USE OF
IXISTING BLDG LgEma ❑
Signature APPLICANT �L.._ TEL FINAL
OWNER-BUILDER DECLARATION (PRINT) )9� Np DAA 1
I hereby affirm that I am exempt from the Contractors License �ewv�,�ts +
Law for the following reason (Section 7031 5, Business and ADDRESS A4.�'I' / movr.r NA _ FINAL F#L.�T''
erpfessions Code) k _ !Y5] 1,
I, as owner of the property, or my employees with 1 ITEMS wages as their sole compensation,will clothe work and -
the structure is not intended or offered for sale(Section ► TOTAL ,7 _ Q�
❑ 7044, Business and Professions Code ) CONTRACTOR TEL NO ���K
1, as owner of the property am exclusively contracting �`�CCI
with licensed contractors to construe the project (Sec
tion 7044 Business and Professions Code )CONSTRUCTION LENDING AGENCY IREDYARD HWY TOTALSETBA. K FROM EXIST
hereby affum that there is a construction lending regency for WIDTH
he performance of the work for which this permit is issued DuDO-LIOTJI 7/ 5171
(Sec 3097, Civ C)Lender's Name // LDMA Ref M
Lender's Address Pemia Fee 6 .&V ,candy that have read this application and state that theI.vonce Fee �'& LDMA P/C F
above information is correct I agree to comply with all County Inveatipanon Fee �(
ordinances and State laws relating to budding construction Total Fee i• LDMA Per. N
a and hereby authorize representatives of this County to enter
pYq Upo he abc, -men ed pro far inspection purposes
(/ — 9/ e
SH REVERSE FOR EXPLANATORY LANGUAGE
Signature of Apphcaw ent Dole
GEDDA G-AT APPLICATION FOR ELECTRICAL PERMIT /-r.L7
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION LOt 1 ADDR E55 5843 R
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS, SUMMINTENDENTOFBUILDING FLOCALITY San Grabriel
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
�lggqq11yyyy C
RECEP S OWNER J.B Weber Construction
MAIL
LIGHT •
TOTAL FIRST 20 20 ADDRESS .5926 Temple City B
SWITC _a_ OVER 20 6 10 CITY T@ TEL NO
LIGHTING iTOTAL FIRST 20 20 CONTRACTOR
FIXTURES 1( OVER 20 10 ADDRESS
RANGE—D/R�YER�WTR HTR — CITY II TEL NO
4444 39T
STA COOK l_QDISP /_F A U LICENSE NO
SPACE HTR 2L—AIR CON I HER[.Y ACKMOWL DO THAT I HAVE READ THIA APPLICATION
AND STATE THAT THE ABOVE Ip CORRECT AND AOR[[ TO COMPLY
CLOTHES WASH /_ ISHWASH L WITH ALL COUNTY ORDINANCE! AND !TATE LAWS TO
I LECTRICAL WIRING
FAN—OTHER �a 1 00 d
HEREBY CERTIFY THAT 1 AM PROPERLY REGIA TER[D AND/OR
MOTORS TRANSFORMERS RATING LICENSED AS R¢OATI By LOA ANOKLELEGAL
COUNTY AND !TATE OF
CALIFORNIA OR TXAT I VE THE LEGAL OWNER OF. AND INTEND TO
RHO HEATERS ETC HP KW KVA RESIDE IN TH6 ABOVE D[f CRI S[D fflDl NTIALP OPlRTY
SIZE G TYPE OVER TO SIGNATURE
0 - 1 1 00 OF PERMITTE d
I - 10 3 00 GIST RIC fj0 GRO ZO ,E I P CESSES BY V
10 - SO S 00 je [1[
O
50 - 100 1000 NOTES
100 - 500 15 00 Q.
SIGN GAS SIGN AND ONE CIRCUIT 3 00
TUBE OR
MARQUEE ADDITIONAL CIRCUITS 1 00
SERVICE NOT OVER 600 VOLTS OR 200 AMID 2 00
SERVICE OVER 500 VOLTS OR 200 AMP S 00
TEMP SERVICE POLE 6 APPURTENANCES 3 00
APPROVAL! DATE INSPECTOR S SIGNATURE
TEMP POWER POLE
JRROUGHCONOUIT
ORK
UITISSUING FEE 2 00SUPPLEMENTARY ISSUING FEE 1 00ORIZEDPERMIT FEE OTIFIED /-2PLAN CHECK FEE (SO% PERMIT FEE) /, sem
TOTAL FEE JOSEPH C ROOHAN
SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION 0 M o CASH
LAL,o0279SEP 5 2 A 25.80" <
EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
7eA663 CE306 3-69
APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS, SUPERINTENDENT OF BUILDING LOCALITY
FOR APPLICANT TO FILL INNEAREST
C
No EACH r¢ ROSS ST
3 $ OWNER
RECEIPT MAIL �-Ey
LIGHT_ TOTAL FIRST 20 20 ADDRESS V Q
SWITCH— OVER 20 10 CITY TEL NOPLANECK
LIGHTING TOTAL FIRST 20 20 APPLICA T
FIXTURES OVER 20 10 ADDRESS //
RANGE_DRYER_WTR HTR CITY No
STA COOK_DISP _F A U _ CONTRACTOR
SPACE HTR —AIR COND ADDRESS
CLOTHES WASH _DISHWASH CITY NO
FAN_OTHER 1 00 LICENSE NO CLASS
MOTORS TRANSFORMERS RATIM6 1 HERESY ACKNOWLEDGE THAT NAVE READ THIS APPLICATION
IND HEATERS, ETC HP KW KVA AND STATE THAT THE AGOVE IS ONREci AND AGREE TO COMPLY
SIZE C TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
u ECTRIIAL WIRING
0 - 1 1 00 HERESY CERTI" THAT 1 AM PROPERLY REGISTERED AID/O
LICCNICO RI
AB REQUIRED BY LOS ANGELES COUNTY AND STATE OF
1 I - 10 3 00 00 CALIFORNIA LEGAL OWNER 01 ANO INTEND TO d
RESIDE IN ED DENTIAL PR ERTY O
10 – 50 500 V
SIGNATURE
50 – 100 lODO OF PERMIT= 0
100 – S00 500INOTES
srnl cT oy Or PRD E Y
SIGN,GAS SIGN AND ONE CIRCUIT 3 00 H
TUBE, OR /' Z
MARQUEE ADDITIONAL CIRCUITS 1 00 —
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00
SERVICE OVER 600 VOLTS OR 200 AMP 5 00
TEMP SERVICE, POLE, h APPURTENANCES 3 00 APPROVALS DATE INSPECTORS •IGHATVNE
EMP POWER POLE
NDERSLAS WORK
OUGH CONDUIT
IRING
PERMIT FEE (SUB TOTAL) FIXTURES
POWER AUTHORIZED
PLAN CHECK FEE (50% PERMIT FEE)
PERMIT ISSUING FEE 2 00 UTILITY CO NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1 00 FINAL Zp
OOHAN
TOTAL FEE JOSEPH C RECTR
R SUPERVISING ELECTR L ENGINEER
PLAN CHECK VALIDATION CK M D CASH PERMIT VALIDATION CK M D CASH
,tr, 5 9 3 4.9 aL20 2 A 55,0�0-/e
SEE BACK OF APPLICATION /OR COMPLETE IEE SCHEDULE �E%'/'L/i'W'•'V