HomeMy Public PortalAbout6358 TRELAWNEY AVE_Electrical__ r -
7B OBB[A 11-M APPLICATION FOR PERMIT
DEPARTMENT OFNG AND SAFETY ®�®���
COUNTY OFF LOS LOS ANGELES ELECTRIC WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICy NO. GROUP ZONE PERMIT NO.
ELECTRICIAN
RECEIVED BY READY FOR DAT[ ISSUED
ADDRESS FIRBTINBPECTION — ^�
CITY T[L NO
COUNTY
–LICENL.Bn[�N�rO..n n E%PIRES BUILDING
PERMIT
FEEp ADDRESS
NUMBER EACH FEE LOCALI J
LIGHT OUTLETS NEAREST
RECEPTACLES CROSS ST.
WALL SWITCHES OWNER
TOTAL OUTLETS So B MAIL
ELEC RANGES 45 ADDRESS
CLEC HEATERS 45 CITY TEL. NO
FIXTURES B ' HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
MISO APPLICATION AND STAT[ THAT THE ABOVE IB CORRECT
NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING
MOTORS I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOB
NUMOEB �' HORBEPOWER FEE ANGELES COUNTY LICENBE. OR I A GAL OWNER
N[w Mw HP o n 1No EACH OF THE REBIDENTI PROPERTY RIBED A E.
A LE80 0 45 SIGNATURE OF
yx 4 SO PERMITT
a B loo INSPECTION RECORD
S 15 150
is 50 250
So 900 S 00
400 Boo lam -2
Soo 1000 IBM =
OVER IOOO 4000 T Rrr.0 P 7017 FT - Al
_ O
N G BET FRED CHANGER-HP / (C
WELDERSI AC-KVA C'! r, IE/ Y O
GENERATORS - KW
TRANSFORMERS - EVA
TEMP MOTORS (75% or GR1B)
MOVED MOTORS (76 or onto)
Misc
SIGNS
NO NO TRANS. APPROVALS
NO NO LAMPS
Fq—
FOR EACH PERMITI DAT[ INSPECTOR•B NAME
WIRING B/ DO CONDUIT
FIXTURES S1 OD WIRING - /
BUPPL[ EITARY BO FIXTURES L
POWER
TOTAL PEE •� I uTILITYco NOTIFIED
FINAL
WORKER S COMPENSATION DECLARATION y/„
76A663DP29„ APPLICATION FOR ELECTRICAL PERMIT lJ
I
affirm that 1 have a certificate of consent to self insure 7fAe�
or certlficatte of Worker a Compensation Insurance or a certified COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV
copy the4eof(Sec 3800 Lab C I
Policy No Company FOR APPLICANT TO RLL IN JDB
ADDRESS
ElCertified copy is hereby furnished Nen Residential Bk1gs &Pools NO EACH FEE
❑
department
copy is fried with the county building mspectwn 1 ut 2 Family SF Ft
It s OCALI
department Mulb feLnity Sot Ft — CM Si
Date Applicant Residential Swimming Poria ASSESSOR ,
MAP BOON PAGE PARCEL
CERTIFICATE OF EXEMPTION FROM WORKERS Outbts Rec 7—Light Sw / pr MAP BOOR
COMPENSATION INSURANCE First 20
(This section need not be completed If the work Involved by the Total No Additional
permit is for one hundred dollars($100)or less)
I certify that in the performance of the work for which this permit CITY Tel W
is issued I shall not employ any person in any manner so as to PLAN CHECK
became subject to the Workers Compensation Laws Lghung Fxturee� First 20 APPLC
!J Total No Additional ADDRESS
Data �`� r-`� Applicant
NOTICE TO APPLICANT II of r eking this Certificate of RESIDENTIAL APPLIANCES NOT OVER HP CRY Tei No
Exemption you should become subjlt2to the Workers Compensation OTHER APPLIANCES NOT OVER 3 HP RMR
provisions of the Labor Code you must forthwith comply with such Power Apparatus&��AppliancesPUCANr
provisions or this permit shall be deemed revoked
LICENSED CONTRACTORS DECLARATION Sae&Type HP KW KVA or KVAR ADDRESF 0g,3 L
I hereby affirm that I am licensed under provisions of Chapter aOren 3 to 10 Incl(commencing with Section 7000) of Division 3 of the Business and CITY LeTSI No
Professions Code and my_licceensse is in full force and effect Over 10 to 50 Incl
a32
ice\ OYeOver'6010 100 IncluceNBE OR REG NUMBER Dbe� a
License Number LIC Class, DvBr 100 DISTRICT NO P ED BF� Q
. � �►�— Se wces Swbd P�anelype ds in
Contract �-L Date 3'8 �{� 0 353'rmp U=r v / �6 Fl� O
❑ 1 am exempt under Sec 400 1000 Amp Undor 800 V IS VALIDATION V
Over IDDO Amp or Over 600 V RNA W
B&P C for the reesoriBRANCH CIRCUIT FEES By CD
Date ISA or 20A 120V Lighung or Recept Z
1 To 10 Branch Circum
Signature 11 To 40 Branch Circuits;
r-141 Or More Branch Cimurts
Exemptxm for Reg Mamt Elect 15A 2M 208V To 277V Lighting Pr Gmurts
BINDLE FAMILY Temp Power Pole 8 Appurtenances A.ICT.Ir
HOME OWNER BUILDER DECLARATION Si n with One Branch Circuit pp
I hereby affirm that I am exempt from the Contractor s License Law g il.]l17 98.K,for the following reason (Section 7031 5 Business and Professions Addawnal Sign Branch Circuits 3307 ITEM Code) A�1 1 C11�J7s
❑ I ar owner of the property will do the work and the structure Misc Conduits&CorMuctors TOTAL 8. 35
is not intended or �.offered li+C
red for sale (Section 7044 Business Other(See Complete Fee Schedule) ' LI"'Cl f1
and Professions Code
CONSTRUCTION LENDING AGENCY .OD
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 (Sub Total)
Civ C)
PLAN CHECKING FEE a� rO1L1OO-O�]S 3! 4/93
Lerxfere Name OJOV 1 A1110:53,
PERMIT ISSUING FEE 5
Lenders Address
1 certify that 1 have read this application arid under penahy of purtury state TOTAL FEE
that the above mformauon is correct I agree to comply with all County
ordinances and Slate laws regulating Electncal wining and hereby authonze
representatives of thm County to enter upon the above menboned property
for inspection purposes 2 SEE REVERSE FOR EXPLANATORY LANGUAGE
3 e'93
TURE PF PERmiT DATE
COUNTY'OF LOS ANGELES TEMPLE CITY # 0508 (ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 9901110020
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE. (626) 285-0488 EXT:
LEGAL ID FEES PAID BUILDING ADDRESS-,
TR: 14263 LT 7 x6358 TRELAWNEY AV
FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917801311
NEAREST CROSS STREET LEMON
5382-022-035 Al PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID J2 LOCALITY TEMPLE CITY
B2 1 OR 2 FAMILY DWELL 435 DO SQ 45 68
TENANT TOTAL FEES 73 43 ISSUED ON PROCESSED BY PLAN BY EXRRlE§7M_.
01/13/99 UT 01/13/00
OWNER TEL -0 - FINAL DATE CODE
HUANG DONG Q (626) 285-5033- �Ul�cj
6358 TRELAWNEY AV _ [
TBUP 917801311
ELECTRICAL FOR-NEW GUEST HC
-if
E
APPLICANT TEL NO
SAME AS OWNERSPECIAL )NDITIDNS
CONTRACTOR. TEL. NO -
S PNGELES Co
APPROVALS DATE INsFn76ff79rfflUT9ffF--
SAME AS OWNER ,0 NTJ-
LIC NO TE14PORARY POWER POLE
UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER: TEL NO UFFR GROUND
LIC Mlll�R LINE
., 1111111
PUBLIC WORKS PLASTIC Y/N METAL Y/N
UTILITY COMPANY NOTIFIED
q Pg
Service Tha4L
REPORT ID. DPR265 ROUTE TO BS0508