HomeMy Public PortalAbout6361 TRELAWNEY AVE_Electrical__ 75A669.CEB06 ,.BB APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING /
BUILDING AND SAFETY DIVISION ADDRESS !O L e
JOHN A LAMBIE COYNTY ENGINEER
COLEMAN W :JENKINS, SUPERINTENDENT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
NO
RECEPT
S S OWNER
MAIL '
LIGHT TOpTALEF12
ill20 ADDRESS —ZoWN
SWITCH-4-1 _..1L 10 CITY TEL NO
PLAN CHECK
LIGHTING TSO?TAL 20 APPLfCANT
FIXTURES �SL— 10 ADDRESS
RANGE—DRYER—WTR HTR — CITY TEL NO
STA COOK_DIIS/P' F A U _ CONTRAC rOR
SPACE HTR AIR COND ADDRESS e x
CLOT�H/E�WASH _DISH WASH CITY /yS'NIg"EL
FAN—OTHER IDo
V>� LICENSE IND l G1A58 r r O
MOTORS TRANSFORMERS RATING
IND HEATERS ETC HP KW KVA I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
SIZE 6 TYPE OVER TO AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING
0 - 1 00
HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR
I - 10 3 00 LICENSEDA9 REQUIRED BY L03 ANGELES COUNTY AND STATE OF
CALIFORNIACALIFORNOR THAT 1 AM THE LEG DUNE OF AND INTEND TO
10 50 S 00 RESIDE IN THE AB 9CR RE ENTIAL PROPERTY O
50 - 100 10 00 SIGNATURE U
jr ED BY IlL)
TUBE SION A SIGN AND ONE CIRCUIT 3 00 O �f�! d
MARQUEE ADDITIONAL CIRCUITS 1 00 •—
NOTES
SERVICE NOT OVER S00 VOLTS OR 200 AMP 2 00
SERVICE OVER SOO VOLTS OR 200 AMP 5 00
TEMP SERVICE POLE S APPURTENANCES 3 00 APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP POWER POLE
LIN LAB WORK
ROUGH CONDUIT
PERMIT FEE (SUB TOTAL) WIRING
FIXTURES
PLAN CHECK FEE (SO% PERMIT FEE)
ll�� POWER AUTHORIZED
PERMIT ISSUING FEE 200 Vv U7IL IT,
CO NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1 00 FINAL - .I{
TOTAL FEE JOSEPH C ROOHAN
SUPERVISING ELEC CAL ENGINEER
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK M Q CASH
_ � C.
6 7 7 1e DC7 9 2 D 6.20-
,EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
WORK COMPENSATION DECLARATION 7e�Aeea'B DPW(12 e1) APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm thatt I havehave a cavil/Icnte of consent to Bell insure
or a certificate of Worker s Compensation Insurance or a certified COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV
copy thereof(Sec 3800 Lab C)
PobCy No Company FOR APPLICANT TO FILL IN 40B
ADDRESS
❑ Carl copy le hereby furnished New Residential Bldgs a P0013 N10 EACH FEE
❑ e copy le bled with the county building inspection 8 2 Family SQ Ft — i $ LOCALITY
dtlpl NEAREST
department MUnn family Sq F! CROSS ST aa
Date Applicant Residential Swmmlrlg Poole ASSESSOR
AIAP BOOK PAGE PARCEL
CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec _Light_Sw OWNER DR
COMPENSATION INSURANCE FIRM NAME
Fret io MAIL.
(Thio section need not d completed($1 0 the work Involved by the Total No Atltlltlonel � �
permit u for one hundred dollars(3100)or leu) (ITNA4 4-M
I certify that In the performance of the work for which this permit CITY C Tel W Ulf
Is Issued I shall not employ any person In any manner so as to PLAN CHECK J
become subject to the Workers Compensation Lam Lighting Fixtures First 20 APPLICANT
Date l 11 Z 4Applkent D
Total No Additional
A.�� ADDRESS
NOTICE TO APPLICANT It alter making this Certl lncata 1 RESIDENTIAL APPLIANCES NOT OVER 3 HP CITY Tet No
Exemption you should become subject to the Workers Compensell n OTHER APPLIANCES NOT OVER 3 HP
provisions of the Labor Code you must forthwith comply with such
provisions or this permit Mall be deemed revoked Power Apparatus 3 Large Appliances APPLICANT
LICENSED CONTRACTORS DECLARATION Size 6 Type HP KW KVA or KVAR ADDRESS
I hereby affirm that I am licensed under provisions of Chapter 9 Aver 3 to 10 Incl ry
(commencing with Section 7000)of Division 3 of the Business and CITY I W
Professions Code and my license Is In full force and effect Over 10 to 501ncl }
LICENSE Cleo d
,a AM
Over 50 IO 10D Inc] REO NUMBER 41 C
License Number (& 7 G '�S3 Lm Class `_ 1 Over 100 DISTRICT NO SSED By 0
M 8Pa0boards
Contractor I Date µ li "� `^" P 6Wd 800 V FINAL L� 0
❑ I nm exempt under Sec 4� 1000 Amp Untler 800 V DATE 1 Z ��� VALIDATION W
Over 1000 Amp or Over 800 V FINAL (L
B AP C forms, By (n
BRANCH CIRCUIT FEES
Dale 15A or 20A, 12DV Lighting or Receipt z
1 To 10 Branch Circuits
Signature 11 To 40 Branch Circuits
41 Or More Branch Circuits
❑ Exempbon for Reg Mamt Elect 15A 20A 209V To 277V Lighting Br Cogga 2
SINGLE FAMILY Temp Power Pole A Appurtenances ACCT,:
HOME OWNER BUILDER DECLARATION Sign wI[h Ohne Branch Clrart ^� (¢ ��nIy
I hereby affirm that I am exempt from the Contractors License Law 33W W�OV
for the following reason (Section 7031 5 Business and Professions Additional Sign Branch Circuits
Code) 1 ITEMS
❑ I as Owner of the property will do the work and the structure Mlso Conduits d Conductors TOTAL 65 .65.60�6Q
Is not intended or offered for sale(Section 7044 Business Other(Sae Complete Fee Schedule) , Lry
and Professions Code) MCW
K W OFO0
CONSTRUCTION LENDING AGENCY (+W45E •00
I hereby affirm that there Ia a construction lending agency for the
performance of the work for which this permit is Issued (Sec 3097 PERMIT FEE (Sub Total) 0000—Ml 4/23/96
Civ C)
PLAN CHECKING FEE
Lander a Name 6017 1 AM 9�17
PERMIT ISSUING FEE cii,
Lender a Address
I candy that I have reed th s application and under Penalty ofpurlury state TOTAL FEE
that the above Information Is correct I agree to comply with all County
ordinances and Stale laws regulating Electrical wining and hereby,authorize
representatives of this County to enter upon the above-mentioned property
for inspection purpgaee SEE REVERSE FOR EXPLANATORY LANGUAGE
SIGNATURE OF PEPMnTEE Dj
S ,-
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 9912290008
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID FEES PAID BUILDING ADDRESS
TR 14263 LT 9 6361 TRELAWNEY AV
FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917801312
ASSESSOR INFORMATION NUMULK NEAREST CROSS STREET LEMON
5382-020-058 Al PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID J2 LOCALITY TEMPLE CITY
G1 OUTLETS-LGT,SW,RECP 2 00 OUT 3 90
TENANT G2 LIGHTING FIXTURES 1 00 LGT 1 95 ISSUED ON PROCESSED BY PLAN BY
TOTAL FEES 33 60 12/29/99 UT 0 26/00
OWNER TEL NO FINAL DATE FINAL by 99 LUOL
DING LUNGSENG,CHI SHENG S (818) 291-2080-
6361 TRELAWNEY AV
TEMP 917801312DESCRIPTION OF WORK
ELECTRICAL FOR STORAGE SHED
APPLILA TEL NO
SAME AS OWNER -
SPECIAL CONDITIONS
CONTRACTOR TEL SGS PNGELES Co ,, APPROVALS um n97rcT6w-§rffw9roffr--
SAME AS OWNER -
LIC NO
UNDERGROUND CONDUIT
ARCHITECT OR ENGnTnIF— TEL NO UftR LiKUUNU
��
LIC NO//( 1111111ROUGH CONDUIT
ROUGH WIRING
0 �I I O � AiO 1Il\ \1 PLASTIC Y/N METAL Y/N
IIOJJ `�J �V� � JJJ 11 u NJ
11
ServOe Tha*L
REPORT ID DPR265 ROUTE TO BS0508
I !
COUNTY OF LOS ANGELES TEMPLE CITY R 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0310090046
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 DUPLICATE
PHONE (626) 285-0488 EXT
LEGAL ID: --7nT-PAID BUILDING ADDRESS
TR 14263 LT 9 6361 TRELANNEY AV
FEE DESCRIPTION QUANTITY LION AMOUNT TEMP CA 917801312
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET LEMON
5382-020-058 Al PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID J2 LOCALITY: TEMPLE CITY
TENANT G1 OUTLETS-LGT,SN,RECP 23 00 OUT 43 05
G2 LIGHTING FIXTURES 6 00 LGT 11 70 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON
HA FAU LESS 3HP 1 00 FAU 10 95 10/09/03 JK 04/06/04
JB AC UNITS +3-10HP 1 00 AC 19 65
OWNER FINAL DATE FINAL BY EMT-
CHI-SHENG S DING (626) 287-3746- TOTAL FEES 113 10
6361 TRELAUNEY AV ��_K /15�
TEMP 917801312 DMipiiu� OF WORK
ELECTRICAL FOR GUESTHOUSE
APPLi SAME AS OWDIER TEL NO -
SPECIAL CONDITIONS
PNGELES CO APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER - �0CONTRAC TEL NO �NTr
LIC NO TEMPORARY POWER POLE
UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER 1� UFER GROUND
LIC MO/ ROUGH WIRING t7/ ROUGH CONDUIT
�// 1 X1111,11
9UW-MER LINE
4�- 1 n �7
J : II J C p V O RD- K ) PLASTIC Y/N METAL Y/N
UTILITY COMPANY NOTIFIEU
D 0 '? 1' I /
J ❑
I�9
fib/
r t
R: ServWce Tha
REPORT ID DPR265 ROUTE TO BS0508