HomeMy Public PortalAbout4834 ARDEN DR_Electrical__ 76A663•CE806 8-62 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING I /?
BUILDING AND SAFETY DIVISION ADDRESS �V
JOHN A. LAMBIE. COUNTY ENGINEER
WILLIAM A.JENSEN, SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS 1p
RECEPT. TOTAL NO. EACH FEE
OUTLETS FIRST 20 $.20 $ OWNER
LIGHT MAIL
ADD'L1O ADDRESS
SWITCH. OVER 20
CITY TEL. N
LIGHTINGT-TOTAL
F)R5T2O .20
FIXTURES ADD'L .10 ELECTRICIAN i
OVFR 20
RANGES 8--CLO.DRYERS k'WTR.HTRS. 1.00 O ADDRESS D
GARB.DISP. STA.COOK CITY ( C TEL. NO.
DISHWASH. •AUTO.-WASH. STATE
SPACE HTRS. STA.APP.(yi H.P.MAX.) .50
LICENSE NO.
MOTORS: OVER NOT OVER H.P. DIST RICT
N GROUP ZONE PROCESSED 8
O 1 1.00
1 3 1.50 INSPECTION RECORD
3. 8 2.00
8 15 2.50
is so 3.00 IL
50 100 5.00 O
U
SIGNS: NO.TRANS 0:
NO.LAMPS O
SERVICE 0.60OV-NOT OVER 200A 1.00 UO w
SERVICE 0.60OV-OVER 200 A. 2.00 0_
N
SERVICE OVER 600V 5.00 z
MISC.
PERMIT ISSUING FEE 2.00 2 (Ja
SUPPLEMENTAgY PERMIT ISSUING FEE 1.00
1 1
TOTAL FEE od
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COU AND STATE OF FIXTURES
CALIFORNIA OR THAT I HE LEG NE R F THE ABOVE
DESCRIBED RESIDENT OF Y.
POWER
SIGNATURE UTILITY CO.NOTIFIEDe
OF PERMITT
FINAL
ALIDATION ARTHUR C. VEIT
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
L tCo 7 8 2 7 v JAN 2 5 2 0 5,0 Q
7BA663-CE806 9.5, APPLICATION FOR ELECTRIC PERMIT ,
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
O 3 Al. CSR
BUILDING AND SAFETY DIVISION
JOHN A.LAMBIE,COUNTY ENGINEER
CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY rvo'
NEAREST
FOR APPLICANT TO FILL IN cRoss sr.
PERMIT FEES
I T E M NUMBER EACH FEE OWNER �� �`J'.'=. .��h'� - `-'✓ ""
OUTLET4. $ $ MAIL F\�
LIGHTS RECEPT. SW. .10 ADDRESS
LIGHTING FIXTURES .10 CITY TEL.NO.
ELEC.RANGES CLO.DRYERS
ELECTRICIAN _
WATER HEATERS .50 ADDRESS v
ELEC.SPACE HTRS. DISHWASHERS
GARBAGE DISPOSERS AUTO.- CITY TEL.NO.
WASHERS STA.COOKING UNITS .25 STATE
LICENSE NO.
MOTORS: OVER INC. H.P.
O — '/z 25 DISTRICT GROU `E READY FOR INSPECTION
I/z.— 2 .50
INSPECTION RECORD
2 — 5 1.00
5 — 15 1.50
15 — 50 2.50
50— 200 5.00
SIGNS: NO.TRANS.
NO.LAMPS
SERVICE 0-600V 1.00
SERVICE OVER 600V 5.00
misc.
WIRING PERMIT 1.00 ®�
FIXTURE PERMIT 1.00 Q ®tom
SUPPLEMENTARY PERMIT .50'
TOTAL FEE $ 0 APPROVALS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT J
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING �7
ELECTRICAL WIRING. WIRING K � 'I
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE/OF FIXTURES
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE POWER
DESCRIBED RESIDENTIAL PROPERTY. /
SIGNATUREUTILITY CO.NOTIFIED
OF PERMITTEE FINAL
vDATION ARTHUR C.VEIT.
SUPERVISING ELECTRICAL ENGINEER'
CK MO CASH
j...t 2 2 Q 4 fg' MI AR 2 0 2 A 3.40
r
WORKER S'COMPENSATIONDECLAC.RA. CE866G (2-80} APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES <:�7 r BUILDING AND SAFETY
insure, or a certificate of Workers'Compensation Insurance,or
• a certified copy thereof(Sec. 3800, Lab.C.)
FOR APPLICANT TO FILL
IN JOB
Policy No. EACHNO. FEE ADDRESS
Company
New Residential Bldgs.&Pools 3 TAP—"- S) ''
❑ Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ — $ LOCALITY
Multi-family Sq. Ft. — NEAREST
.Certified copy is filed with the county building inspection CROSSST 2 g
department. Residential Swimming Pools OWNER OR
FIRM NAME v0� �
Date Applicant Outlets: Rec.3 LightSw. 3 Sv ADDRESS
Q First 20
CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. y Additional CITY'��� G` Tell o. gS! }
COMPENSATION INSURANCE
PLAN CHECK It
(This section need not be completed if the work involvedSv D APPLICANT OU
by the permit is for one hundred dollars ($100) or less.) Lighting Fixtures First 20 ADDRESS
Additional 0
Total No.
I certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP
CITY Tel No.
permit is issued, I shall not employ any person in any manner PERMIT W
so as to become subject to the Workers' Compensation Laws. Range_ Heater_D.W. APPLICANT p_
Oven _ Dryer_W.M._ ADDRESS N
Date Applicant Top _ FAU f W.H.. Z
L
Hood _ Fan Other_ CITY Tel No.
NOTICE TO APPLICANT: If, after making this Certificate of Disp. _ Room Air Cond-_ O� LICENSE OR
Exemption, you should become subject to the Workers' REG. NUMBER Class
Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO. PROCE ED BY
with comply with such provisions or this permit shall be
deemed revoked. Size&Type HP, KW, KVA,or KVAR
Up to 1 Incl.
FINAL
Over 1 to 10 Incl. DATE `
LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl. / v VALIDATION
I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL
p ,
9 (commencing with Section 7000) of Division 3 of the Busi- Over 100 BY
ness and Professions.Code, and my license is in full force and
effect. Services
License Number Lic.Class 0-200 Amp. Under 600 V
201-1000 Amp. Under 600 V
Contractor Date Over 1000 Amp.or Over 600 V
HOME OWNER-BUILDER DECLARATION Temp. Power Pole& Appurtenances
I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit
License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits
ness a d Professions Code):
Misc.Conduits&Conductors '
U� `� as owner of the property, will do the work and the Other (See Complete Fee Schedule)— a
structure is not intended or offered for sale (Section 5 2 1.0 A
7044, Business and Professions Code).
CONSTRUCTION LENDING AGENCY sl 0 0 0 0 0 2
I hereby affirm that there is a construction lending agency
for the performance of the work for which this permit is PERMIT FEE (Sub-Total) 06 2.o °'1 650
issued (Sec. 3097,Civ.C.).
Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) - ° ° ° 1 (5 5 0 0
Lender's Address PERMIT ISSUING FEE 0 ,2"7—8 2
I certify that I have read this application and state that the TOTAL FEE d
above information is correct. I agree to comply with all County
ordinances and State laws regulating Electrical wiring, and
hereby authorize representatives of this County to enter upon
the above-mentio d pro erty for inspection pur oses. SEE'REVERSE FOR EXPLANATORY LANGUAGE
Signature of Permittee Date
WORKER S'COMPENSATION DECLARATION -806G (2-80)
CEAPPLICATION FOR ELECTRICAL PERMIT
CE-806 �.
I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY
insure, or a certificate of Workers'Compensation Insurance,or
a certified copy thereof(Sec. 3800,Lab. C.)
FOR APPLICANT TO FILL IN JOB
Policy No. Company ADDRESS
New Residential Bldgs.&Pools EACH NO. FEE C `c
❑ Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ — $• LOCALITY-C� GIA- Ca 71,790
Multi-family-Sq. Ft. — NEAREST A/�
Certified copy is filed with the county building inspection CROSS ST l
ElResidential Swimming Pools
department. OWNER
RM NAME
1
Date Applicant Outlets: Rec.—'Light—Sw. MAIL
First 20 ADDRESS d[p
CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY 7'4, e_ 0 ; Tel No.
COMPENSATION INSURANCE PLAN CHECK& }
a
APPLICANT Q
(This section need not be completed if the work involved
by-the permit is for one hundred dollars ($100) or less.) Lighting Fixtures First Additio20'nal �
Total No.
I certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No. 0
permit is issued, I shall not employ any person in any manner PERMIT (�
so as to become subject to the Workers' Compensation Laws. Range_ Heater_D.W. APPLICANT W
Oven _ Dryer_W.M. ADDRESS N
Date Applicant Top _ FAU _W.H.. Z
Hood _ Fan _Other_ CITY o.
NOTICE TO APPLICANT: If, after making this Certificate of Disp. _ Room Air Cond.— LICENSE OR
Exemption, you should become subject to the Workers' REG.NUMBER Class
Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO. PROCESSED BY
with comply with such provisions or this permit shall be
deemed revoked. Size&Type HP, KW, KVAor KVAR
Up to 1 Incl.. -
FINAL
(
Over 1 to 10 Incl. DATE � ' VALIDATION
LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl.
I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inca BY AL
9 (commencing with Section 7000) of Division 3 of the Busi- Over 100
ness and Professions.Code, and my license is in full force and
effect. Services
0-200 Amp. Under 600 V
License Number Lic. Class
201-1000 Amp. Under 600 V
Contractor Date Over 1000 Amp.or Over 600 V.
HOME OWNER-BUILDER DECLARATION Temp. Power Pole&Appurtenances
I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit G 6 3(a 8 A
License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits
#7
Hess and Professions Code): o o o 0 0•2
Misc.Conduits&Conductors
® I, as owner of the property, will do the work and the Other (See Complete Fee Schedule)— 2 0 o 2350
structure is not intended or offered for sale .(Section
7.044, Business and Professions Code). 0 0 0 2 35 0
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency O 9 2.2-8.2
for the performance of the work for which this permit is PERMIT FEE (Sub-Total)
issued (Sec. 3097,Civ.C.).
Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee)
Lender's Address PERMIT ISSUING FEE
I certify that I have read this application and state that the TOTAL FEE
above information is correct.I agree to comply with all County
ordinances and State laws regulating Electrical wiring, and
hereby authorize representatives of this County to enter upon
the above- entione C poperty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Permittee Date
COUNTY OF LOS ANGELES TEMPLE CITY. # 0508 LELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS EL 6568-9706260019
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE-CITY CA
PHONE: (818) 285-0488 EXT:
LEGAL ID: FEES.PAID BUILDING-ADDRESS:
TR: 15098 LT: 11 4834.ARDEN DR
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917804001
ASSESSOR INFORMATIO NUMBER: NEAREST CROSS STREET:
8585-016-020 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 _GRID: B5 LOCALITY: TEMPLE CITY .
G1 OUTLETS-LGT,SW,RECP 2.00 OUT 3.90
TENANT: LA 100 AMP PANELS, MCC .1.00 PAN 38.85 ISSUED ON: PROCESSED BY: PLAN Y: EXPIRES ON:
LN OTHER PNL 0-399 AMPS 1.00 PAN .38.85' 06/26/97 TC 06/26/98
TOTAL FEES. 109.35
OWNER: TEL. NO: FINAL DATE FINAL BY: DE:
YATES RICK;CATHY (818) 444-9662-
4834 ARDEN DR
TEMP 917804001 DESCRIPTION OF WORK
NEW SERVICE PANEL UPGRADE 100 AMP AND SUB PANEL AND 2 OUTLET
APPLICANT: TEL. N0:
SAME AS OWNER -
SPECIAL CONDITIONS: .
CONTRACTOR: TEL. N0:
APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER
LIC. NoTEMPORARY POWER POLE
UNDERGROUND CONDUIT.
ARCHITECT OR ENGINEER: TEL. N0: �� ��'. �� ``�� UFER GROUND
LIC. NO: , ROUGH CONDUIT
ROUGH WIRING
,v MAIN WATER LINE
- PLASTIC Y/N METAL Y/N
UTILITY COMPANY NOTIFIED
-71
REPORT ID: DPR265 ROUTE TO: BS0508