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HomeMy Public PortalAbout4905 ARDEN DR_Electrical__ „ 76A663 DBS SA 7-51 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN � DISTRICT NO. GR 'Ll P I ZONE PERMIT NO. ELECTRICIAN , ew ”' Y S- A —l 72,Q — p RECEIVED BY READY FOR DATE ISSUED ADDRESS D`7 IY L:➢�/j�7'd/ � YOB FIRST INSPECTION � p��' CITY 9`e w NO. ®? � COUNTY LICENSE NO. EXPIRES _30'_J gBUILDING DDRES9 �®� � ( PERMIT FEES FEE NUMBER EACH LOCALITY . LIGHT OUTLETS NEAREST RECEPTACLES CROSS ST. WALL SWITCHES OWNER TOTAL OUTLETS 3 r Sc P MAIL ELEC. RANGES 25 ADDRESSo ELEC. HEATERS 25 CITY�'t O TEL. Na. FIXTURES 1S� 5 s...el© 1 HEREBY VACKNOWLEQGE THAT 1 HAVE READ THIS misc. APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWERFEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER NEw MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. %a 6 LESS $ .25 SIGNATURE OF � 1�2 2 .50 PERMITTEE- 2 2 s 1.00 INSPECTION RECORD _ 5 is so 2.so so 200 5.00 200 Sao 10.00 sop 1000 15.00 Z OVER 1000 20.00 M.G. SET/FRED. CHANGER-HP Ir WELDERS:AC-KVA 0 .GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF ORIGJ MOVED MOTORS (75% OF DRIB.) M ISC. SIGNS NO. NO.TRANS. APPROVALS NO. NQ. LAMPS FOR EACH PERMIT: DATE INSPECTOR'S NAME WIRING $1.00 CONDUIT FIXTURES $1.00 ` WIRING �rJ � c SUPPLEMENTARY .50 FIXTURES a° .�P*/ 7� & POWER TOTAL FEE UTILITYCO.NOTIFIED - FINAL Q —14 � l 0 N 76A663 RS TIO I heref9y aff4•mE hat.1 have aAcertificatelLAof consent to self CE 806G 10i81 n PP IC n MN FOP, E ECTPUC n p Pf2n(,� T insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES FOP, IS Lt, II ll�BUILDING ANDSAFETYor a certified copy thereof (Sec. 3800, Lob. C. u Policy No. Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS ❑ 1 8 2-Family, q. LOCALITY Certified copy is filed with the county,building inspec- y, S Ft. $ — $ tion department. Multi-family Sq. Ft. — NEAREST G CROSS ST Residential Swimming Pools . Date Applicant OWNER OR FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw. ADDR COMPENSATION INSURANCE ESS completed if the work involved b First 20 q (This section need not be com p Y Total No. Additional CITY `'��- �� Tel. No. 6 the permit is for one hundred dollars ($100)or less.) PLAN CHECK b I certify that in the performance•of the work for which this APPLICANT permit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS �r 3, dsL' % Total No. Additional �A .wCITY Tel. No. Date pplicant '-'Fixed Appliances Not Over l HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate o Exemption, you should become subject'to the Workers' Range_ Heater—D.W..— APPLICANT Compensation provisions of the Labor Code, you must forth- Oven _ Dryer _ W.M. ADDRESS 5;— with comply with.such provisions or this'permit shall be Top — FAU —W.H: deemed revoked.- Hood _ Fan _Other_ CITY (21 r el. Noa$'4':/3' LICENSED CONTRACTORS DECLARATION LICENSE OR a I hereby affirm that I am licensed under provisions of Chapter 9 Disp. _ Room Air Condi REG. NUMBER J Class. (commencing with'Section 7000) of Division 3 of the Business DISTRICT NO. PR BY . and Professions Code,and my license is in full force and effect: Power Apparatus& Large Appliances V Size 8 Type HP, KW, KVA, or KVAR' r U �( 0, License License Number Lic. Class Up to 1 Incl. FINAL Over l to 10 Incl. DATE �j �� VALIDATION.'Contractor Date Over 10 to 50 Incl. FI r/ 0 ❑ I am exempt Seca Over 50 to 100 Inc. " B LU Over B.&P.C. for this reason Over 100 Z Date: Services;Swbd., MCC 8 Panelboards � !, 0 -200 Amp. Under 600 V (J Signature 201 - 1000 Amp. Under 600 V ❑ Over 1000 Amp. or Over 600 V Exemption for Reg. Maint. Elect. SINGLE FAMILY Temp. Power Pole 8 Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch`Circuits Low for the following reason (Section 7031.5, Business and Professions Code): ❑ I, as owner'of the property, will do the work and the Misc. Conduits 8 Conductors structure is not intended or offered for sale (Section, Other (See.Complete Fee Schedule)_ D 7044, Business and Professions Code). ;2 4 7(11 A CONSTRUCTIONLENDING AGENCY I hereby affirm that there is a construction lending agency for #•o,o•o o o.2 the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). A o.o 2.5.5 0 lender's Name PLAN CHECKING FEE. 2 5 55 0 2 � PERMIT ISSUING FEE ,6 Lender's Address _ o52.3-86 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-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE` Signature of Permittee Date WORKERS' COMPENSATION DECLARATION 76A663 10/81 n nnp �� �.��®� 12On ftp 12�1?n��n Q �f2n1111�5r' I hereby of,*rm that I have a certificate of consent to self CE-806G loll!"I!—L� /i-d 'FOR R ELLS U Ili AL IS11�1/G11 ll insL.e, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec. 3800, Lab. C.) h Policy No. Company FOR APPLICANT TO FILL IN JOB ADDRESS ✓ fJ Certified copy is hereby furnished. New Residential Bldgs:8 Pools EACH NO. FEE ❑ LOCALITY Certified copy is filed with the county building inspec- 1 8 2-Family, Sq. Ft. $ — $ t. ' tion department. Multi-family$q. Ft. — NEAREST Residential Swimming Pools CROSS ST. 4 Date Applicant OWNER /• �`� FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS" Outlets: Rec�Light Sw. MAIL COMPENSATION INSURANCE ADDRESS (This if the work involved b ✓ !' Tel. No. p"�Q'7— This section need not be completed First 20 Y - ��- �1 the permit is for one hundred dollars($100)or less.) Total No. 'Additional CITY 1 certifythat in the erformance of the work for which this< PLAN CHECK P APPLICANT permit is issued, I shall not employ any person in any manner so as to become subject'to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS " Total No. Additional -- CITY Tel. No. Dat plicont Fined Appliances Not Over 1 HIP PERMIT NOTICE TO APPLICANT: If,'after making this Certificate of APPLICANT /ZL < Exemption, you should become subject to the Workers' Range_ Heater_D.W..— Compensation provisions of the Labor Code, you must forth Oven _ Dryer W.M. ADDRESS with comply with.such provisions or this'permitshall be Top — FAU —W. — deemed revoked... CITY7e . Tel. No. LICENSED CONTRACTORS DECLARATION Hood Fan _Other— C_: �O(o l7r LICENSE OR Disp. _ Room Air Cond. Class. � Y (commencing with Section 7000) of Division 3 of the Business DISTRICT NO. PROCIE 0. Power Apparatus 8 Large Appliances and Professions Code,and.my license is in full force and effect. Q Size 8 Type HP, KW, KVA, or KVAR' L C.1 License Number Lic. Class Up to 1 InclFINAL `/ viz Contractor Date Over 1 to 10 Incl. DATE �n `� VALIDATX U F-1 Over 10 to 50 Incl. FINA W I am exempt under Sec. Over 50 to 100 Inc. BY B.BP.C. for this reason Over 100 Date: Services, Swbd., MCC 8 Ponelboards 0 -200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V ❑� Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY Temp. Power Pole 8 Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch.Circuit I hereby affirm that I am exempt from the Contractor's License �4 8A 5'a Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits # o o.o10, 2 Professions Code): ❑ I, as owner of the,property, will do the work and the Misc. Conduits&Conductors —I 2,0 0 structure is not intended or offered for sale (Section Other (See.Complete Fee Schedule)_ 7044, Business and Professions Code)., .° o:° 112.0 0 3 : CONSTRUCTION LENDING AGENCY Q 6 3 '$6 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued PERMIT FEE (Sub-Total)' 15-0 (Sec. 3097, Civ. C.). . PLAN CHECKING FEE Lender's Name Lender's Address PERMIT ISSUING FEE (/ I certify that I have read this application ohd 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-mentioned property for inspection purposes. •� SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permit ee Date P. COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0503210012 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING DRESS: TR: 11148 LT: 9 BL: A UN: .002 4905 ARDEN DR FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917804048 ASSESSOR INFORMATION BER: NEAREST CROSS STREET: LOWER AZUSA 8585-015-040 Al PERMIT ISSUANCE._FEE 27.75 THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY, C G2 LIGHTING FIXTURES 7.00 LGT 13.65 TENANT: TOTAL FEES 41.40 ISSUED ON: PROCESSED BY: PLA BY: EXPIRES ON: 03/21/05 JK 09/17/05 OWNER: TEL. N0: FINAL. A FINAL BY: CODE: Q0165 BOGUE ST (626) 202-2385- �� H� TEMP 917802703 DES , ,PT10 F WORK ADD7'LIGHT FIXTURES APPLICANT: TEL. 0: SAME AS OWNER - SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - LIC. NO TEMPORARY POWER POLE UNDERGROUND CONDUIT ARCHITECT OR ENGINEER; EL. 0: UFEP, GROUND LIC. NO: ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED REPORT ID: DPR265 ROUTE TO: BS0508