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Home My Public Portal About5305 ARDEN DR_Electrical__ 76,",663-'CE306 10/72 APPLICATION FOR ELECTRICAL-PERMIT •� COUNTY OF LOS ANGELES 'DEPARTMENT OF COUNTY ENGINEER gooREss �T ,�A2'GIeII BUILDING AND SAFETY DIVISION LOCALITY TeTal2le •t NEAREST FOR APPLICANT TO FILL IN CROSS ST, OliVe- OUTLETS N0, EACH FEE OWNER RM N ME George T'om's RECEPT. MAIL LIGHT TOTAL FIRST 20 8 -.25 ADDRESS Same CITY TEL. NO. SWITCH OVER 20 ,10 PLAN CHECK , 42-3505 LIGHTING TOTAL FIRST 20 25 APPLICANT . FIXTURES 20 10 ADDRESS 1�.. OVER RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT RANGE X DRYERX_WTR. HTR._ APPLICANT OWner- STA. COOK DISP. F.A.U. ADDRESS SPACE HTR. AIR COND. X _ �, LI, 00 CITY TEL. NO. 3505— CLOTHES WASH. DISHWASH. LICENSE OR CLASS REG. NUMBER FAN, 1. OTHER +- 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. SIZE &. TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 — 1 1.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I- AM THE LEGAL_ OWNER OF THE ABOVE 1 — 10 3.00 DESCRIP:ED RESIDENTIAL PERTY. p O PERMITEEV R 10 - 50 5.00 SIGNATUE O 50 - 100 10.00 DISTRICT NO. PROC SSED BY U W 100 - 500 15.00 �r� s _ SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTOR'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP, POWER POLE SERVI CENOT OVER 600 VOLTS OR 200 AMP 1 3.00 00 UNDERSLAB WORK SERVICE OVER 600 VOLTS OR 200 AMP 10.00 ROUGH CONDUIT TEMP SERVICE,POLE, &APPURTENANCES 5.00 s WIRING a/T Q , !j---rs- f/ TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL PERMIT FEE (SUB TOTAL) 9 25 NOTES: PLAN CHECK FEE PERMIT ;SSUING FEE 3.00 3 00 TOTAL FEE 1.2..25; PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH 81,6 -1FEB 1225 ® c SEE,BACK OF APPLICATION FOR COMPLETE SCHEDULE WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self insure, 76A663 or a certificate of Workers Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof'(SE'b. 3600 Lab. C.) P❑OIICy No. Company FOR APPLICANT 7U FILL IN JOB /� /"��-71 ADDRESS /..i- (,[e JI/ Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE ❑ _ $ $ LOCALITY Certified co is filed with the count building inspection 1&2-Family,Sq.Ft. PY y g p department. Multi-family Sq.Ft. NEARESTcROss ST. G Date Applicant Residential Swimming Pools ASSESSOR MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER OR ��y C COMPENSATION INSURANCE Outlets:RBC. Light SW. �/ �y FIRM NAME /CEJ First 20 MAIL (This section need not be completed if the work involved by the ADDRESS �y r� permit is for one hundred dollars($100)or less.) Total No.� Additional r/J /✓ I certify that in the performance of the work for which this permit CITY /e �l Tel.No./?4V2 is issued, I shall not employ any person in y man r so aS PLAN CHECK become subject to the Workers' Comp Sall s. Lighting Fixtures First 20APPLICANT Total No. O Additional �� -ADDRESS Date Applica `REBID TIA APPLIANC NOT AVER 3 HP. NOTICE TO.APPLI ANT: If, after making.this Certificate of CITY Tel.No. Exemption,you should become subject to the Workers' Compensation OTHER APPLIANCES NOT OVER 3 HP. e provisions of the Labor Code, you must forthwith comply with such PERMIT i7 provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances APPLICANT LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS (—.C2 I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. CITY Tel.No.,.Q (commencing with Section 7000) of Division 3 of the Business and O Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. �� } Over 50 to 100 Incl. LICENSE OR43, /ter REG.NUMBS Class. fl /n�Z/ Over 100 DISTRICT NO. P O SSED BY Q License Number V ((( Lic.Class �n p V Services,Swbd.,MCC&Panelbcards !/d � 011 g 0-399 Amp.Under 600 V FINALDATE � Q Contractor Date DATE 400-1000 Amp.Under 600 V❑ I_I am exempt under Sec. VALIDATION V Over 1000 Amp.or Over 600 V FINAL /�� W B.&P.C.for this reason BRANCH CIRCUIT FEES BY 101- Date: 15A,or 20A,120V,Lighting or Recept. Z 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits 41 Or More Branch Circuits ❑ Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits SINGLE FAMILY Temp.Power Pole&Appurtenances y HOME OWNER-BUILDER DECLARATION {. . I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits I1_2 Code): ❑ Misc.Conduits&Conductors I,as owner of the property,will do the work and the structure is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) , i rPy•, mea —3 and Professions Code). , CHECK CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the r•'t !�° = '"" performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total) Civ.C.) PLAN CHECKING FEEr�) !; Lender's Name ---gg/ PERMIT ISSUING FEEOsLJ �� ' % f rr -=f`!• Lender's Address I certify that I have read this application and under penalty of purjury state TOTAL FEE that the above information is correct. I agree to comply with all County ordinances and St to laws regulating Electrical wiring,and hereby authorize repres ative this Count o ter upo a above-mentioned property for' s do ur as. SEE REVERSE FOR EXPLANATORY LANGUAGE �+ SI NATURE OF ERMITTEE DATE ' I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0709280012 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: I FEES PAID BUILDING ADDRESS: 1 ITR: 11699 LT: 4 BL: .001 I 5305 ARDEN DR 1 I IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT: 1 TEMP CA 917803320 I (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: FREER 1 18585-004-044 1A1 PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY, Cl I ILB 200 AMP PANELS, MCC 1.00 PAN 38.85 I (TENANT: I TOTAL FEES 66.60 11SSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: I I 109/28/07 SR 03/26/08 (OWNER: TEL NO: (FINAL ATE F N Y: CODE: 1 ILEONARDO & EVELYN BURANDAY (626) 443-9702- I 1 l 15305 A.RDEN DR 1 ITEMP 917803320 1 1 ESCI"IPTION OF WORK 1 I IMETER SERVICE UPGRADE FROM 100 TO 200 AMP 1 1APPLICANT: TEL. NO: 1 I I ISAME AS OWNER I I ISPECIAL CONDITIONS: 1 I I I I 1 i I I ICONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE 1 ISAME AS OWNER - 1 I I LIC. NO 1 ITEMPOR.ARY POWER POLE I I I I I (UNDERGROUND CONDUIT 1 I I I 1ARCHITECT OR ENGINEER: TEL. NO: 1 IUFER GROUND 1 1 1 LIC. NO: I IROUGH CONDUIT I IROUGA WIRING I I IMAIN WATER LINE I I I IPLASTIC YIN METAL YIN I I I I I I I I I I UTIL__-TY COMPANY NOTIFIED I I I I I I I I I I I I I I I I I I i 1 I I { I f I I I I I I I I I I I I i I I I I I I I I I I { I I I I I I I I I I I I 11 I I I I I I IREPORT ID: DPR265 ROUTE TO: BS0508 I I I I I I I i COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1112130040 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: ITR: 11699 LT: 4 BL: .001 1 5305 ARDEN DR I FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( TEMP CA 917803320 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 8585-004-044 IA1 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY, Cl IG1 OUTLETS-LGT,SW,RECP 14.00 OUT 27.20 I 1 (TENANT: IG2 LIGHTING FIXTURES 4.00 LGT 7.80 (ISSUED ON: PROCESSED BY: PLAN BY: TOTAL FEES 62.80 12/13/11 SR (OWNER: TEL. NO: IFINAL DATE FINAL BY: CODE: WANG JM TING (626) 823-3360- 15305 ARDEN DR TEMP 917803320 JDESCRI ION OF WORK ELECTRICAL FOR BEDROOM #3 AND RELOCATED (E) BATHROOM (APPLICANT: TEL. NO: IZHANG, KEVIN (626) 823-3360- 11105 SUNNY SLONE AVE ISPECIAL CONDITIONS: JPADADENA, CA (CONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE WANG, JINTING (626) 823-3360- I 5305 ARDEN DRIVE. LIC. NO ITEMPORARY POWER POLE TEMPLE CITY, CA 91780 NONE UNDERGROUND CONDUIT (ARCHITECT OR ENGINEER: TEL. NO: IUFER GROUND LSC. NO: IROUGH CONDUIT IROUGH WIRING IMAIN WATER LINE IPLASTIC YIN METAL YIN (UTILITY COMPANY NOTIFIED( IREPORT ID: DPR265 ROUTE TO: BS0508 _ I WORKER'S COMPENSATION DECLARATION 9 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT 76A66 I hereby affirm that I have a certificate of consent to self insure, 76A663 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.) Policy No. Company FOR APPLICANT TO FILL IN JOBADDr / Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE LOCALITY El $ $Ft Sq. . — Certified copy is filed with the county building inspection 1 &2-Family, _ NEAREST department. Multi-family Sq.Ft. CROSS ST. Date Applicant Residential Swimming Pools ASSESSOR MAP PAGE 1PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER OR COMPENSATION INSURANCE Outlets:Rec.—Light Sw. p �-- FIRM NAME /O D (This section need not be completed if the work involved by the First 20 MAIL Total No. Additional MAIL permit is for one hundred dollars(5100)or less.) I certify that in the performance of the work for which this permit CITY Tel.No. D is issued, I shall not employ any person in any manner so as to PLAN CHECK become subject to the Workers'Compens ti n Laws. Lighting Fixtures First 20 APPLICANT n Total No. Additional ADDRESS Date Applican RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTIC T APPLICANT: If, aft making this Certificat of CITY Tel.No. Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. y provisions of the Labor Code, you must forthwith comply with such APPLICANT PERMIT provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances A F' !i_ ✓ /rUt LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. (commencing with Section 7000) of Division 3 of the Business and CITYTel.N 6V'S 1,6 Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. LICENSE OR a Over 50 to 100 Incl. REG.NUMBER Class. /'� Over 100 DISTRICT NO. P OCES ED BY O License Number Lic.Class ` v Services,Swbd.,MCC&Panelboards �� ? Q 0-399 Amp.Under 600 V FINAL Contract Date DATE c F— ❑ 400-1000 Amp. Under 600 V 5 —Z � U I am exempt under Sec. VALIDATION W Over 1000 Amp.or Over 600 V FINAL B.&P.C.for this reason BRANCH CIRCUIT FEES BY Z Date: 15A,or 20A,120V,Lighting or Recept. — 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits SINGLE FAMILY Temp.Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION ` Sign with One Branch Circuit 20� it _t I hereby affirm that I am exempt from the Contractor's License Law 3 for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits ti �i e� Code): 1 I I L!!Zj Misc.Conduits&Conductors El I,as owner of the property,will do the work and the structure A` '� is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) I� tf� Vii and Professions Code). CHECK 4"a.;.` CONSTRUCTION LENDING AGENCY ( HANGIE ,00 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 00003-13001011 EE 7/93 Lender's Name ^ t 'f i(°32 PERMIT ISSUING FEE a/ 9`�= �' ��t` - Lender's Address I certify that I have read this application and under penalty of purjury state TOTAL FEE that the 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 inspec io purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE 4T&14ArfURE OF PE 7E E ATE