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Home My Public Portal About4847 ARDSLEY DR_Electrical__ WORKS,RS'.,COMF*CNSATION DECLARATION C-603 tO/$� APIPp CATION OR {fin EC MICA ' PEEN T �. CE-806G I� L� If 11�) LS tL-LS�s II Gi�L PERNT , 1 heretzy'@ . • ,r CE ,y, •..: (firm tfjat I'have a certificate of-consent.to self. insure, =or a certificate of Workers' Compen"sation Insurance, or a certified, COUNTY OF LOS.ANGELES BUILDING AND SAFETY copy thereof(Sec.•3800,Lab.:C.) _ Policy No. Company - - FOR APPLICANT,TO•FILL IN.,- JOB � M�� ❑ Certified copy is hereby furnished New Residential Bldgs;'&Pools EACH NO.- FEE ADDRESS G �1 Certified•copy y',filed WA-fe.county building inspection 1 &'2-Family,Sq.Ft. — OCALITY ' C Ci' .NEAREST /� .. . $' $ L C"hL department. Multi:family Sq.Ft.'" CROSS ST. G /..! VA Swimming Pools �A A� /1!� yy1 //7 Date Applicant •. _ FOIRM NAME�G/�/��4JV /V r CERTIFICATE OF EXEMPTION FROM,WORKERS" Outlets:Re Light Sw MAIL- „ 1 ” ,— 'COMPENSATION INSURANCE ADDRESS '-This section need'not be'completed-if the work involved by the First 20 'R * � i CITY Tel.No Z permit is for one hundred dollars($100)or less.) Total No. Additional •PLAN CHECK - L certify that in the,performance of,the work for which this permit APPLICANT is issued,d shall not),employ,any-person-in any:manner so-as to , become subject to th'e Worke[s•Compensation Lighting,Fixtures first 20 - 'ADDRESS C/ ' Additional Total No CITY Tel.No Date — '�`�APPlicant• �c7!h-�... _ NOTICE TO .APPLICANT: If,: . fter,-making 'this Certificate bf.. Fined Appliances Not Over 1 HP PERMIT' Exemption,you should become.subject to the Workers'.COmpensation Range_ Heater__DW APPLICANT .provisions of the Labor Code;you'must.forthwitt:comply with such Oven Dryer _ W.M., ADDRES provisions or this permit shall be deemed revoked. Top FAU _ 'W.H LICENSED>CONTRACTORS DECLARATION Hood fan. _•Other_ n CITY'' TeL No. ✓n .l hereby;affirm that I am licensed',,y,nder provisions of Chapter 9 6 LICENSE OR (commencing,with,Section 7000) of Division,3 of;the Business and Disp."—;Room Air Cond: Class. �� - , i REG.NUMBS - •. 'f'1 Professions Code,and my license'is in full force and,effect:, Power Apparatus& Large-Appliances N -. {. : DISTRICT- _ R • O. PROCESSFp BY/ „ . Size&Type HP;KW,KVA,or KVAR f/i/ ; I } License Number , Lic.Class O l '- Up to 1 IncC FINAL U Over 1 to 10 Incl CC DAT /�� Contractor Date A "� Over.10 to 50 incl , .❑ 1�am exempt under Sec: Over SO ao 100 Inc. U VA ID TION,:'. r U B.&P.C.for this reason LJJ Over 100. Services-:Swbd.;MCC&-Panelboar ds Date: 0-200 Amp.Under 600 V D ' Signature ` '201 -1000_Amp.Under 600 8 7 Z.'l A Over 1000 Amp. or Over 600"V # o o 0 0,o 2 ❑ Exemption for Reg.Maint Elect.,. SINGLE FAMILY' Temp. Power Pole&''Appurtenancesf„ .' 0 0 HOME OWNER-BUILDER'DECLARATION' a Sign with Orie Branch Circuit• : •'., ", '• .. o 0 0 2 Q= Q'5 I hereby affirm that.I,am exempt.from'itha Contractor's License Law for,-the following reason(Section 7031.5 Business and Professions Additional Sign Branch Circuits --� � ' U Misc Conduits•& Conductors 1,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)._ and.Professions-.Code): CONSTRUCTION LENDING AGENCY " I hereby affirm that there is a construction.lending agency for the ' " p P ( PERMITTEE' (Sub-Total) erformance of the work for which this ermit is issued Sec.3097, Civ:C.). U ' PLAN CHECKING FEE ,Lender's Name PERMIT ISSUING FEE L'ender's Address �l I certify"that I have read this application and state that the above TOTAL FEE U information is correct. I agree to comply with all County ordinances andState 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 WOPKERS'COMPENSATION DECLARATION 76A663 10/81 jo 0 0 0 PL�RMU 0 0 I 4t�`e!y affirm that I have a certificate of consent to self CE-806G 1 111 LI 'A � opq FOR ELECT�� `VAL ns e, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING A D SAFETY or decertified copy thereof (Sec. 3800, Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS El Certified copy'is filed with the county building inspec- 1 & 2-Family, Sq. Ft. $ _ $ LOCAL IT , /j4V tion department. Multi-family S Ft. 'NEAREST P Y q' CROSS ST. /�i Date Applicant Residential Swimming Pools '" OWNER OR ^ �, .t l FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw. (MAIL COMPENSATION INSURANCE j ADDRESS This section need not be completed if the work involved b First 20 ( p Y Total No. Additional CITY T'Aid' G Tel. No.y/�. jL� the permit is for one hundred dollars ($100)or less.) that in the ePformance of the work for which this PAN CHECK I certify P APPLICANT / permit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Comp. ns tion Law . Lighting Fixtures First 20 ADDRESS r /` Additional C�/ �� ph Total No. CITY Tel. No. Date r ' ' Applicant e:a..t� 'f /,I -e<'l..rX•c� -5ixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT 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 permit shall be Top — FAU —W.H. — deemed revoked. CITY Tel. No. LICENSED CONTRACTORS DECLARATION Hood _ Fan _Other- - Disp. — Room Air Cond. LICENSE OR Class.. I hereby affirm that I am licensed under provisions of Chapter 9 REG. NUMBER (commencing with Section 7000) of Division 3 of the Business DISTRICT NO. PROCESSE Y and Professions Code,and rn license is in full force and effect. Power Apparatus & Large Appliances >. y Size &Type HP, KW, KVA, or KVAR' o License Number Lic. Class Up to 1 Incl. FINAL V Contractor Date Over 1 to 10 Incl. DATE VALI. TION o ❑ Over 10 to 50 Incl. FI U I am exempt under Sec. Over 50 to 100 Inc. LU B.&P.C. for this reason Over 100 of Services, Swbd., MCC & Ponelboards Date: 0 -200 Amp. Under 600 V S Signature 201 - 1000-Amp. Under 600 V -. Over 1000 Amp. or Over 600 V Exemption for Reg. Maint. Elect. SINGLE FAMILY 'Temp. Power Pole & Appurtenances' HOME OWNER-BUILDER DECLARATION ( Sign with One Branch Circuit :2 ] 1 ] rj A I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits Law for the following--reason"(Section 7031.5, Business and # m o 0 0 0 2'- \, Profro)essions Code): . 14-21 I, as owner of the property, will do the work and the Ot'he Conduits &Conductors i' . - 2550 0 structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ 7044, Business and Professions Code). D o o ° 2 5 5.04' CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for 06 04 -87 the performance of the work for which,this permit is issued PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address _ I certify that I have read'this application and state that the TOTAL FEES�v 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 Eb -mentione% /�d property icor i�spection purposes. _ SEE REVERSE FOR EXPLANATORY LANGUAGE Si ture of Permittee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0701050007 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 - PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 14647 LT: 30 4847 ARDSLEY DR FEE DESCRIPTION: - QUANTITY: UOM: AMOUNT: TEMP CA 917803802 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: TEMPLE CITY 8590-017-024 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: AS LOCALITY: TEMPLE CITY, C G1 OUTLETS-LGT,SW,RECP 21.00 OUT 40.35 TENANT: G2 LIGHTING FIXTURES 14.00 LGT 27.30 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: HA FAU LESS 3HP 1.00 FAU 10.95 01/05/07 JK 07/04/07 H2 RES GRBG DISP LT 3HP 1.00 DIS 10.95 - - OWNER: TEL. NO: H3 RES DISHWASHR LT 3HP1.00 DIS 10.95 FI A DA FI4AL BY: CODE: YOUNG ISAAC;ESTHER J (626) 285-8842- H4 RES RANGE HDS LT 3HP 1.00 BOO 10.95 4847 ARDSLEY DR H5 RES WASH MACH LT 3HP 1.00 WAS 10.95 TEMP 917803802 H7 RES EXHAUST FANS. 1.00 EX 10.95 D C IPTI N OF WORK IA N-RES EX FANS LT 3HP 1.00 EX 15'.30 ELECTRICAL FOR ADDITION , JA HEAT PUMPS +3-10HP 1.00 HT 19.65 APPLICANT: TEL. NO: TOTAL FEES 196.05 PERALTA _ (818) 523-3373- _ 7318 VALIAN AVE SPECIAL CONDITIONS: VAN NUYS CA 91406 CONTRACTOR: TEL. NO: - APPROVALS DATE INSPECTOR SIGNATURE A & WORKERS ASSOCIATES . . (818) 982-7904- 13141 HARTLAND ST. LIC. NO TEMPORARY POWER POLE NO. HOLLYWOOD, CA 91605 697160 B UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: _ UFER GROUND LIC. NO: ROUGH CONDUIT 'ROUGH WIRING r MAI:: WATER LINE PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED REPORT ID: DPR265 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0706190010 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: I FEES PAID 1 BUILDING ADDRESS: ITR: 14647 LT: 30 I 1 - 4847 ARDSLEY DR I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( TEMP CA 917803802 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: TEMPLE CITY 1 18590-017-024 IA1 PERMIT ISSUANCE FEE 27.75 1 THOMAS PAGE: 597 GRID: A5 LOCALITY: TEMPLE CITY, Cl I ILB 200 AMP PANELS, MCC 1,.00 PAN 38.85 1 ITENANT: I TOTAL FEES 66.60 IISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 106/19/07 SR 12/16/07 1OWNER: TEL. NO: IF_NAL D F CODE: I - IYOUNG ISAAC;ESTHER J (626) 285-8842- I 14847 ARDSLEY DR ITEMP 917803802 IMSCIRIPTION OF WORK I i (UPGRADE SERVICE PANEL TO 200 AMP (APPLICANT: TEL. NO: 1 ISAME AS OWNER - 'I I I _ I (SPECIAL CONDITIONS: 1 I I I I I I ICONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE I SAME AS OWNER - I I LIC. NO ITEMPORARY POWER POLE I I I (UNDERGROUND CONDUIT I 1 I ARCHITECT OR ENGINEER: TEL. NO: i - IUFER,GROUND I - I�-I LIC. NO: i TROUGH CONDUIT I TROUGH WIRING 1 ( IMAIN:WATER LINE 1 jPLASTIC Y/N META Y/N I (UTILITY COMPANY NOTIFIEDI I 1 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 I I I REPORT ID: DPR265 ROUTE TO: BSO508 I I I I I I I