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Home My Public Portal About5003 ARDSLEY DR_Electrical__ w 7GA663•CES06-I .56 APPLICATION FOR ELECTRIC PERMIT 1 BUILDING AND SAFETY DIVISION Department of County Engineer BUILDING _ County of Los Angeles ADDRESS JOHN A. LAMBIE. COUNTY ENGINEER CASSATT D. GRIFFIN. SUPT of BUILDING LOCALITY NEAREST r FOR APPLICANT TO FILL IN Ross T. PERMIT FEES OWNER ; r�Y LIGHTS RECEPTACLES SWITCHES '- NUMBER I TEM EACH FEE MAIL ADDRESS TOTAL OUTLETS $ ,10 ELEC. RANGES, WATER HEATERS, -CITY TEL. NO. CLOTHES DRYERS ,50 77 ELEC. SPACE HEATERS, STAT-Y. COOK- ELECTRICIAN 2 ING UNITS, GARBAGE DISPOSERS, �( p ADDRESS.' AUTO WASHERS, DISHWASHER ,25 LIGHTING FIXTURES .10 + CITY 0' 'TEL. NO. MOTORS STATE LICENSE NO. 4. HORSEPOWER H.P. OVER INC. DISTRICT NO. GROUP 1 1 Z NE READY FOR INSPECTION 1/z &LESS .25 1/2 2 .50 INSPECTION RECORD 2 5 1.00 5 15 1.50 15 50 2.50 50 200 5.00 misc. SIGNS ( NO.TRANS NO.LAMPS SERVICE O-600V 1.00 r` SERVICE OVER 600V 5.00 WIRING PERMIT 1.00 7 -1 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .50 APPROVALS TOTAL FEE 5 a DATE INSPECTOR'S SIGNATURE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION 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 1 AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAIT I /*f HE LEGAL OWNER OF THE ABOVE I POWER DESCRIBED RES IDEN -?R RTY• -"" UTILITY CO. NOTIFIED 6 •�� SIGNATURE � -•" .�^`'. s OF PERM[. .E ✓,r+,.'I ✓° .. �.,.., FINAL ) 4�• JOHN A. LAMBIE. `//// ATION ARTHUR C.VEIT, COUNTY ENGINEER `r� K O CASH SUPERVIGING ELECTRICAL E GINEER Col 74s-" 28 2 1 0.65 t ORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT 76A663 I he � ,Ct that I have a certificate of consent to self insure, or a cent. XteWI—Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT'OF PftdC dt`ORKS BUILDING AND SAFETY DIV. copy thereof(Sec.3800 Lab.C.) FOR APPLICANT TO FILL IN JOB Policy No. Company +'j ADDRESS OO �•' S f Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE ❑ _ $ $ LOCALITY Certified copy is filed with the county building inspection 1 &2-Family,Sq.Ft. _ NEAREST department. Multi-family Sq.Ft. CROSS ST. Date Applicant Residential Swimming Pools ASSESSOR fl� MAP BOOK PAGE PARCEL tlets: CERTIFICATE OF EXEMPTION FROM WORKERS' ! OWNER OR COMPENSATION INSURANCE Rec. Light Sw. 2 FIRM NAME QAlle S (2_ q (l (This section need not be completed First 20 MAIL permit is for one hundred dollars($100)or less.)the work involved by the Total No. 9 Additional ADDRESsr�?3 /,r cls D, I certify that in the performance of the work for which this permit CITY Tel.N �.2�77,7Z U sw /is sued, I shall not employ any person in any manner so as toPLAN CHECK me subject to the Workers' Compensation Laws. Lig ting Fixtures First 20" APPLICANT Total No.� Additional f ADDRESS / f-30 3 Applicant �'"�� RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: If, t making this Certificate of CITY Tel.No. Exemption„you should become s b'.ct to the Workers' Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code, you must forthwith comply with such PERMIT p p y provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances APPLICANT 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 ` CITY Tel.No. Professions Code, and my license is in full force and effect. Over 10 to 50 Incl LICENSE OR Class. Over 50 to 00 REG.NUMBER a Over 10 DISTRICT NO. PRKEE'D BY License Number Lic.Class 0 Services,Swbd.,MCC&PanelbS uJ ��VU 0-399 Amp.Under 600 V U FINAL O Contractor Date DATE 1 ❑ I am exempt under Sec. 400-1000 Amp.Under 600 VVALIDATION 7 V Over 1000 Amp.or Over 600 V FINAL SJ LU 8.&P.C.for this reason BRANCH CIRCUIT FEES BY a. CD Date: 15A,or 20A, 120V,Lighting or Recept. Z 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits El 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 r=•:; A v for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits Code): _u ❑ 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) , f P•Ai and Professions Code). _ 6 CONSTRUCTION LENDING AGENCY C`HECT`. 86.35' 1 hereby affirm that there is a construction lending agency for the (_.sti}F`I(sE EI7 performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total) Cao, Civ. C.) PLAN CHECKING FEE Lender's Name 4i_};iS_i— f�I PERMIT ISSUING FEEy riji_t 1 iM a L._tE.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 r presentatives of this County to enter upon the above-mentioned property for i spection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE NATURE OF P TT DATE COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 9907200003 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 13329 LT: 54 5003 ARDSLEY DR., FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803807 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 8590-018-014 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A5 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT,SW,RECP 24.00 OUT 44.55 TENANT: G2 LIGHTING FIXTURES 5.00 LGT 9.75 ISSUED ON: PROCESSED BY: PLAN BY: . EXPIRES ON: HA FAU LESS 3HP 1.00 FAU 10.95 07/20/99• UT 01/16/00 . H7 RES EXHAUST FANS 1.00-EX 10.95 OWNER: TEL. N0: JB AC UNITS +3-10HP 1.00 AC. 19.80 FIN L DATE FI BY: CODE: STRATIS (626) 287-2333- LB 200 AMP PANELS, MCC - 1.00 PAN 39.00 5003 ARDSLEY DR TOTAL FEES 162.75 TEMP 917803807 D SCRIPTION OF WOR ELECTRICAL FOR ADDITION, RELOCATE SERVICE PANEL, HVAC AND\ AIR CONDITIONING SYSTEM APPLICANT: TEL. NO: L D H CONSTRUCTION - 9643 OLIVE ST. _ SPECIAL CONDITIONS: TEMPLE CITY, CA CONTRACTOR: TEL. N0: � APPROVALS DATE INSPECTOR SIGNATURE � L D H CONSTRUCTION (626) 286-7119- 9634 OLIVE ST LIC. NO TEMPORARY POWER POLE TEMPLE CITY .562071 B % UNDERGROUND CONDUIT :. ARCHITECT OR ENGINEER: TEL. N0: UFER GROUND L D H CONSTRUCTION (626) 286-7119- 9634 OLIVE ST LIC. NO'-' ROUGH CONDUIT TEMPLE CITY 562071 B! 1111111 Imo— ROUGH WIRING G'�FL��C. ��V 0c�) �� MAIN PLASTIC TY/NER LIMETAL Y/N _ UTILITY COMPANY NOTIFIED El REPORT ID: DPR265 ROUTE TO: BS0508 • J J 'r COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS ` 9701 LAS TUNAS EL 0508 9909160002 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 13329 LT: 54 5003 ARDSLEY DR FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803807 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 8590-018-014 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A5 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT,SW,RECP 15.00 OUT 29.25 TENANT: G2 LIGHTING FIXTURES 10.00 LGT 19.50 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: TOTAL FEES 76.50 09/16/99 UT 03/14/00 OWNER: TEL.. NO: FINAL DATE FINA Y: CODE: STRATIS (626) 287-2333- 5003 ARDSLEY DR /y��' TEMP 917803807 DESCRIPTION OF WORK ELECTRICAL FOR NEW RESIDENTIAL GARAGE APPLICANT: TEL. NO: L D H CONSTRUCTION - 9643 OLIVE ST. SPECIAL CONDITIONS: TEMPLE CITY, CA ES CONTRACTOR: TEL. NO: ®� �� APPROVALS DATE INSPECTOR SIGNATURE L D H CONSTRUCTION (626) 286-7119- f� 9634 OLIVE ST LIC. NO TEMPORARY POWER POLE TEMPLE CITY 562071 B UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: UFER GROUND LIC. NOI: / 1111111 ROUGH CONDUIT L ROUGH WIRING U P (� �� r'a MAIN WATER LINE IL1=� ILLL111^LLL`1111p117 PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED O 0 O 0 �f.h `mak El 'service REPORT ID: DPR265 ROUTE TO: BS0508