HomeMy Public PortalAbout4814 BIRCHLAND PL_Electrical__ } X11..111
7W�3 CE-80
6
111 /78) APPLICATION FO LECTRI L PERMIT - - -_ -
COUNTY OF LOS ANGELES BUILDING AND SAFETY'
FOR APPLICANT TO FILL IN JOB
FAppliances
idential BIdg5:&Pools EACH NO, FEE - ADDR `
Family,Sq. Ft. $ .025 -' $ LOCALITY `-
family Sq. Ft.'� .02 - NEAREST,
25.00 ST.
ntlal Swlmm ng Pools R
Lght- Svc. -- - IL - - - -
First 20 .50 ADDRESS
O. Additional 30 pC�11q"1�,C �{ _1111V T,QI. No. _
APPLICANTK
Fixtures hirst 20 •50 E4kDDRESS
Additional 30
o. t• CITI Tel. No. "
pliances Not Ever 1 HP
L APPLICANT
Range_Heater D.W.
Oven_DryeF'_�Z:W.M ADDRE55 - r --
Top _FAU —W.H._ CITY Tel.
)-food—Fan _Other_ LICENSE OR
Disp.—Room Air Cond. 2.50 REG.NU BER Class.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA•,
Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO
SIze&Type HP, KW, KVA,or KVAR - COMPLY "WITH'q1L COIINTY-'ORDINANCES AND STA7E-rAW5
2.Sb REGULATING ELECTRICAL WIRING.
T Up to 1 Incl. I HEREBY-CERTIFY THAT rAM PROPERLY REGISTERED AND/OR U
Over 1 to 10 Ind. 5.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF tl
Over-lO to 50 bat 12.50 CALIFORNIA OR THAT I AM,_ME.Lr_��.Q14NkR OF THE A$QVE ,.0
Over 50 to 100 Inc_-. _
25.00 DESCRIBED RESIDENTIAL PROPERTY.
-Over,100 40.0.0 PERAUTEE -
` SIGNATURE
Services DISTRICT NO. ED BY- -.
0-200 Amp.Under 660 V 12.50 n
201-1000 Amp. Under 600 V 25.00. F
Over 1000 Amp.or Over 600 V 50.00 Z
'Temp. Power Pole&4lou"nonces 10,00 -
Sgn with One Branch Circuit 10.00
Additional Sign Branch Circuits 2'GO INSPECTION_- >
Misc.Conduits&Conductors 10.00 INFORMATION ;
Other(S."Complete Fee Schedule) ON REVERSE
SIDE
f56. 22A
_ ° ° U O °
PERMIT FEE fSuliTotalj
PLAN CHECKING FEE lone-Fourth Permit'Feel
{
PERMIT ISSUING FEE $7.00 19,00
RM
TOTAL FEE ; o7.23 -7'9
INSPECTION FINALED," �'o A
date: r'`'"� BY
W �
1
WORKERS'COMPENSATIONDECLARATION 76A8E9
CE-8060 (2-800- APPLICATION FOR ELECTRICAL PERMIT �-
x
I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDINQ AND SAFETY
insure, or a certificate of Workers'Compensation Insurance,or
a certified copy thereof(Sec. 3500,Lab.C.)
an FOR APPLICANT TO FILL IN JOB
Policy No: Company New Residential Bldgs.&Pools EACH NO. FEE ADDRESS
Certified copy is hereby furnlahed. 1 &2-Famll $ — a LOCALITY jLLM
y,Sq. Ft.
Certified copy is filed with the county building inspection Multi-family Sq. Ft. CROSS ST
department. Residential Swimming Pools OWNER OR
FIRM NAME
Data Applicant Outlets: Ree LightSw._4 MAIL
—3—First 20 ADDRESS
CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional
CITY Tel Nop a
COMPENSATION INSURANCE PLAN CHECK ,
APPLICANT
(Thls section need not be campleted if the work tmotved Lighting Fixtures First 20
by the permit is for one hundred dollars ($100) or ler.) Additional ADDRESScc
Total No. O
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 parson In any manner PERMIT
so as to become apbject to the Workers' Compensation Laws. Aenge_Heater_D.W. APPLICANT a
Oven _ Dryer W.M._K, ADDRESS Z
Date, �_�Appljcant � /a -'I / S Top T FAU _W.H.
Hood _ Fen _Other_ CITY Tel No.
NOTICE TO APPLICANT: If, after making this Certificate of Dlsp. — Room Air Cond` -LICENS9 ON
Exe�ptlon, you should become subject to the Workers' REO.N MBER Claw
Compensaflon provisions of-the Labor Code, you must fortx
h- Power Apparatus& Large Applleres DISTRICT N . PR ED BY
with comply with such provislons or this pbrm-t shall be P,KW, KVA,or KVA
Size&Type HO Q
deemed revoked. Up to 1 Incl.
Over FINAL 1 to 10 Incl. DATE ,cl
LICENSED CONTRACTORS DECLARATION Over 10 to 150 Incl. �r VALIDATION
I hereby affirm that I am licensed under provisions of Chapter Over 60 to 100 Inc. FINAL /
�.
9 (commencing with Settlors 7000) of Division 3 of the Buai- Over 100 BY
nets and Professions-Code,,and my license 1s in full force and'
effect. Services
License Number Llc.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&Appurtanences
I hereby affirm that I ■m exempt from the Contractor's Sign with One Branch Circuit
License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits
nass end Professions Code):
Misc.Conduits&Conductors
❑ 1, as owner of the property, will do the work and the Other(See Complete Fee Schedule)—
structure Is not intended or offered for sale (Section
7044,Business and Professions Code).
CONSTRUCTION LENDING AOENCY A'l 2 2 `ti A
J hereby affirm that them Is a constructioh lending agency
for the performance of the work for which this permlt is PERMIT FEE (Sub-Total) $! 0 0'0 0 0
Issued(Sec. 3097,Civ.C.).
Landel's Name PLAN CHECKING FEE (One-Fourth Permit Fee) 2 r 0
Lender's AddressPERMIT ISSUING FEE 0 0 C. j (; r)
I certify that I have read this eppllca_tion and state that the TOTAL FEE
above information Is correct.I agree to comply with all County
ordinances and State laws regulating Electrical wiring, end
hereby authorise representatives of this County to enter upon
the above-mentioned property for Insp 7V
purposes. SEE-REVERSE FOR EXPLANATORY LANGUAGE
tura of ttee' Date
COUNTT 0➢ Lob ANGHLES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DYPARTMXNT 0➢ PUBLIC WORKS 9701 LAB TUNAS IL 0508 0607060005
BUI1DING AMID SAFETY / LAWD DZVELOPKKlrT TEMPLE CITY CA 91780
PRONE: (676) 785-0488 IZT.
LEGAL ID. FEES PAID BUILDING KDDRE88.
TR. 14771 LT: 3 4814 BIRCHLAID PL
PER DESCRIPTION. QUANTITY: UOK. AMOUNT: TEMP CA 917604013
A38ES90R INFORMATION WW®ERt NKARF69T CROSS STREET. LOWER AZUSA
8585-013-003 Al PERMIT ISSUANCE FEZ 27.75 THOFOIS PAIIEt 597 IDI BS LOCALLITTt TEMPLE CITY, C
O1 OUTLETS-LOT,SW,R.ZCP 10.00 OUT 19.50
TEIANT01 LIGErT3300 ➢TXTTp� 3.00 LUT 5.85 ISSUED ONt PROCZBSID BYt PLAN BYs ZKPIRIS OWi
H1 PAU LESS 3HP 1.00 PAU 10.95 07/06/06 JL 01/07/07
LB 700 AMP PANELS, MCC 1.00 PAN 38.85
090M. TEL. NO- TOTAL FEES 107.90 ➢ Ta FIST. BY: -"CODR�
GALAXI8 ANASTABIOSIPAWBOOS (676) 575-3164- /^
4814 BIRCELAND PL
TEMP 917804017 DESCRIPTION OF WORK
KIXC RACAL FOR ADDITION 10 OUTLETS, 3 LIST FIXTURES, PAU,
UP<ERKDE SERVICE 700 AMP
APPLICINTi TIL. NOc
SAME AS OWNER -
SPECIAL CONDITIONSt
CONTRACTORS TTL. NO: APPR071L8 DATE INSPECTOR SI®ITURE
SAME AS OWNER -
LIC. NO TIOM"RY POWER POLI
UNDERGROUND COIDIIIT
ARCHITZCP OR INGINIM: TIL. NO. UrXR GROUND
TANKOSKY, JOHN (818) 736-3060-
4547 NEW YORK AVE LIC. NOi ROUGH COKDIIIT
LA CREBCOM,L CA 13544 RE
ROUUH NTRII0
N IN WATER LINE
PLASTIC Y/I KrEAL Y/N
UTILI7Y COMPANY NOTIFIED
REPORT ID: DPR365 ROUTE TO. B80508