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Home My Public Portal About9433 BLACKLEY ST_Electrical__ 76A663-CES0610_62 APPLICATION FOR ELECTRIC L PERMIT COUNTY OF LOS ANGELES 'DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS o! /• t+ JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. RECEP s TOTAL I NO. EACH FEE OUTLETS FIRST 20 $20 $ OWNER LIGHT /�.�-�� MAIL ADD'L SWITCH. •1O ADDRESS OVER 20 LIGHTING FIRST 20 20 TOTAL CITY TEL. NO. -/g -- ` y� FIXTURES v ADD L 10 �ELECTRICIA a OVER 20 RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS ARB.DISP. STA.COOK CITY TEL.NO. �f Y� DISHWASH. AUTO.-WASH. STATE SPACE HTRS. STA.APP.(yi H.P.MAX.) 3 .50 LICENSE NO. �� MOTORS: OVER NOT OVER H.P. DIST ICT N GR P E O 1 1.00 04 i 3 1.50 INSPECTION CORD o. 3 8 2.00 O 8 15 2.50 V 15 50 3.00 50 100 5.00 Q. SIGNS: NO.TRANS. NO.LAMPS z SERVICE O.600V-NOT OVER 200A 1.00 L SERVICE 0.600V-OVER 200 A. 2.00 SERVICE OVER 600V 5.00 MISC. PERMIT ISSUING FEE 2.00 SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE $ 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR S SIGNATURE 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 CERT THAT I AM PROPERLY REGISTERED AND/OR J ^p�� p� ��,. !y�/JJ• _ LICENSED AS R U ED BY LOS ANGELES UNTY AND STATE OF FIXTURES /A CALIFORNIA O T AT I AM THE LE AL NE OF THE ABOVE F/ DESCRIBED RES TI PROPERTY. POWER SIGNATURE UTILITY CO.NOTIFIED OF PERM). LIDATION ARTHUR C. VEIT MO CASH SUPERVISING ELECTRICAL ENGINEER CK - - V 41LO 5 3 0 0 FES 5 2 D 13.20— �T` r 76A663 CSE-806 NF 6/78 APPLICATION rRELECTRIC L PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN JOB q� [Appl sidential Bldgs.&Pools EACH NO. FEE ADDRESS 1 � E 1 -Family,Sq. Ft, $/ — $ LOCALITY i-family Sq. Ft. — NEAREST CROSS ST. entiol Swimming Pools OWNER OR e�,� . FIRM NAME V Rec Light Sw. MAIL s First 20 ADDRESS No. Additional CITY Tel. N — �� `I PLAN CHECK � nalt1CA� d��5 Fixtures First 20 ADDRESS ®� o l No. Additional CITY d Tel. No.'s��• /�� ppliances Not Over 1 HP PERMIT APPLICANT J e_Heater_D.W. _Dryer_W.M. ADDRESS _FAU —W.H._ CITY Tel. No. Hood_Fan —Other LICENSE OR s� Disp.—Room Air Cond. REG.NUMBER I' 0 / Class. IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA Power Apparatus&Large Appl ionces TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO Size&Type HP, KW, KVA,or KVAR COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. a Up to 1 Incl. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR Over 1 to 10 Incl. LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF Over 10 to 50 Incl. CALIFORNIA OR THAT I AM THE LEGAL WNER OF THE ABOVE 29 DESCRIBED RESIDENTIAL^PERTY. Over 50 to 100 Inc. PERMIT Over 100 SIGNATURE Services DISTRICT NO. OCE SED B 0-200 Amp.Under 600 V 201-1000 Amp. Under 600 V Over 1000 Amp.or Over 600 V Z O Temp. Power Pole&Appurtenances Sign with O e Branch Circuit Addi►lonal Sign Branch Circuits INSPECTION > I ' INFORMATION Misc.Conduits&Conductors ON REVERSE Other(See Complete Fee Schedule) SIDE v Q o . s PERMIT FEE (Sub-Total) Z PLAN CHECKING FEE (One-Fourth Permit Feel O Q PERMIT ISSUING FEE c J Q TOTAL FEE > INSPECTION FINALEDr W date. s � By WORKER'S COMPENSATION DECLARATION 20 76A663 APPLICATION DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self insure, ' or a certifiAlte of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. cgpy thereof(Sec.3800 Lab. C.) a Policy No. Company FOR APPLICANT TO FILL IN JOB ADDRESS Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE LOCALITY ❑ 1 &2-Family,Sq. Ft. — $ $ Certified copy is filed with the county.building inspection _ NEAREST department. Multi-family Sq.Ft. CROSS ST. DateApplicant Residential Swimming Pools ASSESSOR ra PAGE �� PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec/Light Sw. p� FIRM NAME 7V g COMPENSATION INSURANCE First 20 O -C AIL (Thi' ADDRESS s section need not be completed if the work involved by the AA permit is for one hundred dollars($100)or less.) Total No. Additional ! �e I certify that in the performance of the work for which this permit CITY `re1mrL.J�' OUTV Tel.No. is issued, I shall not employ any person in any manner so as to PLAN CHECK become subject to the Workers' Compens3ifn Laws. Lighting Fixtures . First 20 APPLICANT Total No. Additional99 ADDRESS Date ` Applicant L APPL((��pp,N� ES 0 OVER 3 HP. NOTICE TO APPLICANT: If, after making this Certificate of CES CITY Tel.No. Exemption,you should become subject to the Workers' Compensation %0417� I NOT OVER 3 HP. provisions of the Labor Code, you must forthwith comply with Such PERMIT g t/ I�Cn P Y P Y APPLICANT L IY6�-�Li°FP provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS o iA E R I hereby affirm that I am licensed under provisions'of Chapter 9 Over 3 to 10 Incl. y� �ry� (commencing with Section 7000) of Division 3 of the Business and CITY IL/ Tel.No. -�y/gOs Professions Code, and my license is in full force and effect. Over 10 to 50 Incl. LICENSE OR G*�'� Over 50 to 100 Incl. REG.NUMBER Class. Q. .s p Over.100 DISTRICT NO. frSSED BY License Number �u/ b 3' Lic.Class ,Q aO�G'' V A FINAL Services,Swbd.,MCC&Panelboards �� V Contractor Date GeV 0-399 Amp.Under 600 V DATE ❑ 400-1000 Amp. Under 600 V I am exempt under Sec. I VALIDATION W Over 1000 Amp.or Over 600 V FINAL d B.&P.C.for this reason BRANCH CIRCUIT FEES BY CD 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 HOME OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit rrls_'_ . .•a for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits F Code): ❑ I, as owner of the property,will do the work and the structure Misc.Conduits&Conductors 7 I Gt fj' is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) a"i T s 3:50 70 and Professions Code). D CONSTRUCTION LENDING AGENCY -"- 1 hereby affirm that there is a construction lending agency for the CHAIP6- ,f!I performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total) Civ.C.) PLAN CHECKING FEEr. Lender's Name I"`" 111` I` PERMIT ISSUING FEE11.4 4 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 ins io purpo s. 71 SEE REVERSE FOR EXPLANATORY LANGUAGE t� S GNATURE OF PERMI EE DATE COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0307140027 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: ON FILE 9433 BLACKLEY ST FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803141 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: SERENO 8590-003-039 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY HA FAU LESS 3HP 1.00 FAU 10.95 TENANT: JB AC UNITS +3-10HP 1.00 AC 19.65 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: LA 100 AMP PANELS, MCC 1.00 PAN 38.85 07/14/03 JK 01/10/04 TOTAL FEES 97.20 OWNER: TEL. NO: FINAL DATE FINAL BY: CODE: GREENE ROBIN (626) 286-2952 9433 BLACKLEY ST - /'S -63 TEMP 917803141 DESCRIPTION 0 WORK C/O FURNACE & A/C; UPGRADE SERVICE PANEL TO 100AMP PPLICANT: TEL. NO: FAST TRAK PERMIT SERVICE (909) 279-0604- 5030 VICEROY AVE SPECIAL CONDITIONS: NORCO 92860 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE AIR-TRO INC. (626) 357-5311- 1630 S. MYRTLE AVE. LIC. NO TEMPORARY POWER POLE MONROVIA, CA 91016 258228 C20 UNDERGROUND CONDUIT RCHITECT OR ENGINEER: TEL. N0: UFER GROUND LIC. NO: ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED �aI REPORT ID: DPR265 ROUTE TO: BS0508