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Home My Public Portal About9471 BLACKLEY ST_Electrical__ 5A 11-50 APPLICATION FOR PERMIT 'DiVffRTMENT OF BUILDING AND SAFETY WI COUNTY OF LOS ANGELES , 1 L WILLIAM J. FOX, CHIEF ENGINEER " RIC FOR APPLICAN TO FILL IN DISTRICT NO. GROUP I ZONE PERMIT NO. Aj, -v Z ELECTRICIAN , RECEIVED BY READY FOR DATE ISSUED ADDRESS FIRST INSPECTION CITY EL N d Z//L� COUNTY LICENSE_ NO EXPIRES EXPIRES BUILDING PERMIT FEES ADDRESS FEE NUMBER EACH LOCALITY LIGHT OUTLETS NEAREST Q� CROSS ST. RECEPTACLES S' •� WALL SWITCHES TOTAL OUTLETS 5c $ MAIL'S ELEC RANGES 25 i ADDRESS ' ELEC. HEATERS 25 if CITY TEL. NO FIXTURES SL 1 HEREBY ACKNOWLEDGE; THAT I HAVE. READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS _ AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE�CIRCU ITS ' AND STATE,LAWS REGULATING ELECTRICAL WIRING. MOTORS 1 CERTIFY THAT' I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER jII ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER NEW MVD. HP OVER INC. EACH„ I OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. •1/2 &LESS $ .25 SIGNATWF - '1/2 2 50 PE 2 5 100 INSPECTIO RECORD 5 151 1.50 , 15 50 2 50 50 200 5,00 •1 200 Soo 10 00 ”' - ,J Soo 1000 15 00 Z OVER 1000 20 00 1 - _ (,• M G SET/FREQ CHANGER-HP WELDERS AC-KVA GENERATORS-KW , TRANSFORMERS-K A TEMP MOTORS (75 0 .) , MOVED MOTORS (7 o ORIG.) MISC _ - I SIGNS (.;1 •tA NO. NO. TRANS. APPROVALS ' NO NO LAMPS I ` DAT-E INSPECTOR'S NAME FOR EACH PERMIT. CONDUIT WIRING $1 00 4' FIXTURES $1 00 WIRING �^�'=`��%S/^r/ SUPPLEMENTARY 50 FIXTURES POWER TOTAL FEE I $/ I ; UTILITY CO NOTIFIED I FINAL ^'. 'F'rie3 DBSSA 11-50 "--APPLICATION FOR PERMIT PARTMENT OF BUILDING AND SAFETY �� ' COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TOFILL IN DISTRICT NO. GROUP I ZONE PERMIT NO. ELECTRICIAN RECEIVED BY READY FOR DATE ISSUED ADDRESS y rl FIRST INSPECTION CITY 7 TEL. NO ,� t/ •/ COUNTY LICENSE NO. < EXPIRES BUILDING PERMIT F ES ADDRESS NUMBER EACH FEE LOCALITY L LIGHT OUTLETS Z 3 NEAREST CROSS ST. RECEPTACLES �r�+ WALL SWITCHES TOTAL OUTLETS SO $ '�, MAIL 1 ELEC. RANGES 25 ---�f— ADDRESS ELEC. HEATERS 25 CITY TEL. NO. FIXTURES _ 5 _ 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS MISC. APPLICATION AND BTATE THAT THE ABOVE 19 CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWERFEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER NEw MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. V2 & LESS $ .25 SIGNATURE OF ,r V2 2 .50 PERMITTEE- 2 s 1.00 INSPECTION REC RD s is 1.50 is so 2.50 50 2013 5.011 200 800 113.00 J 500 1000 15.00 Z OVER 1000 20.00 E3 M.G. SET/FREQ. CHANGER-HP Q' WELDERS: AC-KVA' O GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% DF ORIG•) MOVED MOTORS (75% OF GRID.) MISC. SIGNS 1�T NO. NO.TRANS. APPROVALS NO. NO. LAMPS FOR EACH PERMIT: DATE INSPECTOR'S NAME WIRING $1.00 '� CONDUIT FIXTURES $1.00 G 0 WIRIND SUPPLEMENTARY .50 FIXTURES POWER TOTAL FEES UTILITY CO.NOTIFIED 1f FINAL dp�� `�`WORKERS'COMPENSATION DECLARATION 76A663 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self CE-8066 , insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SA TY or a certified copy thereof (Sec 3800, Lab C ) �/ , Policy No Company FOR APPLICANT TO FILL IN JOB rSL�r%r Certified copy is hereby furnished New Residential Bldgs & Pools EACH NO FEE ADDRESS �( ❑ Certified copy is filed with the county building mspec_ 1 & 2-Family, Sq Ft $ _ $ LOCALITY v tion department Multi-family Sq' 'Ft 'NEAREST r CROSS ST Date Applicant Residential Swimming Pools OWNER OR LAX> Q FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec Light Sw_ MAIL ^ COMPENSATION INSURANCE ADDRESS (This section need not be completed iF t work involved by First 20 the per is For one hundred dollars ( 1 0)or ess:)" Total No Additional CITY Tel No PLAN CHECK I certify that in the performanc of th or for which this APPLICANT permit is issued, I shall n pl y e so in any manner Lighting Fixtures First,20 ADDRESS so as to becom�bl to e r ers' m en tion Laws 9 9 F/V^�� Total No Additional CITY Tel No '74ate pelican Fixed Appliances Not Over 1 HP PERMIT �rC NOTICE TO APPLICANT If, aft ma ing i Cert icate of APPLICANTLodl \ Exemption, *you should become sublec t he orkers' Range_ Heater_D W ^Cr Compensation provisions of the Labor Co o st forth- Oven _ Dryer W M ADDRESS with comply with such provisions or thi 'ermi shall be Top — FAU —W H — deemed revoked Hood _ Fan _Other_ CITY n-a '0 /\ Tel No 57 r,4 LICENSED CONTRACTORS DECLARATION Disp Room Air Cond LICENSE OR G O C' Class _ I hereby affirm that I am licensed under provisions of Chapter 9 REG NUMBER l (commencing with Section 7000) of Division 3 of the Business DISTRICT NO PROCESSE BY and Professions Code,and m Ice in full force and effect Power Apparatus 8 Large Appliances �^ IL Size &Type HP, KW, KVA, or KVAR J / Q License Number Co Lic Class<_14 0 Up to 1 Incl FINAL V Over 1 to 10 Incl DATE �r�Z�JL VALIDATION 0 Contractor Date Over 10 to 50 InclVVV FINAL ' (~j ❑ I am exempt under Sec Over 50 to 100 Inc BY r d B &P C for this reason Over 100 S ry CC & Panelboards ► /� -- Date 0 -200 Am rider 600 V Signature mp Under 600 V t/ �13-3 ❑ Over 1000 Amp or Over 600 V -2309. 1 A Exemption for Reg Maint Elect SINGLE FAMILY Temp Power Pole &Appurtenances #.o o o.o o 2 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ' I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits ,2� Law for the following reason (Section 7031 5, Business and Professions Code) °?' ° ° 2',5,,5 0 c= ❑ as owner of the property, will do the work and the Misc Conduits &Conductors , O*6 2 'J 8'J structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ 7044, Business and Professions Code) CONSTRUCTION LENDING AGENCY I hereby affirm that there,is a construction lending agency for the performance of the-work r 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 FEE SQ above information is correct I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby thorize representatives of this County to enter upon he a o -mentioned property for inspec pn pur s -0 , SEE-REVERSE FOR EXPLANATORY LANGUAGE 1 , CTgncituroVof Permi ee Date C/ 1 1 G CATV OF LOS ANGELES TEIAPLL l = i aJ8 E--ECTPICAL,PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS Tul"As EL 0508 0410180061 BUILDIN''S AOD SAFETY / LAND DEVELOPt'ENT TEMPLE CITY ZA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID _ BUIL :.!C ✓bJRESS: — ON FILE 9471 B!IICYLEY ST FEE DESCRIPTION: QUANTITY: UOM- 4VOUNT: TEMP fA Q171t„3158 ASSESSOR INFORMATIONNUMBER: NEAREST CROSS STREET: CLOVERLY 8590-004-015 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J4 LGCA�iTY: TEMPLE CITY, C F1 120V, 15/20A 83 `'KTS 3.00 'BR 51.75 +TENANT: G1 OUTLETS-LGT,SW,RECP 6.00 OUT 11.70 ISSUED ON: P.00FSSED BY: PLAN BY: E .^: .:C CN: G2 LIGHTING FIX%RElc 2.00 LGT 3.90 10/18/04 1K L=/1(;/U5 TOTAL FEES 95.10 �OWNER: TEL. NO: FINAL DAT Xp— Y.I BCG',F: BOELE NANCY E TR NANCY E SOELE TRUS 19471 BLACKLEY ST TEMP 917803158 DESCRIPTION OF '.40,', I ELECTRICAL FOR NEL! BATHROOM ,APPLICANT: EL. NO: (SAME AS OWNER _ SPECIAL CONViTIONS: — I- iCONTRACTOR: TEL. NO: APPROVALS DATE !NSPFCTCR SIGNATURE (SAME AS OWNER A1C. NO TEMPORARY rQ�r2�rCLE--r UNDERGROUND CONDU?T �ARCHITEC ORENGINEER: TEL. NO: UFE'R GR3—UNL l LIC.-No. ROUGH CONDUIT ---�! — ROUGH WlRlr MAIN WATER. LINE -- PLASTIC YIN. METAL Y/[J _^— UTILITY COiPANY—'Y NOTI"iEC REPORT ID: DPR2u5 ROUTE TO: SS0508 V r