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Home My Public Portal About9575 BLACKLEY ST_Electrical__ 76A663-CE806 8/63 APPLICATION FOR ELECTRI MIT 7S- COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A.JENSEN, SUPT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. [71 TOTAL NO. EACH FEE AIT OUTLETS FIRST 20 $20 $ �� MWNERADD'L 10 , ADDRESS OVER 2O TOTAL FlasT 20, 20 CITY TEL. NO.} ADD'L 1O ELECTRICIAN OV R 20L/V RANGES •CLO.DRYERS WTR.HTRS. 1.00 ADDRESS GARB.DISP. STA.COOK / iL CITY TEL. NO. 777 DISHWASH. / AUTO.-WASH. �v STATE G.r L-j SPACE HTRS. STA.APP.('/s H.P.MAX.) .50 LICENSE NO. MOTORS: OVER NOT OVER H.P. DISTRICTNO. GjrP NE P CESSED B O 1 1.00 O 1 3 1.50 INSPECTION RECORD 30-2.00 D_ O B is 2.50 U 15 50 3.00 Qd O 50 100 5.00 ~ V Lu SIGNS: NO.TRANS- N NO.,LAMPS Z SERVICE 0-600V-Nor OVER 200A 1.00 SERVICE 0-600V-OVER 200 A. 2.00 SERVICE OVER 600V 5.00 MISC. PERMIT ISSUING FEE 2.00 0 SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE $ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT A WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING pp�. ��_ ELECTRICAL WIRING. WIRING ®.-i� 1,5( 1HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED LOS ANGEL COUNT AND STATE OF FIXTURES ` CALIFORNIA OR THAT AM THE LEG OWNE OF HE BOVE `� Y DESCRIBED RESIDENTIA P RTY. POWER w -A-yJ SIGNATURE UTILITY CO.NOTIFIED OF PERMITTEE FINAL C O ' LIDATION ARTHUR C. VEIT CK MO CASH SUPERVISING ELECTRICAL ENGINEER L;;tio 5.4 1 8-0 OCT 3 0 2 D 1 9.0 0 d' WORKERS'COMPENSATION DECLARATION CE 86 6G (2-80) APPLICATION FOR ELECTRICAL' PERMIT I hereby affirm that I have a certificate of consent to self COUNTY'OF LOS ANGELES BUILDING AND SAFETY insure, or a certificate of Workers'Compensation Insurance,or f a certified copy thereof(Sec. 3800, Lab.C.) FOR APPLICANT TO FILL IN JOB A Policy No. Company EACH NO. FEE ADDRESS New Residential Bidgs.&Pools Certified copy is hereby furnished. 1 &2-Family,Sq Ft. $E — $ LOCALITY Q ,p P Cl y QMulti-family Sq. Ft. — NEAREST r/ e Certified copy is filed with the county building inspection CROSS ST department. Residential Swimming Pools OWNER OR FIRM NAME r Y`. Date— Applicant Outlets Rec—Light_Sw � (�`(� re MAIL C- � QC�/@ First 20 ADDRESS a7 �/ CERTIFICATE OF EXEMPTION FROM WORKERS' Total No AdditionalCITYlole ClTel No. COMPENSATION INSURANCE PLAN CHEC a APPLICANT (This section need not be completed if the work involved �r,CQ 1 O f'/ Lighting Fixtures First 20 ADDRESS U by the permit is for one hundred dollars ($100) or less.) Total No. Additional ' I certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY G Te No.[l/ _ �a 0 permit is issued;I•shall not employ any person in any manner PERMIT -�-^ U so as to become subject to the Workers' Compensation Laws., Range_ Heater_D.W. APPLICANT T 1 C_! / �W Oven Dryer_W.M. ADDRESS l7 to Applicant Top FAU _W.H. z Date A PP CITY��CQ Hood Fan _Other_ NOTICE TO APPLICANT: If, after making this Certificate of Disp. — Room Air Cond.— LICENSE OR C Exemption, y.ou should become subject' to the Workers' REG NUMBER3aa5'0 W6 Class Compensation provisions of the Labor Code, you must forth- Power Apparatus.& Large Appliances DISTRICT NO PROC S BY with comply with such provisions or this permit shall be Size&Type HP, KW, KVA,or KVAR � deemed revoked: Up to 1 Incl. FINAL Over 1 to 10 Incl. 1 DATE �g —/7- VALI DATIO LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. BY AL 9 (commencing with Section 7000) of Division 3,of the Busi- Over 100 ness and Professions Code, and my license is in full force and effect. Services License Number1 a �9 O14C 4C Lic.Class C 10 0-200 Amp. Under 600 V r f ,/r r 201-1000 Amp. Under 600 V Contractor t / to Over 1000 Amp.or Over 600 V HOME OWNER-BUILDER DECLARATION Temp. Power Pole& Appurtenances Sign with One Branch Circuit \ I hereby .affirm that I am exempt from the Contractor's Additional Sign Branch Circuits License Law for the following reason (Section 7031.5, Busi- ness and Professions Code): Misc.Conduits&Conductors F1I, as owner of the property, will do the work and the Other (See,Complete Fee Schedule)--;— .structure chedule)=•structure is not intended or offered for sale (Section 7044, Business and,Professions Code). CONSTRUCTION LENDING AGENCY2 0 9 5 AI hereby affirm that there is a construction lending agency for the performance of the work for which this permit is PERMIT FEE (Sub-Total) issued(Sec. 3097,Civ.C.). # 0 0 0 0 0 2 Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) 2'0 o 1 3.0 0 Lender's Address PERMIT ISSUING FEE ) 0 0 0 pt I certify that I have read this application and state that the TOTAL FEE 09, 1 1 :_8 0 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 thea ve-mentioned,property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE ignature/f Permiftekv Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0607070012 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 29492 LT: 2 9575 BLACKLEY ST FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803143 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: CLOVERLY 8590-006-022 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY, C G1 OUTLETS-LGT,SW,RECP 12.00 OUT 23.40 TENANT: G2 LIGHTING FIXTURES 4.00 LGT 7.80 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: TOTAL FEES 58.95 07/07/06 JK 01/03/07 OWNER: TEL. NO: FINALL DAT„E FINAL-BY: CODE: BADARO OUBERTO J;JACQUELINE M (626) 653-2324- /”!^ 9575 BLACKLEY ST TEMP 917803143 DESCRIPTION OF WORK ELECTRICAL FOR KITCHEN AND RELOCATING BATHROOM APPLICANT: TEL, NO: SAME AS OWNER SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - ' LIC. NO TEMPORARY POWER POLE UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: UFER GROUND LIC. NO: ROUGH CONDUIT ROUGH WIRING MAIN 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 0210160023 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL D: FEES PAID BUILDING ADDRESS: TR: 29492 LT: 2 9575 BLACKLEY ST FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803143 ASSESSOR INFORMATION UMBER: NEAREST CROSS STREET: CLOVERLY 8590-006-022 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT,SW,RECP 4.00 OUT 7.80 TE ANT: TOTAL FEES 35.55 ISSUED N: PROCESSED BY: PLAN BY: EXPIRES ON: 10/16/02 JK 04/14/03 OWNER: TEL. NO: FINAL DATE FINAL BY: CODE: BADARO OUBERTO J;JACGUELINE M / 2- J Z ��] 9575 BLACKLEY ST TEMP 917803143 DESCRIPTION OF WORK ELECTRICAL FOR ADDITION APPLICANT: TEL. NO: G FELIX CONSTRUCTION (626) 401-1391- 4924 HALIFAX RD SPECIAL CONDITIONS: TEMPLE CITY 91780 -=- - CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE G FELIX CONSTRUCTION (626) 401-1391- 4924 N HALIFAX RD LIC. NO /'j� O,t �� TEMPORARY POWER PO E TEMPLE CITY CA 91780 449477 B UNDERGROUND CONDUIT r__'..�,.r VT ARCHITECT R ENGINEER: TE N0: f ' 'C� - li � ' UFER GROUND �' `' LIC. N0: -�I_;� j ' - -' ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE PLASTIC Y/N METAL Y/N UTILITY-COMPANY NOTIFIED REPORT ID: DPR265 ROUTE TO: BS05O8