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Home My Public Portal About9591 BLACKLEY ST_Electrical__ 76A663-CE806 8/63 -APPLICATION FOR ELECTRICAL PERMIT'RMIT , COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER FAD ING BUILDING AND SAFETY DIVISION ESS JOHN A. LAMBIE. COUNTY ENGINEER WILLIAM A.JENSEN, SUPT OF BUILDING Lliff ITY ESTFOR APPLICANT TO FILL IN S ST. RECEPT TOTAL NO. EACH FEE OUTLET FIRST 20 $20 $ d OWNER LIGHT MAIL ADD'L 10 ADDRESS SWITCH. OVER 20 TOTAL CITY G L. NO LIGHTING l FIRST 20 .20 FIXTURES 1 ADD'L 1O ELECTRI IAN OVFR 20 RANGES CLO.DRYERS WTR.TRS. 1.00 ADDRESS GARB.D19P. •STA.COOK / ol CITY TEL.'NO.'4,4 'DISHWASH. ! AUTO.-WAS-H.- /_ STATE ((] L� 6PACE LICENSE NO. HTRS jI BTA.APP.('A H.P.MAX.) .50 MOTORS: OVER NOT OVER H.P. DISTRICT NO. GROUP ONE P OCESSED Y O 1 1.00 �� 1 3 1.50 INSPECTION RECORD 3 S 2.00 B is 2.50 0 15 50 3.00 so 100 5.00 ; b I SIGNS: NO.TRANS NO.LAMPS N Z SERVICE 0.60OV•NOT OVER 200A 1.00 SERVICE 0.60OV-OVER 200 A. 2A0 SERVICE OVER 600V 5.00 MISC. PERMIT ISSUING FEE 2.00 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 19 CORRECT AND AGREE TO COMPLY CONDUIT ) A WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR �� F / .,/J�,. LICENSED AB REQUIRED BY LOS ANGELES COU TY D STATE OF FIXTURES i r�i q�G1S IJ^"�'Iv' CALIFORNIA OR TNA 1 AM THE LE AL OW E ABOVE DESCRIBED RESIDEN L PERTY. POWER r / y� ,�,*yp4 ��+' SIGNATURE UTILITY CO.NOTIFIED OTC� '4,AIy!kl OF PERMITTIE 'I /9/¢`s FINAL ALIDATION ARTHUR C. VEIT ' CK MO CASH SUPERVISING ELECTRICAL ENGINEER �,Co5420 QCT30 2 D 1 9.10 WORKERS'COMPENSATION DECLARATION 76463 10,61 APPLICATION FOR ELECTRICAL PERMIT I hereby Affirm that I haVe,a certificate of consent to self insure, CE'-e06G L, f or a certificate of Workers' Compensation Insurance, or a certified COUNTY-OF LOS ANGELES, BUILDING AND SAFETY , U copy thereof•(Sec.,3800,Lab:C.) Policy No. Company' FOR APPLICANT TO FILL IN '" JOB 'v D/ ,„_``/• J�, ❑ F EACH NO FEE ADDRESS Certified copy is In furnished New Residential Bldgs•& Pools _�. i• $ — $ LOCALITY GG > N/� ❑ Certified copy is filed'.with the county'building inspection 1 & 2-Family,Sq Ft. — �G� (� departmentMulti-family Sq.Ft -NEAREST _ CROSS ST Date Appli'carit Residential Swimming Pools OWNER OR. E .." c -` 'n i FIRM.NAME •• CERTIFICATE OF:EXEMPTION FROM WORKERS'• ,Outlets:Rec/ Light-�Z Sw '1', MAIL je COMPENSATION INSURANCE �•" f¢ ADDRESS (This:section need•not be•cdmpleted if the work'involved by the First 20 , permit is for one hundred-,dollars;($100)or less.) Total No. _ Additional O D• 'CITY /a! Tel.No I certify'that in the,performance of�the..work•for which this permit PLAN CHECK ° p '� APPLICANT _ C?� �s� G7/�IC4 , is issued, I,shall.not employ any person in any manner so as toADDRESS• O• % -become subject toLighting Fixtures First 20',the Workers'Compensation Laws 9 ��i �f�iL S • /7— Additional, _ �r Total No. CITY Tel Date -Applicantri �t / �-fOj�/ NOTICE .TO APPLICANT-`If„ after making •,this Certificate of Fixed Appliaices Not C;er 1 HP PERMIT '.-Exemption,you should m becoe subject to the Workers'Compensation Range Heater= D.W. APPLICANT, proq+sions of the-Labor Code, you must forthwith comply with such Oven - Dryer_ W.M ADDRESS {provisions or this permit shall be deemed,revoke d:* Top FAU W H. CITY , r " Tel No. y-'6! LICENSED CONTRACTORS DECLARATION Hood Fan Other_ LICENSE OR I.hereby affirm that,I am licensed under,provisions of Chapter 9 Dis —,-Room Air Cond. Class • (commenting with Section.7000) of Division 3 of.ttie Business and• P• REG NUMBER ' Professions Code,and my:license is in full force and effect. Power.-.Apparatus& Large Appliances DISTRICT NO " �1+r et G PRQC SED BY ' - Size,&Type HP,KW,KVA,or KVAR 0' License Number Lic Class Up to 1 Incl. FINAL U. Over 1 to 10 Incl. DATE r ��'LZ VALIDATION 5 Contractor "' Date Over -10 to 50 Incl. V • FINAL ❑. I am exempt-under Sec Over 50 to*100,Inc, - - gY - _ W B&P.C.for this reason Over 100 NI Services, Swbd-,MCC& Panelboards Z Date- 0-200 Amp.Under 600 V ^` 'Signature 201 - 1000 Amp'Under 600 V _ -- Over 1000 Amp.or Over 600 V ❑. Exemption for.:Reg.Maint•Elect. :'� SINGLE FAMILY _Temp Power Pole& Appurtenances HOME OWNER-BUILDER.DECLARATION _-.r.r Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5,Business and Professions Additional Sign-Branch Circuits :-:•. Code • Misc.Conduits& Conductors- - •• - - - •• .;, •E•i )•i+1' 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) '�"h: s-"t ,�-=_e and,Professions Code). oil. - i -tree �� CONSTRUCTION LENDING-AGENCY I - I hereby affirm that there fs, a construction lending agency,for.the A. � i4a performance of the work for-which this permit is issued(Sec 30,97, PERMIT FEE - (Sub-Total) •.Civ.C). ' .PLAN CHECKING FEE. )1;1t-i tll�'€ ): ?ti :,;• Lender's Name PERMIT ISSUING FEE t Lender's Address I certify that I have read this application and state that the above TOTAL FEE information is correct I agree to comply with all County ordinances and St laws regulating,.Electr.ical wiring, and hereby'authorize re sti fives of th' ounty to enter upon the above mentioned �•'• rope y for insp ion p oses. SEE REVERSE FOR.EXPLANATORY LANGUAGE Signaty of Permitteg to COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0402170034 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID. FEES PAID BUILDING ADDRESS: �TR: 29492 LT: 4 9591 BLACKLEY ST FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803143 ASSESSOR LiNIF0RMAJION NitiMBER: NEAREST CROSS STREET: ENCINITA 8590-006-024 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY, C G1 OUTLETS-LGT,SW,RECP 1.00 OUT 1.95 ;'ENANI __- - H7 RES EXHAUST FANS 1.00 EX 10.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: TOTAL FEES 40.65 02/17/04 VG 08/15/04 OWNER: T�. TEL. NO: FINAL AT FINA CODE: TOOHEY ROBERT J;MARY M (626) 286-8476- 9591 BLACKLEY ST TEMP 9'17803143 DES RI TION OF WORK ELECTRICAL FOR BATH REMODEL APPLICANT: TEL. NO: GLASS (818) 994-1853- SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE ALL STAR REMODELING (800) 441-1758- ' 14039 SHERMAN WAY LIC. NO TEMPORARY POWER POLE SUITE# 102 740295 B VAN NUYS CA 91405 UNDERGROUND CONDUIT ARCHITECT OR ENGINES TEL. NO: LIFER GROUND LIC. NO: ROUGH CONDUIT ROUGH WIRING / MAIN WATER LINE PLASTIC Y/N METAL Y/N 0 UTILITY COMPANY NOTIFIED REPORT ID: DPR265 ROUTE TO: BS0508