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Home My Public Portal About9639 BLACKLEY ST_Electrical__ r COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer am DIVISION OF BUILDING & SAFETY WILLIAM J. FOX, County Engineer E L E C".1,AR I C /Z FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. _ _r '7 j;q ELECTRICIAN - f RECEIVED BY READY FOR DATE ISSUED ADDREB13 4 , FIRST INSPECTION CITY TEL NO. COUNTY LICENSE NO. EXPIRES ADUILDING D CSS PERMIT FES '��YYY Ler FEE - NUMBER EACH LOCALITY LIGHT OUTLETS NEAREBT T RECEPTACLES CR089 ST. ,J WALL SWITCHES OWNER _ TOTAL OUTLETS 5C $ MAIL ELEC. RANGES 25 ADDRESS ELEC. HEATERS 25 CITY TEL. NO. FIXTURES B 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE 19 CORRECT NUMBER OF LIGHT CIRCUITS 1-1 D 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 MVO. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. 1/2 6 Lrss $ .25 SIGNATURE OF 1/2 2 .50 FERMITTE z 5 1.00 INSPECTIOW RECORD 5 15 1.50 15 50 2.50 50 200 5.00 200 500 10.00 W F- 500 1000 15.00 Q ---— Ll OVER 1000 20.00 J M.G. SET/FREQ. CHANGER-HP a WELDERS: AC-KVA D GENERATORS - KW TRANSFORMERS - KVA _ TEMP. MOTORS (75% OF ORIG.) MOVED MOTORS (75% OF ORIG.) MISC. SIGNS NO. NO.TRANS. APPROVALS NO. NO. LAMPS FOR EACH PERMIT: D INSPECTOR'S NAME WIRING 61.00 CONDUIT ,• y i FIXTURES $1.00 WIRING - Ai Gr•-• 7• 1�� SUPPLEMENTARY •50 FIXTURES /f jj POWER / TOTAL FEE III UTILITY CO.NOTIFIED FINAL 76A663 DBS#$5A 4-52 / WOR LRS'COMPENSATION DECLARATION 76-663 10/81 APPLICATION.FOR ELECTRICAL PERMIT Lere'byAil i, that"I have a certificate of consent to,self insure, CE-806G or a certificate of Workers'*Compensation Insurance, or a certified � COUNTY OF, LOS ANGELES BGILDING'AND'SAFETY copy thereof (Sec 3800,Lab C) Policy No D 3 � Company'gTb�T� f_11f-1� FOR APPLICANT TO FILL IN SOB ❑ ADDRESS qu??a BLACK, Certified copy is hereby furnished. New Residential Bldgs & Pools EACH,: NO. FEE .. Certified copy is filed with the county building inspection 1 & 2-Family,Sq Ft $ — $ LOCALITY _ department. y, Multi-family Sq.Ft — NEAREST ^�+ -�" gAC�AQ� T Date Applicant Residential Swimming Pools- t CROSS OWNER OR AL � I FIRM NAME M Wi COH Light CERTIFICATE OF EXEMPTION.FROM WORKERS' Outlets Rec 1! ' Sw t MAIL COMPENSATION INSURANCE v� ADDRESS G LAG (This section need not tie completed if the work involved-by the First 20Zg i permit is for one,hundred dollars ($100)or less.) Total No Additional CITY LC_ C'.� Tel.NoPLA I certify'that in the performance of the work for which this'permlt APPNICANT K� QA •C ` is issued, I shall,not employ any person in any manner so as to become subject.to the.Workers'Compensation Laws Lighting Fixtures First 20- ADDRESS O Total No. %Q Additional to CITY Tel N f _f Date Applicant Fixed Appliances Not Over, 1 HP PERMIT NOTICE, TO APPLICANT If, after making this Certificate of Exemptloh,you should become subject to the Workers Compensation Range_ Heater DW _ APPLICANT 'Provisions of the Labor Code, you must•forthwith comply with such Oven Dryer _ W.M. ADDRESS C provisions or this permit shall be deemed revoked 4 'Top FAU W.H LICENSED CONTRACTORS DECLARATION. Hood Fan Other_ CITY L&W 14(m. Tel.N 'I hereby, affirm that'I am'licensed under provisions of Chapter 9 Disp — Room Air.Cond (CENSE OR (commencing with Section 7000) of Division 3 of the Busi6ess and REG NUMBER Class Professions Code,and my license is in full force,and effect Power Apparatus,& Large Appliances DISTRICT NO �' / PROCESSED BY ' Size & Type HP,KW,KVA,or KVAR � License Number ]Z5 510 Lic.Class Up to 1 Incl. FINAL U 2 Over 1 to 10 Incl DATE . c�S9 V/LIATION IX Contractor i7C�J l_ NON Date' 'r J �0, Over 10 to 50 Incl U ❑ FIN- U I am exempt under Sec. Over 50 to 100 Inc_. BY Over 100 B&PC for this reason OW. Services,Swbd.,MCC& Panelboard _R ' ► 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 (1 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that'( am'exempt from the Contractor's License Law 1 °'0 6 Q 5 'for the following reason(Section 7031 5, Business and Professions Additional Sign Branch Circuits o 0 0 6 Q 5 07Zi . Code).' 0,068.8 Misc Conduits&Conductors ' ' El, I;as owner of the property,will do the work and the structure Other,(See Complete Fee Schedule) is not intended or offered for sale (Section 7044,• Business and Professions-Code). 'CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work,for which this permit is Issued(Sec'3097, PERMIT FEE (Sub-Tdtal) Civ. C) PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE 6 Lender's Address %. }t I ce tify..that I have read this application and state that the above TOTAL FEE 6 V t formation is correct I agree to comply with all County ordinances nd S ate law r ulahng Electrical wiring, and hereby authorize epre nt.tive :of'his County to enter upon the above-mentioned rop y for i n purposes: , SEE REVERSE FOR EXPLANATORY LANGUAGE Si nature of Permittee Date J ' COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0508250006 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: - FEES PAID BUILDING ADDRESS. ON FILE 9639 BLACKLEY ST FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803852 ASSESSOR INFORMATION NUMBER: _ NEAREST CROSS STREET: TEMPLE CITY 8589-002-012 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID- A4 LOCALITY: TEMPLE CITY, C B2 1 OR 2 FAMILY DWELL 590 00 SQ 61 95 TENANT: TOTAL FEES 89.70 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 08/25/05 JK 02/21/06 OWNER: TEL NO: FINAL DATE FINAL BY: CODE: RINCON ROBERT R;ANNA M (626) 285-1080- 9639 BLACKLEY ST TEMP 917803852 DESCRIPTION OF WORK ELECTRICAL FOR NEW GUEST HOUSE APPLICANT: TEL. NO: MELILLO (626) 237-0942- 9703 GARIBALDI AVE SPECIAL CONDITIONS: TEMPLE CITY CA 91780 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE D T M CONSTRUCTION CO. (626) 237-0942- 9703 GARIBALDI AVE. LIC. NO TEMPORARY POWER POLE ' TEMPLE CITY, CA 91780 266616B 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