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HomeMy Public PortalAbout10022 DAINES DR_Electrical__ ~TbAd63 DB9 SA 3-513 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRICIAN RECEIVED BY READY FOR DATE ISSUED ADDRESSMme(// FIRST INSPECTION p CITY �7 TEL.NO. ��/� COUNTY LICENSE NO. EXPIRES ) gDDRE99 �� �e2 �8/� /te/ es r. PERMIT FEES NUMBER EACH FEE LOCALITY I LIGHT OUTLETS NEAREST CROSS ST. RECEPTACLES WALL SWITCHES OWNER 6. • 01 TOTAL OUTLETS Sc $ MAIL ELEC. RANGES25 ADDRESS ELEC. HEATERS 25 CITY TEL NO. FIXTURES 5 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS MISC. APPLICATION AND STATE 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 I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER NEw Mvo. HFtl_ OVER I INC• EACH j OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. a LEBB $ .25 SIGNATURE OF / % 2 .50 PERMITTEE /- 2 5 1.00 INSPECTION RECORD 5 15 1.S0 1 s 50 2.50 60 200 5.00 •/ 200 500 10.00 500 1000 15.00 OVER 1000 20.00 �� , ^•. ,,� Z M.G. SET/FREQ. CHANGER-HP w WELDER9:AC-KVA O GENERATORS - KW ' TRANSFORMERS - KVA TEMP. MOTORS (75% OF oRlo.) MOVED MOTORS (7S% of ORIG.) MISC. SIGNS NO. NO.TRANS N0. NO. LAMPS T7-- APPROVALS DATE INSPECTOR'S NAME FOR EACH PERMIT: WIRING $1.00 CONDUIT FIXTURES $1.00 -106 WIRING SUPPLEMENTARY .50 FIXTURES POWER / TOTAL FEE $ O UTILITY CO.NOTIFIEDj__ FINAL 76A663-CE8011_71` APPLICATION FOR ELECTRICAE PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING J BUILDING AND SAFETY DIVISION ADDRESS _ LOCALITY _ NEAREST FOR APPLICANT TO FILL IN CROSS ST. �. OUTLETS NO EACH I FEE OWNER ' C RECEPT._ $ $ MAIL LIGHT TOTAL FIRST 20 25 ADDRESS • CITY TEL NO. SWITCH OVER 20 10 PLAN CHECK LIGHTINGTOTAL FIRST 20 25 APPLICANT FIXTURES OVER 20 10 ADDRESS RESIDENTIAL APPLIANCES CITY TEL. NO. RANGEDRYER_WTR. HTR APPLICANT STA COOK DISP F.A.0 ADDRESS L SPACE HTR, AIR COND. CITY TEL. N0. CLOTHES WASH. DISHWASH LICENSE NO Z - CLASS. FAN OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND HEATERS, ETC HP KW KVA ELECTRICAL WIRING SIZE & TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF d CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO A1 - 10 j 300 RESIDE IN, THE ABOVE 0 IBE RESIDENTIAL PROPERTY VO (/�/ SIGNATURE d. 10 - 50 500 OF PERMITTEE O 50 - 100 1000 DISTRICT NO. CLASZ E 1 PROCESSED BY Lil 100 - 500 1500 [:;Io L15 SIGN; GAS SIGN AND ONE CIRCUIT 5 D NOTES: ? TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 SERVI CENOTOVER 600 VOLTS OR 200 AMP 300 APPROVALS DATE INSPECTOR'S SIGNATURE SERVICE OVER 600 VOLTS OR200AMP 1000 TEMP.POWER POLE TEMP SERVICE,POLE, &APPURTENANCES 500 TEMP LIGHT OR RECEPT. SYSTEM _ 300 UNDERSLAB WORK ROUGH CONDIUT WIRING FIXTURES PERMIT FEE (SUB TOTAL) POWER AUTHORIZED UTILITY CO. NOTIFIED / PLAN CHECK FEE FINAL ' PERMIT ISSUING FEE 300 TOTAL FEE 00 PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATIO CK-' M o CASH uiw 9 , 8 oizt OCT 1.1 2 0 9.O 0- SEE NSEE BACK OF APPLICATION FOR COMPLETE SCHEDULE C � WORKER'S COMPENSATION DECLARATION 20-0019 DPW 9/89 I herebyaffirm that/l have a certificate of consent to self Insure, 76A663 APPLICATION FOR ELECTRICAL PERMIT or a certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy there )o�f(Sec 3800 li0 La •C) - •'; ` -- I ' PO Cy O(vw].L�-�'-Ozehompany Wen m� FOR APPLICANT TO FILL IN JOB ADDRESS 0Q 2N •• ❑ Certified copy Is hereby furnished New Residential Bldgs &Pools -EACH NO FEE $ _ $ LOCALITY _r• C. Certified copy Is filed with the county budding Inspection 1&2-Family,Sq Ft - rtment Multi-family Sq Ft ) CROSARE s7 Date Applicant Residential Swimming Pools ASSESSOR MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION OM WORKERS' I OWNER OR COMPENSATION INSURANCE -" Outlets Rec _Light Sw / / O FIRM NAME First 20 MAIL (This section need not be completed if the work involved by the Total No Additional ADDRESS }- permit is for one hundred dollars($100)or less.) I certify that in the performance of the work for which this,permit — CITY Tel No is Issued, I shall not-employ any person in any manner-so as to PLAN become subject to'the Workers' Compensation Laws Lighting Fixtures First 20 APPLICANT K Total No Additional _ ADDRESS Date • Applicant i" ' NOTICE TO APPLICANT If, after making this Certificate of 15 OR 20A,120V BRANCH CIRCUITS - CITY Tel No Exemption,you should become subject to the Workers'Compensation 1 TO 10 INCLUSIVE EACH provisions of the Labor Code, you must forthwith comply with such 11 TO 40 INCLUSIVE EACH PERMPIT , Ar provisions or this permit shall be deemed revoked 41 OR MORE BRANCH CIRCUITS EACH APLICANT LICENSED CONTRACTORS DECLARATION ADDRESS } I hereby affirm that I am licensed under provisions of Chapter 9 15 OR 20A,208V TO 277V LIGHTING EACH 4. (commencing with Section 7000) of Division 3 of the Business and CITY Tel No ` 0 Professions Code,and my license is In full force and effect RESIDENTIAL APPLIANCES UP TO 3HP LICENSE OR Power Apparatus&Large Appliances REG NUMBER ClassC'_ 0 License Number�����Llc Class Size&Type HP,KW,KVA,or KVAR DISTRICT NO P SSED BY O 3 H P Up to 3 Incl eo� a w COntraClO Over 3 t0 10 Ind FINAL C1 - - Over 10 to 50 Incl DATE /}A Z ❑ I am exempt under Sec Over 50 to 100 Incl SC F VALIDATION B&P C for this reason Over 100 FINAL BY Services,Swbd,'MCC&Panelboards 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 PUT AT- HOME OWNER-BUILDER DECLARATION ` I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch CircuitM;�- for the following reason (Section 7031 5, Business and Professions Additional Sign Branch.Circuits Code) ❑ I,as owner of the property,will do the work and the structure Misc Conduits&Conductors - TOTAL 4-o 03 Is not Intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) i ��••, , f":-. and Professions Code) CONSTRUCTION LENDING AGENCY _ _ f' IiiSOC -` 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-Total) _ Civ C) PLAN CHECKING FEE q Lender's Name PERMIT ISSUING FEE 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 State laws regulating Electrical wiring, and hereby authorize representatives of this County to enter upon the above-mentioned - property for Inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE t SIGNATUR F APP CANT R AGENT ATE • COUNTY OF"LOS ANGELES-,'=% : TEMPLE CITY # 0508 ELECTRICAL PERMIT DEARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508'99081.30013 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID LD ADDRESS: ON FILE' -10022 DAINES DR FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802704 ASSESSOR-INFORMATIONN NEAREST CROSS STREET: BALDWIN 8586-023-010 Al PERMIT ISSUANCE FEE 27.75 -THOMAS PAGE: 597 GRID: B3 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT,SW,RECP 18.00 OUT 35.10 TENANT: G2 LIGHTING FIXTURES 16.00 LGT 31.20 I : PROCESSED : PLAN BY: P H2 RES GRBG DISP LT 3HP 1.00 DIS 10.95 08/13/99 UT 02/09/00 H3 RES DISHWASHR LT 3HP 1.00 DIS 10.95 OWNER: TEL. NO: H4 RES RANGE HDS LT 3HP 1.00 HOO 10.95 FINAL DATE FINAL BY CO E: ERDMANN ROBERT W JR;BARBARA (626) 579-4949- H7 RES EXHAUST FANS 1.00 EX 10.95 110022 DAINES DR. LB 200 AMP PANELS, MCC 1.00 PAN 38.85 TEMP 917800057 TOTAL FEES 176.70 DE C 0 _N OF WORK ELECTRICAL FOR ADDITION AND REMODELING APPLICANT: 0: SAME AS OWNER - SPECIAL CONDITIONS: ES CONTRACTOR: TEL. NO: ®�j �/�� APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO / POLE UNDERGROUND-CONDUIT ARCHIi TEC NGI TEL. NO: UFER GROUND LIC.-No 1111111 ROUGH CONDUIT � ROUGH G F n O LC WO n 17©�K � MAIN W INE U \1`I//\`\/// PLASTIC Y/N METAL Y/N ' Uff[fTY COMPANY OT I D 6f 08 q Gl ❑ '* •/ ❑ ® ®y Service 11% V" REPORT ID: DPR265 ROUTE TO: BS0508