HomeMy Public PortalAbout10112 DAINES DR_Electrical__ a
76AS63 DBS SA 11-49 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER ELECTRIC 1
FOR APPLICANT TO FILL DISTRICT NO. GROUP ZONE PERMIT
/NO.
ELECTRICIAN < -
RECEIVED BY READY FOR DATE ISSUED
ADDRESS A e2,vl- 4, FIRST INSPECTION
CITY ' - IEL. NO. /�-
COUNTY LICENSE NO. EXPIRES 34-z) rLBUILDING / er) _ L
PERMIT FEES ADDRESS �(�GR�.�t/��ca
o FEE
p NUMBER OUTLETS EACH LOCALITY
LIGHT Sc $ NEAREST
CROSS ST.
RECEPTACLES- 5 I
FIXTURES 5 OWNER
~ WALL SWITCHES 5 MAIL
ee::ss1, EL C. RANGES 25 ADDRESS
..ice ELEC. HEATERS 25 CITY TEL. NO.
MdSC. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
NUMBER OF CIRCUITS INSTD:
TOTA1 APPLICATION AND STATE THAT THE ABOVE IS CORRECT
LIGHTS RECEPTACLES AND AGREE TO COMPLY WITH, ALL COUNTY ORDINANCES
MOTORS ' AND STATE LAWS REGULATING ELECTRICAL WIRING.
NLJMBFRFEE
HORSEPOWER I CERTIFY THAT I POSSESS THE ABOVE VALID LOS
New MVD. HP OVER INC. EACH ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
Jj `/2L
.25 OF THE RESIDENTIAL PROPEF&TYY DESCRIBE D A VE.
A 2 $
%2 2 .50 SIGNATURE OF
2 5 1.00 PERMITTEE
s15 I.so INSPECTION RECORD
7 s so 2.50
so 200 5.00
200 500 10.001
s 10 1 000 is-OO
OVER 10013 20.00 Z
_ M.G. SET/FREQ. CHANGER-HP 9
WELDERS: AC-KVA
GENERATORS - KW O
TRANSFORMERS - KVA 1
TEMP. MOTORS (75% OF CRIB.)
MOVED MOTORS (75% OF ORIG.)
MISC.
SIGNS
TYPE: NO.TRANS.
rTYPE: NO. LAMPS APPROVALS
FOR EACH PERMIT: DATE INSPECTOR'S NAME
WIRING ,$1.00 CONDUIT
FIXTURES $1.00 WIRING �•� — �" I—�YYH
SUPPLEMENTARY .50 FIXTURES Z (L
POWER
TOTAL FEE sD UTILITY CO. NOTIFIED
FINAL !' /u -/'y' `��y�/•
�I he �RhatRShavOeMa oertifclaOte'oEconsentlOto self insure, CE-806G 10/81 APPLICATION FOR ELECTRICAL PERMIT
or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY '
copy thereto(Sec 3A00,Lab C)
Policy No* - Companyi- FOR APPLICANT TO FILL IN JOB /-�
aEACH NO FEE ADDRESS C> / Z Y /
Certified copy is hereby furnished New Residential Bldgs & Pools $ _ $ LOCALITY -' G
® Certified copy is fled with the county buildin spection 1 & 2-Family,Sq Ft
-department_• Multi-family Sq Ft — NEAREST
_ CROSS ST'
Date Applicant �` Residential Swimming Pools OWNER OR -�
FIRM NAME.
CERTIFICATE OF'EXEMPTI M'WORKER Z MAIL J•
COMPENSATION INSURANCE Outlets Rec Light _ --sw Oft ADDRESS
•(This section need not be completed if the work Involved by the First 20
permit is for,one hundred,dollars•($100)or less)
Total No• Additional .CITY, Tel No ,r7� -7V yf
PLAN CHECK
I certify that in the performance of the work for.which this•permit
' APPLICANT
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
Additional
Total No CITY Tel No
Date Applicant Fixed Appliances Not Over 1 HP PERMIT
NOTICE TO APPLICANT,' If, after making.,this Certificate of APPLICANT
Exemption,you should become subject to,the Workers'Compensation Range_ Heater_ DW '
i
provisions of the Labor Code, you must forthwith comply with such Oven Dryer _ W M ADDRESS
provisions or this permit shall be deemed revoked Top FAU WH CITY Tel NoQp�D
LICENSED-CONTRACTORS DECLARATION. Hood Fan Other_ (
I hereby affirm that I am licensed under provisions-of Chapter 9• LICENSE OR /
Disp Room Air Cond / Class
(commencing with Section 7000) of Division 3 of,the Business and REG NUMBER
Professions Code,and my license is in full force and effect Power Apparatus& Large Appliances DISTRICT NO R ESS BY
►a, Size& Type HP,KW,KVA,or KVAR U'
License Numberr I t�Lic Class Up to 11 Incl FINAL
(�2�,Date "� -Z Over 1 to 10 Incl DATE - VALIDATION OO
Contracf6F � Over 10 to 50 incl
❑ FINAL U
I am exempt under Sec 'Over 50 to 100 Inc gy W
B&PC for this reason Over.100 0.
Services,Swbd,MCC& Penelboards Z
D 0-'200 Amp Under 600 V
Signature 201 - 1'000'Amp Under 600 V
Over 1000 Amp or Over 600 V
•Exemption for,Fg�t7lamt Elect ` ,
• SINGLE FAMILY Temp Power Pole & Appurtenances -^ _
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit *'-• - M
I hereby affirm that I am exempt from the Contractor's License Law _Additional Sign Branch Circuits Hb41/�
A
for'the following reason(Section 7031 5,Business and Professions -f �C
Code) _ lI.GJ
Misc'Conduds & Conductors Y ITM*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)-_ ,
and Professions Code) TOTAL 17.+25
CONSTRUCTION LENDING AGENCY " OECK 17.25
1 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 -Total) 7
Civ C) I
PLAN CHECKING FEE -
'' 1 Sli'1/89
Lender's Name Q
PERMIT ISSUING FEE _ GYftC wej A=1
Lender's Address O
b certify that I have read this application and state that the above TOTAL FEE
information is correct I agree to comply dh all County ordinances
and State laws regulating Electrical w ing, and hereby authorize _-
representatives of this County to en ` on the above-mentioned
property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE
Signat of P mi tae Date e
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 SII ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0512050022
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 ERT: i
LEGAL ID FEES PAID BUILDING ADDRESS
ON FILE 10112 DAINES DR
FEE DESCRIPTION: QUANTITY. UOM• AMOUNT: TEMP CA 917802705
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: RYLAND
8586-025-023 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID B3 LOCALITY: TEMPLE CITY, C
HA FAU LESS 3HP 1 00 FAU 10.95
TENANT JB AC UNITS +3-10HP 1 00 AC 19.65 ISSUED ON: PROCESSED BY PLAN BY: EXPIRES ON.
',A 100 AMP PANELS, MCC 1 00 PAN 38.85 12/05/05 JK 06/03/06
TOTAL FEES 97.20 '
OWNER: TEL. NO - FINAL' DATE FINAL BY: CODE:
PRINDLE, BEVERLY (626) 422-9573- /may!
10112 DAINES DR 7�y cy �_ -
TEMP 917802705 DESCRIPTION OF WORK
ELECTRICAL FOR FAU, AC UNIT, AND UPGRADE SERVICE PANEL TO
100 AMP
APPLICANT TEL. NO
MENDIETA ELECTRIC (626) 688-9760-
225 ALABAMA ST SPECIAL CONDITIONS:
SAN GABRIEL CA 91775
CONTRACTOR TEL. NO. - APPROVALS DATE INSPECTOR SIGNATURE
MENDIETA ELECTRIC (626) 309-1338-
225 ALABAMA ST LIC. NO TEMPORARY POWER POLE
SAN GABRIEL, CA 91775 551372/C10
UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER: TEL. NO: UFER 3ROUND
LIC NO: ROUGH CONDUIT
ROUGH+WIRING
MAIN 14ATER LINE
PLASTIC Y/N METAL Y/N
UTILI-PY COMPANY NOTIFIED
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(REPORT ID DPR265 ROUTE TO: BS0508 ,
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