HomeMy Public PortalAbout10166 DAINES DR_Electrical__ DBS-5A 11.58 APPLICATION ION FOR ELECTRIC PERMIT � 4
DBS-5A
DIVISION OF BUIMING AND SAFETY
Department of County Engineer BUILDING
County of Los Angeles ADDRESS
JOHN A.'LA BIE, COUNTY ENGINEER
CASSATT D. GRIFFIN, SUPT OF BUILDING _LOCAL,TY 7'y
FOR APPLICANT TO FILL IN NEAREST !� �•
PERMIT FEES CROSS ST, j�
NUMBER r D
„ OWNER
LIGHT OUTLETS ' n _
IL
RECEPTACLES ADDRESS �/4 G7 ' S. EA R L A
WALL SWITCHES FEE CITY S A /T 4 R 4TEC.NO.
TOTAL OUTLETS @ 5¢ E
$ y
LECTRICIAN J h e 4 S
ELEC. RANGES 25 ADDRESS
ELEC. HEATERS 25
KEN EA CITY LEX TEL.NO.
STATE
FIXTURES g LICENSE NO. z 3 G 3
MOTORS DISTRICT NO. GROUP ZONE READY FOR INSPECT ICN
NUMBER HORSEPOWER FEE � I �f
NEW MVD. HP OVER INC. EACH
>h&LESS $ 25 INSPECTION RECORD
14 2 .50
2 s 1.00
5 - Is 1.50
15 ISO 2.50
50 200 5.00
misc. I•cI E
,r
NO.SIGNS NO.TRANS.
NO. SIGNS NO. LAMPS
FOR EACH PERMIT:
WIRING $1.00
FIXTURES $1.00
SUPPLEMENTARY .50 APPROVALS
TOTAL FEE $ D DATE INSPECTOR'S SIGNATURE
I0ACKNOWLEDGE THAI 1 HAVE READ�THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT q/
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING
ELECTRICAL WIRING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE POWER
DESCRIBED RESIDENTIAL PRO ERTY. i
-s� -
SIGNATURE UTILITY CO.NOTIFIED
OF PERMITTEE FINAL �� `d A 1-$
JOHN A.LAMBIE,COUNTY ENGINEER �iD�TION' ARTHUR C.V_ EIT,CHIEF ELECT.INSPECTOR
CK MO 'CASH '
Lj
,3242 N 16 2 1 .10 0
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78A
DSS-SA II-SDAPPLICATION FOR ELECTRIC PERMIT
BA-DMSION OF BUILDING AND SAFETY t
D6pm, ent Of County Engineer BUILDING
CtI �p Of LOS Angeles ADDRESS
JOHN A. LANIBIE. COUNTY ENGINEER
CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
PERIMIT FEES c OSS ST. ,
NUMBER OWNER
LIGHT OUTLETS
qq MAIL
1.[. RECEPTACLESADDRESS
w.
WALL SWITCHES FEE CITY TEL.NO."
v TOTAL OUTLETS @ S¢ $
ELEC. RANGES 25 ELECTRICIAN
EC. HEATERS 25 "b ADDRESS
EA CITY TEL. NO.Id—
KW
STATE
FIXTURES 5 LICENSE NO. I Vo
MOTORS DISTRICT NO. I GROUP I ZONE I READY FOR INSPECTION
NUMBER . HORSEPOWER FEE I
NEW MVD. HP OVER INC. EACH
,,2&LESS $ '25 INSPECTION RECORD
Y2 2 .50
2 s 1.00
5 is 1.50
15 ISO 2.50,
s0 zoo s.00
MISC.
NO. SIGNS NO.TRANS.
NO. SIGNS NO-LAMPS
FOR EACH PERMIT:
WIRING $1.00
FIXTURES $1.00 S
SUPPLEMENTARY .50 APPROVALS
TOTAL FEE $
DATE INSPECTOR'S SIGNATURE
I HEREBY ACKNOWLEDGE THAT 1HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING
ELECTRICAL WIRING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES i
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE POWER
DESCRIBED RES[DEN IAL PROPERT
SIGNATURE UTILITY CO.NOTIFIED
OF PERMITTE '`
JOHN A. LAMEV.. COUNTY ENGINEER' MATION ARTHUR C.VETT. HIEF ELECT. INSPECTOR
C MO CASH
L lCo 3465 N-C18 2 6.75 In
r'
=WORKERS'•COMPENSATION DECLARATION
CE-806G (2-80) APPLICATION FOR ,ELECTRICAL PERMIT
�• CE-806
U hereby laffirmeahat I have a certificate of conserit td self COUNTY OF LOS ANGELES BUILDING AND SAFETY
insure, or a certificate of Workers'Compensation Insurance,or
a certified copy thereof(Sec 3800,Lab C)
?� o �ACMAW . FOR APPLICANT'TO FILL IN JOB �•
Policy N Company�(�! \ EACH NO FEE ADDRESS
New Residential Bldgs &Pools / 6 C7 i4/,*j
Certified copy is hereby furnished. I & 2-Family,Sq Ft $ — $ LOCALITY
Multi-family Sq Ft — NEAREST
eCertified'copy is filed withthe county bbildmg inspection CROSS ST
department Residential Swimming Pools ,OWNER OR {► t
•, x - FIRM°NAME D C
Date Applicants • Outlets Rec/•Light Sw �_ MAIL
First 20 ADDRESS
CERTIFICATE OF EXEMPTION FROM WORKERS' Total No• Additional CITY —� L,p G Tel-No
COMPENSATION INSURANCE 0
' - •. - _ PLAN C ECK •
(This section need,not be completed if the work involved APPLICANT U,
by the permit is for one hundred dollars Fixtures -First 20 ADDRESS
s ($100)-or less.) p�
' Total No AddiUonal O
.I certify-that rn the performance of the work for which this Fixed Appliances Not Over 1 HP= CITY Tel No
U
permit is issued, I shall not employ any person•rri any manner —C7—PERMITLU
so-as to become subject',to the'Workers'�Compensation Laws Range_ Heater—' D.W APPLICANT W AJ?b Q a
Oven Dryer_W M ADDRESS
Top FAU _W.H t . S� Al_ �uC•!-1 f) Z
Date Applicant CITY ��!<}��1 TeI No 6—%D? d
Hood _ Fan _Other_
NOTICE TO APPLICANT'If,'after making this Certificate of Disp. Room Air Cond. LICENSE OR u
Exemption, you should become- subject to the Workers' REG NUMBER� 7 75 Class ^—
Compensation provisions of'the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NOB BY
with comply with ,such provisions or this permit shall'be
deemed revoked. Size&Type HP,KW, KVA,or KVAR / ��
` I Up to 1 Incl FINAL
Over 1•to 10 Incl DATE
LICENSED CONTRACTORS DECLARATION VALI TION
Over 10 to 50 Incl 7
I hereby affirm that I am licensed under-provisions of Chapter Over 50 to 100 Inc - - F I N A 9«
• '
9 (commencing with Section 7000) of Division 3 of the Busi- B Y
Over 100
ness and Professions Code, and my license is in full force and
effect Services `
—7� '� 0-200 Amp Under 600 V
License Number /�� Lic Class 2 2 �, A-
- 201-1000 Amp Under 600 V ••.
ContiactorD__9 EDbKd Date G�� . Over 1000 Amp-or Over,600 V i'�^,� ' ,, ;
HOME OWNER-BUILDER DECLARATION o,• 2
Temp Power Pole&Appurtenances
Sign with One Branch Circuit J •o,? 1 S,2 5
I hereby affirm that I am,exempt -from the Contractor's Additional Sign BranchCircuits
License ,Law for the following reason (Section 7031 5, Busr- ; e o o•1 5t 2 5 v
ness and Professions Code)
Misc Conduits& Conductors t'
0 I, as owner of the property, will do the work,and the Other (See Complete Fee Schedule)—
606t8`5
structure is not intended ort offered for sale-(Section
7044, Business and Professions Code)
CONSTRUCTION LENDING AGENCY
I hereby.affirm that there is a construction lending agency
for jthe performance of the work for which this permit- is PERMIT FEE • (Sub-Total) r;
issued (Sec. 3097,Civ C)
Lender's,Name PLAN CHECKING FEE (One-Fourth Permit Fee)
Lender's Address PERMIT ISSUING'FEE
I certify that I have read this application and state that the TOTAL FEE s
above information is correct I agree,to comply with all County =
ordinances and State laws regulating Electrical wiring, and
hereby au honze representatives of this County•to enter upon
he above entioned property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE' l
Signature of Permittee Date
COUNTY OF LOS ANGELES - TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS ' 9701 LAS TUNAS EL 0508 1112190002
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE -(626) 285-0488 EXT:
ILEGAL ID - "FEES PAID _ BUILDING ADDRESS -
' ON FILE I a' - - 10166 DAINES DR
IFEE DESCRIPTION- QUANTITY• UOM AMOUNT TEMP CA 917802706
I
ASSESSOR INFORMATION NUMBER I NEAREST CROSS-STREET BALDWIN _
18586-027-024 1A1 PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 597 GRID B3 LOCALITY. TEMPLE CITY, Cl
IG1 OUTLETS-LGT,SW,RECP 2 00 OUT 3 90 I
TENANT -, IG2 LIGHTING FIXTURES 10 00 LGT 19. 40 JISSUED ON PROCESSED BY PLAN BY
• IH2 RES GREG DISP LT 3HP 1 00 DIS 10 90 112/19/11 SR
IH3 RES DISHWASHR LT 3HP 1 00 DIS 10 90 1
OWNER. TEL NO IH7 RES EXHAUST FANS 1 00 EX 10 90FINAL DATE FINAL BY CODE
ILEE, ANN W _ - (626) 203-2330- 1 _ _ TOTAL FEES 83 80 J 1 -
110166 DAINES DR - I �'1
TEMP 917802706_ JDESCRTPTION OF'WORK
' - (ELECTRICAL FOR KITCHEN AND TWO BATHROOMS REMODEL
I
(APPLICANT - TEL NO
ILEE, ANN W (626) 203-2330- -
1
110166 DAINES DR - (SPECIAL CONDITIONS.TEMPLE CITY CA 91780
I
ICONTRACTOR TEL NO` (APPROVALS DATE INSPECTOR SIGNATURE
IZ S CONSTRUCTION INC (626) 203-2330- I I
1608 E VALLEY BLVD. #D-274 _ LIC', NO ITEMPORARY POWER POLE
ISAN GABRIEL, CA, 91776 - - 912278-B _
(UNDERGROUND CONDUIT
I I I
1ARCHITECT OR ENGINEER- TEL NOIUFER GROUND I
_ I I I
11
LIC. NO - IROUGH CONDUIT
_ I I I
" I - IROUGH WIRING I '
- IMAIN WATER LINE
PLASTIC YIN METAL YIN
1UTILITY COMPANY NOTIFIED(-
�T
REPORT,.ID DPR265 ROUTE TO BS0509
I I I I I I
. • r h J r
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1304290002
BUILDING AN-6 SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE. (626) 285-0488 EXT
LEGAL ID FEES PAID BUILDING ADDRESS
ON FILE 10166 DAINES DR
FEE DESCRIPTION , QUANTITY UOM. AMOUNT TEMP CA 917802706
ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET- BALDWIN
8586-027-024 JAI PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 597 GRID B3 LOCALITY• TEMPLE CITY, Cl
IG1 OUTLETS-LGT,SW,RECP 40.00 OUT 65 90 1
TENANT IG2 LIGHTING FIXTURES 9 00 LGT 18 00 JISSUED ON PROCESSED BY PLAN BY
IRA FAU LESS 3HP 1.00 FAU 11 00 04/29/13 SR
JH1 RES ELEC OVEN LT 3HP 1 00 OVE_ 11.00 1 1
OWNER- TEL. NO- JH2 RES GRBG DISP LT 3HP 1.00 DIS 1100 IFINAL DATE FINAL BY CODE-
ILEE, ANN W (626) 203-2330- IH3 RES DISHWASHR LT 3HP 1 00 DIS 11.00
10166 DAINES DR IH4 RES RANGE HDS LT 3HP 1 00 HOO 11 00 1'(��/U
TEMP 917802706 IHS RES WASH MACH LT 3HP 1 00 WAS 11 00 ID SCR PTION OF WORK
JH7 RES EXHAUST FANS 1 00 EX 11 00 IRE-WIRE EXISTING HOUSE AND NEW ADDITION, HVAC SYSTEMS,
ILB 200 AMP PANELS, MCC 1 00 PAN 38.90 JUPGRADE SERVICE PANEL TO 200 AMP AND SUB-PANEL 100 AMP
APPLICANT TEL NO ILN OTHER PNL 0-399 AMPS 1 00 PAN 38.90
ILIANG, YANGS HUANG (626) 757-2132- TOTAL FEES 266.50
11323 W DURNESS ST' I (SPECIAL CONDITIONS I
IWEST COVINA CA 91790
CONTRACTOR TEL NO JAPPROVALS DATE INSPECTOR SIGNATURE
IY S L CONSTRUCTION INC (626) 320-7602- 1
11323 W DURNESS STREET LIC NO (TEMPORARY POWER POLE I I I
IWEST COVINA CA 91790 982850
(UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER TEL NO I 1UFER GROUND
ILAM, GARY (626) 588-8615-
12550 W MAIN STREET LIC NO. IROUGH CONDUIT
1ALHAMBRA CA 91801 982850 1 �-/--�
ROUGH WIRING
MAIN WATER LINE
(PLASTIC Y/N METAL Y/N
I 1UTILITY COMPANY NOTIFIE51
/ I
I_ 11 1
I* ADDITIONAL DATA ON FILE
REPORT ID DPR265 ROUTE TO BS0508
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1306050036
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
, PHONE (626) 285-0488 EXT
LEGAL ID FEES PAID 'BUILDING ADDRESS
ON FILE - I 10166 DAINES DR
IFEE DESCRIPTION: QUANTITY UOM AMOUNT 1 TEMP CA 917802706
(ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET BALDWIN
18586-027-024 1A1 PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 597 GRID B3 LOCALITY TEMPLE CITY, Cl
E1 TEMP SERV POWER POLE 1 00 TMP 43 70 1
ITENANT ITOTAL FEES 71 50 1ISSUED ON PROCESSED BY PLAN BY 1
1 1 106/05/13 SR
I J I I
1OWNER TEL NO IFINAL DATE FINAL BY- CODE 1
ILEE, ANN W (626) 203-2330- 1 _
110166 DAINES DR 1 I I
ITEMP 917802706 I (DESCRIPTION OF WORK 1
I ITEMPORARY POWER POLE
I
1APPLICANT• TEL NO 1
ILIANG, YANGS HUANG (626) 757-2132- 1 1 1
11323 W DURNESS ST 1 (SPECIAL CONDITIONS
IWEST COVINA CA 91790 1
I I I I
I I I I
ICONTRACTOR TEL NO (APPROVALS DATE INSPECTOR SIGNATURE 1
IY S L CONSTRUCTION, INC (626) 320-7602- 1 1
11323 W DURNESS STREET LIC NO ITEMPORARY POWER POLE
(WEST COVINA CA 91790 982850 I 1 1 1 1
1 1 (UNDERGROUND CONDUIT
I 1 I 1 I 1
1ARCHITECT OR ENGINEER TEL, NO- I IUFER GROUND I _
(LAM, GARY (626) 588-8615- 1 1-1 1
12550 W MAIN STREET LIC NO 1 (ROUGH CONDUIT I 1
1ALHAMBRA CA 91801 982850
1 I
(ROUGH WIRING 1 1
I I I I I I
1 IMAIN WATER LINE 1
1 1 (PLASTIC YIN METAL YIN I 1
1 1 I I IF1
I (UTILITY COMPANY NOTIFIED1i ` 1
I I I I I I
1 I I 1 I 1
I I I I I I
I I I I I I
I I I I I I
I I I I I I
I I I I I I
I 1 I 1 1 I
I I I I I I
I I I I I I
I 1 1 1 I I
1 1* ADDITIONAL DATA ON FILE 1 1 1 1
I I I I I I
I I I I I I
I 1REPORT ID DPR265 ROUTE TO BS0508 I 1 1 1
I 1 1 1 I I
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1307250060
BUILDING AN'J SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID I FEES PAID I BUILDING ADDRESS I
ON FILE 1 1 10166 DAINES DR I
(FEE DESCRIPTION QUANTITY UOM AMOUNT- 1 TEMP CA 917802706
ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET BALDWIN
18586-027-024 _ IA1 PERMIT ISSUANCE FEE 27 80 I THOMAS PAGE 597 GRID B3 LOCALITY. TEMPLE CITY, Cl
I IG1 OUTLETS-LGT,SW,RECP 40 00 OUT 65 90 1 1
TENANT 1G2 LIGHTING FIXTURES 30 00 LGT 52 40 JISSUED ON PROCESSED BY PLAN BY. I
I I TOTAL FEES 146 10 107/25/13 SR I
(OWNER TEL NO I IFINAL DATE FINAINBY CODE- I
ILEE, ANN W (626) 203-2330-
110166 DAINES DR
ITEMP 917802706 ID SCRRIPTION OF WORK I I
140 OUTLETS AND 30 LIGHT FIXTURES
I
(APPLICANT TEL NO I I
IYONG, SHUANG LIANG (626) 320-7602- I 1 1
11323 W DURNESS ST I ISPECIAL CONDITIONS I
IWEST COVINA CA 91790 1 1
I I
I I
I
(CONTRACTOR. TEL NO (APPROVALS DATE INSPECTOR SIGNATURE I
1
IY S L CONSTRUCTION, INC (626) 320-7602- 1 1 1
11323 W DURNESS STREET LIC NO 1 ITEMPORARY POWER POLE I I I
IWEST COVINA CA 91790 982850 I 1 1 1 1
I 1 1UNDERGROUND CONDUIT
I
1ARCHITECT OR ENGINEER TEL. NO I IUFER GROUND
LIC NO i TROUGH CONDUIT 11
1 I IROUGH WIRING
I 1I I
I 11
(MAIN WATER LINE
1 I IPLASTIC YIN METAL YIN
I I I
1 1 1UTILITY COMPANY NOTIFIEDI I 1
I I I i I I
I I I I I I
I I I I I I
I I I I I I
I I I I I I
I I I I I I
I I I I I I
1 I I I I I
1 IREPORT ID DPR265 ROUTE TO BS0508 I 1 1 1
1 I I I I I