Loading...
HomeMy Public PortalAbout10924 DAINES DR_Electrical__ APPLICATION FOR ELECTRICAL AMI T " ]5A 563-CEB05 1/]0 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEERBUILDING - BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER LOCALITY COLEMAN W. JENKINS SUPERINTENDENT OF BUILDING NEAREST FOR APPLICANT TO FILL 77F CROSS ST. OUTLETS NO. O W N ER Z(r�4 REC EP T.�� $ MAIL S LIGHT TOTAL FIRST 20 ADDRESS b CITY / EL. NO. CJS SWITCH f� OVER 20 -- P,LAN=CHECK`<. LIGHTING l FIRST 20 APPLICANT )} TOTAL OVER 20 ADDRESS FIXTURES APPLIANCES CITY TEL. No. PERMIT RANGE_DRYER_WTR, HTR._ APPLICANT STA. COOK_DISP._F,A.U._ ADDRESS a/L- SPACE HTR. AIR GOND. CITY / TEL, NO. CLOTHES WASH._DISHWASH._ LICENSE NO. CLASS. FAN_OTHER 1.00 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. RVA. ELECTRICAL WIRING. 912E & TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR O - 1 100 LICENSED A9 REOUIflED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER Of, AND INTEND TO 1 - 10 300 RESIDE IN, THE ABOVE DESCRIBED SIDENTIAL PROPERTY. Y SIGNATURE CL 10 - 50 500 OF PERMITTEE 0 50 — 100 10.00 y D19TRICTNO. CLASS G OUP ) PRO 99ED BY 100 — 500 15.00 l OHA HA SIGN, GAS SIGN AND ONE CIRCUIT 3.00 NOTES:k—IQ —`/ AzweJ . TW o Gter-S h TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 7-0 _J(/ST b/ _s / L� /✓ T- ? SERVI CEN070VER 600 VOLTS OR 200 AMP .00 APPROVALS DATE INSPECTOR'S SIGNATURE SERVI CE OVER 600 VOLTS OR 200 AMP 5.00 TEMP.POWER POLE TEMP SERVICE,POLE, &APPURTENANCES 300 UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM 3.00 ROUGH CONDIUT e� c1 WIRING r'I&- O1 13D.9.0 « .1 FIXTURES PERMIT FEE (SUB TOTAL) POWER AUTHORIZED PLAN CHECK FEE (50% PERMIT FEE) UTILITY CO. NOTIFIED PERMIT ISSUING FEE 00t"111157, SUPPLEMENTARY PERMIT ISSUING FEE 100 JOSEPH C. ROOHAN TOTAL FEE SUPERVISING ELECTRICAL ENGINE PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK, M.o. CASH SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE WORKERS'COMPENSATION cate of co N CE-806 10,61 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self CE-8066. insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec 3800, Lab. C.) - Policy No f r7 - ompan FOR APPLICANT TO FILL IN ADDRESS ('© (�\ l�7 Certified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE Certified copy is filed with the county building inspec- 1 8 2-Fomily, Sq. Ft. $ _ $ LOCAUT ^ 'NEAREST �— tion par enf. Multi-family Sq. Ft. CROSS ST. L- . Residential Swimming Pools OWNER OR Date plicon FIRM NAME RT KATE OF EXEMPTION FRO ORKERS' � MAIL Outlets Rec Light_Sw._ COMPENSATION INSURA �, ADDRESS _- (This section-need,notbe completed if the work involved b - - [[,,[[ ___First 20 _ P Y--. Total No.—/— Additional. .CITY.-. _ _ - _ -_Tel. No. the permit is for one hundred dollars($100)or less.) PLAN CHECK=--4p: I certify that in the performance of the work for which this APPLICANT 5� permit 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 - Total No. Additional CITY Tel. No. Date Applicant Fixed Appliances Not Over 1 HPPERMIT NOTICE TO APPLICANT: If, offer making this Certificate of APPLICANT Exemption, you should become subject to the Workers' Range_ Heater—D.W. — Compensation provisions of the Labor Code, you must forth- Oven — Dryer — W.M.— ADDRESS with.comply with such'provisions*or this permit shall be Top FAU —W.H. — CITY Tel. No deemed revoked. Hood Fan _Other_ LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp, Room Air Cond. REG. NUMBER r' ^ Class. (commencing with Section 7000) of Division 3 of the Business DISTRICT NO. PROLE ED BY and Professions Code,and my license is in full farce and effect. Power Apparatus 8 Large Appliances �1 ��// O}. >`i�fy/' �Tf Size 8 Type HP, KW, KVA, or KVAR �it' I ,.,.i O License Number. L Lic Class+i Up to 1 Ind. FINAL . _- V - I i , Over I to 10 Inc[. DATE VALIDATION 0 Contractor Date Over 10 to 501nd. ❑ -- --f1 __ // FINAL am exempt under Sec. Over 50 to 100 Inc. BY - B.BP.C. for this reason Over 100 r/) Date: Services, Swil MCC 8 Ponelboards D Z 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 8 Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits Low for the following reason (Section 7031.5, Business and Professions Code): -5 8 0 9,3 A I, as owner of the property, will do the work and the Misc. Conduits 8 Conductors efe/o e e 2 structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)— .. 7044, Business and Professions Code). D - 't o o } a 9 0 CONSTRUCTION LENDING AGENCYu o o.� 0.9 0 I hereby affirm that there is o construction lending agency for the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) jr `;Z - - - (Sec 3097, Civ. C.). . D 1 20.6-82 PLAN CHECKING FEE t Lender's Nome .PERMIT ISSUING FEE S�0' Lender's Address x I certify that I have read this application and state that the TOTAL FEE 0, �V above 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 urposes. SEE REVERSE FOR EXPLANATORY LANGUAGE ignawre rmi Dot \NORKERS'COMPENSATION DECLARATION , 76E A6 680BG (2-80) lJ APPLICATION FOR ELECTRICAL PERMIT _ -{� 7 I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY insure, or a certificate of Workers'Compensation Insurance,or 2 y - a certified copy thereof(Sec. 3800,Lab.C.) FOR.APPLICANT TO FILL IN JOB Policy No. Company EACH NO. FEE ADDRESS ❑ New Residential Bldgs. &Pools Certified copy is hereby furni 1 & 2-Family,Sq. Ft. $ — 5 LOCALITY Certified co Multifamily Sq. FL — NEAREST F py is fil ith the county building inspection CROSS ST •C'.,' department. Residential Swimming Pools OWNER OR FIRM NAME Date Applicant Outlets: Rec.—Light—Sw. MAIL First 20 BTIFICATE-OFrEXEMPTION'FROM'WORKERS" _ - - �` _ - -- -- - -- -- - - Total No AdditfOnal CITY Tel No. COMPENSATION INSURANCE PLAN CHEC (L APPLICANT O' (This section need not be completed if the work involved Lighting Fixtures First 20 ADDRESS U by the permit is for one hundred dollars (3100) or less.) - Additional Total No. O 1 certify that in the performance of the work.for which thisCITY Tel No. Fixed Appliances Not Over 1 HP perm it,is issued, I shall not employ any person in any manner PERMIT W so as to become subject to the Workers' Com ensation Laws. Range_ Heater_D.W. _ APPL IC AN CL Z Oven _ Dryer - W.M.— ADDRESS z 10 &_Z Top — FAU _W.H..— _ 7I-� /r, Dat /7 Applicant CITY Tel No. Hood _ Fan _Other_ NOTICE TO APPLICANT: If, after making this Certificate of Disp. _ Room Air Cond.— LICENSE OR Exemption, you should become subject to the Workers' REG.NUMBE Y Class Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO. PROCE SED By with comply with such provisions or this permit shall be deemed revoked.- Size& Type HP,KW, KVA,or KVAR 5--'oUp to 1 Incl. C1LI r Over 1 to 10 Incl, fS'� FINAL DAT LICENSED CONTRACTORS DECLARATION E_ VALIDATION Over 10 to 50 Incl. J/-�„� I herebyaffirm that I am licensed under FINAL BY provisions of Chapter Over 50 to 100 Inc. FINAL 9 (commencing with Section 7000) of Division 3 of the Busi- Over 100 "" ness and Professions Code, and my license is in full,force and /�S effect. Services �3K� /Z L ! 17 0-200 Amp. Under 600 V7 License Nu Lia Class //''�1 201-1000 Amp.Under 600 V Contrac Date /lam`/ Over 1000Amp.or Over 600 V , HOME OWNER-BUILDER DECLARATION - Temp. Power Pole&Appurtenances I hereby affirm that I amexempt from the Contractor's Sign with One Branch Circuit License Law for the following reason (Section 7 .5, Busi- Additional Sign Branch Circuits ness and Professions Code): Misc.Conduits&Conductors 1, as owner of the property do the work and the Other (See Complete Fee Schedule)— 1 60,O A. structure is not intends or offered for sale (Section - 7044, Business and P essions Code).',� o a,a o o"Z CONSTR ION LENDING AGENCY 1 hereby affirm at there is a construction lending agency 2 . 2 U,rj 0 . for the pert once of the work for which this permit is issued (Se 097,Civ.C.). PERMIT FEE (Sub-Total) o o, o 2 q, S 0 0 Lender' ame PLAN CHECKING FEE (One-Fourth Permit Fee) nder's Address —1 / ( Q 2 1 PERMIT ISSUING FEE s I certify that I have read this application and state that the TOTAL FEEd above 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 bov ned roper[ for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE e Signature of Permittee Date WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12:91) APPLICATION FOR ELECTRICAL PERMIT 'b '� 76A663 I hereby affirm that I have a certificate of consent to self insure, or a certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec. 3800 Lab.,C.) Policy N0. Company FOR APPLICANT TO FILL IN - OADDRESS B < U Certified copy is hereby furnished. r New Residential Bldgs.&Pools NO. EACH FEE LOCALITY - ❑. Certified copy is filed with the county building inspection 1 &2-Family,Sq.Ft. $ $ tlepartment. Multi-family Sq.Ft. GROSS ST. Date Applicant Residential Swimming Pools ASSESSOR MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' NEAOa COMPENSATION INSURANCE Outlets:Rec. Light_Suv. IRM NAME First 20MAIL (This section need not be completed If the work involved by the `t ADDRESS ,� permit is for one huridretl dollars($100)or less.)` Total No. Additional , /2G 1 certify that in the performance of the work for which this permit CITY Ti No. Y J/ 6� is issued, I shall not employ any person in any manner so as to PLAN CH Etk become subject to the Workers' Compensation Laws. Lighting Fixtures First 20 APPLICANT- Total No. Additional ADDRESS ' Dale Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE..TO APPLICANT:-If, after making this Certificate of CITY 'TeI.No. Exemption, you should became subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code, you must forthwith comply with such Power Apparatus If Large Appliances APPLICANT PERMIT provisions or this permit shalt be deemed revoked. LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS I hereby affirm that I am licensed under provisions of Chapter 9 Over3 to 10Incl (commencing with Section 7000) of Division 3 of the.Business and . CITY Tel.No. Professions Code,and my license is in full force and effect. Over 10 to 50 Ind. LICENSEClass. d Over 5010 100 Incl. REG.NUMBB ER License Number Lia-0lass Over 100 DISTRICT NO. PROCESSED BY O ` U Services, wb C &Pall rdss Q�� ��7 p%, fl� «���� cc Contractor Date -3 AmnV — �/ DATE O ❑ I am exempt under Sec. 400-1000 Amp.Under 600 V Over 1000 Amp.or Over 600 V VALIDATION W FINAL d B.&P.C.for this reason BRANCH CIRCUIT FEES BY 1:0 Date: 15A,or 20A, 120V,Lighting or Recept. - Z 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits Exemption for Reg.Maint.Elect. 15A,20A.208V To 27 Lighting Dr.Circuits SINGLE FAMILY Temp.Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit for thllowing reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits cod TT1'ialn 1, as owner of the property,will do the work and the structure Misc.Conduits&Conductors is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the {:IfiHFi4 >= e{lit performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total) Civ. C.) PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE `)ill Lender's Address I certify that I have read this application and under penaltyof purjury state TOTAL FEE that the above 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 inspectionheurposes. SEE REVERSE FOR EXPLANATORY LANGUAGE - 5 1 TU E PERMI E `/'f DATE ' COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS EL 0508 9712180024 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: LEGAL ID: FEES PAID BUILD NG ADDRESS: TR: 10898 LT: 28 BL: B 10924 DAINES DR FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802920 ASSESSOR I ORMATION NUMBER: NEAREST CROSS STREET: SANTA ANITA 8573-017-020 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: D3 LOCALITY: TEMPLE CITY HA FAU LESS 3HP 1.00 FAU 10.80 TENANT: - JB AC UNITS +3-10HP 1.00 AC 19.65 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: TOTAL FEES 58.20 12/18/97 UT 12/18/98 OWNER: TEL. NO: FINAL DTEN B : CODE: MARKOFSKI MARY A (626) 443-5631- 10924 DAINES DR O TEMP 917802920 L)Lti(;KlPl ION OFWORK' ELECTRICAL FOR HEATER CHANGE UT AND ADDING A/C APPLICANT: TEL. NO: AIR-TRO, INC. (626) 357-5311- _ - - SPECIAL CONDITIONS: WN-TRACTOR: TEL. N0: j � l��\��� APPROVALS DATE INSPECTOR SIGNATURE AIR-TRO, INC. (818) 357-5311- 1630 SOUTH MYRTLE AVE LIC. NO ���1 � -? .`�� TEMPORARY POWER POLE MONROVIA, CA 91016 258228/C20 UNDERGROUND CONDUIT � 7 ARCHITECT OR ENGINEER: TEL. N0: ^ � Y :� UFER GROUND LIC NO r _ + ? ,i ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED OIL * ADDITIONAL DATA ON FILE REPORT ID: DPR265 ROUTE TO: BS0508