HomeMy Public PortalAbout9401 DAINES DR_Electrical__ 76AS63 D895A 11-49 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY ELECTRIC
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COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO.
ELECTRICIAN TRAP, Ut ;\c, 3 R/ 2,�� r7ir
AA ,�! J �+ W_ '
BY READY FOR DATE 1•SSUED
ADDRESS L'� A/'�{1O. �CC Z i/ L. FIRST INSPECTION
CITY ( TEL. NO.�,,Z,� �'1 II �N /_
COUNTY LICENSE NO. C ' EXPIRES BUILDING
PERMIT FEES ADDRESB /�➢.�A�
Cg �I
NUMBER OUTLETS EACH FEE LOCALITY �i"I r�� / / _
LIGHT Sc $ Q .NEAREST (1 n
RECEPTACLES
CROSS ST.
Z 5 O c�1�
FIXTURES 5 /,�t� OWNER
WALL SWITCHES 5 MAIL
ELEC. RANGES 25 ADDRESS
ELEC. HEATERS 25 CITY TEL. NO.
MISC. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
NUMBER OF CIRCUITS INSTALLED: q`-
TOTAL- 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.
NUMBER HORSEPOWER FEE I CERTIFY THAT I POSSESS THE ABOVE VALID LOS
NEW MVD. HP OVER INC. EACH ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
I/2 6 LESS $ .25 ttt c�
I/2 2 .50 _ SIGNATURE OF
O0 PERMITTEE
2 s l
Y
s is 1.50 INSPECTION RECORD
is so 2.50
so 200 S.00
_ 200 Sao 10.00
Sao I 1000 iS.00 - JQ
OVER 1000 20.00 Z
M.G. SET/FREIJ. CHANGER-HP [']
WELDERS:AC-KVA
O
GENERATORS - KW
TRANSFORMERS - KVA '
TEMP. MOTORS (75% OF ORIG.)
MOVED MOTORS (75% OF ORIG.)
MISC.
SIGNS
TYPE: NO.TRANS.
TYPE: NO. LAMPS APPROVALS
FOR EACH PERMIT: DATE INSPECTOR'S NAME
WIRING $1.00 I �� CONDUIT
FIXTURES $1.00 WIRING
SUPPLEMENTARY .50 FIXTURES
POWER /
TOTAL FEE $ g UTILITY Co.NOTIFIED /
FINAL / PSG..-Gt-•..� - a9.•L.
�• WORKERS' COMPENSATION DECLARATION CE-806 foist APPLICATION FOR ELECTRICAL PERMIT
I hereby•affirm that I have a certificate of consent to self CE-806G
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. Company FOR APPLICANT TO FILL IN JOB �
Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS TV/ t ae, o��w✓ (v
1 & 2-Family, S Ft. $ _ $ LOCALITY
Certified copy is filed with t e county building inspec- Y- q•
tion department. Multi-family Sq. Ft. 'NEAREST
Residential Swimming Pools CROSS ST.
Date 112 Applic f� FIRM
NAME r/�L�/7
CERTIFICATE OF EXEMPT N FRO WORKERS' Outlets: Rec Light�Sw.� MAIL
COMPENSATION INSURANCE ADDRESS
First 20
(This section need not be completed if the work involved by Total No. Additional CITY Tel. No.
the permit is for one hundred dollars ($100)or less.)
I certify that in the performance of the work for which this
PLAN CHECK
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
l Additional
Total No. ` CITY Tel. No.
Date Applicant Fixed Appliances Not Over 1 HP PERMIT
NOTICE TO APPLICANT: If, after making this Certificate of APPLICAN
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 O2AIn. 1�
with comply with such provisions or this permit shall be Top FAU —W.H. — CITY Tel. No G
deemed revoked. Hood — Fan /_Other— - d 2` /
LICENSED CONTRACTORS DECLARATION LICENSE M
I hereby affirm that I am licensed under provisions of Chapter 9 Disp. _ Room Air Cond. REG. NUMBER - �� Class.
(commencing with Section 7000) of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO. P ED BY >_
and Professions Code, and my license.is in full force and effect. @'
Type / Q
o r24 Size&T e HP, KW, KVA, or KVAR
License Number & Lic. Class Up to 1 Incl. FINAL / 1
Over 1 to 10 Incl. DATE ' LIUATION
Contractor Date Over 10 to 50 Incl.
FINAL
I am#.efplu der Sec. Over 50 to 100 Inc. IU
Over 100 e
B.&P.C. for this reason vt
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
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
Law for the following reason (Section 7031.5, Business and
Professions Code): O A
I, as owner of the property, will do the work and the Misc. Conduits& Conductors
structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ ® Ai- 0 0 0 0,0 2
7044, Business and Professions Code).
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for o o o 1 7,.0.0
the performance of the work for which this permit is issued PERMIT FEE (Sub-Total)
(Sec. 3097, Civ. C.). 7.01 —87
PLAN CHECKING FEE
Lender's Name
PERMIT ISSUING FEE
Lender's Address p
I certify that I have read this application and state that the TOTAL FEE o
4informahn is correct. I agree to comply with all County
State laws regulating Electrical wiring, anda representatives of this County to enter upon coonprpo es. SEE REVERSE FOR EXPLANATORY LANGUAGE
mittee ate
WORKERS' COMPENSATION DECLARATION CE-806 10/81 APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I have o certificate of consent To self CE-806G
insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY
or ateNifiedwopy thereof (Sec. 3800, Lab. C.)
Policy No. Company FOR APPLICANT TO FILL IN JOB I �C ,q
Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS CL V li f
prz
❑ q 1 & 2-Family, S Ft. $ _ $ LOCALITY
Certified copy is filed with the county building inspec-
tion department. Multi-family Sq. Ft. I'NEAREST
Residential Swimming Pools ROSS ST.NER OR
tt [[ `
Date Applicant FIRM NAME V [ C D LF V R Ff
CERTIFICATE OF EXEMPTION FROM WORKERS' � �" MAIL E
- —
COMPENSATION INSURANCE Outlets: Rec Light Sw. . L
ADDRESS , r
.First 20 i
(This section need not be completed if the work involved by Total No.�� Additional CITY P�.t �- Tel. No.%5
the permit is for one hundred dollars ($100)or less.)
LAN CHECK
I certify that in the performance of the work for which this APPLICANT
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 HP PERMIT
NOTICE TO APPLICANT: If, after 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..—
deemed revoked. Hood _Fan _Other_ CITY Tel. No.
LICENSED CONTRACTORS DECLARATION LICENSE OR
I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. REG. NUMBER Class.
(commencing with Section 7000) of Division.3 of the Business DISTRICT NO. PROCESS BY
and Professions Code, and my license is in full force and effect. Power Apparatus& Large Appliances
Size &Type HP, KW, KVA, or KVAR'
License Number Lic. Class Up to 1 Incl. FINAL
Over 1 to 10 Incl. DATE !J_— VALIDATION
Contractor Date Over 10 to 50 Incl.
FINAL
❑ I am exempt under Sec. Over 50 to 100 Inc. BY
B.&P.C. for this reason Over 100
Services, Swbd., MCC& Ponelboards
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. 3 0 5.8 A
SINGLE FAMILY Temp. Power Pole&Appurtenances
HOME OWNER-BUILDER DECLARATION 0 0 0 0 0 2Sign with One Branch Circuit •
I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits 2 0 0.1 3.5 Q
Law for the following reason (Section 7031.5, Business and
Professions Code): c 'o O 3,50 H
❑ I, as owner of the property, will do the work and the Misc. Conduits &Conductors
structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ , 0622—83
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 PERMIT FEE (Sub-Total)
(Sec. 3097, Civ. C.).
PLAN CHECKING FEE "
Lender's Name
PERMIT ISSUING FEE
Lender's Address
I certify that I have read.this application and state that the TOTAL FEE
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 purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
� -2-
is V
2-S' ture of Permittee Date
."%' "COUFTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1111140009
,BUILDING AND SAFETY LAND DEVELOPMENT TEMPLE CITY CA 91780 ,
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID BUILDING ADDRESS:
ON FILE 9401 DAINES DR I
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( TEMP CA 917803113 I
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 1
18588-030-016 IA1 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY CAI
I IF1 120V, 15/20A BR CKTS 10..00 BR 173.10 1
(TENANT: IF2 208, 277V LGT BR CKT 1.00 BR 27.30 (ISSUED ON: PROCESSED BY: PLAN BY:
IG1 OUTLETS-LGT,SW,RECP 25.00 OUT 45.70 111/14/11 SR I
I _IG2 LIGHTING FIXTURES 15.00 LGT 29.10 1 1
(OWNER: TEL. NO: IH2 RES GRBG DISP LT 3HP - 1.00 DIS 10.90IFINAL DATE FI BY: CODE: I
ICHANG, GEORGE (626) 233-3832- IH3 RES DISHWASHR LT 3HP 1.00 DIS 10.90 I - I
19401 DAINES DR IH4 RES _RANGE HDS LT 3HP 1.00 H00 10.90 1 I-
ITEMP 917803113 1145 RES WASH MACH LT 3HP 1.00 WAS 10..90 IDESCRIPTION OF WORK I I
1 - 1147 RES EXHAUST FANS 1.00 EX 10.90 (ELECTRICAL REWIRE FOR RESIDENCE. 10 CIRCUITS, 1 BRANCH
I _I TOTAL FEES 357.50 CURCUIT, 25 OUTLETS, 15LIGHTING FIXTURES, 1 GARBAGE
(APPLICANT: TEL. NO: I (DISPOSAL, 1 DISHWASHER, 1 RANGE HOOD, 1 WASHING MACHINE, I
ITHE ELECTRICIAN MAGICIAN
1 I ISPECIAL CONDITIONS:
ICONTRACTOR: TEL. NO: - I (APPROVALS DATE INSPECTOR SIGNATURE
ITHE ELECTRICIAN MAGICIAN (818) 590-8574-
1524 E. GLEN OAKS #D LIC. NO ITEMPORARY POWER POLE I I I
GLENDALE CA 91207 727369 C10 I I I I
I I (UNDERGROUND CONDUIT I I
I I I I I I
IARCHITECT OR ENGINEER: TEL. NO: IUFER GROUND I I - I
I I
I LIC. NO: I IROUGH CONDUIT 1
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I 1 IROUGH WIRING
IMAIN WATER LINE
- IPLASTIC Y/N METAL Y/N
(UTILITY COMPANY NOTIFIEDI I I
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• IONAL QN IIS
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• .�. ,r. - 22"��^^H'^' _ - REPORT III: DPR26S ROUTE-TO BSOS
- 'COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
LiEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1111220031
.BUILDING AND SAFETY y LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: FEES PAID BUILDING ADDRESS: 1
I ON FILE I 9401 DAINES DR
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( TEMP CA 917803113 I
(ASSESSOR INFORMATION NUMBER: I I . NEAREST CROSS STREET:
18588-030-016 IA1 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY CAI
I ILB 200 AMP PANELS, MCC 1.00 PAN 38.80 I
(TENANT: I TOTAL FEES 66.60 (ISSUED ON: PROCESSED BY: PLAN BY: I
1 111/22/11 SR
(OWNER: TEL. NO: I IFINAL DATE FINAL BY: CODE:
ICHANG, GEORGE (626) 285-8132- �� I
19401 DAINES DR
ITEMP 917803113 I IDESCRIPTION OF WORK
I (UPGRADE SERVICE PANEL TO 200 AMP SERVICE I
(APPLICANT: TEL. NO:
ITHE ELECTRICIAN MAGICIAN
ISPECIAL CONDITIONS:
I I I l
ICONTRACTOR: TEL. NO: I (APPROVALS - DATE INSPECTOR SIGNATURE I
ITHE ELECTRICIAN MAGICIAN (818) 590-8574- I I
1524 E. GLEN OAKS #D LIC. NO I ITEMPORARY POWER POLE I
IGLENDALE CA 91207 727369 C10 I I I
I (UNDERGROUND CONDUIT
(ARCHITECT OR ENGINEER: TEL. NO: I IUFER GROUND I I I
I LIC. N0: I (ROUGH CONDUIT I I I
IROUGH WIRING
I I I I I I
I IMAIN WATER LINE I
IPLASTIC Y/N METAL Y/N I 1
(UTILITY COMPANY NOTIFIEDI1 '57
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IREPORT ID: DPR265 ROUTE TO: BS0508 I
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