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Home My Public Portal About9903 DAINES DR_Electrical__ �D.S.S SA 25M SETS t❑-47 "PLICATION FOR PE -Dr OF RUYLIDING AND S ld� 1L,1i u111 1� FOR 1CII1.11LY COUNTY OF LOS ANGELESELEC J. F CHIEF ENGINEER, Z DISTRICT NO. GROUP ZONE PERMIT NO. a NAME �J ADDRESS CITY TEL NO. ^'13 Y RECEIVED BY FIRST INSPECTION DY FOR DATE IS'SU/E J COUNTY i il W CERT.NO. D 2 EXPIIRH$ "444 APPLICANT FILA. IN HEAVILY OUTLINED PORTION ONLY JOB DESCRIPTION OF WORD ADDRE95 SD Gam, NUMBER OF OUTLETS ON CIRCUITS LOCALITY• LOCATION BY ROOMS NEAREST LIGHT OUTLETS 8W. PLUGS FIxT CR SS ST CIRCUIT A I /B� C D E / F G H )J ic NAME 1 3 MAIL ADDRESS O - CITY TEL.NO. 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CrERT IFICATION.. \ i ELECTRICIAN. I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE OWNER. COIMMONS r J Q Z , IY O OTA NO. OF OUTLETS 2- ffi U APPROVALS NO. OF FIXTURES ffi DATE INSPECTOR'S NAME NO. OF MOTORS H.P. ffi CONDUIT / NO. OF SIGNS TRANS. ffi WIRING �"�/ � 4j NO. OF HEATERS FIXTURES 1 MtSCuj2aNE2usffi Qq POWER PERMIT FEE !B i s UTI LITYCO.NOTIFIED J-- TOTAL --TO A FEE Ft c COUNTY OF LOS ANGELES APPLICATION FOR PERM DEPARTMENT OF COUNTY ENGINEER �' 1 DIVISION OF BUILDING & SAFETY WILLIAM I. FOB, COUNTY ENGINEER FOR`APPLICANT TO FILL IN DISTRICT NO. GROWP ZONE PERMIT NO. ELECTRICIANf o� ADDRESS / RECEIVED Y READY FOR DATE ISSUED FIRST INSPECTION CITY TEL'. NO '. ' .� ,� S¢ COUNTY LICENSE NO. 6) EXPIRES BUILDING PERNUT FEEd ADDRESS FEE NUMBER EACH LOCALITY / LIGHT OUTLETS NEAREST V RECEPTACLES ROSS ST. s WALL SWITCHES OWNER TOTAL OUTLETS Sc $ MAIL ELEC. RANGES 25 ADDRESS ELEC. HEATERS 25 FIXTURES 5 - CITY TEL. NO. MISC. 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER NEW MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED /jABOVE. +/2 a LESS $ .25 - SIGNATURE OF �- +/2 2 .50 �b PERMITTEE � �-' 2 5 1.00 1 INSPECTION RECORD' 5 15 '1.50 Is 50 2.50 SO 200 5.00 200 Soo 10.00 J. 500 1000 15.00 Q OVER 1000 20.00 Zz M.G. SET/FREQ. CHANGER-WP Q WELDERS: AC-KVA 0 GENERATORS •KW TRANSFORMERS-KVA TEMP. MOTORS (75% OF ORIG.) MOVED MOTORS (75% OF ORIG.) MISC. SIGNS NO. NO. TRANS. APPROVALS NO. NO. LAMPS FOR EACH PERMIT: DATE INSPECTOR'S NAME WIRING $1.00 CONDUIT FIXTURES $1.00 WIRING ) `•" SUPPLEMENTARY .50 FIXTURES L POWER TOTAL FEE $ V UTILITY CO. NOTIFIED / ll FINAL 76A 66S DBS# SA. 4-02 _ t+ WORKERS' COMPENSATION DECLARATION 1D 8; APPLICATION FOR"ELECTRICAL PERMIT °,•I��ie+by arfirm CE-80676A66310/8f 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 Company FOR APPLICANT TO FILL IN JOB IDCertified copy is hereby furnished J New Residential Bldgs & Pools EACH NO FEE ADDRESS O //✓Sr Certified copy is filed with the county building inspec- 1 & 2-Family, Scl Ft $ — $ LOCALITY tion department - Multi-family Scl Ft — NEAREST _ _ CROSS ST Residential Swimming Pools OWNER OR � Date Applicant FIRM NAME /a: CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec ;/ Light �i MAIL _ .' -COMPENSATION INSURANCE Sw ADDRESS First 20 (This section need not be'completed If the work Involved by Total No Additional CITY Tel No��7_ the permit is for one hundred dollars ($100)'6r less.) I certifythat in the pe of the work for which this PLAN CHECK P APPLICANT permit is issued, I shall not employ any person in any manner so as to become sublect to the Workers'Compensation Laws Lighting Fixtures First 20 ADDRESS Additional Total No CITY Tel No, Date 74—Cy--Applicants 4L /mssr Fixed Appliances Not Over 1 HP PERMIT NOTICE -TO APPLICANT If, after m ng this Certificate of APPLICANT- Compensation PPLICANT /9 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'revokedCITY Tel No LICENSED CONTRACTORS DECLARATION Hood _ Fon _ Other_ Disp Room Air Cond LICENSE Class I hereby affirm that I am licensed-under provisions of Chapter 9 REG NUMBER (commencing with Section,7000) of Division 3 of The Business DISTRICT N PROCESSED BY and Profess,ons Code,and my license is in full force and effect Power Apparatus& Large Appliances L ',Size &Type HP, KW, KVA, or KVAR 0 License Number Lic�Class Up to 1 Incl ' FINAL V Over 1 to 10 Incl DATE VALIDATION Contractor Date ❑ Over 10 to 50 Incl H FINAL I am exempt under Sec Over 50 to.100 Inc BY IW B &P C for this reason' Over 100 1 Z Date Services, Swbd ,-MCC& Ponelboards Poo. — 0 -200 Amp Under 600 V Signature 201 - 1000 Amp Under 600 V Over 1000 Amp or Over 600 V Exemption for Reg Mamt 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) – Misc"Conduits &Conductors 1, as owner of the,property, will do the work and the structure is not intended or offered for sale (Section Other,(See Complete Fee Schedule)_ , � 7044, Business and Professions Code) - 253 CONSTRUCTION LENDING AGENCY0 0 0.o o � 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) 2 ° ° 2 00 (Sec' 3097, Civ C ) ' PLAN CHECKING FEE Q*• Lender's Name I4 PERMIT ISSUING FEE Lenders 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 = N the above-mentioned property for,inspection purposes �/ SEE-REVERSE FOR EXPLANATORY LANGUAGE l SignaOP& of Permittee Date 4 WORKERS'COMPENSATION DECLARATION 76A663CE-806 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of cons�`it 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 ) PolicyNo-Company FOR APPLICANT TO FILL IN JOB ❑ Certified copy is herebyf furnished New Residential Bldgs & Pools EACH NO FEE' ADDRESS D 3 ❑ _ Certified copy is filed with the county building inspec- 1 8 2-Family, Sq Ft $ $ LOCALITY NEAREST tion department Multi-family Sq Ft CROSS ST w +' Residential Swimming Pools OWNER OR 11 A^ Date Applicant FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec Light Sw_ MAIL COMPENSATION INSURANCE ADDRESS This section need not be completed If the work Involved b First 20 p cz ( p Y Total No Additional CITY Tel No .,�38 the permit is for one hundred dollars ($100)or less.) I certif that in the performance of the work for.which this PLAN CHECK Y. e APPLICANT P permit'is issued, I shall not employ any person in any manner so as to become subject to the W kers'Compensation Laws Lighting Fixtures -First 20 ADDRESS Total No Additional CITY Tel No Dat � Appl1: t Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT If, of r makin is Certificate of APPLICANT Exemption, you should' be o e subj t to the Workers' Range_ Heater_D W Compensation provisions of t 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 CITY Tel No LICENSED CONTRACTORS DECLARATION LICEHood _ Fan _ Other_ Disp Room Air Cond REGNSE OR NUMBER Class I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the BusinessDISTRICT NO PROCESSED BY and Professions Code,and m license is in full force and effect Power Apparatus 8 Large Appliances >- y Size &Type HP, KW, KVA, or KVAR License Number Lic Class Up to 1 Incl FINAL �� Over 1 to 10 Incl DATE SIL VALIDATION Q U Contractor Date El 10 to 50 Incl FINAL U I am exempt under Sec Over 50 to 100 Inc BY d Over 100 B 8P C for this reason Servic �wb Panelboards ► Date n 200 Amp Under 600 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 5 6 8,3 A Law for the following reason (Section 7031 5, Business and Professions Code) #'o o o 0 o 2 ❑ 1, 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)_ 7044, Business and Professions Code) CONSTRUCTION LENDING AGENCY 2 0 0 2 5.5 0 I hereby affirm that there is a construction lending agency for 0'0 0 215 5 0 c=i the performance of the work for which this permit is issued -PERMIT FEE (Sub-Total) (sec 3097, Civ C > 0 9, 3 0-8 3 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 ereby authorize representatives of this County to enter upon t e above-men tio ed property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE 21?_� Sign of Permittee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0208220007 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: BUILDING ADDRESS: TR: 13805 LT: 58 9903 DAINES DR FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802639 ASSESSOR INFORMATION N NEAREST CROSS STREET: BALDWIN 8588-016-033 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT,SW,RECP 10.00 OUT 19.50 G2 LIGHTING FIXTURES 5.00 LGT 9.75 ISSUED ON: PROCESSED : PLAN BY: EXPIRES ON: HA FAU LESS 3HP 1.00 FAU 10.95 08/22/02 JK 02/18/03 H7 RES EXHAUST FANS 2.00 EX 21.90 OWNER: TEL N JB AC UNITS +3-10HP 1.00 AC 19.65 FIN DA FINAL BY: E: MEI SUNG (626) 285-3256- TOTAL FEES 109.50 5835 PRIMROSE AVENUE TEMPLE CITY 91780 DESCRIPTION 0 ELECTRICAL FOR ADDITION & HVAC & REPLACE FAN IN OTHER BATH L. 0: SAME AS OWNER - SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: a � nAPPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO �\ TEMPORARY O UNDERGROUND ONDUIT ARCHITECT OR L. NO: UFER GROUND LIC.-NO' � � �,1 ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE �- �l PLASTIC Y/N METAL Y/N UTILITY-- __--_--_- ---- - --_ -_-_ - -- / COMPANY �I ,w i _�n'�, 7 �— REPORT ID: DPR265 ROUTE TO: BS0508