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Home My Public Portal About5306 ENCINITA AVE_Electrical__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1307110039 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: FEES PAID BUILDING ADDRESS: ITR: 11492 LT: 18 I 5306 ENCINITA AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( TEMP CA 917803137 1 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 1 18590-001-031 1A1 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY CAI IG2 LIGHTING FIXTURES 1.00 LGT 2.00 I (TENANT: I TOTAL FEES 29.80 (ISSUED ON: PROCESSED BY: PLAN BY: I 107/11/13 SR OWNER: TEL. NO: I I DATE FIN CODE: 1 1PAULSON RENAE A (626) 893-2073- 15306 ENCINITA AV I ( ' ITEMP 917803114 IDESCRII O OF WORK I IREPLACE EXTERIOR LIGHT (APPLICANT: TEL. NO: 1 IGHITA, DAVID (877) 559-5005- 1 14810 EXCELENTE DRIVE ISPECI.AL CONDITIONS: IWOODLAND HILLS 91364 I 1 (CONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE I PRESTIGE CONSTRUCTION AND DESIGN (877) 559-5005- 1 14810 EXCELENTE DRIVE LIC. NO ITEMPORARY POWER POLE I I WOODLAND HILLS, CA 91364 858940 1 1 1 (UNDERGROUND CONDUIT 1ARCHITECT OR ENGINEER: TEL. NO: I IUFER GROUND I I 1 LIC. NO: I 1ROUGH CONDUIT 1 1 1 1 1 1ROUGH WIRING I 1 1 IMAIN WATER LINE I I 1 1PLASTIC YIN METAL YIN 1 1 (UTILITY 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 I I I I I I I IREPORT ID: DPR265 ROUTE TO: 2SO508 1 1 I 1 I I I I I I WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT I r,ereby affirm that I have a certificate of consent to self insure, 76A663 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.) P❑OIICy NO. Company FOR APPLICANT TO FILL IN JOB ADDRESS �� ►V a C 10 i'1•P Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE $ $ LOCALITY E-1Certifiedcopy is filed with the county building inspection 1 &2-Family,Sq.Ft. NEAREST department. Multi-family Sq. Ft. CROSS ST. Date Applicant Residential Swimming Pools ASSESSOR MAP BOOK Jq l,/ PAGE ®Q) PARCEL CJ CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec. Light Sw. OWNER OR 07 ap— c71�°LrJOlJ COMPENSATION INSURANCE M NAME (This section need not be completed First 20 7O MAIL the work involved by the Total No. s Additional ADDRESS 53(•'rio N r E NCI't s {T-R permit is for one hundred dollars($100)or less.) I certify that in the performance of the work for which this permit CITYT' (2117y Tel.No.7 @3 Z is issued, I shall not employ any person in any manner so as to qVie PLAN CHECK �tJ become subject.to the Workers' Compensation Laws. Lighting Fixtures First 20 0 APPLICANT Total No. Additional ADDRESS Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT; If, after making this Certificate of CITY Tel.No. Exemption,you should become subject to the Workers' Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code, you must forthwith comply with such PERMIT provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances APPLICANT LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. (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 Incl. >- LICENSE Class. a_ Over 50 t0 100 Incl. REG.NUMBB ER Over 100 DISTRICT NO. PR C SED BY O License Number Lic.Class �� U Services,Swbd.,M &Pane oards -�l..� Q Contractor Date 0-39! mp.Underr 660 V I? d FINAL DATE o El 400-1000 Amp.Under 600 V 1 Q—�rz VALIDATION W I am exempt under Sec. Over 1000 Amp.or Over 600 V FINAL J 0- B.&P.C.for this reason BRANCH CIRCUIT FEES BY (1) Date: 15A,or 20A, 120V,Lighting or Rece pt. 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits r_141 Or More Branch Circuits Exemption for Reg.Maint.Elect, 15A,20A,208V To 277V Lighting Br.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 ITEMS for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits ' ' Code): . 9-� ai ❑ I, as owner of the property, will do the work and the structure Misc.Conduits&Conductors t3 x �� is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) !' �' F'?- and Professions Code). , CHARGE om,+ r C})t CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the t t� performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total) }il ;—L�,-tjI Civ. C.) PLAN CHECKING FEE (721 1 Mil.-4 Lender's Name PERMIT ISSUING FEE ' Lender's Address I certify that I have read this application and under penalty of purjury state TOTAL FEE that the above information is correct. I agree to comply with all County ordinances and State laws regulatin ectrical wiring,and hereby authorize represent s of this Count enter n the above-mentioned property for ins c' n purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE /I GNA R O PERMITTEE DATE. WORKERS'have a certificate of 76-663 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that,I have a certificate of consent to self insure, CE-906G or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof QO,Lab. C.) J0,46! /A 1Do, /�� Lli� L PoIICyO. l 6U� Company FOR APPLICANT TO FILL IN ADDRESS ❑ ~ L Certified copy is hereby furnished. New Residential Bldgs.&Pools EACH NO. FEE ✓�� Ft S 2-Family, q. . $ — l Certified copy is filed with the county building inspection 1 & $ LOCALITY — NEAREST department. Residential Swimming Pools Multi-family Sq.Ft. CROSS Date — Applicant A0 yh� OWNER OR /f /) t l�� FIRM NAME /l/� /" (! C�.r ,J CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec Light Sw. MAIL j �1 I/� COMPENSATION INSURANCE ADDRESS 4j /UC/A) � (This section need not be completed if the work involved by the First 20 y permit is for one hundred dollars ($100)or less.) Total No� Additional CITY�� CLT Tel.No. I certifythat in the performance of the work for which this permit PLAN CHECK P 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 2A ADDRESS Additional IV Total No. I CITY Tel.No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of Exemption,you should become subject to the Workers'Compensation Range_ Heater_ D.W. _ APPLICANT ` provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer _ W.M.— ADDRESS r V�/ QLl �� V provisions or this permit shall be deemed revoked. Top — FAU _ W.H. CITY CATel.N LICENSED CONTRACTORS DECLARATION , Hood — Fan Other_ I hereby affirm that I am licensed under provisions of Chapter 9 LICENSE OR Disp. Room Air Cond. REG.NUMBER Class. (commencing with Section 7000) of Division 3 of the Business and Professions Code,and my license is in full force and effect. DISTRICT N PROC ED By Power Apparatus& Large Appliances g _ U C C C �/l Size& Type HP,KW,KVA,or KVAR `n�•Q License Number J, u 7 7 Lic. Class k / `' Up to 1 Incl. 0 FINAL `/'► C� A !� �_ Over 1 to 10 Incl. DATE C j VALIDATION Contractor Date .� Over 10 to 50 Incl. ttt I ❑ FINAL U I am exempt under Sec. Over 50 to 100 Inc. BY Over 100 B.&P.C.for this reason 0 D —2-7— Services,Swbd.,MCC & Panelboards Z ® / 0 200 Amp.Under 600 V —/ Z 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 Law it h Ci B l Si i itonaSign Branch Circuits for the following reason (Section 7031.5, Business and Professions Add ,g Code): Misc.Conduits& Conductors `f' !r 1117.6-1-_ I,as owner of the property,will do the work and the structure .I is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) Poo. 1 i and Professions Code). CONSTRUCTION LENDING AGENCY ) I hereby affirm that there is a construction lending agency for the CHECK ill.Ch performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total) i' # eLli� Civ.C.). .HAP]E PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE 00010-00101 Lender's Address . ,2S I certify that I have read this application and state that the above TOTAL FEE L.:i_F. N 1�I=.4 information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize representatives of this C my to enter upon the above-mentioned pr r f inspection poses. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature df lye itt e Date