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HomeMy Public PortalAbout5729 ENCINITA AVE_Electrical__ a WGR"ERS'°OdPENSATIQN DECLARATION 76"663 0'81 CE-806G APPLICATION FOR ELECTRICAL PERMIT. {1 I hereby affinh that I have a certificate of consent to self•insure, LJor a.certifil of Workers' Compensation Insurance,or a certified 'COUNTY OF LOS ANGELES. BUILDING AND SAFETY copy thereof (See 3800,Lab. C.) - - Policy No: r' " Company _ FOR APPLICANT-TO FILL IN JOB BRESSFEECH NO. \ f � - ' � •- „Certified.copy is her eby.furnlshe'd. New Residential Bldgs. & Pools EACH 'LOCALITY Certified copy Is filed with the.-county 'building inspection, 1 & 2-Family,Sq.Ft' $ - _ $ f 1 department: 1 • Multi-family Sq Ft. NEAREST _ GROSS ST.. ))(V - Date. ,Applicant Residential Swimming Pools OWNER OR - - - . FIRM NAME G CERTIFICATE OF EXEMPTION FROM WORKERS' o /5 /4 MAIL COMPENSATION INSURANCE Outlets:Rec—Light Sw 'p0 00 7 - v /J, AOORE55 (This section need not be completed it the work involved by the First 20 Or P _ rCITY ( Tel:No. permit is for one hundred dollars ($100)or less.) Total No. Additional _ I certify that in the'performance Of the.Work for which•thiS,permit PLAN CHECK APPLICANT - Js issued, shall not employ any person.tany manner so as to - - - - become subject to the Workers'Compensation Laws. Lighting Fixtures 'Q First 20. 'ADDRESS T Total No. �✓ Additional CITY - Tel.No: ' Date Applicant Fixed Appliances Not Over 1 HP NOTICE TO. APPLICANT ll making' this Certificate of • . PERMIT r Exemption,you should become subject to the Workers Compensation' Range Heater_ DW APPLICANT provisions of.the Labor Cade, you must,forthwith comply,with such Oven Dryer _ W.M.�-,, /O D• ADDRESS ' provisions or this permit shall be deemed revoked; Top — FAU ✓ W.H ✓ - CITY - - LICENSED,CONTRACTORS DECLARATION Hood L'Fan Of r - ,� / • , •TCL No. it,hereby.affirm that I am licensed underr provisions df Chapter 9ro LICENSE OR Disp. ROOM-Air Con ^ (commencing with Section 7000) of Division 3 of,the.BOSI0e65 and � REG.NUMBER •class._ Professions Code,and,my license is In full farce and effect. Power Apparatus& Large Appliances DISTRICT Na _ P SED BV Size& Tye HP,K�V!/�/y/V'{'p'or KVAR . 0� Q License Number Llc.ClassUp td 9 lhcr FINAL - �7 T Over,1 to 10 rel. DATE 1-22� -4,6� VALIDATION O Contractor Date Over'10 to 50 Inc]. G V FINAL E] am exempt under Sec. Over 50 to 100 Inc: Fa Over 100 6&P.C.for this reason - N Services/�,�+A - . .- _ ._ _.. , _ xi Dale: 0 2Amp' n ' y00v� Z 600 V w 'Sr _ D "1_ - Signature 201 - 1606 Amp.Under 600 V - - - •. ,. Over 1000 Amp.or Over 600.V - Exemptbn for Reg. Maint. Elect' - _ SINGLE FAMILY Temp.Power Pole & Appurtenances _ HOME OWNER-BUILDER DECLARATION - i Sign with One Branch Circuit ACCT I hereby affirm that I am exempt from.the Contractors License Law Additional Sign Branch Circuits - - -}�/1 forthe Mowing reason (Section 7031.5,Business and Professions 3303 "• `- •+w Code)' • Misc.Conduits& Conductors r - '- a: --- - 1. ITEMS I,as owner oft property,well do the work and the structure Other(See Complete Fee Schedule) TOTAL. �� is not intended or offered for sale(Section 7044, Business - D .. and Professions Code). • CHECK 259.50 ' CONSTRUCTION LENDING AGENCY CHANGE .0 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued(Sec.3097'. • PERMIT FEE - (Sub-Total) � Civ.C.). •' -PLAN CHECKING FEE -` • - 0000-0001.. 9/22/95' Lender's Name 2425 . 1 AM $:46 - PERMIT ISSUING FEE - •- - - p( - . _ .. _ Lender's Address I certify that I have read this application and state that the above - .TOTAL FEE information is correct. I agree to comply with all County ordinances .and State laws regulator Electrical iring, and hereby authoriie repres latives of. this aunty to ter upon.the above-mentioned grope y r inspect i purposes: SEE REVERSE FOR EXPLANATORY LANGUAGE - i Si ature of ermittee ate WORKER have in COMPENSATION 20-0019 0-001 76A669DPW1,2-9„ APPLICATION FOR ELECTRICAL PERMIT I.hereby affirm that I have a certificate of consent to self sure, or a'oe'rtin`caT..of worker's Compensation Insurance, or a gertified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDINP AND SAFETY DIV. copy thereof. Sec. 3800 Lab. C.) Policy No. ° Company FOR APPLICANT TO FILL IN 3ADD0D RESS ❑' Certified Co is hereby furnished. - NO. EACH FEE PY Y New Residential 81dge.8 Pools _ $ $ 'LOCALITY L ❑I Certified copy is filed with the county building inspection 1 &2-Family,Sq.Ft. _ wEAREST department. Multi-family Sq. FC CROSS ST. Date Applicant Residential Swimming Pools' MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' _Light Sw. OWNER OR Outlets:Rec. COMPENSATION INSURANCE FIRM NAME (This'sectlon need not be completed If the work involved by the First ADO EBB 3'(/ permit is for one hundred dollars($100) or less.) Total No. Additional I certify that in the performance of the work for which this permit CITY T.I.No. 06 fl Is issued, I Shall not employ any person in any manner So as to PLAN CHECK become subject to the Workers' Compensation Laws. „ Lighting Fixtures First 20 APPLICANT - ' Total No. Additional ADDRESS' 7 ye Date 'Applicant NOTICE TO APPLICANT: If, after making this Certificate of RESIDENTIAL APPLIANCES NOT OVER 3 HP. CITY Tel.No. - Exemption,you should become subject 10 the Workers' Compensation OTHER APPLIANCES NOT OVER 3 HP. revisions of the Labor Code, you must forthwith comply With Such '' 11 p p y PERMIT Power Apparatus&Large Appliances - APPLICANT' provisions or this permit shale be deemed revoked. LICENSED CONTRACTORS DECLARATION Size 8 Type HP,KW, KVA,or KVAR ADDRESS bd I hereby affirm that I am licensed under provisions ofM1Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Over 3 to 10 Incl. CITY Tel.No. Professions Code, and my license is In full force and effect. Over 10 to 50 Ind. LICE SE OR Over 50 to 100 11 1. RE3NNUM ER Class. d Over100 DISTRICT NO. PROCES 0 License Number Lia Class Q Services,Swbd.,MCC&Panelboards �• Mfr CC Contractor Date 0-399 Amp, Under 600 V DIANE / 0 ❑ am exempt under Sec. 400-1000 Amp.Under 600 V W Over 1000 Amp.or Over GOO V _ FINAL /4 2y r VALIDATION d B.&P.C.for this reason — BRANCH CIRCUIT FEES BY (� 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.Moron.Elect. 15A,20A,208V To 277V Lighting Br.Circuits F.dfcCiflst441} 1y� SINGLE FAMILY Temp. Power Pole&Appurtenances HOME OWNERBUILDERDECLARATION Sign with One Branch Circuit - I hereby affirm that I am exempt from the Contractor's License Law for the hawing reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits Cotl I, as owner of the property,will do the work and the structure Misc.Conduits&Conductors is not intended 07 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 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 Lender's Address I certify that I have read this application and under penalty of purjury state TOTAL FEE Ila t the above in rmalion is correct I agree to comply with all County ortlinaoces and ate laws regulating 'ctrical wiring,and hereby authorize representatives f ounty toe of uponAtheoe-mentioned property for inspection poses. / SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE Of PERMITTEE n COUNTY OF LOS ANGELES APPLICATION FOR PERMIT DEPARTMENT OF COUNTY ENGINEER ^- � DIVISION OF BUILDING 6 SAFETY 1155 ,lll WILLIAM I. FOX, COUNTY ENGINEER FOR APPLICANT TO FILL I DISTRICT NO. GROUP I ZONE PERMIT No. E LOV � V 721 ADDRESS, R CEIVED BY READY FOR DATE ISSUED GG FIRST INSPECTION COUNTY LIC SE NO. E%P RES - BUILDING 1 ' PERMIT FEES ADDRESS / i.cu�ul FEE NUMBER EACH LOCA LIT LIGHT OUTLETS NEAREST RECEPTACLES CROSS T WALL SWITCHES OWNER TOTAL OUTLETS 5c $ 20 MAIL ELEC. RANGES 25 ADDRESS lzi ELEC. HEATERS 25 FIXTURES 5 CI rFtr TEL. NO. MISC. I HEREBY fACKNOWLED99r,THAT 1 HAVE READTHIS NUMBER OF LIGHT CIRCUITS APPLICATION AND. STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUIT AND STATE LAWS REGULATING ELECTRICAL WIRING. ' MOTORS I CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER FEE ' ANGELES COUNTY LICENSE. OR I AM THE LEGAL OWNER NEW Mw. HP GYER INC.1. EACH OF THE RESIDENTIAL PROPER.-AY DESCRIBED OV . V/ a LEES $ .25 SIGNATURE OF Vz 2 .50 PERMI7T 2 5 1.00 INSPECTION RECORD 5 15 1.50 1s so 2.50 50 200 5.00 200 500 10.00 J ' 500 '1000 15.00 - Q Z OVER 100G 20.00 M.G. SET FRED. CHANGER-HP WELDERS: AC-KVA O 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,pp CONDUIT //� FIXTURES $1.00 ® WIRING �✓'/- / ..lS✓ �2 SUPPLEMENTARY .50 -FIXTURES j POWER y TOTAL FEE $ /l % UTILITY CO. NOTIFIED f � �i -I FINAL. IYebHM �n �S JSA GG3 GBS# EA. A-59 . 4AVCI"A.s EA s-AS ® APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES ��4 WILLIAM J. FOX, CHIEF ENGINEER DISTRICT NO. GROUP ZONE PERMIT NO. FOR APPLICANT TO FILL IN /D /SG 14 ELECTRICIAN AF550eI4G RECEIVED BY READY FOR DATE ISSUED ADDRESS .411�/ /l�F,�/^�// � //,F 1��I/1�a FIRST INSPECTION CITY RTJB® TEL,M� L t'�+-� IY! V w /-x zz-u9 COUNTY LICENSE NO. �J / EXPIRES .T B�3[!' BUILDING G- c,0,o0 17 4 -PERMIT FEES � y� /J_�� _ NUMBER OUTLETS EACH FEE LOCALITY /"Y�} LIGHTS SC $ '0 CROAREST SS ST. T �? RECEPTACLES 5 FIXTURES 5 I O OWNER i- (� v/ �✓� WALL SWITCHES 5 MAIL ELEC. RANGES 25 ADDRESS ELEC. HEATERS 25.' CITY TEL. NO. MISC. 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ,THIS NUMBER OF CIRCUITS INSTALLED: APPLICATION AND STATE THAT THE ABOVE 19 CORRECT LIGHTS RECEPTACLES AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES MOTORS AND STATE LAWS REGULATING ELECTRICAL WIRING. NUMDER HORSEPOWER I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS FEE ANGELES COUNTY LICENSE, OR 1 AM TH LEGAL OWNER NEW MVO. HP OVER I IN0. EACH OF THE RESIDE TIAL ROPERTY DESG IBED A OVE. 9 LES9 S .25 +/z 2 .50 / SIGNATURE OF / PERMITTE 2 5 1.00 5 15 1.50 INSPECTION RECORD 15 50 2.50 - 50 200 5.00 200 500 10.00 500 1000 15.00 Q OVER 1000 20.00 Z M.G. SET/FRED. CHANGER-HP E WELDERS: AC-KVA Q GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS 75% OF ORIG.) MOVED MOTORS (]5% OF ORIG.) MISC. SIGNS TYPE: NO. TRANS. TYPE: NO. LAMPS. APPROVALS DATE INSPECTOR'S NAME FOR EACH PERMIT: CONDUIT WIRING $1.00. l3'fJ WIRING �/.-3Q�/ f/• AA/.s FIXTURES 81.00 6'b SUPPLEMENTARY .SO FIXTURES i 7 POWER TOTAL FEE 5 36 UTILITY CO. NOTIFIED �f &4 FINAL L�1 u -yGRKER$'CGMPEN$ATION DECLARATION m-coty olnv s/e) APPLICATION 11 ®IA ELECTRICAL PERMIT O II`iSereby affirm that I have a certificate of consent to self ce"rya i'U i'9 WI R P9 insure, or,a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certified copy thereof (Sec. 3800, Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB' .�y) r N/ ��L'J JZ J,( Certified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE ADDRESS b /V Certified copy is filed with the county building inspec- 18 2-Family, Sq. Ft. $ _ $ LOCALITY tion department. Multi-family Sq. Ft. NEAREST j �.r _1u�IJ� ✓1 Residential Swimming Pools CROSS SO LN] T. Date Applicant OWNER OR FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec_LightSw._ MAIL SY. ,./ COMPENSATION INSURANCE First 20 ADDRESS V• (This section need not be completed if the work involved by Total No. Additional CITY ��,• Tel. No.l� '��' the permit is for one hundred dollars ($100) or less.) ' certify that in the performance of the work for which this PLAN CHECAPPLICANT permit is issued, I shall not employ any person in any manner Lighting Fixtures First 20 ADDRESS so as to become subject to the Workers'Compensation Laws. Additional Total No. CITY Tel. No. Dote Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of APPLICATION Exemption, you should become subject to the Workers' Range— Hedter—D.W. Compensation provisions of the Labor Code, you must forth- Oven — Dryer _L W.M.L ADDRESS with comply with such provisions or this permit shall be Top — FAU —W.H. deemed revoked. - fZJ "2 /y �p CITY Tel. No. Hood — Fan —Other— LICENSED Other—LICENSED CONTRACTORS DECLARATION LICENSE OR Disp. — Room Air Cond. 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 Power Apparatus 8 Large Appliances DISTRICT NO. FROG ED Y d and Professions Code,and my license is in full force and effect. Size 8 Type HE, KW, KVA, or KVAR © O License Number Lic. Class Up to 1 Incl. FINAL U Over I to 10 Incl. DATE t Contractor Date '�! 7/ VALIDATION ❑ Over 10 to 50 Incl. H FINAL / ^ LU I am exempt under Sec. Over 50 to 100 Inc. BY I `7}/ B.BP.C. for this reason Over 100CL ' Services, Swbd., MCC 8 Ponelboards D �I Date: 0- 200 Amp. Under 600 V Z Signature 201 - 1000 Amp, Under 600 V El Exemption 1000 Amp. or Over 600 V Exemption for Reg. Maint. Elect. SINGLE FAMILY Temp. Power Pole 8 Appte urnances HOME OWNER-BUILDER DECLARATION ^ hereby affirm that exempt from the Contractor's License Sign with One Branch Circuit {;!,:(, ,v Law for the followingg reason (Section 7031.5, Business and Additional Sign Branch Circuits Professions Code): - '21'`� 4i.' Misc. Conduits 8 Conductors +. 1 I, as owner of the property, will do the work and the i i EA17 structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ 't Business and Professions Code). L = "1- CONSTRUCTION LENDING AGENCY �•iiG'_ ii,. 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) �1- (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name II711_.}'_loll): ','�1 ,P; PERMIT ISSUING FEE Lender's Address TOTAL FEE -All 1_'.�7 - n� ��c! I certify that I have read this application and state 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- ntiq roperty for inspection purposes. t Z spy SEE REVERSE FOR EXPLANATORY LANGUAGE Signature Permittee Dote - • COUNTY OF LOS ANGELES TEMPLE. CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0405260014 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: S PAID - BUILDING ADDRESS:- ON FILE 5729 ENCINITA AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802418 ASSESSOR INFORMATION NUMBER: NEAREST,CROSS STREET: 5387-018-013 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, C GI OUTLETS-LGT,SW,RECP 10.00 OUT 19.50 TENANT: G2 LIGHTING FIXTURES 6.00 LGT 11.70 Ts-s-u-E-D--oN: PROCESSED BY: PLAN Y: EXPIRES ON: H2 RES GRBG DISP LT 3HP 1.00 DIS 10.95 05/26/04 VG 11/22/04 H7 RES EXHAUST FANS - 1.00 EX 10.95 OWNER: TEL. NO: LB 200 AMP PANELS, MCC "1.00 PAN 38.85 FINAL DATA - - "+9L BY: CODE: TAM, SIMON - TOTAL FEES 119.70 / - 5729 ENCINITA AV ``WUR ..LLQ TEMP 917802418 DE CRI PT ION SLK ELECTRICAL FOR NEW BATHROOM APPLICANT: TEL. NO: PETRA CONSTRUCTION MANAGEMENT INC. (626) 233-8148- SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE PETRA CONSTRUCTION MANAGEMENT (626) 233-8148- ' 2550 W. MAIN ST., #211 LIC. NO TEMPORARY OWER POLE ALHAMBRA, CA 91801 761300 B _ UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: UFER GRC !. LIC. NO: ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED REPORT ID: DPR265 ROUTE TO: BS0508