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Home My Public Portal About6108 ENCINITA AVE_Electrical__ COUNTY OF IAS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0912140013 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: 6108 ENCINITA AV ON FILE IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 TEMP CA 917801636 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 15385-003-024 1A1 PERMIT ISSUANCE FEE 27.75 1 THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY, Cl I IG1 OUTLETS-LGT,SW,RECP 18.00 OUT 35.10 1 1 TENANT: IG2 LIGHTING FIXTURES 45.00 LET 72.75 11SSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: TOTAL FEES 135.60 112/14/07 SR 06/11/08 II IOWNER: TEL. NO: iF$N TE FI CODE: 1CONEY LU 626) 487-7248- ly\ 16108 ENCINITA AV 1 ITEMP 917801636 (DESCRIPTION OF WORK 1ADD 18 OUTLETS AND 45 LIGHT FIXTURES 1APPL ICANT: TEL. NO: I I I POLY DESIGN GROUP (626) 679-5238- 19960 OLIVE ST. SPECIAL CONDITIONS: ITEMPLE CITY CA 91780 CONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE ICONEY LU (626) 497-8668- 1- 16108 ENCINITA AVE. LIC. NO ITEMPORARY POWER POLE 1 1 ITEMPLE CITY, CA 91780 NONE (UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: IUFER GROUND I I I LIC. NO: IROUGH CONDUIT IROUGH WIRING /- MAIN WATER WATER LINE PLASTIC YIN METAL YIN I I OTILITY COMPANY NOTIFIED( I I 11 I I I REPORT ID: DPR265 ROUTE TO: RS0508 COUNTY OF LOS ANGELES TEMPLE CITY 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0910250019 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: FEES PAID I BUILDING ADDRESS: I ON FILE 6108 ENCINITA AV IFEE DESCRIPTION: QUANTITY: TOM: AMOUNT: ( TEMP CA 919801636 (ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET: 15385-003-024 IA1 PERMIT ISSUANCE FEE 29.95 I THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY, Cl C2 SPAS, HOT TUBS, OTHR 1,00 SPA 54.45 1 I (TENANT: III OUTLETS-LGT,SW,RECP 18.00 OUT 35.10 (ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: IG2 LIGHTING FIXTURES 3.00 LGT 5.85 110/25/07 SR 04/22/08 IH2 RES GRBG LISP IT 3HP 1.00 DIS 10.95 I OWNER: TEL. NO: IH3 RES DISHWASHR LT 3HP 1.00 DIS 10.95 IF NAL DATE FIDIAL BY: CODE: IMR. CONEY LU 626) 489-7248- IH4 RES RANGE HIS LT 3HP 00 H00 10.95 1 _ 16108 ENCINITA AV ILB 200 AMP PANELS, MCC 1.00 PAN 38.85 ITEMP 917801636 1 TOTAL FEES 194.85 1DESCRIPTION OF WORK 1 1ELECTRICAL FOR NEW ADDITION, REMODEL AND UPGRADE SERVICE IPANEL TO 200 AMP (APPLICANT: TEL. NO: 1 IPOLY DESIGN GROUP (626) 679-5238- 19960 OLIVE ST. SPECIAL CONDITIONS: ITEMPLE CITY CA 91780 (CONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE 1 ' ICONEY LU (626) 497-8668- 16108 ENCINITA AVE. LIC. NO ITEMPORARY POWER POLE ITEMPLE CITY, CA 91780 NONE 1 (UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: 1UFER GROUND I I I LIC. NO: IROUGH CONDUIT 1 IROUGH WIRING 1(/) I (MAIN WATER LINE I PLASTIC Y/N METAL Y/N ((UTILITY COMPANY NOTIFIED �- I I I I I I I I I I I I I I I I II III 111 11 II I I I I I I 111 111 I I I (III I I I I I II 11 11 II I I I I I I III 111 III IREPORT IO: DPR265 ROUTE TO: BS0508 I WORKERS' COMPENSATION DECLARATION zo-aow oaw siev APPLICATION ��n ��p��®fin ®�, ELECTRICAL ECTRI r A L PERMIT it hereby affirm that I have a certificate of consent to self •76A663 P'i L A II I IL is P9 lG �/A II insure, or a certificate of Workers'-Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certified copy thereof (Sec. 3600, Lob.'G)' ' Policy No. Company FOR APPLICANT TO FILL IN JOB /:/O /17 Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO, FEE ADDRESS C!/ Certified copy is filed with the county building inspec- 1 8 2-Family, Sq. Ft. $ _ $ LOCALITY 7 Han department. Multi-family Sq. Ft. NEAREST CROSS Residential Swimming Pools OWN ERSOR T. Date Applicant FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec_LightSw._ MAIL COMPENSATION INSURANCE ADDRESS First 20 (This section need not be completed if tha work involved by Total No. Additional C Tel. No� the permit is for one hundred dollars($11 00)or less.) PLAN CHEC I certify that in the performance of the work for which this \ .. I APPLICANT permit is issued, I shall not employ any person in any manner so as to become subject to the Worker$'Compensation Laws. Lighting Fixtures First 20 ADDRESS Additional Total No. CITY Tel. No. Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of Fixed Appliances Not Over I HP PERMIT Exemption, you should become subject to the Workers' Range— Heater—D.W. — APPLICATION 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_ CITU Tel. No. LICENSED CONTRACTORS DECLARATION LICENSE OR Disp. __ ROom Air Cond. REG. NUMBER Class. Thereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NO. PRO ED BY > and Professions Code,and my license is in full force and effect. , �' (J' n- ' d Size & Type HP, ON, KVA, or KVAR LLL.L/�/// O License Number Lic. Class Up to 1 Incl. FINAL / p Q O Over 1 to 10 Ind. DATE I��ZO �` - VALIDATION Cc Contractor Date Over 10 to 50 Incl. / 0 F1FINAL am exempt under Sec O Over 50 to 100 Inc. BY W B.&P.C. for this reason Over 100' d Services, Swbd., MCC& Panelboards fn Date: 0- 200 Amp. Under 600 V Ifo /J1 D Z Signature 201 - 1000 Amp.Under 600 V O - Over 1000 Amp. or Over 600 V Exemption for Reg. Mainz. Elect. SINGLE FAMILY Power Pole 8 Appurtenances. HOME OWNER-BUILDER DECLARATION TempHLiT a I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit :. +'v Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits Professions Code): NA i T_'_. kN I, as owner of the property, will do the work and the Misc. Conduits &Conductors _ _ structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ D OTA ,3--'r�L' r: 0172 .Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for "Ht'F��]E the performance of the work for.which this permit is issued PERMIT FEE (Sub-Total) r�3Q (Sec. 3097, Civ. C,). PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE OD `f t�Il_I 1 Ari `ICY Lender's Address 2 / I certify that I have read this application and state that the TOTAL FEE ✓ Ca 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,-me property for inspection purposes. ` J SEE REVERSE FOR EXPLANATORY LANGUAGE ;g Lure Permittee Date ~� ®'