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Home My Public Portal About4858 FIESTA AVE_Electrical__ 76A663 CE806 8/63 APPLICATION FOR ELICICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER r.,-1. BUILDING BUILDING AND SAFETY DIVISION ADDRESS JOHN A LAMBIE COUNTY ENGINEER WILLIAM A JENSEN SUP T OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST RECEPT TOTAL NO EACH FEE OUTLETS FIRST 20 $20 $ Q OWNER LIGHT MAIL ADD L ADDRESS O SWITCH � � OVER 20 10 LIGHTING TOTAL FIRST 20 20 CIT TEL NO FIXTURESADD L 10 ELEC ICIAN I OVFR 2O RANGES CLO DRYERS WTR HTRS too ADDRESS l GARB DISP STA COOK -7� CITY04 TEL NO V �- DISHWASH AUTO WASH STATE / �( /� SPACE HTRS STA APP (,/a H P MAX ) 50 LICENSE NO / Q J MOTORS OVER NOT OVER HP DISTRICT NO GROUP ZQNE P CESSED BY 0 1 11001 I 3 150 INSPECTION .,RECORD S S 200 o O 8 Is 250 V 15 50 s 00 O 50 100 500 ~ u W SIGNS NO TRANS D_ NO LAMPS h Z SERVICE O 600V NOT OVER 200A 1100 SERVICE O 600V OVER 200 A 200 SERVICE OVER 600V 500 MISC PERMIT ISSUING FEE 200 (J SUPPLEMENTARY PERMIT ISSUING FEE 100 TOTAL FEE $ 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT 1 WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING f �,f�'A�,t ELECTRICAL WIRING WIRING 7�/J1.17/(d 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR TUTAMHE LEGAL OWNER OF THE ABOVEDESCRIBED R0 RTYLAPOWERSIGNATURE / / _ UTILITY CO NOTIFIEDOF PERMITTWW l FINAL LIDATION ARTHUR C VEIT CK MO CASH SUPERVISING ELECTRICAL ENGINEER LAG-)9 7 2 1' MAR 1 9 2 0 5 2 O N lz WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) 76A663 APPLICATION_ FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self insure, 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.) r f Policy No. C Companyjqk�r _ C ry7Tw~� FOR APPLICANT TO FILL IN JOB ESS J7 ` Certified co Is hereby furnished. NO. EACH FEE / PY Y New Residential Bldgs.&Pools LOCALITY TV Certified co is filed with the count building inspection rlvf 1 &2-Family,Sq. Ft. PY Y g P NEAREST department. / Multi-family Sq. Ft. CROSS ST. L�wc /L A LLis� 6: LIS' �C�L X/ Residential Swimming Pools ASSESSOR Date ApplicantMAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS Outlets:Rec. Light Sw. RRM NAME COMPENSATION INSURANCE First 20 MAIL (This section need not be completed if the work involved by the Total No. Additional ADDRESS permit is for one hundred dollars($100)or less.) I certify that in the performance of the work for which this permit CITY Tel.No. is issued. I shall not employ any person in any manner so as to PLAN CHECK 6 become subject to the Workers' Compensation Laws, Lighting Fixtures First 20 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 PERMIT1' provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances APPLICANT /` LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS 5-31 S�/1 _"/ d !C I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. Y! (commencing with Section 7000) of Division 3 of the Business and CITY f�7 . Tel.No. Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. >. LICENSE OR (� !� Z^ Class. _ Over 50 to 100 Incl. REG.NUMBER T' 1� J n- Gi Over 100 DISTRICT NO. PROCESSED BY 0 �+ License Number 00 Lic.Class `� Services,Swbd.,MCC&�a (boards FINAL Cc RC1 CLLR. Contractor " LDate S C 0-399 Amp. Under 600 V O DATE ❑ I am exempt under Sec. 400-1000 Amp. Under 600 V f � � Z I 1 Over 1000 Am or Over 600 V VALIDATION P FINAL d B.&P.C.for this reason BRANCH CIRCUIT FEES BY 0 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.Maint. Elect. 15A,20A,208V To 277V Lighting Br.Circuits 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 for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits Code): ❑ I, as owner of the property, will do the work and the structure Misc.Conduits&Conductors is not intended or 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 vl'� 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 a St a laws regula Iectrical wiring,and hereby authorize representa' es is County t en r upon the ove-mentioned property for ins_A oses. SEE REVERSE FOR EXPLANATORY LANGUAGE REO P I E DATE `WORKERS' COMPENSATION DECLARATION 76-663 t0/81 APPLICATION FOR ELECTRICAL PERMIT f'Ihereby aff?rrri'ttiat I have a certificate of consent to self insure, CE-Bose or a-certificate of Workers' Compensation Insurance, or a certified COUNTY OF,LOS ANGELES BUILDING AND SAFETY copy thereof (Sec.3800,Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB �C ❑ Certified copy is hereby furnished. New Residential Bldgs.& Pools EACH NO. FEE ADDRESS E 1:1Certified copy is filed with the county building inspection 1 & 2-Family,Sq.Ft. $ — $ LOCALITY department. Multi-family Sq.Ft. — NEAREST CROSS ST. Date Applicant Residential Swimming Pools OWNER OR.4+.,, IRM NAME (/` CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec L Light w. MAIL / a COMPENSATION INSURANCE `"0 '7Z) rTD. ADDRESA-' g GS / VQ (This section need.not be completed if the work involved by the First 20 CITY � � � i,t Tel.No. , permit is for one hundred dollars ($100)or less.) Total No..0> Additional I certifythat in the'performance of the work for which this permit PLAN CHECK p 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 ADDRESS Total No. Additional D-U �' CITY Tel.No. Date Applicant Fixed Appliances Not Over 1 HP NOTICE TO APPLICANT: If, after making this Certificate of PERMIT Exemption,,you should become subject to the Workers'Compensation, Range_ Heater_ D.W. APPLICANT Z-G provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer _ W.M. _ ADDRESS provisions or this permit shall be deemed revoked. •Top — FAU _ W.H. CITY Tel.No. LICENSED CONTRACTORS DECLARATION Hood Fan Other_ I hereby affirm that I am licensed under provisions of Chapter 9 LICENSE OR (commencing with Section 7000) of,Division 3 of the Business and Disp. — Room Air Cond. REG.NUMBER Class. Professions Code,and my license is in full force and effect. DISTRICT NO. P SSED BY Power Apparatus& Large Appliances >; Size& Type HP, KW,KVA,or KVARU License Number Lic.Class Up to 1 Inct. FINAL Over 1 to 10 Incl DATE VALIDATION Q Contractor Date Over 10 to 50 Incl. U FINAL El I am exempt under Sec. Over 50 to 100 Inc. BY i1 BAP.C.for this reason Over 100 N Services, Swbd.,MCC& Panelboards Date: 0- 200 Amp.Under 600 V Signature 201 - 1000 Amp.Under 600 V E] Exemption 1000 Amp.or Over 600 V Exemption for Reg.Maint.Elect. 2 SINGLE FAMILY Temp.Power Pole& Appurtenances ACCT.®r HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit A I hereby affirm that I am exempt from the Contractor's License Law 79.70 for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits Code): ' 1 ITEM -7� I,as owner of the property,will do the work and the structure Misc.Conduits& Conductors TOTAL is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) and Professions Code). 04ECK 79074 CONSTRUCTION LENDING AGENCY CHANGE o44 I hereby affirm that there is a construction lending agency for the f� performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total) a U Civ.C.). PLAN CHECKING FEE OM-4441 1/ 8/96 Lender's Name 4125 1 AM 14 o 43 PERMIT ISSUING FEE 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 regulating Electrical wiring, and hereby authorize repre seof this County to e er ropert s pon the above mentioned re of pecti rposes. SEE REVERSE FOR EXPLANATORY LANGUAGE S,gnatuPetee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS EL 0508 9807230013 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 14647 LT: 7 4858 FIESTA AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803814 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LA ROSA 8590-017-013 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A5 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT,SW,RECP 4.00 OUT 7.80 TENANT: G2 LIGHTING FIXTURES 1.00 LGT 1.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: H7 RES EXHAUST FANS 1.00 EX 10.80 07/23/98 UT 07/23/99 TOTAL FEES 48.30 OWNER: TEL. NO: FINAL DATE FINAL BY: CODE: LIU STEVEN H;TRACY L (626) 285-2389- 7 4858 FIESTA AV L--v-48 TEMP 917803814 DESCRIPTION OF WORK ELECTRICAL FOR 3RD IN EXISTING SJ. FT APPLICANT: TEL. NO: SAME AS OWNER SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO TEMPORARY POWER POLE UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: UFER GROUND LIC. NO: ROUGH CONDUIT ROUGH WIRING / MAIN WATER LINE �(,1 PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIF REPORT ID: DPR265 ROUTE TO: BS0508