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Home My Public Portal About4933 FIESTA AVE_Electrical__ T1 EPOPL IE CRY"LF 76A666-CE6064.60 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS IZ232 JOHN A.LAMBIE, COUNTY ENGINEER WILLIAM A.JENSEN, SUP•TOF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. PERMIT FEES OWNER ITEM NUMBER EACH FEE AIL OUTLET :. ^ $ $ ADORES LIGHTS RECEPT SW. ee .10 LIGHTING FIXTURES CITY TEL.NO r .10 ELEC. RANGES CLO. DRYERS � ELECTRICIAN WATER HEATERS .50 J V ADDRESS ELEC.SPACE HTRS�DISHWASHERS CITY TEL.NO. F GARBAGE DISPOSERS AU-TO.-/ STATE WASHERS STA.COOKING UNITS ,2g LICENSE NO. y1^ MOTORS: OVER INC. H.P. DISTRI GROUP ZONE PR ESSED BY O — V2 +iz — 2 _ 50 INSPECTION RECORD 2 — s 1.00 nom. 5 — 1s 1.50 O V Ix 15 — 50 2.50 0 50 — 200 5.00 W e.; SIGNS: NO TRANS. - N NO. LAMPS Z SERVICE 0.600V 1.00 s,- SERVICE OVER 600V 5.00 MISC. r .i; WIRING PERMIT 1.00 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT 50 TOTAL FEE HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION i APPROVALS _ DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT L = ELECTRICAL WIRING. WIRING . I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. POWER SIGNATUREUTILITY CO. NOTIOF PERMITTEE 24�2FINAL t IDATION ARTHUR C.VETT. CK MO CASH SUPERVISING ELECTRICAL ENGINEER ♦. .� �� 11 f.. U tom, 7 .`J 76A663-CE�0612/75 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES f"• DEPARTMENT OF COUNTY ENGINEER JOB JADDREss 4933 Fiesta BUILDING AND SAFETY DIVISION FOR APPLICANT F N OCALITY Temple it New Residential Bldgs& Pools EACH NO. FEEEAREST 1 & 2-Family, Sq. Ft. $ 025 — g ROSSSTMulti-famil S Ft. ,02 — WNER OR Multi-family q. FIRM NAME J. Gourley Residential Swimming Pools 20.00 MAIL ADDRESS 4933 Fiesta Outlets: Light,Switch & Receptacle CITY Temple City Tel.No. 286-3393 First 20 .50 PLAN CHECK Additional .30 APPLICANT ADDRESS Lighting Fixtures First 20 .50 CITY Tel.No. Additional .30 PERMIT APPLICANT AAA Conditioned Air Inc. Fixed Appliances Not Over 1 HP ADDRESS 925 Rosemead Blvd. Range_Heater_D.W._ CIT""Rosemead Tel.No. 288-6431 Oven=Dryer_W.M._ LICENSE OR Top FAU W.H._ REG.NUMBER 293529 Class.0-20 Hood_ Fan 2.00 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION Disp._A.C. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING Power Apparatus& Large Appliances ELECTRICAL WIRING. Size & Type HP, KW, KVA, or KVAR I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF Up to 1 Incl. 2.00 JC CALIFORNIA$.00 OR HA1 I AM THE LEGAL OWNER OF THE ABOVE ®. Over 1 t0 10 Incl. DESCRWED R I NTIAL PROPERTY. Over 10 t0 50 Incl. 10.00 PERMITEE U Over 50 to 100 Incl. 20.00 SIGNATURE CA Over 100 30.00 DISTRICT NO. OC SSED BY Services . 0 � 0- 200 Amp. Under 600 V 12.50 INS ECTOR'S 96 201-1000 Amp. Under 600 V 25.00 APPROVALS DATE SIGNATURE Vf Over 1000 Amp. or Over 600 V 50.00 TEMP.POWER POLE Temp. Power Pole& Appurtenances 10.00 UN DERSLAB WORK Sign with One Branch Circuit 10.00 ROUGH CONDUIT Additional Sign Branch Circuits 2.00 WIRING (Other) FIXTURES POWER AUTHORIZED UTILITY CO.NOTIFIED FINAL PERMIT FEE (Sub-Total) NOTES PLAN CHECKING FEE (One-Fourth Permit Fee) PERMIT ISSUING FEE $6.99– TOTAL FEE PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION MO. CASH s 3 s :,APR 2 1 2 ® 1 0.5 0 08 SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT I hereby af�ftrm 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 FORKS BUILDING AND SAFETY DIV. copy thereof(Sec. 3800 Lab. C.) Policy NO. Company FOR APPLICANT TO FILL IN JOB ADDRESS ` G Certified copy is hereby furnished. New Residential Bldgs.&Pools NO, EACH FEE r _ El _ $ $ LOCALITY Certified copy is filed with the county building inspection 1 &2-Family,Sq.Ft. department. Multi-family S Ft. NEAREST p y q� CROSS ST. C Date Applicant Residential Swimming Pools ASSESSOR MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec.L Light Sw. OWNER OR COMPENSATION INSURANCE FIRM NAME L Q First 20 (This section need not be completed if the work involved by the .dao ADDADDRESS permit is for one hundred dollars($100)or less.) Total No.� Additional RESS Zi e I certify that in the performance of the work for which this permit CITY Tel. is issued, I shall not employ any person in any manner so as to PLAN become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 �9 APPLICANT K Total No. Additional ADDRESS Date Applicant RESIDENTIAL �TTM3�P. NOTICE TO APPLICANT: If, after making this Certificate of � CITY Tel.No. Exemption, you should become subject to the Workers' Compensation OTHER AP O 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 �G 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. Over 50 t0 100 Incl. REGNNUMBER Class.SE OR d Over 100 DISTRICT NO. PROCESS E 0 License Number Lic.Class Services,Swbd.,MCC&Panelboards �� Cc Contractor Date 0-399 Amp.Under 600 V FINAL O DATE I ❑ I am exempt under Sec. 400-1000 Amp.Under 600 V VALIDATION U Over 1000 Amp.or Over 600 V UJ FINAL IZ B.&P.C.for this reason BRANCH CIRCUIT FEES BY (n Date: 15A,or 20A, 120V,Lighting or Recept. Z 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits El41 Or More Branch Circuits Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits 2 SINGLE FAMILY Temp.Power Pole&Appurtenancest s HOME OWNER-BUILDER DECLARATION ACC t .1I I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit t�ya�;)� for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits 3 ; 60 Code): 1 ITEMS ❑ I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors TOTAL 1130 is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) CHECK and Professions Code). ' lf7El;''f` l�vi�iJ CONSTRUCTION LENDING AGENCY CHANGE a Oct 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) d Civ.C.) PLAN CHECKING FEE 0070-0001 6/119 Lender's Name 6826 1 Yfif 8*-56 PERMIT ISSUING FEE ` b Lender's Address I certify that I have read this application and under penalty.of purjury state TOTAL FEE O �® 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-mentioned property for inspection purposes. j SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE OF PERMITTEE / DATE