HomeMy Public PortalAbout4881 FRATUS DR_Electrical__ DEIS SA 3 55 APPLICATION FOR ELECTRIC ROM 0 ERMIT 1
DBS SA
DIVISION OF BUILDING AND SAFETY
Department of County Engineer
County of Los Angeles BUILDING i
WM J FOX, COUNTY ENGINEER /6�"" ADDRESS
CASSATT D GRIFFIN SUPT OF BUILDIN
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
PERMIT FEES CROSS ST
NUMB R EACH FEE �r
OWNER
_LIGHT OUTLETS •r _
MAIL Y f +�
RECEPTACLES ADDRESS - .�// •"'l�
WALL SW ITCHES °y/�'�
TOTAL OUTLETS �' 5Q $ r/ ,tj� CITY lei TEL�yNO _ !) /I
ELEC RANGES 25 ELECTRICIAN- G f
_ELEC HEATERS 25 ADDRESS 1Lv
KW EA CITY ,.''! -TEL NO
FIXTURES 7 1 5 �� LICENS NO r
NUMBER OF LIGHT CIRCUITS -—dDISTRICT NO I GROUP I ZO /�IE I READY FOR INSPECTION
NUMBER OF RECEPTACLE CIRCUITS !� ,+(//JJ.�3
MOTORS
NUMBER FEE HORSEPOWER INSPECTION RECORD
NEW MVD HP OVER I INC EACH
1/Z&LESS $ 25
1/2 2 so
2 5 1 00
5 15 ISO
15 1 50 250
50 1 200 5 00
MISC
NO SIGNS NO TRANS
NO SIGNS NO LAMPS
FOR EACH PERMIT
WIRING $100
FIXTURES $1 00
SUPPLEMENTARY 50 I APPROVALS
TOTAL FEE I S DATE INSPECTOR S SIGNATURE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CONDUIT 17-:2J.-d -7S ! .
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING •77 7 r+1GQ/�!b•—�
ELECTRICAL WIRING 1
1 HEREBY CERTIFY THAT 1 AM PROPERLY,REGISTERED AND/OR FIXTURES !-U AAX 7r
LICENSED AS REQUIRED B. LOS ANGELES QOUNTY AND STATE OF
CALIFORNIA OR TI+AT 1`AM THE LEGAL WNER F T E ABOVE POWER
DESCRIBED RESIDENTIAL ROP
SIGNATURE
PERM TTEE UTILITY CO NOTIFIED 't7
FINAL
WILLIAM J. FOX, COUNTY ENGINEER VALIDATION A. C VEIT, CHIEF ELECT. INSPECTOR
AC; 8 4 0 2- 14AY 21 2 6 00 Gn
' �r! ��
76AI0.' E��4.68 APPLICATION FOR ELECTRICAL PIERMIT
COUNTY OF LOS ANGELES
DEPAF;TMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
ADDRESS
JOHN A LAMBIE. COUNTY ENGINEER O
COLEMAN W JENKINS, SUPERINTENDENT OF BUILDING LOCALITY /�–
NEAREST
FOR APPLICANT TO FILL IN CROSS ST l O /LjLBN F7'O
NO EACH FEE
$ $ OWNER
RECEPT
MAIL
LIGHT TOTAL FIRST 20 7j0 20 Cie) ADDRESS QQ _
SWITCH OVER 20 10 CITY TEL NO
r, PLAN CHECK
LIGHTING TOTAL FIRST 20 `f' 20 �� APPLICANT
FIXTURES "l OVER 20 10 ADDRESS `
RANGE_DRYER—WTR HTR _ CITY TEL NO `
STA COOK_OISP F A U
CON TRAC rOR 0,. ,R�N.4c-t-
SPACE HTR AIR COND X ADDRESS lZktl` Y' � �AA/,4
CLOTHES WASH —DISHWASH CITY �L d��� TEL NO
FAN OTHER 1 00 GD -
LICENSE 1-40nO (4v .5r_ n CLASS �—!O
MOTORS TRANSFORMERS RATING
IND HEATERS ETC HP KW KVA I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
SIZE & TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING
0 – 1 1 00
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
1 – 10 3 00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
10 – 50 5 00 RESIDE IN THE ABOVE OES('RIPED RES NTIAL PROPERTY O
� U
SIGNATURE
50 – 100 10 00 OF PERMITTEE p
100 — 500 15 00 DISTRICT NO GROLIPJ ZONE i PRO 'XID BY w
SIGN GAS SIGN AND ONE CIRCUIT 1 3 00 1S� Q V)
TUBE OR Z
MARQUEE ADDITIONAL CIRCUITS 1 00 qq NOTES i
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00 f+ rlD
SERVICE OVER 600 VOLTS OR 200 AMP 5 00
TEMP SERVICE POLE &APPURTENANCES 3 00 APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP POWER POLE '
UNDERSLAB WORK
ROUGH CONDUIT a•
PERMIT FEE (SUB TOTAL) WIRING G_s +
FIXTURES
PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED
PERMIT ISSUING FEE 2 00 UTILITYCO NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1 00FINAL V
TOTAL FEE `^ JOSEPH C ROOHAN
SUPERVISING ELECT AL ENGINEER
PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION cK M O CASH
0 2 a Troy 2 g p 1 0.8 0
i
SEE BACK OF APPLICATIOWFOR COMPLETE FEE SCHEDULE I'
WORKERS'COMPENSATIONDECLARATION 63
CE806G (2 801 APPLICATION FOR ELECTRICAL PERMIT
CE 8IJ 1
I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY
insure, or a certificate of Workers Compensation Insurance,or
a certified copy thereof(Sec 3800,Lab C)
FOR APPLICANT TO FILL JOB
Policy No EACH NO FEE ADDRESS
Company N
New Residential Bldgs &Pools
F1 Certified copy is hereby furnished 1 &2-Family,Sq Ft $ — $ LOCALITY ��W
❑ Multi-family Sq Ft — NEAREST _
Certified copy is filed with the county building inspection CROSS ST�W
department Residential Swimming Pools ORM NOR
AME t D
c �a cS
Date Applicant Outlets Rec_Light Sw MAIL
First 20 ADDRESS
CERTIFICATE OF EXEMPTION FROM WORKERS' Total No Additional CITY
COMPENSATION Tel No Z9 >_COMPENSATION INSURANCE PLAN°CHECK d
APPLICANT r LJ Q >0 0
(This section need not be completed if the work involved U
Lighting Fixtures First 20 ADDRESS
by the permit is for one hundred dollars ($100) or less) Additional
Total No
I certify that in the performance of the work for which this CITY No 0
Fixed Appliances Not Over 1 HP
permit is issued, I shall not employ any person in any manner PERMIT 0
LU
so as to become subject to the Workers' Compensation,Laws Range_ Heater_D W APPLICANT O a-1��5 d
Oven _Dryer_W M ADDRESS U)
FAU _W H Z
Date Applicant Top _ '
Hood _ Fan —Other CITY Tel No
NOTICE TO APPLICANT If, after making this Certificate of Disp _ Room Air Cond_ LICENSE OR
Exemption, you should become subject to- the Workers' REG NUMBER Class
Compensation provisions of the Labor Code, you must forth Power Apparatus& Large Appliances DISTRICT NO p PR C S D BY
with comply with such provisions or this permit shall be Size&Type HP,KW, KVA,or KVAR y
deemed revoked Up to 1 Incl !J
Over 1 to 10 Incl Q FINAL /
LICENSED CONTRACTORS DECLARATION DATE VALIDATION
Over 10 to 50 Incl a
I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc FINAL �f
9 (commencing with Section 7000) of Division 3 of the Busi Over 100
ness and Professions Code, and my license is in full force and
effect Services
License Number Lic^Class 0-200 Amp Under 600 V
201-1000 Amp Under 600 V
Contractor Date Over 1000 Amp or Over 600 V ;20409A
HOME OWNER-BUILDER DECLARATION Temp Power Pole&Appurtenances
I he by affirm that I am exempt from the Contractor's Sign with One Branch Circuit # 0 0 0 0 0 2 s
Additional Sin Branch Circuits
Lw se Law for the following reason (Section 7031 5, Busr g r 2 0 0 1 ,700
ne and Professions Code) +
Misc Conduits& Conductors o o o 1 70060
[, as owner of the property, will do the work and theOi
V er (See Complete Fee Schedul
e)—
structure is not intended or offered for sale (Section / az_ 71.2,0-81
7044, Business 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 PERMIT FEE (Sub-Total) 0
issued(Sec 3097,Civ C)
Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee)
Lender's Address PERMIT ISSUING FEE
I certify that I have read this application and state that the TOTAL FEE
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 perty for inspection purposes
I SEE REVERSE FOR EXPLANATORY LANGUAGE
L�`� 1
Signature of Pe i e Date
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0606260002
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID FEES PAID BUILDING ADDRESS
TR 22321 LT 12 4881 FRATUS DR
FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917803718
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET RIO HONDO
8590-030-037 Al PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID JS LOCALITY TEMPLE CITY, C
LB 200 AMP PANELS, MCC 1 00 PAN 38 85
TENANT TOTAL FEES 66 60 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON
06/26/06 JK 12/23/06
OWNER TEL NO FI�ALFy / FINAL BY � CODE
OTODAWNER
MASAFUMI,EIKO - Cc/J�,J�`y��—?C/�/ ��1[�4\`��
4881 FRATUS DR
TEMP 917803718 DESCRIPTION OF WORK
SERVICE UPGRADE FROM 100 AMP TO 200 AMP
APPLICANT TEL NO
BAHENA (626) 454-1216-
4136 EUNICE AVE SPECIAL CONDITIONS
EL MONTE CA 91731
CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE
BAHENA ELECTRIC (626) 454-1216-
4136 EUNICE AVENUE LIC NO TEMPORARY POWER POLE
EL MONTE, CA 91731 486181 C10
UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER TEL NO UFER GROUND
LIC NO ROUGH CONDUIT
ROUGH WIRING
MAIN WATER LINE
PLASTIC Y/N METAL Y/N
UTILITY COMPANY NOTIFIED ' G
i
REPORT ID DPR265 ROUTE TO BS0508
r•
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0711150051
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID FEES PAID BUILDING ADDRESS
ITR 22321 LT 12 4881 FRATUS DR
I IFEE DESCRIPTION QUANTITY UOM AMOUNT I TEMP CA 917803718 1
(ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET RIO HONDO
18590-030-037 1A1 PERMIT ISSUANCE FEE 27 75 I THOMAS PAGE 596 GRID J5 LOCALITY TEMPLE CITY, Cl
I IG1 OUTLETS-LGT,SW,RECP 5 00 OUT 9 75 1
ITENANT 1G2 LIGHTING FIXTURES 2 00 LGT 3 90 (ISSUED ON PROCESSED BY PLAN BY EXPIRES ON 1
I 1 TOTAL FEES 41 40 111/15/07 SR 05/13/08
1OWNER TEL NO 1 IFINAL DATE FINAL Y CODE 1
ITODA MASAFUMI,EIKO (626) 285-0311- I
14881 FRATUS DR
1
1 14-�
ITEMP 917803718 1 IDES RIPT ON OF WORK I
(ELECTRICAL FOR ADDITION
(APPLICANT TEL NO 1 I
ITODA (626) 285-0311- 1 1
14881 FRATUS DR I ISPECIAL CONDITIONS I
ITEMPLE CITY CA 91780 1 I
1 I I I
ICONTRACTOR TEL NO I (APPROVALS DATE INSPECTOR SIGNATURE 1
ITODA, MASAFUMI (626) 285-0311- 1 1 I
14881 FRATUS DR LIC NO I ITEMPORARY POWER POLE I I I
ITEMPLE CITY, CA 91780 NONE I I I I
I I 1UNDERGROUND CONDUIT
I I I
(ARCHITECT OR ENGINEER TEL NO 1 IUFER GROUND I I I
I I I
ITODA, MASAFUMI (626) 285-0311- 1 I I I
14881 FRATUS DR LIC NO I IROUGH CONDUIT I
ITEMPLE CITY, CA 91780 NONE I I I I
1 i ROUGH WIRING
I I IMAIN WATER LINE
1 1 (PLASTIC Y/N METAL Y/N I I I
I (UTILITY COMPANY NOTIFIEDI I I
I I I I I I
I I I I I I
I I I I I I
1 1 I I I I
I I I I I I
1 I I I I I
I I I I I I
I IREPORT ID DPR265 ROUTE TO BS0508 I I I
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1108090035
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
ILEGAL ID FEES PAID BUILDING ADDRESS
ITR 22321 LT 12 I I 4881 FRATUS DR
I IFEE DESCRIPTION QUANTITY UOM AMOUNT I TEMP CA 917803718 I
(ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET RIO HONDO I
18590-030-037 lAl PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 596 GRID J5 LOCALITY TEMPLE CITY, Cl
G1 OUTLETS-LGT,SW,RECP 1 00 OUT 1 90 I 1
ITENANT IG2 LIGHTING FIXTURES 1 00 LGT 1 90 (ISSUED ON PROCESSED BY PLAN BY
IRA FAD LESS 3HP 1 00 FAU 10 90 108/09/11 VG
1 1JB AC UNITS +3-10HP 1 00 AC 19 70 1 1
(OWNER TEL NO 1 TOTAL FEES 62 20 IF AL DATE FIN BY CODE 1
ITODA MASAFUMI,EIKO (626) 285-0311- _ I
14881 FRATUS DR I � 1
ITEMP 917803718 IDESCRIPTION OF WORK v1
1ELECTRICAL FOR HVAC I
(APPLICANT TEL NO 1
I
ICONTRERAS, CARRA (626) 286-3157- 1
ISPECIAL CONDITIONS
I
I
ICONTRACTOR TEL NO JAPPROVALS DATE INSPECTOR SIGNATURE 1
ICONNOR AIR CONDITIONING (626) 286-3157- 1
14931 ENCINITA AVE LIC NO I ITEMPORARY POWER POLE 1 I I
ITEMPLE CITY, CA 91780 403735 C2O 1
(UNDERGROUND CONDUIT 1
ARCHITECT OR ENGINEER TEL NO i IUFER GROUND I I
II
1 LIC NO 1 IROUGH CONDUIT 1
I I I
TROUGH WIRING I I 1
1 IMAIN WATER LINE I 1 I
1 1 IPLASTIC Y/N METAL Y/N 1
(UTILITY COMPANY NOTIFIEDI
I I I I
I 1 I I I I
I I I I
I
I I I I I I
1 1 I I I I
I I I I I I
1 I I I I I
I I I I I I
I I I I I I
I I
1 (REPORT IO DPR265 ROUTE TO BS0508 i 1