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HomeMy Public PortalAbout5102 FRATUS DR_Electrical__ 76ASS3 DBS SA 11-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY ' COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMIT NO. r F ELECTRICIAN RF. r r t .40 ��? `r-7�`-- • -- RECEIVED BY READY FOR DATE ISSUED ADDRESS pa. 1�6•;O'I 1 At— tFIRST INSPECTION -CITY $fin (T$beTEL- NO A (;Rq�_ k;COUNTY LICENSE NO. 1104 EXPIRES BUILDING 9219 LaRosa Dr. PERMIT FEES NUMBER EACH FEE LOCALITY Teeny Cit LIGHT OUTLETS NEAREST RECEPTACLES - 7 CROSS 9T. WALL SWITCHESOWNER Be E. Tumor TOTAL OUTLETS Sc _ MAIL ELEC RANGES 25 ADDRESS ELEC HEATERS 25 CITY TEL. NO. FIXTURES 5 L= 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS MISC APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT I POSSESS THE ABOVE VALID LOS FEE NUMBER HORSEPOWER ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER NEW MVD HP OVER INC EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. J I/2 & LESS $ 25 SIGNATURE OF 1.44 'T '/2 2 .50 PERMITTEE z s 1.00 INSPECTION RECORD 5 15 7 5O 15 50 2 50 _ 50 200 5 00 _ 200 500 10 00 111 500 1000 1500 Q [] OVER 1000 2000 J M G BET/FREQ CHANGER-HP IL WELDERS: AC-KVA GENERATORS - KW TRANSFORMERS - KVA TEMP MOTORS X75% DF DRIo) MOVED MOTORS (75% OF DRIG) MISC SIGNS NO NO TRANS APPROVALS NO NO LAMPS _ DATE INSPECTOR'S NAME FOR EACH PERMIT. WIRING $1 00 CONDUIT FIXTURES $1.00 QC! WIRING SUPPLEMENTARY .50 FIXTURES POWER TOTAL FEE $ UTILITY CO NOTIFIED FINAL WORKERS'COMPENSATION DECLARATION 76- 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self insure, CE-806G or a certificate of'Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thet�f( ec 3800 Lab C) Policy No I � FOR APPLICANT TO FILL IN JOB m ❑ Certified copy is hereby furnished EACH NO FEE ADDRESS5169.©a Pf t,(itsyr New Residential Bldgs &Pools � $ — $ LOCALITY Certified copy�is filed with the county bud1 & 2-Family,Sq Ft ding inspection — de artment Multi-family Sq Ft NEAREST CROSS CROSS ST � Date o bean CJCw Residential S ming Pools OWNER OR t PP - FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS MAIL �J�� COMPENSATION INSURANCE Outlets Recght — Sw ADDRESS (This section need not be completed if the work Involved by the First 20 al CITY Tel No permit Is for one,hundred dollars ($100) or less) Total No Additional .I certif that in the performance of the work for which this permit PLAN CHECK Y P P APPLICANT is issued, I shall not employ any person in any manner so as to become subject to the WorkersAdditional'Compensation Laws Lighting Fixtures First 20' ADDRESS ' � Total No CITY Tel No Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT If, after making this Certificate of Exemption„ _you should become subject to the Workers'Compensation Range_ HeaterDW APPLICANT / provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer _ W M _, ADDRESS^ ' C {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-9LICENSE OR Disp Room Air CondClass (commencing with Section 7000) of Division 3xof the Business and REG NUMBER Professions Code,and my license is m'full force and effectPower Apparatus& Large Appliances DISTRICT NO PROCE BY r/7 /��//) Size& Type HP, KW,KVA,or KVAR �t a License Number - 3 Lir. Class G Up to 1 Incl FINAL U Contractor ' ate i Over 1 to 10 incl DATE/S iG �/ XUDATION O ❑ Over 10 to 50 Incl FINA 4/ U i am exempt under Sec Over 50 to 100 Inc BY W B&PC for this reason Over 100 Q„ N Services,Swbd,MCC& Panelboards Date 0- 200 Amp Under,600 V r' Signature 201 - 1000 Amp Under 600 V ❑ Over 1000 Amp or Over 600 V Exemption for Reg Mamt Elect SINGLE FAMILY Temp Power Pole& Appurtenances $ 2 A HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit # o o o o o 2 1 hereby affirm that I am exempt from the Contractor's License Law Additional Sign Branch Circuits, for the'following reason (Section 7031 5,Business and Professions I o l0 1350 50 Code) ❑ I,as owner of the property,will do the work and the structure Misc Conduits & Conductors � �° °'° 1 Y5 0=� is not intended or offered for sale (Section 7044, Business Other (See Complete Fee Schedule) and Professions Code) , Q 9,3 Q'`$7 CONSTRUCTION LENDING AGENCY - I hereby affirm that there is a construction lending agency for the performance of the v rk for which this p rmit is issued(Sec 3097, PERMIT FEE (Sub-Total) - Civ C) , PLAN CHECKING FEE Lenders Name I PERMIT ISSUING FEE (1 Lender's Address I certify that I have th apple anon an to that the above TOTAL FEE information is correct I agree to comply with all Co Y ordinances and State laws regulating Electrical wiring, and hereby authorize re atives of County to enter upon the above-mentioned _ pr i rty or insp io urpos ^ SEE REVERSE FOR EXPLANATORY LANGUAGE ig *6 of P it ee Date WORKERS'COMPENSATION DECLARATION to, 86 10/81 CEAPPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to-self CE 806GG insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec 3800, Lab C ) P❑al cy No Company FOR APPLICANT TO FILL IN JOB ^ A Certified co s hereby furnished EACH NO FEE ADDRESS d J PY Y New Residential Bldgs & Pools ❑ 1 & 2-Famil S Ft $ — $ LOCALITY Certified copy is filed with the county building mspec- Y. q tion department Multi-family Sq Ft NEAREST CROSS ST Residential Swimming Pools OWNER OR Date Applicant Q FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec O Light Sw MAIL e COMPENSATION INSURANCE ADDRESS Q , as (This not be completed if the involved b First 20 ( is section neep , e worvoY Total No - CITY Tel No the permit is for one hundred dollars ($100)or less ) Additional PLAN CHECK I certify that,injthe performance of the,work for which this APPLICANT permit is issued, I shall'not employ any person in any manner so as to become subject to the Workers'Com ensatio ows Lighting Fixtures First 20 ADDRESS , TAdditional Total No CITY Tel No Date dN.Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT If, after ma ing this Certificate of APPLICANT Exemption, you should become subject to the Workers' Range_ Heater_D W Compensation provisions of the'Labor Code, you must forth- Oven Dryer _ W M — ADDRESS �`C'�' DR with comply with such provisions or this permit shall be Top FAU —W H — deemed revoked Hood _ Fan _Other_ CITY � �+� Tel No 37091 LICENSED CONTRACTORS DECLARATION Q LICENSE OR 1 hereby affirm that I am licensed under provisions of Chapter 9 D sp — Room Air Cond REG NUMBER Class (commencing with Section 7000) of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO ® PROCESSED BY and Professions Code,and m effect license is in full force and eect (/�/ Size &Type HP, KW, KVA, or KVAR 0 License Number Lic Class Up to 1 Incl FINAL / u Contractor Date Over 1 to 10 Incl DATE f `'��- VALIDATION 0 ❑ Over 10 to 50 Incl FINAL /1 P_ I am exempt under Sec Over 50 to 100 Inc BY (/ � d B &P C for this reason Over 100 L� CA Date Sery bd , MCC 8 Panelboards ► — 200 p Under 600 V Signature 201 - 1000 Amp Under 600 V ❑ Over 1000 Amp or Over 600 V Exemption for Reg Maint Elect I SINGLE FAMILY Temp Power Pole&Appurtenances r HOMEOWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits Law,for the following reason (Section 7031 5, Business and Professions Code) s 0.8a8 R ❑ I, as owner of the property, will do the work and the Misc Conduits & Conductors structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ ► Y 0 0 0 0 o 2 7044, Business and Professions Code) 2 0 e 4 1.0 0 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for o�o o 1; 1.0 0 the performance of the work for which this permit is issued PERMIT FEE -' (Sub-Total) (Sec 3097, Civ C ) 0 5 041)-8(j ¢ PLAN CHECKING FEE Lender's Name - N PERMIT ISSUING FEE Lender's Address I certify that I have read this application and state that the TOTAL FEE �0 ' 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 y the ve-menti ne pr erty for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Per Date J.. COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0311040001 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGALID: FEES PAID BUILD NG ADDRESS TR: 16475 LT: 106 5102 FRATUS DR FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803724 ASSESSOR TR-FORMATION NU B R: NEAREST CROSS STREET: LA ROSA 8590-010-006 Al PERMIT ISSUANCE FEE 27 75 THOMAS PAGE: 596 GRID: J5 LOCALITY: TEMPLE CITY H5 RES WASH MACH LT 3HP 1.00 WAS 10.95 TENANT: H9 RES APPL LT 3HP 1.00 RES 10 95 ISSUED ON- PROC SSED BY: PLAN BY EXPIRES ON: TOTAL FEES 49.65 11/04/03 VG 05/02/04 OWNER: TEL. N0: FINAL DATED FINAL BY CODE: CHAN REGINA (213) 922-7452- 5102 FRATUS DR TEMPLE CITY 91780 DESCRIPTION OF WORK INSTALL CIRCUITS FOR WASHER AND DRYER IN ENCLOSED PATIO 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 PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED REPORT ID: DPR265 ROUTE TO: SS0508