Loading...
HomeMy Public PortalAbout10511 FREER ST_Electrical__ 76A663-CE806 ,,,70 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING UIL IN BUILDING AND SAFETY DIVISION tt /� COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN ' CROSS ST. OUTLETS ND EACH I FEE OWNER Te :a r $ RECEPT. $_ MAIL LIGHT TOTAL FIRST 20 25, ADDRESS CITY �en9 TEL. N0. SWITCH, OVER 20 1p PLAN CHECK LIGHTING TOTAL FIRST 20 25 APPLICANT OVER 20 ADDRESS FIXTURES 10 - APPLIANCES CITY TEL. NO. P RANGE�DRYER—WTR.'HTR. APPLICANT STA. COOK DISP. F.A.U. - ADDRESS SPACE HTR. AIR COND. CITY TEL. NO.- - CLOTHES WASH. OISHWASH. LICENSE N0, CLASS. FAN OTHER 100 / 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ANO STATE THAT THE ABOVE IS CORRECT"AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. - SIZE & TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO >- 1 - 10 300 RESIDE IN, THE ABOVE DESCRIBED RREESSIIIDE•NTIAL ROPERT,Y a SIGNATURE _ jL O 10-- 50 500 OF PERMITTEE (fl /Vs!�el SO - lOO 1000 DISTRICT NCLASS ZON P C E Y O 1 00 - 500 1500 ✓,OO. , SIGN, GAS SIGN AND ONE CIRCUIT 500 NOTES: H Z TUBE, OR — MARQUEE ADDITIONAL CIRCUITS 100 SERVI CE NOT OVER 600 VOLTS OR 200 AMP 300 - APPROVALS DATE INSPECTOR'S SIGNATURE SERVICEOVER 600 VOLTS OR 200 AMP 10.00 . TEMP.POWER POLE TEMP SERVICE,.POLE,.&APPURTENANCES 500 ' UNDERSLAS WORK TEMP LIGHT OR,RECEPT. SYSTEM 300 ROUGH CONDIUT WIRING FIXTURES POWER AUTHORIZED PERMIT FEE (SUB TOTAL) _ UTILITY CO. NOTIFIEDS1 'Itz PLAN CHECK FEE , FINAL PERMIT ISSUING FEE 30C JOSEPH C. ROOHAN TOTAL FEE SUPERVISING ELAL ENGINEER. PLAN CHECK VALIDATION CK D CASH PERMIT VALIDAT N CK M 0 CASH LALo 4 n"6 1.,, JAN 21 2 A - 0e c SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 768663-CFBO61p/72 APPLICATION R ELECTRICAL PERMIT COUNTY OF LOS ANGELES �^ DEPARTMENT OF COUNTY ENGINEER JOB ADDRESS BUILDING AND SAFETY DIVISION LOCALITY NEAREST f /� FOR APPLICANT TO FILL IN CROSS ST. I=s2Pe�Q, OUTLETS NO EACH FEE OWNER OR b�e �� t ) -, / RM NAME `( &;r—( RECEPT.� $ $ FMAIL I ADDRESS o5Jt Fp, LIGHT 7 TOTAL FIRST 20 P9 J DU �, , v CITY ' M TEL. NO. -373 SWITCH J OVER 20 10 PLAN CHE FIRST 20 25 APPLICAN FIXTURES T LIGHTING TOTAL 10 OVER 20 ADDRESS RESIDENTIAL APPLIANCES CITY TEL. N0. PERMIT RANGE DRYER_WTR. HTR. APPLICANT STA. COOK DISP. F.A.U. ADDRESS SPACE HTR. AIR COND. CITY TEL. NO. CLOTHES WASH. DISHWASH. LICEN0 CLASS. REG. NUMSE FAN OTHER 100 D 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND HEATERS, ETC HP KW. KVA. ELECTRICAL WIRING SIZE & TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE 1 - lO 300 DESCRIPED RESID TIAL P R O PERT Y.rJ(I�� O PERMITEE o/%�//VI► V 10 - 50 500 SIGNATURE CD I- 50 - 100 1000 DISTRICT NO�� PROCESS D BY W 100 - 500 15 00 O SIGN, GASSIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECiO ' SIGHATU RE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 TEMP. POWER POLE SERVICE NOTOVER600VOLTS OR200AMP 300 UNDERSLAB WORK SERVICEOVER600VOLTS OR200AMP 10.00 ROUGH CONDUIT p TEMP SERVICE,POLE, &APPURTENANCES 500 WIRING TEMP LIGHT OR RECEPT, SYSTEM 300 FIXTURES —7e lb � r POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL 17-,2 -7 s-^'5 Q,Q PERMIT FEE (SUB TOTAL) NOTES: PLAN CHECK FEE /' PERMIT ISSUING FEE 300 3 (U0 TOTAL FEE PLAN CHECK VALIDATION cK M 0 CASH PERMIT VALIDATION CK M O. CASH © 7 31"MAY 20 2 D 1 1.8 5Ari SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 76A663-CESO612-58 APPLICATION FO R ELECTRIC PERMIT COUNTY OF LOS ANGELES • DEPARTMENT OF'COUNTY ENGINEER BUILDING �O.✓7' t. F/QE.E/Q v�'T BUILDING AND SAFETY DIVISION ADDRESS JOHN A.LAMBIE,COUNTY ENGINEER CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST 6W/f�y'e p F�,c,€R• PERMIT FEES CROSS ST. ITEM NUMBER EACH FEE OWNERMAIL `V�/YrA ,C�r-Qb� OUTLET r $ ADDRESS /OS/i '�'� 4 �C.p s� LIGHTS RECEPT. SW. / .10 4 �• LIGHTING FIXTURES ,10 CITY TEL.NO. ELEC.RANGES CLO.DRYERS ELECTRICIAN WATER HEATERS .50 ADDRESS ELEC.SPACE HTRS. DISHWASHERS v CITY L.NO. GARBAGE DISPOSERS AUTO.- STATE WASHERS STA COOKING UNITS .25 LICENSE NO MOTORS: OVER INC. H P DISTRICT NO. GROUP ZONE PROCESSED BY r 1/2— z .50 INSPECTION RECORD 2- 5 100 7-3 O / D PF_ H/TTfD 5— 15 1.50 7"0 A91F�tiT.S. 15— 50 250 � �✓/� OvT.S'/oE L/G.y 50—200 5.00 SIGNS: NO TRANS NO LAMPS SERVICE 0-600V 1.00 'G - >�`7 a r ft? SERVICE OVER 600V 500 / w MISC. O '1 I-�y� -�7l�2 pl✓i WIRING PERMIT 1.00 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .50 TOTAL FEE S 'ZQ APPROVALS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ,WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT q ELECTRICAL WIRING WIRING 'i I '�C r A- :mss- 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 / r DESCRIBED RESIDENTIAL PROPERTY. n POWER L�SIGNATUREF PERM TTEE �"�'�'• �• UTILITY CO NOTIFIED -�a '-�-,�a'7`,� FINAL .3h Ai.'- .�s5..•^mP,,b�'4�'. ®FVALIARTHUR C. VETT, DAVON1 ��� SUPERVISING ELECTRICAL ENGINEER CK MO CASH 94 7 8JUL 1 4. 2 A 2 .7 768663-CE606 iD,72 APPLICA ION- OFA ELECTRICAL PERMIT I COUNTY OF LOS ANGELES i DEPARTMENT BUILDING AND SAFETY DIVISION IER AD ADDRESS � LOCALITY /C �F ` •'i . NEAREST /c FOR APPLICANT TO FILL IN CROSS ST. hl� / OUTLETS N0. EACH I FEE OWNER OR /1 j S �E►2d s FIRM NAME Q, " =• {7/���,L�/v RECEPT._ MAIL , FIRST 20 25 JC f,a ADDRESS d,,�l� �ef'Q.- LIGHT ',TOTAL .J SWI'TCH� OVER 20 10 CITY P&a k- I'1 TEL NO. PLAN CHECK LIGHTING TOTAL FIRST 20 25 ,t. C) APPLICANT ADDRESS OVER 20 FIXTURES '� 10 RESIDENTIAL APPLIANCES clTy TEL. NO. RANGE DRYER_.W TR. HTR._ - PERMIT ICANT STA. COOK DISP. '' F.A.U. -ADDRESS SPACE HTR. AIR COND.- CITY. TEL N0. ' CLOTHES WASH.- DISHWASH. LICENSE OR REG. NUMBER CLASS. FAN OTHER - 100 I HEREBY ACK OWLEDGE THAT I HAVE READ THIS APPLICATION, AND STATE THAT THE ABOVE 15-CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LA WE REGULATING INDHEATERS, ETC HP KW. KVA ELECTRICAL WIRING SIZE & TYPE OVER TO 'HEREBY CERTIFY THAT I-AM, PROPERLY REGISTERED ANO/OR 0 - 1 100 / LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE } 1 - lO 300 DESCRIPED RESIDENTIAL P OPT � PERMITEE � � � C7 10 - 50 500 SIGNATURE O 50 - 100 1000 DISTRICT NO. SED BY CU 100 - 500, 15 00 G �' a . SIGN, GAS=SIGN ONE CIRCUIT 500 APPROVALS DATE INSPE OR'S SIGNATURE TUBE, OR . MARQUEE ADDITIONAL CIRCUITS 100 TEMP. POWER POLE - SERVICENOTOVER 600VOLTS OR200AMP 300 UNDERSLAB WORK ` SERVI CE OVER 600 VOLTS OR 200 AMP 1000 ROUGH CONDUIT TEMP SER.VICE, POLE, &APPURTENANCES 500 WI,RING TEMP LIGHT OR RECEPT. SYSTEM 300 FIXTURES ` POWER AUTHORIZED 1 UTILITY CO. NOTIFIED FINAL PERMIT FEE (SUB TOTAL) NOTES: y/9 PLAN CHECK FEE /! .._.._�. �♦i r,Jr PERMIT ISSUING FEE 300 TOTAL ,FEE' PLAN CHECK•VALIDATION r CK ' M O CASH PERMIT VALIDATION CK M.0 CASH 61 O r a y 2 D 720A�, SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE " CTI `'C? 08 8-A 10-41 23M APPLICATION LEAD ]?FJ 1�Tn - DEPARTMENT OF BUILDING AND SAFETY ELECTRIC �.l��i COUN'T'Y OF LOS ANGELES M..J. FOX CHIEF ENGINEER a NAME DISTRICT NO. GROUP �Z(/�OI NE PERMIT NO. ADDRES �7 M L 6/a✓ F- TEL-NO-� 4 RECEIVED BY 'READY FOR DATE ISSUED W CITY � FIRST INSPECTION �y .I COUNTY / q W CERT.NO./ � `• EXPIRE P ���"' l!9 `�'�• !! / APPLICANT FILL gN HEAVILY OUTLINED PORTION ONLY DESCRIPTION OF WORK ADDRESS ;a NUMBER OF OUTLETS ON CIRCUITS LOCALITY LOCATION BY ROOMS NEAREST LIGHT OUTLETS SW.I PLUGS IFIXT CROSS ST, CIRCUIT A B C D E F G H a NAME ` z MAIL ADDRE68 0 CITY t< 'iEL NOa 1 AM THE LEGAL POSSESS �OF T�E V- S ANGELES COUNTY, CERTIFI Q •• $LSCTRICIAN.j_ II AM THE LEGAL:OWNER OR ITIS PROPERTX JDEBCRIBED ABOVE OWNER. CQFWEC�'HONS 0 TOTAL NO. OF OUTLETS' S APPROVALS NO. OF FIXTURES S M DATE INSPECTOR'S NAME NO. OF MOTORS H.P. S CONDUIT ry ' NO. OF SIGNS TRANS. S WIRING NO. OF RANGES OR HEATERS ffi FIXTURES r .MISCELLANEOUS S POWER PERMIT FEE S\ $ iJ UTILITY CO.NOTIFIED]_ TOTAL FEEFINALzz i WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT IJ 76A663 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) ; Policy NO Company FOR APPLICANT TO FILL IN 'JOB ADDRESS i C) Rt-IrIZ. Certified copy Is hereby furnished New Residential Bldgs &Pools NO. EACH FEE , _ $ $ LOCALITY ❑J Certified co Is filed with the count building ms ection 1&2-Family,Sq.Ft. PY Y 9 P NEAREST department Multi-family Sq.Ft. CROSS ST 'Residential Swimming PoolsAssESSOR Date Applicant _ MAP BOOK ...J PAGE©�/ PARCEL p CERTIFICATE OF EXEMPTION FROM WORKERS' ZOR COMPENSATION INSURANCE Outlets.Rec. LightSW z' O U FFIIRM NAME o j�Z-rti-t LT_V First 20 MAIL / (This section need not be completed if the work involved by the Total No Additional' (O� �rZ(L J i permit is for one hundred dollars($100)or less.) I certify that in the performance of the work for which this permit CITY .780-0,0' C14 Tel No is Issued, I shall not employ-any-person n"any manner so as to PLAN CHECK- ry 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 PERMIT Power Apparatus&Large Appliances APPLICANT provisions or this permit shall be deemed revoked , LICENSED.CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS I he�e6y 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 LICENSE OR ss Cla Over 50 to 100 Incl- REG NUMBER d Over 100 DISTRICT NO P�Of�.ESSED BY Q License Number Llc Class Services,Swbd,MCC&Panelboards 0-399 Amp Under 600 V FINAL �. O Contractor Date DATE ❑� - 400-.1000 Amp Under 600 V VALIDATION V I•am exempt under Sec. Over,1000 Amp,or Over 600 V FINAL W B&P C for this reason BRANCH CIRCUIT FEES FI LU Date:- 15A,or 20A, 120V,Lighting or,Recept Z 1 To 10 Branch Circuits' Signature 11 To 40 Rranch Circuits ❑ _ 41 Or More Branch Circuits Exemption for'Reg Mauit..Elect. 15A,20A,208V To 27N Lighting Br.Circuits SINGLE FAMILY Temp Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION T I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit 1 i°•C 1 a a for the following reason (Section 7031 5, Business and Professions Additional Sign Branch Circuits Cod ) 1� •� ggy`-- 1, as owner of the ro ert Mlsc Conduits&Conductors 1 j p p y,will do the work and the structure is not Intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) and Professions Code). {y I t -CONSTRUCTION LENDING AGENCY C. EC I hereby affirm that Were is a construction lending agency for thet;5?(;�is �s!L+ performance of the work for which this permit is issued (Sec 3097, PERMIT FEE (Sub-Total) / Civ. C.) PLAN CHECKING FEE Lender's Name {31Zt1 —t!!_i_i _.4/l :', . PERMIT ISSUING FEE An«iG Lender's Address D 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 and State laws regulating Electrical wiring,and hereby authorize representatives of this County to enter upon the above-mentioned property for'inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE ^ SIGNA URE OF PERMITTEE DATE ` t V OF LOS ANGELES TEMPLE CITY # 0508 fELECTRICACP—ERMITT OF PUBLIC WORKS 9071 LAS TUNAS Lkj:0 08�969022000.4:;7 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: LE AL D: FEES PAID BUILDING ADDRESS: TR: 11290 LT: 11 BL: .001 110511'FREE-RS T FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803446 ASSESSOR INFO MATIO NUMBER: NEAREST CROSS STREET: 8585-021-020 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT,SW,RECP 6.00 OUT 11.70 TENANT: G2 LIGHTING FIXTURES 2.00 LGT 3.90 ISSUE ON: PROCESSED B : PLAN BY: EXPIRES ON: TOTAL FEES 43.35 10/22/96 TC 10/22/,97 OWNER: TEL. N0: LIU ROBERT W;GRETCHEN Y (818) 448-5550- FINAL DATE FINAL BY CODE: 10511 FREER ST �Z TEMP 917803446 DESCRIPTION OF WORK SOWS EXTEND BEDROOM AND BATHROOM 171.5 SQ. FT. APPLICANT: TEL. N0: SAME AS OWNER - SPECIAL CONDITIONS: CONTRACTOR: TEL. N0: SAME AS OWNER _ �� O APPROVALS DATE INSPECTOR SIGNATURE LIC. NO �j .'�: ,^ 0Ooz CTEMPORARY POWER POLE G UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. N0: - L �!� � , S UFER GROUND LIC. NO: ROUGH CONDUIT utttt^- UI — i I G WO—UGH WIRING MAIN WATER LINE l n% (i JLASTIC Y/N METAL Y/N \� UTILITY COMPANY NOTIFIED 0031 REPORT ID: DPR265 ROUTE TO: SS0508 { WOR,<ERS' COMPENSATION DECLARATION 76- 10/81 CE-806G APPLICATION- FO.R ELECTRICAL PERMIT B06 - •I,heriPy affirm that•I have a certificate of consent to*self insure, or'a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS,ANGELES BUILDING'AND SAFETY ,-'. , copy thereof(Sec 38'00,Lab C.) • , '• •Policy No'' ' - 'Cpmpany ._•. FOR APPLICANT TO FILL°,IN-•"•" JOB" ;':''❑ EACH'' NO FEE ADDRESS I•�S ( � Fr� IZ ST. Certified copy hereby.furnished New Residential"Bldgs.& Pools' Family, Sq Ft $ — $• : LOCALITY' ❑ `Certified 'copy is' filed'wdh the county, bud1 & 2-ding inspection, — NEAREST _ department,,- _ Multi-family Sq Ft p CROSS ST Residential'Swimming Pools S V4w� Date' ,, Applicant OWNER'OR',. -t-•1' e - - - FIRM NAME-.,• �,OB LTIZ., .LZV CERTIFICATE OF EXEMPTIOWFROM WORKERS' MAIL " -Outlets Rec Light. - Sw ..L p�' .' F2 S r :COMPENSATION,INSURANCE'�,,; '. ADDRESS First,20- (Thissection need not be completed•if the work involved by the ++�;' CITY. ��' Tel No permit is for one hundred•dollars($100)or less.) Total-No l' Additional Tem ( `' "�� PLAN CHECK, I certify,that in the.performance-of the work for which this-permit' 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 ' AdditionaP; J� µ ° y CITY, Tel N' , •Date Applicant ' .. Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT. If ,after-'making this:,Certificate of � Ran e_ Heater- •D W._ APPLICANT d- - --Exemption,you should become subject to the Workers'Compensation g — provisio`ns.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:._ NUMBER, LICENSED Class CONTRACTORS DECLARATION Hood — Fan Other_ " CITY .T�ti C� Tel.No I-hereby affirm-that 1•am.licensed under provisions,of Chapter 9 Cond. 3, d 'LICENSE Disp. Room Air OR (commencing with'Section 70 00) of.Division•3 of the•Business and � REG , Professions Code,and my license is m'full force and,effect DISTRICT NO ° PROCESS BY Power Apparatus& Large Appliances. Size& Type.HP,KW;KVA,or KVAR, O o 0 License Number' Lic Class Up to 1 Incl.- FINAL U Over 1,to101ncl, DATE' 0' _ VALIDATION- O Contractor Date Over 10 to 50 Incl V FINAL ❑ I am exempt under Sec _ Over 50.to 100 Inc, BY _ W Over 100- B&PC for this reason Cn Z Services,Swbd;MCC& Panelboards nate 0- 200 Amp Under 600 V Signature 201 -`1000 Amp Under 600 V R' .Over 1000 Amp or Over 600'V ! Exemption f eg Maint Elect.. , a SINGLE FAMILY Temp'Power Pole.,& Appurtenances' ') HOME•-OWNER-BUILDER-DECLARATION. ` " Sign with'One Branch•Circuit a„ ACCT r{' I hereby,affirm that-I;am exempt;from the Contractor's,License Law • tr d•• - ,-for the following reason (Section;7031 5,-Business,and Professions Additional Sign,Branch'Circuits. - �t-7og Code), 1 336 2,5: . •• 25. 5.•. Misc Conduits'&Conductors °' ' ;`• ' "'ITEMS' I,"as owner of the property,wdl'do the work and the structure 1 .'-is not intended or offered'for`sale (Section 7044, Business Other (See Complete_Fee Schedule) ;and Professions Code) T�TRl. .25 c 25 op CONSTRUCTION LENDING AGENCY' - { 25.25 I.hereby affirm'that there is a construction lending agency for the a ,. AA ' performance of°the work,for which this permit is issued(Sec 3097•, ' `'PERMIT=FEE (Sub-Total), , 4r,' T7A14 Civ C) , PLAN CHECKING FEE - tint�n 1t��n 5I1�/v •. Lender's Name Vl vV"Vuu� S7 Y,•. PERMIT ISSUING FEE . 301" I �'5!-7 Lender's Address a 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, _ representatives+of'this County,to enter upon the above-mentioned property for inspection purposes.- % -.SEE REVERSE'FOR EXPLANATORY LANGUAGE Signature of,Permittee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0610100006 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 11290 LT: 11 BL: .001 10511 FREER ST FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803446 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: HALIFAX 8585-0212020 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY, C G1 OUTLETS-LGT,SW,RECP 6.00 OUT 11.70 TENANT: G2 LIGHTING FIXTURES 2.00 LGT - 3.90 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: TOTAL FEES 43.35 10/10/06 JK 04/08/07 OWNER: TEL. NO: FI ALD T FI AL Y:" '- "" "- CODE: LIU ROBERT W;GRETCHEN Y (626) 448-5550- _ 10511 FREER ST TEMP 917803446 DESCRIPTION OF WORK 6 OUTLETS, 2 LIGHT FIXTUR S 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 0 G MAIN WATER LINE N PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED REPORT ID: DPR265 ROUTE TO: BS0508