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Home My Public Portal About5013 GOLDEN WEST AVE_Electrical__ r ua5->yw a•°s APPLICATION FOR ELECTRIC PERMIT DriMON OF. BUMDINO AND SAFETY. I � ��' FADRKo p/'y WM.J. FOX COUNTY_ ENG�IN[IRRSBDG`ASSATT D.GRIFFIN, ■UF'T OF■URLUI• LITY, FOR APPICqNT TO FILL IN N PEN= FEF CVioaaRE-1-OTT. NUMBER EACH �E LIGHT OUTLETSOWNER RECEPTALES MAIL Cf! ADDR WALL SWITCHES TOTAL OUTLLYS 6'LEC.RANGES YE ELECTRICIANOWN KLEC. HSAT'ImsY8 ADORMia d KW LLA CITY TEL NO FLXTURXg 15 ICENGF,NO, NUMOER OF LIGHT CIRCUITS - 'DIST'RICT NO. GROUP ZONE of 4,0■Ira►lKCT Ion NUMBER OF RECEPTAC E CIRCUITS MOTORS NUFI1[R HORSEPdWdR PEE I�ISPF' 'CYTON $} 'OBD NrW Yw. HP OVER lNc. RACH •LK" .217 Y .50 ra a 1.00 e 75 1.50 Ia 50 1.150 a0' 200 17.00 MIS-- NO.SIGNS NO.TRANS.. - N 1 NH NO OR EACH PER-MtTv WIRING FIXTURES 1.00 [AND AIRY Ise APPFiOVALB TOTAL SEE T6 INSPECTOR'S SIGNATURE EREBY A OW LEDGE THAT HA RSA THIS A 11CA•TION CONDUIT STAI,TETHA�T1��TTTYYHE�ABOYE IS CORRECT AAD AGREE TO GGOYPI1,,YWITH ATRICAL-OUP , ORDIRANCES AND STATE LAWS REGI LATIMG WIRING EBY CERTIFY THAT 1 AY PROPERLY REGLOTERED AND/ORIED AS REOUIREp BT 1QS ANGECEI! COUNTI J1XD STATE OF FORNIA OR THAT I A■ E LEGAL OF THE ABOVE POWER RISES REBID IAS,PROP TY. UTILiTYCO.NOTIFIED ATURIPKRMITT-4 FINAL WILLIAM J. FOX,COUNTY ENa/Nsmpe VALIDATION A. C.VrLfT,CHIMF BLmaT. INST[CTOR 11: 953iR =15 2 130 �• WORKERS' COMPENSATION DECLARATION 76A663 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self Insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec. 3800, Lab, C.) Policy No. Company POR ANT TO ML IN JOB ❑ Certified copy Is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE ADDRESS_ got. LOCALITY F1tion copy is filed with the county building Inspec- 1 8 2--Family, Sq. Ft. $ _ _ tion ddpartmant. Multl-famlly Sq. Ft.T T CROSS ST. Date A IlcanT Residential Swimming Pools SER OR pp FIPM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec�Llght,,�Sw. L COMPENSATION INSURANCE D ADo1Ess (This section need nFirst 20ot be completed If the work Involved by Total No� Additional Ic CITY s Tel. N the permit Is for one hundred dollars ($100)or less.) PLAN Cl-ECK I certify that In the performante of the work for which this APPLICANT permit Is Issued, I shall not employ any pers6�in any manner so as to become subject-to the Workers mpenZLysatio�LE Lighting Fixtures First 20 ADDRESS Total No. Additional CITY Tel. No. Date Ilca Fixed Appliances Not Over 1 HP pERM17 NOTICE TO APPLICANT: If, after making this Certfffcate App�pM a Exemption, you should become subject to the Workers' Range— Heater_D.W. s Compensation pr6vlsI6ns of the Labor Code, you must forth- Oven _ Dryer —W.M.— ADDRESS with comply with such provisions or this permit shall be Top FAU W.H. — CITY Tel. deealed rovoked. Hood Fan _Other— LICENSED CONTRACTORS DECLARATIONLICENSE I hereby afflnn that-I am licensed under provisions of Chapter 9 Dlsp. Room Air Cond. M Class• �` (commencing with Secilon 7000) of Division 3 of the Business Pd,a-r Apparatus 8 Large Appliances DISTRICT NO. PROCESSED >_ and Professions Code, and and Is In full force.00d effect. 0. d Size 8 Type HP, KW, KVA, or KVAR S. C) O O License Number I Ic. Class Up to 1 Incl. FI v .Over 1 to 10 Incl. DA -7r�/—� VALFDATION 0 Contractor Data Over 10 to 50 Incl., -FINAL under5d r ❑ I am exempt Sec. Over to 100 Inc. B BY �T CL B.BP.C. for this reason Over 100 dld 1111110. a X1C es, Swb�., MCC8 Panelboards Date' 0200 Amp. Under 600 VSignature - 1000 Amp. Under 600 V 1 2 2 7 A ❑ Over 1000 Amp. pr Over 600-V Wo.o o o • `Z Exemption for Reg. Malnt. Elect. SINGLE FAMILY Temp. Power Pgle 8 Appurtenances 2.° 1 0 0 HOME OWNER-BUILDER DKLARATION Sign with One Branch Circuit o oQ I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits ' Law for the following reason (Section 7031.5, Dusineu and Professions Code): ❑ I, as owner of the property, will do the work and the Misc. Conduits$Conductors structure Is not Intended or offered for sale (Sectlon Other (See Complete Fee Schedule)— , 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a cohstruction lending agency for the performance of the work for which this permit Is Issued PERMIT FEE (Sub-Tot9l) (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name I O PERMIT ISSUING FEE Lender's Address I certffy that I have read this application and state that the TOTAL f$ F above Infortrwtlon Is correct. I agree to comply with all County [ D _ ordinances and State laws regulating Electrical wiring, andv'' hereby au ze representatives of this County to enter upon the abov pallors opeJr Inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date WORKERS I's have a ce8/1T10N DECLARATION 7a,%M DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT I hereby nHIrW thsi I have a certHlcate of consent to eel} Insure, or a.pertlflcate of Worker's Compensation Insurance, or a certifled COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. oopy thereof(Sec.3800 Lab. C.) Pdioy No. Company r'OR APPLICANT TO Fal IN CA ❑ Card-fled copy Is hereby fumistled. New ReMdentiel Bkk;L 8 Pcots NO. EACH FEE LOGALFrY Gy ❑ Cerffled copy Is flied with the county building tnspeodon 1 S 2-Family,Sq.Ft. — = �- NEAREST department. Multi-famny Sq.FL CRoas ST. 67 Dade Reeidential Swtmming Poole A88EggpR MAP PAUE, PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:RmZ--4—L1ght Z.Sw. bR JtE COMPENSATION INSURANCE First 20 7D D Fl� (1 hie section need not be completed H the work Inrofved by the Total No —� MAL AppREge 3 permh Is for one hundred dollars(1100)or lean.) �� Q kfuT I certify that In the performance of the work for which this permit Ci TeL No. Is Issued, I shall not employ any person In any manner to as to PLM C✓E become subject to the Worker&' Conlpensatlon Laws. Llghting Fixtures Fl rat 20 pppr Total No. Additional ADDRESS Date AP~ RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: If, after making this Certificate of CITY TKA Exemption,you should beoome subject to the Workers' Compensation OTHER APPLIANCES NOT OVER 3 HP. provlalona of thq Labor Code, you must forthwlth comply with such PE f Power Apparatys 8 Large Appliances provisions or this permit shall be deemed revoked. ^ T LK;FN CONTRACTORS DEC1-ARATION Stra S Type HP,KW,KVA,or KVAR ADDRESS I hereby afflrm that I am Ilcenaed under provisions of Chapter B Over 3 to 10 Ind. Na (commencing with Sectlon 7000) of Dlvlelon'3 of the Business and CITY Tei Profesabns Code,and my license Is In full force and effect. Over 10 to 60 Ind. IICt7i8e OR Over 60 to 100 Ind. REL.NUMBER Over 100 WR RICT 00. BY Llcense Number LkL gale Services,Swbd.,MCC A Panalboards �D u Date 0-390 Amp.Under 000 V oA Y' O Contactor❑ I am exempt under Seo. 400-1000 Amp.Under 800 V r Over 800 V r VALIDAT}ON Over 1000 Amp.cW FavAL. ,. B.BP.C.for this reason BRANCH CIRCUIT FEES 13Y (L (/) Date: 16A,or 20A,120V,DghttrLg or Reoept. Z V 1 To 10 Bran oh ClrcuIts 84witure 11 To 40 Branch CbDu is 41 Or More Branch Ct rLft { Exemption for Reg.MalnL Elect. 16A,20A,206V To 277V Br.grads n SINGLE FAMILY Temp.Power Pde✓f AppurterwxAs ,�,l. T HOME OWNER BUILDER DECLARATION Sig with One Branch Circuit AU .i I hereby affirm that I am exempt from the Contractor's License Law 5'7171.62 t 1 for the following reason (Seatlon 7031.6, Business and Professions Addttlonal*n Branch C4rcutts 3x 171.42 Code): - ��1 �t11C I,as owner of the property,will do the work and the structure Mk�o Conduits S Conduotoro I ITEM L Ie not Intended or offered for sale (Section 7044, Business Other(See ConLpiete Fee Sdwcl le) ' MAL 171 . 62 and Professions Code). ' 1 L[ t��*yy. I i CONSTRUCTKNN LENDING AGENCY �`4v 171.1�6y� I hereby affirm that there Is a construction lending agency for the � ■W performance of the work for which this permit Is Issued (Sec. 3007, PERMrr FEE (Sub-Totaf) T CIV.C.) PLAN CHECKING FEF GOOD-01M 1 12/ 4/92 LerLder's Name _ PERMrr ISSUING FEE 6881 1 AM11:59 Lender's Addnee I certify that I have read&"applioadon and under penalty of pudury strte TOTAL FEE / - thed the above krforrnation Is oorreot. I agree to oompty wRh all County ordbumcae and State Leve regulating Electrical wldng,and hereby autf or representatives d tide County to enter upon the above-manboned property Icr Fu SEE REVERSE FOR EKJPLANATORY LANGUAGE TIDE I DA r � COUNTY OR LOS AWJla,S TE14PLE CITY Q 0508 EaJi=CAL PERb= . DEPARTRENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1206210038 BDILDIMG AND SAFETY / LAND DEV&iLOP[;NT T 24PLE CITY CA 91780 _ PHONE: (626) 285-0488 ETT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 14832 LT: 21 5013 GOLDEN M= AV FEE DESCRIPTTON: QUANTITY: DOM: All7ONT: TE3e CA 917803939 ASSESSOR INFORMATION NUMBER: NEAR-Wr CROSS S'IR=: LA ROSA 8589-018-011 P2 PC RES PV<IOKW _ 153.90 TFONXS PAGE: 597 GRID: A4 LOCALITY: TXPL,R CITY, C Al PERI{IT 2.9S11ANCE FEE X7.80 TENANT: P3 INVRTR RES PV<10KW- 27.90 SCID ON: PRCCE9SIM BY: PLAN BY:. TOTAL FEES 209.60 07/02/12 ER O1flPER: TEL. L7O: F BY: CODE: PURDY CLARK (626) 286-3271- 5013 GOLDEN WF6ST AV TES 917803939 CRIPTION OF WORK ROOF MOUNTED 9OLAR 5.10 ESI SYSTEM 1 INVERTER AND 1 AC D I9 COta7ECT APPLICANT: TEL. NO: . HIIARACS-IA, CHRIS (714) 493-1235- 1211 N. BATAVIA ST. _ SPECIAL CONDITIONS: ORANGE, CA 92867 CONTRACTOR: TEL. NO: APPROVALS DA INSPECTOR SIGNATURE VERENOO SOLAR (714) 471-6453- 1211 N. BATAVIA STREET LIC. NO T24PORARY POSTER POLE ORANGE, CA 92867 935263 CIO _ UNDERGROUND COND AR.CHITE(7T OR ENGINEER: TEL. 'NO: UFER GIZOUIM - LIC. NO: ROUGE CONDUIT ROUGE WIRING L4AIN WATER L.I1Gli PLAMC YIN METAL YIN UTILITY COMPANY NOTIY= REPORT ID: DPR265 ROUTE TO: BSO508 J