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Home My Public Portal About10903 GRAND AVE_Electrical__ 76A663 DBS SA 11-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY ELECTRIC 1 COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMIT NO. ELECTRICIAN '.0 vri C --ii RECEIVED BY READY FOR DATi ISSUgD ADDRESS FIRST INSPECTION Ar CITY ` V; !JT r TEL. NO / ! COUNTY LICENSE NO—2- / 7 EXPIRES✓-^ +K �'✓ BUILDING PERMIT FEES ADDRESS C/ J NUMBER EACH FEE LOCALITY 17-e e%l LIGHT OUTLETS NEAREST 61 CROSS ST. 7 V 1/4 !7 LtiP RECEPTACLES L' WALL SWITCHES OWNER C 6.1-11 a TOTAL OUTLETS 5C s ! MAIL ,�{{ ELEC. RANGES 25 ADDRESS .� G' I ELEC. HEATERS 25 Za` CITY {c�/Yl - C �� TEL. O. /2 .z E FIXTURES G. 5 n 1 HEREBY ACKNOWLE GE THAT 1 HAVE READ THIS misc. .�1 �'j 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 1 POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER NEW MVD. HP OVER INC. EACH OF THE RESIDENTIAL-PROPERTY DESCRIBED A VE. I ' 1/z a LESS $ .25 SIGNATURE PERMITTEE 1/2 2 .50 2. s 2 5 1.00 INSPECTION RECORD 5 15 1.50 _ ,n 15 50 2.50 50 200 5.00 200500 10.00 �} R +�?.:_ Q 500 1000 15.00 Cr to t: OP T tF t Z OVER 1000 20.00 y (� M. G. SET/FREQ. CHANGER-HP I i , hI1 WELDERS: AC-KVA GENERATORS-KW TRANSFORMERS-KVA TEMP. MOTORS (75%OF ORIG.) MOVED MOTORS (75%OF ORIG.) - M ISC. SIGNS NO. NO. TRANS. APPROVALS NO. NO. LAMPS DATE INSPECTOR'S NAME FOR EACH PERMIT: WIRING $1.00 I CONDUIT FIXTURES $1.00 I WIRING SUPPLEMENTARY .50 FIXTURES POWER TOTAL FEE $ 9 UTILITYCO. NOTIFIE 7 I FINAL W�'S COMPENSATION DECLARATION 20-0019 DPW 9189 hereby att►rm that I have a certificate of consent to self Insure, 76AM APPLICATION FOR ELECTRICAL PERMIT or,a gartlficate of Worker's Compensation Insurance, or a certliied COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thsrevf(-Seo'.3800 Lab. C.) Pofky No, Company POR APPLIC-A T TO Pat N JOB,X:rn I ❑ CerdW oopy is hw"fun fshsd. Mew Realdenttel Bldgs-IL Pools EACH NO. FEF L ` ❑ Cari oopy In fl 6d with the county building Inepectlon Mutti-hmRyRy Sq Ft.� +depart—L NEAREST ST. Al/J 1 SL Date Art Redderrtlel Swimming Pools A88EB80R 7 MAP BOOP( PAGE Pr5F1C8 CEFMMCATE OF EXE)PTK)N FROM WORKEW Outlwa Reo. Llpht---t 9w. COMP ENSA INSURANCE �HAM / R roi 20 � �7 (This section need not ba com tf the work Invotrsd by the Total No. AdditW ROOF BB t% v pormk to for ons hundred dolls )or ) I oerdfy that In the partcrrhanoe f th wo r lob this rmtt CITY �_� Ti No. 7 ie Issued, I ;1'1 not employ any are n a y ner s to ptw q f Q become su a Workero' pe ` Llghtlng Ffxbres Ftot 20 APp�ylT //4-� Total No Additlortal ADDRESS Dam pNOTI TOPPLICANT: �1, or making this CertlMtths 16 OR 261120V BRANC*i CIRCUITS CTTy Ti 14 - l Fir tlon,you ahould ct to the Workero'Com1 TO 10 MAJ SrVE EACH provisions of the - eust forthwith oomply 11 TO 401NCLUSlVEEACH r provisions or this permit shall be deemed revoked. 41 OR MORE BRANCH CUICLM EACH LK� d ADDRESS d I hereby affirm that Iem Ilse CONTRACTORS nder pyroAAviso provisions of Chapter 9 16 OR?D,,2D6V TO 277V LKIH71N0 EACH � ^ (commencing with Section 70D0) of Division 3 of the Bwlnass and CITY Ti Profession@ Code, and my license �Iss In.full foroe and effect. APPLI AV�8 UP TO 3HP OR 0� v VVO P—Appeniftm&Large License N �r+ f Lb.Class ^/0 Stze 8 Type HP,KW,KVA,or KVAR rr0. v BY Up to 3 Ind. J� �tLrC.�� W 1 Ovw 3 bD 10 Incl. N Contractor ❑ Over 10 To 60 Ind. Z em exempt udder Sec. Over 60 to 100 Ind. vu s�rrnu B.tl,P.C.for thio reason Over 100 BBY - 8orAoss,Swbd.,MCC 8 Panetboards Dais' 0-200 Amp.Under 600 V Signahrre 201-1000 Amp.Under 000 V ❑ Over 1000 Amp.or Over 600 V Exemptlon for Rea Ma1nL EieoL n &Nt3LE FAMILY Temp.Power Poi@ 8 Appurtonanoes iy T HOME OWNER-BUILDER DECLARATION Sign wRh One Breach Ctrixft I hereby affirm that I am exempt from the Contractor'e IJoen@e Lew for the following reason (Section 7031.6, Business and Professions Addttloref BiQr Branotr Circuits 74.111 Code): �t-rk� F11. as owner of the property,wIII do the work and the allucture Mho-Conduits 8 Conductors 1 I t CI r� Is not Intended or offered for sale (Seadon 7044, Business Other(See Compote Fee 8chedrde) ' ��IT(ti� 74 - 0-3 and Professions Code). -y L•11 1 4 CONSTRUCTK)N LENINNO AGENCY t �L I hereby affirm that there Is a construction lending agency for the 1-�� •I�� performance of the work for which this perm Is Issued (Sec. 3097, PERMIT FEE (Sub-Total) Ctv. C.) PLAN CNECKNO FEE cLA7C�"C c 1 b/12/ Lenders Name t-� PERMIT ISSUING FEE O� ti}i.�( i 9 9:v that I have read this appllcetlon end state that the above TOTAL FFA o.a Address— :R 1 rm oorreot I ■gro comply with all County ordinances a eta ulating I rtoal wiring, and hereby authorize r sea le ty enter upon the above-mentioned pro for I p SEE REVERSE FOR EXPLANATORY LANGUAGE Or Af2 OR DATE WORKERS'COMPENSATIONDECLARA.TION CE-8M (2-80) APPLICATION FOR ELECTRICAL PERMIT I hereby aftlrm 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 LLLJJJ ■cer ifled copy thereof(Sec.3800,Lab.C.) FOR APPLICANT TO FILL IN JOB Policy No. Company EACH NO. FEE ADDRESS F-1Certified Residential Bldgs.&Pools Certified copy is hereby furnished. 1 &2-Famlly,Sq. Ft. — b LOCALITY .T_ F1 Certified copy Y filed with the county building inspection Multi-family Sq. Ft. CROSS PT department., Residential Swimming Pools OWNER'OR FIRM NAME &F �.. Date Applicant' Outlets: Rec.—Light Sw. MAIL --pIrst 20 ADDRESS CERTIFICATE OF EXEMP'T'ION FROM WORKERS' Total No. Additional COMPENSATION INSURANCE CITY Tel too. } PLAN CHECK F d (This section need not be letdd if the Work involved APPLICANT O by the permit is for one hundred dollars ($100) or lest.) Lighting Fixtures Firat 20 ADDRESS (1 Total No. Additional I certify that In the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No. U w permit is Issued, I shall not employ any person in any manner PERMIT 1L as to bey`ome subject to the Workers' Compensation Laws. Range_Heater_D.W. PPLICAN q p Oven Dryer_W.M. ADDRESS , N Date ApplicanLA.s�! �i��-� � Top FAU _W.H. _ Hood Fan _Other_ CITY Tel No NOTICE TO APPLICANT: If, after making this Certificate of Dlsp. — Room Air Condom LICENSE OR Exemption, you should become subject to fhe Workers-' REQ.NUMBER Class Compensation provisions of the Labor Code, you must forth- Power Apperetut& Large Appliances DISTRICT O. PROCESSED BY with comply with such provisions or this per�ltt shall be Size&Type HP,KW, KVA,or KVA �� deemed revoked. - Up to 1 Incl. Over 1 to 10 Incl. FINAL DATE �� LICENSED CONTRACTORS DECLARATION Over 10 to 60 Incl. VALIDATION I hereby affirm-that I ani licensed under provisions of Chapter Over 60 to 100 Inc. FINAL 9 (commencing with Section 7000)of DfAsion 3 of the Busi- Over 100 noes and Profeesions.Code, and my license Is In full force and effect. Services n 0-200 Amp. Under 600 V L- License Number_ Llc,Class 201-1000 Amp. Under 600 V Contractgr Date Over 1000 Amp.or Over'600 V HOME OWNER-BUILDER DECLARATION Temp.Power Pole& Appurtenances I hereby affirm that I ■m exempt from the Contractor's Sign with One Branch Circuit License Law for the following reason (Section 7031.3, Busi- Additional Sign Branch Cfrcults ness and'Profeasforu Gode): -921 1,3 A • Misc.Conduits&Conductors u owner of the property, will do the work and the Other (See Complete Fee Schedule)— # o'o.0 0 0 2' at ructure Is not intended or offered for Lala (Section 704-4, Business and Professions Code). 2 0''0 1 9. 50 CONSTRUCTION LENDING AGENCY I hereby ■ rm that there is a construction lending agency ffotr or the performance of the work for which this permit isPERMIT FEE (Sub-Total) 0 0 0 ) 9,, 3 0 E issued (Set. 3097,Civ.C,). �,3�,—S 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 authorise representatives of this County to enter upon the above-mentioned property for inspection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee ~ Date WORKERS'COMPENSATION DECLARATION CE-BWG (2-80) APPLICATION FOR - ELECTRICAL PERMIT E�08 I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES r ,, BUILDING AND SAFETY Insure, or a certificate of Workers'Compensation Insurance,or LAO a certified copy theraof(Sec. 3800,Lab.C.) �/ FOR APPLICANT TO FILL IN JOB Policy No. Company EACH NO. FEE ADDRESS New Residential Bldgs.&Pools Certified copy Is hereby furnished. 1 &2-Famlly,Sq. Ft. >! — Is LOCALITY TEN r7l, e C I �-T ❑ Multi-family Sq. Ft. Certified copy Is filed with the county building Inspection CROSS 8T department. Residential Swimming Pools OWNER'049- —� v It/1 /U Date Applicant Outlets: Rec.-Light SwAIL M Irt 0 ADDRESS CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITYF Tal No. COMPENSATION INSURANCE / N L } PLAN CHECK 4 (This section need riot be completed if the wort lavolred APPLICANT UV by the permit L for one hundred dollars ($100) or law) LJghtlRg Fixtures First 20 ADDRESS Total No. Addltlonal O I certify that In the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No. 0 permit Is issued, I shall not employ any person in any maner nPERMIT t to as to,become subject to the Worker' Compensation Laws. Range_ Heater_D.W. PP ICANT /cif- Q Oven Dryer_W.M._ ADDRESSU Z Date Applicant Top FAU _W.H. TI Hood Fen _QtY her_ CITNP Tal o. NOTICE TO APPLICANT: If, after making this Certificate of Disp. Room Air Condom LICENSE OR Exemp-tion, you should become subject to the Workers' RE . N MBER Clan Compensation provisions of thp Labor Code, you must forth- Power Apperaws& Large Appliances DISTRICT PRO ED with comply with such provisions or this permit deemed revoked. Size&Type HP, KW, KVA,or KVA v Q U0 to 1 Incl. FINAL LICENSED CONTACTORS DECLARATION Over 1 to 10 Inc[. DATE Reyr VALIDATION Over 10 to 60 Incl. I hereby affirm that I em licensed under provisions of Chapter Over 60 to 100 Inc. FINAL 9 (commencing with Section 7000) of Division 3 of the BwBYi- Over 100 ness and Profession-Coda, and my license is In full force and effect. Services G 0-200 Amp.Under 600 V License Number Lic.Class 201-1000 Amp.Under 600 V _ Contractor Date Over 1000 Amp.or Over 600 V 1 4 A HOME OWNER-BUILDER DECLARATION Tamp.Power Pole&Appurmnencea #,0 0 o e 2 Sign with One Branch Circuit I hereby affirm that I ■m exempt from the Contractor's Additional Sign Branch Circuits 2 0 0 0 License Law for the following reason (Section 7031.5, Busi- near and Professions Code): 0.0 0 0 5 �7Misc.Conduits&Conductor D41 as owner of the property, will do the work and the Other( Complete Fee Schedule)— Q05-81 structure is not intended or offered for sale (Section . 7044,Bwiness and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lendink agency 1 for the performance of the work for which this permit Is PERMIT FEE (Sub-Total) 1 425 A lnued(Sec. 3097,Civ.C.). Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) # 0 0 0.0 0 2 Lender's Address PERMIT ISSUING FEE 2 0 o 9. 00 I certify that I have read this application and state that the TOTAL FEE o 0 0 0 9. 0 0 above information is correct.I agree to comply with all County A �� 1 005-81 ordinances and State laws regulating Electrical wiring, and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposm. SEE'REVERSE FOR EXPLANATORY LANGUAGE /d '�= 1 919nadure of Permittee Date COUNTY OF LOS ANGRIM TEMPLE CITY N 0508 kr•r_=cAL PERMIT DEPARTMENT OF PUBLIC WORL9 9701 LAS TUNAS -EL 0506 1202160017 BUILDING AND SAFE'T'Y / LAND DEVEIAPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDIM ADDRESS: TR: 11497 LT: 16 BL: A UN: .002 10903 GRAND AV FEE DESCRI=Ol4: QUANTITY: UOM: AMOUNT: TRW CA 917803552 ASSESSOR INF'ORMAT'IOM NUMBER: NHARRST C:R098 9TREfiT: 8574-006-018 Al PERMIT ISSDANCB FEE 27.80 THOMAS PAGE: 597 GRID: D4 LACALLITY: TE PLE CITY, C _ Ol OUTLETS-LC?T,BW,RECP 11.00 OUT 21.40 TITULNT: O2 LIGHTNING FIXTURES 8.00 LOT 15.50 ISSUED ON: PROCESSED BY: PIAN BY: TOTAL FEES 64.70 02/16/12 SR OWNER: TEL. NO: F.11ML DAT& FIW Y: CODE: MOON CHIN (626) 283-0710- 10903 GRAND AV T'ERP 917803552 DF.SCRIPTfON OF WORE Ea.E rvTCAL FOR NEW BEDROOM AND BATHROOM APPLICANT: TEL. NO: SAME AS OWNER - SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SICBWTURE SANE AS OWNER - LSC. NO TEMPORARY POWER POLE UNDERGROUND CONDUIT ARCHITECT.OR ENOINRER: TEL. NO: LIFER GROUND BOBADTISA, GABRIEI, (626) 510-0617- 725 E. WALNUT ST. LIC. 190: ROUGH COtE= PASADENA, CA 91101 _ NONE ' ROUGH WIRING MAIN WATER LIRE PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED REPORT ID: DPP-265 RD= TO: BS0508