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HomeMy Public PortalAbout5555 HALLOWELL AVE_Electrical__ . L4 76A663 C*q-806(6%78) APPLICATION FOR ELECTRICAL PERMIT . COUNTY OF LOS ANGELES BUILDING AND,SAFETY FOR APPLICANT TO FILL IN JOB New Residential Bldgs.&Pools EACH NO. FEE ADDA 1 &2-Family,Sq. Ft: $ .025 — $ LOCALITY y Multi-family Sq. Ft. .02 — NEAREST i Residential Swlmming Pools 25,00 CROSS ST. OWNER OR FIRM NAME Outlets: Rec_l�Light Sw. MAIL First 20 50 1 ADDRESS .4:570 7 10� 1� Total No. Additional .30 CITY Tel. No. Ilk PLAN CHECK APPLICANT Lighting Fixtures First 20. .50 ADDRESS Additional .30 Total No. CITY Tel. No. Fixed Appliances Not Over 1 HP PERMIT \� APPLICANT ? Range_Heater_D.W. Oven—Dryer_ W.M. ADDRESS / 96 g_0� Top —FAU — W.H._ CITY r f i -Te 1. No. a ti Hood_Fan —Other LICENSE OR Disp.—Room Air Cond. 2'50 REG.NUMBER Class, Z I HEREBY K WL D E THAT I HAVE READ THIS APPLICA- Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO Size&T e.HP, KW, KVA,or KVAR COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS yp REGULATING ELECTRICAL WIRING..' p U to 1 Incl. 2.50 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR Over 1 to 10 Incl. 5.00 LICENSED AS REQUIRED BY_,60S ANGELES COUNTY AND TE OF W Over 10 to 50 Incl. 12.50 CALIFORNIA OR THAT THE LEGAL OWNER OF ABOVE Over 50 to 100 Inc. 25.00 DESCRIBED RESIDE PROPERTY. 40.00 PERMITEE Over 100 SIGNATOR Services DISTRICT NO, P CES D BY 0 200 Amp. Under 600 V 1 2.50 201-1000 Amp. Under 600 V 25.00 �� Over 1000 Amp.or Over 600 V 50.00 Z O Temp. Power Pole&Appurtenances 10.00 Q Sign with One Branch Circuit 10.00 Additional Sign Branch Circuits 2.00 INSPECTION > Misc.Conduits&Conductors 10.00 INFORMATION uON REVERSE z Other(See Complete Fee Schedule) SIDE U ;90823A J d aa0002 PERMIT FEE (Sub-Total) 2,o o 2200 PLAN CHECKING FEE (One-Fourth Permit Feel 10 o o o'2 2 0 0 F2 0 PERMIT ISSUING FEE $7.00 c �° Q1 8 7 ' J Q TOTAL FEE > INSPECT Q. A L E D W date: /r � ��— �- _ ((( ©s 'a WORKERS'COMPENSATION DECLARATION 76A663 DPW 3/87 APPLICATION FOR ELECTRICAL PERMIT I hr--by,affirm that I have a certificate of consent to self ce eo6c O instI, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or ms erti,`IeJd��coopy thereof (Sec. 3800, Lobb..C. Policy No./39 ZtO Company "J IF+1 ��A I J FOR APPLICANT TO FILL IN JOB ❑Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE A D D R E 5 S rtified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. $ — $ LOCALITY -^ tion department. Multi-family Sq. Ft. — NEAREST CROSS �ry-� _C -rorl 6L[ 'u Residential Swimming Pools OWNER5 Date T.OR a1 �T Applicant FIRM NAME ,tr ,�c `/9 Aq*AA CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: RectLightXSw.� MAIL COMPENSATION INSURANCE J ADDRESS r�G(Gl E1CZf This section need not be completed if the work involved b �J�, First 20 ( P Y Total No. Additional CITY Tel. No. '-7 the permit is for one hundred dollars ($100)or less.) PLAN CHECK I certify that in the 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'Compensation Laws. Lighting Fixtures First 20 ADDRESS Total No. Date Applicant Additional CITY Tel. No. NOTICE TO APPLICANT: If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT APPLICATION 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 with comply with such provisions or this permit shall be Top — FAU —W.H. — •�_ �yd deemed revoked. Hood — Fan —Other_ CITY �` Tel. No.�g7,�fIZ LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. — Class. REG. NUMBER (commencing with Section 7000)of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO. PROCESSED BY and Professions Code,and my license is in full force and effect. Size &Type HP, KW, KVA, or KVAR !! d 0 License Number 547/ Lic. Class Up to 1 Incl. FINAL U iki� / Over 1 to 10 Incl. Contractor /�� � Date 'd �. DATE L VALIDATION 0 ❑ - Over 10 to 50 Incl. FINA 0 I am exempt under Sec. Over 50 to 100 Inc. BY UJIU Over 100 B.&P.C. for this reason Oveta- Z1 Services, Swbd., MCC& Panelboards Z Date: 0-200 Amp. Under 600 V -- — Signature 201 - 1000 Amp. Under 600 V ❑ Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY Temp. Power Pole &Appurtenances HOME OWNER-BUILDER DECLARATION I herebyaffirm that I am exempt from the Contractors License Sign with One Branch Circuit u Contractor's Additional Sign Branch Circuits ( `IX Law for the following reason (Section 7031.5, Business and g , Professions Code): ❑ 1, as owner of the property, will do the work and the Misc. Conduits&Conductors structure isnot intended or offered for sale Section 7044, Other (See Complete Fee Schedule)_ TOT AL. Business and Professions Code). 4:3 90 CONSTRUCTION LENDING AGENCY ?_.{ti. ; �:,,s{.1 I hereby.affirm that there is a construction lending agency for t the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) © CHANGE {' (Sec. 3097, Civ. C.). qp PLAN CHECKING FEE Lender's Name /� I 131010-!II3E Ti ;_F' f., t PERMIT ISSUING FEE ?, Lender's Address .t.PT i 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 property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Si nature of Pe ittee Date ©s 4� OF LOS ANGELES TEMPLE `I_E"-RICAL PERMIT DER OTMEN' OF PUBLIC WORKS 9701 Lff- "UNNIS 0410140036 BUILDING AND SAFETY LAND DEVELOPMENT TEMPLE CA 91780 PHONE. 2--j -35-0488 EXT: 1-LE-GAL ID: FEES PAID BUILD; -' 'TR: 30308 LT- 9 i 5555 HAL-:%:ELL AV IFEE DESCRIPTION: QUANTITY: UOM: "'Mi'DUNT ARCO CA 111007;3418 ASSESSOR INFORMATION N u 111 ffl-.R i NEAREST fTRUSS `--;TREET: LIVE OAK 8586-015-032 lAl PERMIT ISSUANCE FEE ;7.75 THOMAS FAG-; !•Q7 GRID: B3 LOCY�ALTTTLEMPLE CITY, C I GI OUTLETS LGT,Slwl,RECR 2.00 OUT IP I TENAHA PAU LESS 3HP 1.00 FAU 10.95 ISSUED ON: P R 0 0 -D -B Y: PLAN BY: EX,FTRE.75 N !JB AC UNITS +3­11CIE"I'd 1.00 AC !'x.65 10/14/04 04i TOTAL FEES 2.25 UWN ER: TEL. NO: TI WA L DATE -4AL/By -0-DE: IGAMBOA JON C;JUDY A 155,55 HALLOWELL AV :ARCD 910078418 i DESCRIPTION Gr ELECTRICAL FOR A/C PAU (APPLICANT- TEL. NC ,-,-.LnVER (626) 357-5311- SPECIAL C011 6 Ti-:�Tj F,4 15R TEL. NQ; APPROVALS DATE I,% AIR-TINC.-RO I (626) 7�7-�3111- I 1 ------- 116-30 E MYRTLE AVI - E. L�IC.'NO TEMPORARY Puri, FULL — IMOMROVIA, CA 91016 UNDERGROUND CONDUIT nG!" 1 ECT jUF0Z—GROUND OR ENGJTNE*R: TEL. NO: LIC. N". ROUGH CONDUIT TTITIT IM�lt� WKTER PLASTIC Y/Kl 'f UTI L I TY C0 mf PUT TN,i7 T A ru, ADDITIONAL DATA ON FILE REPORT ID: DPR265 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0809150039 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: I FEES PAID BUILDING ADDRESS: ITR: 30308 LT: 9 1 5555 HALLOWELL AV I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 ARCD CA 910078418 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: DAINES 18586-015-032 1A1 PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE: 597 GRID: B3 LOCALITY: TEMPLE CITY, Cl IG1 OUTLETS-LGT,SW,RECP 6.00 OUT 11.70 (TENANT: IG2 LIGHTING FIXTURES 6.00 LGT 11.70 11SSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: IH7 RES EXHAUST FANS 1.00 EX 10.95 109/15/08 SR 03/14/09 1 TOTAL FEES 62.10 1 IOWNER: TEL. NO: I IFINAL DATE FIN Y: CODE: GAMBOA, MR/MRS. JOHN 15555 HALLOWELL AV 1 (ARCD 910078418 1 IDESCRI TION IF WORK I 1ELECTRICAL FOR MASTER BATHR OM REMODEL I I I I (APPLICANT: TEL. NO: 1 1O-LEARY - 1 15827 AGNES AVENUE ISPECIAL CONDITIONS: 1 ITEMPLE CITY CA 91780 1 I I I I (CONTRACTOR: - TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE ITOM O'LEARY CONSTRUCTION (626) 287-0927- 1 1 15823 AGNES AVENUE LIC. NO ITEMPORARY POWER POLE ITEMPLE CITY, CA 91780 489354 B-1 1 1 11 I 1 1 1UNDERGROUND CONDUIT I I I I I I (ARCHITECT OR ENGINEER: TEL. NO: I IUFER GROUND I I 1 1 LIC. NO: 1 IROUGH CONDUIT I 1 I I 1 IROUGH WIRING 1 IMAIN WATER LINE IPLASTIC Y/N METAL Y/N I I I 1UTILITY COMPANY NOTIFIED( I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I IREPORT ID: DPR265 ROUTE TO: BS0508 1 I I I I I I