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Home My Public Portal About8832 HERMOSA DR_Electrical__ that COMPS a ce,if caLq oR¢TION 76A�3 '°'B' APPLICATION FOR ELECTRICAL PERMIT W'tifi.d that I have a cerfifimL. of,carsent to self CE-8°6Gficateof Workers' Compensation Insurance, COUNTY OF LOS ANGELES - BUILDING AND SAFETY r py thereof (Sec. 3800, Lab. C.) J P❑ol Icy No. Company FOR APPLICANT TO FILL IN - ADDRESS L Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ❑ Certified copy is filed with the county building inspec- 1 & 2-Family, Sq. R. $ — $ LOCALITY c17 tion department. Multi-family Sq. FL — 'NEAREST CROSS ST. Q� Residential Swimming Pools OWNER OR Date Applicant FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec LightSw._ MAIL COMPENSATION INSURANCE ADDRESS (This section need not be completed if the work involved by First 20 _t the permit is for one hundred dollars ($100)or less.) Total No: Additional CITY Tel. PLAN CHECK certify that in the performance of the work for which this APPLICANT permit is issued, shall not employ any person in any manner so as to become subject to the Wor r Compen ws. Lighting Fixtures First 20 ADDRESS Total No. Additional CITY Tel. No. Date 1 Applica Fixed Appliances Not Over 1 HP PERMIT f NOTICE TO APPLI ANT: If, after making this Certificate of APPLICANT �r7 LAS�Pih 'S p� 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. — 9oz c deemed revoked. CITY LICENSED CONTRACTORS DECLARATION Hood _ Fan _ Other— el. Disp. _ Room Air Cone. LICENSE OR Class.0 Z�3 �0 (commencing with Section 7000) of Division 3 of the Business Power Apparatus&Large Appliances DISTRICT PROCESS Y and Professions Code, and my license is in full force and effect. 6 '��'7 _ Size &Type HP, KW, KVA, or KVAR' s O License Number /� / ac_)iilic Class �'l� a V Up to 1 Incl. FINAL ///� � �8 �` Over 1 to I5 Incl. _ i/ Contractor Cr /' i Date� DATE !/ VALIDATI O ❑ Over IO to 50 Incl. H FINAL I am exempt under Sec Over 50 to 1,00 Inc By tVx B.&P.C. for this reason Over 100 _ H Dote: Services, Swbd., MCC & Ponelboords ► ;2 1 2 9 A Z 0 - 200 Amp. Under 600 V Q✓] # e • • e e 2 Signature 201 - 1000 Amp, Under 600 V ❑ Over 1000 Amp. or Over 600 V I • e 2 7. 0 0 Exemption for Reg. Main. Elect. e e e 27.0 (,5SINGLE FAMILY Temp. Power Pole& Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ( 1.28-84 1 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): ❑ 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)— POP. Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). PLAN CHECKING FEE . . Lender's Name PERMIT ISSUING FEE Lender's Address 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 adinonc sand State laws regulating Electrical wiring, and hereb thorize repres.n ive this County to enter upon - the e-mentio pr rty ins a urpases. SEE REVERSE FOR EXPLANATORY LANGUAGE A z� ignature of Permittee Date COUNTY OF LOS ANGELES TEMPLE CITY p 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0607270014 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 ERT: LEGAL ID: FEES PAID BUILDING ADDRESS: IN: 3623 LT: 109 8832 HERMOSA DR FEE DESCRIPTION: QUANTITY: JON: AMOUNT: TEMP CA 917801815 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: IVAR 5387-010-022 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY, C G1 OUTLETS-LGT,SW,RECP 52.00 OUT 82.20 TENANT: G2 LIGHTING FIXTURES 10.00 LGT 19.50 ISSUSD ON: PROCESSED BY: PLAN BY: EXPIRES ON: H1 RES ELEC OVER LT 3HP 1.00 OVE 10.95 07/27/06 JX 01/23/07 H2 RES GREG DISP LT 3HP 1.00 DIS 10.95 OWNER: TEL. NO: H5 RES WASH MACH LT 3HP 1.00 WAS 10.95 FINAL DATE FINAL BY: CODE: POLONI, CRISTIAN A (626) 437-4620- TOTAL FEES 162.30 �7 V� f 8832 HERMOSA DR /f b b TEMP 917801815 DESCRIPTION OF WORK REWIRE THE ENTIRE HOUSE APPLICANT: TEL. NO: ROGELIO (323) 567-3760- 9209 VIRGINIA AVE SPECIAL CONDITIONS: SOUTH GATE CA 92080 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE ROGELIO RIVERA (323) 567-3760- 9209 VIRGINIA AVENUE LIC. NO TEMPORARY POWER POLE SOUTHGATE, CA 90280 580594CID UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: UFER GROUND LIC. NO: ROUGE CONDUIT ROUGH WIRING MAIN WATER LINE PLASTIC Y/N METAL YIN UTILITY COMPANY NOTIFIED REPORT ID: DPR265 ROUTE TO: BS0508 s 1 COUNTY OF LOS ANGELES TEMPLE CITY p 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0611300025 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 3623 LT: 109 8832 HERMOSA DR FEE DESCRIPTION: QUANTITY: DOM: AMOUNT: TEMP CA 917801815 _ ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: ROSEMEAD 5387-010-022 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE:'596 GRID: H3 LOCALITY: TEMPLE CITY, C G1 OUTLETS-LGT,SW,RECP 2.00 OUT 3.90 TENANT: RA FAD LESS 3HP 1.00 FAU 10.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: JB AC UNITS 3-10HP 1.00 AC 19.65 11/30/06 JK 05/29/07 TOTAL FEES 62.25 " OWNER: TEL. NO: FINAL DATE FINALH CODE: POLONI, CHRISTEN (626) 437-4620- 8832 HERMOSA DR �'- f+"� TEMP 917801815 ESS CRIPTION OF WORK ELECTRICAL FOR EVAC SYSTEM APPLICANT: TEL. NO: , WALLIN HEATING & AIR, INC. )909) 466-0527- 5357 TOPAZ ST. SPECIAL CONDITIONS: ALTA LOMA, CA 91701 CONTRACTOR: TEL. NO: APPROVALS GATE INSPECTOR SIGNATURE WALLING HEATING & AIR, INC. (909) 466-0527- _ 5357 TOPAZ STREET LIC. NO TEMPORARY POWER POLE - ALTA LOMA, CA 91701 609238 C20 UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: UFER ^,ROUND LIC. NO: ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED REPORT IN: DPR265 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY M 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0607240021 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-04BB EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 3623 LT: 109 8832 HERMOSA DR r r PER DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917601815 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: IVAR j 5387-010-022 Al PERMIT ISSUANCE FEE 27.75 rTHOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY, C LB 200 AMP PANELS, MCC 1.00 PAN 38.85 " TENANT: TOTAL FEES 66.60 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 07/24/06 SK 01/20/07 OWNER: TEL. NO: FINAL DATE FIN ..,BY: CODE: 8832POLONI, MOSST SAN A (626) 437-4620- 8832 917801A DR RC ld TEMP 917801015 DE CRIPT ION OF WORK UPGRADE METER BOX 200 AMP ON FRONT HOUSE APPLICANT: TEL. NO: ROGELIO (323) 567-3760- 9209 VIRGINIA AVE SPECIAL CONDITIONS: SOUTH GATE CA 92080 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE ROGELIO RIVERA (323) 567-3760-, r 9209 VIRGINIA AVENUE LIC. NO TEMPORARY POWER POLE SOUTHGATR, CA 90280 580594CIO --- UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: UFER GROUND LIC. NO: ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE PLASTIC YIN METAL YIN UTILITY COMPANY NOTIFIEll coli REPORT ID: DPR265 ROUTE TO: BS0508 (