HomeMy Public PortalAbout9034 HERMOSA DR_Electrical__ /6A660-CESOO 10-60 APPLICATION FOR ELECTRICAL PERMIT 1
COUNTY OF LOS ANGELES
DEPARMENT OF COUNTY ENGINEER BU LE
No
- BUILDING AND SAFETY DIVISION ADDRESS G -t/L/jW-('611J-O,y-.
JOHN A. LAMBIE. COUNTY ENGINEER �--.
WILLIAM A.JENSEN.SUPT OF BUILD OIG LOCALITY k GL;
NEAREST
FOR APPLICANT TO FILL IN CROSS sr. "L-
PERMIT FEES OWNER n 1 T E M NUMBER EACH FEE MAILV� �
OUTLET$: l 6 S ADDRESS6}-
LIGHT.
REOEIT. 6W. ! ' .10 a CITY `/ ' TEL NO.
LIGHTING FIXTURES / .Ip `Pi � O
iL
ELEC. RANGES CLO. DRYERS ELECTRICIAN`` C E'(LJLI'(�L
WATER HEATERS .50 ADDRESSYL� 5/'
ELEC.SPACE HT". DISHWASHERS / q j
CITY CLb LTi TEL NO N L
GARBAGE DISPOSERS AUTO.- STATE d
WASHERS STA.COOKING UNITS .25 LICENSE NO.
MOTORS: OVER INC. H.P. _ DISTRICT NO. GROUP ZONE ESSED BY
.25
_— 2 .56 INSPECTION R CORD - >
2— 5 1.00
O
5— t5 - 1.50 U
C
Is— 50 2.50Or
50— 200 5.00 W
a
SIGNS: NO TRANS. {/)
NO.LAMPS
SERVICE 0-000V 1.00
SERVICE OVER 600V 5.00
MISC.
WIRINGPERMIT 1.pp B'C
FIXTUREPERMIT 1.00 00
SUPPLEMENTARY PERMIT .50 '
TOTAL FEE S 2 Q -
I HEREBY ACKNOWLEDGE. THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS
.To
ELECTRICAL WIRING. WIRING Q /.�.��
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED ANO/OR
LICENSED AS REQUIRED BY LOS ANGELES.COUNTY AND STATE OF FIXTURES l_1..�...� '
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE ��p -
DESCRIBED RESIDENTIAL PRROOPER Y. POWER /7
SIGNATURE f[.� ( p UTILITY CO.NOTIFIED ,V
OF PERMITTE FINAL
A IDA
moTION ARTHUR C. VETT'
K. cases SUPERVISING ELECTRICAL ENGINEER
U09756 JUL 10 2 D 2 .60 �
G��J
76"663-`ES0610'74 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER .IDB
BUILDING AND SAFETY DIVISION ADDRESS �—
LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
OUTLETS NO, EACH FEE OWNER.OR
S 5 FIRM NAME
RECEPT.=1 OVER MAIL
LIGHT_ TOTAL
11 FIRST 20 25 ADDRESS
20 CITY TEL.
SWITCH .10 PLAN CHECK
GHTING TOTAL LFIRST 20 25 APPLICANT
FI%TURES .10 I
OVER 20 ADDRESS
RESIDENTIAL APPLIANCES CITY TEL. NO,
PERMIT / /
RANGE_DRYER_WTR. HTR._ APPLICANT [�y�
STA. COOK_DISP./F.A.U._ ADDRESS J J"f
SPACE HTR. AIR GOND. CITY TEL. NO.
CLOTHES WASH.-DI SHWASH._ LI CENSE OR ./j Ij CLA55.
REG. NUMBER ✓� i
FAN-OTHERH!0 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
N-3 yr AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND. HEATERS, ETC. HP. KW. MVA. ELECTRICAL WIRING.
912E B TYFE OVER TO
HEREBY CERTIFY THAT AM PROPERLY REGISTERED AND/OR
0 - 1 100 LICENSED A9 RF0YY LOS ANGE ES COUNTY ANO 9iATE OF
CALIFORNIA OR THAI THdI I AM T LE L OWNER OF TN
E ABOVE d
300 OESCRIP.EO REBID' N PR RT U
10 - 50 5.00 PERMITEE •y-•
SIGNATURE-*If
D
50 - 100 10.00 W
DISTRICTJN'0 Q P E ED BY y
100 - S00 1500
SIGN, GAS SIGN AND ONE CIRCUIT 500 APPROVALS DATE INSPECTDR'S SIGNATURE
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 100 TEMP. POWER POLE
S ERVI CE NOT OVER 600 VOLTS OR 200 AMP �40 UNDERSLAB WORK
SERVICEOVER 600 VOLTS OR 200AMP 10.00 1 ROUGH CONDUIT
TEMPSERVICE,POLE, &APPURTENANCES 5.00 WIRING
TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES
POWER AUTHORIZED
UTILITY CO. NOTIFIEO
FINAL
PERMIT FEE FEE (SUB TOTAL) NOTES: V-7 Am-r- > e"ll
PLAN CHECK FEE ,
PERMIT ISSUING FEE 3.00 Q
TOTAL FEE Q�
PLAN CHECK VALIDATION CK. M.G. CASH. PERMIT V IOATION cK. M.O. CASH
Li � 6;0
1 9 4"1 PR 7 �1^ 1 2.0 0
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
i Wm that I have a COMPENSATION of consent
76_663 to/Bt APPLICATION FOR ELECTRICAL PERMIT {�
I`hereby affirm that 1 have a certificate of consent to self insure, CE-SDBG LJ
or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY
copethereof fee, 380C.Lab. C.) _
Policy No. Company- FOR APPLICANT TO FILL IN JOB
❑ Certified copy is herebyfurnished. EACH NO. FEE ADDRESS -1 C 3 '1 �. , Lim U S ♦1 QQ s
New Residential Bldgs.& Pools
�❑ Certified copy is filed with the count building 1 & 2-Famil $ —
$
LOCALITVT��r\'`h �� ��� gyp`
y g inspection Y.Sq.FL
department. Multi-family Sq.Ft. p — NEAREST CROSS ST1 A
i&esidercliel-6mmrmng-Pools S l - 0 . ' bs,l-Y N
.Date Applicant 1 eve
• ,OWNER OR
\ \� ;FIRM NAME V \�
CERTIFICATE-OF EXEMPTION FROM WORKERSOutlets:Ree— Light —Sw. 'MAIL '
COMPENSATION INSURANCE •_ 'ADDRESS q0 3 4• L . h�Ls�mos . OIt
(This section need not be completed if the work involved by the First 20 \ n
permit is for one hundred dollars(S 100)or less.) ' , Total No. Additional CITYT'lS �t: CI Tel' o'a�S b 4D Y
I certify that in the performance of the work for which this permit .. APPLICANTK
is issued, I shall not employ any person in any manner so as to -
become subject to the Workers'Com soften Laws Lighting Fixtures First 20 - ADDRESS
Additional
Total No. CITY � Tel.No.
xDate Applica Fixed Appliances Not Over 1 HP ,
NOTIC TO,AP LICANT: If, after akmg Ihis Certificate of PERMIT
Exemption,you should become subie to the Workers'Compensation Range_ Heater_ D.W. _ APPLICANT
provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer _ W.M._ ADDRESS
I provisions•or this permit shall be deemed revoked. Top — FAU — W.H. _
CITY Tel.No.
LICENSED CONTRACTORS DECLARATION Hood — Fan Other_
I hereby affirm that`I am licensed under provisions of Chapter 9 LICENSE OR
(commencing with Section 7000) of Division 3 of the Business and Disp, — Roam Air Coed. REG.NUMBER. Clasa,
Professions Code,and my license is in full force and effect. .DISTRICT NOPROCESSED BY
Power Apparatus& large Appliances d
Size& Type HP,KW,KVA,or KVAR
Liter se Number Lic.ClassUp to 1 Incl. FINAL V
Over 1 to 10'lncl. DATE VALIDATION 0
Contractor - Date Over 10 to 50 In . - FINAL � f ~
❑ 1 am exempt under Sec. Over 50 to 100 Inc. By - r-'-'-= W
B,&P.C.for this reason Over 100
Services,Swbd.,MCC& Panelboards
Date:
0-200 Amp.
Under 600 V W PPP
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 2
HOME OWNER-BUILDER DECLARATION 'Sign with One Branch Circuit
I hereby affirm that I am exempt from the Contractor's License Law t14CT,T
for the following reason(Section 703 1.5,Business and Professions Additional Sign Branch Circuits
X Code): - r 3307 00.50
I,as owner of the property,will do the work and the structure Misc.Conduits.&Conductors - 1 ITEMS.
is not intended or offered for.sale (Section 7044, Business Other(See Complete Fee Schedule)
and Professions Code). - , - - TOTAL 30. 50
CONSTRUCTION LENDING AGENCY _ MCK 30.50
I hereby affirm that there is a construction lending agency for the CHANGE .00
performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total)
Lender's Name
Civ.C.). -
PLAN CHECKING FEE - OODD'0001 HI18/8S
� _ � CL
PERMIT ISSUING FEE 5154 1 AM 8:50
Lender's Address -
I certify that I have read this application and state that the above TOTAL FEE
information is correct. 1 agree to comply with all County ordinances
and State laws regulating Electrical wiring, and hereby, authorize _
representatives of this County to enter upon th above-mentioned Property -
for inspection es. // ,
// �(�9S(((///nnnLLW[V///rW///t'q///ry SEE REVERSE FOR EXPLANATORY LANGUAGE
Si nature of .ermine / Date
COUNTY OF LOS ANGELES TEMPLE CITY 4 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1004270024
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID BUILDING ADDRESS: 1
ITR: 5905 LT: 112 1 9034 HERMOSA DR
I IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT:1 TEMP CA 917801841 1
1 ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: ROSEMEAD
15387-014-009 1A1 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY, Cl
I IF1 120V, 15/20A BR CKTS 1.00 BE 17.25
I TENANT: HA FAU LESS 3HP 1.00 FAD 10.95 (ISSUED ON: PROCESSED BY: PLAN BY:
I JB AC UNITS +3-10HP 1.00 AC 19.65 104/27/10 SR
I ILB 200 AMP PANELS, MCC 1.00 PAN 38.85 1
10WNER: TEL. NO: I TOTAL FEES 114.45 FINAL DATE FINAL BY: CODE:
ICEN, STEVEN (626) 292-6727- 1 11
19034 HERMOSA DR I v I 2'-it)
ITEMP 917801841 DESCRIPTION OF WORK
(ELECTRICAL FOR HVAC SYSTEM AND UPGRADE SERVICE PANEL TO
1200 AMP I
1APPLICANT: TEL. NO: I I
IWONG (626) 443-1688- 1 1 1
12511 ROSEMEAD BLVD. I SPECIAL CONDITIONS:
ISOUTH EL MONTE 91733 1 1
I I I
CONTRACTOR: TEL. NO: I 1APPROVALS DATE INSPECTOR SIGNATURE
IG W AIR CONDITIONING, INC. (626) 443-1688- 1 1
12511 ROSEMEAD BLVD. LIC. NO I ITEMFORARY POWER POLE I I I
]SOUTH EL MONTE, CA 91733 50556SC20 I I I I
I IUNDERGROUND CONDUIT
I
(ARCHITECT OR ENGINEER: TEL. N0: I 1UFER GROUND 1
LIC. NO: I IROUGH CONDUIT
IROUGH WIRING
I I
I 1 (MAIN WATER LINE 1 I I
I ,! (PLASTIC YIN METAL YIN
JUTILITY COMPANY NOTIFIED( I
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(REPORT ID: DPR265 ROUTE TO: BS 0508 I I I I
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