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Home My Public Portal About9118 HERMOSA DR_Electrical__ '6Ass"E 80TR 10"' APPLICATION FOR _ELECTRICAL_ PERMIT COUNTY OF LOS ANGELES ... DEPARTMENT OF COUNTY ENGINEER JOB cc BUILDING AND SAFETY DIVISION' ADDRESS - 0M C)VA ' FOR APPLICANT TO FILL IN LOCALITY New Residentiol Bldgs.&Pools EACH NO. FEE NEAREST 1 &2-Family,Sq..Ft. $ .025 — $ CROSS ST.'OWNEROR /(�� Multifamily Sq. Ft. .02 — FIRM NAMEAA �-l' Residential Swimming Pools 25.00 MAIL ADDRESS Outlets,Rec LightSw. CITY Tel.No:L First 20 +50 PLAN CHECK - Total No. Additional .30 APPLICANT ADDRESS Lighting Fixtures First 20 .50 1 1 1 CITY Tel.No. Total No Additional .30 APPLICANT S -, �( L C KJ/-� Fixed Appliances Not Over 1 HP ADDRESS G�� 3 W fN S L Range_Heater_D.W._ CITE Oven —Dryer_W.M._ ic LICENSE OR Top Top —FAU —W.H._ REG.NUMBER 3�� 8/ ClassC_< Hood_Fort _Other— I HEREBY ACKNOWLEDGE THAT I.HAVE READ THIS APPLICATION AND STATE Disp. — Room Air Cond. 2.50 THAT THE ABOVE IS CORRECT ANO AGREE TO COMPLY WITH PLL COUNTY ORDIN- ANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. Power Apparatus&Large Appliances Site&Type HP, KW, KVA,Or KVAR HEREBY CERT FT TH T I A OPERLY GISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGEL CO TV ND AT OF CALIF NIA OR THAT I AM >' Up to 1 Incl. 2.50 iHELEGALOWNEROFTHE BO EDE R ED RE DE IA OPERTY. p Over 1 to 10 Incl. 5.00 c.a Over 10 to 50 Incl. 12.50 PERMITTEE o Over 50 to 100 Inc. 25.00 SIGNATURE Over 100 40.00 DISTRICT NO. PROC SED BY ti Services 0- 200 Amp, Under 600 V 12.50 INSPECTOR'S 201 1000 Amp.Under 600 V 25.00 APPROVALS DATE SIGNATURE Over 1000 Amp.or Over 600 V 50.00 TEMP. POWER POLE UNDERSLAB WORK Temp. Power Pole&Appurtenances 10.00 Sign with One Branch Circuit 10.00 ROUGH CONDUIT Additional Sign Branch Circuits 2.00 WIRING Misc.Conduits&Conductors 10.00 FIXTURES Other(See Complete Fee Schedules POWER AUTHORIZED UTILITY CO. NOTIFIED -'7[� FINAL 17-12-79 PERMIT FEE (Sub-Totall 1-2, 'r NOTES PLAN CHECKING FEE (OneFourthPermit Feel PERMIT ISSUING FEE $7.00 Q7 O 0 T — TOTAL FEE PLAN CHECK VALIDATION CK. M . CASH PERMIT VALIDATION CK. M.O. CAST( 7.1 5:P. JUL "17 2 U SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE !/I WORKERS' `OMPE"SAT'°N,jECLAgATI°" pmt°DPW"a' APPLICATION FOR ELECTRICAL PERMIT 1 hereby affirm:thot'l hove o certificate of consent to self CE 80c insure, w a ceriificmte of Workers' Compensation.Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certified copy thereof (Sec. 3800, Lab. C. - Policy No. Company FOR APPLICANT TO FILL IN )OB Certified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE ADDRESS eY `L- �Certified copy is filed.with the county building inspec- 1 & 2-Family, Sq. Ft. $ — $ LOCALITY tion department. Multi-family Sq. Ft, — NEAREST CROSS ST. Residential Swimming Poois ONER OR Date Applicant WFIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS'. Outlets: Rec Light5w.�/ MJ�IL COMPENSATION INSURANCE 3 5 ADDRESS This section need not be completed If the work involved b First 20 ( P Y Total No. Additional CITY 7e1. No. S 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, 1 sholl not employ any person in any manner Lighting Fixtures First 20 ADDRESS so as to become subject to the Workers'Compensation Laws. Additional Total No.� CITY Tel. No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of PERMIT 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. - -deemed revoked. Hood — Fan —Other— CITY Tel. No. LICENSED CONTRACTORS DECLARATION LICENSE OR Disp. _ Room Air Cond. REG. NUMBER Class. I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT PRO E Y T and Professions Code,and my license is in full force and effect. - Size 8 Type HP, KW, KVA, or KVAR C 0 d ( P 0 License Number Lia Class - V Up to I Incl. lu DATE Contractor Over 1 to 10 Incl. DATE VALIDATION Q Date a Over 10 to 50 Incl. FINAL I am exempt under Sec Over 50 to 100 Inc, BY U LU 100 CIL B.BP.C. for this reason Over � - 'Services, Swbd., MCC 8 Ponelboards 00.Date: 0- 200 Amp. Under 600 V ? Signature 201 - 1000 Amp. Under 600 V ❑ Over 1000 Amp. or Over 600 V Exemption for Reg. Moint. Elect. SINGLE FAMILY Tem Power Pole 8 A 2 HOME OWNER-BUILDER DECLARATION p Appurtenances a here-by offirm that I am exempt from the Contractor' Sign with One Branch Circuit s License RGGT., Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits [ Professions Code): 307 21L SIJ VN I, as owner of the property, will o the work and the Misc. Conduits'&Conductors 1 ITEMS structure f not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ oil, - TOTAL 2S _ �FCi c Business and Professions Code). � - CONSTRUCTION LENDING AGENCY CHECK 16.511 - thereby affirm that there is a construction lending agency for ` - - the performance of the work for which this permit is issued PERMIT.FEE (Sub-Total) CHANGE . .. ........... .IJI-I (Sec. 3097,.Civ. C.). PLAN CHECKING FEE Lender's Name - f� GCIGO'OtAl1 1�� 1CJ PERMIT IS FEE (f Lender's Address 6556 1 AM 1n:09 1 certify that I have read this application and state that the TOTAL FEE t above information is correct. I agree to comply with all County - ordinances and State laws regulating Electrical wiring, and , hereby authorize repr�rsentotives of this County to enter upon the above-m Ila e, ¢roperty for inspection purposes. (J � SEE REVERSE FOR EXPLANATORY LANGUAGE r Sign ure o Permittee Date �' COUNTY OF LOS ANGELES TELE TY IC LE CI # 0508 ELECTRICAL.PERM I T.cj DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS EL 0508-9701230645 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: LEGAL ID: EES PAID BUILDING-ADDRESS: TR: 5905 LT: 85 9.118 HERMOSA_DR FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP-CA-9178 01918 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: HART 5387-016-031 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT,SW,RECP 4.00 OUT 7.80 TENANT: G2 LIGHTING FIXTURES 1.00 LGT 1.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: TOTAL FEES 37.50 01/23/97 TC 01/23/98 OWNER: TEL. NO: FINAL DATE FINAL BY: ODE: LIANG JACK C;DORIS T (818) 287-9585- �y 9118 HERMOSA DR z' Z� -I TEMP 917801918 DESCRIPT ON 0 ORK 80f/uELECTRICAL FOR NEW ENCLOSED PATIO A C T: TEL. NO: SAME AS OWNER - t� o SPECIAL CONDITIONS: CONTRACTOR: TEL. N0: `� \ •�� APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - '-� "" `'''� 0 0 / a LIC. NO ;-�'.i =% - O / TEMPORARY POWER POLE 0 O LL _ - UNDERGROUND CONDUIT ARCHITECT OR E \\J ENGINEER: TEL. NO: i �� '7 //V� 0 u 7 El"if 1.� UFER GROUND LIC. NO: -� _ ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE p PLASTIC Y/N METAL Y/N G d UTILITY COMPANY NOTIFIED REPORT ID: DPR265 ROUTE TO: BS0508