HomeMy Public PortalAbout9927 HOWLAND DR_Electrical__ 76A663C- CEBl761B ;z,75 Ml1 UCEM FOR KENNER PERM
BUILDING AND FETY DIVISION
FOR APPLICANT TO FILL IN JOB 2,7 OWI.M DR.
New Residential Bldgs..&-Pools
EACH NO. FEE ADDRESS 91
1 &,2 Finaily Sq. Ft. $ — LOCALITY LE
Multi-family Sq. Ft. — NEAREST
CROSS ST.
Residential Swimming Pools OWNER OR
FIRM NAME . ULZADA .LUIS
Outlets: Light, Switch& Receptacle MAIL '
First 20 ADDREISS�+�,�p - p p
Additibnal - CITY 11:,.i•l,[1.1•. ,�yy Tel. No. 285-8058
PLAN CHECK
Lighting Fixtures, APPLICANT
First 20 ADDRESS
Additional
CITY Tel. No.
PERMIT
Fixed Appliances Not Over 1 HP APPLICANT TRADE HCC
Range Heater 'D.W. ADDRESS
Oven Dryer W.M.
Top FAU W.H. CITY .S. EL MNTE Tel. NO. 579-7982
Hood Fan LICENSE OR o
REG. NUMBER Class. _ c�
Disp. A.C: 1 50 �
THEREBY ACKNOWLEDGE THAT HAVE READ THIS APPLICATION Q
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING W
Size&Type.HP, KW, KVA,Or KVAR ELECTRICAL WIRING. Q_
co
Up to 1 InclERz
I HEBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
'Over 1 tO 10 Incl. .LICENSED AS REQUIRED BY LOS ANG 5 COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE G L NER OF THE ABOV
Over 10 to 50 Incl. DESCRIBED RESIDENT A PR ERT J
Over 50 to 100 Incl. PERMITEE
Over 100 SIGNATURE
Services DISTRICT NO. Z CES D BY
0'-200 Amp: Under 600 V 4 50G,�� 1
201 - 1000 Amp: Under 600 VAPPROVALS DATE INSP OR'S
Over 1000 Amp.or Over 600 V SI ATURE .
TEMP. POWER POLE
Temp..Power Pole&Appurtenances
UNDERSLAB WORK
Sign with One Branch Circuit. ,
'Additional Sign Branch Circuits ROUGH CONDUIT
"(Other) WIRING "^ "
FIXTURES
P,OWE:R AUTHORIZED'
PERMIT FEE (Sub-Total)
0 UTI LITY CO.NOTIFIED
PLAN CHECKING FEE (One-Fourth Permit Fee) FINAL
PERMIT ISSUING FEE +►
NOTES
TOTAL FEE 15.00
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION M.O. CASH
0 :3:5' AUG 6 -20 1 5.0 C) e_
WORKERS'COMPENSATION DECLARATION CE-806 10,81 QPPUC ANON FOR ELECTQ CAL pEaG�10T
I hereby affirm that I have a certificate of consent to self. CE-806G
insure`, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY
or a certifi copy thereof (Sec. 3800, Lpb. C.1)
Policy N 22? Company �<yf / js FOR APPLICANT TO FILL IN JOB
❑ Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE - ADDRESS
1 &2-Family, LOCALITY
Certified copy is filed with the count building inspec- y, Sq. Ft. $ — $
tion par ' ent. Multi-family Sq. Ft. — NEAREST
CROSSST1-7
Date /Z" �Z ��ApplicanCv l+y-` Residential Swimming Pools OWNEROR
FIRM NAME
CERT( KATE OF EXEMPTION FROM WORKERS' � MAIL _
Outlets: Rec.- Light Sw.
COMPENSATION INSURANCEADDRESS ? G
This section need not be coFirst 20
( m completed if the work involved b y Total No. Additional CITY �-_3/7 Tel. No
the permit is for one hundred dollars ($100)or less.) ,
I certifythat in the performance of the work for which this PLAN CHECK
p - 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. Additional
CITY Tel_. No.
Date Applicant Fixed Appliances Not Over 1 HP PERMIT
NOTICE'TO APPLICANT: If, after making this Certificate of APPLICANT
Exemption, you should become subject to the Workers' Range_ Heater—D.W. —
Compensation pro'v'isions of the Labor Code, you must forth- Oven _ Dryer — W.M1: ADDRESS g2g 7!f
with comply with such provisions or .this permit shall be Top. — FAU —WOther.H.
Hood Fan
deemed revoked. CITY j��� Tel. No,-2-r6
LICENSED CONTRACTORS DECLARATION _ _ _ f-
TICENSE OR
I hereby affirm that I am licensed under provisions of Chapter 9 Disp. _ Room Air Cond. REG. NUMBER S`S `S� Class.
(commencing'with Section 7000) of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO. PRO SED BY
and Professions Code, and my license is in full force and effect.
Size &Type HP, KW, KVA, or KVAR' O
Lic. Class License Number �l s Up to 1 Incl.
FINAL
,/��i,��}// <<L/j �� Over 1 to 10lncl. DATE �� -�
d1I r VALIDATION
Contracto , Date Over 10 to 50 Incl.
❑ I am,exempt
exempt under Sec. Over 50 to 100 Inc. BY LU
B.&P.C. for this reason Over 100
Services, Swbd., MCC & Ponelboards D
�Dr�e: 0 -200 Amp. Under 600 V
Signatur` =�✓Z-"��. rJ %1C> I u 201 - 1000 Amp. Under 600 V
❑ Over 1000 Amp. or.Over 600 V
Exemption for Reg. Maint. Elect.
SINGLE FAMILY Temp. Power Pole&Appurtenances
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 75�. 2 A
I hereby affirm that I am exempt from the Contractor's License ' •
Law for the following reason (Section 7031.5, Business and 'Additional Sign Branch Circuits u o o o c 2
Professions Code):
Misc. Conduits&Conductors' .2,0 0 5
El 1, as owner of the property, will do the work and the a'o o -
structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_
7044, Business and Professions Code). D
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
ordinances and State lows regulating Electrical wiring,and
hereby authorize representatives of this County to enter upon
ih a ve-mention p operty for inspection purposes.
t SEE (REVERSE FOR EXPLANATORY LANGUAGE
Signature of Permittee Date.
'COUNTY OF LOS ANGELES - TEMPLE CITY - - # 0508. ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0608280002
` BUILDING AND SAFEkY / LAND DEVELOPMENT TEMPLE CITY CA 91780 "
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
TR: 6755 - LT: 19 9927 HOWLAND DR
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803235
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET:
8589-005-015 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY, C
C2 SPAS, HOT TUBS, OTHR 1.00 SPA 54.45
TENANT: G1 OUTLETS-LGT,SW,RECP 9.00 OUT 17.55 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
LB 2001AMP PANELS, MCC 1.00 PAN 38..8508/28/06 JK 02/24/07
.TOTAL FEES 138.60
OWNER: TEL. NO: FINAL DAT ` FINAL BY: CODE: "
THOMAS IAN C;GREENE MARCELLE E -
9927 HOWLAND DR - -
TEMP 917803235
DEfCAIPfTIdN7OF WORK
- UPGRADE SERVICE PANEL TO 200 AMP, SPA AND 9 OUTLETS
APPLICANT: TEL. NO:
SAME AS OWNER - -
SPECIAL CONDITIONS: -
CONTRACTOR: .TEL. NO: - - - APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER _ - "
LIC. NO TEMPORARY POWER POLE - -"
UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER: - TEL. NO: UFER GROUND
LIC. NO: ROUGH CONDUIT nq
ROUGH WIRING
'Y
MAIN WATER LINE
PLASTIC YIN METAL YIN
- UTILITY COMPANY NOTIFIED. _
2 n.
- REPORT ID: DPR265 ROUTE TO: BS0508