The URL can be used to link to this page

Home My Public Portal About10217 LA ROSA DR_Electrical__ DBS-5A APPLICATION FOR, ELECTRIC PERMIT 1 76A 66 usa DIVISION OF BUILDING AND SAFETY ` Department of County Engineer County of Loa Angeles - BUILDING ) ,( WM. J.FOX, COUNTY ENGINEER ' _ADDRESS ID,z 7 - 4.4 '9`0�A CASSATT 0. GRIFFIN, SUPT OF BUILDING FOR APPLICANT TO FILL IN a LOCALITY ' l 'Ell / J_ra �1�}"T�N A� /G PERMIT FEES NEAREST EST. ✓IL • FEE NUMBER EACH ` W,LL{.gr� LIGHT OUTLETS OWNER Vy � RECEPTACLES M AIL WALL SWITCHES ADDRESS 102_ / 7 A A 13c,5Q� . /y 7-`/ TOTAL OUTLETS 50 IS CITY /C/ I />L r, Lr/ 7 'TEL. NO. - ELEO. RANGES 25 ELECTRICIAN ELEC. HEATERS 25 —ADDRESS KW EA CITY TEL. NO. FIXTURES 5 LICENSE NO. NUMBER OF LIGHT CIRCUITS _ DISTRICT NO. IGROUP I ZONE RE>tov FOR IxsRrcrlox NUMBER OF RECEPTACLE CIRCUITS . .MOTORS .L 10 t NUMBER HORSEPOWER FEE INSPECTION aCORD •% �/, NEW MVO. .HP OVER INC. EACH _ y2 R Less 5 .25 v3 2 .50 OF-- 2 5'- '1.00 --_ 5 .. � 15 1.50 _ 15 50. 50 200 5.00 MISC. NO, SIGNS NO. TRANS. I _ NO. SIGNS NO. LAMPS _ FOR EACH PERMIT: _ WIRING S1.00 't dU _ FIXTURES . S1.00 SUPPLEMENTARY .50 _ -- APPROVALS TOTAL FEE - $ 11-2-5 DATE INSPECTOR'S SIGNATURE 1 HEREBY ACKNOWLEDGE THAT I' HAVE READ THIS'APPLICATION CONDUIT n AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY , WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING ELECTRICAL WIRING. I HEREBY CERTIFY THAT I AM. PROPERLY REGISTERED AND/OR FIXTURES' LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF POWER CALIFORNIA OR THAT i AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL ROPERTY.. UTILITY CO: NOTI FIEO - I/ �• �� SIGNATURE OF PERMITTEE L FINAL — Y WILLIAM J. FOX. COUNTY•ENGINEER 'VALI. 'J 5 -5 JAN 11 :2 • 125 * °3 'BY . . DEPUTY 76A663-Cl,80611,TD APPLICATION "FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING . BUILDING AND SAFETY DIVISION ADDRESS /o'Zj'7 EA COLEMAN W. JENKINS SUPERINTENDENT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL-IN CROSS ST. &I OUTLETS NO. EACH FEE OWNER oM S S REC EP T.firl MAIL ' II TOTAL FIRST 20 '25 ADDRESS GHT �w CITY TEL. N0. SWITCH ` -� OVER 20 m -LID PLAN CHECK. - LIGHTING 1 FIRST 20 25 L O L) 'APPLICANT %TURES .10 - T TOT L OVER 20 ADDRESS 'FI APPLIANCES CITY TEL, NO. PERMIT RANGE_DRYER-LWTR. HTR._ APPLICANT STA. COOKDISP.L/—,F.A.U._ ADDRESS; SPACE HTR. AIR CON D. "CITY 42201,dW TEL. NO. CLOTHES WASH.-WASH.' DISMWAS H.� LICENSE NO.'Ji o y CLAS S.0 /y FAN-OTHER r�.r� f}T,r 100 Ot I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ANO STATE THAT THE,ABOVE IS .CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING 1 WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. SIZE 6 TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 - I IOD LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF, AND INTEND TO ).. I - IO 3.00 RESIDE IN, THE ABOVE DESCPIBED RESIDE; l_ PROPERTY. 1 O 10 - 50 5.00 OF PERMRITTEE l.J K 50 - 100 10.00 O. DIS TRICTNO. CLASS ZONE PROCESSED BY 100 - 500 1500 J D - _j I 1 LU SIGN, GAS SIGN AND ONE CIRCUIT 5.00 NOTES: TUBE. OR ? MARQUEE ADDITIONAL CIRCUITS. 100 SERVICENOTOVER 600 VOLTS'OR 200 AMP '3.00 P APPROVALS DATE INSPECTOR'S SIGNATURE S ER VICEOV ER 600 VOLTS OR 200 AMP 10.00 TEMP.POWER POLE � TEMP.SERVICE,POLE, &APPURTENANCES 5.00 UNDERSLAB WORK . TEMP LIGHT OR RECEPT. SYSTEM 3.00 ROUGH CONDIUT PI L92--17 WIRING FIXTURES PERMIT FEE (SUB TOTAL) POWER AUTHORIZED PLAN CHECK FEE UTILITY CO. NOTIFIED FINAL PERMIT ISSUING FEE 3.00 - p JOSEPH C. ROOHAN TOTAL FEE -O, SUPERVISING ELECTRICAL ENGINEER. PLAN CHECK VALIDATION CK. M.D. , CASH PERMIT VALIDATION cK. M.o: CASH 1 I A 77-A DEC SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE TffNORKERS'COMPENSATION DECLARATION CE-80B ID/et APPLICATION FOR ELECTRICAL PERMIT -• 'CE-806G I�hereby affirm;tnat I�uave a certificate of consent to self insure, _ ,. , �or a certificate of Workers Compensation Insurance, or a certified COUNTY OF LOS ANGELESBUILDING,AND SAFETY copy thereof(Sec.3800,Lab.C.) '- Policy No; I Company � /�- ✓/tJ - FOR APPLICANT TO FILL IN JOB `q Certified copy is hareb ;furnished. �/ - - ''•:EACH NO.. . FEE ADDRESS ��. - /-' -/� v ��/Y r Y New Residential Slogs,& Pools LOCALITY Certified copy is filed with the county budding inspection 1 8 2-Family,Sq.FL. S ",department � � Multi family;Sq Ft. — � NEAREST D/� c �,,� Residential Swimming Pools CROSS Si. l C Date APPlieanl OWNER OR 1. , .. - -� .., (7 N , ... . CERTIFICATE OF EXEMPTION FROM WORKERS' / O _ MAIL A O T- ME ��Q COMPENSATION INSURANCE , Outlets Rec Light Sw _ d ADDRE .• ,(This section need not be completed if the work IJr vofved by the First 20 - „permit is for one,hundred,dollars ($100) or IessJ. . Total No. Additional - 'CITY r• Tel No. - / ' •' - PLAN CHECK - I certify that'in the performance of the work for which this,permit APPLICANT• - - ' is issued.) shall,not employ any the in.any.manner„so as to. r - - .. become subject to the Works ompensation Laws Lighting Fixtures First 20• •� ADDRESS Additional Total No. CITY Tel No _ Dale - Applicant' - ` ; Nq O APPLICANT: If, after making this' Certificate of Fixed Appliances Not Over 1 HP PERMIT Emotionyou should become subject to fhe.Workers'Compensation ', Range_ Heater_ D.W. _ - APPLICAN /ZL/ �/ ._� /CA �• provisions of.the Labor Code, you must forthwith comply,with such Oven Dryer _ W.M._ ADDRESS �/'-5- ,PST provisions or this permit shall be tleemsd revoked. Top, FAU W.H. _ CITY / Gl - -7e1. - 'LICENSED CONTRACTORS DECLARATION Hood Fan Other_ - ', T hereby affirm that I amlicensed under'provisions of Chapter 9 - Air Cond. uCE OR - (commencing with Section 7000)of Division 3 of the Business and Disp: — Room REG.NUMBEClass. R _ Professions Code,and my license.is'in full force and effect. - DISTRICT NO. PROCESSED BV Power Apparatus!8 Large.Appliances <:� Size& Type HP,KW,KVA,or KVAR License Number Lia.Class - UP to tancl. FINAL •U �/ ,` _ /J�, 9 - Over 1 to 10 Incl. DATE �� VALI TION r 'Contractor/' ''Date 7 /1” FIN !!! /// xt _ O Over 10 to 50 Incl 1 am exempt under Sec. _ Over 50 to,100 Inc' _ BY _ /_ ,/ W _ B.&P.C. for this reason Over 100 Q� - Services,Swbd.,MCCA-Panelboards 1 N • - Date: 8O21 0-200 Amp.Under 600 V - � -t Signature '' / 'r. 201 - 1000-Amp.Under 600 V• � `A Over 1000 Amp.or Over 600 V g 0'+,0.0 2 Exemption for Reg.Maint.Elect - .- r - . 11 a SINGLE FAMILY - / Temp.Power Pole& Appurtenances .1 7 5 0 ' HOME OWNER-BUILDER DECLARATION ,Sign with One Branch Circuit x I hereby affirm that I am exempt from the Con ,Ctors License Law •• •;• • 1 �•5.0 ao ' for the following reason(Section 703 5, mess and Professions - Additional Sign Branch Circuits - - _- Code): `0 9.2'9 t 8 7 -❑ I,as owner of the Proper -' -�Misc.`Conduits 8 Conductors •- - ' p p wJl do the work'and thesfructure i . •is not intended or of ed for sale (Section.7044, Business Other(See Complete Fee Schedule) ? i and Profession Cao e). i. • ,, ' C NST' RUCTION LENDING AGENCY' - I hereby at( that there is a construction lending agency for peform a of the work for which this permit is issued(Sec.3097,.'- PERMIT FEE - - (Sub-Total Civ: -PLAN CHECKING FEE - _ - . _: 411 Lender's-Name .. _ `` - `• «_♦PERMIT ISSUING FEE .- _ , J • , _ _ Lender's Address - - I certify that I have read this application and state that the above .TOTAL FEE - •/ . ( S + ,: information is correct.I agree to:comply with all County ordinancesand State laws regulating Electrical wiring, and hereby authorize' - representatives,of this County toe Pon the•above-mentioned Proper y i hspeeamn purpose - /AA SEE REVERSE FOR EXPLANATORY LANGUAGE' "Y 'S.•, I afore of Permitle Date. `WORKERS' COMPENSATION DECLARATION ID/BI APPLICATION FOR ELECTRICAL PERMIT I hereb>'e affirm that CE-806 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 certified copy thereof (Sec. 3800, Lob. C.) Policy No. Company FOR APPLICANT TO FILL IN . JOB ADDRESS L Certified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE ❑ Certified copy is filed with the county building inspec- 18 2-Family, Sq. Ft. $ — $ LOCALITY tion department. Multi-family Sq. FI. — 'NEAREST Residential Swimming Pools - CROSS ST. OWNER Date Applicant OR FIRM NAME - CERTIFICATE OF EXEMPTIONFROM WORKERS'• . � g _L Sw� - - i• ^MAIL COMPENSATION INSURANCE Outlets: Rec Li ht / ADDRESS _ First 20 F/ (This:action need not be completed If the work involved by Total No. Additional CITY el. No. the permit is for one hundred dollars($100) or less:) `i CK I certifythat in the performance of the work for which this PIAN C ET P C �'� APPLICANT permit is issued, I'shall not employ any person in any manner es ��i"'� - so as to become ,b(�1 to the Workers' mpensation La Lig ling Fixtures First 20 ADDRESS L Additional Total No.� -CITY :01e. No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT Exemption, TO APPLICANT: If, after making t o a Wore of APPLICANT 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. CITY Tel. No. Hood _ Fan _ Other— - - LICENSED CONTRACTORS DECLARATION ,. LICENSE OR I hereby affirm that I am licensed under,provisions of Chapter 9 Disp. _ Room Air Cond. REG. NUMBER Class. (commencing with Section 7000) of Division 3 of the BusinessDISTRICT NO. PROCES ED BY and Professions Code, and m license is in full force and effect. Power,Apparatus 8 Large Appliances y IL Size 8 Type HP, KW, KVA, or KVAR' 1 . s O License Number Uc. Class Up to 1 Incl FINAL _� _ > W Over 1 to 10 Incl. DATE y IDATION 0 Contractor Date Over 10 to 50 Incl L V ❑ I-am exempt under Sec. Over 50 to 100 Inc. B d B.SP.C. for this reason Over 100 rA Date. ' Services, Swbd., MCC 8 Poneiboards ► - 2 0 - 200 Amp. Under 600 V Signature 201-- 1000 Amp.Under 600 V -8055A Over 1000 Amp. or Over 600 V ❑ Exemption for Reg. Maint. Elect. - # e i'e •! 2 SINGLE FAMILY - Temp. Power Pole 8 Appurtenances _ HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I,.e • 5.7 5 I hereby affirm that I am exempt from the Contractor's License gdditibnal-Sign Brunch.Circuits = i Low for the following reason (Section 7031.5, Business and �j,7 5'c� ,Professions Code): e e4 /`�T�/1_,I Misr,Conduits 8 Conductors s as owner of the property,_will do the work and the I O.O5 a7 structure is not intended or offered for sale (Section Other (See Co__m plete Fee Schedule)- 7044, 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 ordinances and State laws regulating Electrical Wiring, and •hereby authorize representatives of this County to enter upon the alb mention d properly for inspection purpas s. ' SEE REVERSE FOR EXPLANATORY LANGUAGE Signature bf rkriVibe COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 9912220006 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 13531 LT: 3 -10217 LA ROSA DR FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803307 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: ARDEN 8585-006-003 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY HA FAU LESS 3HP 1.00 FAU 10.95 TENANT: JB AC UNITS +3-10HP 1.00 AC 19.65 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: TOTAL FEES 58.35 12/22/99 UT 06/19/00 OWNER: TEL. NO: FINAL DATE FINAL BY: CODE: MORTON WEBSTER G;EDITH R (626) 443-2528- h;ij_ 10217 LA ROSA DR TEMP 917803307 DESCRIPTION OF UORK ELECTRICAL FOR NEW HVAC SYSTEM IN RES JENCE APPLICANT: TEL. NO: BRYANT HEATING AND AIR CONDITIONING (626) 286-1141- 1350 E. LAS TUNAS SPECIAL CONDITIONS: SAN GABRIEL, CA CONTRACTOR: TEL. N0: SGS P1\1GE LE S CoAPPROVALS DATE INSPECTOR SIGNATURE Ty BRYANT HEATING AND AIR CONDITIONING (626) 286-1141- 1350 E LAS TUNAS DRIVE LIC. NO TEMPORARY POWER POLE SAN GABRIEL CA 91776 221751 C20 / UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: / UFER GROUND LIC. NO: 1111111 ROUGH CONDUIT `(►J-'Lr_U� ROUGH WIRING MAIN LINE I BL C V0 1 S PLASTCY/NMETAL Y/N UTILITY COMPANY NOTIFIED � j r,. `b�rc Servicce ThaIL REPORT ID: DPR265 ROUTE TO: BS0508 ' COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0004280002 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL D: FEES PAID BUILDING ADDRESS: TR: 13531 LT: 3 10217 LA ROSA DR FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803307 ASSESSOR INFORMA ION NUMBER: NEAREST CROSS STREET: BALDWIN 8585-006-003 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY, C G1 OUTLETS-LGT,SW,RECP 7.00 OUT 13.65 T NANT: G2 LIGHTING FIXTURES 3.00 LGT 5.85 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES-ON.- JX N.- JX MOTORS, LT 3 HP 1.00 MOT 15.30 04/28/00 VG 10/25/00 TOTAL FEES 62.55 OWNER: TEL. NO: FINAL DATE FINAL BY: COD . MORTON WEBSTER G;EDITH R (626) 443-2528- 10217 LA ROSA DR EC IPTIO �/ TEMP 917803307 DF WORK ELECTRICAL FOR STORAGE AND WATER FALL APPLICANT: TEL. N0: SAME AS OWNER - SPECIAL CONDITIONS: 1: LES CO CONTRACTOR: TEL, N0: S �1V APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO TEMPORARY POWER POLE / UNDERGROUND CONDUIT S'e ARCHITECT OR ENGINEER: TEL. N0: / UFER GROUND LIC. N0: / 1111111 ROUGH CONDUIT ROUGH WIRING u , MAIN WATER LINE U O L C W0�llQ� PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED d 8 O 0 O 0 46�rc Service Tlb, 'L REPORT ID: DPR265 ROUTE TO: BS0508