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HomeMy Public PortalAbout9922 LA ROSA DR_Electrical__ 75AGS3 Das 5A 7-51 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY ELECTRIC i COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO F LL IN DISTRICJ. NO. GR UP ONE PERMIT NO. ELECTRICIAN R EIVED BY READY FOR DATE ISSUED ADDRESS ��` FIRST INSPECTION ♦ / /�� CITY TEV NO. ([ {��•�' 7 !/� /`-I /{�/) y/ COUNTY LICENSE NO. EXPIRES BUILDING PERMIT FEES - ADDRESS "� / A /.� T..L�•I I J> 'rA -i /FEE l::LF(1� � (NUMBER EACH LOCALITY �JIf}yl ,(l LIGHT OUTLETS f •% ...JJJ /( � � CROSS ST. RECEPTACLES /••Z WALL SWITCHES v OWNER C-fr CJ�. /nI/�•.rA-¢�/� TOTAL OUTLETS Sc ® ELEC. RANGES 25 =LESS /�'] / EL ELEC. HEATERS 25 ,fes CITY �AI rl� L� NO. FIXTURES 9 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS 12 AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT I POSSESS THE ABOVE VALID LOS NuMRew HORSEPOWERPEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER NEw MVD. HP Ycq IRC. SADR OF THE RESIDENTIAL PROPERTY DESCRIBED A(/B•OVE. LE55 $ .25 Q SIGNATURE Or/ �� 1 2 .50 PERMITTEE _- 2 5 I= INSPECTION RECORD s is 1.50 15 50' 2.50 12/12• /+ _ 50 200 5.00 /)[`) �n•4 Sfrp✓ 'C- 200 - 2O0 / 500 10.00 �� �yT„AoW �a,A.r .�2r•f,I.! A•/F'� J _ Boo 1000 15.00 - a GQAJ� C n A 1 Z OVER tppp zp.DD p _ M.O. SET/FREQ. CHANGER-HP s A YIP MSC 6 � WELDERS: AC-KVA GENERATORS - KW q �� GD Jn GLe. e TnvEt fyaaeciBLP TRANSFORMERS - KVA _TEMP. MOTORS (75q OF ORIG-) '� 0/4�g5r nAJ V.QL�• / MOVED MOTORS (75% vF vRIG.) MISC. SIGNS NO. NO.TRAM& APPROVALS NO. NO. LAMPS FOR EACH PERMIT: DA/TE INSPECTOR'S NAME WIRING $1.00 J CONDUIT FIXTURES $1.00 'd WIRING / /i.�.r�i - }-N TZ BUPPLEMENTARY .50 FIXTURES ® POWER TOTAL FEE $ ` / UTILITY CO.NOTIFIED !3 FINAL � /Z WORKERS'COMPENSATION.DECLARATION 16A663 10,81 APPLICkiION FOR ELECTRICAL PERMIT hereby affirm'that I have a certificate of consent to self CE-806G insure, or d cerlificate of Workers',Comperepption Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY • or a certified copy thereof (Sec 3800, Lab. C.) Policy Nb. 4ompany. FOR APPLICANT TO FILL IN JOB 1 �( �n ,,!! ❑ Certified copy is hereby furnished. New Residential Bldls EACH NO. FEE ADDRESS 12. (.-iT FKO.SA FJ✓E 7C /P C gs. 8 Poo `7 ❑ Certified copy is filed with the county building inspec- 1 8 2-Family, Sq. Ft. $ — 8 LOCALITYni /. q� tion departmentMultifamily NEAREST ily Sq. CROSS Residential Swimming Pools OWNEROR ((,�r Date Applicant FIRM NAME MV 'Of, 1-Cl Ce}otl CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec __r Light_2_Sw. Z t MAIL COMPENSATION INSURANCE First 20 — ADDRESS P 0 13OX 1341 (This section nerd not be completedlga if the$10work involved by Total No.—go Additional CITY ,ato,4MBW Ctg4&),Tel. No.x'73-f{CD the permit is for one hundred dollars (f100)or less.) I certify that in the performance of the work for which this PLAN CHECK permit is issued, APPLICANT 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 I 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 provisions of the Labor Code, you must forth- Oven — Dryer — W.M._ ADDRESS P 0 PDX ( 142 with comply with such provisions or this permit shall be Top _ FAU —W.H. �� IQal �_�� deemed revoked. Hood _ Fan _Other_ CITY Tel. No. o 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 Business }' ( 9 ) DISTRICT NO. P OCES D BY d and Professions Code, and my license is in full force and effect. Power Apparatus 8 Large Appliances 0 "/ koa / p 1 Size R.Type HP, KW, KVA, or KVAR . 09 0 license Number Y'Y" (R O• Lic Class C_ Up to I Incl. FINAL cc DATE 0 �, 10-31Over I to 10 Incl. VALIDATION IF. Contractor Date Over 10 to 50 Incl. ❑ FINAL W I am exempt under Sec. Over 50 to 100 Inc. BY B.BP.C. for this reason Over 100 Z Date: Services, Swbd., MCC 8 Ponelboords ► ` m \D Signature 201 - 1000 Amp, Under 600 V Over 1000 Amp. or Over 600 V ` /1 ❑ Exemption for Reg. Maint. Elect. Q� SINGLE FAMILY Temp. Power Pole 8 Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 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 Professions Code): ❑ I, as owner of the property, will do the work and the Misc. Conduits 8 Conductors ` 2 5 85 O-A structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ , # e r e e e 2 7044, Business and Professions Code). ( e e 3�.0 O CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for P e e 3 3 o Q V the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) (Sec. 3097, Ci, C.). 8 6 PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address 1 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 theaboveQment oned propert for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE to-V—9� Signature of Peilminee Date ORATION. +zaDowDPW s/a] 6APPLICATION FOR ELECTRICAL .PERMIT /of consent to sell ,0rsa80 ec �J t ipensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS .Y•-Lab. C.) y FOR APPLICANT TO FILL IN _ - JOB qq 1 .rnished. New Residential Bldgs. Pools EACH NO. FEE ADDRESS / 1� f '4 y9 /<�rU"`P OQ . 8 � - 'I lith the county building inspec- 1 8 2-Family, Sq. Ft. $ s - LOCALITY Multi-family Sq.Ft. — NEAREST l CROSS$T. Residential Swimming Pools - OWNER OR , ^PPlimnt - �!� '�/' _ .- FIRM NAME C✓P,Y .E 'Cyrl1G.Hl :r EXEMPTION FROM WORKERS' /$ Z't71 e. � MAIL :1PENSATION INSURANCE Outlets: Rec�Light Sw_ O / ADDRESS 9 c, 2'- �-/� USF V(Z r /j'� First 20 _ Tel. No.217.i-6GSS' - need not be completed if the.work•invdlved'by Total No._,G..� CITY TEm C LQ G/-T i;1. Total is for one hundred dollars ($100)'or less.) - Additional '� d�� ' _ PLAN CHECK h'I certify that in the performance of the work for vihich this _ ' f � \ 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 d ADDRESS Additional Date 7"!/-`,/f Applicant /✓-zn /r; �T Total,No. 13 CITY _ Tel. No. NOTICE TO APPLICANT: If, 'after magi this Ceri Icoie-oi Fixed Appliances.Not Over 1 HP PERMIT 9 'S'-!i✓ Range— Heater—D.W. APPLICATION Exemption, you should become subject to the Workers" Compensation provisions of the Labor Code, you must forth- Oven — Dryer __L W.M.L ADDRESS with comply with such provisions or this permit shall be Top FAU —L-W.H. - - deemed revoked. �� CITY Tel. No. Hood — Fan —Other— LICENSED"CONTRACTORS DECLARATION LICENSE OR - Disp., — Room Air Cond. — - - {lass. , I hereby affirm that I am licensed under provisions of Chapter 9 ' REG. NUMBER (commencing with Section 7000)of.Division 3 of the Business Power Apparatus 8 Large Appliances 'DISTRICT NO. R ESSED BY d and Professions Code,and my license is in full force and effect. __ 0- Size 8 Type HP, KW, KVA, or KVAR ,���i O C License Number Lic. Class Up to 1 Inc], - - 'FINAL- - - - I Over 1 to 10Ind., DATE. ,I_ 1(s" ?. -_ VALIDATION 0 Contractor _ Date -" Over 10 to 50 Incl. J h- ❑ FINAL0 I am exempt under Sec. Over 50 to 100 Inc. BY 9 LU B.BP.C. fore his reason - Over 100 V - Data. - .Services, Swbd., MCC.B Ponelboards / - - Z 0-200 Amp. Under 600 V Signature - 201-- 1000 Amp. Under 600V - - -- ❑ Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V - SINGLE FAMILY. HOME OWNER-BUILDER DECLARATION Temp. Power Pole 8 Appurtenances y _ _ - I hereby affirm that I am exempt from the Contractor's License Sign with One-Branch Circuit 'n. Law for the following reason (Section 7031,5,-Business and _Ad_dition_al Sign Branch Circuits ` `3(; Professions Code): - 1 : I, as owner of the property, will o the wor- Misc. Conduits 8 Conductors Tht� f so and the -- �- structure is not intended or offered for-sale(Section 7044, Other (See Complete Fee Schedule)— ® ;i_y j�"'�-'1Z � �.-_s m �-+ Business and Professions Code). - !�.Yt!_K. `=``•'-' CONSTRUCTION LENDING AGENCY I - 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 _u'VCjI I_��Jtli - Lender's Name - a PERMIT ISSUING FEE dHilt Lender's Address TOTAL FEE certify that have read this application and state that the 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 above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE /✓ r l✓ 7—//— S 1 ©s Sinnolure of Permittee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0703230002 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91000 DUPLICATE PHONE: (626) 285-0488 EXT: ILEGAL ID: FEES PAID BUILDING ADDRESS: 1 ITR: 9481 LT:, 19 1 9922 LA ROSA DR IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:1 TEMP CA 917803922 (ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET: 18589-023-005 IA1 PERMIT ISSUANCE FEE 29.75 I THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY, Cl IG1 OUTLETS-LOT,SW,RECP 4.00 OUT 7.80 1 1 TENANT: IG2 LIGHTING FIXTURES 3.00 LOT 5.85 (ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: TOTAL FEES 41.40 103/23/07 JK 09/19/07 I OWNER: TEL. NO: _ FZI�Y'S`pT= FIyAj��Y: CODE: WRIGHT WAYNE A;WANG LUCTNDA WEN-HUE - L/V�. I /7%1/' 19922 LA ROSA DR 1TEMP 917803922 1 IDESCRIPTION OF WORK 1 14 OUTLETS, 3 LIGHT FIXTURES I I 1APPLZCANT: TEL. N0: I I I 1HAUN (714) 871-4165- 1765 S. STATE COLLEGE 1 ISPECIAL CONDITIONS: IFULLERTON, CA 92631 1 I I I I ICONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE IAMBIANCE ADDITIONS (714) 871-4165- 1 1 1765 S STATE COLLEGE BLVD LIC. NO (TEMPORARY POWER POLE 1 ISUITE p I 541733 S FULLERTON, CA 92631 (UNDERGROUND CONDUIT I I 1ARCHITECT OR ENGINEER: TEL. NO: I IUFER GROUND I I I I I I I I I LIC. NO: IROUGH CONDUIT I I I 1 I TROUGH WIRING I 1 I (MAIN WATER LINE I PLASTIC Y/N METAL Y/N I I I (UTILITY COMPANY NOTIFIED( I 1 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 1 I I I I I I I I I I I I I I I I I I I I I I I• ADDITIONAL DATA ON FILE I I I (REPORT ID: DPR 265 ROUTE T0: BS 0508 I I I I I I