HomeMy Public PortalAbout10018 LIVE OAK AVE_Electrical__ 76A663 DBS SA 3-50 APPLICATION FOR PERMIT
-t� DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES 7�3 L %Am;T AR'lC i
WILLIAM J. FOX, CHIEF ENGINEER
F�OR�APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO.
ELECTRICIAna�I
ADDRESS ! Q �� v �( RECEIVED BY READY FOR DATE ISSUED
FIRST INSPECTION //-7
v �
CITY yy TEL NO.
COUNTY LICENSE NO. //,tea EXPIRES ,� BUILDING
PERMIT FEES v R ADDRESS / C'
NUMBEEACH FEE LOCALITY s1,41 4 /Q0% X A.6
LIGHT OUTLETS NEAREST
CROSS 8T.
RECEPTACLES
WALL SWITCHES /1
OWNER
TOTAL OUTLETS SO $ 4.ol MAIL b"r/
ELEC. RANGES 25 ADDRESS l/!
ELEC. HEATERS 25 CITY TEL. NO.
FIXTURES r 5 g
- 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
M19C. APPLICATION AND STATE THAT THE ABOVE 19 CORRECT
NUMBER OF LIGHT CIRCUITS 3 AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. ,
MOTORS 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
NUMBER HORSEPOWER ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
NEw MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
b �
t.{ I�z a LESe $ .23 S SIGNATURE OFIt /� ,,yy
%2 2 .50 PERMITTEE
2 5 1.00 CINSPECTION RECORD
5 15 1.50
15 so 2.So
50 200 5.00
200 500 10.00 J
500 1000 15.00 Z
OVER 1000 20.00
M.O. BET/FREQ. CHANGER-HP Q'
WELDERS:AC-KVA O
GENERATORS - KW
TRANSFORMERS - KVA
TEMP. MOTORS (75% OF ORIG.)
MOVED MOTORS (75% OF ORIG.)
M ISC.
SIGNS
NO. NO.TRANS.
APPROVALS
NO. NO. LAMPS
FOR EACH PERMIT: DATE INSPECTOR'S NAME,
WIRING $1.00 CONDUIT
FIXTURES $1.00 WIRING / a�F�a L 3IP7
SUPPLEMENTARY ,50 FIXTURES
POWER
TOTAL FEE rll� UTILITY Co.NOTIFIED
FINAL
I
ION
WORKER'S I have
a certificate
of consent to 20-0019 DPW(12-9t) P' PPLIC6' MN, F®^ ELECT ICAL PERMT
76A663 - 1� �( �J
I hereby affirm that I have a certificate of consent to self Insure,
or a certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV.
copy thereof(�ec 3800 Lab C)
Policy No Company FOR APPLICANT TO FILL IN JOB
ADDRESS
Certified copy is hereby furnished New Residential Bldgs &Pools NO EACH FEE
$ $ LOCALITY
ET Certified copy Is filed with the county budding Inspection 1 &2-Family,Sq Ft
or
department Multi-family Sq Ft CROSS ST
Date Applicant Residential Swimming Pools ASSESSOR
MAP BOOK PAGE PARCEL
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec Light Sw O• M
t NER OR
COMPENSATION INSURANCE
/l, � `V�` �� � NAME
(This section need not lie completed if the work Involved by the MA
Total No 1 Additional CJ ADDRESS /UO/8 Lt✓C
permit is for one hundred dollars($100)or less.)
I certify that in the performance of the work for which this permit CITY 'rC /e e Tel No 7�/_9 �
is Issued, I shall not employ any person In any manner so as to 1
become subject to the Workers'Compensation Laws Lighting Fixtures First 20 _ PLAN CHECK
1 P 9 9 _ APPLICANT
Total No Additional -
ADDRESS
Date ApplicantRESIDENTIAL APPLIANCES NOT OVER 3 HP
NOTICE TO APPLICANT ,If, after making this Certificate of CITY Tel No
Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP
provisions of the Labor Code, you must forthwith comply with such PERMIT
provisions or this permit shall be deemed revoked
Power Apparatus&Large Appliances APPLICANT
" LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS
I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl
(commencing with Section 7000) of Division 3 of the Business and CITY Tel No
Professions Code,and my license Is In full force and effect Over 10 to 50 Incl }•
REG NUMBER Over 50 t0 100 Incl LICENSE Class a
Over 100- DISTRICT NO P O ESSED BY O
License Number Llc Class �i V
Services,Swbd,MCC&Panelboards OO
0-399 Amp Under 600 V FINAL
Contractor Date
DATE
400-1000 Amp Under 600 V n V
ElO I am exempt under Sec VALIDATION U.I
Over 1000 Amp or Over 600 V FINAL a.
B&P C for this reason BRANCH CIRCUIT FEES BY 0
Date 15A,or 20A, 120V,Lighting or Recept Z
1 To 10 Branch Circuits
Signature 11 To 40 Branch Circuits
❑ 41 Or More Branch Circuits n
Exemption for Reg Maint Elect 15A,20A,208V To 277V Lighting Br Circuits y
SINGLE FAMILY Temp Power Pole&Appurtenances i f
HOME OWNER-BUILDER DECLARATION t: °ir
I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit
for the following reason (Section 7031 5, Business and Professions Additional Sign Branch Circuits 5J_.j %J
\Code) f NEMS
X/I I, as owner of the property,will do the a work and the structure Mlsc Conduits&Conductors 1 A
is not Intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule)
and
and Professions Code) - r
F_HECK
CONSTRUCTION LENDING AGENCY Lfii I�tL117
I hereby affirm that there Is a construction lending agency for the fi
performance of the work for which this permit is issued (Sec 3097, PERMIT FEE (Sub-Total)
Civ C) I
PLAN CHECKING FEE �) ��-
Lender's Name ry j Sh, !
� � �? PERMIT ISSUING FEE 2 r i I
Lender's Address O to 7t L (yt A 6),- A
I certify that I haverear pphcahon�er penalty of pupury state TOTAL FEE )V
that the above Information Is correct I agree to comply with all County T -
ordinances and State laws regulating Electrical wiring,and hereby authorize
representatives of this County to ter upon the above-meritioned property -
for Inspectio rpose Id - 2- 1 _n,3 SEE REVERSE FOR EXPLANATORY LANGUAGE
SIGNATURE OF PERMITT E DATE
• • COUNTY OF LOS ANGELES p TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS EL 0508 9808140002
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA
PHONE: (818) 285-0488 EXT:
LEGAL FEES PAID U ING ADDRESS:
TR: 16957 LT: 23 10018 LIVE OAK AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802711
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: BALDWIN
8586-021-010 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY, C
HA FAU LESS 3HP 1.00 FAU 10.80 /
TENANT: JB AC UNITS +3-10HP 1.00 AC 19.80 ISSUED PROCESSED BY: PLAN BY: EX 0 :
LA 100 AMP PANELS, MCC 1.00 PAN 38.85 08/14/98 VG 08 /99
TOTAL FEES 97.20
OWNER: TEL. NO: FINAL DATE FINAL B CODE:
ATIA ATIA YOUNAN;NADIA MORICE (626) 574-9020- _
10018 LIVE OAK AV
TEMP 917802711 N—SIC—RI-P—TION OF WOR
UPGRADE ELECTRIC SERVICE 100 AM ND CIRCUIT TO A/C
APPLICANT: 0:
SAME AS OWNER
----_ SPECIAL CONDITIONS:
CA
CONTRACTOR: TEL. N0: ®�� �� APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER /
LIC. NO �/ 1�n� \\ Y POWER
/ t-( w UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER: / Ii Ir UFER GROUND
LIC. NO:�; ��l�il ROUGH CONDUIT
ROUGH
Gi�' � �ti� MAIN WATER LINE
L�:fJ Lt'���J �','�J ���J ��L��� j� PLASTIC Y/N METAL Y/N
UTILITY 1 -- ---- — - --- — -- — , COMPANY NOTIFIED
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REPORT ID: DPR265 ROUTE TO: BS0508