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HomeMy Public PortalAbout5339 LOMA AVE_Electrical__ PPUC ATO GOP t dR MUC AL pC W4 76A663-EE806 10772 Q AD 0 0 O COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER JOB BUILDING AND SAFETY DIVISION ADDRESS LOCALITY eye i• NEAREST` FOR APPLICANT TO FILL IN CROSS ST. OUTLETS NO EACH FEE OWNER NAME $ $ [i ER OR RECEPT. MAIL ' LIGHT TOTAL FIRST 20 25 0 ADDRESS j �i,Q rid: Z( OVER 20 -0 CITY TEL. N0. SWITCH 10 PLAN CHEC LIGHTING FIRST 20 25 APPLICANT TOTAL FIXTURES OVER 20 10 ADDRESS RESIDENTIAL APPLIANCES CITY TEL. No. PERMIT RANGE DRYERWTR. HTR._ APPLICANT STA..COOK DISP F.A.U. ADDRESS _ SPACE HTR.-Al R*COND. - CITY TEL. NO. CLOTHES WASH. DISHWASH. LICENSE OR CLASS. REG. NUMBER FAN OTHER 100 1 HEHEBY ACKNOWLEDGE THAT I HAVE READ'THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC HP KW KVA. ELECTRICAL WIRING. SIZE IN TYPE OVER TO / I HEREBY CERTIFY THAT I AM PROPERLYREGISTERED AND/OR 0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAI I AM THE LE AL OWNER'OF HE ABOVE 1 - 10 300 DESCRY ED RESIDENTIAL P PERT a O P E R M I T E E V 10 - 50 500 SIGNATURE _ O 50 - 100 1000 DISTRICT NO. PR00O3SED BY. W 100 - 500. 1500 JS tan SIGN, GAS SIGN AND ONE CIRCUIT 500 APPROVALS DATE INSPECTOR' SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 TEMP. POWER POLE . , i SERVICENOTOVER 600VOLTS OR200AMP 300d UNDERSLAB WORK, , SERVI CE OVER 600 VOLTS OR 200 AM P 10'00' , ROUGH CONDUIT ' TEMPSERVICE,POLE, &APPURTENANCES 5 D WIRING TEMP LIGHT OR RECEPT. SYSTEM 300 FIXTURES - POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL PERMIT FEE (SUB TOTAL) NOTES: PLAN CHECK FEE PERMIT ISSUING FEE 300 jJ TOTAL FEE PLAN CHECK VALIDATION CK M O. CASH PERMIT VALIDATION CK M 0 CASH 9:B.4P-JUN 4 .2 'D 1 1.8. 5 SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE WORKERS'COMPENSATION DECLARATION 76 663 -DPW 3AFFUCATMN FOR ELEC TMICAd' PERNT I hereby affirm that I have a certificate of consent to self CE-806G O ♦ansura, or a certificate 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 JOB FICertified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO FEE ADDRESS El Certified copy is filed with the county building 'in spec- 1 & 2-Family, Sq. Ft. $ — $ LOCALITY tion department Multi-family Sq. Ft — NEAREST Residential Swimming Pools CROSS ST Date Applicant OWNER OR ' FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec Light - Sw_ MAIL COMPENSATION INSURANCE First 20 7 ADDRESS (This section need not be completed if the work involved by Total NoCITY Tel. No !6- a the permit Is for one hundred dollars ($100)or less.) Additional. 1 /7/ I certify that in ;he performance of the work for which this PIAN CHECK permit is issued, I shall not employ any person in any manner - ,/;.yty� �1� f VL [' APPLICANT m_ so as to become subject to the Workers'Compensation Laws Lighting Fixture First 20 , 1 ADDRESS ,� (� f 9�d Iry "'e- Additional 15-22 A Ad Date -� u Applicant P yam. T6tal No. CITY Tel No. NOTICE TO APPLICANT If, after making this ertificate of Fixed Appliances Not Over 1 NP PERMIT Exemption, you should become subject to the• Workers' Range— Heater—.D.W APPLICATION 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 315-0 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 Power Apparatus & Large Appliances I DISTRICT NO 1 PROCESSED BY >_ and Professions Code,and my license is in full force and effect. t1 Size &Type HP, KW, KVA, or KVAR �C 0 License Number Lic Class - 0 Up To 1 Incl. FINAL � Contractor Date Over.l to 10 Incl. DATE Z- VA IDATION 0 ❑ Over 10 to 50 Incl FINAL F- I am exempt under Sec. Over 50 to 100 Inc. BY V Over 100 W B.&P.0 for this reason a D Date: - Services, Swbd., MCC 8 Panelboards C,l� Z W 0-200 Amp. Under 600 V J (/ Signature 201 - 1000 Amp. Under 600 V D - Over 1000 Amp. or Over 600 V Exemption for Reg. Maint Elect. SINGLE'FAMILY HOME OWNER-BUILDER DECLARATION Temp Power Pole&Appurtenances 0311,7 A Sign with One Branch Circuit # o o,o,o,o 2, I hereby affirm that I am exempt from the Contractor's License Sig � Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits Professions Code)- aI °'°,1 8,0 0 _ 1 KI, as owner of the property, will do the work and the Misc Conduits &Conductors o;o o 11 8 0,0 6 structure is not intended or offered for sale(Section I 7044, Other (See Complete Fee Schedule)_ D Business and Professions Code). 07.29-t-88 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 above-mentioned property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of P 01tttee ate ©s • COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ,EL ,0508 9906040010 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: EG D: FEES PAI ' BUILDING ADDRESS: TR: 11218 LT: 6 BL: E 5339 LOMA AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803002 ASSESSORMATIO NEAREST CROSS STREET: OLIVE 5388-007-006 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT,SW,RECP 1.00 OUT 1.95 HA FAU LESS 3HP 1.00 FAU 10.80 ISSUED ON: PROCESSED B A . JB AC UNITS +3-10HP 1.00 AC 19.80 06/04/99 UT 12/01/99 - TOTAL FEES 60.30 OWNER: TEL. NO: FINAL DATE FINAL BY: ODE: VYAS RAJESH S;HASUMATI R (818) 285-8541- 5339 LOMA AV �~ TEMP 917803002 DESCRIPTION OF WURK ELECTRICAL FOR REPLACEMENT OF HVAC SYSTEM E 6: - CONNOR AIR CONDITIONING (626) 286-3157- 4931 N. ENCINITA AVE SPECIAL CONDITIONS: TEMPLE CITY, CA CIE LES C® CONTRACTOR: TEL. NO: ®� ��1. APPROVALS DATE INSPECTOR SIGNATURE CONNOR AIR CONDITIONING (626) 286-3157- 4931 ENCINITA AVE LIC. NO TEMPORARY TEMPLE CITY, CA 91780 - 403735 C20 e UNDERGROUND CONDUIT ARCHITECTL. GROUND s LIC. N0: ./ 1111111 ROUGH CONDUIT Ll ROUGH ! G U J —WORKS PLASTIC Y/N METAL Y/N 0 UTILITY CO A - O 0 I. ,® ❑ ®y El O� c Service V1-oh-a� REPORT ID: DPR265 ROUTE TO: BS0508