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HomeMy Public PortalAbout5925 LOMA AVE_Electrical__ 7SA663-CE80610.62 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS t '.2.� NO, Lo/f JOHN A. LAMBIE, COUNTY ENGINEER � E G WILLIAM A.JENSEN, SUPT OF BUILDING LOCALITY pL !•rY NEAREST FOR APPLICANT TO FILL IN cRoss ST. RECEPT. TOTAL NO. EACH FEE OUTLETS FIRST 20 $2O $ OWNER c� tr TA-119A.1 LIGHT MAIL !� Ale / �A j SWITCH. ADD'L 10 LIGHTING FIRST 20 .20 ADDRESS Al S /� S e 4,0�,/ OVER 2O TOTAL CITY TEL. NO. � / FIXTURES ADO'L 10 ELECTRICIAN 65� � 5 E 4EGT OVER 20 RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS R / A CITY � GARB.DISP. STA.COOK `A TEL.NOLJ/// DISHWASH. AUTO.-WASH. STATE ,.�q y SPACE HTRS. STA.APP.(+/i H.P.MAX.) .50 LICENSE NO. `+� 2" L Op MOTORS: OVER NOT OVER H.P. DISTRICT NO. GROU Z NE PRO�ESSED BY 1 3 1.50 INSPECTION RECORD 3 S 2.00 a B 1 s 2.50 0 15 50 3.00 p„+ 50 100 5.00 SIGNS: NO.TRANS. a NO.LAMPS _ ty4o b SERVICE 0.600V-Nor OVER 200A 1.00 SERVICE 0.60OV-OVER 200 A. 2.00 SERVICE OVER 600V 5.00 MISC. Grf.�nic"c':$-'c 2✓/e E '4'o 4'9 10/./ PERMIT ISSUING FEE 2.00 SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE $ 1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT i AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PR ERTY. POWER SIGNATURE UTILITY CO.NOTIFIED I�'�:JAijl OF PERMITTEE - ,- FINAL 0LIDATION ARTHUR C. VETT CK MO CASH SUPERVISING ELECTRICAL ENGINEER / tv 9_6.3 4Z05 JUN 3 2 D 3.0 0Na WORKERS'COMPENSATION DECLARATION CE-806 10/81 APPLICATION FOR ELECTRICAL PERMIT 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 certified copy thereof (Sec. 38001ab. C.) -�-, Policy No. Company�(� �%� -V ��� FOR APPLICANT TO FILL IN JOB `r l.- /� Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS a Lp" A — $ F 1 &2-Family, _Certified copy is filed with the county building inspec- y- S q Ft. $ LOCALITY — tion department. Multi-family Sq. Ft. 'NEAREST s CROSS ST. �( �o�)A •7 �� j`' pp Residential Swimming Pools Date 4- licant OWNER OR FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec-A—Light MAIL COMPENSATION INSURANCE Sw. ADDRESS s section neenot completed if the work involved b First 20 (Thitid t b P Y Total No. Additional CITY Tel. No. the permit is for one hundred dollars ($100)or less.) PLAN CHECK I certify that in the performance of the work for which this 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 provisions of the Labor Code, you must forth- Oven — Dryer — W.M.— ADDRESS�Gt 7ff�& 'E�` with comply with such provisions or this permit shall be Top FAU —W.H. �— T deemed revoked. Hood Fan _ Other— CITY � C � el. No.Zg-1-IZZ'O�- LICENSED CONTRACTORS DECLARATION LICENSE OR ��� �a 7 1 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 DISTRICT NO. PROCESSED BY and Professions Code, and m license is in full force and effect. Power Apparatus&Large Appliances ,,r., 9L y Size &Type HP, KW, KVA, or KVAR' j� �� O License Number..— Lic. Class Up to'1 Incl. FINAL ContractorZ-"1�� L�� Z ti�3 Over I to 10 Incl. DATE VALIDATION Over 10 to 50 Incl. FINAL U I am exempt under Sec. Over 50 to 100 Inc. BY ��,�+ UJI B.&P.C. for this reason Over 100 v3 Services, Swbd., MCC & Ponelboards Date: 0 -200 Amp. Under 600 V Signature 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 I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits Law for the following reason (Section 7031.5, Business and Professions Code): a-9 9&O A I, as owner of The property, will do the work and the Misc. Conduits &Conductors structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ 7044, Business and Professions Code). 2 o - 2625 CONSTRUCTION 262Jr- CONSTRUCTION LENDING AGENCY I hereby affirm that there.is a construction lending agency for ° ° ° G 2 the performance of the work for which this permit is issued PERMIT FEE - (Sub-Total) 022.2-.83 (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 uthorize representatives of this County to enter upon \he above-ment'one pro nspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Per " tee Date P/ORKER'S COMPENSATION DECLARATION 9 DPW 9/89 APPLICATION FOR ELECTRICAL PERMIT 76A66 I hereby affirm that I have a certificate of consent to self insure, 76A663 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(Sec.3800 Lab.C.) Policy No.��I 9,740-/g�ompany �5 Ti9TC u�uD FOR APPLICANT TO FILL IN JOB EEjj �t'�� N/.. �LJ�.� Certified copy is hereby furnished. New Residential Bldgs.&Pools EACH NO. FEE ADDRESS LOCALITY 1 &2-Family,Sq.Ft. $ — $ /Em�L ertified copy is filed with the county ildmg inspection _ NEAREST department. Multi-family Sq.Ft. CROSS ST. p S /� Date l c Applicant a Residential Swimming Pools ASS BOOK / OWN I PAGE PARCEL ' CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec./Light Sw.L IRM NAME /t f COMPENSATION INSURANCE O 7/�?� First 20 MAIL (This section need not be completed.if the work involved by the Total No. Additional ADDRESS I L VF 4Z� Qf permit is for one hundred dollars($100)or less.) I certify that in the performance of the work for which this permit CITY? C � Tel.No. ,/iT/Z�7� is issued, I shall not employ any person in any manner so as to PLAN CHECK become subject to the Workers'Compensation Laws.. Lighting Fixtures First 20 APPLICANT Total No. Additional 40 ADDRESS Date Applicant 15 OR 20A,120V BRANCH CIRCUITS NOTICE TO APPLICANT: If, after making this Certificate of CITY Tel.No. Exemption,you should become subject to the Workers'Compensation 1 TO 10 INCLUSIVE EACH provisions of the Labor Code, you must forthwith comply with such 11 TO 40 INCLUSIVE EACH PERMIT �D.t�,C1 A-Jeq P Y P Y APPLICANT provisions or this permit shall be deemed revoked. 41 OR MORE BRANCH CIRCUITS EACH LICENSED CONTRACTORS DECLARATION ADDRESSQ © d I hereby affirm that I am licensed under provisions of Chapter 9 15 OR 20A,208V TO 277V LIGHTING EACH O (commencing with Section 7000) of Division 3 of the Business and CITYZ u Tel.No. Professions Code,and my license is in full force and effect. RESIDENTIAL APPLIANCES UP TO 3HP LICENSE OR `/ L� Power Apparatus&Large Appliances REG.NUMBER�� 7`Z Class. ?_ O License Number c S�Q 7"� / Lic.Class � -� Size&Type HP,KW,KVA,Or KVAR DISTRICT NO. PRC4��SED BY U ^p Q Up to 3 Incl... C, C W Contractor .� C P,1X t19/K Date -/ Over 3 to 10 Incl. DATE G" ❑ Over 10 to 50 Incl. �7 Z I am exempt under Sec. Over 50 to 100 Incl. l�FINAL VALIDATION Over 100 ` B.&P.C.for this reason By Services,Swbd.,MCC&Panelboards Date: 0-200 Amp.Under 600 V 17 Signature 201 -1000 Amp.Under 600 V F] 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 I hereby affirm that I am exempt from the Contractor's License Law ' for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits Code): t I '� _ t d &C i d Conuts Conductors --[r I,as owner of the property,will do the work and the structure Misc. ? ;'s• ! =? _iL is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) andErr ,Professions Code). , ._ ,(A CONSTRUCTION LENDING AGENCY s..j=at I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total) Civ.C.) ;i 3 i;j PLAN CHECKING FEE { Lender's Name PERMIT ISSUING FEE Cp, 41 Lender's Address I certify that I have read this application and state that the above TOTAL FEE 111,19-31 information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize repres fives of this County to enter upon the above-mentioned prope y fo `nspec ion purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE v�d SIGNATURE OF APPLICANT OR MSENT DATE COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ' ',EL 0508 9807090023 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 5904 LT: 355 5925 LOMA AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801924 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LAS TUNAS 5384-014-029 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT,SW,RECP 15.00 OUT 29.25 TENANT: G2 LIGHTING FIXTURES 3.00 LGT 5.85 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: TOTAL FEES 62.85 07/09/98 UT 07/09/99 OWNER: TEL. NO: FINAL DATE FINAL BY: CODE: SELTMAN BOBBY W;MARLENE F TRUS (818) 285-8542- 5925 LOMA AV TEMP 917801924 DESCRIPTION OF WOR ELECTRICAL FOR-3RD BEDROOM AND BATH APPLICANT: TEL. NO: PHINEAS CONSTRUCTION (626) 797-8703- 2063 PEPPER DR. SPECIAL CONDITIONS: ALTADENA, CA 91001 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE PHINEAS CONSTRUCTION (626) 797-8703- 2063 PEPPER DR. LIC. NO TEMPORARY POWER POLE ALTADENA, CA 91001 741350 B UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: UFER GROUND LIC. NO: ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED �.)f,htiatil�iQ (0`� REPORT ID: DPR265 ROUTE TO: BS0508