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HomeMy Public PortalAbout9425 LAS TUNAS DR_Electrical__ 76g60-G•E.80610/72 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES °.DEPARTMENT OF COUNTY ENGINEER gooREss BUILDING AND SAFETY DIVISION LOCALITY NEARES FOR APPLICANT TO FILL IN CROSS ST. OUTLETS NO. EACH FEE OWNER OR $ $ FIRM NAME , RECEPT._ 1 MAIL LIGHT TOTAL FIRST 20 25 ADDRESS • CITY TEL. N0. SWITCH OVER 20 ,10 PLAN CHECK LIGHTING TOTAL FIRST 20 25 APPLICANT FIXTURES .10 OVER 20 ADDRESS RESIDENTIAL APPLIANCES CITY TEL. NO. - � RANGE DRYER_WTR. HTR. PERMIT _ APPLICANT f o STA. COOK DISP. F.A.U. - ADDRESS SPACE HTR. AIR COND. CITY TEL. NO. a2,6 Q CLOTHES WASH. DISHWASH. LIC REG. NUMNSE ORBER 1 1CLAS FAN OTHER I.00 1 HEREBY 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 & TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 - 1 1.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIF OR THE LEGAL OWNER OF THE ABOVE 1 - 1O 3.00 DESCR I P. TIAL PROPERTY. V PERMI EE 10.- 50 5.00 SIGN URE O H 50 - 100 10.00v DISTRIC P ED BY W 100 - 500 15.00 SIGN, GAS SIGN AND ONE CIRCUIT 5.00 L7 nAPPROVALS DATE INSPEC 'S SIGNATURE TUBE, OR �./ `• MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE SERVI CENOT OVER 600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK SERVI CEOVER 600 VOLTS OR 200AMP 10.00 ROUGH CONDUIT TEMPSERVICE,POLE, &APPURTENANCES 5.00 WIRING A 1 R TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES / f V POWER AUTHORIZED UTILITY CO. NOTIFIED ` I) Hll FINAL v U PERMIT FEE (SUB TOTAL) NOTES: PLAN CHECK FEE PERMIT ISSUING FEE 3.00 3 do-0 TOTAL FEE o0 PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION C M.O. CASH 0 1 0 -313 MAR 21 2 0 1 8.00- SEE .00-- SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE �� v - tel+ • � � J �76A663-CE80611-71 APPLICATION i& ELECTRICAL PERMIT COUNTY OF LOS ANGELES ' DEPARTMENT OF COUNTY ENGINEERBUILDING BUILDING AND SAFETY DIVISION ADDRESS V� LOCALITY' NEAREST FOR APPLICANT TO FILL IN CROSS ST. � OUTLETS NO. EACH FEE aa�� OWNER RECEPT�C MAI L $ $ ADDRESS Ice,spL�-J LIGHT TOTAL FIRST 20 "�' ,p5, J OVER 20 `,� CITY TEL. N0. SWITCH .10 G/ PLAN CHECK FIRST 20 APPLICANT LIGHTING 1 TOTAL '25 ��j I OVER 20 ADDRESS FIXTURES - .10 RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT active Electrical Contra tox RANGE. DRYER_WTR�HTR. APPLICANT " STA. COOK DISP. F.A.U. ADDRESS, P e 0. Box 143 Inc SPACE HTR, AIR COND. CITY Covina TEL. NO. 967-2787 CLOTHES WASH. DISHWASH. LICENSE NO. 230-79 '55 CLASS.0 10 FAN OTHER 1.00 1 HEREBY 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 & TYPE OVER TO I HEREBY CERTIFY THA I M PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED L S ANGELES COUNTY.AND STATE OF 0 - 1 1.00 �- CALIFORNIA OR THAT I T E LEGAL OWNER , AND INTEND TO 0 1 - 1O 3.00 3 '� RESIDE IN, THE AB E ESCRIBED ES NTIAL PRO PEff,TY V Cc+ayjcc l 10 - 50 5.00 SIGNATURE OF PERMITTEE Q 50 - 100 10.00 0 DISTRICT NO. CLASS ZONE - PROLE SED BY W 100 - 500 15.00 ' 09 �-Z--w � h SIGN, GAS SIGN AND ONE CIRCUIT 5.00 NOTES: . D�/ t"� Z TUBE, OR ` MARQUEE ADDITIONAL CIRCUITS 1.00 SERVICENOTOVER600VOLTS0R200AMP 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE SERVICEOVER 600VOLTS OR200AMP 10.00 Ile TEMP.POWER POLE TEMP SERVICE,POLE, &APPURTENANCES 5.00 UNDERSLAB WORK � � t�"s';it � Ca TEMP LIGHT OR RECEPT. SYSTEM 3.00 ROUGH CONDIUT O h.-I ®-0 Ni 1 �`��• WIRING Z/ d FIXTURES ` ��d dq PERMIT FEE (SUB TOTAL) POWER AUTHORIZED Iv dA y Ia ' UTILITY CO. NOTIFIED JI �� 0 1AJE PLAN CHECK FEE -IL✓ FINAL �� PERMIT ISSUING FEE 3.00 r TOTAL FEE U . PLAN CHECK VALIDATION CK. M.D. CASH PERMIT VALIDATION (�cK. ,1 M.O. tlCASH SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 76A663 1 1-7 1 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING / , UtiQ BUILDING AND SAFETY DIVISION ADDRESS �,C( LOCALITY' NEAREST FOR APPLICANT TO FILL IN CROSS ST. Fi6�b/G.T� OUTLETS NO. EACHI FEE 0 W N E' :sz�� k�7/6i/v ze/ $ $ RECEPT._ MAIL FIRST 20Zg ADDRESS LIGHT TOTAL CITY TEL. N0. SWITCH OVER 20 .10 PLAN CHECK FIRST 20 Zg APPLICANT LIGHTING TOTAL OVER 20 ADDRESS FIXTURES .10 RESIDENTIAL APPLIANCES CITY TEL.-NO. RANGE DRYER_WPERMITTR. HTR._ APPLICANT STA. COOK DISP. F.A.U. ADDRESS f%✓ �: SPACE HTR. AIR COND. CITY _ TEL. N0. CLOTHES WASH. DISHWASH. LICENSE NO. CLASS. FAN ' OTHER 1.00 I HEREBY ACKNOWLEDGETHAT 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 & TYPE OVER TO 1 HE BY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR 0 - 1 1.00 LICENSE REQUIRED BY LOS ANGELES COUNTY-AND STATE OF d CALIFORNI T LEGAL OWNER OF, AND INTEND TO 1 - 10 3.00 RESIDE BOVE D SCRIBED, RESIDENTIAL PROPERTY. O V 10 - 50 5.00 SIGNA URE a, OF PE ITTEE O 50'- 100 10.00 ~ DISTRICT NO. CLASSZONE PROCES ED BY �V 100 - 500 15.00 — n' SIGN, GAS SIGN AND ONE CIRCUIT 5.00 NOTES: v ? TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 i SERVI CENOTOVER 600 VOLTS OR 200 AMP 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE SERVICEOVER 600 VOLTS OR 200AMP 10.00 TEMP.POWER POLE TEMP SERVICE,POLE, &APPURTENANCES 5.00 UNDERSLAB WORK TEMP LIGHT OR RECEPT:SYSTEM 3.00 ROUGH CONDIUT WIRING FIXTURES POWER AUTHORIZED PERMIT FEE (SUB TOTAL) UTILITY CO. NOTIFIED PLAN CHECK FEE Q FINAL PERMIT.ISSUING FEE 3.00 TOTAL FEE PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH iris NOV ? 2 0 1 8,00- SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE _ 76A663-CE80610/72; APPLICATION FO LECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMIENT OF COUNTY ENGINEER JOB '��"�Z✓ t (�•�j (j. 7 BUILDING AND SAFETY DIVISION LOCALITY. - NEAREST FOR APPLICANT TO FILL IN CROSS ST, OUTLETS NO. EACH FEE OWNER OR $ $ FIRM NAME Ot1--Vit l.'N S RECEPT._ MAIL ADDRESS LIGHT TOTAL FIRST 20 .25 n CITY ` TEL. NO.OVER 20 .lp PLAN CHECK FIRST 20 25 APPLICANT LIGHTING TOTAL OVER 20 ADDRESS FIXTURES .10 RESIDENTIAL APPLIANCES CITY,PERMT NOVA � t TEL. No. RANGE DRYER WTR. HTR. APPLIICANTT / O p � G.. STA. COOK DISP. F.A.U. AODRESS37 7-3 W. M 05C-lfeA-V--el SPACE HTR. AIR COND. CITY Vlel"4 ejXjj TEL. CLOTHES WASH. DISHWASH. LICENSE OR � CLASS.�-�(O REG. NUMBER FAN OTHER 1.00 1 HEREBY 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 & TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REG S N1) AND/OR 0 - 1 1.00 LICENSED AS REQUIRED BY LOS ANGELES COUNT AND STATE OF CALIFORNIA OR THAI- I AM THE LEGAL OWNER OF THE ABOVE .r. DESCRIBED REST NTIAL PROPf.RT Y. A/ CL- 1 L 1 - 10 3.00 U 71/� U PERMITEE P/''l 'f%(/ 10 - 50 5.00 SIGNATURE 50 - 100 10.00 W DISTRIC3N __� ROC SED BY 100 - 500 15.00 v7 SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPE R'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE SERVICENOTOVER600VOLTS OR200AMP 3.00 UNDERSLAB WORK SERVICEOVER600VOLTS OR200AMP 10.00 ROUGH CONDUIT TEMP SERVICE,POLE, &APPURTENANCES 5.D0 WIRING TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED fY• FINAL PERMIT FEE (SUB TOTAL) `•' NOTES: PLAN CHECK FEE PERMIT ISSUING FEE 3.00 Vpp.. © TOTAL FEE Q® PLAN CHECK VALIDATION CK. M.D. CASH PERMIT VALIDATION CK. M.O. CASH 2 � , 6.0 0 SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE ' WORKER'S.COMPtNSAT10N DECLARATION 20-0019 DPW(12-91) 76A663 APPLICATION FOR ELECTRICAL PERMIT - ' I.herebyaffirm that I'have a certificate of consent to self insure, or a certificate of Worker's Compensation Insurance, or aL certified OUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof (Sec.3800 Lab. C.);O",/L11• �(_}�)NV,6/"VJ 1-14 '04Policy N s! t COmrpann`yy". 0� '` 'r ' FOR APPLICANT TO FILL IN AD it 2-e` L-A T 4L_ ADDRESS "� f V/�C ❑ Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE LOCALITY -T-UM ❑ .. . 1 &2-Family,Sq.Ft. — $ $ (�� Certified copy:is filed with the county building inspection — NEAREST cl artme Multi-family Sq.Ft. CROSS ST. C)14+:�_ 1b R esidential Swimming Pools ASSESSOR �! Date _ Applicant ``rr - MAP BOOK" '1 PAGE - PARCEL - CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec.J Z Light Sw. G OWNER OR COMPENSATION INSURANCE First 20 FIRM NAME /-� (This section need not be completed if the work involved by the /�j nooRESs 2 C I►� permit is for one hundred dollars($100)or less.) Total No. 6 r. Additional 1 00 J ` '�- B� SFS I certify that in the performance,of the work for which this permit CITY ` Tel.No.?�� l 1 is issued, I shall not employ any person in any manner so as to ��O �� PLAN CHECK ' become,subject to the Workers' Compensation Laws. Lighting Fixtures First 20 APPLICANT , Total No. Additional ADDRESS Z j �j L Date Applicant g,��/�� NOTICE TO APPLICANT: If, after making this Certificate-of RESIDENTIAL APPLIANCES NOT OVER 3 NP. 61TY F-,)06 W- t) Tel.NoA0iB Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. rovisions of the Labor Code, you must forthwith comply with such PERMIT �� ���,'r",•.., P Y P Y � APPLICANT Gyf+� provisions or this permit shall be deemed'revoked. Power Apparatus&Large Appliances U ,v �✓1� 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 N�� ' Tel.No. Professions Code, and my license is in full force and effect. Over 10 to 50 Incl. } LICENSE OR Over 50 to 100 Incl. REG.NUMBER 3 i Class. Over 100 DISTRICT NO. . P ESSED BY O License Number Lic.Class Services,Swbd.,MCC&Panelboards Cr Contracto � IQ 2. a IlDATE ❑ 400-1000 Amp, Under 600 V p V I am exempt under Sec. i 2� VALIDATION W Over 1000 Amp.or Over 600 V FINAL d B,&P.C.for this reasorBY n W BRANCH CIRCUIT FEES / .. 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. Exemption for.Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits 'Z SINGLE FAMILY Temp,Power Pole&'Appurtenances HOME OWNER-BUILDER DECLARATION with One Branch Circuit wL I hereby affirm that'I am exempt from the Contractor's License Law • Sign y-(i- '• for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits a' Q -, ❑ I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors 'is not intended or offered forsale (Section 7044, Business Other(See Complete Fee Schedule) , --u =,r5 and Professions Code). I_IML ._r CONSTRUCTION LENDING AGENCY , I hereby affirm that there is a construction lending agency for the C !t+'¢-`;'•s performance of..the work for which this permit is issued(Sec. 3097, PERMIT FEE (Sub-Total) �3 Civ.C) PLAN CHECKING FEE. - -4 Lender's Name E t i4ii,, U,001 :2;r:. PERMIT"ISSUING FEE �ti A g 1 s -A. Lender's Address I certify that I have read this application and under penalty of purjurystate TOTAL FEE [.v 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 i^ssp��erctio purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE WERMITTEE DATE " WORKERS'COMPENSATIO N DECLARATION CE-806G (2-80) CE-806APPLICATION FOR ELECTRICAL PERMIT _ C I hereby affirm that 1 have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND.SAFETY insure, or a certificate of Workers'Compensation Insurance,or a'certified copy thereof(Sec. 3800,Lab.C.) FOR APPLICANT TO FILL IN ,JOB f ' Policy No. L Company �5 � � New Residential Bldgs.&Pools EACH NO. FEE ADDRESS ` bis :s' D Ce ified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ LOCALITY Multi-family Sq. Ft. — NEAREST If Certified copy is filed with the co my building inspection CROSS ST department. Residential Swimming Pools OWNER OR X7- FIRM NAME [[ILG��I. a� �/.It" Date Applicant Outlets: RecLight_ Sw. MAIL First 20 ADDRESS 7Y• 'h �f CERTIFICATE OF EXEMPTION FROM WORKERS'. Total No. �. Additional CITY A d Tel No. 9 COMPENSATION INSURANCE } PLAN CHECK d (This section need not be completed if the work involved PPLICANT 0 by the permit is for one.hundred dollars ($100) or less.) Lighting Fixtures ADD Additional RESS Total No. U � A�I I certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No. 0 permit,is issued, I shall not employ any person in any manner I PERMIT U so as to become subject to the Workers' Compensation Laws. Range_ Heater_D.W. APPLICANT i 4Z' W Oven Dryer—W.M.— ADDRESS C Date Applicant Top Hood _ Fan FAU Other_ CITY f cTel No. p.' Room Air Cond. r_7 Z — NOTICE TO APPLICANT: If, after making this Certificate of Dis _ ER f (f. Exemption, -you should become subject to the Workers' REG.'NUMBClass Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO. PROCESS BY' with comply with such•provisions or this permit shall be deemed revoked. Size&Type HP,KW, KV A,or KVAR rD d Up to 1 Incl. FINAL Over 1 to 10 Incl. DATE LICENSED CONTRACTORS DECLARATIONf.�-� VALIDATION `Over 10 to 50 Incl. I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100'lnc. FFINALBY 9 (commencing with Section 7000) of Division 3 of the Busi- Over 100 ' ness and Professions.Code, and my license is in full force and effect. Services C Q 0-200 Amp. Under 600 V License Numb" Lic.Class C�� C� 201-1000 Amp. Under 600 V Contracto lAi0il r,-- Date ���%S"'7S Over 1000 Amp.or Over 600 V HOME-OWNER-BUILDER DECLARATION . Temp. Power Pole&Appurtenances 2 5 6 2 8 A I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit # 0 0 0 0 0 2 License, Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits . ness and Professions Code): 0 4 2 7,7 5 Misc.Conduits&Conductors j ❑ I, as owner of the property, will do the work and the Other (See-Complete Fee Schedule)— 10 0 0 27-7 5 U structure is not intended or offered for sale (Section i 7044, Business and Professions Code,). 0 9 28 83 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit, is PERMIT FEE (Sub-Total). issued (Sec. 3097,Civ.C.). Lender's Name ' PLAN CHECKING FEE (One-Fourth Permit Fee) Lender's Address PERMIT ISSUING FEE l 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 thea o -menti o d pro rt for inspection purposes. SEE-REVERSE FOR EXPLANATORY LANGUAGE gnature of Permittee Date �yM WORKERS, CCAMPENSATION DECLARATION 7E-806 10/81 APPLICATIONFOR ELECTRICAL PERMIT ¢V I hereby affirm"that I�have a''-ertificate of consent to self CE-806G irssure, •13r a Qe#rt icate of Workers' Compensation Insurance,' COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified cop thereof (Sec. 3800, Lab. C.y/)- �j� . Policy No. Company ��` 'z "(Ar FOR APPLICANT TO FILL IN- JOB ADDRESS A-5— 4,sL`S Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. .FEE $ _ g LOCALITY ❑ Certified copy is filed with the county building inspeo. 1 & 2-Family, Sq. Ft, — (' P tion department. / Multi-family Sq. Ft. CROSS ST. ��' `jr,`O �Gc*aCf �OX Residential Swimming Pools OWNER OR Date, Applicant `FIRM NAME CERTIFICATE1bF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw a` MAIL CONA,PENSATION INSURANCE ADDRESS i2ol 50, First �' (This section need not be completed if'the work involved by Total No. + ' CITY /f— Tel. No. (f� the permit is for one hundred dollars ($100)or less:) AddiTio 1a that in the performance of the work for which this PLAN CHECK •1 certify p 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 Additional Total No. CITY Tel. No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT .y.. NOTICE TO APPLICANT: If,'after making this Certificate of APPLICANT 0 P 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. • ` - Hood _ Fan , Other— CITY ,4 fir,+• Tel. No.� LICENSED CONTRACTORS DECLARATION LICENSEOR �d riJ I hereby affirm that I am licensed under provisions of Chapter 9 Pisp: _ Room Air Cond. -- Class. REG. NUMBER (commencing with Section 7000) of Division 3 of the.Business DISTRICT NO�` "// PROC ED BY and Professions Code, and my-license is in full force and effect. Power Apparatus& Large Appliances - o (x, �n `a• Size &Type HP, KW, KVA, or KVAR' 0 License Number )U �J �� Lic. Class C` ` O Up to 1 Incl. � � DATEL � � OC � �p. �� Over 1 to 10 Incl. ' V ATION O Contractor � Date / � Over 10 to 50 Incl FI u ❑ I am exempt under Sec. Over 50 to 100 Inc. BY LU B.&P.C. for this reason Over 100 — Date: Services, Swbd.,'MCC& Panelboards 0 -200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V 8,0 7_1 p ❑ Over 1000 Amp. or Over 600 V Exemption for Reg. Maint. Elect, o 0 0.o'o #, 2 SINGLE FAMILY Temp.,Power Pole & Appurtenances HOME OWNER-BUILDER DECLARATION ) .o 0 2 Q Jr O Sign with One Branch Circuit 1 hereby affirm that I am exempt from the Contractor's License SignBranch Circuits-_ _ Law for the following reason (Section 7031.5, Business and Additionals o,:®,2 a 5 0B0 Professions Code)' I Q O" ❑ 1, as owner of the property, will do the work and the M'i'sc. Conduits & Conductors f . 8 7 structure is not intended or offered for sale (Section Other (See Complete 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 above-mentioned property for inspection purposes. �� SEE REVERSE FOR EXPLANATORY,LANGUAGE I , gn-ture of PermVee" Date L j WORKERS'COMPENSATION DECLARATION. 76-663 10/81 CE-806G APPLICATION FOR ELECTRICAL PERMIT Ir7 I hereby affirm that I have a certificate of consent to self insure, ' or a certificate of Workers' Compensation Insurance, or a certified' COUNTY OF LOS ANGELES BUILDING.AND SAFETY copy thereof(Sec.3800.Lab.C.) Policy No. 'Company _ FOR APPLICANT TO FILL IN - -JOB - 0 Certified copy is hereby furnished „ New Residential Bldgs.& Pools EACH NO. „FEE ADDRESS " Certified copy is filed with the county building inspection 1 & 2-Family,Sq.Ft: $ — $` LOCALITY.. Cs,_1464 CLT'' departments Multi-family Sq.Ft. Date Applicant Residential Swimming Pools -CROSSSST. /r t - -. - i .FFIWNER OR IRM NAME' ' - I AILGERYs1CATE OF EXEMPTION FROM WORKERS' Outlets:Rec Light Sw. Z SO- sCOMPENSATION INSURANCE, ADDRESS - First 20 , (This section need not be completed if the:work involved by the ( '.) > _ CIT'Y'-'- Tel.No. `' permit is for one•huTotal No. Additional ndred dollars:($100)or less.) . '". PLAN CHECK I certify that in the performance of the work for.which this permit APPLICANT ;is issued, I shall not_employ any person in any,manner,so as to become subject to.the Workers'Compen ation Laws. Lighting Fixtures First 20 ADDRESS m TotCITY No. Additional CITY Tel."No. Date. Applicant �� ��r��✓ NOTICE '.AP LICANT; If, after making this Certificate 'of Fixed Appliances Not Over 1 HP PERMIT' Exemption,you should become subject to the Workers'.Compensation Range_ Heater_ D W. APPLICANT J GT 2/L `.;provisions.of.the Labor Code, you must forthwith comply:with such Oven Dryer W.M._ ADDRESS !X(��/2 � provisions or this permit shall be deemed revoked. Top — FAU _ W.H. CITY w/✓� C Tel.No.o2/3 33-02 LICENSED CONTRACTORS DECLARATION Hood'— Fan — Other_ I hereby affirm that I am licensed under provisions of.Chapter-,9LICENSE OR (commencing with'Section.7000) of Division 3 of,the Business and Disp. — Room Air Cond. O 6/ 6 Class. s°—/O REG.NUMBER•• Professions Code,and my license is in full force and effect: - DISTRICT NO PROCESSED BY Power Apparatus& Large Appliances 5� /- Size&Type HP,KW,KVA',or KVAR U License Number S �� Lic.Class j tJp to 1 Incl. ,p FINAL AGI rt �� d _ Over 1.-to 10 Incl ,/ti','• DATE -fil� yIDATION Contractorl� Date o (/ O Over 10 to 50 Incl FINA V ❑ I am exempt under Sec. Over.50 to.100 Inc. BY W B.&P.C.for this reason Over 100 �- N Services,Swbd.,MCC&Panelboards. Z Date: 0- 200 Amp.Under 600 V.: 9 6f1.8 A . Signature 201 - 1000 Amp.Under 600 V Over. 1000 Amp.or Over 600 V 0• Exemption for.Reg..Maint.Elect. # o e ° b ° 2 SINGLE FAMILY Temp.Power Pole& Appurtenances J -6 6.1125 HOME OWNER-BUILDER DECLARATION' Sign with One Branch Circuit t: _ I hereby affirm that.1'am exempt from the Contractor's.License Law ®:°:° 1 a2 51' for the following reason(Section 7031.5,Business and Professions Additional Sign Branch Circuits Z + Code): � 05:] 788 I',as owner of the ro ert Misc.Conduits& Conductors p p y,'will do the work and the structure t _ is not intended or.offered forOther(See Complete Fee Schedule) :sale (Section 7044, Business P. 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(Sec.3097, PERMIT FEE (Sub-Total) 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'above TOTAL FEE :. S 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 propert r' spection purpo s. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date ' -� COUNTY OF LOS ANGELES TEMPLE CITY - #. 0508 ELECTRICAL PERMIT .s DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0612070021 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL-.ID: FEES PAID BUILDING ADDRESS: TR: 6561 LT: 345 BL: .001 9425 LAS TUNAS DR FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802136 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: OAK 8587-007-023 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE �CITY, C G1 OUTLETS-LGT,SW,RECP 4..00 OUT 7.80 TENANT: TOTAL FEES 35.55 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 12/07/06 _ JK 06/05/07 OWNER: TEL. NO: FINAL DATE� �REDY; CODE: CHEVRON USA INC - 9425 LAS TUNAS DESCRIPTION OF WORK REMOVE EXISTING DISPENSERS AND INSTALL (4) NEW DISPENSERS DISCONNECT EXISTING ELECTRICAL AND RECONNECT APPLICANT: TEL. NO: DTS ENGINEERING (714) 237-7741- _ 1240 N. VAN BUREN ST SPECIAL CONDITIONS: ANAHEIM, CA 92807 CONTRACTOR: TEL. NO: - - APPROVALS DATE INSPECTOR SIGNATURE DTS ENGINEERING (714) 237-7741- 1240 N. VAN BUREN STE. 240 LIC. NO TEMPORARY POWER POLE RANCHO CUCAMONGA, CA 91730 NONE _ UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: UFER GRODND ECS - 9128 PLACER STREET LIC. NO: ROUGH CONDUIT RANCHO CUCAMONGA, CA 92807 NONE ROUGH WIRING MAIN WATER LINE PLASTIC YIN METAL YIN UTILITY COMPANY NOTIFIED REPORT ID: DPR265 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0504070012 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID - BUILDING ADDRESS: . TR: 6561 LT: 345 BL: .001 9425 LAS TUNAS DR FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802136 ASSESSOR INFORMATION NUM E : NEAREST CROSS STREET: OAK 8587-007-023 Al PERMIT ISSUANCE.FEE 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, C K1 SIGNS, OUTLINE LGT 3.00 SIG 116.55 TENANT: TOTAL FEES 144.30 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: SHELL STATION 04/07/05 JK 10/04/05 OWNER: TEL. NO: FINAL DAT BY: CODE: FRYDOUN, SHEIKHPOOR (310) 430-1603- 9425 LAS TUNAS DR. XPIRM TEMPLE CITY CA 91780 DESCRIPTION OF WOR ELECTRICAL FOR SIGNS APPLICANT: TEL. NO: VIDALES (714) 254-0099- 1410 N. DALY ST. SPECIAL CONDITIONS: ANAHEIM, CA 92306 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE DONCO & SONS, INC. (714) 254-0099- 1410 N. DALY STREET LIC. NO TEMPORARY POWER POLE ANAHEIM, CA 92806 435616C45 UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: . N0: UFER GROUND LIC. NO: ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED 00 g REPORT ID: DPR265 ROUTE TO: BS0508