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Home My Public Portal About9141 LONGDEN AVE_Electrical__ 76A663C- Ceeese.t2,75 APPLICATION FOR ELECT CAL PERMIT BUILDING SAFETY DIVISION FOR APPLICANT TO FILL IN ,JOB New Residential Bldgs.&Pools { EACH NO. FEE ADDRESS 1 &2 Finaily Sq. Ft. $ — $ LOCALITY L Multi-family Sq. Ft. — NEAR-EST Residential Swimming Pools CROSS ST. OWNER OR FIRM NAME Outlets: Light,Switch&Receptacle MAI L. �. Q First 20 �7 ADDRESS Additibnal Af CITY Tel. PLAN CHEC ,,1n. Lighting Fixtures �t APPLICANT s-'�IJ � First 20 �7 , � O ADDRESS d Additional CITY Tel.No PERMIT Fixed'Appliances Not Over 1 HP APPLICAN Range_ Heater. D.W. ADDRESS Oven Dryer _ W.M. Top FAU W.H. _ CITY Tel.No. Hood Fan3 LICENSE OR r REG.NUMBER Q class. -�d c �Disp. A.C. c.� 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY Q Power Apparatus& Large Appliances WITH, LL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. 13 Size&Type HP, KW,KVA,or KVAR LVa Up to 1 Incl. 07 I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR Over 1 to 10 Incl. LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN THE ABOVE Over 10 to 50 Incl. DESCRIBED .. PROP .TY. Over 50 to 100 Incl. PERMITEE Over 100 SIGNATOR DISTRICT NO. SSED BY Services --. 0 00 Am Under 600 V d 201 -1000 Amp. Under 600 V APPROVALS DATE INVECTOR'S Over 1000 Amp.or Over 600 V GNATURE TEMP.POWER POLE Temp.Power Pole&Appurtenances UNDERSLAB WORK Sign with One Branch Circuit ROUGH CONDUIT Additional Sign Branch Circuits /f / (Other) WIRING FIXTURES POWER.AUTHORIZED PERMIT FEE (Subtotal) UTILITY CO.NOTIFIED PLAN CHECKING FEE (One-Fourth Permit Fee) FINAL "a--P PERMIT ISSUING FEE ' OW TOTAL FEE NOTES PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH 1 .os ou 3 2 0 2 7.8 5 76A668 DBS SA 11-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY ELECTRIC COUNTY OFF LOSLOS ANGELES WILLIAM J FOX, CHIEF ENGINEER FOR PPLICA F L 1NZI DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRICIAN RECEIVED BY READY FOR DATE ISSUED ADDRESS ! .. � �� p FIRST INSPECTION / CITY L. NO Ao J� COUNTY LICENSE NO. dil X181 EXPIRES �� BUILDING @� PERMIT FEES ' ADDRESS TP vc�i FEE 6"00 .0or NUMBER EACH LOCALITY 7-1 -20 LIGHT OUTLETS NEAREST D{� RECEPTACLES CROSS ST. WALL SWITCHES OWNER TOTAL OUTLETS e� Sc S MAIL ELEC. RANGES 2s ADDRESS ELEC. HEATERS 25 CITY TEL. NO. FIXTURES 5 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS p 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 L ENSE,��,,,,OyyyyR��'ii I AM THE LEGAL WNER FEE OF THE RESIDENT' PR UIBED ABONEW MVD. HP OVER I INC. EACH U�!1/2ALESS S .2B SIGNATURE OF 12 2 .50 PERMITTE 2 5 i.00 INSPECTION RECORD s Is 1.50 1s so 2.50 50 200 5.00 200 Boo 10.00 a soo I000 •' 15.00 Z OVER 1000 20.00 M. G. SET/FREQ. CHANGER-HP WELDERS:AC-KVA GENERATORS-KW ,TRANSFORMERS-KVA TEMP. MOTORS (75%OFORIG.) MOVED MOTORS (75%OFORIG.) MISC. SIGNS" NO. NO.TRANS. I I APPROVALS. NO. NO. LAMPS DATE INSPECTOR'S NAME FOR EACH PERMIT: CONDUIT I,; Ji(T WIRING $1.00 /WIRING - FIXTURES $1.00 SUPPLEMENTARY .50 FIXTURES - POWER n TOTAL FEE $ UTILITY CO. NOTIFIED Y'. l/. ('T I'llorm. ® / 'FINAL U l LY ul �/(V ray gg, ARK COMPENSATION DECLARATION76A&3 ,10/e1 APPLICATION FOR ELECTRICAL PERMIT _I`F,.eroby'offi.rm that I have a certificate of consent to self "insure, orV' certificate of Workers'Compensation Insurance, „ COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified•• iipy;,erea�(Sec. 3800, Lab. C.) t // �7' Policy N MpanY r v r-',I1A_VNN 4. FOR APPLICANT TO FILL IN JOB. Certified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH. NO. FEE ADDRESS Certified copy is filed with the county building inspec- 1 8 2-Family, Sq. Ft. $ — $ LO tiondepartment. Multi-family Sq. Ft. — NEAREST CROSS ST. Residential Swimmin Pools Date � �Applicant g OWNER RM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Re0MLight Sw� MAIL COMPENSATION INSURANCE First 20 V ADDRESS (This section need not be completed if the work involved'by 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 Date Applicant•' i i CITY Tel. No. NOTICE TO APPLICANT: If., after making this Certificate. of Fixed Appliances Not Over 1 HP PERMIT Exemption, you should became- subject to the.!Workers' Range_ Heater�W. - APPLICANT 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 �fher_ CITY Tel. • 4 LICENSED CONTRACTORS DECLARATION LIC 0 I hereby affirm that I am licensed under provisions of Chapter 9 Disp. _ Room Air Cond. REG. NUMBE Class. -1 (commencing with Section 7000)of Division.3.of the Business DISTRICT NO. PROCE Y and Professions Code,and my license is in.full force and effect. Power Apparatus 8 Large Appliances.' l ,�` Size 8 Type HP, KW, KVA, or KVAR' License Number#��''7TSy Lic, Class' �f FINAL Up to 1 Incl. .DATE Over 1 to 10 Incl. VALI TION. Contracto Over 10 to 50 Incl. W FINAL ❑; I am exempt under See. Over'S0 to 100 Inc. BY p: B.BP.C. for this reason Over 100 Z, Dole: Services, Swbd..,MCC&Panelboards o-200 Amp. Under 600 Panel.boards 8 6 5 A Signature 201 - 1000 Amp. Under 600 V ❑ Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V # 0 0 0 0-02 SINGLE FAMILY Temp. Power Pole 8 Appurtenances HOME OWNER-BUILDER DECLARATION Sign with.One Branch Circuit II o - 69..00 I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits o 0 0 69.005 Law for the following reason (Section 7031.5, Business and Professions Code): ❑ i, as owner of the property, wi[I do the work and the Misc. Conduits 8 Conductors 0 1, 1 7 8 6 structure is not intended or offered for sale. (Section Other(See oorn to ewe Schedule)_ ► 7044, Business and Professions Code). 1� �– 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 (8616-Total)• (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name % PERMIT ISSUING FEE (j Lender's Address I certify that I have read this application and state that the TOTAL FEE 6�`�D 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 ve-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE G � Signature of Permittee Dafe • , COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1307290016 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: (LEGAL ID: FEES PAID I BUILDING ADDRESS: 1 ON FILE 1 9141 LONGDEN AV ]FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:( TEMP CA 917801604 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 15382-023-040 1A1 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY, Cl I 1G2 LIGHTING FIXTURES 2.00 LGT 4.00 I 1 TENANT: I TOTAL FEES 31.80 ISSUED ON: PROCESSED BY: PLAN BY: 1 1 i 107/29/13 SR 10WNER: TEL. NO: 1 IFINAL DATE FINAL BY: CODE: I 1LUK, CHERRY (626) 286-8480- 1 1 , ] 9141 LONGDEN AV (TEMP 917801604 1 �E�P��F WORK I I REPLACE 2 LIGHT FIXTURES I (APPLICANT: TEL. NO: 1 I I ICORREA, MANUEL (626) 786-2347- 1 I I 12509 EUCLID CRES E 1 ISPECIAL CONDITIONS: (UPLAND CA 91784 I 1 I ICONTRACTOR: TEL. NO: 1 1APPROVALS DATE INSPECTOR SIGNATURE IB X D CONSTRUCTION (626) 786-2347- 1 I 12509 EUCLID CRES E LIC. NO 1 ITEMPORARY POWER POLE I I I (UPLAND CA 91784 627142 1 1 1 1 I I I (UNDERGROUND CONDUIT I I I (ARCHITECT OR ENGINEER: TEL. NO: 1 IUFER GROUND I I I LIC. NO: i TROUGH CONDUIT I I I ] ]ROUGH WIRING I I IMAIN WATER LINE PLASTIC YIN METAL YIN ] I 1 JUTILITY COMPANY NOTIFIE5 1 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 ] 1 (REPORT ID: DPR265 ROUTE TO: BS0508