HomeMy Public PortalAbout9224 LONGDEN AVE_Electrical__ 7,fA66 ADB °"Z
APPLICATION .FOR 'ELECTRICAL: PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER JOB �y - ..
BUILDING AND SAFETY DIVISION ADDRESS (�c
LOCAU TY
NEAREST' , s
FOR_APPLICA.NT• TO'FILL .IN, CROSS S.T.• d !✓
OUTLETS NO. EACH I FEE OWNER OR'
RECEPT. •'. MAIL.
LIGHT TOTAL
'FIRST 2O' 25ADDRESS
: �+.
CITY g f O TEL. N0..�.+�6s'7� Ld"
SWITCH _ OVER 20 .10. PLAN CHECK
FIRST 20 25 APPLICANT-
LIGHTING TO AL.
FIXTURESf0 OVER 20 ADDRESS
\ .RESIDENTIAL APPLIANCES CITY TEL.-NO..
RANGE .. .'DRYER'=WTR. HTR- PER
•. � APPLICANT
STA. 'COOK DISP. . F.A.U. ADDRESS
SPACE HTR. AIR COND. CITY TEL. NO.
CLOTHES WASH.. . bISHWASH. LICENSE OR •CLASS.' '
REG'. NUMBER
FAN ._ OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I NAME RBAD THIS'AP.PLI.CATION'
' AND STATE THAT THE.ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING v .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
1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY'AND S'TAT'E OF
CALIFORNIA OR THAI' I:AM THE .LEGAL OWNER OF THE A:BO,VE
• 1. DESCRIRED' R.ESIDENTIA ROPE p„
V
_ PERMITTEE = -
10 - to 5.00 SIGNATURE C
O
50 _ 100 10.00
DISTFt:ICT NO.: PROCES BY ud
• x
100 - 500 15.00®$,
'SIGN, GAS SIGN AND.ONE;CIRCU.IT 5:00 APPROVALS DATE INSPEcTORrs IGNATURE
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS fA0 TEMP.: POWER POLE
SERVICE NOT OVER GOO VOLTSOR200AMP &00 UNDERSLAB,WORK
SERVICEOVEK 600 VOLTS OR.200AMP - 10.00 ROUGH CONDUIT
TEMP SERVICE,POLE,&APPURTENANCES 5.00 WIRING.. o..
TEMP LIGHT OR RECEPT. SYSTEM' 3.00 FIXTURES
'POW.E.R AUTHORIZED
UTILITY CO.-NOTI;FIED e
FINAL `fJ -7Y- f/ �aF+/
PERMIT FEE (SUB TOTAL)' 'NOTES.:.
PLAN CHECK FEE d
.PERMIT 4SSUING FEE - 3.00 - ✓7.0
TOTAL FE-E. 5
_ 5
PLAN CHECK VALIDATION 1 CK. M.O. CASH PERMIT VALIDAT_ N CK,, en.o. C H•
SEE BACK OF APPLICATION.FOR COMPLETE SCHEDULE - •i -' '
DB 5-A 12-43 25M ' ���CATION FOR,ERM
DEPARTMENT OF BUILDING' ANA SAFER' AMATION V lI'lTtl�iii -
•COUNTY OF LOS ANGELES
ELECTRICrte'= WM.,J. FOX CHIEF ENGINEER
Z DISTRICT NO. GROUP E ZONP RMIT NO.
• `_ NAME �� I. � �•�` 11:+ r � �
U ADDRESS
GiAA ,
,p .vAl� All FIRST I
COUN
CERT. TEL.NO. i RECEIVED BY READY FOR DATE ISSUED
CITY
ell
£,aPECwTION
NO. i J_ ESPIRES /4" '•1
APPLICANT PILL IN HEAVILY OUTLINED PORTION ONLY h . /t
DESCRIPTION OF WORK ADD _RESS 9 Je � ``6 L6A/e`l0�F'�
NUMBER OF OUTL5TS ON CIRCUITS LOCALITY ���� �A:` P I X 7
LOCATION BY ROOMS g
-LIGHT OUTLETS SW. PLUGS F&T CROSS yST_
CIRCUIT A 13 C D E F. G H tC NAMS' g'
Id MAIL
P ADDRESS .
O Ys ;P Y
CITY- ,� / TEL.NC.
AM .THE LEG .. POSSESfklOR OF.,THE ABOVE LOS
ANGELES COUNTY CERTIFICATE OF,Qjmumcknom.
` ELECTRICIAN.
ABi OA g TM.*XGA OWNER OF THE PROPFRTY DESCRIBED
OWNER.
CORRECTIONS ,
J
• Z
TOTAL• O P`
NO. OF OUTLETS APPROVALS`
NO. OF FIXTURES ffi If DATE IN8P,tECTOR•S NAME
NO. OF MOTORS H.P. ffi CONDUIT /
NO.,OFSIGNS TRANS.• ffi WIRING- I-'ID /;+Fryf�l•��'
NO. OF RANGES OR HEATERS ffi FIXTURES
MISCELLANEOUS $ ) p� POWER
PERMIT FEE ffi ! 2-,7 UTILITY CO.NOTIFIED L
TOTAL FEE I•�� FINAL r��%f��u Y.
• x ,
y •
6"GAE-906(6/79) APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN JOB G �+
New Residential Bldgs.&Pools EACH_ NO.. FEE ADDRESS / oZ CZw
1 &2-Family,Sq.Ft. $ .025 — $ LOCALITY
Multi-fornily Sq.Ft. .02 — NEAREST
CROSS ST
Residential Swimming Pools 25.00 OWNER OR
FIRM NAME
Outlets:Rec 3? Light--(a—Sw. MAIL
First 20 .50-2-() ADDRESS Gam/
Total No- '_ Additional 30 CITY o Tel.No.
PLAN CH EC
APPLICAbff
Lighting Fixtures First.20. •50 ` AD NA6
Additional .30
Total No. (11 Y Tel.No.
Fixed Appliances Not Over 1 HP ERMIT
Range_Heater_D.W.— APPLICANT
Oven_Dryer_W.M. ADDRESS
Top _FAU —W.H._ CITY Tel.No.
Hood_Fan —Other LICENSE OR
Disp.—Room Air C6nd. 2.50' REG.NUMBER Class.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA•
Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO
Size&Type HP,KW,KVA,or KVAR COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
2:50 REGULATING'ELECTRICAL WIRING.
Up to 1 Incl. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR V
Over I to 10 Incl. 5.00 LICENSED AS REQUIRED.BY,LOS ANGELES COUNTY AND STATE OF
Over 10 to 50 Incl... 12.50 [ CALIFORNIA OR THAT I AM THE LEGAL OWNER.OF THE ABOVE O
25.00 DESCRIBED.RESIDENTIAL PROPERTY , 0
Over 50 to 100 Inc. PERMITEE
Over 100 40.00 SIGNATOR
Services DISTRICT NO. P SSEY
0-200 Amp.Under 600 V �l� 12.50 / Z �-� Q
201-1000 Amp.Under 600 25.00 '
Over 1000 Amp.or Over 600 V 50.00 Z
O
Temp.Power Pole&Appurtenances 10.00 a
Sign with.One Branch Circuit 10.00
Additional Sign Branch Circuits 2'00 INSPECTION >
INFORMATION u
Misc.Conduits&Conductors 10.00 ON REVERSE z
Other(See.Complete Fee Schedule) - SIDE
z. r
IL
o a n r
PERMIT FEE ISub-Total) 2 o o l[ 2 7/ (;
PLAN CHECKING FEE (One-Fourth Permit Feel O o 0 0
PERMIT ISSUING FEE $7.00 0 L,2
TOTAL FEE >
INSPECTION FINALED W
date: By ®s
WORKERS'COMPENSATION DECLAR'joATION 76_663 APPLICATION FOR ' ELECTRICAL. PERMIT'
I hereby affirm that I have a certificate of consent to self C 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 /
Policy No. Company EACH NO. FEE ADDRESS 22 Le
• - New Residential Bldgs.&Pools -
a Certified copy-is Hereby furnished. r 1 &2-Family,Sq.Ft. $ — $ LOCALITYT,
'Multi-family Sq.,,Ft. — NEAREST -
E Certified copy is filed with the county building inspection CROSS ST
department. Residential Swimming Pools OWNER OR
i FIRM NAME
Date Applicant Outlets: ReciL-Light Sw. ! MAIL /
First 20 ADDRESS Z. G A. de-1-11
CERTIFICATE OF EXEMPTION FROM WORKERS' Total No.04' !% AdditionalCITY C_ Tel No.2,r .,2x
COMPENSATION INS URANCE PLAN CHECK
d
APPLICANT
('This section need not be completed if the work involved O
by the permit is for one hundred dollars ($100) or less.) Lighting Fixtures First 20 ADDRESS V
Total No. Additional M
I certify that.in the.performance•of the work for which this Fixed Appliances Not pppp��•1.HP r CITY Tel No. O
permit is issued,.I.shall not employ any person in any manner / PERMIT V
so as to become'subject to rkers' Compensation Laws: Range_Heater D.W.— APPLICANT K/ W
Oven _ Dryer_W.M._ ADDRESS •`
Date Applica Top _ F,AI,J�,,_W,H.._
Hood_ Fan• —Other.-- qp CITY Tel No.
NOTICE TO APPLICANT: If, after'making this Certificate of Disp. _Room Air Cond. LICENSE OR
,Exemption, you should become subject to the Workers' REG.NUMBER Clas
Compensation provisions of the Labor Code, you must-forth- Power Apparatus&Large Appliances DI$tRICT NQ. PROCESSED BY
with comply with such provisions or this permit shall be ,• ..
i4
Size&Type HP KW,KV ,or KVAR
deemed revoked. !J
' Up to 1 Incl. FINAL
r s
LICENSED CONTRACTORS DECLARATION / Over 1 to 10 Incl, DATE VALIDATION
` Over 10 to 50 Incl.
I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100•Inc. FINAL
9 .(commencing with Section 7000)of Division 3 of the Busi- Over 100 BY
ness and,Professions.Code, and my license is in full force and
effect. Services rj c k ��yp��' ,
0-200 Amp.Un r 600 V r
License Number' Lic.Class 201-1000 Amp.Under 600 V
Contractor Date Over 1000 Amp.or Over 600 V
HOME OWNER-BUILDER DECLARATION Temp.Power Pole&Appurtenances ' 5.0 9.$P
I hereby affirm that 'I am exempt from the Contractor's Sign with One Branch Circuit
License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits0 0 0 0 02
ness.and Professions'Code):
Misc.Conduits&Conductors 2'° ° 5270
❑ I, as owner of the property, will do the work.and the Other(See Complete Fee Schedule)—
structure is not intended or offered for sale (Section 0 0 0 0,7044,Business and Professions Code). ` CE
CONSTRUCTION LENDING AGENCY 07.21 —F2 ,
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
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. i SEE'REVERSE FOR EXPLANATORY LANGUAGE
Signature of Permittee. Date I
M
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1411240029
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
ON FILE 9224 LONGDEN AV
IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT:( TEMP CA 917801606
ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET:
15385-001-004 IA1 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY CAI
I IP2 PC RES PV<IOKW 153.90
(TENANT: 1P3 INVRTR RES PV<10KW 27.90 ISSUED ON: PROCESSED BY: PLAN BY:
TOTAL FEES 209.60 111/24/14 SR
OWNER: TEL. NO: IF NAL DATE FIVAL Y: CODE:
IIVERSON DAVID R;MITZI S TRS (626) 286-2230- I I
19224 LONGDEN AV II_7 �/
elly
TEMP 917801606 I ESCR PTION OF WORK
I2 55 KW PV SYSTEM (10) MODULES
APPLICANT: TEL. NO:
STEPHANIE MORA (310) 955-6576-
I3055 CLARVIEW WAY ISPECIAL CONDITIONS:
ISAN MATEO CA 94402 I
I I
CONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE
ISOLARCITY CORPORATION (650) 963-5630- I I
13055 CLEARVIEW WAY LIC. NO ITEMPORARY POWER POLE I I
ISAN MATEO CA 94402 888104 * I 1-1
I JUNDERGROUND CONDUIT
ARCHITECT OR ENGINEER: TEL. NO: IUFER GROUND
LIC. NO: I (ROUGH CONDUIT 1
IRODGH WIRING I�vlr
TALL GROUNDING AND BONDING OF THE PV SYSTEM SHALL COMPLY IMAIN WATER LINE 1
IWITH LOS ANGELES COUNTY REQUIREMENTS. NOTE: WEEB PLATESI IPLASTIC Y/N METAL Y/N
I, WASHERS, AND SIMILAR DEVICES ARE NOT ACCEPTED. I I I
(UTILITY COMPANY NOTIFIED(
I I I I I I
I I I I I I
I I I I I I
I I I I 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
I I I I I
I* ADDITIONAL DATA ON FILE
I I I
I I I
IREPORT ID: DPR265 ROUTE TO: BS0508
I I I I I I