HomeMy Public PortalAbout10684 LORA ST_Electrical__ 75A6.8C-C6a0sB 18/75 APPLICATION FOR ELECTRICAL PERMIT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN JO B
New Residential Bldgs.&Pools. EACH NO. FEE ADDRESS
1 &2 Finaily Sq. Ft. $ — $ L-OCALIT
Multi-family Sq. Ft. — NEAREST
Residential Swimming Pools CROSS ST:7592
OWNER OR
FIRM NAME }_
Outlets: Light,Switch&Receptacle MAI L
First 20 U ADDRESS
Additibnal 00 CITY Tel. No.
PLAN CHECK
Lighting Fixtures APPLICANT
First 20 0 Q ADDRESS
Additional CITY Tel.N
PERMIT
Fixed Appliances Not Over 1 HP APPLICANT
Range_ Heater_ D.W. ADDRESS
Oven _ Dryer _ W.M.
Top _ FAU W.H. _ CITY Tel.No.
Hood Fan REG NUMBER. / Class. • (/ p
D.isp. A.C. d c.2
1 NEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION W
AND STATE THAT THE ABOVE IS.CORRECT AND AGREE TO COMPLY CD
Power Apparatus&Large Appliances -WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING V
Size&Type HP,KW,KVA,or KVAR
ELECTRICAL WIRING. LI.I
a
Up to 1 Incl. I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED ANO/OR
Over 1 to 10 Incl. LICENSED AS RE,OUIRED BY LOS ANGELES COUNTY AND STATE OP
CALIFORNIA OR THAT I AM THE LEGAL 'OWNER OF THE ABOVE
Over 10 to 50 Incl. DESCRIBED RESIDENTIAL PROPERTY.
Over 50 to 100 Incl. PERMITEE
Over 100 SIGNATURE
D:ISTRICT NO. PFMCE ED BY
Services v�-- Q
0-200 Amp. Under 600 V !J 191
201 -1000 Amp. Under 600 V APPROVALS IIATE INSPECTOR'S
Over 1000 Amp.or Over 600 V SIGNATURE
IF
MP.POWER POLE
Temp.Power Pole&Appurtenances DERSLAB WORK
Sign with One Branch Circuit .
Additional Sign Branch Circuits UGH CONDUIT t;
(Other) . . RING
XTURES
WER AUTHORIZED
PERMIT FEE (Sub-Total) I LITY CO.NOTIFIED
PLAN CHECKING FEE (One-Fourth Permit Fee) NALPERMIT ISSUING FEETESTOTALFEE
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
10 4 N JhN 1 D 2 1.10
IAG63-CESO6 I0-60 APPL-ICATIO 000R. ELEC ICAL PERMIT 1 .
COUNTY OF LOS ANGELES
DEPARMENT OF COUNTY ENGINEER BUILDING.
BUILDING AND SAFETY DIVISION ADDRESS Lori
JOHN A.LAMBIE. COUNTY ENGINEER nn
WILLIAM A.JENSEN,SUPT OF BUILDING - LOCALITY
NEAREST
FOR APPLICANT TO FILL• IN CROSS ST. y57
PERMIT FEES OWNER r
I T E M Numarml EACH FEE MAIL
- UT _ b L'. a•Y•i
LIADDRESS GHTS RECEPT. . 6w. / Ao CITY O Q, TEL. NO.
LIGHTING FIXTURES 130
ELEC.RANGES CLO.DRYERS ELECTRICIAN
WATER HEATERS .SO ADDRESS R D ffC�JJ''��
ELEC.SPACE HTRS. DISHWASHERS TEL N0.6+1J
CITY
GARBAGE DISPOSERS AUTO.- - STAT _
WASHERS STA.COOKING UNITS •,a$•' . LICENSE NO.
Morons: 0M INC H.P. DIST GRO JP ZONE IPR ESSED BY
0 ..as _ 6
1/2— a .so INSPECTION RECORD
a
5— 1s I.so
Is— so
a.so
so— zoo _
9.00 y ! /
SIGNS: NOTRANS. ��yii'
NO.LAMPS /6
SERVICE 0_60OV 1.00
SERVICE OVER 800V 5.00
MISC.
WIRING PERMIT 1.00
FIXTURE PERMIT 1.00
SUPPLEMENTARY PERMIT BO
TOTAL FEE
i HEREBY 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 STATB LAWS REGULATING
ELECTRICAL WIRING. WIRING
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR j
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OFABOVE=' -
DESCRIBED RESIDENTPROP TY. -POWER
SIGNATURE UTILITY CO.NOTIFIED
OF PERMITTE FINAL
.�n
VALIDATION ARTHUR C.VEIT
CK NO CASH SUPERVISING'ELECTRICAL ENGINEER
11_1 �r'j 2 7 0 SEP ' 6 ' 2 0 2.8.0 i
76A663A-CE806A 4/72 APPLICATION 7irOk ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER FADDRE
{�
BUILDING AND SAFETY DIVISION j7Z!.4j d,%e !<'1
FOR APPLICANT TO FILL IN CROSS NEAREST. J r L6 G; �o`vA_r_ �
OUTLETS NO. EACH FEE
OWNER✓4l�tF'�,L/.�0�/�I�iBL�IQG"
RECEPT._ $ 5 ADDRESS /V414 Q A/j
LIGHT TOTAL FIRST 20 p
OVER 20 CITY �Wi�e TEL. NO.
SWITCH_ PLAN CHECK
LIGHTINGTOTAL FIRST 20 APPLICANT
FIXTURES
OVER 20 ADDRESS
RESIDENTIAL APPLIANCES CITY TEL. NO.
PERMIT
RANGE DRYER_WTR. HTR. APPLICANT O WNL
STA. COOK DISP. F.A.U. ADDRESS
SPACE HTR. AIR CONP. CITY TEL. NO.
CLOTHES WASH. DISHWASH. LICENSE NO. CLASS.
FAN OTHER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY C
MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING C.7
IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING.
SIZE & TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 — 1 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF C~.7
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
1 — 10 .RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. H
Z
10 - 50 SIGNATURE
OF PERMITTEE
50 - 100
DISTRICT NO. CLASS 20N PROCEqbp BY
100 - 500 0
SIGN, GAS SIGN AND ONE CIRCUIT NOTES:
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS
SERVI CENOTOVER 600 VOLTS OR 200 AMP
SERVICEOVER 600 VOLTS OR 200AMP APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP.POWER POLE
TEMP SERVICE,POLE,&APPURTENANCES
UNDERSLAB WORK
TEMP LIGHT OR RECEPT. SYSTEM
ROUGH CONDIUT e
WIRING
FIXTURES
PERMIT.FEE (SUB TOTAL) POWER AUTHORIZED
UTILITY CO. NOTIFIED
PLAN CHECK FEE
FINAL
PERMIT ISSUING FEE
TOTAL FEE t9o
PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION OM.O. CASH
50.7rOeT 5 2 g � 9.00A!k
WORKERS'COMPENSATION DECLARATION -80toiel APPLICA� ION FOR ELECTRICAL PERMIT
I hereby•affirm that is CE-806G
or a certificate of Workers' Compensation Insurance,or a certified, COUNTY OF LOS ANGELES BUILDING AND-SAFETY
copy, thereof(Sec.3800,Lab.C-)
Policy N0. Company FOR.APPLICANT TO FILL IN JOB
ADDRESS /10"Z111Sr
E] CerCertified copy 'is filed with. the 'county building inspection
tified copy is hereby furnished. New Residential Bldgs.&Pools EACH NO. FEE
❑ 1 &2-Family,Sq.Ft. $ — $ LOCALITY��iyJ
department. Multi-family Sq.Ft. — NEAREST n
Residential Swimming Pools CROSS 8T Q� L
Date Applicant OWMNER OR
FlRNAME
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec-Light`� Sw.4 MAIL .��
COMPENSATION'INSURANCE First 20 D ADDRESS 1w/} �i69- ;o
(This section need not be completed'if the work Involved by the �/ CITY Tel.No.
permit is for one hundred dollars($100)or less.) Total No.—Ea- Additional �A7�G?� y�
I certify that in the performance of the work for which this.permit PLAN CHECK G
APPLICANT a[t//Y/W
is issued, I shall not employ any person tri arty'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
NOTICE TO APPLICANT% If, after making this Certificate of PERMIT
Exemption,you should become subject.to the Workers'Compensation Range_ Heater_ D.W. APPLICANT
provisions of the,Labor Code,.you must forthwith comply with'such Oven _ Dryer_ W.M._ ADDRESS
provisions or this permit shall be deemed revoked. Top — FAU _ W:H.
LICENSED CONTRACTORS DECLARATION CITY Tel.No.
Hood Fan _ Other_±
I .affirm that I am licensed under provisions. of Chapter 9 0 LICENSE OR
(commencing with Section 7000)of Division 3 of the Business and Disp.. L Room Air Cond: ® REG.NUMBER
class.
Professions Code,and my license is in full force and effect. DISTRICT NO: PRO ED B.Y
• Power Apparatus&Large Appliances � }
Size&Type HP,KW,KVA,or KVAR ® ' 0
License Number Lic:Class Up'to 1 Incl. FINAL' U
_
Over 1 to 10 Incl: 7 DATE -- VALIDATION O
Contractor Date Over 10 to 50 Incl.
FINAL ,
❑ ''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
Signature 201 - 10.00 Amp.Under 600 V �
❑
Exemption for Reg:Maint.Elect. Over 1000 Amp.or Over 600-V
SINGLE FAMILY Temp..Power Pole&Appurtenances
HOME OWNER-BUILDER.DECLARATION Sign with One Branch Circuit y
I hereby affirm that I am exempt from.the Contractor`s License.LawC`-' •e'
for the following.reason(Section 7031.5,Business and Professions Additional Sign Branch Circuits ACC{n F
,Code): -%70117
I,as owner of the property,'will do the work-and the structure Misc.Conduits&Conductors }, ;.T`M
is not intended or offered for sate (Section 7044,,B.usiiness Other(See,Complete Fee,Schedule) _
.and Professions.Code). pop. ;.�f 1�� +rjl.�' � iJ-
CONSTRUCTION LENDING AGENCY r, �_r `�'pyj.'_;,
I.hereby affirm that there is a construction lending agency for the
0
performance of the work for whish this permit is issued(Sea 3097, PERMIT'FEE (Sub-Total) 4r1t?NGE ,.L}►
Civ.C.).
PLAN CHECKING FEE' ,
Lender's Name �.� Q DL� i -CI7�i O 's Cl' PERMIT ISSUING FEE � `
Lender's Address C,I]+ 1 j< All 8-46
I certify that I have read this application and state that the above TOTAL FEE i
information is correct.I agree to comply with all County ordinances
and State taws 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 '
7—if
Signature of Permittee Date I
' COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0306190011
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL D: FEES PAID BUILDING ADDRES&i---
TR: 12585 LT: 8 10684 LORA ST
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803429
ASSESSOR INFORMATION N NEAREST CROSS STREET: PAL MAL
8585-030-008 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY
F1 120V, 15/20A BR CKTS 1.00 BR 17.25
TENANT: LA 100 AMP PANELS MCC 1.00 PAN 38.85 ISSUED : PROCESSED B LAN BY: EXP S 0
LN OTHER PNL 0-39§ AMPS 1.00 PAN 38.85 06/19/03 JK 12/16/03
TOTAL FEES 122.70
SONNEOWNER: TEL. N0: FINpL DAT FI L B CODE:
10684 LORA JACK M;SANDRA U - ( _ lf_ (�I, -n �� Q��
10684 LORA ST �O �O V� �V Y V"�tr'
TEMP 917803429In-ar-rT- ,, OF WORK
INSTALL SOLAR PHOTOVOLTAIC SYSTEM
APPLICANT: L. 0•
AMECO (562) 595-9570-
3909 ELM AVENUE SPECIAL CONDITIONS:
LONG BEACH 90807
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
AMECO (562) 595-9570-
3909 ELM AVE LIC. NO TEMPORARY POWER POLE
LONG BEACH CA 90807 6493 B/L
UNDERGROUND CONDUIT
ARCHITECT RENGINEER: TEL. NO: UFERGROUND
LIC. NO: ROUGH CONDUIT
ROUGH WIRING
MAIN WATER LINE
PLASTIC Y/N METAL Y/N
UTILITYCOMPANY NOTIFIED
* ADDITIONAL DATA ON FILE
REPORT ID: DPR265 ROUTE TO: BS0508