The URL can be used to link to this page

Home My Public Portal About4939 MCCLINTOCK AVE_Electrical__ C11.806(6/78) APPLICATIO OR ELECT CAL PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN JOB New Residential Bldgs.&Pools EACH NO. FEE ADDRESS + 1 &2.Family,Sq.Ft. $ .025 — $ LOCALITY Temple7 t Multi-family Sq.Ft. .02 — NEAREST Residential Swimming Pools 25.00 CROSS ST. OWNER OR FIRM NAME Shackelfort Outlets:Rec Light—Sw. MAIL First 20 .50 ADDRESS Same Total No. Additional .30 CITY IaMae :byTel.No448_4108-- PLAN CHECK APPLICANT Lighting Fixtures First 20 .50 ADDRESS Additional .30 Total No. CITY Tel.No. Fixed Appliances Not Over 1 HP PERMIT Range—Heater—D.W.— APPLICANT Daxt Systems Oven—Dryer_W.M. ADDRESS 1_1+0 Dynamics Unit J Top _FAU —W.H._ CITY Tel.No. Hood_Fan —Other LICENSE OR 2163n , Disp._Room Air Cond.' 2.50 REG.NUMBER 37059.9 Class. 10-20 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA- Power Apparatus&Large Appl ionces TION AND STATE THAT THE ABOVE IS CORRECTAND AGREE TO Size&Type HP,KW,KVA,or KVAR COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS Yp REGULATING ELECTRICAL WIRING. Up to 1 Incl. 2.50 Q I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 3� Over 1 to 10 Incl. 5.00' 0 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 I DESCRIBED RESIDENJlQL PROPERTY. Over 50 to 100 Inc. Gv�/ Over 100 40.00 PERMITEE SIGNATURE d Services DISTRICT NO. Vf OCES ED BY 0.200 Amp,Under 600 V 12.50 l 1 12. 0 �U 201.1000 Amp.Under 600 V 25.00 Over 1000 Amp.or Over 600 V 50.00. n /1 Temp.Power Pole&Appurtenances 10.00 Sign with One Branch Circuit 10.00 I o Additional Sign Branch Circuits 2.00 INSPECTION > INFORMATION _ Misc.Conduits&Conductors 10.00 ON REVERSE z ^ Other(See Complete Fee Schedule) u �' r' SIDE t� oocoor o. 2 2 it G PERMIT FEE ISub-To'tall 0002(,,,- C1L PLAN CHECKING FEE (One-Fourth Permit Fee) O 0525-79 PERMIT ISSUING FEE $7.00 00 D TOTAL FEE 24.50 > INSPECTION FINALED W date: By i es WORKERS'COMPENSATION cafe of cons - CjE.W6 1n�B1 ; APPLICATION FOR ELECTRICAL PERMIT 4•hereby "affirm that I have a certificate of consent to-self CE-BO6G insure, ora certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or certified copy thereof(Sec. 3800, Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB Certified co is hereby furnished; EACH NO. FEE ADDRESS PY� Y New Residential Bldgs. &Pools ❑ .Certified co y g ' p 1 &2-Family, S Ft. Z $ — $ LOCALITY copy is filed with the count building ins.pec- Y� q• '� Nil— tion department. Multi-family Sq. Ft. — NEAREST CROSS ST. Residential Swimming Pools Date Applicant OWNER OR FIRM NAME VL 1 CERTIFICATE OF EXEMPTION FROM WORKERS' QQ MAIL COMPENSATION INSURANCE Outlets: Rec3L_LightSw.s� ADDRESS. iyY� S b (This section need not be completed N the work involved by First 20 J`— the permit is for one hundred dollars(5100)or less.) Total No. Additional CITY Tel. No. I certify that in the performance of the work for which this APPLAPPLICANT 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 _ Drypp4ohr I.M. ADDRESS with comply with such. provisions or this permit shall be Top FAU —W.H.. — CITY Tel. No. deemed revoked. Hood _ Fan —Other— LICENSED CONTRACTORS DECLARATION LICENSE OR 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 Power Apparatus&Large Appliances DISTRICT NO. IROCUS BY and Professions Code,and my license is in full force and effect. Size&Type HP, KW, KVA, or KVAR• -License Number Lic. Class Up to 1 Incl. FINAL Over 1 to 10 Incl. DATE VALIDATION. Contractor Date Over 10 to 50 Incl. I.' FINAL 4y ❑ I am exempt under Sec. Over 50 to 100 Inc. BY L B.&P.C. for this reason- Over 100 Date: Services, Swbd., MCC&Panelboards A 57 ► 0 -200 Amp. Under 600 V Signature l 201 - 1000 Amp.Under 600 V ❑ Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY Temp. Power Pole&Appurtenances F18 7.6 A 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 jf o 0 0 0 0 2 Law for the following reason (Section 7031•.5, Business and , Professions Code): 2 ° ° 4850 ❑ I, as owner of the property, will do the work and the Misc. Conduits&Conductors o 0 0 = structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)_ , 4 8,5 cr 7044, Business and Professions Code). 1,0,7_8 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 Ahe ces and State 1 s regulating Electrical wiring, and authorize rep se tatives of this County to enter upon- noon pr. perty for inspection purposes. ISEE REVERSE FOR EXPLANATORY LANGUAGE re of Permittee D to COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0608170015 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 4902 LT: 12 BL: .001 4939 MCCLINTOCK AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917804104 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: GRAND 8574-024-032 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: D4 LOCALITY: TEMPLE CITY, C F1 120V, 15/20A BR CKTS 1.00 BR 17.25 TENANT: G1 OUTLETS-LGT,SW,RECP 10.00 OUT 19.50 ISSUED ON: PROCESSED HY: PLAN BY: EXPIRES ON: G2 LIGHTING FIXTURES 2.00 LGT 3.90 08/17/06 JK 02/13/07 LB 200 AMP PANELS, MCC 1.00 PAN 38.85 OWNER: TEL. NO: TOTAL FEES 107.25 FINAL DATE FINAL BY: CODE: IBARRA, AMY G (626) 444-4924- ��®^ 6 4939 MCCLIN'TOCK AV TEMP 917804104 DESCRIPTION OF WORK ELECTRICAL FOR ADDITION AND UPGRADE SERVICE PANEL TO 200 AMP APPLICANT: TEL. NO: SAME AS OWNER - SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO TEMPORARY POWER POLE UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: UFER GROUND LIC. NO: ROUGH CONDUIT I I ROUGH WIRING MAIN WATER LINE PLASTIC YIN METAL YIN UTILITY COMPANY NOTIFIED REPORT ID: DPR265 ROUTE TO: BS0508 i