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Home My Public Portal About5113 MCCLINTOCK AVE_Electrical__ 7GAGG3-Cr%S$6 10172 APPLICATION FOR ELECTRICAL PERMIT r•- COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER fiewSS �;1 (-` BUILDING AND SAFETY DIVISION LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST, OUTLETS NO. RACK I F OWNER FIRM IIAME RECEPaa S MAIL �, C LIGHT TOTAL FIRST 20 ?s ADDRESS SWITCH OVER 20 CITY TEL. N0. 10 PLAN CHECK LIGHTINGFIRST 20 m APPLICANT TOTAL FIXTURES 10 OVER 20 ADDRESS RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT RANGE DRYER_WTR. HTR. APPLICANT STA. COOK DI5P. F.A.U. ADDRESS SPACE HTR. AIR CD n- CITY TEL. NO. CLOTHES WASH.-DISH 1&Elf&R CLASS. FAN-/--OTHER 1.00 1 HERRST ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE I! CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCE! AND STATE LAW! REGULATING IND.HEATERS, ETC. HP. RW.RYA. ELECTRICAL WIRING. SIZE S TYPE OVER TO 1 HEREBY CERTIFY THAT 1 AM PROPERLY 9EG1lTERlD ANDkIR 0 — 1 100 LICENSED AS REQUIRED BY LOB ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AMTHFILEGAL OWNER OF THE ABOVE 1 - 10 Sol DElCRIrE SIIDENTIAL PROP TV. 10 - 50 Boo PERM ITE SIGNATURE oC go - 100 10110 DISTRICT N0. PROCESSED BY N- 100 - 500 1500 LJ- d SIGN, GAS SIGN AND ONE CIRCUIT LOD APPROVALS DATE BI NTOWsIIBRIITillls TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE SERVI CENOTOVER 600 VOLTS OR 200 AMP B.Oo UNDERSLAB WORK SERVICEOVER 600 VOLTS OR 200AMP 10 ROUGH CONDUIT TEMP SERVICE.POLE,III APPURTENANCES 8.00 WIRING TEMP LIGHT OR RECEPT. SYSTEM B.OD FIXTURES POWER AUTHORIZED ,� UTILITY CO. NOTIFIED , FINAL - PERMIT FEE (SUB TOTAL) NOTES; PLAN CHECK FEE PERMIT ISSUING FEE BAD TOTAL FEE PLAN CHECK VALIDATION CR. M.O. CASH PEJR//u�'1T VALIDATION K. .o. CASH V / 9 2 39NOV a5 2 O 1 8.7 0 Abd 999 BACK of APPLICATION FOR COMPLITS SCHEDULE �WORKERS'COMPENSATION DECLARATION 76-883 toiai APPLICATION FOR ELECTRICAL PERMIT kaertificate affirm that I have a certificate of consent to self insure, CE-BoeG LI of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY opy;thereof($ec.3800,Lab.C.) Policy No. Company FOR APPLICANT TO FILL IN JOB �� ❑ Certified copy is hereby furnished. New Residential Bldgs.&Pools EACH NO. FEE ADDRESS ❑ CuoAlock- W4;-: Certified copy is filed with the county building inspection 1 & 2-Family,Sq.Ft. $ — $ LOCALITY "T department. Multi-family Sq.Ft. — NEAREST Residential Swimming Pools CROSS ST. Date Applicant OWNER OR `' FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' /`� -WIL COMPENSATION INSURANCE Outlets:Rec "Light_ — ADDRESS fi (This section need not be completed if the work Involved by the Firstt 2 20 permit Is for one hundred dollars($100)or less.) Total No. Additional CITY Tel.No. I certify that in the performance of the work for which this permit PLAN CHECK APPLICANT 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 e&L ADDRESS Total No., <� Additional 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: CITY Tel.No. LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other_ I hereby affirm that I am licensed under provisions of Chapter 9 LICENSE OR Disp. - Room Air Cond. REG.NUMBER Class. (commencing with Section 7000) of Division 3 Of the Business and Professions Code,and my license is in full force and effect. Power Apparatus&Large Appliances DISTRICT NO. PR9CE D BY Size&Type HP;KW,KVA,or KVAR Q License Number Lic.Class Up to 1 Incl. FINAL f, GG77 Contractor Date Over 1 to 10 Incl. DAT VALIDATION O Over 10 to 50 Incl. FIN V ❑ I am exempt under Sec. Over 50 to 100 Inc. BY GW.. B.&P.C.for this reason Over 100 Z Services,Swbd.,MCC&Panelboards Date: 0-200 Amp.Under 600 V Signature 201 - 1000 Amp.Under 600 V Over 1000 Amp.or Over 600 V F Exemption for Reg.Maint.Elect. � °o o SINGLE FAMILY Temp.Power Pole&Appurtenances oc J�2 HOME.OWNER-BUILDER DECLARATION Sign with One Branch Circuit 2 J 18—3 I hereby affirm that I am exempt from the Contractor's License Law for the following reason(Section 7031.5,Business and Professions Additional Sign Branch Circuits Cod Misc.Conduits&Conductors I,as owner of the property,will do the work and the structure Other(See Complete Fee Schedule) _ is not intended or offered for sale (Section 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(Sec.3097, I PERMIT FEE (Sub-Total) Civ.C.). PLAN CHECKING FEE Lender's Name. PERMIT ISSUING FEE Lender's Address l • I certify that I have read this application and state that the above TOTAL FEE information is correct.I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize repres tor of this County to enter upon the above-mentioned prope y for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date WORKERS'COMPENSATIONDECLARATION CE-806G (2.80) APPLICATION FOR ELECTRICAL PERMIT I CE-806 I hereby 21hlrm that I 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(S 3800,Lab.C.) /r/f• FOR APPLICANT TO FILL IN JOB i Policy No�r�l� 'o panyi//,_JA ��'L�� ADDRESS New Residential Bldgs.&Pools EACH NO. FEE 0 Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ — $ LOCALITY ❑ Multi-family Sq. Ft. NEAREST Certified copy is filed with the county building inspection CROSS ST department. Residential Swimming Pools OWNER OR Date Applicant FIRM NAMEk/Fl h C�r'1 �J PP Outlets: ReclLight Sw. � MAIL 1 (� " `` e� First 20 ADDRESS a C1 , ;J CERTIFICATE OF EXEMPTION FROM WORKERS" Total No. Additional CITY � �e � � 'TeI N � Z COMPENSATION INSURANCE PLAN CHE } (This section need not be completed if the work involved APPLICANT 0a by the permit is for one hundred dollars ($100) or less.) Lighting Fixtures First 20 ADDRESS V Total No. Additional cc I certify that in the performance of the work for which this ' CITY Tel No. 0 is issued I shall not employ an person in an manner Fixed Appliances Not Over 1 HP -permitP y Y P Y PERMIT V V so as.to become,subject to.the Workers'Compensation Laws. Range_Heater D.W._ APPLICANT'V? Oven —.Dryer_W.M._ ADDRESS .�� ti Date Applicant Top _ FAU _W.H. Z Hood _ Fan _Other_ CIT 1 I N-. 110 Q `S NOTICE TO APPLICANT: If,.after making this Certificate of Disp. _Room Air Cond._. LICENSE OR Exemption, you should become subject to the Workers' REG.NUMBS Class Compensation provisions of the Labor Code,you must forth- Power Apparatus&Large Appliances DISTRICT N9. PROCESSED BY with comply with such provisions or this permit shall be Size&Type HP,KW,KVA,or KVAR en deemed revoked. 'r � , Up to 1 Incl. Over 1 to 10 Incl. DATE FINAVALIDATION re LICENSED CONTRACTORS DECLARATION Over 1. to 50 Incl. VALIDATION 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 1�b3 813 (�G� 0-200 Amp.Under.600 V License Number Lic.Class �6 � �^ ((-�� //'�- 201-1000 Amp.Under 600 V Contractosr/�a,rZ?,!✓�mate Over 1000 Amp.or Over 600 V HOME OWNER-BUILDER DECLARATION Temp.Power Pole&Appurtenances 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 Circuits ness and Professions Code): Misc.Conduits&Conductors I,"as owner of the property, will do the work and the. Other(See Complete Fee Schedule)— :22498A structure is not intended:or offered for sale (Section . 7044,Business and Professions Code). CONSTRUCTION LENDING AGENCY # 0 0 0 0 o 2 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). �rQ 2,0 0 2. 1 G issued(Sec.3097,Civ.C.). Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) v Lender's Address PERMIT ISSUING FEE qPM 1231 8 1 I certifyy 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 ereby authorize representatives of this County to enter upon he,elbove-men io d roperty for inspection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0109280001 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL IDi--- FEES PAID BUILDING TR: 133LT: 26 5113 MCCLINTOCKS 84 AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803557 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 8574-004-012 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: D4 LOCALITY: TEMPLE CITY, C HA FAU LESS 3HP 1.00 FAU 10.95 JB AC UNITS +3-10HP 1;.00 AC 19.65ISSUED S . S TOTAL FEES 58.35 09/28/01 VG 03/27/02 . OWNER- TEL. NO: FINAL DZT5 CODE: THOMPSON DONALD K;GLORIA J (626) 448-2740- 5113 MCCLINTOCK AV �b IL TEMP 917803557 SC 0 0 ELECTRICAL FOR HVAC APPLICANT: O: FAST TRAK PERMIT SERVICE (909) 279-0604- SPECIAL CONDITIONS: CONTRACTOR: TEL. N0: ES cot1/� APPROVALS DATE INSPECTOR SIGNATURE AIR-TRO, INC. (626) 357-5311- 1630 S. MYRTLE LIC. NO \� R ER POLE MONROVIA, CA 91016 258228C20 + UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: - / ER GROUND LIC. N0:'; _-- I `�111111`I 1 ROUGH CONDUIT ROUGH R U Q L C � . 170 - K S MAIN TER LINE J L Jll�r! �L PLASTIC Y/N METAL Y/N UTILITY COMPANY 0 ED Li D �oc 'Yervice'fha`�� * ADDITIONAL DATA ON FILE REPORT ID: DPR265 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS I 9701 LAS TUNAS I EL 0508 0107100019 BUILDING AND SAFETY / LAND DEVELOPMENT i TEMPLE CITY CA 91780 ! PHONE: (626) 285-0488 EXT: -LEGALA GA RSS: I TR: 13384 LT: 26 I 5113 MCCLINTOCK AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 'TEMP CA 917803557 ASSESSOR - NEAREST CROSS STREET: FREER 8574-004-012 I Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: D4 LOCALITY: TEMPLE CITY ( LB 200 AMP PANELS, MCC 1.00 PAN 38.85 1 TOTAL FEES 66.60 ISSUED ON.--p-R-OC-ESSED EXPIRES 07/10(01 UT 01/06/02 . OWNER: TEL. 0: F I NALI T FM 6L i : CODE: THOMPSON DONALD K;GLORIA J (626) 448-2740- 5113 MCCLINTOCK AV -7 1 TEMP 917803557 C UPGRADE SERVICE PANEL APPLICANT: -Tn-. 0: SAME AS OWNER - - SPECIAL CONDIT ONS: CONTRACTOR: TEL. NO: n�:�� APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - LIC. NO +' f �/"� \, P POWER-POLE UNDERGROUND CONDUIT 111 � ARCHIfE-CT OR ENGINEER: TEL. NO: LIFERGROUND III �'I LIC. NOf' _ _JL_�1 I I -� I 1 �y I i, 1,', ROUGH CONDUIT I ' I •- ,, ;1 I-' --- -- J-_ - -J --� �_ - -1 ROUGH G !! f`�t' �`» 9 AIN WATERLINE U 1 PLASTIC Y/N METAL Y/N �- - ------_ UTILITY COMPANf OTIFIED ` - rviee i t REPORT ID: DPR265 ROUTE TO: BS0508 I