HomeMy Public PortalAbout10432 MILOANN ST_Electrical__ DBS-5A ta:sa APPLICATION FOR ELECTRIC PERMIT
DBS-5A
DIVISION OF BUILDING AND SAFETY
Deportment of County Engineer
County of Los Angeles BUILDING /04 3
WM.J. FOX, COUNTY ENGINEER J_ ADDRESS
CASSATT D.GRIFFIN,SUPT OF BUILDING
FOR APPLICANT TO FILL IN LOCALITY
PERMIT FEES NEAREST f
CROSS ST. AL JZ:A X
NUMBER
--� EACH FEE NL n
LIGHT OUTLETS OWNER �� L �YC
RECEPTACLES _ MAIL /V1
WALL SWITCHES _J� ADDRESS
TOTAL OUTLETS 5, $ CITY � Jc TEL. NO.
ELEC. RANGES 25 ELECTRICIAN C — LC IC SHOP
ELEC.HEATERS •25 L ADDRESSRci:-70 D
KW EA •CITY 7'm TEL.
FIXTURES 5 -LICENSE NO. �J
NUMBER OF LIGHT CIRCUITS
NUMBER OF RECEPTACLE CIRCUITS DISTRICT NO. GROUP 7,QNE READY FOR INSPECTION
. 3
MOTORS L!!r I J+
NUMBER HORSEPOWER FEE INSPECTION RECORD
NEW MVD. HP OVER INC. EACH
_ I/Z&LESS $ .25
2 .50
2 5 1.00
5 15 1.50
_ 15 50 2.50
50 200 5.00 0
1,
MISC.
i
NO.SIGNS NO.TRANS.
NO.SIGNS NO. LAMPS
FOR EACH PERMIT:
WIRING $1.00 00
FIXTURES $1.00Q'�
SUPPLEMENTARY .50
APPROVALS
TOTAL FEE �s DATE INSPECTORS SIGNATURE
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION CONDUIT n
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND. STATE LAWS REGULATING WIRING r •,^� �h i
ELECTRICAL WIRING.
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR (FIXTURES G?
LICENSED AS REOUIRED'BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT i AM THE LEGAL OWNER O THE ABOVE -POWER
DESCRIBED RESIDENTIA ROPERTY. UTILITY CO.NOTIFIED
SIGNATURE PERMIT'1'E ' FINAL W r
WILLIAM J. FOX,COUNTY ENGINEER VALIDATION
i
j:j . 039233 FEB 9 2 . 3.0 5
By -
� 'DEPUTY,
® v /vJ ✓✓
OOURTY OF LOs ARalLli APP=&=N FOB PAZ
Deparbmwl of DMS BMMING MING&�SAFS+1'Y
WILLIAM L FOX, Onsty K6slEur ELECTRIC 1
FOR APPLICANT TO FILL IN DIOTRlCT No. RROUPON� PER O.
ELECTRICIAN M
REDEIVED MY READY FDR DATE IMSA®
ADDREW If FIR■T INSPECTION
CITY TEL.No. I B ' o_ r�
�L.IOEN E No. EXPIRES +-•? �.. io1LDINM
�S ADDRESS
NUMBER EACH FIE LOCALITY • •
LIMHT OUTLETS NEARERT
RECKPTABLEM CROW iT �IA A Ir
WALL MWITOHEM OWNER &
TOTAL OUTLETS MB MAIL
ELEEL RANMli SB ADDTEW
ELin. HEATERS W CITY TEL. No.
FIXTURES i 1 HEREBY ACKNOWLEDSE THAT 1 HAVE READ THIN
MISO. APPLICATION AND STATE THAT THE ABOVE IN CORRECT
NUMBER of LIMHT 01RCU1Ti AND AMR= To COMPLY WITH ALL COUNTY ORDINANCES
NUMBER of RECEPTACL! CIROU177 AND MTATE L.AWM REMULATINM ELECTRICAL WIRINM.
MOTORM 1 CERTIFY THAT 1 POW THE ABOVE VALID LOU
NUMBER HORSEPOWER FEE ANSELE■ OOUNTY LIUCHIM ON 1 AM THE LKMAL CWNER
New MVS. HP DYER INS. EACH OF THE RESIDENTIAL PERTY DEBORIBED ABOVE.
Va ATU
�N
8 L®R .BO MIM MATURE CF -2 '..r i••'rI'
ym IIIyam__•
S B 1.0a Z rTVINPECMN EMBD
s Is 1.60
s0. Tao s.ao
w e,
Eno soa 10.01
son low 11111.00 Z
OVER I mn so.00 p
Mo. myr/mcm. oNANSER-HP
WELDERMI AO-KVA O
MENCHATOW - KW
TRANSFORMERM - EVA
TEMP. MOTORS I7111of oRIRa
MOVED MOTORS 17 of BRIMJ
M ISO.
slums
No. No.TRANM. AWEMALS
MEL N LAMPM
FOR EACH PKRMITf T! INSPEOTOR9S NAME
WIRINM 1,p1 /t+7 OCNDUIT
FIXTURES I.00 WIRINM
PP !
FIXTURES � �+
POWER
TOTAL FEs M -�y.7+� UTILITYodNDTIFIED n•+ .
FINAL �� •
76"02 SRR#RA R-N
WORKERS'COMPENSATION DECLARATION' 78-883 1o/67 APPLICATION FOR ELECTRICAL PERMIT
I f 'y aft+ that I have a certificate of. consent to self insure, ;CE-BoeG �1 '
or.a"certificate of Workers' Compensation Insurance, o�r7a.-/certified I COUNTY OF LOS ANGELES BUILDING AND SAFETY IUI
copy thereof(Sec..3800,Lab: .
Policy No. A C ariy FOR APPLICANT.TO FILL.IN JOB I ( {
59 Certifi d.c furnished. EACH NO.. FEE ADDRESS / (/�,$ �- I-I L jj0�ri{
rpZ - // New Residential Bldgs.&Pools
I'7S $ — $ LOCALITY ? .
0 Certified copy is-.filed'with the county building inspection 1 &2-Family,Sq.Ft.
e_p rtment Multi-family Sq.Ft.. NEAREST
CROSS ST.
Date Applicant M•Qr`� r bid Residential Swimming Pools OWNER OR ��
CERTIFICATE OF EXEMPTION FROM WORKERS' / FIRM NAME MR ^r-/ L(/!1 t
IL
COMPENSATION INSURANCE Outlets:Ree--1—Light First 20 Q ADDRESS u .
(This section need not be completed If the work involved by the •J CITY Tel,No.
permit.is for one hundred dollars($100).or'I.ess.), Total No. Additional'
I cern that in the performance of thelwork for..Which this emit PLAN CHECK
certify P APPLICANTis 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
NOTICE�TO APPLICANT: 'If, after making this Certificate of Fixed Appliances.Not Over 1 HP PERMIT ,,//)� ��y, � /'
Exemption,you should become subject to the Workers'Compensation Range_ Heater D.W APPLICANT (�K PJpV 'L
..provisions of the Labor Code,you must.forthwith comply with such Oven Dryer._ W.M._ ADDRESS Akoh V.ako ,
provisions or this permit shall be deemed revoked.
LICENSED CONTRACTORS DECLARATION Top _� L W.H. _ CITY L� Te1.No
Hood — Fan Other_ `
I. hereby affirm that I afn-.licensed under provisions•of Chapter 9 ` �C REG.NUMBER
LICENSE OR
(commencing with Section 7000)of Division 3 of the Business and Disp. Room Air Cond. ClassP.l PProfessions Code,and my license is in full force and effect. Power Apparatus&,Large Appliances.+ DISTRICT No. SSED By
�y- ? j7 �_�,} Size&Type HP,KW,KVA,or KVAR _�6Lst.r�si�c� OO
License Number-., �" ��Y Lic..Class 'V f 4 Up to 1 Incl. FINAL �i
y�� 7 .. , Over 1 to 10 Incl. DATE �(�. q� fY
• Contractor�rrl��i//►/ ��a Date '� N y .I VALIDATION Q
&- Ap.
1000 50 Incl. FINAL (~)
I am exempt under Sec. 50.to'100 Inc. BY a
100_
B.&P.C.for this reason - Z
SeC'&Panelboards
Date: QUnder 600 V
Signature 1i Under 600 V
❑ Over 100.0 Amp.or Over 60.0 V
Exemption for Reg.Maint.Elect.
SINGLE FAMILY Temp.Power Pole&Appurtenances
HOME OWNER-BUILDER DECLARATION' Sign with One Branch Circuit 2
I hereby affirm that I am exempt from the Contractor's L'icensq Law IAdditional Sign Branch Circuits ►` s
for the following reason(Section 7031.5,Business and Professions F).CCT
Code):
` Misc.Conduits&Conductors330.3 • .99 40
I,as owner of the property,will do the work and the structure*
is not intended or offered for sale (Section 7044,Business Other(See Complete Fee Schedule) _ ® ITEM'
and-Professions Code).
TO Xpq
CONSTRUCTION LENDING.AGENCY CHECK
40
1'hereby affirm that there is a construction lending agency for the � _
performance of the work for which this permit is Issued(Sec.3097, PERMIT FEE (Sub-Total) � O, CHANGE e00
Civ.C.).
+ PLAN CHECKING FEE
Lender's Name
PERMIT ISSUING FEE _ Q �j - OBJ! 7/j°f,95
Lender's Address ®TOTAL FEE 1, 98 1 AM 2(0 o 28
1 certify that I have read this application.and state that the above
information is correct.I agree do comply with all County ordinances
and State 11105. regulollIng Electrical wiring, and hereby authorize
represents' s of t ' Courtly to enter upon the above-mentioned
property r inspec :.purpose SEE REVERSE FOR EXPLANATORY LANGUAGE
S gna of Perm i ee Date
Y COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1304240020
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: FEES PAID I BUILDING ADDRESS: 1
ITR: 14053 IT: 8 I 1 10432 MILOANN ST ]
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:( TEMP CA 917803471 1
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: HALIFAX
18585-018-008 1A1 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY, Cl
I G1 OUTLETS-LGT,SW,RECP 1.00 OUT 2.00 I I
TENANT: G2 LIGHTING FIXTURES 1.00 LGT 2.00 ISSUED ON: PROCESSED BY: PLAN BY:
I I I
1 TOTAL FEES 31.80 04/24/13 SR 1
(OWNER: TEL. NO: 1 IF DATE FI BY: CODE: 1
IKWOK, TONY (626) 628-5666- I I
110432 MILOANN ST I I
ITEMP 917803471 I DESCRIPTION F WORK
I
GFCI OUTLET AND LIGHT FIXTURE
(APPLICANT: TEL. NO: I I
ISAME AS OWNER
ISPECIAL CONDITIONS: ]
I I I
I I �
(CONTRACTOR: TEL. NO: I ]APPROVALS LATE INSPECTOR SIGNATURE
SAME AS OWNER -
I - I
LIC. NO 1 ]TEMPORARY POWER POLE I I
I 1UNDERGROUND CONDUIT I I
ARCHITECT OR ENGINEER: TEL. NO: _ i JUFER GROUND I I
LIC. NO: 1 IROUGH CONDUIT I I ]
ROUGH WIRING
IMAIN WATER LINE 11
I IPLASTIC YIN METAL YIN I 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 1 1 ] I 1
I I I 1 I I
(REPORT ID: DPR265 ROUTE TO: BS0508 I I I
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1011010001
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID BUILDING ADDRESS: I
1 TR: 14053 IT: 8 10432 MILOANN ST 1
ASSESSOR INFORMATION NUMBER: [FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:( TEMP CA 917803471
I I NEAREST CROSSSTREET: HALIFAX
18585-018-008 1A1 PERMIT ISSUANCE FEE 27.80 f THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY, Cl
1G1 OUTLETS-LGT,SW,RECP 8.00 OUT 15.50 I 1
(TENANT: G2 LIGHTING FIXTURES 6.00 LGT 11.60 [ISSUED ON: PROCESSED BY: PLAN BY:
1H2 RES GREG DISP IT 3HP 1.00 DIS 10.90 111/01/10 SR
(OWNER. 1H4 RES RANGE HDS IT 3HP 1.00 H00 10.90 1 I
TEL. NO: 1 TOTAL FEES 76.70 IFINAL DATE FINAL BY: CODE:
1XWOK, TONY (626) 628-5666- 1I
110432 MILOANN ST I I P�W
1 ITEMP 917803471 1 1 ESCRIPTION OF WORK I 1ELECTRICAL FOR KITCHEN REMODEL
(APPLICANT: TEL. NO: I I I
SAM AS OWNER
1 1SPECIAL CONDITIONS: 1
ICONTRACTOR: TEL. NO: [APPROVALS DATE INSPECTOR SIGNATURE
ISAME AS OWNER -
1 LIC. NO 1 1TEMPORARY POWER POLE I I I
I I (UNDERGROUND CONDUIT 1 I I
[ARCHITECT OR ENGINEER: TEL. NO: 1UFER GROUND I I I
I
LIC. NO: IROUGH CONDUIT [
1ROUGH WIRING v1
[ 1 IMAIN WATER LINE I I
I 1 1PLASTIC Y/N METAL Y/N I I 1
I 1UTILITY COMPANY NOTIFIED( I I
I I I I I I
I I I
I
I
I I I 1 I
1 I I I I I
1 1 I I I
1 1 I I
I I 1 I
I I I
1 1 I I 1
I I 1 I I I
I IREPORT ID: DPR265 ROUTE TO: BS0508
I I I I I