HomeMy Public PortalAbout6003 MUSCATEL AVE_Electrical__ 76p663-CE808 10/72 APPLICATION FOR ELECTRICAL PE MIT
COUNTY OF LOS ANGELES w�
DEPARTMENT OF COUNTY ENGINEER FAl9()C5":S lV. 1�\VS�`-� `'
BUILDING AND SAFETY DIVISION
�LNEARESTpCFOR APPLICANT TO FILL IN 7 Tt� \" V�
OUTLETS NO. EACH FEE I OWNER ORy�� C �(� \
FIRM NAME /1\Y�_J. t le\`-� •ie=
RECEPT.� $ $ AMAIL
DDRESS
LIGHT TOTAL FIRST 20 •25 D ,}�, r
CITY _t.C_ 6 TEL. NO.
^10
SWITCH_ OVER 20 pLANICHECKANT Civ I CScCIwt dL
FIXTURES •10
LIGHTING TOTAL FIRST 20 •25
} OVER 20 ADDRESS Q 1 �MA'v k `J,
RESIDENTIAL APPLIANCES CITY 16,0Gml TEL. NO. cfPER
RANGE DRYER_WTR. HTR. APPILICANT � "��
�'�
STA. COOK DISP. F.A.U. ADDRESS 0 \- A4, CAUAA-1 Ile
SPACE HTR, AIR COND. A CITY SH . TEL. NO. ', q 8119
CLOTHES WASH. - DISHWASH. I LICENSE OR /'
1 REG. NUMBER 'Ro\ CLASS. t o
FAN OTHER 1.001' I HEREBY ACKNOWLEDGE THAT 1 HkVE,.READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING 'I WITH ALL COUNTY ORDINANCES AND 'STATE LAWS REGULATING
IND. HEATERS, ETC. HP. KW. KV.A. ELECTRICAL WIRING.
SIZE & TYPE OVER TO
,I I HEREBY CERTIFY THAT I AM ?AIL
ERLY REGISTERED AND/OR
0 - I LICENSED AS REQUIRED BY LOS AES COUNTY AND STATE OF
1.00
CALIFORNIA OR THAI' 1 AM HE OWNER'OF THE ABOVE
1 - 1O 9.00 DESCRIBED R NTIAL P OPE C7
V
10 — 50 5.00 PERM.ITEESIGNATURE O
50 - 1.00 IOAO DISTRICT NO. PROCE� ED Y a
100 - 500 15.00 r 0
SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DA INSPECTOR'S SIGNATURE
TUBE, OR
MARQUEE ADDITIONAL Cl t
RCUITS1.00 TEMP. POWER POLE
SERVICENOTOV ER 600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK
ZERVICEOVER600 VOLTS OR200AMP 10.00 I ROUGH CONDUIT
TEMP SERVICE,POLE,&APPURTENANCES 5.00 I WIRING
TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES
POWER AUTHORIZED (o
UTILITY CO. NOTIFIED
_4 FINAL
A 71r-
PERMIT FEE (SUB TOTAL) I NOTES:
PLAN CHECK FEE
PERMIT ISSUING FEE 3.00 3 b
TOTAL FEE 7$
PLAN CHECK VALIDATION CK. 1J.0. CAS PERMIT VALIDATION Q) M.O. CASH
I •f'_ 3 5 1 i
VV4)R5ERs'COMPENSATION DECLARATION 76A663 ,D,9, APPLICATION FOR ELECTRICAL PERMIT
I'I ere61T affirm that I have a certificate of consent to self CE-WMG
insure, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY
for a certifi copy thereof(Sec. 3800, Lab. C.)
Policy No� 6ompany4"7711 — FOR APPLICANT TO FILL IN SOB A p - j
❑ Certified co is hereby furnished. EACH NO. FEE !A DRESS. J666
copy Y New Residential Bldgs. &Pools
l $ — $ ;LOCALITY.
a 1 &2,Famil S Certified copy is filed with the county building inspec- y q' Ft. — ale
NEAREST
.tion department. (/� Multi-family Sq. Ft. CROSS ST.
Date J -1 ' Applicant F: Residential Swimming Pools OWNER OR
����(( ' FIRM NAME
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: ReC;Light 9 Sw.d, MAIL
COMPENSATION INSURANCE First 20 to ADDRESS G'F
(This section need not be completed if the work involved by Total No. Additional CITY Tel. No.
the permit is for one hundred dollars($100)or less.) PLAN CHECK.
I certify that in the performance of the work for which this ' APPLICANT
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
k Total No.. F7 Additional CITY Tel. No.
Date Applicant Fixed Appliances Not Over 1 HP PERMIT
NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT Q fVA
Exemption, you should become subject to the Workers' Range— Heater_D.W. —
Compensation provisions of.the Labor Code, you must forth- Oven _Dryer —W.M.— ADDRESS {'
with comply with such provisions or this permit shall be Top FAU —W.H.
deemed revoked. Hood —Fan —Other— CITY' C�3��jP"7e Tel. No.
LICENSED CONTRACTORS DECLARATION LICENSE OR
I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Con.d: REG.NUMBER ,j;� Class.
(commencing with Section 7000) of Division 3 of the Business .DISTRICT NOPROCE E BY
Power Apparatus&Large Appliances �
and Professions Code,and-my license is in full force and effect. `/
Size&Type HP, KW, KVA, or KVAR' sat O
License.Number '�_ Lic. ClassUP to 1 Incl. FINAL 4J
}� — Over 1 to 10 Incl. DATE r, VALI ION aE
Contractor 19h� 17 Date � /� Over 10 to 50 Incl. FINAL V
❑ I am exempt under Sec. Over 50 to 100.1nc. BY Im
d
B.&P.C. for this reason Over 100
Date: Services, Swbd., MCC&Panelboards
0 -200 Amp..Under 600 V S 0� ► 91 9 Q 4 A
Signature 201 - 1000 Amp. Under 600 V
0 0 0 0 2
Over 1000 Amp. or Over 600 V # 0
❑ Exemption for Reg. Main.t. Elect. ) - . 47.7,5
SINGLE FAMILY Temp. Power Pole&Appurtenances =
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit o 0 o 4 7,7 5 5
I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits
Law for the following reason (Section 7031.5, Business and Q k 2 2—8 5
Professions Code):
❑ I, as owner of the property, will do the work and the Misc. Conduits&Conductors
structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)-
7044, Business and Professions Code). ,
CONSTRUCTION LENDING AGENCY I
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 7
I certify. that I have read t -I ell
his 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 sentatives of this County to enter upon
the. bove-me oned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
ignafure of Permittee Date -
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0212130004
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
BUILDINGLEGAL ID: FEES PAID
TR: 5903 LT: 75 6003 MUSCATEL AVN
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: SGAB CA 917752622
ASSESSOR 0 0 NEAREST CROSS STREET:
5386-012-053 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY
G1 OUTLETS-LGT,SW,RECP 3.00 OUT 5.85
G2 LIGHTING FIXTURES 1.00 LGT 1.95 ISSUED 0 PROCESSED LAN BY: EXPIRES ON:
TOTAL FEES 35.55 12/13/02 JK 06/11/03
OWNER: TEL. NO: FIN7L DATE FINAL BY: CODE:
VUONG CAN TO;STACEY T (626) 571-0335- /fes
6003 MUSCATEL AV i
SGAB 917752622 DESCRIPTTTN—OF WORK
ADD 151X181 STORAGE RM TO BACK OF GARAGE
APPLICANT: TEL. NO:
SAME AS OWNER -
SPECIAL CONDITIONS:
CONTRACTOR: TEL. 0: APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER -
LIC. NO TEMPORARY POWER POLE
UNDERGROUND-CONDUIT
ARCHITECT OR ENGINEER: L. N ER GROUND
LIC. NO: ROUGH CONDUIT
ROUGH WIRING
MAIN WATER LINE
PLASTIC Y/N METAL Y/N
UTILITYCOMPANY NOTIFIED
REPORT ID: DPR265 ROUTE TO: BS0508