HomeMy Public PortalAbout6208 MUSCATEL AVE_Electrical__ 76A668 CE-806141 8/76 APPLICATION FOR ELECTRICAL PERMI�� `�
COUNTY OF LOS ANGELES �J
•DEPARTMENT OF COUNTY ENGINEER ADDRESS46209110.
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN LOCALITY
New Residential Bldgs.&Pools EACH NO. FEE NEAREST
1 &2-Famil S Ft. $ 025 — $ CROSS ST.
Family, q' OWNER OR
Multifamily Sq.Ft. •02 — FIRM NAME
Residential Swimming Pools 20.00 MAIL
Go ADDRESS
Outlets:-Rec Light—2-Sw. �_ �! CITY SCyyL. Tel.No.'2$'S
First 20 .50 PLAN CHECK ••
Total No. Additional .30 APPLICANT
ADDRESS
Lighting Fixtures First 20 .50 CITY Tel.No.. "
Total No. Additional 30 n IT
APPLICANT
Fixed Appliances Not Over 1 HP i ADDRESS 3 r,7
Range_Heater_D.W._ 1' CITY /I _ Tel.No.?, —S�
Oven_Dryer_W.M. LICENSE OR
Top —FAU —W.H. REG.NUMBER �j lZ 3 97 Class.C
Hood_Fan _Other— I I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
Disp. _ Room Air Cond. 2.00 I THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDIN.
ANCES AND STATE LAWS REGULATING ELECTRICAL WIRING.
Power Apparatus&Large Appliances
Size&Type HP,KW,KVA,or KVAR I I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS
2�� n REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM
Up to 1 Ind. ` THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY.
Over 1 to 10 Incl. 5.00
Over 10 to 50 Incl. 10.00 PERMITTEE __ 1
Over 50 to 100 Inc. 20.00 SIGNATURE /�� U
Over 100 30.004DISTRICT NO. PROCESSED BY 0
Service 25.00APPROVALS DATE SIGNATURE Z
200 Ap. der 600 V INSPECTOR'S
201.1000 Amp.Under 600 VOver 1000 Amp.or Over 600 V 50.00 POWER POLE
Temp.Power Pole&Appurtenances ces 10.00 UNDERSLAB WORK
Sign with On8 Branch Circuit 10.00 ROUGH CONDUIT
2.00 WIRING
Additional Sign BroncKCircuits
Misc.Conduits&Conductors 15.00 FIXTURES
Other(See Complete Fee Schedule) POWERAUTHORIZED
UTILITY CO.NOTIFIED loop
ll FINAL
PERMIT FEE (Sub-Total) NOTES
PLAN CHECKIN..9 FtE (One-Fourth Permit Feel
PERMIT ISSUING FEE /$^6.00
7
TOTAL FEE (,• 6
7 lop
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE ,
78A86C-CE#'608 54 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS 42U
JOHN A. LAMBIE. COUNTY ENGINEER
WILLIAM A.JENSEN,SUPT OF BUILDING LbCALITY C
FOR APPLICANT TO FILL IN
CROSSS T. t41L
PERMIT FEES OWNER
I T E M NUM13FRI EACH 11 FEB MAIL /^
OUTLETSI S $ ADDRESS 7
LIGHTS RECEPT. SW. .10 17-4
CITY NO.
LIGHTING FIXTURES
ELEC.RANGES CLO.DRYERS .10 ELECTRICI r
WATER HEATERS .SO ADDRESS
ELEC.SPACE HTRS. DISHWASHERS
CITY
GARBAGE D1aPO5EIW AUTO.-
STATE
WASH STA.COOKING UNITS Z ,2$ LICENSE NO.
MOTORS: OVER 'INC. H.P. DISTRICT NO. OUP P"ESSED
0 1/z .25
1/2— 2 ,$0 INSPECTION RECORD
2— 5 1.00
O
S— 1s 1.50 u
1s— so 2.50 0'
O
s0— 200 5.00 U
W
SIGNS: NO TRANS. H
NO.LAMPS
SERVICE 0-600V 1.00
SERVICE OVER 600V 5.00
M ISC.
WIRING PERMIT 1.00
FIXTURE PERMIT 1.00
SUPPLEMENTARY PERMIT .50
TOTAL FEE
IHEREBY 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 STATE LAWS REGULATING yy
ELECTRICAL WIRING. WIRING r �F✓ —
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES Al—
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTI ROPERTY. L POWER
SIGNATURErl] UTILITY CO.NOTIFIED
OF PERMITTE / '
FINAL g "�n r/ t ;l,� le'VALIDATI ARTHUR C. VEIT
CK MO casx SUPERVISING ELECTRICAL ENGINEER
L' :.. ,-
r
4 '
N. WORKER'S COMPENSATION DECLARATION 200018 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT
76A883
I hereby affirm.that I have a certificate of consent to self insure,
or a certificate of Worker's Compensation Insurance, or a certified COUNTY-OF LOS ANGELES DEPT.,OF PUBLIC WORKS BUILDING AND SAFETY DIV.
copy thiereof(Sec..3800 Lab.C.)
Policy No. Company FOR APPLICANT TO FILL IN JOB
Certified copy is he..reby furnished. New Residential Bldgs.&Pools NO. $EACH $, FEE LOCALITY
❑ Certified copy is filed with the county building inspection' 1&2-Family,Sq.Ft. _ NEAREST / ,� A
department. Multi-family Sq.Ft. CRosS ST. !-•(� G� I/v
Date Applicant Residential Swimming Pools ASSESSOR
MAP BOOK -2 A0 I PAGE 19 1,4 PARCEL I• {(J
CERTIFICATE OF EXEMPTION FROM WORKERS' titlets:R6C Light�' �SW. OWNER OR
.COMPENSATION INSURANCE 10 FIRM NAME
First 20 MAIL !/1
(This section need not be completed the work Involved by the Total No. Additional ADDRESS
permit ie'for one hundred dollars.(57000)or less.) _
1 certify that In the performance of the work for which this permit CITY Tel:No.
Is Issued, I shall not employ any person in any manner so as to PLAN CHECK
become subject to the Workers'Compensation Laws. Lighting Fixture First 20 APPLICANT
Total No. Additional
ADDRESS
Date Applicant. RESIDENTIAL APPLIANCES NOT OVER 3 HP.
NOTICE TO APPLICANT: If; after making this Certificate of CITY Tel.NO.
Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP.
provisions of the Labor Code,you must forthwith comply With such PERMIT
provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances APPLICANT
LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS
I hereby affirm that-I am Licensed under provisions of Chapter 9 Over 3 to 10 Incl.
(commencing with Section.7000)'of Division 3 of the Business and CITY, Tel.No.
Professions Code,and.my license is.in full,force and effect. Over 10'to 50 Incl. }
LICENSE.OR Class.
Over 50 to 100 Incl. REG.NUMBER d
License Number LIC.Class 'Over 100DISTRICT N !� PROCESSEDBY V
Services,Swbd.,MCC&Panelboards .V IY
Contractor Date 0-399 Amp.Under 600 V DATE 0
- 400 I•f
1000 Amp.Under 600 V i O
F-1 I am exempt under Sec. � -� :•!. ATION. V
• Over 1000 Amp.or Over 600 V � .. FlNAL .. � � •- �c LJ.I
B:&P.G•for this reason BRANCH CIRCUIT FEES BY J ,y D °' -1 n'
(n
Date: -15A,or 20A,120V,Lighting or Recept. :- ZTENZ
1 To 10 Branch Circuits
g 11 To 40 Branch Circuits I AL
�'
Signature T��
❑ Exemption for Reg.Meint.Elect. 15A uits
2UA,208V To 277VV OLighting Br c rcu�ts 58.09.
._...
SINGLE FAMILY Temp.Power Pole&Appurtenances ' CHANGE 600 .
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit
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 .,
Code): I i701 -1001 6i 7i93
I,as owner of the property,will do the work and the structure Misc.Conduits.&Conductors L135 1 AM11C 13•
Is not intended or offered for sale(Section 7044, Business 'Other(See Complete Fee Schedule) ,
and Professions Code).
I
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, PERMIT FEE (Sub-Total) LIA
Civ.C.)
r
PLAN CHECKING FEE
Lender's Name
PERMIT ISSUING FEE
Lender's Address i
I certify that'I have read this application and under penalty of purjury state TOTAL FEE
that the above information is correct. I agree to comply with all County
ordinances and State laws regulating Electrical wiring,and hereby authorize
representatives of this County to enter.upon the above-mentioned property
o I, action purpose ✓ /i SEE REVERSE FOR EXPLANATORY LANGUAGE
IGNA RE OF PER EE I JOATE
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a ';COUNT'Y OF LOS ANCELC$ ; iq f elt,•rTi'i .:sem I+ ,�: •d:,
' NATURE OF IN$T '.
•e ,;,' AI•�.ATION':`:,;:%!;; ClIT.ZfCT.NO.' CROUP ZON; •? MR Ns.
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APPLICANT FILL—I-N—NRAVIL- •u`UTL.tNRD'PORTION ONLY
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Lt,,3EMPTIUN (ll? 1YORS MAR.:
MUMMER Or OYTLrm ON CIRCYITy 'AOOR r
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LOCA7104 /Y ROOMR
LIONT OUTL[T'R SW.
" CINCUIT �YOe ' 1 AM THE LEGAL IbeetReOR O/ 7fI! A
A B C D R 4 ANOEL� COUNTY rARTIr1 ; OPP aYAy A
Lf VINO ROOM , a ..� -t• {,. +�; r
I Df�rNaa ROOM r 1 AN THE'L[aZAf.011Mq asf haul.•.�
tR/fT.RM. AboVe. C PROPme" 1 ;
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COUNTY OF IAS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1203200026
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: I FEES PAID BUILDING ADDRESS:
JTR: 5904 IT: 8 6208 MUSCATEL AV N
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:j SGAB CA 917752627
ASSESSOR INFORMATION NUMBER: I INEAREST CROSS STREET:
5386-010-016 JAI PERMIT ISSIIANCE FEE 27.80 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY, Cl
IG1 OUTLETS-LGT,SW,RECP 1.00 OUT 2.00
ITENANT: TOTAL FEES 29.80 ISSUED ON: PROCESSED BY: PLAN BY:
103/20/12 SR 1
OWNER: TEL. NO: SINATMATE FINAL BY: CODE:
SMITH BYRON F;PHYLLIS A (626) 285-894721
-
16208 MUSCATEL AV
ISGAB 917752627CRI O OF WORK
I I (CHANGE OUT 1 ELECTRICAL OAMET
APPLICANT: TEL. NO:
IYARDEN, FARASH (800) 989-1410-
I I
SPECIAL CONDITIONS:
I
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
IT L C HOME IMPROVEMENT, INC. (800) 989-1410-
1333 S GRAND AVE LIC. NO ITEMPORARY POWER POLE
25TH FLOOR 299161-B
UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER: TEL. NO: JUFER GROUND
LIC. NO: IROUGH CONDUIT
ROUGH WIRING
MAIN WATER LINE
PLASTIC Y/N METAL Y/N
UTILITY COMPANY NOTIFIED
I I I I I
I
I+ ADDITIONAL DATA ON FILE
REPORT ID: DPR265 ROUTE TO: BS0508