HomeMy Public PortalAbout10101 OLIVE ST_Electrical__ COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Department of County Engineer
DIVISION OF BUILDING & SAFETY
ELECTRIC
WILLIAM J. FOX, County Engineer I
FOR PLICA TS FILL IN DISTRICT NO. GROUP ZONE PERMIT NO.
ELECTRICIAN s
ADDRESS `' RECEIVI(4 �.
E/D�I'/B�Y READY FOR FIRST INSPECTION DATE ISSUED
CITY TEL NO. QL tr II_' ` /
COUNTY 1-11--41111 NO. % EXPIRES BUILDING
PERMIT FEES ADDRESS O/
NUMBER EACH FEE LOCALITY
LIGHT OUTLETS NEAREST• '`
RECEPTACLES _ CROBB BT. �4
WALL SWITCHES OWNER
TOTAL OUTLETS 5C $ MAIL
ELEC. RANGES 85 ADDRESS
ELEC. HEATERS 25 CITY TEL. NO.
FIXTURES S
or I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
MIB:. ! 'APPLICATION AND STATE THAT THE ABOVE 19 CORRECT
NUMBER OF LIGHT CIRCUITS �/'ll AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS y AND STATE LAWS REGU TING ELECTRICAL WIRING.
MOTORS I CERTIFY THAT POSSESS THE ABOVE VALID LOS
NUMBER
HORSEPOWER ANGELEB COUNTY ENBE■ OR 1 AIN THE LEGA OWNER
FEE
NEw Mvo. HIS OVER INC. EAOH OF THE REBIDENTI ROPER ESC 19ED ABOV
00
%2 a LEeS $ .25 SIGNATURE OF
I/2 Z .613 PERMITTEE ---
2 a 1.100 INSPECTION RECORD
6 15 7.50
75 5D 2.50
.50 200 5.00
2013 500 10@00 J
500 1000 15.00 Z
OVER 1000 20.00 I'
M.G. SET/FREQ. CHANGER-HP
WELDERS:AC-KVA O
GENERATORS - KW _
TRANSFORMERS - KVA
TEMP. MOTORS (75% or OR16.)
MOVED MOTORS (75% of CRIB.)
M ISC.
SIGNS
NO. NO.TRANS.
APPROVALS
NO. NO.LAMPS
FOR EACH PERMIT: DATE INSPECTOR'S NAME
WIRING $1.100l
ONDUIT
FIXTURES $1.00IRING
SUPPLEMENTARY .50IXTURES
OWER
TOTAL FEE TILITY CO.NOTIFIED f
INAL ( .�/�, ►ev�..� /��
76A663 DBS#6A 4-52
76A868-CE6081-67 APPLICATION FOR UiiE TRI AL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING s
BUILDING AND SAFETY DIVISION ADDRESS 91 I ple
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINSI SUPERINTENDENT OF BUILDINGLOCALITY c/
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
I RECEFT., ` TOTAL NO. I EACH FEE Ij/
LIGHT
/Z OUTLETS FIRST 20 8.20 OWNER Sa h w c- v-d-s
AIL
SWITCHADD'L .10 ADDRESS
OVER 20
TOTAL FIRST 20 .20 CITY TEL.NO..
LIGHTING FIXTURES
FIXTURES ADD
'L CONTRACTOR S C Ian OVER 20 .10AN aA.
RANGES DRYERS WTR.HTRS. 1.00 ADDRESS Y 3 s-odar
GARB.DISP STA.COOKt / eR
l CITY/? i C8K TEL.NO.
DIBHWASH. +'s AUTO.-WASH./ STATE
apgce HTRS. erw�App+L-'f. 50 So LICENSE NO. Q
MOTORS. 'OVER NOT OVER 'H.P. DI T 12T G Z P Y
O 1 1.00 s (J
1 s 11.50 INSPECTION R RD
a S 2.00
S is 2.50
.15 50 9.00
SC Soo 5.00 V
SIGNS= NO.TRANS.
NO.LAMPS O
SERVICE O.600V-NoT OVER 200A 1.00
SERVICE 0-000V-OVER.200 A. 2.00
N
SERVICE OVER 600V 5.00
OTHER (SEE COMPLETE FEE SCHEDULE)
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 APPROVALS DATE INSPECTOR'S BIGNATURIE
TOTAL FEE i (� Lo
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION UNDERSEAS WORK
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ROUGH CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND.STATE OF
CALIFORNIA OR TH I AM THE LEGAL OWNER O AND INTEND TO POWER
RESIDE IN.THE ABO C IBED TIA OPERTY. ,
SIGNATURE UTILITY CO.NOTIFIED
OF PERMITTEE
FINAL
P
(DATION SPERVISI JOSEPH t.GMO GASH E ECTRICAL ENGINEER
L;Qg 7 5 .1� X24 2 0 1 5 40ct
WORKER'S COMPENSATION DECLARATION r 7gA66�DP*(1?-91) APPLICATION FOR ELECTRICAL PERMIT L!
I hereby affirm lltiat I Eiave a certificate of consent to self insure; {
61"'a cehificat&of Worke'r's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV.
copy th�erVe�o,0 90,2O��L W9)
POIi Nb. �J / 7���Companet� �7'
FOR APPLICANT TO FILL IN JOB�ertif copyts°eFetSy fu9-a ad. � NO. EACH FEE ADDRESS ��Q� C�
New Residential Bldgs.&Pools LOCALITY
❑ 1&2.-Family,Sq.Ft. — $ $
Certified copy is filed with the county building inspection _ NEAREST or
de art �t. /y�$a ��N� � Multi-family Sq.Ft. CROSS ST.
Date App Icant Residential Swimming Pools ASSESSOR
MAP BOOK PAGE PARCEL
AW
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec._Light SW. OWNER ORFIRM NAME
First 20 MAIL
COMPENSATION INSURANCE
(This section need not be completed if the work Involved by the Total No. Additional ADDRESS
permit Is for one hundred dollars($100)or less.)
I 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
CK
become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANTK
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
provisibhs or this permit shall be deemed revoked. Power Apparatus&Large Appliances APPLICA
LICENSED CONTRACTORSDECLARATION' Size&Type HP,KW,KVA,or KVAR ADDRESS
I hereby affirm that I am licensed under provisiohs of Chapter 9 �_Over 3 to 10 Incl.
(commencing with Section 7000)'of Division 3 of the Business and CI T.I.No.
Professions Code,and my-license is in.full force and effect. Over 10 to 50 Incl.
LICENSE OR /l��/ O2 OIC `� O
Over 50 t0 100 Incl. REG.NUMBER / (d�61 J 4
/�� Over 160 DISTRICT NO. SEED BY
License Number Lic.Class. U
Services,Swbd.,MCC,&PanelboaWe p_/•Dd Q'
Contract 0-399 Amp.Under 600 V FINAL 0
❑ I am exempt under Sec. 400-1000 Amp.Under 600 V —20 VALIDATION W
Over 10.00 Amp.or Over 600 V FINAL. a
B.&P.C.for this-reason _��ff/ BRANCH CIRCUIT FEES BY C0
Date: �`G� 15A,or 20A,1 V,Light!?;oylD�scept. Z
1 TO a Circuits i
Signatu 11 To 40 Branch Circuits
41 Or More Branch Circuits
❑ Exemption for Reg.Maint.Elect.. 15A,20A,208V To 277V Lighting Br.Circuits 2
SINGLE FAMILY Temp.Power Pole&Appurtenances
HOME OWNER-BUILDER DECLARATION ACCT av
I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit ) 3tL
for the following reason(Section 7031.5, Business and Professions Additional Sign Branch Circuits ,�,5�'�,i 4�og�
'
Code):
❑ Misc..Conduits&Conductors 1 ITEMS
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) TOTAL 63-811
and Professions Code). CHECK. 63.80
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the CHANGE ' 0
performance of the work for which this permit is issued(Sec. 3097, PERMIT FEE (Sub-Total)
Civ.C.)
PLAN CHECKING FEE 0000'0001 .6/26/96
Lender's Name PERMIT ISSUING FEE 7130 1 AM110-25
Lender's Address
I certify that I have read.this application and under penalty of purjury state TOTAL FEE (0
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
for inspection purposes. ,�` SEE REVERSE FOR EXPLANATORY LANGUAGE
00
s° / M- 6K
�'%bIGNATURE OFPERmrr E DATE
COUNTY OF LO-9 ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS
EL 0508 1107220019
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID I BUILDING ADDRESS:
ON FILE I 1 10101 OLIVE ST I
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:1 TEMP CA 917803345 1
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: I
18586-025-019 JAI PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY CAI
IG1 OUTLETS-LGT,SW,RECP 4.00 OUT 7.80 1 I
TENANT: G2 LIGHTING FIXTURES 7.00 LGT 13.60 (ISSUED ON: PROCESSED BY: PLAN BY: 1
H2 RES GRBG DISP LT 3HP 1.00 DIS 10.90 07/22/11 SR 1
IH3 RES DISHWASHR LT 3HP 1.00 DIS 10.90 1
(OWNER: TEL. NO: IH4 RES RANGE HDS LT 3HP 1.00 H00 10.90 FINAL DATE FIN Y: CODE: I
ILOI STEVEN;SHEN OI YAN (626) 377-3574- I TOTAL FEES 81.90
110101 OLIVE ST
ITEMP 917803345 I I ESCRIPTION 6F WORK I
(REPLACE KIT CABINET & COUNTER TOP REPLACE 3X3 SLIDING
(APPLICANT: TEL. NO: 1 I I
IK N D* - 1
I I ISPECIAL CONDITIONS: 1
I I
I I
ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE
I
IK N D CONSTRUCTION (626) 524-0803- 1 I I
13129 NORWICH AVE LIC. NO 1 (TEMPORARY POWER POLE
IALHAMBRA CA 91803 NONE I
I I
UNDERGROUND CONDUIT
I
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(ARCHITECT OR ENGINEER: TEL. NO: I IUFER GROUND I I I
LIC. NO: I (ROUGH CONDUIT I I I
IROUGH WIRING
I
IMAIN WATER LINE I I I
I I I
I IPLASTIC YIN METAL YIN I I 1
(UTILITY COMPANY NOTIFIEDI I I
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I I I I I I
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I (REPORT ID: DPR265 ROUTE To: BS0508 1 I I I