HomeMy Public PortalAbout9340 OLIVE ST_Electrical__ 76A663A-CE606A 4/72 APPLICATIONOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER FNEARE5T
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BUILDING AND SAFETY DIVISION '[
FOR APPLICANT TO FILL IN CROSS ST. S
OUTLETS N0. EACH FEE
OWNER lAtl
RECEPT._ $ $ ADDRESS (J
LIGHT TOTAL FIRST 20
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OVER 20 CITY TEL. NO.
SWITCH- PLAN CHECK
LIGHTING l TOTAL FIRST 20 APPLICANT
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FIXTURES
OVER 20 ADDRESS
RESIDENTIAL APPLIANCES CITY TEL. NO.
PERMIT
RANGE_-�-- DRYER_WTR. HTR. APPLICANT
STA. COOK DISP. F.A.U. ADDRESS
SPACE HTR. AIR COND. CITY TEL. NO.
CLOTHES WASH. DISHWASH. LICENSE NO. CLASS.
FAN OTHER1 HEREBY ACKNOWLEDGE-THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CD
MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CEJ
IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. cc
SIZE & TYPE OVER TO c=01 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 — 1 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF 13
CALIFORNIA OR THAT THE LEGAL OWNER OF, AND INTEND TO W
RESIDE IN, THE A OV DESCRIBE OSIDE L PROPERTY. y
1 - 10
SIGNATURE �
10 - 50 OF PERMITTEE
50 - 100
DISTRICT NO. CLASS IZONE PRO SED BY -
100 - S00 . 00
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SIGN, GASSIGN AND ONE CIRCUIT NOTES:
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS
SERVI CENOTOVER 600 VOLTS OR 200 AMP
APPROVALS DATE INSPECTOR'S SIGNATURE
SERVICE OVER 600 VOLTS OR 200 AMP
TEMP.POWER POLE
TEMP SERVICE,POLE,&APPURTENANCES
TEMP LIGHT OR RECEPT. SYSTEM UNDERSLAB WORK
ROUGH CONDI UT
WIRING
FIXTURES
PERMIT FEE (SUB TOTAL) POWER AUTHORIZED Al
UTILITY CO. NOTIFIED
PLAN CHECK FEE
FINAL
PERMIT ISSUING FEE S
TOTAL FEE
PLAN CHECK VALIDATION CK. M.0. CASH PE M VALIDATION. / M.O. CASH
4 4 9XOSEP :W 10.5 0 era
WORKERS'COMPENSATION DECLARATION ICE g 6G (2-80) APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES I BUILDING AND SAFETY
insure,or a certificate of Workers'Compensation Insurance,or
_,arcelufied,c,�o�p,Y thereof(Sec.3800,Lab.C.) '
/? A� egjiY /)` !, ..1 FOR APPLICANT TO FILL IN JOB
PPolicy No. Company ADDRESS !�T
New Residential Bldgs-&Pools EACH NO. FEE
El Certified copy is hereby furnished. 1 &2-Family.Sq. Ft. $ — $ LOCALITY
Multi-fam.ily Sq. Ft. — NEAREST
Certified copy is filed with the county building inspection CROSS ST
Residential Swimming Pools
department. OWNER OR
y FIRM NAME
Date Applicant „�. �-�s Outlets: Rec.aLight_ o Sw. y �� ADDRESS
First 20
CERTIFICATE OF EXEMPTION FROM WORKERS' Total No.. Additional CITY Tel No. 1..$5_ d/ >
COMPENSATION INSURANCE PLAN CHECK 0.
(This -section need not be completed if the work involved � � APPLICANT V
Additional by the permit is for one hundred dollars ($100) or less.) Lighting Fixtures First onal ADDRESS
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I certify that in the performance of the work for which this Total No.i CITY Tel No.
Fixed'Appliances Not Over 1 HP
permit is issued., I shall not employ any person in any manner PERMIT W
so as to become subject to.the Workers' Compensation Laws. Range Heater D.W._ APPLICANT d
Oven _ Dryer L W.M. ADDRESS N
Date Applicant Top _ FAU _W.H.,_ '
Hood _ Fan _Other_ dr CITY 6-L-0 Tel No./f77-5
NOTICE TO APPLICANT: If, after making this Certificate of Disp. _Room Air Cond— LICENSE OR C��
Exemption, you should become subject to the Workers' REG.NUMBER 2.19'4/Jv Class
Compensation provisions of the Labor Code, you must forth- Power Apparatus&Large Appliances DISTRICT PROCESSED BY
with comply with such provisions or this permit shall. be Size&Type HP,KW,KVA,or KVAR �/
deemed revoked. ` P d
Up to 1 Incl. FINAL
LICENSED CONTRACTORS DECLARATION Over 1 to 10 Incl. DATE VALIDATION
Over 10 to 50 Incl. -
I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100.Inc. FINAL�c^r
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 ✓J 3«��l,
License Number �S Lic.Class C_ 0-200 Amp.Under 600 V � � e ��'�/. ` /
/ p 201-1000 Amp.Under 600 V
Contract ��� Date !r�—7 $'?/ Over 1000 Amp.or Over 600 N
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): Z_ �+3 1, A
Misc.Conduits&Conductors }
E I, as owner of the property, will do the work and the Other(See Complete Fee Schedule)—
o 0 0 0 0 2
structure is not intended or offered for sale (Section
7044,Business and Professions Code). n o 0 3 4 9 0
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency o u o 311 9 0 U
for the performance of-the work for which this permit is PERMIT FEE (Sub-Total)
issued(Sec.3097,Civ.C.). 0 6'0 9-8 2
Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee)
Lender's Address PERMIT ISSUING FEE
I certify 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 I
hereby authorize representatives of this County to enter upon
the above-menti ed property for inspection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE
/0
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Signature of Permittee Date
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1208060044
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID_ I BUILDING ADDRESS: [
ITR: 11492 LT: 7 BL: B I I 9340 OLIVE ST I
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:[ TEMP CA 917803127 1
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET:
18590-002-007 IA1 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY, Cl
IG1 OUTLETS-LGT,SW,RECP 5.00 OUT 10.00
TENANT: IH2 RES GRBG DISP LT 3HP 1.00 DIS 11.00 (ISSUED ON: PROCESSED BY: PLAN BY:
[H3 RES DISHWASHR IT 3HP 1.00 DIS 11.00 108/06/12 SR [
IH4 RES RANGE HDS IT 3HP 1.00 HOO 11.00 1 I
(OWNER: TEL. NO: 1 TOTAL FEES 70.80 IF ATE FINAL BY: CODE: 1
THOU ERIC S;JANET N (626) 731-0611- I 1
9340 OLIVE ST
ITEMP 917803127 I IDDOSCRIPTION OF WORK
IS OUTLETS, GARBAGE DISPOSAL, DISHWASHER AND RANGE HOOD FOR Al
IKITCHEN REMODEL 1
(APPLICANT: TEL. NO: I I I
ISAME AS OWNER
ISPECIAL CONDITIONS:
I
I
ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER - I I I
LIC. NO 1 ITEMPORARY POWER POLE I I I
I I (UNDERGROUND CONDUIT I I
I I I
(ARCHITECT OR ENGINEER: TEL. NO: - I IUFER GROUND I I I
LIC. NO: I IROUGH CONDUIT I I
I I TROUGH WIRING
MAIN WATER LINE I I
IPLASTIC Y/N METAL Y/N
I I I
I [UTILITY COMPANY NOTIFIEDI I I
I I I I I I
I I I I I I
I I i I I I
I I I I I I
I I I I I I
I I I I I I
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IREPORT ID: DPR265 ROUTE TO: BS0508 I I