HomeMy Public PortalAbout9510 OLIVE ST_Electrical__ 7GA663-CES0612-65 APPLICATION FOR ELECTRIltAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE. COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING. LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS S
RECEPT. 1 TOTAL NO. EACH FEE
I OUTLETS I 7 -7,
FIRST 20 $.20 $ OWNER
at
LIGHT J} MAIL
SWITCH ADD'L 10 ADDRESS
OVER 20
TOTAL FIRST 20 .20 CITY TEL.
LIGHTING FIXTURES o
FIXTURES ADD'L 10 CONTRACTOR
OVER 20
RANGES DRYERS WTR.HTRB. 1.00 ADORES
lsARB.DISP_ STA.COOK
CITY TEL.
DISHWASH. AUTO.-WASH. STATE 17V/ �}. / O
SPACE HTRB. I BTA. APPL. .50
LICENSE NO. Q
MOTORS: OVER NOT OVER H.P. DIST ICS N GRO P Z E P O D
O 1 1.00 • L//�J C� }
1 3 1.50 INSPECTION R C RD °-
O
3 8 2.00 V
m
8 15 2.50 Q
I-
15 50 3.00 W
d
50 100 5.00 Z
SIGNS:
NO.TRANS.
NO.LAMPS
SERVICE 0.600V.NOT OVER 200A 1.00
SERVICE 0-600V-OVER 200 A. 2.00
SERVICE OVER 600V 5.00
OTHER (SEE COMPLETE FEE SCHEDULE)
PERMIT ISSUING FEE 2.00 a QQ
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 APPROVALS DATE INSPECTOR'SSIGNATURZ
TOTAL FEE $ (0 9Q
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION UNDERSLAB 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
LRESIDE
EBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES
ED AS REQUIRED Y LOS ANGELES COUNTY AND STATE OF
RNIA OR THAT AM THE GAL OWNER OF,AND INTE TO POWER
IN,THE ABO D CRI REBID TI PROP R
TURE UTILITY CO.NOTIFIED f
RMITTE
IDATION JOSEPH C. ROOHAN
CK O CASH SUPERVISING ELECTRICAL ENGINEER
LJC6 2 6 9 9:Do JUN 10 2 D 6.9 0- G
�J
'WO.KERStCOMPENSATION DECLARATION � DPW 3/87 APPLICATION FOR ELECTRICAL PERMIT
•tlnsur4-or"af C oif cafe of Workyid'Compensation Selnsurancnt to ef �cE ep6G
COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS
dertified copy thereof(Sec. 3800; Lab..C.)
Policy No. ='Company FOR APPLICANT TO FILL IN JOB ADDRESS
v
is-Kereb furnished. EACH NO. FEE ADDRESS J • e-i
Certified copy� y New Residential Bldgs. &Pools
0 Certified copy is filed'with the county building inspec- 1 &2=Family, Sq. Ft. $ $ LOCALITY
tion department. Multi-family Sq. Ft. NEAREST
ST.
Date Applicant
Residential Swimming Pools OWNER OR
FIRM NAME
CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL '
COMPENSATION INSURANCE Outlets: Rec Light Sw._ ADDRESSFirst "� /f ,��"'� ��
(This section need not be completed if the work involved by I Total NoAdditional
CITY w., /)Lc y.�,,,,o 0 Tel. No.
.
the permit is for one hundred dollars($100)or less.) LAN 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 Lighting Fixtures First 20 75-
ADDRESS
so as to become subject to the Workers'Compensation Laws. i
Additional
Date � h_ Applicant � ""+ �' Total No. CITY Te
pp �—� Fixed Appliances Not Over 1 HP ' PERMIT
NOTICE TO APPLICANT: If, after making this Certificate of APPLICATION
Exemption, you should become subject to the Workers' I Range— Heater—D.W. —
Compensation provisions of the Labor Code, you must forth- Oven — Dryer —W.M.— , ADDRESS r
with comply with such provisions or this permit shall be Top — FAU W.H. —
deemecl revoked. Hood — Fan —Other— CITY Tel. No.
LICENSED,CONTRACTORS DECLARATION LICENSE OR
Disp. _ Room Air Cond. — Class.
I hereby affirm that I am licensed under provisions of Chapter 9 REG. NUMBER
(commencing with Section 7000)of Division 3 of the Business Power Apparatus&Large Appliances DISTRICT NO. ROCESSED BY a
and,Professi.ons Code,and my license is in full force and effect.
Size&Type HP, KW, KVA;or KVARI IF U
License Number Lic. Class Up to 1 Incl. , FINAL
'
Over 1 to 10 Incl. DATE • VA L ION.
Contractor Date Over l0-to 50 Incl. I 0
❑ FINAL
I am exempt under Sec. Over 50 to 100 Inc. BY U.I
B.&P.C. for this reasonOver 100 9 8 9.2'A CL
Services,Swbd., MCC&Panelboards ,(� Z
Date: 0-200 Amp. Under 600 V �,`� # 0 0 0 0 o 2 _
Signature 201 - 1000 Amp.-Under 600 V y) o -.1 200
Exemption for Reg, Maint. Elect. Over 1000 Amp. or Over 600 V o 0 -,l _
SINGLE FAMILY � � 1 �'�O U
HOME OWNER-BUILDER DECLARATION Temp. Power Pole&Appurtenances• �.
I hereby affirm that I am exempt from the Contractor's License .
Sign.with One Branch Circuit
06,15-88
Law for the following reason (Section 7031.5, Business and A'dd'itional Sign Branch Circuits i
Professions Code): i.
I, as owner of the property, will do the work and the Misc. Conduits&Conductors
structure is not intended or offered for sale(Section 7044,. ' Other(See Complete Fee Schedule). ,
Business and Professions Code).
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 PERMIT FEE ub-Total)
(Sec. 3097, Civ.
PLAN CHECKING FEE
Lender's Name
PERMIT ISSUING FEE S
.Lender's Address n /�
I certify that I have read this application and state that the TOTAL FEE r7( V
above information is correct. I agree to comply with al.l.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
Signature of Permittee Date ®'
y COUNTY OF LOS ANGELES TEMPLE CITY # 0508 CELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS L 0508-0005-110038
BUILDING"AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUIL-91, G ADDRESS:
TR: 17190 LT: 80 BL: .001 (-9510 OLIVE_ST=-
FEE DESCRIPTION: QUANTITY: UDM: AMOUNT: \ TEMP CA 917803131
ASSESSOR INFORMATION NUMBER: `-NEAREST-CROSS STREET: TEMPLE CITY BLVD.
8590-005-001 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: A LOCALITY: TEMPLE CITY
G1 OUTLETS-LGT,SW,RECP 6.00 OUT 11.70
TENANT: G2 LIGHTING FIXTURES 1.00 LGT 1.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
HA FAU LESS 3HP 1.00 FAU 10.95 05/11/00 UT 11/07/00
TOTAL FEES 52.35
OWNER: TEL. NO: FINAL DATE FINAL BY: clC
ONG; SILENUS (626) 614-8911- Zs
-o
OLIVE ST.
TEMPLE CITY, CA DESCRIPTIOff-OF WORK
ELECTRICAL FOR NEW GFICIS AND FAU
APPLICANT: TEL. NO:
NICK'S REMODELING (626) 442-7985-
9941 HOWLAND DRIVE SPECIAL CONDITIONS:
TEMPLE CITY, CA
��GELES Co
CONTRACTOR: LING TEL. N442-7985- o� ��A� APPROVALS DATE INSPECTOR SIGNATURE
9941 HOWLAND DRIVE LIC. NO TEMPORARY POWER POLE
TEMPLE CITY, CA 91780 409663 B
UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER: -TTL-. NO: - / FER GROUND
LIC. N0: L 1111111 ROUGH CONDUIT
U. 0 G WIRING
LI UEBUC W 0��/ S MAIN WATER LINE
u� PLASTIC Y/N METAL Y/N
S �
UTILITY COMPANY0 FIED
o
❑ r't R•
�t
�erv�e Tha�'�
REPORT ID: DPR265 ROUTE TO: BS0508