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Home My Public Portal About9655 OLIVE ST_Electrical__ 76.0683-CE806 ,1.71 APPLICATION F�DIt LECICAL PERMIT LI COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION + ADDRESS 9655 Olive Street LOCALITY Temple City NEAREST e FOR APPLICANT TO FILL IN CROSS S OUTLETS NO. EACH FEE $ $ OWNER RECEPT.8 MAIL MiW Parkhurst LIGHT 3 TOTAL FIRST 20 16 25 4 00 ADDRESS SWITCH 10 5 16 OVER 20 CITY TEL. N0. I PLAN CHECK LIGHTING FIRST 20 25 I -APPLICANT TO AL `j FIXTOVER 20 .f0 I ADDRESS URES RESIDENTIAL APPLIANCES CITY TEL. No. PERMIT RANGE DRYER_WTR. HTR. APPLICANT B Electric Co. STA. COOK DISP, F.A.U. ADDRESS, 114 E School ST]R.eet SPACE HTR, AIR COND. CITY Covina TEL. No. 3321862 CLOTHES WASH. DISHWASH. LICENSE NO. 1855376 CLASS. CI)O FAN OTHER 1 1.00 1 0o i I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW.KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO I1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 - 1 1.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ' CALIFORNIA OR THAT I AM THE EGAL OWNER OF, AND INTEND TO I - 10 3.00 I RESIDE IN, THE ABOVE DE R BED RESIDENTIAL PROPERTY. O I V 10 — 50 5.001 SIGNATURE OF OF PERMITTEE }; 50-- 100 10DD DISTRICT NO. CLASS PRO SS ED Y �/ ^1 W 100 - Soo 15.00 �/• I IL SIGN, GAS SIGN AND ONE CIRCUIT 5.00 NOTES: ® �l TUBE, OR I p 7 �FI� d�/i /i!!/ O/Q Z MARQUEE ADDITIONAL CIRCUITS 1.00 SERVICENOTOVER 600 VOLTS OR 200AMP 3.00 ) APPROVALS DATE INSPECTOR'S SIGNATURE SERVI CEOVER 600 VOLTS OR 200 AMP 10.00 TEMP.POWER POLE TEMP SERVICE,POLE,&APPURTENANCES 5.00 UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM 3.00 ROUGH CONDI UT WIRING FIXTURES . `f--"97, 1 i POWER AUTHORIZED PERMIT FEE (SUB TOTAL) I UTILITY CO. NOTIFIED PLAN CHECK FEE �qq 75' // /1 PERMIT ISSUING FEE 9.00 3 00 FINAL i� 7 TOTAL FEE 8 755 PLAN CHECK VALIDATION CK. M.O. CASH PERMI VALIDATION CK. 0. CASH 2 2L 9 i>!QN 13, 2 D 8.7 5 ,Aud SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE I - - " I 76A653-CE80611-71 APPLICATION FOR ELECTRICAL PERMIT LI COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS 9655 Olive St .. LOCALITY Temple Cit NEAREST FOR APPLICANT TO FILL IN CROSS ST, OUTLETS NO. EACH FEE OWNER Parkhurst RECEPT._ $ $ MAIL LIGHT TOTAL FIRST 20 25 ADDRESS same OVER 20 CITY TEL. NO. SWITCH f0 PLAN CHECK LIGHTINGTOTAL FIRST 20 25 i -APPLICANT i OVER 20 ADDRESS FIXTURES .f0 RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT RANGE DRYER_WTR. HTR. APPLICANT eC 1C O STA. COOK DISP. F.A.U. ADDRESS, 114 E,SChool SPACE HTR. 1 AIR COND. ] 00 CITY Covina TEL. No3321862 CLOTHES WASH. DISHWASH. LICENSE NO. 185376 CLASS.CIO FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 - 1 1.00 LICENSED AS REQUIRED LOS ANGELES COUNTY AND STATE OF d CALIFORNIA OR THAT I THE LEGAL OWNER OF, ND INTEND TO 1 - 10 3.00 RES DE IN, THE AB E DESCRIBED RESIDEN V SIGNATURE Im 10 - 50 5.00 I OF PE MITT O 50 - 100 10.00 DISTRICTNO. 1CLASS 12ON I PROCESSED BY Lu 100 — 500 15.00 I Its-. ® � J �/ N SIGN, GAS SIGN AND ONE CIRCUIT 5.00 NOTES: Z TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 SERVICENOTOVER 600 VOLTS OR 200 AMP 3.00 { SERVICE OVER 600 VOLTS OR200AMP 10.00 I APPROVALS DATE INSPECTOR'S SIGNATURE iTEMP SERVICE,POLE,&APPURTENANCES 5.00 TEMP.POWER POLE UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM 3.00 ROUGH CONDIUT G� WIRING FIXTURES POWER AUTHORIZED PERMIT FEE (SUB TOTAL) UTILITY CO. NOTIFIED PLAN CHECK FEE FINAL ��r'�� • PERMIT ISSUING FEE 3.00 TOTAL FEE 4 OOI PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION cK M.O. CASH SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 76Ab63-GEBQfi`10/72 APPLICATION FOR ELECTRICAL P MIT + COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER =TAO ' BUILDING AND SAFETY DIVISION ESS �p5�ALITY REST J' FOR APPLICANT TO FILL IN CROSS ST. OUTLETS N0. EACH I FEE OWNER OR $ $ FIRM NAME RECEPTI-s MAIL � LIGHT TOTAL FIRST 20 �� 25 � � ADDRESS SWITCH OVER 20 10 CITY`' d, TEL. NO ' $ f a PLAN CHECK LIGHTING 1 TOTAL FIRST 20 ®� .25 D APPLICANT FIXTURES 1( �– OVER 20 10 ADDRESS RESIDENTIAL APPLIANCES CITY A SEL. NO. PERIT RANGE_j_DRYER_WTR. H.TR. I' APPLI ANT STA. COOK DISP.7V—F.A.U. i ADDRESS 3.I , y? qCOMPLY SPACE HTR. I A]R COND. _ ; CITY TEL. NOCLOTHES WASH._�DISHWASH.� REG NNUMBER -94 CLAFAN OTHER 1.00 � �. 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THISANO STATE THATTHE ABOVE IS CORRECT AND AGR MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 — 1 100 i LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAI I AM THE LEGAL OWNER OF THE ABOVE 1 — 10 3.00 1. DESCRIBED RESIDENTIAL PROPERTY. C7 CO 1 PERMITEE 1= 10 – 50 5.001 SIGNATURE a O V 50 – 100 f0A0 t DISTRICT N0. PROC SSED BY W CL. 100 — 500 15.00 i G Q 6 k SIGN, GAS SIGN AND ONE CIRCUIT 5,00 APPROVALS DATE INSPE R'SSIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE IF SERVI CENOTOVER 600 VOLTS OR 200 AMP 3.00 3L UNDERSLAB WORK SERVICEOVER 600 VOLTS OR 200AMP 10.00 I ROUGH CONDUIT TEMP SERVICE,POLE,&APPURTENANCES 5.00 I WIRING TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL PERMIT FEE (SUB TOTAL) ( NOTES: /217.2 1 PLAN CHECK FEE z Is PERMIT ISSUING FEE 3.00 O ®l TOTAL FEE Ir—O A- PLAN CHECK VALIDATION CK. M.O. CASH 4ERMIT VALIDATION CK. M.O. CASH ! fit' 04 i ' PR 2 Q 23.30g v 1 SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE WORKERS'COMPENSATION DECLARATION : oPw3ier APPLICATION FOR ELECTRICAL PERMIT ^ 1ierebyureaffirm that I have a certificate of consent to self i s�pya O in33 , 76MO or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES I DEPT. OF PUBLIC WORKS or a certified copy thereof(Sec. 3800, Lab. C.), Policy No. Company FOR APPLICANT TO FILL IN JOB , Certified copy is hereby furnished. New Residential Bldgs. &'Pools EACH NQ. FEE ADDRESS Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. $ — $ LOCALIT tion department. Multi-family Sq. F.t. -- NEAREST Residential Swimming Pools CROSS ST. OWNER OR Date Applicant FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS.' Outlets: Rec Light Sw._' F LCOMPENSATION INSURANCE DRESS'(T.his section need not be completed ifT.he work'Involved by First 20 ` Tel. No. the permit is:For one hundred dollars(5100)or less.) Total No. Additional � 1� � 7(07 I certify that in the performance of the work for which this FLAN CHECK APPLICANT permit is issued,I shall not employ any person in any manner Lighting Fixtures First 20 ADDRESS so as to become subject to the Workers'Compensation Laws. Total No. . Additional CITY Tel. No. Date Applicant Fixed Appliances Not Over f HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of APPLICATION 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 T W.H. — deemed'revoked. CITY Tel. No. Hood — Fan —Other_ .LICENSED CONTRACTORS DECLARATION ILICENSE OR Disp. _ Room Air Cond. — Class. I hereby affirm that I am licensed under provisions of Chapter 9 REG. NUMBER. Ycommencing with Section 7000)of Division 3 of the Business Power Apparatus&Large Appliances DISTRICT NO. PR Q9SSED BY d and Professions Code,and my license is in full force and effect. v Size&Type HP,.KW, KVA, or KVAR ' O O License Number Lic. Class. Up to 1 Incl. FINAL / U '� cl Contractor Over 1 to 10 In . �� / Date DATE VALIDATION 0 Over 10 to 50 Incl. FINAL. W I am exempt under Sec. Over 50 to 100 Inc. .BY B.&P.C. for this reason Over 100 d Services, Swbd:, MCC&Panelboards / Z Date: 0-200,Amp. Under 600 V — Signature 201 -1000 Amp. Under 600 V aOver 1000 Amp. or Over.600 V Exemption for Reg..Maint. Elect. SINGLE FAMILY Temp. Power Pole&Appurtenances �• rGTai HOMEOWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License { Sign with.One Branch Circuit 11 L 1 tllj Law for'the following reason (Section 7031.5, Business and t Additional Sign Branch Circuits ProfWssions Code): 1 ITEMMisc. Conduits&Conductors -a I, as owner of the property, will do the-work and the I TOTAL A 31-00 structure is not intended or offered for sale(Section 7044, Other(See Complete Fee Schedule)_ Business and Professions Code). j PooET1 1 31.1111 CONSTRUCTION LENDING AGENCY CHANGE e i jll 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.). 011019-001CI i PLAN CHECKING FEE Lender's Name I. . 5912 1 AM10:36 .PERMIT ISSUING FEE Lender's Address. 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 hereby authorize representatives of this County to enter upon I above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE .i "G Signature We ee Date' t ®'