HomeMy Public PortalAbout9705 OLIVE ST_Electrical__ GAGGS-CESOG-10.36 APPLICATION FOR ELECTRIC PERMIT 1
BUILDING AND SAFETY DIVISION
Dep Qr103ent of County Engineer BUILDING
'ADDRESS
JOHN ACl!t&OEOCSAeEsNGINEER D ,�
CASSATT D.GRIFFIN.SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL 1N ROSS
PERMIT FEES
OWNER: �r�
LIGHTS RECEPTACLES eeG� SWITCHES 161
MAIL
NUMBER I T E M EACH FEE
ADDRESS
TOTAL OUTLETS $ ,10 $ , o
ELEC. RANGES, WATER HEATERS, CITY TEL.NO.
CLOTHES DRYERS .50
EL C. SPACE HEATERS, STAT-Y. COOK- ELECTRICIAN
.ING ;UNITS- GARBAGE DISPOSERS- - /� ADDRESS J
AUTO WASHERS. DISHWASHER .25
/ LIGHTING FIXTURES ,10 ,h_ CITY TEL.NO 'lo
MOTORS STATE
LICENSE NO. I 546
HORSEPOWER ��•�ffff����1111
H.P. OVER INC. -DISTRI�NO. GR IJ.P 7,( N READY FOR INSPECTION
V2&LESS .25 SID
Yi - 2 so INSPECTION RECORD
2 5 1.00
S 1s 1.50
Is — 50 2.50
50 200' 5.00
MISC.
SIGNS I, NO.TRANS
NO.LAMPS
SERVICE O-BOOV 1.00 yl6 6
SERVICE OVER GOOV 5.00
WIRING PERMIT 1.00 L6
FIXTURE PERMIT 1.00 zoo
SUPPLEMENTARY PERMIT 50 APPROVALS
TOTAL FEE S c. DATE SPECTOR-S SIGNATURE
1 HEREBY ACKNOWLEDGE THAT I HAVE. READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING db
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE POWER
DESCRIBED RESIDENTIAL PROPER
SIGNATURE UTILITY CO.NOTIFIED _
OF PERMITTEE
FINAL
OHN A. LAMBIE. VALIDATION ARTHUR C.VEIT.
.OUNTY ENGINEER CK MO CASH SUPERVISING ELECTRICAL ENGINEER
L&0.:2 846 f,:;JAN 10' 2 A 11.50.
WORKER S'COMPENSATION DECLARATION CE-806G (2-80) APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY
insure, or a certificate of Workers'Compensation Insurance,or
a certified copy thereof(Sec.3800,Lab.C.) i
FOR APPLICANT TO FILL IN JOB
Policy No. Company EACH NO. FEE ADDRESS
New Residential Bldgs.&Pools
Certified copy is hereby furnished. 1 &2-Family,5q. Ft. $ — $ LOCALITY "-
❑ Multi-family Sq. Ft. NEAREST
Certified copy is filed with the county build' pection CROSS ST
department. Residential Swimming Pools OWNER OR
` FIRM NAME
' Date Applicant Outlets: Rec._Light Sw. ADDRESS
First 20
CERTIFICATE OF EXEM ON FROM WORKERS' Total No. Additional CITY Tel No.
' COMPENS
PLAN CHEC d
is section need' of be co�=e �ffiv�,ed APPLICANT
by the permit 'sfor one hundred dollars ($100) or less.) Lighting Fixtures First 20 ADDRESS V
Total No. Additionalcc
I certify, t in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No. O
permit ' issued, I shall not employ any person in any manner PERMIT Ur
so to become subject to the Workers' Compensation Laws. Range_Heater D.W._ APPLICANY W
a
Oven — Dryer_W.M._ ADDRESS �-
Dat rpplicant��� Top _ FAU _W.H.._ '
Hood _ Fan _Other_ CITY�, Q_�� Tel No. U)
Z F
N.O E TO APPLICANT: If, after making this Certificate of Disp. —Room Air Cond._ LICENSE OR Gy
Exemption, you should become subject to the Workers' REG.NUMBE o Class
Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO. PROCESSED BY
with comply with such provisions or this permit shall be
deemed revoked. Size&Type HP,KW,KVA,or KVAR
Up to 1 Incl. '
Over 1 to 10 Incl. FINAL
LICENSED CONTRACTORS DECLARATION DATE ..��P ? VALIDATION
Over 10 to 50 Incl•.
I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL //--
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 andVl
effect. • Services
License Numbe_4ic.Class 4^ / J 0-200 Amp.Under 600 V
s� 201-1000 Amp.Under 600 V
Contract ��/–�"' Date L 2_ Over 1000 Amp.or Over 600 V
HOME OWNER-BUILDER D ARATION 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): ,
Mise,Conduits&Conductors •I` 0 0 0 0 0 2
I, as owner of the property, will do the work and the Other(See Complete Fee Schedule)—
structure is not intended or offered for sale (Section 2 � 0 1 17 G
7044,Business and Professions Code).
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency o e 0 11 7, �+I
for the performance of the work for which this permit is PERMIT FEE
issued(Sec.3097,Civ.C.). (Sub-Total) Q i. 2 2 M
Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee)
Lender's Address PERMIT ISSUING FEE ! L
I certify that I have read this application and state that the TOTAL FEE G
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
the above-mentioned pr erty for inspection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE I
Signature of Permittee Date
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0607240013
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 ERT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
ON FILE 9705 OLIVE ST
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803253
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: TEMPLE CITY
8588-021-018 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY, C
G1 OUTLETS-LGT,SW,RECP 14.00 OUT 27.30
TENANT: G2 LIGHTING FIXTURES 5.00 LGT 9.75 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
TOTAL FEES 64.80 07/24/06 JK 01/20/07
OWNER: TEL. NO: FIN DATE FINAL BY: CODE:
LOPEZ, EDGAR (626) 287-8323-
9705 OLIVE ST
TEMP 917803253 DESCRIPTION OF WORK
ELECTRICAL FOR ADDITION
APPLICANT: TEL. NO:
SAME AS OWNER
SPECIAL CONDITIONS:
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER
LIC. NO TEMPORARY POWER POLE
UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER: TEL. NO: UFER GROUND
LIC. NO: ROUGH CONDUIT
ROUGH WIRING
MAIN WATER LINE
PLASTIC YIN METAL YIN
UTILITY COMPANY NOTIFIED
REPORT ID: DPR265 ROUTE TO: BS0508