HomeMy Public PortalAbout9937 OLIVE ST_Electrical__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1301100040
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: i FEES PAID I BUILDING ADDRESS: I
ON FILE 1 9937 OLIVE CT I
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:( TEMP CA 917803239 I
(ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: BALDWIN
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18588-019-014 Al PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY CAI
I IC2 SPAS, HOT TUBS, OTHR 1.00 SPA 54.50 I I
ITENANT: IG1 OUTLETS-LGT,SW,RECP 4.00 OUT 8.00 ISSUED ON: PROCESSED BY: PLAN BY:
IH2 RES GREG DISP IT 3HP 1.00 DIS 11.00 101/10/13 SR
I IH3 RES DISHWASHR IT 3HP 1.00 DIS 11.00 1I
(OWNER: TEL. NO: IH4 RES RANGE HDS IT 3HP 1.00 HOO 11.00 IF NAL DATE FI Y: CODE: 1
PAN, SHU (626) 280-9317- IH7 RES EXHAUST FANS 1.00 EX 11.00 1 I
19937 OLIVE COURT 1 TOTAL FEES 134.30 1 I
ITEMPLE CITY CA 91780 I I ESCR PTI N OF WORK m1
(ADD 4 LIGHT FIXTURES, GARBAGE DISPOSAL, DISHWASHER, RANGE 1
IHOOD AND EXHAUST FAN FOR KITCHEN AND BATHROOMS REMODEL I
(APPLICANT: TEL. NO: 1 I I
ISAME AS OWNER
I ISPECIAL CONDITIONS: 1
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ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE 1
SAME AS OWNER - I
LIC. NO i ITEMPORARY POWER POLE 1
I I I
I JUNDERGROUND CONDUIT I I
(ARCHITECT OR ENGINEER: TEL. NO: I IUFER GROUND I I I
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LIC. NO: I IROUGH CONDUIT I I
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ROUGH WIRING I I I
IMAIN WATER LINE I I 1
IPLASTIC YIN METAL YIN
(UTILITY COMPANY NOTIFIED( I I
I
I I I
I I I I
I I I I I I
1 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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REPORT ID: DPR265 ROUTE TO: BS0508
'WORKER'S COMPENSATION DECLARATION 76A 83 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT LJ
I hereby affirm that I have a certificate of consent to self insure,
or a certificato of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV.
Copy thereof(See.3800 Lab.C.) L p� �]*� /.' �•
Poll Cy No. `1Z' R Company a6 1��- FOR APPLICANT TO FILL IN JOB
Certified copy is hereby furnished. New Residential Bldgs.&Pgyl6` NO. S�� FEE O LOCALITY � i(
❑ 1&2-Family,Sq.Ft. pp((
Certified copy is filed with the county building inspection NEAREST
4d��Pjacrt Qnt.J / Multi-family Sq.Ft. CROSS ST.
Date e"6�-`® Applicant`��C��r ���• Residential Swimming Pools ASSESSOR
MAP BOOK PAGE 1PARCEL
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Ree.-Light Sw. OWNER OR
COMPENSATION INSURANCE FIRM NAME
First 20 MAILA
(This section need not be completed jf the work involved by the Total No. Additional ADDRESS z-7-s 4(J cs+ /�✓Li
permit is for one hundred dollars($700)or less.)
I certify that in the performance of the work for which this permit CITY FA Vy,6VLJe Tel.No.
is issued, I shall not employ any person in any manner so as to PLAN CHECK
become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANT
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 �`��
p p y Power Apparatus&Large Appliances APPLICANT
provisions or this permit shall be deemed revoked.
Lrir
LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS
I hereby:affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl.
(commencing with Section 7000)of Division 3 of the Business and CITY ICENSE OR Tel.No [S-W
Over 10 to 50 Incl. L
Professions Code,and my license is in full force and effect. C +� � � a
r�-..-��/��s� Over 50 t0 100 IflCI. REG.NUMBER J J Cl..
License Number •�o Lic.Class Over 100 ZZ
DISTRICT NO. ` P SSED BY U
��A /f Services,Swbd.,MCC&Panelboards G
Contractor)� �e (� Date ( L t-1 0-399 Amp.Under 600 V DATE O
F1 I am exempt under Sec. 400-1000 Amp.Under 600 V W
VALIDATION
Over 1000 Amp.or Over.600 VFINAL d
B.&P.C.for this reasonBY
BRANCH CIRCUIT FEES
Date:A 19& 15A,or 20A,120V,Lighting or Recept. _
1 To 10 Branch Circuits
Signature 11 To 40 Branch Circuits
❑ 41 Or More Branch Circuits
Exemption for Reg.Mamt.Elect. 15A,20A,208V To 277V Lighting Br.Circuits 2
SINGLE FAMILY Temp.Power Pole&Appurtenances
HOME OWNER-BUILDER DECLARATIONSign with One Branch Circuit AGGTo4
I hereby affirm that I am exempt from the Contractor's License Law
for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits 3303 352080
Code):
❑ I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors 1 ITEMS
is not intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule) ' TOTAL 252.80
and Professions Code).
CHECK 252.80
CONSTRUCTION LENDING AGENCY CHANGE eQQ
1 hereby affirm that there is a construction lending agency for the n
performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total)
Civ.C.)
PLAN CHECKING FEE 0000-0001 4/18/96
Lender's Name PERMIT ISSUING FEE47 5938 1 AMID-'07
Lender's Address c7y�
I certify that I have read this ap lication and under penalty of purjury state TOTAL FEE
that the above information is rrect. I agree to comply with all County
ordinances and State laws reg ting Electrical wiring,and hereby authorize
representatives this my o enter upon the Zabove�entlroperty
for inspe ' n p o s. SEE REVERSE FOR EXPLANATORY LANGUAGE
SIGNATURE PERMIITEE DATE