HomeMy Public PortalAbout9514 PENTLAND ST_Electrical__ Wm that I have
a certificate
DECLARATION CE-603 ,D,B, APPLICATION FOR ELECTRICAL PERMIT {1 1
I hereby affirm that I have a certificate of consent to self insure, cE-soOG �J
or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY
copy thereof(Sec.3800.Lab.C.) �•y��
Policy No. om
6 Cpany<3% — ;gG/ FOR APPLICANT TO FILL IN JOB
I ADDRESS
JK Certified copy " hereby furnished. New Residential Bldgs.& Pools EACH NO. FEE
ri Certified copy is filed with the county building inspection 1 & 2-Family,Sq.FL $ — $ LOCALITY
department. Multi-family Sq.Ft. — NEAREST
u Residential SwimmingPools MNECROSs7.
Date ( Applicant -� OWNER OR
CERTIFICATE OF EXEMPTION FROM WO�#RE 6'
FIRM NAME ���
COMPENSATION INSURANCE Outlets:Rec Light Sw.— DDRESS� i -T� d?—
(This
L
(This section need not be completed If the work Involved by the First 20
permit is for one hundred dollars($100)or less.) Total No. 42 Atltlitioral CIT To I.No.
I certify that in the performance of the work for which this permit PLAN CHECK
to an APPLICANT
is issued, I Shall not employ y y person in any manner so as to
become subject to the Workers Compensation Laws. Lighting Fixtures First 20 ADDRESS
Total No. Additional
Date Applicant CITY Tel.No.
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NOTICE TO APPLICANT: If, atter making this Certificate of Fixed Appliances Not Over TRIP PERMITT!
Exemption,you should become subject to the Workers'Compensation Range_ Heater DW APPLICAN
provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer _ W.M._ ADDRESSy j j <,4:"W c ✓r G*
provisions or this permit shall be deemed revoked. Top — FAU _ W.H. _L 7(r!i
CITY ,,,p � � Tel.No.
LICENSED CONTRACTORS DECLARATION Hood — Fan Other_ ' �f —
I hereby affirm that I am licensed under provisions of Chapter 9LICENSE OR
(commencing with Section 7000) of Division 3 of the Business and Disp. — Room Air Cond. REG.NUMBER3V3 less
Professions Code,and my license is in full force and effect. Power Apparatus& Large Appliances DISTRICT NO. _ PROCESSE By
t'O3�j •Q Size& Type HP,KW,KVA,or KVAR U
License Number Lic.Class 2_ Up to 1 Incl. FINAL
Conttactor Date (J -t: / Over 1 to 10 Incl. DATE VA ION O
❑ Over 10 to 50 Incl FINAL (�
I am exempt under Sec. Over 50 to 100 Inc. gy W
n
B.&P.C.for this reason over 100 to
Services,Swbd.,MCC 8 Panelboards ► Z
Date: 0- 200 Amp.Under 600 V
Signature 201 - 1000 Amp.Under 600 V
Over 1006 Amp.or Over 600 V § 0 8 4 3 A
Exemption for Reg.Maint.Elec.
. . . . .
SINGLE FAMILY Temp.Power Pole& Appurtenances g 2
HOME OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit i 0
for the following reason(Section 7031.5, Business and Professions Additional Sign Branch Circuits . . . 2 a 0 0 5
Cede): I a05-88
El
Misc.Conduits&Conductors
I,as owner of the property,will do the work and the structure Other(See Complete Fee Schedule)
is not intended C offered for sale (Section 7044, 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(Sec.3097, PERMIT FEE (Sub-Total)
Civ.C.).
PLAN CHECKING FEE
Lender's Name
PERMIT ISSUING FEE
Lender's Address 2
I certify that I have mad this application and state that the above TOTAL FEE
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 the above-mentioned
property for inspection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
pat re of Perms TDale
COUNTY OF LOS ANGELES TEMPLE CITY }) 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC FORKS 9701 LAS TUNAS EL 0508 0805070012
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0466 EXT
LEGAL IO FEES PAID BUILDING ADDRESS 1
TR 14572 LT 14 9514 PENTLAND ST
IFEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 919803844
(ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET CLOVERLY
8590-013-011 JAI PERMIT ISSUANCE FEE 21 75 THOMAS PAGE 596 GRID J4 LOCALITY TEMPLE CITY Cl
LA 100 AMP PANELS MCC 1 00 PAN 38 85
(TENANT TOTAL FEES 66 60 ITSSUED ON PROCESSED BY PLAN BY EXPIRES ON
105/07/08 SR 11/03/08 1
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OWNER TEL NO 1F AL DATE FIN Y CODE 1
SONG JERRY (626) 213-9575-
11591 WANDERING DR
MONTEREY PARK 91755 1TCMCRIPTION OF WORK
I ISERVICE PANEL UPGRADE TO 100 AMP
(APPLICANT TEL NO
IRICHARD GATES (626) 442-1517- 1 1
110827 MULHALL ST I (SPECIAL CONDITIONS 1
1EL MONTE, CA 91731 1 _ 1
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CONTEACTOP TEL NO APPROVALS DATE INSPECTOR SIGNATURE
PREFERRED ELECTRIC (626) 442-1519- 1 1
11OB27 MULHALL STREET LIC NO TEMPORARY POWER POLE
EL MONTE CA 91731 454934 CIO
UNDCRGROUND CONDUIT
1ARCHITECT OR ENGINEER TEL NO UFER GROUND
LIC NO ROUGH CONDUIT
1ROUGH WIRING
(MAIN WATER LINE
PLASTIC YIN METAL YIN
(UTILITY COMPANY NOTIFIED(
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REPORT ID DPR265 ROUTE 10 B50508 I I