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Home My Public Portal About5532 PERSIMMON AVE_Electrical__ 76A663-CEA0611-71 APPLICATION MR ELE TRICAL PERMIT. S COUNTY OF LOS ANGELES k'�EPARTKIENT-.OF COUNTY ENGINEER TADDRES&,.,� NG BUILDING AND SAFETY DIVISION - �� e ITY-�ml dST rRRFOR APPLICANT TO FILL IN ST. r OUTLETS NO. EACH FEE $ $ OWNERkO� IYIC Cr RIE i RECEPT. MAIL LIGHT TOTAL • FIRST 20 9 25 S ADDRESS "a J o;% C Y UP_ a SWITCHA. OVER 20 CITYT a TEL. N0. 3 .10 PLAN CHECK LIGHTING TOTAL FIRST 20 .25 APPLICANT 1 1( -h-1 OVER 20 ADDRESS FIXTURES .f0 RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT RANGE DRYER_WTR. HTR. APPLICANT STA. COOK DISP. F.A.U. ADDRESS SPACE HTR. AIR COND. CITY TEL. NO. CLOTHES WASH. DISHWASH. LICENSE NO. CLASS. FAN • OTHER1 1.00 Q�! IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RAT[ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW. KNG VA. ELECTRICAL WIRING. SIZE & TYPE OVER TO 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 - 1 1.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF C CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO 1 - 10 3.00 RESIDE IN, THE ABOVE DESCRIBED RESIDER IAL'PROPERTY. V SIGNATURE 10 - 50 5.00 OF PERMITTEEO 50 - 100 10.00 ti DISTRICT t�Q. CL.ASS ZO 0 B W 100 — 500 15.00 c 0 S 1 n 1N SIGN, GASSIGN AND ONE CIRCUIT 5.00 NOTES: ? TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 SERVI CENOTOVER 600 VOLTS OR 200 AMP 3.00 SERVICEOVER 600 VOLTS OR 200AMP 10.00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP.POWER POLE TEM PSERVICE,POLE,&APPURTENANCES 5.00 TEMP LIGHT OR RECEPT. SYSTEM 3.00 UNDERSLAB WORK ROUGH CONDIUT WIRING �� 77i FIXTURES POWER AUTHORIZED r J ^ PERMIT FEE (SUB TOTAL) UTILITY CO. NOTIFIED PLAN CHECK FEE FINAL PERMIT ISSUING FEE 3.001 31 f TOTAL FEE PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION CK. O. CASH LCD.6 a•8 4 iS AZUL I O 2 D 1325- d SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE - WORKERS'COMPENSATION DECLARATION U 78A883 10/81 CE-806G APPLICATION FOR 'ELECTRICAL-PERMIT I hereby affirm that I have a'certificate of consent to self insure, i or a certificate of Workers' Compensation Insurance, or a certified i COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec.3800,Lab.C.) f fl Policy N0. Company FOR APPLICANT TO FILL IN �' JOB Q 0 Certified copy is hereby furnished. EACH NO. FEE i ADDRESS - New Residential Bldgs.&Pools n Certified 'copy is filed with the county building inspection i 1 &:2-Family,Sq,Ft: $ -- $ I'. LOCALITY' " department. 1 Multi-family Sq:Ft. — i' r cRoss sNEAREST• • � ' t Date Applicant Residential Swimming Pools OWNER T. FIRM NAME p *V'\ CERTIFICATE OF EXEMPTION FROM WORKERS' I � MAIL COMPENSATION INSURANCE Outlets:Rec�_Light t — //J? g ADDRESS wI�YI e/ .(This section need not be completed if the work involved by the ( First 20 •J I .CITY' Tel..No. 14 permit is for one hundred dollars($100)-or less.) j Total No.1—. Additional � I certify that-in the.$erformance of the work.,for which this permit i r APAPNLICANT K Y is issued, I shall,not employ any person in any manner so as to become subject to the Workers'Compensation Laws. 4 Lighting Fixtures First 20 / ADDRESS. Additional Total No. I CITY Tel.No. Date Applicant NOTICE M.APPLICANT: If, after making this Certificate of Fixed Appliances Not Over 1. HP ( PERMIT Exemption,you should.become subject to the Workers'Compensation Range_ Heater DW, APPLICANT provisions of.the Labor Code,you.must.forthwith comply with such Oven Dryer_ W.M._ ADDRESS provisions&this permit shall be deemed revoked. Top FAU — W.H. _ ' CITY Tel.No. LICENSED CONTRACTORS DECLARATION Hood _ Fan _ Other_ I.hereby affirm that I am licensed under provisions of Chapter 9 LICENSE OR (commencing with Section 7000)of Division 3 of the Business and Disp. — Room Air Cond.. REG.NUMBER Class. Professions Code,and my license is in full force and effect. DISTRICT No. PROCE Power Apparatus&Large Appliances. Sike&Type HP,KW,KVA,or KVAR S7.o Q� License Number Lic:Class Up to 1 Incl• FINAL v T Over 1 to 10 Incl. DATE (� Contractor Date Z-3-11 VALIDATION, Over 10 to 50 Incl. FINAL am exempt under Sec. Over 50 to 100 Inc. I.. BY B.&P.G.for this reason - Over 100 I y' Services,Swbd.,MCC&Panelboards oil. Date: 0-200 Amp.Under 600 V Signature 201 - 1000 Amp.Under 600 V Over 1000 Amp.or Over 6OG V q •f— t QExemption.for Reg.Matnt.Elect. r'=V: a SINGLE FAMILY Temp.Power Pole&Appurtenances —= =�= HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit T'• hereby affirm that I am exempt.from the Contractor's License'Law = ti t:r for the following reason(Section 7031.5,Business and Professions Additional.Sign Branch Circuits z a�+ 1 Wis 1 tit,AL 2�" a 2-8Misc.Conduits&Conductors `` ' ` 26I,as owner of the property,will do the work and the structure '-_not intended or offered for sale (Section 7044, Business l Other(See Complete Fee Schedule) CHANGE ;�.N j and Professions Code). r '' , CONSTRUCTION LENDING AGENCY 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,CJ. 41 I Jy( 7= PLAN CHECKING FEE Lender's Name i PERMIT ISSUING FEE �,3a Lender's Address I certify that I have read this application and state that the above I TOTAL FEE information Is correct.I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize I representatives of this County to enter upon.the above-mentioned property jor inspection purposes. - + '•p SEE REVERSE FOR EXPLANATORY LANGUAGE • ignatu Permittee Date V1IOR.KER'S'COMPENSATIONDECLARATION 200663019 DPW(12.91) APPLICATION FOR ELECTRICAL PERMIT ll 76A I-hereby affirm.that I have a certificate of consent to self insure, or a certificate of Worker's Compensation Insurance, or a oertifigid COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy there f(Se .3800.La / Policy No Z � e sCompany f�, • "' FOR APPLICANT TO FILL IN JOB ' ADDRESS 3 fI El-, Certified copy is hereby furnished. New Residential Bldgs.&Pools NO, EACH FEE LOCALITY 1.&2-Family,Sq.Ft. _ $ I$ Certified copy is filed.,with the county building insp n NEAREST department. 1� Multi-family Sq.Ft. CROSS'ST: + ! 4 Date pplicant 4. Residential Swimming Pools AssEssoR MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION OM WORKERS' Outlets:Rec. Light Sw. j O FIRM NAME Q6 f— /4 r1, / . COMPENSATION INSURANCE First 20 MAIL (This section need not be completed if the work Involved by the Total No. Additional ADDRESS IT 73 Z. permit Is for one hundred dollars(5100)or less.) ' I certify that in.the performance of,the work for which this permit CITY Tel.No.�� is issued, I shall not employ any person in any manner'so as to / Q PLAN CHECK 7 U become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANT R Total No.. Additional • f ADDRESS Date Applicant, RESIDENTIAL APPLIANCES NOT OVER 3 HP. 1 NOTICE-TO APPLICANT: If, after making this Certificate of CITY Z e/S �� Tel.No. Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code, oli must forthwith comply with such PERMIT P Y P Y APPLICANT 91-1 11174 �� provisions or this permit shall tie deemed.revoked. Power Apparatus&Large Appliances LICENSED CONTRACTORSDECLARATION. Size&Type P,KW,KVA,or KVAR ADDRESS 63-7 i''l 1C 4 yJp9 1 hereby affirm that I.am licensed under provisions of Chapter 9 A IC Over 3 to 1.0 Incl. (commencing witfi Section.7000) of Division.3 of-the Business and CITY�#-ZlIp T.I.No. `1 Professions Code;and my license is in full force and effect. Over 10 to 50 Incl. LICENSE OR "?,, Clew. Ili a Over 50 to 100 Incl. REG.NUMBER J 7j Lic.Class Over 100 DISTRICT NO. PROCESSED BY 0 License Number + 0 V Services,Swbd.,.MO 7 0-39 A Mnp, er 6� d FINAL Contractor Date 400-1..000 Amp.Under 600 V "" VALIDATION W ❑' lam empt under Sec. Over 100 Amp .or Over 600 V FINAL d B.&P.C.for this reason BRANCH CIRCUIT FEES BY .Date: 15A,or 2 120V,Lighting or Recept.. , 1 To 10 Branch.Circuits Signature 11 To 40 Branch Circuits El 41 Or More Branch.Circuits Exemption for Reg.Maint.Elect. 15A,:20A,2DBV To 27TV Lighting Br.Circuits SINGLE FAMILY Temp.Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ACCT.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 30.1 123°61 Code): El, I,as.owner of the property,will do the.work and the structure Misc.Conduits&Conductors �TE MS is not Intended of offered for sale(Section 7044, Business Other(See Complete Fee Schedule) TOTAL 123.61 and Professions Code). CHECK V35.61 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) C11.C.) - 13000-0001 1/29/93 • PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE 117� 72.86 1 Aft 9:25 Lender's Address I certify that I have read this application and under penalty of purjury state TOTAL FEE that the above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring,and hereby authorize repress es of this County to enter upon the above-mentioned property for pe on purpo s. VF/ SEE REVERSE FOR EXPLANATORY LANGUAGE AA SIGN REO P RMITTEE DATE , COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT ' DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0306030030 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 ." PHONE: (626) 285-0488 EXT: LEGAL FE D S • TR: 13613 LT: 26 5332 PERSIMMON AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802801 ASSESSOR IN0 0 NEAREST CROSS STREET: 8573-005-014 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT,SW,RECP 12.00 OUT 23.40 TENANT:- G2 LIGHTING FIXTURES 4.00 LGT 7.80 fSSUED 0N: PROCESSED BY: LA P RES . TOTAL FEES 58.95 06/03/03 JK 11/30/03 . OWNER: TEL. NO: FINAL AT FINAL BY: CODE: ALBUERA;JENNIFER & ROLANDO (626) 533-4266- / 5332 PERSIMMON AV TEMPLE CITY 91780CR ' 0 0 0 ELECT ITCAL FOR ADDITION/REMODEL APPLICANT: TEL. NO: ELISA DEMBSKY (818) 674-6034- 5440 OAK PARK LN#244 SPECIAL CONDITIONS: OAK PARK, CA 91377 CONTRACTOR: TEL. 0: APPROVALS DATE INSPECTOR SIGNATURE RENAISSANCE CONSTRUCTION (818) 609-7880- 12400 VENTURA BLVD #618 LIC. NO TEMPORARY POWER-POLE STUDIO CITY CA 91604 801590 B UNDERGROUND CONDUIT ARCH] C OR GI ER-i- TEL. NOi: UFER GROUND LIC. NO: ROUGH CONDUIT ROUGH RI G MAIN WATER LINE PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIF15U REPORT ID: DPR265 ROUTE TO: BS0508