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HomeMy Public PortalAbout9116 RANCHO REAL RD_Electrical_1971-01-08 76AGGS-CESOG 3-69 vp APPLICATION FOR ELECTRICAL PERMIT C60UNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING C/ BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER } [� COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY /J7 Z'ql e ��'/ kr /l mlo FOR APPLICANT TO FILL IN NEAREST CROSS ST. /SOS e Q I�OG, ZA7 NO. EACH FEE ,/ � $ S OWNER ON\ l� Y' r 0. vOX (J O RECEIPT MAIL LIGHT TOTAL FIRST 20 t ,20 02 ADDRESS SWITCH . 13- -OVER 20 ,10 CITY �-e e C TEL.NO.Z1sC� D PLAN CHECK LIGHTING TOTAL FIRST 20 ,20 APPLICANT ST NEARE FIXTURES } OVER 20 .10 ADDRESS RANGE DRYER WTR. HTR. CITY TEL.NO STA. COOK_DISP._F.A.U. CONTRACTOR SPACE HTR. AIR COND. ADDRESS CLOTHES WASH._DISHWASH. CITY TEL.NO. FAN_OTHER 1.00 LICENSE NO. CLASS. MOTORS,TRANSFORMERS RATING 1 HEREBY ACKNOWLEDGE THAT IHAVE READ THIS APPLICATION IND. HEATERS, ETC. HP, KW. KVA. AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. 0 - 1 1.00 1 HEREBY CERTIFY THAT AM PROPERLY REGISTERED AND/OR LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF I - 10 3.00 CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF. AND INTEND TO a RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. C 10 - 50 5.00 L SIGNATUREIN 50 - 100 10.00 OF PERMITTEE 111A14 C H 100 - 500 15.00 DISTRICT NO GR ZO P O 5 1. • LL SIGN GAS SIGN AND ONE CIRCUIT 3.00 �� © 0. TUBE, OR v Z MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES: SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 SERVICE OVER 600 VOLTS OR 200 AMP 5.00 TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP. POWER POLE UNDERSLAB WORK ds ROUGH CONDUIT WIRING IY L ��.r�(;7��' �.e�.�✓�.� t r�;,s.� PERMIT FEE (SUB TOTAL)' FIXTURES PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED PERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINALr�¢.. TOTAL FEE JOSEPH C."ROOHAN f SUPERVISING ELECTRICAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. ASH 2 8 3ciz4 JAN 8 2 D 2.60- q SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE - s s VI RKECOMPENSATION DECLARATION CEWM 10/81 that APPLICATION FOR ELECTRICAL PERMIT I biq,�lYy:rei44�'M hat I have a certificate of consent to self insure, or a'hertificti+bv of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY rtifieu copy thereof (Sec. 3800, Lab. C.) Po icy No. Co FOR APPLICANT TO FILL IN ADDRESS ' `Certified copy is hereby furnished. New Residential Bldgs. & ools EACH NO. FEE LOCALITY Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. $ _ ,g CJ NEAREST tion department. Multi-family Sq. Ft. CROSS ST. Date Applicant Residential Swimming Pools OWNER OR �{{�] FIRM NAME y CERTIFICATE OF EXEMPTION FROM WORKERS' Out ReO�LightASw.� MAIL COMPENSATION INSURANCE oO ADDRESS •First 20 (This section need not be completed If the work Involved by Total No. Additional CITY , Tel. No. ?5-561 the permit is for one hundred dollars($100)or less.) PLAN CHECK 1 certify that in the performance of the work for which this APPLICANT permit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS Total N .. Additional CITY Tel. No. Date y1ro a pplicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after mcKing this Certificate of APPLICANT Exemption, you should become subject to the Workers' Range_ Heater—D.W. Q J02 Compensation provisions of the Labor Code, you must forth- Oven —Dryer W.M. ADDRESS q 6 CIQ4� with comply with such provisions or this permit shall be I Top _ FAU W.H. — CITYI el. IVo. ..1. deemed revoked. )V LICENSED CONTRACTORS DECLARATION Hood _ Fan _Other— LICENSE O I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. REG.•NUMBER 1 Class. -I� (commencing with Section 7000)of Division 3 of the Business DISTRICT NO. PROCE y and Professions Code,and m license is in full force and effect. Power Apparatus&Large Appliances 0 _ Size&Type HP, KW, KVA, or KVAR lam'sV L' ense Number Lic. Class C FINAL Oa Up to 1 Incl. ytGDry� � b _� Over 1 to 10 Incl. DATE r ��/„ VALI.ATION o ac o 8`ra Dote❑ Over 10 to 50 Incl. CCCJJJCv v W FINAL I am exempt under Sec: Over 50 to 100 Inc. BY N B.&P.C. for this reason Over 100 Date: Services, Swbd., MCC&Panelboards 30001 h O ► 0 -200 Amp. Under 600 V JCI Signature 201 - 1000 Amp. Under 600 V ❑ Exemption for Reg.Maint. Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY Temp. Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits Law for the following reason (Section 7031.5, Business and Professions Code): A-52 C 0 A ❑ I, as owner of the property, will do the work and the Msc. Conduits 8 Conductors structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)_ # 0 0 0 0 .0 2 7044, Business and Professions Code). 1,9 o94.50 CONSTRUCTION LENDING AGENCY 0 0 o 9 4.5 0 C 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). $ 7:$6 (Sec. 3097, Civ. C..). 0 Lender's Name PLAN CHECKING FEE PERMIT ISSUING FEE (J Lender's Address 67� I certify that I have read this application and state that the TOTAL FEE above information is correct. 1 agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize representatives of this County to enter upon the bove-mentioned property for inspection purposes. O SEE REVERSE FOR EXPLANATORY LANGUAGE R- Signatutp of Permittee Date i r COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1207240062 + BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: ITR: 11218 IT: 8 BL: D 9116 RANCHO REAL RD IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803032 ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: ROSEMEAD 15388-005-008 IP2 PC RES PV<IOKW 153.90 THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY, CI IA1 PERMIT ISSUANCE FEE 27.80 TENANT: IP3 INVRTR RES PV<10KW 27.90 ISSUED ON: PROCESSED BY: PLAN BY: TOTAL FEES 209.60 108/08/12 SR OWNER: TEL. NO: i IF _ 11Y DATE FINAL BY: CODE: IGUNTHER JUDITH H (626) 285-5613- l> I 9116 RANCHO REAL RD d TEMP 917803032 IDESCRIPTION OF WORK v I ROOF MOUNTED PV-10 PANELS 2.03 KW APPLICANT: TEL. NO: ICREPEAULT, TOM (714) 373-8545- I (SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: JAPPROVALS DATE INSPECTOR SIGNATURE IKILLION ENERGY INC (714) 373-8545- I 115261 CONNECTOR LANE LIC. NO ITEMPORARY POWER POLE ]HUNTINGTON BEACH, CA 92649 971660 I (UNDERGROUND CONDUIT I I I [ARCHITECT OR ENGINEER: TEL. NO: I IUFER GROUND MORALES, DOUGLAS M (714) 373-8545- I 1102 PINON TREE IN LIC. NO: I ROUGH CONDUIT I I COSTA MESA CA 92627 NONE IROUGH WIRING I I IMAIN WATER LING IPLASTIC YIN METAL YIN I I I I I (UTILITY COMPANY NOTIFIED( I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I � I I IREPORT ID: DPR265 ROUTE TO: BS0508 I I