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Home My Public Portal About5016 RIO HONDO AVE_Electrical__ f 76AS63 DBS SA 11-50 APPLICATION FOR PERMIT i DEPARTMENT OF BUILDING AND SAFETY • COUNTY OF LOS ANGELES ELECTRIC 1 � WILLIAM J. FOX. CHIEF ENGINEER FOR APPLICANT TO FILL 1N DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRICIAN R. F. Walton1 ADDRESS 5134 N, ACACIA. St. RECEIVED BY READY FOR FIRST INSPECTION DATE ISSUED CITY San aab, TEL. NO. - -s COUNTY LICENSE NO. 1104 BUILDING PERMIT FEES EXPIRES ADDRESS 5016 Rio Hondo Avep NUMBER EACH FEE LOCALITY Temple City LIGHT OUTLETS 9 NEAREST RECEPTACLES 16 CROSS ST. WALL SWITCHES 16 OWNER Turner Homes TOTAL OUTLETS 41 Sc ffi 2 05 MAIL ELEC. RANGES E5 ADDRESS ELEC. HEATERS 25 CITY TEL. NO. FIXTURES 9 g 45 MISC. 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWERANGELES COUNTY LICENSE. OR I AM THE LEGAL OWNER FEE NEW MVO. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. 1/4 I/a&LESS ffi .25 25 SIGNATURE OF -111 1/a 2 .50 PERMITTEIT 2;;�F 2 5 1.00 INSPECTION RECORD 5 1s 1.50 15 so 2.50 so 200 S.oo 200 Soo 10.00 J Boo 1000 15.00 Z OVER 1000 20.00 M. G. SET/FREQ. CHANGER-HP WELDERS:AC-KVA O GENERATORS-KW TRANSFORMERS-KVA TEMP. MOTORS (7s%OF ORIG.) MOVED MOTORS (75%OFCRIS.) MISC. SIGNS NO. NO.TRANS. I APPROVALS NO' NO. LAMPS FOR EACH PERMIT: DATE INSPECTOR'S NAME / WIRINGffi1.00 IOO CONDUIT FIXTURES $1.00 00 WIRING v i SUPPLEMENTARY .50 FIXTURES G� 4 17.9 POWER TOTAL FEE s UTILITY CO. NOTIFIED O ® FINAL '424_ /y /v r 4opy KERS'COMPENSATION DECLARATION 76A663CE-806 1081 APPLICATION FOR ELECTRICAL PERMIT I hq tthat i ave a certificate of consent to 'self CE-9066 �insrs'ififate.of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY' or thereof(Sec. 3800, Lab. C,) Policy No. Company FOR APPLICANT TO FILL IN JOB /_. Certified copy is hereby furnished. New Residential 6�i7/6 Bldgs. &Pools EACH NO. FEE ADDRESS ❑ Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. $ _ $ i LOCALITY tion department. Multi-family Sq. Ft. NEAREST Residential Swimming Pools ICROSS T. OWNER Date Applicant FIRM NAME a. CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL COMPENSATION INSURANCE Outlets: Rec Light Sw._ First 20 ADDRESS (This section need not be completed if the work involved by Total No. CITY / Tel. No.. the permit is for one hundred dollars(;100)or less.) Additional Lt I certify that in the performance of the work for which this PLANCCAHNETT permit is issued,.I shall not employ any person in.any manna so as to become subject to the Workers'Compensation Laws Lighting Fixtures First 20 I ADDRESS J Total No. . Additional CIN Tel. No. Dat pelican pl NOTI E TO[APPLICANT: If, after maki this Certificate of Fixed Appliances Not Over 1 HP J PERMIT Exemption, you should become subject to the Workers'' Range_ Heater_D.W. — I APPUCAN Compensation provisions of the Labor Code, you must forth-' I Oven —Dryer —W.M.— ADDRESS with comply with such provisions or this permit shall be, Top — FAU —W.H. — deemed revoked. - .1 Hood _ Fan _Other— CITY Tel. No. LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. _ Room Air Cond. REG. NUMBER Class. (commencing with Section 7000) of Division 3 of the-Business power Apparatus&Large Applidnces DISTRICT NO.�. PROCESS >_ and Professions.'Code,and my license is in full force and effect. g, Size&Type HP, KW, KVA, or KVAR' O License Number Lic. Class ' Up to 1 Incl. FINAL l,9 Over 1 to 10 Incl. DATEjVALID ION IM Contractor DateOver 10 to 50 Incl. FIN v ❑ I am exempt under Sec. Over 50 to 100 Inc. I BY U1 B.&P,C, for this reason Over 100 ' Services, Swbd., MCC&Panelboords n`1 Date: 0 200 Amp. Under 600 V QIV Signature i 201 - 1000 Amp. Under.600 V ' ❑ I Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY Temp. Power Pole&Appurtenances y HOME OWNER-BUILDER'DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License 1 Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits I) A2 3 9.4 A. Professions Code):. # 0 0 0 0 a 2 i I, as owner of the property, will do the work and the � Misc. Conduits&Conductors � 0 0 2 ca Jr O structure is not intended or offered for sale (Section I Other(See Complete Fee Schedule)_ 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY o a o 2 5 5 Q U I hereby affirm that there is a construction.lending agency for 705-85 ;the performance of the work for which this perm.'it is issued PERMIT FEE (Sub-Total) Q (Sec. 3097, Civ. C.). ! f PLAN CHECKING FEE i Lender's Name 1 ,15� .PERMIT ISSUING FEE U Lender's Address I certify that I have read this application and state that the TOTAL FEE 5. above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and here§y authorize representatives of this County to enter upon �e b ve-mentione ropert�fr ;ecli �, SEE REVERSE FOR EXPLANATORY LANGUAGE Signature ermittee I 1 i. . yV✓ORKERS COMPENSATIONbECLARATION CE-8e3 10/ 11 APPLICATION FOR ELECTRICAL PERMIT +i CE-808G I� PJB 6 fl�l I`.�reby aff�rp It I.have r3 certificatb of consent to self Insure, , or a certificate of Workers' Crompehsation insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY OW, ^(�Sec:3800 Lab.'C) , iaL� L`Ompd,yj it' � FOR APPLICAIyT TO FILL.IN JOBRESS ❑ eJ Certified copy'is hereby.furnished: ;t New Residential Bldgs.&Pools: EACH NO.. FEE LOCALITY � Certified copy is. filed with the county building 'nspection 1 8 2-Family,Sq.Ft. $ _ $ /� Gs7 , department. Multifamily Sq.Ft. — NEAREST / CROSS ST. W15-16-1 .�� Date �/l a Applicant Residential Swimming Pools t, ! SNE 'MOR V E p CERTIFICATE OF EXEMPTI AA RKERS' Outlets:Rec Q Light L17 Sw. COMPENSATION INSURANCE I ADDRESS (This section need not be completed If the work involved by the First"god'- Total.No. Additional permit is.for one hundred dollar#($100)or less.) .CITY Tel:No. 1 certify that in the performance of the work for which this permit. PLAN CHECK . is issued, I shall not employ any person in any manner so as fo become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS APPLICANT Total No.. /�� Additional CITY Tel.N DateApplicant NOTICE TO APPLICANT if, after making this Certificate of ' Fixed.Applian .. Not Over 1 HP l f.�� -/ PERMITExemption,.you should become subject to the Workers'Compensation Range Heater APPLICANT `✓ APPLICANT provisions,of the Labor Code,:you must forthwith comply with such Oven _ Dryer V W.M. !_/. ADDRESS provisions or this permit,shall be deemed'revoked. Top 7VFAU WH. CITY Tel_ ., , LICENSED CONTRACTORS DECLARATION Hood �J .an Other_ No I hereby.affirm that ]-a licensed under provisions of Chapter 9 Disp. Room.Air Cond.. S5 LICENSE OR (commencing,with:Section 7000)of.Division.3:of tie Business.and REG.NUMB . � � Class . . Professions Code,and my.license is in full force and effect:. Power.Apparatus&Large Appliances DISTRICT NO. PROC D BY Size&Type HP,KW,KVA,or KVAR .D� 0. : License,Number �/T S Lic.Class. _ Upto'1Ind. FINAL V i. Over 1 to 10 Incl. ContraeforJ Date- .. ll�: .'. L.('J �/ ` DAT � VALIDATION Over 10 to 50 incl... S V ❑ r,.,. . ,;,,,t am exempt under Sec:. . Over 50 to 10.0 Inc: t,y Over 100 D. B:&P.C:for this reason N $ery y0 C Panelboards Z . .'Da 0_-200 Amp.Under 600 Signature i ' 201'- 1000'Amp.,Under 600.V Over 1000 Amp. Over 600 V [J 'Exemption for. eg.M.aint, ect. SINGLE FAMILY Temp:,Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I heNeby affirm that I am exempt from the Contractor's License Law Additional Sign Branch Circuits -for the following reason(Section 7.031.5,•Business and Professions Code):. Misc.Conduits&Conductors I;as owner of the property;will do the work and the structure is not intended or offered for sale (Section 7044, Business Other(See.Complete Fee Schedule) _ and Professions Code). F _ ® #-47322. CONSTRUCTION LENDING AGENCY. 0 0 0 6 I hereby affirm.that there is a construction lending agency for the ; I -.0 99.00 performance of the work for which this permit is issued(See.3.097, PERMIT FEE (Sub-Total). I CIV.C): :.o. 0 0 9 9,.0 01 5 M1 l PLAN CHECKING FEE Lender's Name 0624&87 • PERMIT ISSUING FEE Lender's Address. I certify that I have.read this application and state that:the above TOTAL FEE �, I • information-Is.correct.I agree to comply with all County ordinances and: State la..ws regulating Electrical wiring, and .hereby authorize representatives of this County to enter upon+:the above-mentioned I /J prop rt for inspection:purposes. � • SEE REVERSE FOR EXPLANATORY LANGUAGE g ture of Date. , . KERS'COMPENSATION DECLARATION C 8� 10/81 APPLICATION FOR ELECTRICAL PERMIT I h rm that I {save a certificate of consent to self ,c'nsirrt artafuate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a cen, opy thereof (Sec. 3800, Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB / Ka No4do Certified copy is hereby furnished. New Residential Bldgs. IC,& Pools EACH NO. FEE ADDRESS � -6!6 ❑ Certified copy is filed with the county building inspec- 1 & 2-Family, Sq. Ft. $ = $ LOCALITY tion department, Multi-family Sq. Ft. NEAREST CROSS S7 Date Applicant Residential Swimming Pools OWNER FIRM NAME � � da�t' CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw._ MAIL COMPENSATION INSURANCE ADDRESS �- s section need not be completed If the work Involved b First 20 (Thitip Y Total No. Additional CITY7120 61 Tel. No-1916 the permit is for one hundred dollars($100)or loss.) PLAN CHECK 4E I certify that in the performance of the work for which this APPLICANT�i� permit is issued, I shall not employ any person in any manner so as to become subject to the Workgrs'Compensation Laws. Lighting Fixtures First 20 ADDRESS J9 Total No. Additional Dat�� Applican CITY Tel. No. NOTI E TO PPLICANT: If, after maki , this Certificate of Fixed Appliances Not Over 1 HP PERMIT Exemption, you should become subject to the Workers' Range— Heater—D.W. _ APPLICAN Compensation provisions of the Labor Code, you must forth- Oven — Dryer —W.M.— ADDRESS with comply with such provisions or this permit shall be Top — FAU —W.H. — CITY Tel. No. deemed revoked. Hood — Fan —Other— LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. REG. NUMBER Class. (commencing with Section 7000) of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NO. (/! �L _f4 PROCESS and Professions Code,and m license is in full force and effect. 1 Size&Type HP, KW, KVA, or KVAR O License Number Lic. Class Up to 1 Incl. FINAL l"ji' Over 1 to 10 Incl. DATEVALID ION Contractor Date Over 10 to 50 Incl. FIN [[[�� O U ❑ I am exempt under Sec. Over 50 to 100 Inc. BY Over 100 B.BP.C. for this reason Services, Swbd., MCC 8 Panelboards n� Date: 0 -200 Amp. Under 600 V f1 Signature 201 - 1000 Amp. Under 600 V ❑ Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY Temp. Power Pole 8 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 - -r 1 Law for the following reason (Section 7031.5, Business and a:�Z Q,(, j Professions Code): t 0 0 0 0 0 2 j, as owner of the property, will do the work and the Misc. Conduits&Conductors r ` structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)_ ° 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 PERMIT FEE (Sub-Total) 7,C)5-35 ) (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name I PERMIT ISSUING FEE Lender's Address I certify that I have read this application and state that the TOTAL FEE �- above information is correct. I agree to comply with all County '5 101 ordinances and State laws regulating Electrical wiring, and hereby authorize representatives of this County to enter upon �teab ve-mentioned roperty f r ipurposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature o ermitns action tee Dafe