HomeMy Public PortalAbout5744 RIO HONDO AVE_Electrical__ TEMPLE CETY
r6Afiso62 =APPLICATION FOR ELECTRICAL PERMIT '
V-2. COUNTY OF LO$ ANGELES -
DEPARTMENT-OF COUNTY ENGINEER BUILDING.
BUILDING AND SAFETY DIVISION ADDRESS J
JOHN A.`LAMBIE..COUNTY ENGINEER J
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY
NEAREST FOR APPLICANT.TO FILL IN.. cliosa,sr.
RECEPT. ` TOTAL NO. EACH FEE `
OUTLETS FIRST 20 Q $2O S OWNER
LIGHT -•-� "OWNER
" I
ADD'L ` 10 '.ADDRESS ✓� X�/O I ���� �,
SWITCH. OVER 20
LIGHTING TOTAL FIRST 2q .20.' CITY TEL NO / y
F.IXTG•RE$ ADD'L
OV911.20 . 01. ., :ELECTRICIAN G�fl1
1 - '
RANGES CLO.DRYERS WTR.HTRS. 1.00 .ADDRESS
t
.GARB.DISP." STA.COCK TEL..NO.,
DISHWASH.y AUTO.-WASH. •• - /► S"8TATE
SPACE HTRS. WTA.APP-.(V.H.P.MAX..) .SO
(/. ".LICENSE NO. '
MOTORS:' :oveR NoT,OVER H:P. p'. ; DISTRi3r N G P •Z P O D
0 1• 1•.,00 6/ '
1 , s 1.50. a; ,i INSPECTION RE &D n Y �'
J
a :.a' z:oo ��' 1� 6��' kitm _' Q11 •i1r �6
a 13 2.50 g �./ r. r• +i �� g, .�' . ,r-
a�e^
15150 3.00
so' f00 5.00 i• �� ✓ O
SIGNS, NO.TRANS• �! v - 0
NO.LAMPS �.
SERVICE 0.600V-NOT OVER.200A 1.00 ..... . y�
SERVICE 0-600V-OVER 200 A.. 2.00. W
SERVICE OVER 600V 5.00 _ �+ Jy �� p/
MISC.
c
PERMIT ISSUING'•FEE 2.00 '
.SUPPLEMENTARY PERMIT.ISSUING FEE 1.00 [
-TOTAL FEE i h s•
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE-18 CORRECT AND AGREWTO COMPLY ^CONDUIT '
WITH ALL'-COU'N'TY ORDINANCES AND STATE LAWS REGULATING:
ELECTRICAL WIRING. WIRING
-I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ` n
•LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND.STATE OF FIXTURES Pt•n .►I V! � ` )f�/ "•4
CALIFORNIA•OR THAT I AN THE LEGAL OWNER9 THE ABOVE / �I
DESCRIBED RESIDENTIAL PRO _ / � � 4 POWER - r' 6•r r �• � ¢ ,.
SIGNATURE :UTILITY CO.NOTIFIED
OF PERMITTEE
41DAT.ION ARTHUR C. VEIT- f'
C MO CASH SUPERVISING ELECTRICAL ENGINEER
LAAO 4 5 64%-0 JAN 17 2 D 1 .0.5 0-
-7
r 9
AT
I hA1(;31iy of irrnORhaE LhavelVle cerStif elate oEconsen Oto salt insure, 20-0019 DPW(12.91)
76A663 APPLICATION FOR ELECTRICAL PERMIT
,ttor a certificate of worker's Compensation Insurance, or a certified ZOUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV.
copy thereof(Sec.3800 Lab.C.)
Policy No. Company FOR APPLICANT TO FILL IN JOB
ODDRESS S��E� �i(� ��/j V1�11 R[�
'1 V L-
❑ Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE LOCALITY T[I���,` C( � 91-790
❑ 1 &2-Family,Sq.Ft. _ $ $
Certified copy is filed with the county building inspection NEAREST
department. Multi-family Sq.Ft. CROSS ST. w .(k-C.V40%✓e
Date Applicant Residential Swimming Pools ASSESSOR O ��p7-JOrI -
2 PAGE 34/i5 PARCEL J d
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rea_Light Sw. FIRM NAME Ql�►v/v`i T�I-SvfJ inl G3 H
COMPENSATION INSURANCE
(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. Additional ADDRESS ���,�( �I V WoN�(7 /�VLp
1 certify that in the performance of the work for which this permit CITY 7 jS M I't,L C-1-11 Tel.No. S( -Z r(•��j�1
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 �f�1v�1� Z �—SUS WD
P Y P Y APPLICANT 1
provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances
LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,ofiKVAR ADDRESS S114<f R,j O 01v�O Avl=
I hereby affirm that I am licensed under provisions of Chapter 9 _� Over';1t i ncl. /
(commencing with Section 7000)of Division 3 of the Business and CITY (�� 19`` �+ Tel.No.N-791-1637
Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. >_
LICENSE L� Class. I L
Over 50 to 100 Incl. REG.NUMBB S O
Over 100 DISTRICT NO. P C ED BY V
License Number Lic.Class Q
Services,Swbd.,MCC&Panelboards O LVR cc
Contractor Date 0-399 Amp.Under 600 V DATE 2O
❑ 400-1000 Amp.Under 600 V _Z ofATION V
I am exempt under Sec. Over 1000 Amp.or Over 600 V FINAL A � a� a
B.&P.C.for this reason BRANCH CIRCUIT FEES •� 07 tt 11
I BY r7�U�' Q't a 2C�
Date: 15A,or 20A,120V,.Lighti g�r ecept. .I
_ MS
L 1 To�.Brech Circuits ATE
Signature 11 To 40 Branch Circuits TOTAL 645-
41 Or More Branch Circuits
❑ Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits CHEEK 64.25
SINGLE FAMILY Temp.Power Pole&Appurtenances CHANGE .00
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit
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 0000-0001
�nn ��yy (:({�'y /
Code): L 000-0001 7:23 9
I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors 7613 1 PM ens 1
is not intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule) ,
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 .2 176
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
repr entatives of this County to enter upon the above-mentioned property
for' pection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
SI&KATURE OF P MITTEE DATE ,
e
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0501310009
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: BUILDING
TR: 6561 LT: 760 UN: .002 FEES P 5744 RIO HONDOSAV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802432
ASSESSOR INFOR14ATION N ER: NEAREST CROSS STREET: WORKMAN
8587-004-018 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, C
G1 OUTLETS-LGT,SW,RECP 2.00 OUT 3.90
TOTAL FEES 31.65 ISS ED : PROCESSED BY: PL-AN-BY: P RE ON:
OWNER: TEL, 0: A
�Il nFr,-,(�C 07/30/05
WONG DANNY T (626) 272-8242-
FINAL BY: CODE:
5744 RIO HONDO AV
TEMP 917802432 DESCRIPTION OF VIORK
ADD TO 2 GFI OUTLETS.
APPLICANT: TEL. NO:
SAME AS OWNER -
SPECIAL CONDITIONS:
CONTRACTOR: TEL. 0: APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER -
LIC. NO TEMPORARY-POWER 0
UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER: TEL. NO: UFER GROUND
LIC. NO: ROUGH CONDUIT
ROUGHR
MAIN WATER LINE
PLASTIC Y/N METAL Y/N
UTILITY COMPANY F
REPORT ID: OPR265 ROUTE TO: SS0508