HomeMy Public PortalAbout10619 ROSEGLEN ST_Electrical__ 1
OOUKTY OF Los ANe[LE6 APPLICATION FOS PERMIT
Department of County Engineer
DIVISION OF BUILDING & SAFETY
ELECTRIC i
WILUAN J. FOX, 0*"tr MWIMW
FD FILL 11j DIQTRICT NO. GROUP ZONE PERMIT NO.
ELECTRIC
RECEIVED SY READY FUR DAT[ tMINUED
ADDR[liS /' FIRIT INSTIOTION
CITY
COU LIO SE No. 1 ■UILDINO
PERT AD D RIw
Fts
NUMB EACH LDOALIT'
LIGHT OUTLETS NEAREST
CROSS ST.
REOEPTAOLIS
WALL SWITCHES OWNER
TOTAL OUTLx-ra bo MAIL
[LEC. PLNOK0 sm _ ADDRESS
ELE0. HEATIRS 9i CITY TEL N0.
FIXTURES 1 HERESY ADKN0`WlUMMi THAT I HAVE WLAD THIB
MIPM APPU12ATION AND BTATE THAT THE ASOVE IS CORRECT
NUMBER OF LIGHT OIROUITS AND A17RE[ TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTA13LX DIRCUITO AND NTATE LAWS RILOULATIME ELECTRICAL WIRINGL
MOTORB 1 OOlTIFY THAT 1 POSSIESS THE ABOVE VALID LOS
Nuwwtw HORHt=POWER �E ANUELKS COUNTY UOCNS[, OR 1 M THE LEGAL OWNER
N[W Mw. HP aViR IND. i OF THE RESIDENTIAL [liTY ESO ED
• �� •� ■IONATURE OF
1 .60 PERMI
s s l.+m INSPECTION RECORD
6 16 1.50
115 ISO 9.60
60 10C 6.00
900 ■OO 10.00
600 1 OOO 15.E93
OVER 1000 90.DO
M.D. SET/FR OHANO[R-HP
WELDERDI AC-ICVA 13
OEN[RATUR! - KW
TRAI•ISFORMERE - KVA
TEMP. MOTORS (76 or owlet.
MOVE MOTORS (76 OF ORI■
MIE0.
SIGNS
NO. NO.TRAHNL
APPROVALS
FOR EACH P[RMITI DATE INSPECTOR'S NAM[
WIRING 1 013 CONDUIT
FIXTURES $1.00 •�� WIRING —
PP [ FIXTURES
POWER
TOTAL FEE UTILITY 130.NOTIFIED
FINAL d-
7&&&63 oew#iLA 2-84
woRKEIr8 COMPENSATION DECLARATION DEW(12-91).1 7114M APPLICATION FOR ELECTRICAL PERMIT
I hereby afflrrp that I have a certificate of consent to self Insure,
or sr-certJTloate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV.
copy the�eof(Seo.3800--Lab.
Cll.) (� •
Pdlcy No.all Lv Com m 'uQ roR APPLYCANr_TO mi IN q
❑ Certified copy b herby fumlaled New Residentlal Bldgs.S Pods NO. EACH }FEE. LOCA1JlY t
1 S 2 famfty,Sq.Ft — $ $
F1 C-egtW copy fa Mod with the county bulldlrlg Ulepectbn Multklamlfy Sq.Ft — Ca
Date + G Applkxurt, 6-et, Reeidentlal Swimming POOIe MAP 8001( PAGE PAFICa (�
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec._Light FIRM
N
Sw. FINAME
011
COMPENSATION INSURANCE Flt1
Flrot 2fl
(This section need not be completed H the work Involved by the App gg
Total No. AddFtbnal
permtt Is for one hundred dollars($100)or lees.)
I certify that In the performance of the work for which this permit C" a T«'N0' o�3V 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 Fuer" F1 rat 20 APPLICANT
Total No. Addkknal ADDRESS
Date APPD-rrt RE81DDOAL APPLIANCES NOT OVER 3 HP.
NOTICE TO APPLICANT: If, after making this Certificate of CITY TOL No.
Exemption,you should become subject to the Workers' Compenaatlon OTHER APPLIANCES NOT OVER 3 HP.
provisions of the Labor Code, you must forthwfth comply with such Power APPS f1�� PFT
provlslons or thle permit shall be deemed revoked.
. LICENSED CONTRACTORS DECLARATION Stze 8 Type HP,KW,KVA,or KVAR ADDRESS 1
I hereby affirm that I am licensed under provisions of Chapter 9 Oyer 3 to 10 Ind.
(commencing with Sectlon 7000) of Dlvlelon 3 of the Business and Cal' (�(�1 TOL NO
Profeaslons Code,and my license Ia In full force and effect. Over 10 to 50 Ind. LIC>3SE OR
Over 50 to 100 Incl. FC-&HUMBEFI O d
License Number AW ) 1 3 Lio.C1aaa 0-10 Over 100 DtgTwCT Nia BY O
Contreotor VN 6'u- Data �` -10- VP'""`f' DAT
400-1000 Amp.Under 000 V 5�238
E-1I am exempt under Sao. Oyer 1000 Amp.or Over 800 VAUDATION V FsrAL W
&&P.C.for this reason BRANCH CIRCUIT FEES BY CO
Date: 16&or 20A,120V,Lighting or Recept Z
1 To 10 Branch Cfroulte
Skpiatu re 11 To 40 Branch C1ra�lla
41 Or More Brand Ctarfb
❑ Exemption for Reg.Malnt Elect. 1 6A,20A,208V To 271V Ll Br.Cira�a
SINGLE FAMILY Temp.Power Pole 8 Appurtertancee `
HOME OWNER-BUILDER DECLARATIONwr r taffirmI hereby arm that I am exempt from the Cortraotore Lioenae Law with One Branch ClroDn WXT.T
for the following reason (Section 70,31.6, Business and Profeealone Additional Sign Branch Clrcune
33 T fit+ .7t5
Code):
❑ I,as owner o1 the property,will do the work and the struoture Misc.C'ondutts S Conductors 1 IM h7
Is not Intended or offered for sale (Section 7044, Business Ofher(See Complete Fee Schedule) TOTAL Poo.. _ r
eal
and Profeons Code). cwcy
l 63.45
CONSTRUCTION LENDING AGENCY t��ul�� ���5y
I hereby affirm that there Is a construction lending agency for the C-rt�I V4GE .X
performanos of the work for which this permit Is Issued (Seo. 3097, PERMff FEE (Sub-Total)
Cly.C.)
PLAN CHECKING FEE DOOD-0001 5/20/94
Lenders Name
PERMIT ISSUING FEE 1 AN10:5'}
Lenders Address / �.
I certify that I have read this spp kxdon and under penalty of purjury state TOTAL FEE
thea tits above Irrfomudion Is corrsot- I agree to comply with ell County
ord]nances and State 1 regulsbV wlrtng,and hereby authorfze
lite my to upon the abarotnentloned property
SEE REVERSE FOR EXPLANATORY LANGUAGE
a
OP PEF&MTrEE I DATE
COUNTY OF LOS ANGELES TEMPLE CITY 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0503220006
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LFrfU ID: FEES PAID BUILDING ADDRESS:
TR: 19189 LT: 47 10619 ROSEGLEN ST
FEE DESCRIPTION: QUANTITY: LION: AMOUNT: TEMP CA 917804131
ASS S:SOR INFORMATION NLMER: NEAREST CROSS STREET: PAL MAL
8585-026-022 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY
G1 OUTLET S-LGT,SW f2ECP 42.00 OUT 68.70
G2 LIGHTING FIXTII(MES 15.00 LGT 29.251 SSUED ON: PROCESSED BY: PLAN BY: EKPIRES .
H1 RES ELEC OVEN LT 3HP 1.00 OVE 10.95 03/24/05 JK 09/20/05 .
H2 RES GRRG DISP LT 3HP 1.00 DIS 10.95
H3 RES DISHWASHR LT 3HP 1.00 DIS 10.95
MARK RK E•MARIA E (323) 720-7556-MARIA H4 RES RANGE HDS LT 3HP 1.00 HOO 10.95
10619 R08EGLEM ST H5 RES WASH MACH LT 3HP 1.00 WAS 10.95
TEMP 917804131 H7 RES EXHAUST FANS 2.00 EX 21.90 CRIPTION OF WORK
JB AC LIMITS +3-10HP 1.00 AC 19.65 ELECTRICAL FOR ADDITION AMD.UPGitADE SERVICE TO 200 AMPS
LB 200 AMP PANELS, MCC 1.00 PAM 38.85
APPLICANT: TEL. . TOTAL FEES 260.85
SAME AS OWNERSPECIAL CONDITIONS:
CONTRACTOR: TEL.-10: - APPROVALS DATE INSPECTOR si5RTUffF--
-
SAME AS OWNER -
LIC. MO T CRARY POWER POLE
LINDERGMIND
ARCHITECT OR ENGINEER: TEL. 160: LIFER tOl D
LIC. N0: ROUGH CMUIT
ROLIGH WIRING
PLASTIC Y/M METAL Y/N
UTILITY COMPANY NOTIFIED
I
REPORT ID: DPR265 ROUTE TO: 880508