HomeMy Public PortalAbout9226 ROSEGLEN ST_Electrical__��7 . A E Q I - C I S O G _ O �� A P P L I C A T I O N F O R E L E C T R I C P E R M I T 1 ,
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A I L D S T A T E T H A T T H E A B O V E I S C O R R I C T A N D A G R E E T O C O I P L T C O N D U I T
W I T H A L L C O U N T T O R D I N " M A N D S T A T E L A W S R E G U L A T I N G
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wORICER'S COM PEN sAnoN°E°"„RA„°" 200D,6DPW(12-°'' APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that h have a certifloate of consent to self Insure, ��
or a•aerdflolre of Worter's Compensatlon Insurance, or a certlfled COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV.
copy therwiT(Sec.3800 Lab.C.)
No. y FOR APPU CANT TO FILL Ili
El Certified copy Is hereby fumbhed. New Raeldential Bldgs.S Pooh NO. EACH
LOCALFFY
❑ CerfflW oopy to sled wrth the county buiddrrg Inepeodw 1 S 2 family,Sq.Ft — NEAREST
depRrtrrGent. Mufti-family Sq.Ft ST.
DW APPt Realderrtfal Swimming Poole ASSESSOR
it MAP BOOT( PAGE PAfGCg
M47FICATE OF EXEMPTION FROM WORKERS' out":Rec. LightSw. OWtM 0*:'COMPENSATION INSURANCE
First b RRw
OV
(This section need not be completed if the work Involved by the uAl
permtt b for one hundred dollars(8100)or less.) Total
� �
I oertlfy that In the performance of the wor ,for which this permit TOL
Is Issued, I shall not employ any person any manner so as to ''� M
become subject to the Workers'Compsan Ion Lawn. Arat 20 / �v d
Trial No Additional
ADDRES8
Air
Data 'fi t RESIDENTIAL APPLIANCES NOT OVER 3 HP.
NOTICE TO APPLICANT: If, after making this Certlfloate of CFTY Tel.No
Exemption,you should become subject to the Workers' Ccmpensatlon OTHER APPLIANCES NOT OVER 3 HP.
pro+islons of the Labor Code, you must forthwith comply with such PIEFUT
provinlons or this permit shall be deemed revoked. Power Appu"d Large Appltanoee
APPLICANT
L)GENSED CONTRACTORS DECLARATION Stre 8 Type HP,KW,KVA,or KVAR ADDRESS
I hereby affirm that I am licensed under provlslons of Chapter B Over 3 to 10 Incl.
(commencing with Section 7000) of Dlvislon 3 of the Buslneae and CLTY T'L NO-
Professions Code,and my license Is In full force and effect. Over 10 to 60 Incl. LICENBE OR >_Over 60 to 100d.InREG-NUMBER
Class.
Over 100 DtBTFOCT NO. BY -
License Number Llo.Clams n p
Servlose,Swbd.,MCC S Panelboarda M
Contractor Date 0-386 Amp.Under 800 V DATE �
❑ 400-1000 Amp.Under 600 V �^Z 7 VALIDATION W
I am exempt under Sec. Over 1000 Amp.or Over 600 V
FINAL �
B. P.C.for this reason BRANCH CIRCUIT FEES BY
Dats: 16A,or 2aAj 120V,Lighting«Recept- - --_ _..
Z
1 To 10 Branoh Clrcults
lil�Garirre 11 To 40 Burch Ctculls - -
41 Or More Brandi Ctrafts
❑ Exemption f«Rep."rrL Elect. 1i 20A 20BV To 217V Br.Ctnft —,- V- -
SINGLE FAMILY Temp.Power Pole h Appurtenancee — AccT.t
WNER-BUILDER DECLARATION with Orta Ctrouft
P=I
exempt fromthe Contractor's Llcsnse Law Mn (Ssatlan 70305
1.6, Business and Professions Addtlorad Sign&woh Clrcutts i� n1iI� •he property,will do the work and the structure Woo.Condults&Conductor - -- -TOTAi_ 52233 o O5
Is not Intended or offered for sale (Bectlon 704-4, Buslness Otfw(See Compote Fee Sohedule)
end Professions Code). LL fS44ii
CONb'TRlICT10N LENDING AGENCY CHANGE
I hereby affirm that there to a oonatruotlon lending agency for the
performance of the wprk for which this permlt Is Iaeued (Sea. 3087, PERMFr FEE (Sub-ToW
Ctr.C.) - 1 til 6/93
PLAN CHECKING FEE 9570 1 AM 9;02
Lenders Name
PERMrr ISSUING FIS p(
Landers Address
I certify that I have read fhb appbcatlon and under penalty of purjury state TOTAL FEE �. 0
that the above triformsdon.ls oorrocL I agree to compy with all County
ordnanow mind State laws regulaifip Electrical wiring,and hereby authorize
represertILK&eas of this County to anter upon the above-mentioned property
purpoeee. SEE REVERSE FOR E)IPLAHATORY LANGUAGE
SIGNATURE OF PS%Wrrg �� DATE
WORKER'S COMPENSATION DECLARATION 76AM3 °P"(12-91) APPLICATION FOF3 E RICAL PERMIT
I hereby atlrm tpaf�l have a certJflcate of consent to self Insure, 78AB63 y.
ore cert+}Ioaie of Worker's Compensation Insurance, or a certlfled COUNT(OF LOS ANGELES DEPT. OF PUBL''I�WbRKS BUILDING AND SAFETY DIV.
copy thereof(Sed.3800 Lab, C.)
Pdlcy No. Comp" rM APPL"XT TO 19LL IN ADvfiE38
❑ Cerlffied Dopy b hereby furnished. New PAekJentlej Bkipa.8 Pooh NO. EACH FEE
❑ — S i LOCALITY
copy b �
Certifled coflied with the county 8 ty bullding Inspection 1 2-Fam0y,Sq.F[ NEAREST
department Multi tamliy Sq.Ft cao8s ST. EPE
DoteApplicant 11"dwrft Swimming Poole
WAP BOOK PKiE PAFiCg
CEFTTIFICATE OF EXEMPTION FROM 1lJOFlf(ERS' Outlets: Llpht Sw.�.'ge /7� ��/ FIRMOME v
COMPENSATION INSURANCE First '7
MAIL
(This eecdon.nNd not be oompleted H the work Involved by the �taA F�
permh Is for one huhdted dollen(i100)or lose.) Total No'. Addtnonel
I oertlfy that In the performance of the work for whloh this permit Cm T N0
le Issued, I shall not employ any person In any manner so as to PLAN CHECK
becorne subject to the Workers' Compeneetlon Laws. LWhtlng FbstuF9 rat Lk
20 APP '•ANT
Total No. res Addldohal ADDRESS �-
Date Appiloont
NOTICE TO.APPLICANT: If, after making thiRESIDENTIAL APPLANCES NOT OVER 3 HP.
s Certl}Icnte of CITYTt
T.L Na r
Exemption ,you should become subject to the Workers'.0 xnpensatlon OTHER APPLIANCES NOT OVER 3 HP.
provisions of the Labor Code, you must fgrthwlth comply with such PApp
provlelons or this pmid
permit shall be dberevokedpar
. Power Apparatus 8 L9rge AppLtaneee
UCANT
UCENSED CONTRACTORS DECLARATION Sim S Type HP,KW,KVA or KVAA ADDRESS
I hoteby affirm that I am licensed under provisions of Chapter B Over 3 to 10 Ind.
(oommencing with Sectlon 7000) of Division 3 of the Buslness and CITY Tsl.Na
Profeoelons Code,and my license Is In full force and effect. Over 10 to 60 Ind.
Over 60 to 100 Ind. BEA O� 11
Over 100 DIBTWCT NO. 8
BY V
Lkense Number Uc.Clave p
Panelboarde
Contmotor Date �00OAmpU
nder 60o V NA O
nr�-� 400 Under 600 V (_
I am exempt under Seo. Over 1000 Amp.or Over 800 V FINAL `Z3 VAUDATION d
B.dP.C.for this reasonBY
BRANCH CIRCUIT FEES (n
Date: 166,or 20A,12OV,Lighting or Recept Z
1 To 10 Branch Cl
Signature 11 To 40 Breach Ctrails _
Elf 41 Or Mans Branch Ctafls r -
Exemptlon for Rep.Mehl Elect. 15A,20A,206V To 277V UOT&V Br.CtcuRa
84 NG LE FAMILY Temp.Power Pole✓f Appurtenencetlt
HOME OWNER BUILDER DECLARATION .?� i - ■t
I hereby sfflrm that I am exempt from the Contractor's License Law Sign with One Brandi Circuit 3307
�{y 7-}
for the following reason (Seotlon 7031.5, Business and Professions AddRionel Sign Branch Clroutb �`W.r T hTi7
�1--A-1rCi+9- -- -- -
1, as owner of the property,will dc,the work and the structure Mk.Condults S Gcn uoton TSJTIZ -.__157'.!53,
Is not Intended or offered for sale (Sectlon 7044, Business Other(See Complete Fee Schedule) - - ��yy__��IAW �7
and Professions Code). L.TG4ti 1J!■ 3
CONSTRUCTION LENDING AQENCY NANGE
—
I hereby affirm that there Is a construction lending agency for the
performanoe of the work for which this permit Is Issued (Seo. 3087, PERMIT FEE (Sub-T
Civ.C.) °� = - O4a0—Offll 11/17/x-
PLAN CHECIaNG FEE 1 $%sl
Lenders Name ij _
PERMIT ISSUING FEE 4ti
Lendeee Addreea
I certify that I hWlk�,�wer penalty of purjury state TOTAL FEE
that the aboveo comply with ell County
ordinances end ring,end hereby ortrerep above m p
for I u SEE REVERSE FOR EXPLANATORY LANGUAGE oA
COUNTY OF LOS ANGEL TRMiPLE CITY p 0508 Ri BR=CAL PERMIT
DEPART ENT OF PUBLIC WORKS 9701 LAS TUNAS
EI, 0508 1410150017
BUILDING AND SAFETY / LAND DEVELOPMENT TE2GILE CITY CA 91780
PHONE: (626) 285-0488 ETP:
LEGAL ID: FEES PAID B=ING ADDRESS:
TR: 24021 LT: 13 9226 ROSEGLEN ST
FEE D&SCRIPTION: QUANTITY: DOM: A40UW: TE24P CA 917803709
ASSESSOR INFORMATION NUMBER: NEAR= CROSS STREsF•T: ENCINTTA
8590-029-006 P2 PC RF69 PV<10KN 153.90 THOMAS PAGE: 596 GRID: J5 LOCALTPY: TEMPLE CITY CA
Al PERMIT ISSUANCE FEE 27.80
TENANT: P3 INVRTR RES PV<10KW 27.90 ISSUED ON: PROCESSED BY: PLAN BY:
TOTAL FEES 209.60 10/23/14 SR
050ER: TEL. NO: FINAL DATE BY: CODE:
WOW, PAUL (626) 570-9132-
9226 ROSEGLEN ST
TEMP 917803709 ON OF WORK 14
5.13 SW 90LAR PV SYSTEM I2qSTAT.7ATTON (19 PANELS)
APPLICANT: TEL. NO:
JAIN, NAVIN b (948) 243-6421-
7 CALLS LARSPUR SPECIAL CONDITIONS:
RANCHO SANTA MARGARI
CONTRACTOR: TEL. 190: APPROVALS DATE INSPECTOR SIGNATURE
NIPPON ENERGY INC. (949) 243-6421-
7 CALLE LARSPUR LIC. NO TFJ-iPORARY POWER POLE
RANCHO STA MAaROARTTA CA 92688 975779
UNDERGROUND CONDKTIT
ARCHITECT OR ENGINEER: TEL. NO: LIFER GROUND
LIC. NO: ROUOB CONDOTP
ROUGH WIRING
ALL GROUNDING AND BONDING OF THE PV SYSTEM SHALL COMPLY NWEN *m Tsui?
WITH LOS ANGELES COUNTY REQ=EYMNiS. NOTE- VlE�EB PLAT39 PLASTIC YIN METAL YIN
SLASHERS, AND SDCa.AR DEVICES ARE NOT ACCEPTED.
UTILITY COMPANY NOTIFIED
REPORT ID: DPR265 ROUTE T0: BS0508