HomeMy Public PortalAbout4830 RYLAND AVE_Electrical__ 76A663 139"A II-60 APPLICATION FOR PERMIT
•DEPAWITMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES ELECTRIC
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE CPERMIT NO.
ELECTRICIAN
RECEIVED BY READY FOR DATE ISSUED
ADDRESS °L� I FIRST INSPECTION
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te CITY ® TEL. NO. Pv///[n�i /
yy
COUNTY ICENSE �NO. 7 EXPIRES BUILDING
PERMIT, EES ADDRESS
V f
FEE
NUMBER EACH LOCALITY
1
LIGHT OUTLETS NEAREST
CROSS ST. Anolfl
RECEPTACLES I� , J U
WALL SWITCHES O® BQ nn OWNER //l/
TOTAL OUTLETS SC S MAIL
ELEC. RANGES 2B ADDRESS
ELEC. HEATERS 2S CITY TEL. NO.
FIXTURES 5 ss
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 HORSEPOWER ANGELES COUNTY LICENSE. OR I AM THE LEGAL OWNER
FEE OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
NEW MVD. H OVER INC. EACH
I/2&LESS $ .25 IA SIGNATURE OF -
I/2 2 .50 PERMITTE
2 5 1.00 INSPEC ION RECORD
5 is 1.50
is 50 2.50
so 200 5.00
200 Soo 10.00 J
500 1000 15.00
Q
Z
OVER 1000 20.00
M. G. SET/FREQ. CHANGER-HP
WELDERS:AC-KVA 0
GENERATORS-KW
TRANSFORMERS-KVA
TEMP. MOTORS\(75%OF ORICI.)
MOVED MOTORS (75%OFORIG.)
MISC.
SIGNS
NO. NO.TRANS. I I APPROVALS
NO. NO. LAMPS
FOR EACH PERMIT-
DA E INSPECTOR'S NAME
WIRING $1.00 CONDUIT '/e
FIXTURES $1.00. �-G WIRING
SUPPLEMENTARY .50
FIXTURES
POWER g �{
TOTAL FEE $ �J I I UTILITY CO. NOTIFIED 1/ / L`�•�"�
® / FINAL ►r i+1+qlop
WORKERS'COMPENSATIONDECLA&ATION- � APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES r BUILDING AND SAFETY
insure,or a certificate of Workers'Compensation Insurance,or
a certified copy thereof(Sec.3800,Lab.C.)
/➢� �/Wg FOR APPLICANT TO FILL IN JOB
Policy N' pan 1 EACH NO. FEE ADDRESS
New Residential Bldgs.&Pools
Certified copy is hereby furnished. `�:i 1 &2-Family.Sq. Ft. $ — $ LOCALITY
// Multi-family Sq. Ft. NEAREST
Certified copy is filed with the county building inspection CROSS ST
dey,paa�rtgqm��e,,,.ntt...,, Residential Swimming Pools OWNER OR
Dater 92 Applicant FIRM NAME
Outlets: Rec Light—4-- d MAI L
xj
First 20 ADDRESS
CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY Tel No.
COMPENSATION INSURANCE
PLAN CHECK O.
(This section need not be completed. if the work involved Lighting Fixtures First 20 .40 PPLICANT V
by the permit is for one hundred dollars ($100) or less.) ADDRESS
Total No..
'4 Additional 0
I certify that in the performance of the work for which this CITY Tel No.
permit is issued, I shall not em Fixed Appliances Not Over 1 HP F-
p employ y an y person in any manner PERMIT W
so as to become subject to the Workers'Compensation Laws. Range_Heater D.W. A APPLICANT CL
Oven — Dryer_W.M._ ADDRESS
Date Applicant Top _FAU _W.H.._
Hood — Fan _Other— CITY v Tel No. 3
NOTICE TO APPLICANT: If, after making this Certificate of Disp. I Room Air Cond.� ICENSE OR
Exemption, you should become subject to the Workers' REG.NUMBER Class t
Compensation provisions of the Labor Code,you must forth- Power Apparatus&Large Appliances DISTRICT NO. PR ES D BY
with comply with such provisions or this permit shall be
deemed revoked. Size&Type HP,KW,KVA,or KVAR
Up to 1 Incl. C
FINAL
LICENSED CONTRACTORS DECLARATION Over 1 to 10 Incl. DATE VALI DATI
Over 10 to 50 Incl.
I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL
9 (commencing with Section 7000)of Division 3 of the Busi- Over 100 BY
ness and Professions.Code,and 4tny license is in full force and 1 44
effect. Services
' �! �
License Number 0-200 Amp.Under 600 V SI
Lic.Class 201-1000 Amp.Under 600 V 7Y�
ContractorDate 2. Over 1000 Amp.or Over 600 V
HOME OWNER-BUILDER DECLARATION Temp.Power Pole&Appurtenances
I hereby affirm that I am exempt. from the Contractor's Sign with One Branch Circuit _J 4 9,3
License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits
ness and Professions Code):
n G
Misc.Conduits&Conductors
I, as owner of the property, will do the work and the Other(See Complete Fee Schedule)— c e
structure is not intended or offered for sale (Section
7044,Business and Professions Code). , ., , 1 �• �;
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency tl G 2-82
for the performance of the work for which this permit is PERMIT FEE (Sub-Total)
issued(Sec.3097,Civ.C.).
Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee)
Lender's Address PERMIT ISSUING FEE
I certify that I have read this application and state that the TQTAL FEE
above information is correct.I agree to comply with all County
ardinances and State laws regulating Electrical wiring, and
hereby au orize re rese ti of this County to enter upon '
the abo - enti nqA 1A pro rt r inspection purposes. I SEE'REVERSE FOR EXPLANATORY LANGUAGE
- 4-2--fi-
STgfftuie-if Fferr6idee Date
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0706080021
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID BUILDING ADDRESS: ]
ITR: 17107 LT: 38 I 4830 RYLAND AV ]
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917804032
ASSESSOR INFORMATION NUMBER: NEAREST CROSSSTREET: ROBINHOOD
18585-011-018 IA1 PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE: 597 GRID: B5 LOCALITY: TEMPLE CITY, Cl
1G1 OUTLETS-LGT,SW,RECP 2.00 OUT 3.90 I I
]TENANT: 02 LIGHTING FIXTURES 5.00 LGT 9.75 (ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
I THA FAD LESS 3HP 1.00 FAD 10.95 106/08/07 SR 12/05/07 ]
1 IJB AC UNITS +3-3.OHP 1.00 AC 19.65 I I
(OWNER: TEL. NO: TOTAL FEES 72.00 IFINAL DA FI Y: CODE: 1
1HIGA, GARY/TRAGI (626) 443-8774- I I I
14830 RYLAND AVE. 1
ITEMPLE CITY CA 91780 I IDESCRIPTIOW OF WORK 1
1 I (ELECTRICAL FOR HVAC SYSTEM 1
(APPLICANT: TEL. NO: I ] ]
ISAME AS OWNER
I I ISPECIAL CONDITIONS: 1
I
1 i I
ICONTRACTOR: TEL. NO: ]APPROVALS DATE INSPECTOR SIGNATURE 1
ISAME AS OWNER -
I LIC. NO [TEMPORARY POWER POLE I I I
I I (UNDERGROUND CONDUIT I 1 1
[ARCHITECT OR ENGINEER: TEL. NO: 1 IUFER GROUND
_ I I
1 LIC. NO: 1 TROUGH CONDUIT I I I
(ROUGH WIRING -rl 1
1 1 IMAIN WATER LINE I I I
I [PLASTIC Y/N METAL Y/N
I I I I I I
(UTILITY COMPANY NOTIFIED[ I I
I I ] I I I
[ 1 I I I I
I i I I I I
I I I I
I I ] I I
I I I I I
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] ]REPORT ID: DPR265 ROUTE TO: BS0508 I I I I