The URL can be used to link to this page

Home My Public Portal About5017 SERENO DR_Electrical__ T•w"SCE °°1e'P•t APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES BUILDING�AND SAFETY FOR APPLICANT TO FILL IN JOB RE55 5017 J1il�CiLW lA.\. New Residential Bldgs &Pools EACH NO FEE ADD 1 &2 Family Sq Ft $ 025 — S LOCALITY Multi family Sq Ft 02 — NEA ST Q Residential Swimming Pools 2500 WN FIRM NAME ALKLURREs Outlets Rec_lght_Sw IL SAME 20 50 ADDRESS Total No Additional 30 CITY Tel No PLN CHKK APPLICANT Lighting Futures Fiat 20 50 ADDRESS Additional 30 Tocol No CITY Tel No Fixed Appliances Not Over 1 HP PEIT Range—Hewer—DW _ APPLICANT Oven—Dryer_ W M— ADDRESS 203+ N. PFZ( RD Top _FAU >C— W H _ CITY Tel No _ Hood_Fan —Other— LICENSE OR Dnp _Room Art Cond 250 REG NUMBER 2650% Closs C 7i I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA Power Appororvs$Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO Size&Type HP KW KVA or KVAR COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS 250 REGULATING ELECTRICAL WIRING n Up to I IM I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR J_-5H P Over I to 10 Ind 500 LICENSED AS REQUIRED BY LOS ANl COUNTY AND STATE OF Over 10 to 50 Incl 1250 CAUFORNIA OR THAT I A HE L O ER OF THE A�POVE Over 50 to 100 Inc 2500 DESCRIBED RESID AL Over 100 4000 PERMITEE SIGNATURE Services DISTRICT NO PROCESSED.BY 0 200 Amp Under 600 V 12 50 201 1000 Amp Under 600 V 25 00Wax, Z Over 1000 Amp or Over 600 V 5000 Temp Power Pole&Appurtenances 1000 t Sign with One Broach Circuit 10 DO O Additional Sign Branch Circuits 200 INSPECTION 3 Mac Conduits&Conductors 1000 INFORMATION Other(See Complete Fee Schedules_ ON REVERSE f 1 7 3 T, SIDE � • • • • • � 2 • • 1G ` C PERMIT FEE (Sub Total, 7 5 • • is PLAN CHECKING FEE ,One Fourth Permit Fee, = f 21 1 -7E K PERMIT ISSUING FEE $700 7 00= TOTAL FEE 1 LL ; INSPECTIIOTNN/Nh��FFFFINA}L-EED9 }_y'1 date p-3�/1 BY // ms Te.eeatEEoe u-ee APPLICATION FOR ELECTRIC COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS Seeemo Ap JOHN A LAMBIE COUNTY ENGINEER COLEMAN IN JENKINS, SUPERINTENDENT OF BUILDING LOCALITY 7LIGHNEAREST CROSS ST T OTAL ucUTLPIRST IID S20SOWNER EdG MAIL ADD L 10 ADDRE88OVER 30TOTAL FIRST IID IIDCITY TEL NO %TURIS ADD LIDCONTRACTOR C T ��.r WTR NTRE OVER IID 10o ADDRESS c26(.D17 CAIS DIE► STA COCK 339' CITY V / TEL NO DISHWASII AUTO WASH STAT[ SPACt NT11S RA. AAL SO LICENSE NO 0 G MOTORS, oral NOT OVER H• DIBTRI P Z P D B O f 100 1 — a 1150 V INSPECTION RECORD AA4 96J a — S 200 S lS 230 ro [ so 300 SO 100 Soo I 0 , HD TRA"S NG LAw1 Q CE o SOOV NOT OvM EDDA 100 a CE D GOOV OVER 200 A 200 CE OVER SOOV Soo R IME COMPLETt FEZ SCH[ouL[1 PERMIT ISSUING FEE II00 LEMENTARY PERMIT 18SUING FILE 1100 a TOTAL FEE S 6-b HEARST ACKNOWLEOOE THAT 1 HAVE READ THIS AALICATIOM UNDERSLAB WORK STATS THAT THE ABOVE I.CORRECT AND AGREE TO COMPLY ROUGH CONDUIT H ALL COUNTY OROINAM=5 AND STAT[ LAWS REGULATING TRICAL WIRING WIRING HERESY CERTI/Y THAT I AM PROR[RLY REGISTERED AND/ORPIXTURNMD A. REQUIRED BY LO.ANGELES COUNTY AND STAT[OTIDE IN4 0R TNAT 1 AM TNt LEGAL MC IMT[MO TO POWER ID[IN TN[AROVCRTYNATURE W UTILITY CO NOTI► O PERMITTEE -1T FINAL 0140 ON J EPN RO ELECTRICAL Ir CASH BUIERVIBING ELECTRICAL ENGINEER LAW 2 0 7% JLA21 2 D 450 WORKERS COMPENSATION DECLARATION � APPLICATION FOR ELECTRICAL PERMIT O affirm that I have o cendilate of consent to self a certificate of Workers'Compensation Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Pod copy thereof (Sec 3800, Lab C ) Pgli y o Company I FOR APPLICANT TO RLL IN JOB Certified copy is hereby furnished New Residential Bldgs 8 Pools EACH NO AWRE ❑Certified copy is filed with the county budding mspec 1 8 2-Family, Sq FI $ — S LOCALI Icon department Multi family Sq Ft — NEAREST Residential Swimming Pools CROSS ST Dote Applicant OR FIRM AME Q 5 CERTIFICATE OF EXEMPTION FROM WORKERS0 –LSw,L MAR Outlets Rec U ht COMPENSATION INSURANCE O � � AOORESS O (This section rinsed not be completed If she work Imalwd b First 20 CI the permit Is for one hundred dollars($100)or Ins) T Total No Additional Tel N I certify that d the performance of the work for PLAN OEC K I au which this APPLICANT permit issued, 1 shall not employ any person m any moans Lhtm Futures First 20 ADDRESS so car to to become subject to the Workers Compensation Lows 9 9 Total No Additional CITY Tel No Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT If, cher making ilio Certificate of Range— Heater—D W — APPLICATIONExemption, you should become subject to the Workers' n9 Compensation provisions of the Labor Code, you must forth- Oven _ Dryer —W M _ ADDRESS with comply with such provisions or this permit shall be deemed revoked Hood - Fan —Other_ CITY V Tel No LICENSED CONTRACTORS DECLARATIONOR 1 hereby affvm that I am licensed under provisions of Chapter 9 DILP — Room Air Cord REG N NUMBER Class (commencing with Section 7000)of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NO and Professions Code and my license is in full force and effect /D T/ PROCESSED BY a Size d Type HP KW, KVA, or KVAR r o 0 License Number tic ClassUp to 1 Incl FINAL 0 Over I to 101ncl DATE VALIDATION Contractor nate Over 10 to 50 Incl FINAL O ❑ 1 am exempt under Sec Over 50 to IDD Inc By 0 B 8P C for this reason Over 100 LU LU (n Dote Serwcea, Swbd , MCC 8 Ponelboards Z 0• 200 Amp Under Epp V Signature 201 - 1000 Amp Under 600 V ❑ Exemption for Reg MoOver 1000 Amp or Over 600 V Moral Elect SINGLE FAMILY Temp Power Pole 8 Appurtenances HOME OWNER BUILDER DECLARATION A I hereby affirm that I am exempt from the Contractor s License Sign with One Branch Circuit ACCT.T Law for the following reason (Section 7031 5 Business and Additional Sign Branch Circuits `-07 15.71) Professions Code) ❑ I as owner of theperry,o will do the work and the Misc Conduits 8 Conductors 1 ITEMS pr Other See Complete Fee Schedule 5 Business a not attended or offered for sale(Section 704.1 ( P , TOTAL 1•– �O Business and Professions Code) CONSTRUCTION LENDING AGENCY CHECK 15.70 I hereby affirm that there is a construction lending agency for [HANIGE .013 the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) C;1 Q (Sec 3097 Civ C ) Lender s Name PLAN CHECKING FEE MI-0001 1/ 9/91 PERMIT ISSUING FEE 4914 1 Ali 2140 Lender's Address I certify that I have read this application FEE application and stale that the J Q above information is correct I agree to comply with all County ordinonces and State lows regulating Electrical wiring and hereby outhorize representatives of this County to enter upon the above mentioned p for impecttioa=rpooses SEE REVERSE FOR EXPLANATORY LANGUAGE g oture of Permittee Date ms COUNTY OF LOB ANGELES TEMPLE CITY 9 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC BORES 9701 LAS TUNAS EL 0508 0608110022 BUILDING AND SAFETY / LAND DSVRLOPKMT TEMPLE CITY CA 91780 PHONE (626) 785-0688 EZT LEGAL ID FEES PAID BUILDING ADDRESS ON FILE 5017 SURERO DR FEE DESCRIPTION QUANTITY DOM AMOUNT IBM CA 917801028 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET 5188-016-006 Al PERMIT ISSUANCE FEE 77 75 THOMAS PAGE 596 GRID R5 LOCALITY TEMPLE CITY, C O1 OUTLBTB-LGT,SW,RECP 7 00 OUT 2 90 TENANT TOTAL PERS 11 65 ISSUED ON PROCESSED BY PLAN BY EIFIRES ON 08/21/06 JR 07/77/07 OWNER TEL NO FINAL DATE XPIRED�Y CODE IP TWIN LING (676) 651-5961- 5017 MEMO DR TEMP 917801018 DESCRIPTION OF WORE ADD ao-OUTLETS ON GARAGE APPLICANT TEL RO SAME AB ONNER - SPECIAL CONDITIONS CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE SAWN AS OMNER - LIC Po TEMPORARY POWER POLE UNDERGROUND CONDUIT ARCHITECT OR ENGINEER TEL NO UFER GROUND LIC NO ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE PLASTIC Y/E METAL Y/N UTILITY COMPANY NOTIFIED REPORT ID DPR765 ROUTE TO B80506