HomeMy Public PortalAbout5034 SERENO DR_Electrical__ APPLICATION FOR ELECTRIC PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BU'LD
IN
BUILDING AND
B�S,AMTY$DIM�pS�ION ADDRES
aWrr-D 6HIPPEL=t e18YdmIt LOCALITY
NEAREST
ST
FOR APPLICANT TO FILL IN 'Ross
PERM FEES
ITEM NUMBER EACH FEK OWNER
OUTLET { f MAIL
LIOHTM RECErt AW 10 MAILADDRESS
LIGHTING NXTUR f0 1
CITY • � I TE 10
KLKC.RANGES CLO ORVERS ELECTRICIA
WATER HEATERS DO ADDRESS
KLCC SPACE HTRI gIpHWAEHERp
OARDA06 OIEPOpERE AUTO- CITY NO '/
WAOIERi STA COOKIHO UNITE 25 {'� STATE
LICENSE NO
MOTORS ovml INC HP
ra
o— Y, ze
V. — 2 DO 0 1
z — D 100 xR ON HECOEP
IS
15 — ISO 250
DO— 200 500 t �/�'ld I
SIGNS NO TRANS r
NO LAMPS
BERVIC 0 SOON 100
SERVICE VER e00V 500
MISC.
WIRINGPERMIT too
FIXTURE PERMIT too
SUPPLEMENTARY PERMIT DO
TOTAL FEE f AMOVAU
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPUCAT ON DATE INSPECTOR 3SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT-
WITH ALL COUNTY ORDINANCES AND STATE IANS REGULATING
ELECTRICAL WIRING WIRING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES Z
CALIFORNIA OR TRAY 1 AM THE LEGAL OWNER OF THE ABOVE -'
DESCRIBED RESIDENT AL POWER
SIGNATURE UTILITY CO NOTIFIED /
OF PERMTITH
FIN
eV4.IDAIION ARTHUR C VEIT
mt
No ION SAMHUDING ELECTRICAL ENGINEER
20 84
I ' • , WORKERS COMPENSATION DECLARATION 76M63 10/81 APPLICATION FOR ELECTRICAL PERMIT n
Alae-'~yy��alfirm that I have a certificate of censent to self insure �e�
-oh ace Rgee of Nklrkem COMPensehon Insurance or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY ILJ'
copy thered(Sec 38DOYab C)
Policy NO Company FOR APPLICANT TO Fal M ,' JOB
❑
Certified copy a hereby furnishetl EACH NO FEE ADDRESS (nC•6 /C/
New Resdential Bdpe 8 Pools LOCALITY
'❑ 1 d 2-Famay Sq Ft $ — $
department
copy a load wnih the county budding nePednm NNA S Bf W
tleparlment ` Mulirfemdy Sq Ft
Date Applicant Residential Swrmmsg P4ol9 OWNER OR
FRM
CERTIFICATE OF EXEMPTION
NSATION INSURANCEFROMWORKERSOutlets Rec4 Light JL SW �� �
ESS
(ThIs section need not be competed If the work Invotved by the First 20 d vN
1xrmH b for one hundred dollars($100)or lees) Total No Additorel C� N Lt7 r Td No
I certify that m the performance of the Werk for which this Permit PLAN CK
e issued I shall not employ any person in any manner so as to APPLICANT
become subject to the Workersfon Lighting Fixtures First 20 D ADDRESS
Date Z�r Applloanl ( Total No Additional CITY T
NOTICE TO APPLICANT If, after making rtdwete F-W Apdences Net Over i HP pEq
Exemption you should become subtsct to the Workers Compensates Range— Heater_ DIN — APPLICANT
prowaens of the Labor Code,you must forthwith comply with such Oven _ Dryer — W M — ADDRESS uV
prowsons or this permit shall be deemed revoked Top — FAU _ WH — CITY Tel No
LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other_
1 hereby affuam licensed I alicensed under prowsiore of Chapter 8 Dep — Room Air Cond LICENSE B ,
(commenprg with Section 7000) of Divlswn 3 of the Business and REO NUMBER Glas°
Professions Code and my license is In lull force and effect Pourer Apparatus& Large Appliances DSRaCT NO 0 PqdCfSSA BY _
Sae 6 Type HP KW KVA or KVAR
License Number Lc Class I UP to 1 Irxd FINAL
• Over 1 to tO Incl DATE VgLIDATK)N
Contractor Date Over 10 to 50 Ind
❑ , I em exempt under Sec 4Over 50 to 100 IncFINALBY
BSPC for this reason Over 100
_
Services Swhd MCC 8 Panalboerda /
Date -200 Amp Under BOO V
1
Signature - 1000 Arte Under 800 V
Over
orver
r 1000 Amp O 000 V
❑ Ove
' Exampon for Rep Main! Elect -
SINGLE FAMILY Temp Power Pole& Appurtenances
HOME OWNER-BUILDER DECLARATION -
I hereby affirm that I am exempt from the Contractors License Law Sign with One Branch Circuit ,
W the following reason(Section 70315 Business and Professore Additional Sign Branch Csoints • ,
Cafe)
�I Misc Conduits d Conductors
`
p! I e9 owner of o property or do ( wok and the structure a�(� to Fee Schedule
is not Tessio tl a offered for sale (Section 7044 Busseas ) — ,
and Professions Code)
, CONSTRUCTION LENDING AGENCY
I hemby affirm that there is a conawdon lending agency for the
Performance of the work V which the permit is issued(Sac 3097 ;28667AI'ERMR FEE (Sub-Total) -
Civ C)
PLAN CHECKING FEE - -
Lerder s Name I e e 3 5 0 0
PERMIT ISSUING FEE -
Lender a Address • • • 35005
1 certify that I have read this application and state that the above TOTAL FEE
nlormabDri is correct I agree to comply with all County ordinances 1 227,-87
-
and State lava regulating Electrical vwnng and hereby authorae
representatives of this County to enter upon the above-mentioned
• property for inspect rposes SEE REVERSE FOR EXPLANATORY LANGUAGE _
p v Date
i
COUNTY OF LOS ANGELES TEMPLE CITY d 0508 ELECTRICAL-hPERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TORUS CEL 0508_97031900.'i3�
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA
1
PHONE* (818) 285-0488 EXT
LEGAL ID ti BUILDING ADDRESS
i I
ON FILE 5034 SERENO DR
FEE DESCRIPTION QUANTITY LION AMOUNT: TEMP CA 9178=37
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET
5388-012-034 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE. 596 GRID H5 LOCALITY 'TEMPLE CITY
LA 100 AMP PANELS, MCC 1 00 PAN 38.85
TENANT TOTAL FEES 66.60 ISSUED ON: PROCESSED BY. PLAN BY EXPIRES ON
03/19/97 TC 03/19/98
OWNER —Tn--lo- FINAL DATE FINAL BY E:
LA HOANG (818) 285-3657- q,N/n�
504 SEREINO DR f,1,�FdQ�7
TEMP 917803037 OESCIFIP
UPGRADE ELECTRICAL SERVICE PANEL TO 100 AMP
APPLICANT' ILL NO:
ROBERT PANG CHAN (818) 285-8888-
SPECIAL 3NDITIONS-
CONTRACTOR. TEL NO. APPROVALS DATE
ROBERT PANG CHAN (818) 285-8888-
EvS
8321 AE.B C RD LIC. NO TRARY POWER POLE
SAM GABRIELIEL, G 91775 485022 CIO UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER: ' UFER GROUND
LIC. No 1RMH CONDUIT
Ill -kill) ,
USLAC WORKS
KKRIM WATER LINES PLASTIC Y/M METAL Y/N
�0 UTILITY COMPANY #OTITM
0 � L15;�
vJ
cl ° �
E?rvice
REPORT ID DPR265 ROUTE TO BS0508