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Home My Public Portal About5075 SERENO DR_Electrical__ 7aAaaa D9e u -a1 APPLICATION FOR PERMIT , DEPARTMENT OFNG AND SAFETY �� COUNTY OFF LOS LOS ANGELES WILLIAM J FOX, CHtEr ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO GROUPZONE PERMIT NO. ELECTRICIAN _ -/ 613C," ?Z �f� ADDRESS SU-4]7♦Y RECEIVED 9YREADY R FIRSTINBPCCTION DAT[ ISSUED CITY TCL NO -i57(/ ti� COUNTY LID[ BL NO EXPIRES BUILDING ADDRESS /f7 51y 0A., 7.�'{Q�►�O b/ PERMIT FEES NUMBER EACH FE[ LOCALITY LIGHT OUTLETS N[AR[BT CRO.9 ST RECEPTACLES WALL SWITCHES ^' S/ A OWNER TOTAL OUTLETS BC III MAIL ELEC "HOES 95 ADDRESS Vy ♦Vf� ��pa ELEC HEATERS !� 96 •Y'� CITY24a 0 TEL NO T OIl FI%TOREB �.3 • - I HEREBY ACKNOWL DG[ THAT I Hwvf READ THIS MISC APPLICATION AND STAT[ THAT THE ABOVE IB CORRECT NUMB OP;-Lf3HT CI QUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITB AND STATE LAWN REGULATING ELECTRICAL WIRING MOTORS I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOB NUMR[R HORS[POWENANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER r[[ NEW MVP HP OVER IHS [ADM Or THE R[BID[NTIA PROPERTY DESCRIBED ABOVE I a LE89 • 95 SIGNATURE OF ya 2 aC PERMITT[ 9 a 1 D INSPECT19IN RECORD a 1a 1 SO / 15 aD 250 -� O vECN Lvi [� 30 900 am L900 am0 1000 J 500 1000 15 130 Q evT Z OVER IOOO 90 00 � M0 SET/rREo CHANGER-HP �•1-♦�L WELDERS.AC-KVA O•C T-o ,�♦d p,,,,J O GENERATORS - KW TRANSFORMERS - KVA TEMP MOTORS (759/ or ORlo MOVED MOTORS (75 Gr ORIR) mlac SIGNS NO NO TRANS. APPROVALS NO NO LAMPS FOR EACH P[RMITI DAT[ INSPEOTORIS NAM[ WIRING Sl 00 CONDUIT FIXTURES •I OO WIRING RUPPLEMENTARY a0 FIXTURES - PCW[R " TOTAL FEE • {. urILITrcG NSTIrI9 h✓ FINAL i i WCjBKERS COMPENSATION DECLARATION ,T 19 DPW3ie) APPLICATION FOR ELECTRICAL PERMIT r L I L I hereby affirm-that I have a certificate of consent to self �� insure, or a certificals of Workers Compensation Insurance, COUNTY OF, LOS ANGELES DEPT OF PUBLIC WORKS or a certified copy thereof (Sec 3000 Lab C ) Policy No Company FOR A►%K"TO FILL IN JOB O BRESS 7 p J Certified copy is hereby furnished New Residential Bldgs 8 Pools EACH NO FEE r_1 Certified copy is filed with the county building mspec 1 0 2-Family, Sq Ft E — $ LOCALITY tion department Multi-family Sq Ft — NEAREST CROSS ST Date Applicant Residential Swimming Pools _5WIN-ER OR ,A I FIRM RNAME /�! CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec�Light�Sw+/ IL �r COMPENSATION INSURANCE first 20 ADDRESS O J (This section need not be complafad if the work Involved by Total No Additional CITY e ' Tel No Q the p.rroff I.for one hundred dollars({100)or lass) CK CHECHE I certify that in ,he performance of the work for which this' PLAN PLANAPPL permit is issued, I shall not employ any person m nor Lighting Futures First 20 so as to become subject to the Workers Com s 9 9 ADDRESS • Additional CITY Tel No Dote—Applicant Total No NOTICE TO APPLICANT If after m ertificate of Fixed Appliances Not Over I HP PERMIT Exemption, you should become subject to the Workers Range— Heater—DW _ APPLICATI Compensation provisions of the Labor Code, you must forth Oven — Dryer _W M _ ADDRESS with comply with such provisions or this permit shall be Top — FAU —W H — deemed revoked Hood — Fan —Other_ - CITY Ap=Z1,, a Tel No LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 Div — Room Air Cond JL LICENSE(JR REG NUMBER s7 Clan e r (commencing with Section 7000)of Division 3 of the Business Power Apparatus&Large Appliances DISTRICT NO PROCESSED BY Y and Professions Code and my license is in full farce and effect d Size 8 Type HP, KW, KVA or KVAR L O License Number Uc Close U Up e 1 Incl FINAL —7 a Over I to 10 Ind D'4� !/JU'a' (� V ATION Cr Contractor to Over 10 to 50 Incl FINAL O I am exempt un er Sec Over 50 to 100 Inc gy W B 8P C for this reason Over 100 Il Dote Ser Swbd MCC& Panel_boards Z 0-200 Am U _ Signature 201 - 10 Amp Under 600 V ❑ Exemption for Reg Moint Elect Over 1000 Amp or Over 600 V 2 9 9 7,7f-) SINGLE FAMILY Tem Power Pole 8 Appurtenances ppurtenances . • . .` HOME OWNER BUILDER DECLARATION # \!Z I hereby offirm that I am exempt from the Contractor s License Sign with One Branch Circuit -1 Low for the following reason (Section 7031 5 Business and Additional Sign Branch Circuits I • • ••$vim Professions Code) \.��j 426 I, as owner of the property will do the work and the Misc Conduits&Conductors • • � V structure is not intended or offered for sale(Section 7044 Other (See Complete Fee ScheduledPoo. 0 624-88 Business and Professions Code) CONSTRUCTION LENDING AGENCY I hereby off irm that there is a construction lending agency far the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) �-- - (Sec 3077, C,v C ) Lender PLAN CHECKING FEE f 2 9 7 8'A Lenders Name Address 5 / PERMIT ISSUING FEE - 0 * • 2 S ,2 I certify that 1 have read this application and state that the TOTAL FEE3 2,Jr above information a correct I agree gree to comply with all County ordinances and State laws regulating Electrical wiring and - -- �, • • • 3 iL 2 5 5 hereby authorize UNweseKitat.yes of this County to enter upon the above ne rty for inspection pu SEE REVERSE FOR EXPLANATORY LANGUAGE '� 0 Q 2 4 t 8 8 Sinature ee /'Dot " i �s ' COUNTY OF LOS ANGELES TEMPLE CITY N 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0003210004 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 , PHONE (626) 285-0488 EXT LEGAL ID FEES PAID BUILDING ADDRESS ON FILE 5075 SERENO DR ASSESSOR INFORMATION NUMBER FEE DESCRIPTION QUANTITY LION AMOUNT TEMP CA 917803038 5388-017-027NEAREST CROSS STREET ENCINITA Al PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID H5 LOCALITY TEMPLE CITY G1 OUTLETS-LGT,SW,RECP 64 00 OUT 98 40 TENANT G2 LIGHTING FIXTURES 27 00 LIST 48 45 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON TOTAL FEES 174 60 03/21/00 UT 09/17/00 OWNER COOLMAN MARY GTrWK=E CODE (626) 286-0704- 5077 SERENO DR 4 24 260 TEMP 917803038 OF WORK I i ELECTRICAL FOR INTERIOR REMODEL APPLICANT SAME AS OWNERCONTRACTOR - SPECIAL CONDITIONS 5 PNGELES c0 SAME AS OWNER - �� ONAPPROVALS DATE INSPECTOR SIGNATURE Ty LIC NO TEMPORARY POWER POLE UWDERGROUND CONDUIT ARCHITECT OR ENGINEER ILL NU UFER GROUND LIC NO// 1111111ROUGH CONDUIT III((('""jjj■�� ROUGH WIRINGLINE l L bO PUBLIC WORKS PLASTIC YIN METAL YIN UTILITY COMPANY NOTITM In y iN04. '4N,_ w 141— ServNce fh2kk REPORT ID DPR265 ROUTE TO BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0104250010 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT: LEGAL ID FEES PAID BUILDING ADDRESS ON FILE 5075 SERENO DR FEE DESCRIPTION QUANTITY LIN AMOUNT TEMP CA 917803038 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET ENCINITA 5388.017-027 Al PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID H5 LOCALITY TEMPLE CITY LB 200 AMP PANELS, MCC 1 00 PAN 38 85 TENANT TOTAL FEES 66 60 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON 04/25/01 UT 10/22/01 OWNER TEL NU FIRA DATE CODE COOLMAM MARY G (626) 286.0704- ZQ- 2.UU I 5077 SERENO DR I TEMP 917803038ULI NEN 200 AMP SERVICE P EL APPLICANT TEL NO SAME AS OWNERCONTRACTOR TEL NO - SPECIAL CONDITIONS 9 PNGELES CO APPROVALS DATE IN9TE16FTrffUT0ffF-- SAME AS OWNER LIC NO TEMPORARY POWER POLE UNDERGROUND CONDUIT I LL NUI' I LIC NO '1171111 ROUGH WIRING FIIA'JJJ'FF-(FLLLFIUB" L�G VV0S PLASTIC Y/M METAL Y/N UTILITY COMP-96MM $ «a(Ii I / A Li ��®0 Service That i REPORT ID DPR265 ROUTE TO BS0508