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Home My Public Portal About5152 SERENO DR_Electrical__ APPLICATION FOR ELECTRIC PERMIT COUNTY OF LOS ANGELES ZTELNSO DEPARTMENT OF COUNTY ENGINEER ADDRF� C�/�DBUILDING AND SAFETY DIVISIONJOHN A LAMBIE COUNTY ENOINEERCASSATTD GRIFFIN SUPTOFBUILDING LOCALITYFOR APPLICANT TO FILL IN NEAREST FERb= FEES _I T E Y NUMBKR EACH Fie OWNEROUTLETSMAIL LIGHTS RECEFT BW 2f 10f ADDRESS �' �ti drLIGHTING FIXTURES 10 CI 1KLCC HAND" CLO DRYERS ELECTRICIAN 0 41WATER HEATERS 00 ADDRESSELEC SPACEHTRB DISHWASHERS GARswGE Dleroew wuroCITY STATE WAEH6R1 ETA COOKING UNITE 2E LICENSE NO MOTORS oven INC HP DISTRI O RO P PONE P OGESSE BY O— V. 25 S Q A – V.— 2 fD Drop=jON RECORD 2— 5 100 0— IS 150 to— 00 200 00-200 000 SIGNS NO TRANS NO LAMPS SERVICE O-SOOV 100 SERVICE OVER SOOV 000 MISC WIRING PERMIT 100 06 FIXTURE PERMIT too SUPPLEMENTARY PERMIT 00 TOTAL FEE f Mmov= I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION DATE INEFECTOR E GIONw RE ANO STATE THAT THE ABOVE IG CORRECT AND AGREE TO COMPLY (-DNDUIT WITH ALL COU HTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING WIRING I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LIC ENSDJ AS REQUIRED EY LOe N D STATE OF FIXTURES CALIFORNIA OR THAT 1 AY F THE ABOVE DESCRIBED RESIDENTIAL P POWER SIGNATURE UTILITYCO NOTIFIED QE RMI EE FINAL3 X,PHAPATION ARTHUR C VEIT N SUPERVIGING ELECTRICAL ENGINEER CK (�2380M FM 11 2 A 255 lR 1 • Q Qt WORKERS COMPENSATION DECLARATION 76AW ID,BI CE BOAPPLICATION FOR ELECTRICAL PERMIT aZ I hereby affirm that I have a certificate of consent to self eG ` insure or a certificate of Workers Compensation Insurance COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certdied copy thereof (Sec 3800 Lab C ) Policy No Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished New Residential Bldgs 8 PoolsADDRESS EACH NO FEE r�r — s /7C—J Certified copy is fled with the county building ins 18 Y-Fomdy Sq H y LOCALITY hon d rt ent Multi family Sq Ft — NEAREST Residential Swimming Pools GROSS ST Date Applicant �+�r./ - OWNER OR FIRM NAME R IFICATE OF EXEMPTIO FROM WORKERSMAIL Outlets Rec_Ught_Sw COMPENSATION INSURANCE First 20 ADDRESS (This seceson nood not be completed If the work Inwlvod by Total No Additional CITY NQ the Permit Is for ono hundred dollars($100)or loss) I certify that in the performance of the work for which this PLAN CHECK permit is issued I shall not employ any person in any manner APPLICANT so as to become subject to the Workers Compensation laws Lighting Fixtures First 20 ADDRESS Total No Additional CITY Tel No Date Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT If after making this Certificate of APPLICANT Exemption you should become subject to the Workers Range_ Heater_D W Compensation provisions of the Labor Code you must forth Oven _ Dryer _ W M _ ADDRE with comply with such provisions or this permit shall be deemed revoked Top FAU _W H — CIN r/ I No LICENSED CONTRACTORS DECLARATION Hood _ Fon _ OtherjW — hereby affirm that I am licensed under provisions of Chapter 9 D,sp Room Au CENSE Cond REG NUMBER Class (commencing with Section 7000) of Division 3 of the Business power Apparatus 8 Large Appliances DISTRICT NO PROCE BY r and Professiom Code and my license ism full force and effect /yam O Size 8 Type HP KW KVA, or KVAR License Number /7177 1 Class U Up to 1 Incl L Over 1 to 10 Incl DATE -'� "g VAI ATION Contractor to Over 10 to 50 Incl FI U ❑ I am exempt under Sec Over 501° 100 Inc BY IAI i B 8P C for this reason Over 100 r to Rafe Services, Swbd MCC 8 Panelboords , L 0 -200 Amp Under 600 V ` s Signature _ 201 - 1000 Amp Under 600 V r, Exemption for Reg Maim Elect - Over 1000 Amp or Over 600 V 2 2 Q O A ❑ s ss s s 2 i SINGLE FAMILY Temp Power Pole 8 Appurtenances # HOME OWNER BUILDER DECLARATION Sign with One Branch Circuit ( • * 2S50 I hereby affirm that I am exempt from the Contractor s License Additional Sign Branch Circuits Law far the following reason (Section 7031 5, Business and s s o 2 5 Jr 0 Professions Code) ❑ I, as owner of the property will do the work and the Muc Conduits 8 Conductor - o605-85 structure is not intended or offered for sole (Section Other (See Complete Fee Schedule)_ , 7 7044 Business and Professions Code) " CONSTRUCTION LENDING AGENCY - I hereby affum that there is a construction lending agency for the performance of the work for which this permit is issued PERMIT FEE (Sub Total) - (Sec 3097 Civ C ) PIAN CHECKING FEE - Lender s Name PERMIT ISSUING FEE Lender s Address I certify that I have read this application and state that the TOTAL FEE above information is correct I agree to comply with all County ordinances and State laws regulating Electrical wiring and r hereby authorize representatives of this County to enter upon the above mentioned propert for inspection p r s SEE REVERSE FOR EXPLANATORY LANGUAGE _ Sign lure of Per nee vote ` ^ COUNTY OF LOS ANGELES TEMPLE CITY R 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 IAS TUNAS EL 0508 1401140046 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT LEGAL ID FEES PAID BUILDING ADDRESS ON FILEI 5152 SERENO DR I FEE DESCRIPTION QUANTITY UOM - AMOUNT TEMP CA 917803041 1 ASSESSOR INFORMATION NUMBER I 1 NEAREST CROSS STREET I 15388-011-007 1A1 PERMIT ISSQANCE FEE 127 BO THOMAS PAGE 596 GRID H5 VJCALITY TEMPLE CITY CAI 1 IG1 OUTLETS-Lvt SW RBCk 5 00 OUT 10 00 1 ITENANT H2 RES GRBG DISP LT 3HP 1 00 DIS 11 00 (ISSUED ON PROCBSSeD BY PLAN BY H4 RES RANGE NDS LT 3HP 1 00 HOO 11 00 01/14/14 SR I I I TOTAL FEES 59 80 I I OWNER TEL 4- i IFl�� FIyA�,gY CODE ICHAO, HENRY (626) 614-8665- 1 �i G'�(�(n/ I 15152 SERENO OR 1TEMP 917803041 1 DD7CRIPTION OF WORK 1 1 KITCHEN AND BATHROOM REMODEL, REPLACE OUTLETS GARBAGE IDISPOSAL, AND RANGE HOOD IAPPLICANT TEL NO 1 1CORREA, MANUEL - 1 SPECIAL CONDITIONS I I I CONTRACTOR TEL NO I APPROVALS DATE INSPECTOR SIGNATURE I 1B X D CONSTRUCTION (626) 786-2347- I I 2509 EUCLID CRES E LIC NO TEMPORARY POWER POLE (UPLAND CA 91784 627142 1-1 UNDERGROUND CONDUIT I I I I I (ARCHITECT OR ENGINEER TEL NO I IUFER GROUND I 1 1 LIC NO I IROUGH CONDUIT 1 ROUGH WIRING •T I I I IMAIN WATER LINE V l' IPIASTIC YIN METAL YIN wl (UTILITY COMPANY NOTIFIED( 1 I I I I I 1 I I I I I I I I I I I I I I I I I I 1 I I I I I I I I I I I I 1 IREPORT ID DPR265 ROUTE TO BS0508 I I I I I I