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HomeMy Public PortalAbout6234 SULTANA AVE_Electrical__ APPLICATION FOR ELECTRICAL PERMIT 76AI663-00b�6 8-62 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING / y BUILDING AND SAFETY DIVISION ADDRESS 6 Z JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS_ ST. RECEPT. TOTAL NO. EACH FEE OUTLETS FIRST 20 R.20 � OWNER LIGHT MAIL A DD.'L ADDRESS SWITCH. OVER 20 .10 TY TEL. LIGHTING TOTAL� FIRST 20 .20 CITY ' FIXTURES ADO'L t0 'ELECTRICIAN OV R 20 6 RANGES CLO.DRYERS NRR.HTRS. 1.00 b O 'ADDRESS Q O GARB.DISP. STA.COOK - IV CITY i TEL.NO. DISHWASH. AUTO.-WASH. STATE 2 SPACE HTRB. BTA.APP.(y=H.P.MAX.) .SO LICENSE NO. J MOTORS: OVER NOT OVER H.P. DISTTR CT NO. GROUPZ NE PROCESSED BY O 1 1.00 J` d. _ 1 s 1.50 INSPECTION RECORD 3 8 2.00 x •S is 2.50 1S s0 8.00 so too 5.00 OV SIGNS: NO.TRANS. cc NO.LAMPB bSERVICE 0.600V-NOT OVER 200A 1.00 00 W a SERVICE 0.600V-OVER 200 A. 2.00 V) SERVICE OVER 600V 5.00 ? MISC. PERMIT ISSUING FEE 2.00 UV SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE 6 60 I HEREBY ACKNOWLEDGE THAT'1 HAVE READ THIS APPLI TION - APPROVALS TE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE 18 CORRECT AND AGREE'TO COMPLY CONDUIT WITH ALL-COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING / 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR / J LICENSED AS REQUIREDBY LOS ANG" COU Y AND STATE OF FIXTURES ii CALIFORNIA. OR THAT THE 1. AL E OF' THE ABOVE I DESCRIBED RESIDE P PERTY POWER SIGNATUI OF PERM[R r UTILITY CO.NOTIFIED FINAL ✓V- LIDATION ARTHUR C:VEIT ' CK MO CASHSUPERVISING ELECTRICAL ENGINEER LACO-13 5 7 1Q Am 7 2 D 4.00-, g WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT lJ I hereby affirm that I have'a certificate of consent to self insure, 7BA663 or a certifics4e of Workdr's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. espy thereof(Sec.3800 Lab.C.) Policy No. Company FOR APPLICANT TO FILL IN JOB c ADDRESS ` J J Q v�- Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE LOCALITY 01 te ,Sq.Ft. — $ $ { El Certified &2-Family, Certified copy is filed with the county building inspection _ NEAREST department. Multi-family Sq.Ft. CROSS ST. �� Date Applicant Residential Swimming Pools MAP BOOK"y PARCEL V PAGE O� CERTIFICATE OF EXEMPTION FROM WORKERS' �Light� e3 OWNER OR Outlets:Rec. Sw. FIRM NAME COMPENSATION INSURANCE , d // First 20 MAIL f (This section need not be completed if the work involved by the Total No.� Additional ADDRESS ,23 permit is for one hundred dollars($100)or less.) 611 I certify that in the performance of the work for which this permit CI Tel.No 2961-3963 is issued, I shall not employ any person in any manner so as to PLAN CHECK become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANT Total No. Additional ADDRESS Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: If, after making this Certificate of CITY Tel.No. Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code,you must forthwith comply with such APPLICANT provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances l LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. (commencing with Section 7000)of Division 3 of the Business and CITY Tel.No. Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. LICENSE.OR >- Over 50 to 100 Incl. REG.NUMBER Class. d License Number Lic.Class Over 100 DISTRICT NO. - PR �Y 0 Services,Swbd.,MCC&Panelboards 0-399 Amp.Under 600 V DATE 0 Contractor Date ❑ I am exempt under Sec. 400-1000 Amp.Under 600 V ^� VALIDATION W Over 1000 Amp.or Over 600 V FINAL B.&P:C.for this reason BRANCH CIRCUIT FEES BY � Date: 15A,or 20 120V,Lighting or Recept. Z 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits 41 Or More Branch Circuits ❑ Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits SINGLE FAMILY Temp.Power Pole&Appurtenances A - HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ='= ° I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits _'7L7z SLI.°wr Code): _ I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors er is not intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule) ,!_f}HL q =60 and Professions Code). ® �,}} 11 r..I n - 'y.' i•[r�V�'. tir CONSTRUCTION LENDING AGENCY hereby affirm that there is a construction lending agency for the I,41-1GE performance of the work for which this permit is Issued(Sec. 3097, PERMIT FEE (Sub-Total) Civ.C.) PLAN CHECKING FEE rrijt.t""_lV 1.F1 Je i++ v Lender's Name PERMIT ISSUING FEE -' Lender's Address I certift that I have read this application and under penalty of purjury state TOTAL FEE that the above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring,and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes— SEE REVERSE FOR EXPLANATORY LANGUAGE )!AGI.VVOF PERMITTEE WORKERS'COMPENS.l1TIOlaf DLECLARATION w 764663CE4MG (2-8p; APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to ,Self COUNTY OF LOS ANGELES BUILDING AND SAFETY insure,or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) FOR APPLICANT TO FILL IN JOB h �� � ,;u,_—,;7,,� A � Policy No. New Residential Bldgs.&Pools Company i EACH NO. FEE ADDRESS i�7 U_ Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ — $ LOCALITY 1 F_JkAC— ( M, Multi-family Sq. Ft. CROSS ST L (J�(j {V ' 1Z Certified copy is filed with the county building inspection Residential Swimming Pools n�` , l t� department. OWNER IRM NAME�1�iI IV r C) iv1 Date Applicant Outlets: Red—l" Light 10 Sw. g MAIL First 20 ADDRESS UA Fl 1�1 CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. 3Lf Additional aha CITYTM. _ I Tel No.� r COMPENSATION INSURANCE I PLAN CHECK a (This section need not be completed if the work involved APPLICANT O by the permit is for one hundred dollars ($100) or less.) Lighting Fixtures First First 20 ADDRESS V Total No. �� _ Additional X I certify that in the performance of the work for which thisI CITY Tel No. O Fixed Appliances Not Over 1 HP V permit is issued, I shall not employ any person in any manner PERMIT so as to become subject to the Workers'Compensation Laws. Range_Heater D.W. _ APPLICANT ILW Oven _ Dryer_W.M._ ADDRESS U) Date Applicant Top _ FAU _W.H.,_ Hood — Fan _Other_ CITY Tel No. NOTICE TO APPLICANT: If, after making this Certificate of I Disp. _Room Air Cond— LICENSE OR. Exemption, you should become subject to the Workers' REG.NUMBER Class Compensation provisions of the Labor Code, you must forth- Power Apparatus&Large Appliances DISTRICT NO. PRO CES 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. FINAL Over 1 to 10 Incl. DATE / / / VALIDATION LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl. S� r` 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 r��'✓•%�L ness and Professions Code, and my license is in full force and effect. Services License Number Lic.Class 0-200 Amp.Under 600 V 201-1000 Amp.Under 600 V Contractor Date 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 License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits nese and Professions Code): ' Misc.Conduits&Conductors © I, as owner of the property, will do the work and the Other(See Complete Fee Schedule)— structure is not intended or offered for sale (Section 7044,Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency 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 TOTAL FEE above information is correct.I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize representatives of this.County to enter upon the above-mentiony pl�opA�erty for inspection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE Sf ature of Permittee Date V • ' WORKER'S COMPENSATION DECLARATION 200019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT lJ 76A663 I herebli'affirmu that I�have'a certificate of consent to self insure, or or certificase•of,Work€r's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec.3800 Lab.C.) P❑blicy No. Company FOR APPLICANT TO FILL INADr DRESS rJ Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE' LOCALITY 4 ❑. 'Certified copy is filed with the county building'inspection ;.1&2-Family,Sq.Ft. _ $ $ NEAREST department. Multi-family Sq.Ft. CROSS ST. Date Applicant Residential Swimming Pools I'M AP go0K PARCEL 2 3 PAGE OC) CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec.�Light J Sw.� n RM NAME COMPENSATION INSURANCE, , Lle // First 20 MAIL (This section need not be completed If the work Involved by the Total No. Additional ADDREss �,3 L . Sul 11� permit Is for one hundred dollars($700)or less.) 9 I certify that in the performance of the work for which this permit CI Tel.No -39-63 is issued, I shall not employ any person in any manner so as toI PLAN CHECK become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANT Total No. 3 Additional ADDRESS Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: 14, after making this Certificate of CITY Tet.No. Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code,you must forthwith comply with such PERMIT py LTJ Power Apparatus&Large Appliances APPLICANT provisions or this permit shall be deemed revoked. LICENSED CONTRACTORS DECLARATION Site&Type HP,KW,KVA,or KVAR' ADDRESS I.hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. (commencing with Section 7000) of Division 3 of the Business and CITY Tel.No. Professions Code,and.my license is in full force and effect. I Over 10 to 50 Incl. LICENSE OR } Over 50 to 100 Incl. REG.NUMBER Clsse. D. License Number Lic.Class Over 100 DISTRICT NO. G PR ED BY V Services,Swbd.,MCC&Panelboards •�O ��� Contractor Date { 0-399 Amp.Under 600 V DATE ❑ 400-1000 Amp.Under 600 V *Q VALIDATION V I am exempt under Sec. s Over 1000 Amp.or Over 600 V FINAL LJ.I B.&P.C.for this reasonBY 0. BRANCH CIRCUIT FEES I N Date: 15A,or 20 120V,Lighting or Recept. z 1 To 10 Branch Circuits Signature .1. 1 To 40 Branch Circuits F141 Or More Branch Circuits Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits SINGLE FAMILY Temp.Power Pole&Appurtenances _ HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit K.1f I hereby affirm that I am exempt from the Contractor`s License Law for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits 60.60 Code): Misc.Conduits&Conductors L (`il`r I,as owner of the property,will do the work and the structure .. _ ,� r-F ,, is not intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule) ® I OTAL 60 60 and Professions Code), r ' CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the CHANGEL performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total) Civ.C.) % PLAN CHECKING FEE �f lCf•' LIW'i Lender's Name PERMIT ISSUING FEE f;I j110:1 Lender's Address I certiff that I have read this application and under penalty of puriury state TOTAL FEE ejQ, that the above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring,and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes— SEE REVERSE FOR EXPLANATORY LANGUAGE 2 7T / 49NA R�FPERMITiEE WORKER S'COMPEN$ATIONDECLARATION 76A663'a, . ,.� CEj3-MG (2.8p; APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) FOR APPLICANT TO FILL IN JOB -r��n ' AMA � ,n _ Policy No. Company EACH NO. FEE ADDRESS�J ��I�'��/-SIV AJ- 0 New Residential Bldgs.&Pools Certified copy is hereby furnished. 1 &2-Family.Sq. Ft. $ — $ LOCALITY `✓t C C tT ❑ Multi-family Sq. Ft. CROSS ST �►Vtj N (� 1 Certified copy is filed with the county building inspection Residential Swimming PoolsNER 0 \E ` , l lam! P , department. FIRM NAME'30'r IV U {�/! IvC Date Applicant Outlets: Red-P Light—1U') Sw. � ! MAIL First 20 ADDRESS 6U A A QEL CERTIFICATE OF EXEMPTION FROM WORKERS' Total No.?4 Additional CITYT I . ' I Tel No.,)_ �� COMPENSATION INSURANCE i PLAN CHECK d (This section need not be completed if the work involved Lighting Fixtures First 20 APPLICANT U by the permit is for one hundred dollars ($100) or less.) ��-� Additional ADDRESS I certifythat in the I Total No. L 0 performance of the work for which thisFixed Appliances Not Over 1 HP CITY Tel No. O permit is issued, I shall not employ any person in any manner PERMIT so as to become subject to the Workers'Compensation Laws. Range_Heater D.W._ APPLICANT W Oven _ Dryer_W.M._ ADDRESS to Date Applicant Top _ FAU _W.H.,— Hood _ Fan _Other— CITY Tel No. NOTICE TO APPLICANT: If, after making this Certificate of Disp. —Room Air Cond.— LICENSE OR. Exemption, you should become subject to the Workers' REG.NUMBER Class Compensation provisions of the Labor Code, you must forth- Power Apparatus&Large Appliances DISTRICT NO. PR CESSED BY with comply with such provisions or this permit shall be deemed revoked. Size&Type HP,KW,KVA,or KVAR J57 &� Up to 1 Incl. FINAL LICENSED CONTRACTORS DECLARATION Over 1 to 10 Incl. DATE J/ _fi VALIDATION 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 my license is in full force and effect. Services License Number Lic.Class 0-200 Amp.Under 600 V 201-1000 Amp.Under 600 V Contractor Date 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 License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits ness and Professiond Code): ' . ' Misc.Conduits&Conductors ® I, as owner of the property, will do the work and the Other(See Complete Fee Schedule)— structure is not intended or offered for sale (Section 7044,Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency 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 TOTAL FEE 47 above information is correct.I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize representatives of this.County to enter upon the above-mentioneA soperty for inspectionrposis. SEE'REVERSE FOR EXPLANATORY LANGUAGE Si nture of Permittee Date • COUNTY OF LOSANGELESTEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1210250036 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: 1TR: 5904 LT: 202 UN: .002 6234 SULTANA AV ]FEE DESCRIPTION: QUANTITY: DOM: AMOUNT: TEMP CA 917801553 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: LONGDEN I 5384-007-006 IA1 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY, Cl TENANT: 1G2 LIGHTING FIXTURES 4.00 LGT 8.00 1 TOTAL FEES 35.80 (ISSUED ON: PROCESSED BY: PLAN BY: 110/25/12 SR (OWNER: TEL. NO: ] IFINAL DATE FINAL BY: CODE: I VUONG, LE (818) 285-3863- 6234 SULTANA AV I ld'iv I ITEMP 917801553 I IMSCRIPTION OF WORK v1 (INSTALL 4 LIGHT FIXTURES FOR BATHROOM REMODEL I ]APPLICANT: TEL. NO: I ISAME AS OWNER _ I ISPECIAL CONDITIONS: I I ]CONTRACTOR: ] TEL. N0: I (APPROVALS DATE INSPECTOR SIGNATURE I ISAME AS OWNER - I I LIC. NO I ITEMPORARY POWER POLE 1 I I I II (UNDERGROUND CONDUIT I I I ARCHITECT OR ENGINEER: TEL. NO: JUFER GROUND - I I I I .LIC. NO: I IROUGH CONDUIT I I I I ] I IROUGH WIRING ] I ] IMAIN WATER LINE IPLASTIC YIN METAL YIN I I I 1 I ]UTILITY COMPANY NOTIFIED( ] I ] I I ] I I I ] I I I ] I I I I 1 1 I I I I ] I I I I I I I I I I IREPORT ID: DPR265 ROUTE TO: BS0508 ] I I ] I I I I I