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Home My Public Portal About5132 TEMPLE CITY BLVD_Electrical__ 711 Fe eoe level APPLICATION FOR R ELECTRICAL PERMIT COUNTY OF LOS ANGELES8g BUILDING AND SAFETY PCANT �j FOR APLITO FILL IN ADDRESS �]• New Residential Bldgs &Pools EACH NO FEE 1 &2 Family Sq Ft E 025 — S LOCALITY Multi family Sq Ft 02 — I —NEAREST T Residential Swimming Pools 2500 CROWNER OR FIRM NAME _ L Outlets Rec—Light_Sw _ MAIL First 20 50 ADDRESS Total No Additional 30 CITY _ Tel No PLAN CHECK APPLICANT Lighting Fixtures First 20 So ADDRESS Additional 30 _ Tonal No CITY Tel No.. Fixed Appliances Not Over 1 HP PERMIT Range_Heater_D W APPLICANT Oven—Dryer_W M_ ADDRESS - Top _FAU — WH _ CITY Tel No Hood_Fan —Other— _ LICENSE OR Disp _Room Air Cond „� 2 50 REG NUMBER Class I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA Power Apparatus&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 2 50 REGULATING ELECTRICAL WIRING Up to 1 Incl - I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR O Over 1 to 10 Incl 5 00 LICENSED ASR V LOS ANG ES COUNTY AND STATE OF d Over 10 to 50 Ind 1250 CALIFORNIA O HA AL OWNER OF THE ABOVE O Over 50 to 100 Inc 25 DO DESCRIBED RES E TIAL PROPER — ` Over 100 - 4000 - PERMITEE 11�LLj SIGNATUR Services12 50 I DISTRICT NO D P 8 0 200 Amp Under 600 V u. 20) 1000 Amp Under 600 V 2500 Over 1000 Amp or Over 600 V 500 Temp Power Pole&Appurtenances 1000 t Sign with One Branch Crcmt 1000 G Additional Sign Branch Circuits 200 INSPECTION > , INFORMATION M 0 on Mnc Conduits&Conductors ON REVERSE = 31 6 5 3 A Other(See Complete Fee Schedule)_ SIDE _ # e e e e.e 'Z 11 2 . . . 9,50 PERMIT FEE (Sub Total] e e e 99.500 PLAN CHECKING FEE (One Fourth Permit Feel p 1 206-78 PERMIT ISSUING FEE $700 70 TOTAL FEE > INSPECTION F ALED dateS!/�� 7 y Q%L-4 ✓�� ®s 711 CC e0e" II APPLICATION FOR ELECTRICAL PERMIT �COUNTY OF LOS ANGELES Jp DEPARTMENT OF COUNTY ENGINEER ADDRE E' BUILDING D AF DI L410N FOR PPL ANTTO FILL IN LOCALITY New Residential Bldgs 8 Pools EACH NO FEE NEAREST 1 &2 Family Sq Ft $ 025 — $ ST SAX ER OR Multi famJ WN y Sq Ft 02 — FIRM NAME Residential Swimming Pools 25 00 MAIL O ADDRESS Outlets RecLi—Light // Sw CITY Tel No First 20 50 PLAN LHELIiTotal No - Additional —30 - - — -APPLICANT ADDRESS Lighting Fixtures First 20 50 16D CITY Tel No Total No Additional 30 PERMIT III APPLICANT Fixed Applionces Not Over 1 HP ADDRESS Range.Heater—D W — CITY Tel No Oven_Dryer_W M_ LICENSE OR Top —FAU _WH _ REG NUMBER Class Hood—Fan _Other_ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APRICATION AND STATE Dlsp — Room Au Cond 250 CHAT THE ABOVE IS CORRECT AND AWEE TO COMPLY VATH ALL COUNTY ORON ANCES ANDSTATE LAWS RESU 7114(3 RERRICAL WIRING Power Appormus 6 Large Appliances Size b Type HP KW KVA or KVAR I HEREBY CERTIFY THAT I AM PImPERLY REGSTERED AND/OR LICENSED AS REOLIIRED BY LOS ANGELES COLNTYCALIFORNIAND STATE OF CALIFOROR THAT 1 AM Up 1IDC 250 THE LEGAL OWNER BOV DRESIDENTIALPROPERTY Overr 1 to 10 Incl 500 Over 10 to 50 Ind 1250 PERMITTEE Rr Over 50 to 100 Inc 2500 SIGNATUREF CD Over 100 4000 DISTRICT NO PROA93ED BY Servu08es r = 0 200 Amp Under 600V 1250 APPROVALS DATE IMulf TORE 201 1000 Amp Under 600 V 2500 Over 1000 Amp or Over 600 V 5000 TEMP POWER POLE UNDERSLAB WORK Temp Power Pole 8 Appurtenarces 1000 Sign with One Branch Circuit ROUGH CONDUIT r<uit 2� Additional Sign Branch Circurts WIRING Misc Conduits B Conductors 1000 FIXTURES Other(See Complete Fee Schedule, POWER AUTHORIZED UTILITY CO NOTIFIED FINAL 3� !/ PERMIT FEE (Sub Totoll NOTES PLAN CHECKING FEE (One Fourth Permit Feel PERMIT ISSUING FEE V 00 r TOTAL FEE PLAN CHECK VAUDATION CK M0 CASH PSLWT VALIDATION CK M O ! ion 2 7 6 AUG 14 2 9.0 0 A_kb SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE TION WORKERS't I have a certificate of corse 'pamt.�wTri APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a cenrficate of consent to self a Insure or a certificate of Workers Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certified copy thereof (Sec 3800 Lob C ) r Poliy No Company FOR APPLIU Policy NT TO FILL IN E]Certified copy in hereby furnished New Residential BldgsADDRESS 8 Pools EACH NO FEE lV Certified copy is filed with the county budding mspec 1 8 2-Family, Sq Ft S — $ LOCALITY tion department Multi family Sq Ft — NEAREST Residential Swimming Pools CROSS ST �Ov SfJ� Dote Applicant OWNER �/ FIRM NAME LAIC ' CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec-i_Light-tSw 1 111. COMPENSATION INSURANCE ADDRESS QAO _ — __ __ (This section need not be completed R the Involved by= =Total No � -—Additional First 20_._ -- - CITY _- - Tel No e p — —- thrnh Is for one hundred dollars ($100)or Ip s ) PLAN CHECK I certify that in the performance of the work for which this APPLICANT permit is Issued I shall not employ any person in any manner r to as to become subject to the Workers'Compensation Laws Lighting Fixtures First 20 ADDRESS ��TT�''�� _ Dote?_ / _ � Appllcont,� SIK fm, Additional Total No CITY T Fixed Appliances Not Over I HPPERMIT NOTICE TO APPLICANT If, after making this Certificate of Exemption, you should become subject to the Workers' Range_ Heoter—DW _ APPLICATION Compensation provisions of the Labor Code, you must forth Oven _ Dryer —W M — ADDRESS with comply with such provisions or this permit shall be T — FAU _WH — deemed revokedHood F �'�/Other_ ITY Tel No LICENSED CONTRACTORS DECLARATION RSo�or Cord NSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Dltp REG NUMBER Class (commencing with Section 7000)of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NO PROLE D BV >-- and Professions Code and my license Is In full force and effect /� d Size 8 Type HP, KW KVA or KVAR V 0 License Number Lic ClassUp to 1 Inc[ FINAL Over 1 to 10 Ind DAA V DATION Contractor rate 0 ❑ - Over 10 to 50 Incl FI F- I am exempt under Sec Over 50 to 100 Inc B 0 B 8P C for this reason i Over 100 N Dote Services Swbd , MCC 8 Ponelboards Z 0 200 Amp Under 600 V — Signature 201 1000 Amp Under 600V El Exemption for Reg Maint Elect Over 1000 Amp or Over 600 V SINGLE FAMILY Temp Power Pole 8 Appurtenances HOME OWNER-BUILDER DECLARATION San with One Branch Circuit 2 0 6 Q 7 A I hereby affirm that I am exempt from the Contractors License Low for the following reason (Section 7031 5, Business and Additional Sign Branch Circuits _ # e e e e e 2 Professions Code) El ) • I as owner of the property, will do the work and the Mist Conduits 8 Conductors e 1l 7 00 , structure is not intended or offered for sole(Section 7044 Other (See Complete Fee Schedule)_ 1 • • Business and Professions Code) _ e 7 006 , ) t CONSTRUCTION LENDING AGENCY 0 9 06:-88 I hereby affirm 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 t _ above Information is correct I agree to comply with all County. ordinances and State lows regulating Electrical wiring, and hereby authorize representatives of this County to enter upon the above-menti ed property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE O ms Signoture o rmiIt r