HomeMy Public PortalAbout5454 TEMPLE CITY BLVD_Electrical__ 10N
WRKERS I COMPEh1SATate of consent to CE 80B 10,91 APPLICATION FOR ELECTRICAL PERMIT {�
� I hefe6y Alwih that I heye a certificate of consent to sell insure �srdG IJ
or,a,certificate of Workers Compensation Insurance or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY
copy thereof(Sec 3000 Lab C) A / �/ n A
' Policy No Company t FOR APPLICANT TO FILL M JOB
ODRESS .y�!S4 -"/Ir C��7 rJL✓/,
❑ Certified copy is hereby furnished New Residential Burge 8 Pods EACH NO FEE
❑ Certified copy is filed with the county building inspection 1 8 2-Family Sq Ft $ _ $ LOCALITY it., C
department Multi-farriN Sq Ft lEMEST A,(iyv 5
CROSS ST
Date Applicant
Residential Swimming Pools , ON E CR
_ - -. i� FFiM NAME y4RI'C ST PKERRE
CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec—Light _ Sw MAL 6-4,T -feM LE C/rr7r�
ad.
COMPENSATION INSURANCE ,
- First 20
perm section need net be oomars (S H the work Involved M that' - - - - Cm'�mPLE 1'/TY Tel No 207-/41
permit b for tuna hundred tlolbn(5100)or bee) Total No Additional
I certify that in the performance of the work for which this permit _ PLAN CHECK
APDL CANT
b issued I shall rout emplo� any Dain in erry manner so as t0
became subject to the Workers Compensat in Lewe Lighting Fixtures Fust 20 ADDRESS
Additional
Total No CfTV Tel No
NOTICE TO UC Ile Iter I ekIN this Certificate of Fixed Appliances Not Over 1 HP r �M 0
Exemption you should be ecomsubject to the Workers Compensation Range— Heater— DW —
Provisions of the Labor Code you must forthwith-comply wth such Oven _ Dryer _ W M — ADDRESS
provisions or this permit shot[be deemed revoked Top — FAU — WH —
CITV Tel No
LICENSED CONTRACTORS DECLARATION Hood — Fen Olfter—
I hereby affirm that I am licensed under provisions of Chapter 9 Dap — Room Air Cord GCENSE OR Clem
(commengng with Section 7000) of Division 3 of the Business and REO NUMIeER
Rdessiona Code and my license is In full force and effectpSTRICT NO PROCESSED Y
Power Apparatus 8 Large Appliances c/ ]��J
' Size 8 Type HP KW KVA or KVAR �+ CJ
License Number Lie Class Up to 1 Inxd FINAL
t Over 1 to 10 Incl DA's a Z VAU13ATION p�
Contractor Date Oren 10 to 50 incl
FINAL
ElI em exempt under Sec Over 50 to 100 Inc By µ�
BBPC for this reason Over 100 N
Date Services Swbd MCC 8 Panelboards ►
0-200 Artp Under 000 V
Signature 201 - 1000 Amp Under 000 V
❑ Over 1000 Arrp or Over 000 V i ^
Exempion for Reg Melia Elect ��r1
SINGLE FAMILY Temp Power Pole 8 Appurtenances .7JD7
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 3W
I herelay affirm that I am exempt from the Contraclwa License Lav 3 .50
for the folldwing reason(Section 7031 5 Business and Profeaswna _ Additional Sign Branch Orourts
Code)
r —25.50
- 1lnD
® I ari tinter of the property do the work and the Btruure ,
J � is riot intended Or offered foror olMlsc Conduits 8 Conductors —25.50
7044 Busm (Seeeee Other( ContpWte Fee Schedule) — r ,
and Pmfeasions Code) - VOID
CONSTRUCTION LENDING AGENCY - -
r I hereby affirm that there is a construction IeMag agency for the ITEM5
performance of the work for which this permit a issued(Sec 3097 PERMIT FEE (Sub-T iryL f O d
Cr, C) as
PLAN CHECKING rr . nYy�
L.erdare Name ??? Wet,[
PERMIT ISSUING FEE yF Q _
Larders Address r
.0101
I certify that I have read this application and state that the above TOTAL FEE _ r
information is correct I agree t0 compity with All Courrty trd.—
and State laws regulating Electrical wlnng and hereby suttionze 1 7�6
representatives of this County to enter upon the above-mentioned 9 '� ALL�LL��-��-"""""""""""" -
prope for Ispat ion purpose SEE RE1M1=`,�OR EXPL! A�LA*UAGE 4 8Q2�I
of PamBRea DaI6
CDURTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
V DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS EL 0508 9610280006
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA
PHONE (818) 285-0488 EXT
LEGAL ID. FEES PAID BUILDING ADDRESS
ON FILE 5454 TEMPLE CITY BL
FEE DESCRIPTION QUANTITY LION AMOUNT TEMP CA 917803150
NEAREST CROSS STREET DAIMES
8588-023-024 Al PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID: A4 LOCALITY: TEMPLE CITY
RA FAU LESS 3HP 1.00 FAU 10 80
JB AC LIMITS +3-10HP 1 00 AC 19 65 ISSUED ON PROCESSED BY PLAN BY- EXRWff§lW_
TOTAL FEES 58 20 10/28/96 TC - - - _- - -10/28/97 -
OWNER TEL. NO FINAL DATE �LNAL
ST PIERRE NARK,JEANME M (818) 287-1472- / r�,_/)/_
5454 TEMPLE CITY BL %%!O
TEMP 917803150 UEgEmTf
SAME AS OWNER -
��ul aai�as REPLACE HEATING AND ADD A/C TO SYSTEM
APPLICANT TEL NO'
SPECIAL CONDITIONS
CONTRACTOR: TEL NO APPROVALS DATE INSPECTOR SIMU10ffF__
SAME AS OWNER
LIC -NO (� � Li ITEMPORARY POWER POLE
ARCHITECT OR ENGINEER TEL NO s>iuom oiiend UFER GROUND
LID NO
0111ROUGH WIRING
7MAIN WATER LINE
✓ (�C BLASTIC Y/N METAL Y/N
UTILITY MWANY NOT
REPORT ID DPR265 ROUTE TO BS0508
COUNTY OF LOS ANGELES TEMPLE CITY = 0508 , ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC MORES 9701 LAS TUNAS EL 0508 0609140001
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PRONE (616) 105-0488 EXT
LEGAL ID FEES PAID BUILDING ADDRESS
ON FILE 5454 TEMPLE CITY BL
FER DESCRIPTION QUANTITY VOM AMOUNT TEKP CA 917803150
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET DAIMS
8588-013-014 Al PERMIT ISSUANCE PRE 17 75 THOMAS PAGE 597 GRID A4 LOCALITY TEMPLE CITY C
P1 130V, 15/20A BE CKTS 6 00 BR 103 50
TENANT B1 REB GREG DISP LT 3HP 1 00 DIB ` 10 95 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON
R3 RBB DISHMASER LT 3HP 1 00 DIS 10 95 09/14/06 JR 03/13/07
-- H4 RBB RANGE BOB LT 3HP= - - 1 00-800_ - _ 10 95 - _
OIDIEA TEL HO TOTAL NESE 164 10 tItlfL�DATE/ IN FBY CODE
ST PIERRE MAR[,JBA®LB M (616) 187-1471- IN B
5454 TEMPLE CITY BL
TEMP 917803150
DBBCRIPTIOH OF MOHIC
MIRING 6 CIRCUITS • KITCHEN AREA INSTALL MIRING FOR MALL
PLUGS, LIGHTS, L APPLIANCES INSTALL NEW DEDICATE CIRCUITS
APPLICANT TEL NO FROM (E) PANEL TO KITCHEN AREA _
SAME AS OWNER -
SPECIAL CONDITIONS
CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER -
LIC NO - TEMPORARY POWER POLE
U®ERGROUND CONDUIT
ARCHITECT OR ENGINEER TEL NO OVER GROUND
LIC NO ROOM CONDUIT
ROUGE WIRING
MIN WATER LINE
PLASTIC Y/H METAL Y/N
- - - UTILITY COMPANY NOTIFIED
REPORT ID DPR165 ROOTS TO BSO508