HomeMy Public PortalAbout9743 VAL ST_Electrical__ Te Aea3A-CES06A 4/72 APPLICATION �F& ELECTRICAL PERMIT L.1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEERBUILDING
BUILDING AND SAFETY DIVISION ADDRESS
LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST O
OUTLETS NO EACH FE OWNER A
RECEPT S S `
MAIL
LIGHT� TOTAL
FIRST 20 ADDR 5
S WITCH,LOVER 20 CITY TEL N
,` PLAN HECK
LIGHTING 1 TOTAL FIRST 20 APPLICANT
)y
FI%TURES
OVER 20 ADDRESS
RESIDENTIAL APPLIANCES CITY TEL NO
PERMIT
RANGE DRYER WTR HTR APPLICANT
STA COOKDISP F A U ADORES
SPACE HTR AIR COND Cl Ty TEL NO IF
CLOTHES WASH DISHWASH LICENSE NO
FANOTHER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE I! CORRECT AND AGREE TO COMPLY O
MOTOR! TRANSFORMERS RATING WITH ALL COUNTY ORDINANCE! ANO !TATE LAWS REGULATING CJ
IND HEATER! CTC XP KW KVA ELECTRICAL WIRING
SIZE ! TYPE OVER TO 02
HERESY CERTIFY THAT I AM PROPERLY RE913TEREO ANOA)R 02
F
0 — 1 LICENSED AS RESY G! ANGELES COUNTY AND STATETE OF
CALIFORNIA OR THAT H1T I E LE04L OWNER ❑ NO TO
I — 10 RESIDE IN THE A OESCRIE S A
x
10 — 50 SIGNATURE `
OF PERMITTEE
50 — 100
DIlrR cT NO cLAes 20KE RO eaaE ev
100 — 500 Cc4T
SIGN GAS I SIGN AND ONE CIRCUIT NOTES
TUBE OR
MARQUEE ADDITIONAL CIRCUITS
SERVICE NOTOVER 600 VOLTS OR 200AMP
APPROVALS DATE INSPECl01Y!SIGINIDRE
SERVI CE OVER 600 VOLTS OR 200 AMP
TEMP POWER POLE
TEMP SERVICE,POLE 8 APPURTENANCES
UNDERSLAB WORK
TEMP LIGHT OR RECEPT SYSTEM
ROUGH CONDIUT
WIRING
FIXTURES
POWER AUTHORIZED
PERMIT FEE (SUB TOTAL)
UTILITY CO NOTIFIED
PLAN CHECK FEE 77'�
.�\ FINAL
PERMIT ISSUING FEE V
TOTAL FEE �
PLAN CHECK VALIDATION CK M o CASH PERMIT VALIDATION cK M o CASH
8 3 6nNOV 20 2 D 1 1.7 0 enc
r�
7eAeee4 .ae)anal APPLICATION FOR ELECTRICAL PERMIT` _
COUNTY OF LOS ANGELESQp BUILDING AND SAFETY
FOR APPLICANTTO FILL IN ADDRESS
New Residential Bldgs &Pools EACH NO FEE
1 &2 Family Sq Ft E 025 — S LOCALITY
Multi family Sq Ft 02 — NEARS
T
Residential Swimming Pools WN R R +
2500
Outlets Rec Light�Sw i, FIRM NAM
MAIL
First 20 50 ADDRESS
Total No Additional 30 CITY If Tel No
PLANCHK
APPLI AN
Lighting Fixtures First 20 50 ADDRESS
Additional 30 _
Total No CITY Tel No
Fixed Appliances Not Over 1 HP / APPLICANT
Range—Heater. D W ADDRESS Qps
Oven_Dryer_W M— r
Top FAU —W H CITY Tel No
HoodFan —Other— LICENSE OR
Drsp Room Air Cond 250 _ REG NUMBER Zl'G C-/ ClassG�Q
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA
Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE 15 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
Over 1 to 10 Incl 5 00 LICENSED AS REOUI RED Y LOS ANGELES COUNTY AND STATE OF V
Over 10 to 50 Ind
1250 CALIFORNIA OR TH AM THE EGAL OW ER F THE ABOVE V8
Over 50 to 100 Inc 25 00 DESCRIBED RE51 E L PROPS
40 00 PERMITEE
Over 100 SIGNATU
Services DISTRICT NO •- ED B
0 200 Amp Under 600V 1250 a Q_
201 1000 Amp Under 600 V 2500 O
Over 1000 Amp or Over 600 V 5000 t /�
Temp Power Pole&Appurtenances 1000 i
Sign with One Branch Circuit 1000
Additional Sign Branch Circuits 200 INSPECTION ��4[
Mnc Conduits&Conductors 1000 INFORMATION tL'
Other ISee Complete Fee Schedule)_ ON REVERSE
SIDE _ 22960A
q . . . . . 2
PERMIT FEE (Sub Totall # ° ° ° ° ° 2
PLAN CHECKING FEE IOne Fourth Permit Fee) O 2° ° 2 Q 0 0
F
PERMIT ISSUING FEE $7 00 70 ° ° - 2 Q 005
TOTAL FEE �2d Q > 02 2.7—7 9
INSPECTION///FFFINALED
date :/ / By 7QQQ eQ"5�' ®s
COIINTT OF LOS ANGEM APPLICATION FOR PEnIIT
D N OF COMM Er
DISIOO BUILDING 6 SAFY
WUIMM 1. FOX SRGINEM
ELECTRIC 1
FOR APPLICANT TO FILL-IN DISTRICT NOGROUP ZONEJA
MIT NO
ELECTRICIAN d
ADDRESS RECEIVED BY READY FOR
FIRST INSPECTION ��
CITY TEL NO
COUNTY LI N R SUI%%NGVol
I FM ADDRESS
FEE
NUMBER EACH LOCALITY
LIGHT OUTLETS
Z RECEPTACLxs 4 /N
WALL SWITCHES OWNER
TOTAL OUTLETS M
MAIL
6LHC RANGES IIO ADORERS I
^,
ELEC NEATSRS IIB CITY15F ' _ TEL NO 0 ID
FIXTURES 3 S
MSC 1 HEREBY ACKNOWLS THAT 1 HAVE READ THIS
NUMBER OF LIGHT CIRCUITS APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINAN
NUMBER AND STATE LAWS REGULATING ELECTRICAL WIRING
MOTORS 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID
Nu xORSEPOWER FEE ANGELES COUNTY LICENSE OR 1 AM THE LEGAL OWN
NRW Mvo HP, 0Y111 INa m" OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE
_ F:500
1 IIS SIGNATURE OF
va SO PERM
s 1 00 INSPECTION RECORD
S 1 SO
1S 1 BO
SO S o0
100 1000 J
500 1500
z
OVER 1000 20 00
M O 8irr/FRKQ CHANOSR-HP a'
WIELDERS AC-KVA 0
GENERATORS-KW
TRANSFORMERS-KVA
TAMP Y 7 of oma
MOVED MOTORS 7 of omo
SC
SIGNS
NO NO TRANS AMOVALS
FOR CX PERMIT. DATE INSPECTOR'S NAME
WIRING 111 00 CONDUIT
FIXTURES $100 O WIRING
SUPPLEMENTARY SO FIXTURES
POWER
TOTAL FEE S 3 UTILITY CO NOTIFIED
-r� l
TRA RA a M 4111
s •- • WORKERS COMPENSATION DECLARATION 7aAae3 10/81
I heraby affirm that I him a certificate of consent to self CE G APPLICATION FOR ELECTRICAL PERMIT
or a certificate of Workers Compensation hmurence or a cartded COUNTY OF LOS ANGELES BUILDING AND SAFETY
w1ry thereof(Sec 3800 Lab C)
Policy No Company 8/1476 C FOR APPLICANT TO FaL IN JOB
❑
Certified copy Is hereby fumIshed New Residential Bklpa d Pods EACH NO FEE ADDNESS
Cf 7113 VA
Certified copy Is filed vwth the county building inspection 1 8 2-Famiy So Ft S — S LOCA M E L g, C 1 r
department Muth-famly Sq Ft
Date Residential Swimming Pods O L fl 6^� 1.t�6
AODtic�t FIRM NAA% SER 4-ro
CERTIFICATE OF EXEMPRON FROM WORKERS Q ktAl
COMPENSATION INSURANCE Outlets Res L7--- Light Sw �faf A�� 7
(This secten need not be completed If the work Imrdhed by the First 20 W
permh In for oro hundred dollars($700)pT baa) Total No Additional CTS 6 AI Tel No
I certify that In the performance of the work for which this permit PLAN CHECK
e Issued I $hall not employ arty person in any mariner so as to APPUCFNT
becorre sublet to the Workers Corrpereatgn Laws Lghtirg Fixtures First 20 ADDRESS
Date Applicant Taal No _26— Additional CfTV Tel No
NOTICE TO APPLICANT If after maknp the Certificate of Fused Appliances Not Ower 1 HP PERAQT
Fsempton You Should become subject to the Workers Compensation Range_ Heater_ DW _ APPLICANT �^•��y CONST
prowaione of the LBbor Cade you moat forthwith comply, with such Cu9n _ Dryer _ W M _ ADDRESS 8b
provisens or this permit shall be deemed revoked Top _ FAU _ WH
LICENSED CONTRACTORS DECLARATION Flood — Fen _ Other_ CITY O$ N AD Tel Nc3W6q3rC
I hereby affirm that I am kcaread under proeienrn of Chapter 8 Dtsp _ Flom Air Cord LICENSE OR
(commencing Yeth Section 7000)of DNIsnn 3 of the Business and REG NUMBER Cw$$
Professors,Code and my license is m full force and effect Wier Apparel=d Large Appliances DISTRICT NOPROCESSED BY
Size 8 Type FfP KW KVA,or KVAR [
I-icense Nianbar36 0O L 7 L,c Class�J'� (((}}}
Up to , Incl � �
t /"J� /T_ o'.er 1 m 10 Ind
Con rncro(w-+f I w�f/tT Data.-.I 46Z Over 10 to 50 Ind
❑ I am exempt uncor Sec Over 50 to 100 Inc BY BV
86PC for this reason Over 100 iut
p icy N
;91d
tp_200 Arra Under 600 VV
Sioriature >c d 201 - 1000 Amp Under 600 V
Cher 1000 Amp or Over 600 v 1,• • 3 0 0 0
❑ Exemplon forRep Maim Elect 1 • • *3 (1000
SINGLE FAMLY Temp Waver Pte d
HOME OWNER-BUILDER DECLARA11ON h Cwcuxucud rarcae
Sign with Ore Branch Z 1 2-8 8
I hereby affirm that I am exempt from the Cmtraclors License Law
for the Worming reason(Section 7031 5 Busnass and Profession Adtldiomal Sign Branch Circuits '
Coda)
Mac Conduits s Conductors
I as owner of the property mildo the work and the structure Other(See Complete Fee Schedule)
a rot intended or offered far eels (Becton 7044 Biaup$$ ►
and Professions Coda)
CONS-MUCTION LEN024G AGENCY
I hereby affirm that there IS a constnncticn lending agency, for the
performance of the work for which this permit M Issued(Sec 3087
CN C) PERMR FEE - (Sub-Total)
PLAN CHECKING FEE
Lenders Name
PERMIT ISSUING FEE
Lenders Address
I certify that I him read this application and sate that the above TOTAL FEE '
information Is correct I agree to comply with all County ordinances
and State laws regulating Electrical winrg, and hereby authorize
repraaenlatnes of the County to enter upon the abohe-mentioned
property for Inspection purposes
Q, ? /� ��•� SEE REVERSE FOR EXPLANATORY LANGUAGE
I-ClIghature of W see pate
WfMn that
Ihave COMPENSATION DECLARATION toofconsent
�toWw3,� APPLICATION FOR ELECTRICAL PERMIT O
I hereby of(Mn shot I have a certificate of consem to self ��
,Ttsure or a certificate of Workers Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS
ur a certified copy thereof (Sec 3800, Lob C )
Poli No ffCom n �,,77)�a PMO ,,s
Polity Pa Y FOR APPLICANT 70 FILL C ADDRESS 7(1 V/`L
❑Certified copy is hereby furnished New Residential Bldgs 8 Pools EACH NO FEE
®Certified copy is filed with the county building inspec- 1 8 2-Family Sq Ft $ — $ LOCALITY T"
tion department J_- Mulls-family Sq Ft — NEAREST
Dote. 1.2-11s-91 RUs"ell $ K" Residential Swimming Pools CROSSST v61clrw
Applicant VS CV114ERO
{'' 7 FIRM NAME M RS t Ie L,16
CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec Ltghtg'4-Sw(z� MAIL
COMPENSATION INSURANCE �9 First 20 O ADDRESS tss tr
(This saidlon need not be completed If the work Involved by Total No J_ Additional CITY Tel No
the permit Is for one hundred dollars ($100)or Ins) PIAN CHECK
I certify that in he performance of the work for which this L' PLAN A E
permit is issued I shall not employ any person in any manner J
so as to become subject to the Workers'Compensation Laws Lighting Fixtures First 20 ADDRESS
Total No Additional CITY Tel No
Date—Applicant Fixed Appliances Not Over I HP PERMIT
the Wo
NOTICE TO APPLICANT If, after making ilia to of Range— Heater—DW _ APPLICATION
you should become subject to the Workers' 9
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 — Fon —Other
�a_, CITY Tel No
LICENSED CONTRACTORS DECLARATION D,sp — Room Air Cond LICENSE OR Class
I hereby affirm that I am licensed under provisions of Chapter 9 REG NUMBER
(commencing with Section 7000)of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRI1,JO �/ SSED Y >_and Professions Code,and my license is in full force and effect 5 L/ 0.
License Number .S31 L�8 Uc Class Size 8 Type HP, KW KVA or KVAR o 0
Up to I Incl FINAL 0
R�Ss6N1 s Kalaus II Over 1 to 10 Ind Contractor Date Over 10 to 50 Incl GATE \ VALIDATION 0
❑ I am exempt under Sec Over 50 to 100 Inc BYE LU
B 8P C for this reason Over 100 X L 0.
Dote Services Swbd, MCC 8 Panelboardsr � 00 00 Z
0-2(10 Amp Under 600 V V
Signature 201 - ]ODD Amp Under 600 V
❑
Exemption for Reg MoOver 1000 Amp or Over 600 V
Moms Elect
SINGLE FAMILY Temp Power Pole 8 Appurtenances 2
HOME OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit ACCT.A
Law for the following reason (Section 7031 5, Business and Additional Sign Branch Circuits 63.50
Professions Code)
❑ I, as owner of theproperty,
will do the work and the Mix Conduits 8 Conductors 1 ITEMS
Other See Complete Fee Schedule Pilo
structure a not intended or offered for sole(Section 704A, ( P )— TOTAL 63.50
Business and Professions Coda)
CONSTRUCTION LENDING AGENCY UECK 63.50
I hereby affirm that there a a construction lending agency for OVINE .00
(Sac
performance of the work for which this permit is issued PERMIT FEE (Sub-Total)
(Sec 3097, Civ C )
Lender's Name PLAN CHECKING FEE ODDD-0001 DJI II89
PERMIT ISSUING FEE 7406 1 AM 8:57
Lenders Address 5
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 jaws regulating Electrical wiring, and
hereby authorize representatives of this County to enter upon
the abo�ve m�e�n�tioned property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE
ab
Signature of Permittee Date ms
COUNTY OF LOS ANGELES TEMPLE CITY k 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0001060017
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID BUILDING ADDRESS
TR 100000011783 LT 001 9743 VAL ST
FEE DESCRIPTION QUANTITY LION AMOUNT TEMP CA 91780
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET GOLDEN WEST
Al PERMIT ISSUANCE FEE 27 75 THOMAS PAGE GRID LOCALITY TEMPLECITY
G1 OUTLETS-LGT,SW,RECP 14 00 OUT 27 30
TENANT G2 LIGHTING FIXTURES 5 00 LGT 9 75 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON
H2 RES GRBG DISP LT 3HP 2 00 DIS 21 90 01/06/00 UT 07/04/00
TOTAL FEES 86 70
OWNER TEL NO TrUF DA BY CODE
SERUTO, NANCY (626) 447-5910-
9743 VAL STREET
TEMPLE CITY, CA DESCRIPTION OF WORK
UPGRADE KITCHEN ELECTRICAL OUTLETS/SWITCHES/LIGHTS
APPLICANT- TEL NO
SAME AS OWNER -
SPECIAL CONDITIONS
CONTRACTORSOS PNGELES Co APPROVALS DATE INSnTTM-flT0T9ffE—
SAME AS OWNER -
LIC NO TEMPORARY POWER POLE
UNDERGROUND MMUrr—
LIC NO/� '1111111ROIJGH CONDUIT
"`)))x...111'---'����... ,� ROUGH WIRING
PMAIN WATER LINE
LASTIC Y/N METAL Y/N
0
t
Service Tha
REPORT ID DPR265 ROUTE TO BS0508
COUNTY OF LOS ANGELES TEMPLE CITY 0 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS EL 0508 9708260024
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA DUPLICATE
PHONE (818) 285-0488 EXT.
LEGAL ID: FEES PAID BUILDTNG ADDRESS:
BK 16867 PG PC- 9743 VAL ST
FEE DESCRIPTION QUANTITY UOM: AMOUNT- TEMP CA 91780
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET:
Al PERMIT ISSUANCE FEE 27 75 THOMAS PAGE GRID LOCALITY TEMPLE
G1 OUTLETS-LGT,SW,RECP 14.00 OUT 27 30
TENANT G2 LIGHTING FIXTURES 5 00 LGT 9.75 .
TOTAL FEES 64 80 08/26/97 UT 08/26/98
OIAER TEL NO FINAL DATE CODE
SERUTO NANCY L (626) BORED-
9743 UL ST
TEMPLE CITY, CA DESCRIPTION OF WORK
UPGRADE ELECTRICAL FOR EXISTING GARAGE
APPLICANT No
SAME AS OWNER -
SPECIAL CONDITIONS
CONTRACTOR TEL NO APPROVALS ____UTE
&ELES CoCi
SAME AS OWNER -
LIC NO {/ ATEMPORARY POWER POLE
ARCHITECT OR ENGINEER TEL NO UFER GROUND
LIC NO ROUGH CONDUIT
'(
n �
PUBLIC WORKS -29
PLASTIC Y/N METAL Y/N
D
UTILITY COMPANY NOTI
I i� co
REPORT 10 DPR265 ROUTE T0: BSD508