HomeMy Public PortalAbout5436 WELLAND AVE_Electrical__ 791AG63-CESOG'12-58 APPLICATION FOR ELECTRIC PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEERBUILDING
BUILDING AND SAFETY DIVISION ADDRESS 4% We:L3= AV09S.
JOHN A.LAMBIE.CouNTY ENGINEER
CASSATT D.GRIFFIN.SurT OF BUILDING LOCALITY Tem
SU City. Calif
NEAREST L
FOR APPLICANT TO F[LA IN
PFJWT FCROSS sr.
8WW ft-40Y
EES
ITEM NUMBERI EACH I FEE OWNER 161t+DII
MAIL ,522 Hudd t Ste
LIGHTS • ..T. W. $.IO $ ��p��OQL— ADDRESS $
LIGHTING FIXTURES .10 3D CITY Bl XOnt9ji
Ca'l.fTEL.NO.
ELEC.RANGES CLO.DRYERS ELECTRICIA �1— First
y t
WATER HEATERS .50 ADDR��aEss, 2O Wo 1,{rst Sto t `�
ELEC.SPACE HTRS. DISHWASHERS CITYvm11�i D�.mm, TEL.NO. Ed e1 6333
GARBAGE DISPOSERS AUTO.- STATE
WASHERS STA.COOKING UNITS .25 LICENSE NO.
MOTORS: OVER INC. H.P. DISTRIC O. I OROU Z Y
0— V2 .25
1/2— 2 .50 . , INSPECTION RECORD
2— 5 1.00
s— t5 1.50 fa
1s— so 2.50
50-200 5.00
SIGNS: NO.TRANS. -
NO.LAMPS
SERVICE 0-000V 1.00 OQ+ '
SERVICE OVER OOOV 5.00
MISC.
WIRING PERMIT 1.00 1 .OO
FIXTURE PERMIT 1.00 100 _
SUPPLEMENTARY PERMIT .50
TOTAL FEE s 5 APPROVALS
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING ,
n.
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES ' Zfc�'
CALIFORNIA IR THAT 1 A T LEG /OER;7HE ABOVE O
DESCRIBED RESIDENTIAL P 7'Y. POWER
SIGNATUREPERMITTE UTILITY CO.NOTIFIED
OF I� A
FI NAL. 9
�r LIDATION ARTHUR C. T.
SUPERVISING .ELECTRICAL ENGINEER
c/J -MO CASH
6B 6P 98205 `; ji'll1 2 A 8.20
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1306180059
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: FEES PAID I BUILDING ADDRESS: 1
ITR: 10898 LT: 26 BL: B UN: .003 I 1 5436 WELLAND AV 1
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:1 TEMP CA 917803509
ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: DAINES
18573-017-033 [Al PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 597 GRID: D3 LOCALITY: TEMPLE CITY CA
ILA 100 AMP PANELS, MCC 1.00 PAN 38.90
TENANT: I TOTAL FEES 66.70 [ISSUED ON: PROCESSED BY: PLAN BY:
106/18/13 SR
[OWNER: TEL. NO: I IFI Y: CODE: 1
ICHUNG, AMIE (626) 688-6301- I I I
15436 WELLAND AV 1 IFI ��111
ITEMP 917803507 ID9SCRIPTIOS OF WORK
[ I (UPGRADE SERVICE PANEL 100
(APPLICANT: TEL. NO: 1 1 [
IHUANG, YING (626) 696-9910- I I [
12249 HANCOCK ST (SPECIAL CONDITIONS:
ILOS ANGELES 90031
ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE 1
IJAGUAR ELECTRICAL (626) 696-9910- I 1 I
12249 HANCOCK STREET LIC. NO I ITEMPORARY POWER POLE I I I
ILOS ANGELES CA 90031 949859 1 I I
1 IUNDERGROUND CoTU'iT. I I
ARCHITECT OR ENGINEER: TEL. NO: - i JUFER GROUND 1 1
LIC. NO: 1 IROUGH CONDUIT I I
1 i IROUGH WIRING 1 I I
I I IMAIN WATER LINE
I 1 (PLASTIC YIN METAL YIN
I I (UTILITY COMPANY NOTIFI
40
I i I I I I
I 1 I I I
I I I I I
I I I I I I
I
I I I
I I i I
I I I I I
IREPORT ID: DPR265 ROUTE TO: BS0508
WORKERS'COMPENSATION DECLARATION CE-80663
10 51 APPLICATION FOR ELECTRICAL PERMIT
JI hereby affirm that I have a certificate of consent to self insure, -
or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY '
copy thereof(Sec.3800,Lab.C.)
Policy No. Company FOR APPLICANT TO FILL IN JOB //Ady ,/� y/
❑ Certified copy is hereby furnished. EACH NO. FEE ADDRESS (L y 4
New Residential Bldgs.&Pools
❑ Certified copy is filed with the county building inspection 1 &2-Family,Sq.Ft. $ _ $ LOCALITY
department. Multi-family Sq.Ft. NEAREST p�
Residential Swimming Pools' CROSS ST. FRE.
Date Applicant OWNER OR
FIRMNAME ./ •
CERTIFICATEIL
COMPENSATIONI INSURANCE FROM VIiORKERS' Outlets:Rec 2-Light a Sw.C f ! DRESS b E 111 V6AII 16
(This section need not be completed if the work Involved by the First 20 `
Total No. Additional CITY 4 6 Tel.No.
permit is for one hundred dollars($100)or less.) J
I certify that in the performance of the work for which this permit PLAN CHECK
APPLICANT
is issued,•I shall not employ any person in any manner so as to
become subject to the Workers'Compensaticip Laws. ' Lighting Fixtures//�� First 20 ADDRESS
Total No. OC Additional CITY N
Date �'� '- Applicant � � �'+ Fixed Appliances Not Over 1 HP '
NOTICE TO APPLICANT: If, after making this Certific of PERMIT
Exemption,you should become subject to the Workers'Compensation Range_ Heater D.W. APPLICANT
provisions of the Labor Code,you must forthwith comply with such Oven _ Dryer_ W.M.— ADDRESS
provisions or this permit shall be deemed revoked. Top — FAU W.H.
LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other_ CITY Tel.No..
,
I hereby affirm that I am licensed under provisions of Chapter 9LICENSE OR
(commencing with Section 7000)of Division 3 of the Business and Disp. — Room Air Cond. REG.NUMBER Class.
Professions Code,and my license is in full force and effect.. DISTRICT NO. �J l/ PROCESSED Y
Power Apparatus&Large Appliances 5U(
i
Size&Type HP,KW,KVA,or KVAR
License Number Lia Class Up to 1 Incl. FINAL
Over 1 to 10 Incl. DATE 16 /ATION C
Contractor Date Over 10 to 50 Incl. FI (~�
❑ I am exempt under Sec. Over 50 to'100 Inc. fW.,
Over 100
B.&P.C.for this reason
Services,Swbd.,MCC&Panelboards '
Date: 0-200 Amp.Under 600 V
Signature 201 - 1000 Amp.Under 600 V
❑ Over 1000 Amp.or Over 600 V
Exemption for Reg.Maint.Elect.
SINGLE FAMILY Temp.Power Pole•&Appurtenances
085,9A
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit # 0 0 0 0 0 2
1 hereby'affirm that I am exempt from the Contractor's License Law additional Sign Branch Circuits
for the following reason(Section 7031.5,Business and Professions .l' 0 0 1 6 7 5
Code):
❑ Misc.Conduits&Conductors 0 0. 0 1 6755
I,as owner of the property,will do the work and the structure Other(See Complete Fee Schedule)
is not intended or offered for'sale (Section 7044, Business 1 0,06-88
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 issued(Sec.3097,, PERMIT FEE (Sub Total)
Civ.C.).
ti PLAN CHECKING FEE
Lender's Name
Lv ���� PERMIT ISSUING FEE
Lender's.Address `
I certify that I have read this application and state that the above TOTAL FEE 1,6775
5
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 f r inspectionIrposes. SEE REVERSE-FOR EXPLANATORY LANGUAGE
''� /, 0'0
Sig ture of Permittee Date