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Home My Public Portal About9073 WOOLLEY ST_Electrical__ 7BA66A .r. .' AE PLICATION FOR ELECTRIC PERMIT PSN A:A•BB DMSION OF BUMDING AND SAFETY ' Dep f of County Engineer Count ConalY Of LOS AaQ0168 BUILDING ` WM.J.FO COUNTY ENGINEER ADDRESS CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST PERMIT FEES CROSS ST: NUMBER EACH FEE s [RE HT OUTLETS , OWNER EPTACLES MAIL ADDRESS LL SWITCHES OTAL OUTLETS• 5¢ $ . CITY EL.NO. C.RANGES 25 ELECTRICIAN C. HEATERS 25 ADDRESS F EA CITY TEL.NO.URES5 LICENSE NO: 7 BER OF LIGHT CIRCUITSDISTRICT O. GROUP ZO E READY FOR INSPECTION BER OF RECEPTACLE CIRCUITS l MOTORS 7 FNFW HORSEPOWER FEE INSPECTION RECORD HP OVER INC. EACH Ih a LESS $ .25 12 2 .50 2 5 1..00 5 15 1.50 15 50 2.50 50 .200 5.00 , �l�i a9�+ ci.' ' f12--K, PRAIA-- M RAI/-L NO.TRANS. NO.LAMPS FOR EACH.PERMIT: WIRING $1.00 i FIXTURES $1.00 r SUPPLEMENTARY .50 APPROVALS TOTAL FEE g DATE INSPECTORS SIGNATURE_ 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION CONDUIT eZ %414�GG AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY _ i WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING 01 4 ELECTRICAL WIRING. / F I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIAOR THAT 1 A TH G OF THE ABOVE POWER DESCRIBED RESIDENTIAL PR SIGNATURE UTILITY CO.NOTIFIED. ZZ M4110 E 0 F fL ,,,rrr/� I•. OFPERMITTE FINAL �� Z S� �AriGLCCCl4Al WILLIAM J.FOX,COUNTY ENGINEER VALIDATION A.C.vE[T,CHIEF ELECT.INSPECTOR 2.0 71R MV22 2 2:60 '� WORKER S'COMPEIVSATIO'r<iDECLARATION- 76A663 CE-806G (2.301APPLICATION FOR ELECTRICAL PERMIT � , g� I hereby affirm that I have a certi%caae'of bnsdnttb self I `1(OF LOS ANGELES BUILDING AND SAFETY insure,or a certificate of Workers'Compensatidn`Insifrance,or l r o a certified copy thereof(Sec.3800,Lab.C.) FOR APPLICANT TO FILL IN JOB Policy No. Company New Residential Bldgs.&Pools EACH NO. FEE ADDRESS Certified copy is hereby furnished. 1 &2-Family.Sq. Ft. $ — $ LOCALIT building Multi-family Sq. Ft. NEAREST Certified copy is filed with the county g inspection Residential Swimming Pools CROSS ST department. OWNER OR FIRM NAME �i �F•� Date Applicant Outlets: Rec(4#,Light�Sw.� ADDRESS Jr,? First 20 - Ile-If CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional d _ COMPENSATION INSURANCE ` PLAN CHECK e ` • Tel No. A7 }_ (This section need not be completed if the work involved APPLICANT 9C'vE G� Fixtures First 20t Fi hting xu by the permit is for one hundred dollars ($100) or less.) Lig ,` ADDRESS / Additional 6 _ I certify that in the performance of the work for which this Total No. CITY ''P Tel No. • %� Fixed Appliances Not Over 1 HPv permit is issued, I shall not employ any person in any manner ��,.6 PERMIT so as to become subject to the Workers' Compensation Laws. Range_Heater D.W._ APPLICANT tl Oven _ Dryer_W.M._ ADDRESSN Top _ FAU H.._ AAf Z Date Applicant CITY Tel No. Hood _ Fan Other_ 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. PROCESSED 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 LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl. '"2_ VALIDATION I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINA 9 (commencing with Section 7000)of Division 3 of the Busi- Over 100 B ness and Professions Code,and my license is in full force and effect. Services License Number 0-200 Amp.Under 600 V Lic.Class 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 Professions Code): Misc.Conduits&Conductors I, as owner of the property, will do the work and the Other(See Complete Fee Schedule)— Ns , ructure 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.,fS �r , f ,! Lender's Name�� ( [�!`y ��"� ` �� 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 R4 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 Epr iection purposes. SEE'REVERSE.FOR EXPLANATORY LANGUAGE 9 .)J ` 7 U t' ature Permittee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0504130012 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: GA D: FEES PAID BUILDrNa ADDRESS: ON FILE 9073 WOOLLEY ST FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801348 ASSESSOR INFOXHATION NUB R: NEAREST CROSS STREET: 5382-019-030 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY, C C2 SPAS, HOT TUBS, OTHR 1.00 SPA 54.45 TOTAL FEES 82.20 ISSUED 0 SS D EXPIRES O : 04/13/05 JK 10/10/05 OWNER: TEL. L FINAL CODE: WEAL GEORGE L;JOANNE M (626) 285-3796- 9073 WOOLLEY ST TEMP 917801348 DESORIPTION 0 PORTABLE SPA APPLICANT: TEL. NO: SANE AS OWNER - SPECIAL CONDITIONS: CONTRACTOR" TEL. NO: APPROVALS DATE INSPECTOR S C A SANE AS OWNER - LIC. NO TEMPORARY POWER POLE UNDERGROUND CONDUIT ARCHIT9CTG 0: UFER GROUND LIC. NO: ROUGH CONDUIT ROUGHG IN WATER LINE PLASTIC Y/N METAL Y/N UTILITY COMPANY D REPORT ID: DPR265 ROUTE TO: BS0508