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Home My Public Portal About9315 BROADWAY_Electrical__ 76A665 CE-8x616/78) APPLICATION FOR ELECTRICAL PERMIT - COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN. IADDRESS L/ 3"BE, g_ Q Ae idenLiaols l Bldgs.&PoEACH NO. FEE 1 &2-Family Sq. F,��'� S .025 — S LOCALITY .fv Multi�fo 'IyySq..F4-- .02 — NEAREST - _J CROSS 57. ll R ed ntial Swimmi B Pools 25.00 AN OWNER OR !-+ o. /g��y�� 0o FIRM NAME e C s F Outlets:Re r4LKlight-L Sw..� MAIL '9 ''' First 20 .50 ! ADDRESS a lir,�r R' n Total No. Additional .30 CITY7�� e C r- ` Tel. No. ,L /957 ANC K A PLI NT Lighting Fixtures First 20 �50 AD ESS Adchnanol .30 Total No.� Y _ Tel.No. Fixed Appliances Not Over 1 HE PERMIT. 4, D.W. / APPLICA T Oven—Dryer— W.M.— ADDRESS - Top _FAU —WH.— CITYTel. No. Hood_Fon —Other— LICENSE OR Disp._Room Air Cond. _.L 2'50 ov7 REG.NUMBER Class. 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 r REGULATING ELECTRICAL WIRING. 6 2.50 Up t1 Incl HEREBY CERTIFY THAT AM PROPERLY REGISTERED AND/OR Over I to 10 Ind. 0'00 LICENSED IA REQUIRED A LOS ANGELES COUNTY AND STATE OF Over 10 to 501nc1. 12.50 CALIFORNIA SI THAT RO THE LEGAL OWNER Of THE ABOVE C DESCRIBED RESIDENTIAL PROPERTY. - ` Over 50 to 100 Inc. 25.00 _ ICLj 40.00 AE Over 100 SIGNATURE N Services DISTRICT NO. OCES D BY Z ti 0 200 Amp.Under 600 V 12.50 ^ .4 i' N 201-1000 Amp. Under 600 V 25.00 \/ V Over 1000 Amp.or Over 600 V 50.00 _ O Temp. Power Pole&Appurtenances 10.00 1'- Sign Sign with One Branch Circuit 10.00 G Additional Sign Branch Circuits 2.00 INSPECTION i 10,00 INFORMATION W Misc.Conduits&Conductors ON REVERSE x L32 1 3 2 A Other ISee Complete Fee Schedule)_ SIDE u aIti, 0 0 o o 2 6 ® 20 ° 2650 PERMIT FEE (Sub-Torall / ' ° 0 - 26506 PLAN CHECKING FEE (One Fourth Permit Feel O -1109'-7 9 PERMIT ISSUING FEE - $7.00 0 TOTAL FEE > INSPECTION FINALED 7 dote: t WORKERS'COMPENSATION DECLARATION 76A663 10/8I , htsreby affirm that I have'a cartificate of consent to self Ci APPLICATION FOR ELECTRICAL PERMIT •'.Fore, or'.a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy Ihere6f (Sec. 3800, Lab. C.) Policy No. Company FOR APPLICANT TO.FILL IN JOB PolQ Certified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE ADDRESS "1�I—�'+ x _ kil Ai AV ❑ LOCALITY ,QIf Certified copy is filed with the county building inspec- 18 2-Family, Sq. Ft. $ — $ Y � �-/� go ^/�� tion department. Multi-family i-family $q. Ft. CROSS S Date AppT, hT� .C1N D licant Residential Swimming Pools OWNER T. p C FIRM NAME r L r .� CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL Outlets: Rec Light_5w. COMPENSATION INSURANCE 1S ADDRESS 3 � Et ba (This section need not be completed If the work involved b First 20 ( P T Total No._2Additional CITYr,Q��, -'l Cj. T.I. No. y the permit is for one hundred dollars ($100)or less.) I certify that in the performance of the work for which this PLAN CHECK APPLICANT permit is issued, I shall not employ any person in any manner 7 so asVecome bect to the Workers'Co pensa'ion Laws. Lighting Fixtures First 20 ADDRESS AdditionalTotal No. CITY Tel. No. tApplicantFixed Appliancc�es Not Ov r 1 HP PERMIT NOTIO PLICANT: If, after cooking this Certificate of Wkf.l. APPLICANT Exemption, you should become subject''. the Workers' Range_ H��$$t��r,,� D.W. Compensation provisions of the Labor Code, you must forth- Oven — DryLsr"_ W.M.— ADDRESS with comply with such provisions or this permit shall be Top FAU —W.H. — - deemed revoked. CITY Tel. No. LICENSED CONTRACTORS DECLARATION Hood _ Fan _ Other—/ Disp. Room Air Cond. (/ LICENSE Class. I hereby affirm that I am licensed under provisions of Chapter 9 REG. NUMBER (commencing with Section 7000) of Division 3 of the Business5 BY DISTRICT NO.G�. PRO } and Professions Code,and my license is in full force and effect. Power Apparatus 8 Large Appliances ✓ 7 )� d Size 8 Type HE, KW, KVA, or KVAR' r (� CC) License Number Lic. Class Up to I Incl. FINAL ^ Of Over 1 to 10 Incl. DATE , �fc� p Contractor Date O VA DATION ❑ Over 10 to 50 Incl. ,IN , Ed I am exempt under Sec. Over 50 to 100 Inc. B d B.BP.C. for this reason Over 100 z Date. Services, Swbd., MCC 8 Panelboards .011 0 - 200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V f 6 431 A'Q ❑ Oa a Q 3 Exemption for Reg. Mainz. Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY Temp. Power Pole 8 Appurtenances e e e 31 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License additional Sign Branch Circuits 01,29-87 Law for the following reason (Section 7031.5, Business and Professions Code): I, as owner of the property, will do the work and the Misc. Conduits 8 Conductors P� structure is not intended or offered for sale (Section Other (See.Complete Fee Schedule)_ D 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 issued PERMIT FEE (Sub-Total) (Sec. 3097, Civ:C.). - PLAN CHECKING FEE Lender's Nome PERMIT ISSUING FEE Lender's Address I certify that I have read this application and state that the TOTAL FEE r above information is correct. [.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 roper'y for inspecti n purpos s. SEE REVERSE FOR EXPLANATORY LANGUAGE y Signature of Permittee 7e t , COUNTY OF LOS ANGELES - TEMPLE CITY # 0508 ELECTRICAL PERMIT _ DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0203190002 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: . . LEGALIDPAID.- BUILDING ADDRESS: TR._'12410 LT 9 R ' 4 -* -FEES T7 9315-BgOADWAY FEE DESCRIPTION: - QUANTITY: UOM AMOUNT TEMP- CA 977802404 SS SOR INFORMATION UMB _ NEAREST CROSS STREET ENCINI TA - 858.8-002-009 _ x T. ` Al PERMIT:ISSUANCE FEE - 27.75 ;.THOMAS'PAGE. :596L-,GRI D:•J4 LOCALITY: TEMPLE CITY GI OUTLETS-LGT,SW,RECP. :2AO OUT. - '3.90 - - TENANT: _ - -. _ - TOTAL FEES 31.65 ISSUED N: PROCESSED BY: PLAN_ EXPIRES I 03/19/02' JK _ 09/15/02; OWNER: TEL. NO: F[ AAA111 ATE NAL BY: CODE: TSENG KRIS C;ANNE F (626) 286-8310- n,: 9315 BROADWAYO- TEMP 977802404 6E%iL;kTIp-T O� WORK REPAIR LIVING RM WALL -.DAMAGED BY CAR APPLICANT: — MAA (626) 795-5886- �c 56 S VIRGINIA AVE PASADENA 91107 SPECIAL CONDITIONS: - CONTRACTOR: TEL. NO: �5 GEL c� �NT APPROVALS DATE INSPECTOR SIGNATURE MAA GENERAL CONTRACTING CO (626) 795-5886- V �' 56 S VIRGINIA AVENUE LIC. NO TEMPORARY P ER POLE PASADENA, CA 91107 711521BHIC UNDERGROUND CONDUIT - ARCHITECT NO: IJFER`GROUND LIC. NOc.— �---- 111 i11 ROUGH CONDUIT � JIE�IUC nIII I�O�IU� �- MAIN rWATER LINE '•t- . ,7UI vV u� PLASTIC Y/N METAL Y/N• UTILITY COMPANY, NOTIFIEU ; Service Tha�� -- REPORT' ID: DPR265 _ ROUTE T0: BS0508• - ' . . _ - -