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Home My Public Portal About6154 BURTON AVE_Electrical__ F v ` r+WORKERS' COMPFNSJjTION DECLARATION 76A66310/81 'I hereby affirm that f have a certificate of consent to self CE806GAPPLICATION FOR ELECTRICAL PERMIT iisure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY 'or a certified copy thereof (Sec. 3800, Lob. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB pp Certified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE ADDRESS ❑ Certified copy is filed with the county building inspec- I B 2-Family, Sq. Fe $ — $ LOCALITY i a4 tion department. Multi-family Sq. Ft. — NEAREST Residential Swimming Pools CROSS ST, ' 6/U�•7 .E AJ Dale Applicant OWNER OR FIRM NAME /. CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: RecLightSw._ MAIL (,1(f 3� L v6=Q� }� COMPENSATION INSURANCE ADDRESS This section need not be completed if the work involved b First 20 ( P Y (72 the permit is for one hundred dollars ($100)or less.) Total No. Additional CITY a 14125�,>/_ T.I. PLAN CHECK I certify that in the performance of the work for which this APPLICANT permit is issued, I shall not employ any peQon in any manner so as to become subject to the W C pensotio s. Lighting Fixtures First 20 ADDRESS /gcker Additional 3 /e_ �G Total No. CITY Tel. No. Date T: If, a Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT O/ Exemption, you should become subject to the Workers' Range_ Heater_D.W. Compensation provisions of the Labor Code, you must forth- Oven _ Dryer —W.M._ ADDRESS ��-- N�� Q� J�• with comply with such provisions or this permit shall be Top — FAU _W.H. — deemed revoked. CITY 7vGlS 7D +� Tel. No.7 l,/s/_7 LICENSED CONTRACTORS DECLARATION Hood _ Fan _ Other_ Disp. Room Air Cond. LICENSE . I hereby affirm that I am licensed under provisions of Chapter 9 REG. NUMBER Q / J V � } (commencing with Section 7000) of Division 3 of the Business power Apparatus 8 Large Appliances DISTRICT NQ. PRO D BY a' and Professions Code, and my license is in full force and effect, l/J[ '� CL Size 8 Type HP, KW, KVA, or KVAR t Q U License Number Lic. Class Up to I Incl. FINAL DATE cc 0 Over 1 to 10 Incl. zZ V (DATION Contractor Date Over 10 to 50 Incl. FIN Lil ❑ I am exempt under Sec. Over 50 to 100 Inc. B d' B.BP.C. for this reason Over 100 LnZ Date: Services, Swbd., MCC & Panelboards T 0 - 200 Amp. Under 600 V U Signature 201 - 1000 Amp. Under 600 V ❑ Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY Temp. Power Pole 8 Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ;@4 2 7. 2 A I hereby affirm that I am exempt from the Contractor's License additional Sign Branch Circuits Law for the following reason (Section 7031.5, Business and # e o 0 o e 'Z Professions Code): I, as owner of the property, will do the work and the Misc. Conduits & Conductors 5550 structure is not intended or offered for sale (Section Other (See Complete Fee Schedule) 7044, Business and Professions Code). , e - a 5 S 5 0 5 CONSTRUCTION LENDING AGENCY 03.2 1 —86 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 Name PERMIT ISSUING FEE /0 Lender's Address 3SS� 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 laws regulating Electrical wiring, and hereby yp4orize representatives of this County to enter upon n;'6ve m entioned r per or i ection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE .� toSignature of Peritt a Date DEC TION 76A66 WORKERS' theIhave COMPENSATION cafe of corse CE-806 ID,BI APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self CE-8066 insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY II��11or a pcertified copy thereof (Sec. 3800, Lab. C.) wO`Y No./Company Jrz, � FOR APPLICANT TO FILL IN JOB /� ertified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE ADDRESS R. Certified copy is filed with the county building inspec- 1 8 2-Family, Sq. Ft. $ — $ LOCALITY Gp tj ytbrsL�t lion department. Multi-family Sq. Ft. — NEAREST /- CROSS ST. LO ( _W Dates Q ' Applicant A' y�� /T, Residential Swimming Pools OWNER Qt. - FIRM NAME 7CO TT CERTIFICATE OF EXEMPTION FROM WORKERS' qq^^ 6 I MAIL COMPENSATION INSURANCE Out Rec�Light_Sw. First 20. f 20 ADDRESS b(s� BL�Fkna _ (This section need not be completed if the work involved by Total No.33 Additional _ 71CITU pVQ/-`CJ Tel. No. the permit is for one hundred dollars ($100)or less.) PLAN CHECK I certify that in the performance of the work for which this APPLICANT permit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS Total No.(a Additional CITY Tel. No. Date Applicant Fixed Appliances Not Over I HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT F�EG ,:�C„ Exemption, you should become subject to the Workers' Range— Heater_D.W. — p` Compensation provisions of the Labor Code, you must forth- Oven — Dryer — W.M.— ADDRESS LZ�1- �F Q A4 p/ with comply with such provisions or this permit shall be Top FAU W.H. — deemed revoked. Hood FanOther_ CITY Q.G Tel. NoJ4Q 7577 LICENSED CONTRACTORS DECLARATION CENSE OR hereby affirm that am licensed under provisions of Chapter 9 Disp. _ Room Air Cond. REG. NUMBER 2$'17 Class.4"l (commencing with Section 7000) of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NO. PROCES D BY >.and Professions Code,and my license is in full farce and effect. d �2��f Size 8 Type HP, KW, KVA, or KVAR O License Number 10 Lic. Class FINAL tJ _ Up to 1 Incl. Contractor TA bare SLD 0.� Over 1 to IO Incl DATE Q� VALIDATION 0 ❑ Over 10 to 50 Incl. u F- FINAL am exempt under Sec Over 50 to 100 Inc. BYIL B.BP.C. for this reason Over 100 ull Services, Swbd., MCC & Ponelboards Dote: 0 -200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V , ❑ Exemption for Reg. Maine. Elect, Over 1000 Amp. or Over 600 V SINGLE FAMILY Temp. Power Pole 8 Appurtenances 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 1 831 A Law for the following reason (Section 7031.5, Business and Professions Code): 0 0 0.0'0 2 as owner of the property, will do the work and the Mi.sc. Conduits 8 Conductors ( o 0 5•5 50 structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)- 7044, Business and Professions Code). , t ) 55.'S0mu CONSTRUCTION LENDING AGENCY O 5 1 0-83 _8 3 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) Q (Sec. 3097, Civ. C.). PLAN CHECKING FEE ' Lender's Name PERMIT ISSUING FEE Lender's Address I certify that I have read this application and state that the TOTAL FEE �rs 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 abo -mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of ermittee Dolie COUNTY OF LOS ANGELES TEMPLE CITY N 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9901 LAS TUNAS EL 0508 1103170023 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: (LEGAL ID: FEES PAID BUILDING ADDRESS: ITR: 29475 LT: 10 6154 BURTON AV N I IEEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( SGAB CA 917752653 1ASSESSOR INFORMATION NUMBER- I I NEAREST CROSS STREET: - 1 15386-007-071 1A1 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 596 GRID: G2 LOCALITY: TEMPLE CITY, Cl IG1 OUTLETS-LGT,SW,RECP 4.00 OUT 7.80 TENANT: IG2 LIGHTING FIXTURES 4.00 LGT 7.80 (ISSUED ON: PROCESSED BY: PLAN BY: TOTAL FEES 43.40 103/17/11 SR IOWNER: TEL. N0: FZN DATE FI/NAL..BY: CODE: 1WONG,G, PUZ CHING (626) 782-2550- 16159 BURTON AVE. SAN GABRIEL CA 91775 IDESCRIPTION OF WORK ELECTRICAL FOR NEW BATHROOM I APPLICANT: TEL. NO: (SAME AS OWNER - 1 SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - I LIC. NO (TEMPORARY POWER POLE I I IUNDERGROUND CONDUIT I (ARCHITECT OR ENGINEER: TEL. NO: IUFER GROUND I LIC. NO: IROUGH CONDUIT TROUGH WIRING "-1 � �• MAIN WATER LINE �I PLASTIC YIN METAL YIN I I I UTIL ITY COMPANY NOTI FZ EDI 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 (REPORT ID: DPR265 ROUTE TO: BS 0508 I I I I I I 1 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9901 LAS TUNAS EL 0508 1306100033 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91980 PHONE: (626) 225-0488 EXT: (LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 29995 LT: 101 6154 BURTON AV N I IEEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( SGAB CA 919952653 (ASSESSOR INFORMATION NUMBER: 1 NEAREST CROSS STREET: LONGDEN 15386-009-091 JAI PERMIT ISSUANCE FEE 29.80 THOMAS PAGE: 596 GRID: G2 LOCALITY: TEMPLE CITY CAI I 1F1 120V, 15/20A BR CKTS 5.00 BR 86.50 1 TENANT: IG1 OUTLETS-LGT,SW,RECP 40.00 OUT 65.90 (ISSUED ON: PROCESSED BY: PLAN BY- IG2 LIGHTING FIXTURES 20.00 LGT 40.00 106/10/13 SR TOTAL FEES 220.20 1 OWNER TEL. N0: - IFI L TE FINAL B CODE: IWONG, VENA (626) "182-2550- 16154 BURTON AVE ITEMP 919801956 DE5 RIPTION WORK �� 15 BRANCH CIRCUITS, 40 OUTLETS AND 20 LIGHT FIXTURES APPLICANT: TEL. N0: ITAN YEW K (626) 259-8900- 16903 N GOLDEN WEST i ISPECIAL CONDITIONS: ARCADIA CA I 1 1 1 I CONTRACTOR: TEL. NO: i (APPROVALS DATE INSPECTOR SIGNATURE POLYVISION LAND CORP (626) 259-890;- 16903 N GOLDEN WEST LIC NO ITEMPORARY POWER POLE I 1 1ARCADIA CA 91009 NONE 111 1 UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: JDFER -ROUND LIC NO: TROUGH CONDUIT IROUGH WIRING / f IMA IN WATER LINE ( (PLASTIC YIN METAL YIN OTILITY COMPANY NOTI FIQ I I I I I I I I I I � I I REPORT ID: DPR265 ROUTE TO: RS0508 I I I I COUNTY OF LOS ANGELES TEMPLE CITY p 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1307110058 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: FEES PAID BUILDING ADDRESS: JTR: 29475 LT: 10 6154 BURTON AV N IEEE DESCRIPTION: QUANTITY: DOM: ANOUNT: 1 SCAB CA 91]]52653 (ASSESSOR INFORMATION NUMBER: I INEAREST CROSS STREET: LONGDEN 15386-007-071 IA1 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 596 GRID: G2 LOCALITY: TEMPLE CITY CAI I ILB 200 AMP PANELS, MCC 1.00 PAN 38.90 (TENANT: I TOTAL FEES 66.70 (ISSUED ON: PROCESSED BY: PLAN BY: 107/11./13 SR TOWNER: TEL. NO: IFIIAAL�DAT'E FINALL BY: CODE: 1WONG, VENA (626) 782-2550- I 15154 BURTON AVE I TEMP 917801756 IDEACRI TION OF WORK (UPGRADE SERVICE PANEL TO 200 AMP APPLICANT: TEL. NO: TAN YEW K (626) 257-8900- 16703 N GOLDEN WEST SPECIAL CONDITIONS: ARCADIA CA CONTRACTOR: TEL. N0: APPROVALS DATE INSPECTOR SIGNATURE POLYVISION LAND CORP (626) 257-8900- 1 16703 N GOLDEN WEST LIC. NO ITEMPORARY POWER POLE I I I 1ARCADIA CA 91007 879756 UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. N0: IUFER GROUND I LIC. NO: IROUGH CONDUIT I I I (ROUGH WIRING II 11 IMAIN WATER LINE IPLASTIC YIN METAL YIN I I (UTILITY COMPANY NOTIFI eiv I I I I I I I I I I I I I I I I II I I I I I I I I I I 1REPORT ID: OPR265 ROUTE TO: 850508