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Home My Public Portal About5926 ENCINITA AVE_Electrical__ WORKERS'COMPENSATIONDECLARATION CE8636G 12 80) APPLICATION FOR ELECTRICAL PERMIT 76 I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800,Lab.C.) FOR APPLICANT TO FILL IN SOB Policy No. Company ADDRESS New Residential Bldgs.&Pools EACH NO. FEE Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ — S LOCALITY Multi-family Sq. Ft. NEAREST Certified copy is filed with the county building inspection CROSS ST department. Residential Swimming Pools OWNER OR FIRM NAME d Date Applicant MAIL U PP Outlets: Rec.—Light.Sw. ' First 20 ADDRESS CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY Tel No. W COMPENSATION INSURANCE PLAN CHECK y. (This section need not be completed if the work involved APPLICANT T by the permit is for one hundred dollars ($100) or less.) Lighting Fixtures First 20Total No. Additional ADDRESS Q I certify that in the performance of the work for which thisCITY Tel No. It _ permit is issued. I shall not employ any person iFixed Appliances Not Over 1 HIP n any manner PERMIT a so as to become subject to the Workers' Compensation Laws. Range_ Heater_D.W. APPLICANT Cc / Oven _ Dryer_W.M. ADDRESS 7e? mt H DateApplicants r:.i: /f _ �:r Top — FAU _W.H. Hood _ Fan _Other_ CITY Tel No. NOTICE TO APPLICANT: IL 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 IN PROC SED 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 101ncl. DATE LICENSED CONTRACTORS DECLARATION VALIDATION Over 10 to 50 Incl. I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL 9 (commencing with Section 7000) of Division 3 of the Busi- Over 100 BY ness and Professions Code, and my license is in full force and _... effect. Services License Number Lic. Class 0-200 Amp. Under 600 V . . . . 201 1000 Amp. Under 600 V Contractor Date Over 1000 Amp.or Over 600 V HOME OWNER-BUILDER DECLARATION Temp. Power Pole&Appurtenances ' a a I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit Additional Sign Branch Circuits License Law for the following reason (Section 7031.5. Busi- ness and Professions Code): Misc.Conduits& Conductors 1, as owner of the property, will do the work and the Other (See Complete Fee Schedulel— structure 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.C.). Lender's Name 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 ;7 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 proparty for inspection Purposes. SEEREVERSEFOR EXPLANATORY LANGUAGE Signature of Permittee Date COUNTY OF f,0S ANGELES TEMPLE CITY N 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1111210015 BUILDING AND SAFETY J LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0489 EXT: (LEGAL ID: FEES PAID BUILDING ADDRESS: ITR: 6561 IT: 379 BE: .001 UN: .002 5926 ENCINITA AV I IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT: ( TEMP CA 917801931 (ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: 18587-001-018 IA1 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, Cl F1 120V, 13/20A ER CKTS 5.00 BR 86.60 TENANT: IG1 OUTLETS-LGT,SW,RECP. '19.00 OUT 36.90 ISSUED ON: PROCESSED BY: PLAN BY: 02 LIGHTING FIXTURES 10.00 LOT 19.40 111/21/11 SR 1 I - I TOTAL FEES 170.70 1 (OWNER: TEL. NO: I 1FINAL DATE FINAL Y: CODE: IzHANG, XUAN (626) 757-6685- 1 19168 LAS TUNAS DRIVE I TEMP 917801931 1 DESCRIPTION OF WORK (ELECTRICAL FOR INTERIOR REMODEL 1APPLICANT: - TEL. NO: (PUN, PETER (626) 572-9181- 12714 STINGLE AVE 1SPECIAL CONDITIONS: 111 ROSEMEAD CA 91770 CONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE J P CONSTRUCTION (626) 572-9181- 1 12714 STINGLE AVENUE LIC. NO 1 (TEMPORARY POWER POLE ROSEMEAD, CA 91770 642751 d (UNDERGROUND CONDUIT I (ARCHITECT OR ENGINEER: TEL. NO: IUFER GROUND LIC, N0: I ROUSH CONDUIT 111 (ROUGH WIRING *\�, (MAIN WATER LINE I (PLASTIC Y/N METAL Y/N (UTILITY COMPANY NOTIFIEDI I 111 11_ I 111 I I I I I I I I I I I I II II I 11 I 1111 I I I I I I I I I I II II I I I I I I I I I I - I I 11 I 11 _1REPORT ID: DPR265 ROUTE TO: BS0508 I .� WORKER'have a certificate DECLARATION 20-0019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT I h'eraby affym that 1 have a cerci flcate of consent to self insure, 6ASIi3 or-a certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec.3800 Lab.C.) Policy No. Company FOR APPLICANT TO FILL IN JOB 6—A)66- / ❑ ADDRESS �� U Certified copy is hereby furnished. New Residential Bldgs.8 Pools NO. EACH FEE LOCALITY ❑. Certified copy is tiled with the county building inspection 1 &2-Family,Sq.Ft. $ department. Multi-family Y$q�Ft. CNRARSTT. I, N Data Applicant Residential Swimming Pools ASSESSOR PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec._Light Sw._ FlaNER NAMEOR AAJA f}� COMPENSATION INSURANCE (This section need not,be completed if the work involved by the First io MAIL ^ permit is for one hundred dollars(5100)or less.) Total No. Additional .ADORE55 S — �� TUG I certify that in the performance of the work for which this permit CITY -rCMpL/ Tel.N 8 6_70 is issued, I shall not employ any person in any manner so as to PLAN CHECK become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANT A Total No. Additional ADDRESS , / Date 'I Applicant S `.,�� RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: It, after making this Certificate of _ CITY TeLN Exemption, you Should become subject to the Workers' Compensation OTHER APPLIANCES NOT OVER 3 HP, provisions of the Labor Code, you must forthwith comply with such PERMIT provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances APPLICANT LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Ind.(commencing with Section 7000) of Division 3 of the Business and CITY Tel.No. Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. LICENSE OR Over 50 to 100 In . REG.NUMBER Cl..,,. d Over 100 DISTRICT NO. P O SSED BY 0 License Number Lia Class j� Seryjces;S_btl CC 8 Pan oald5 •709 L1f+ v FINAL Contractor Date 0- mp. oder V GATE � ❑ 1 am exempt under Sec. 400-1000 Amp.Under 600 V Over 1000 Amp.or Over 600 V FINAL VALIDATION W B.&P.C.for this reason - O. BRANCH CIRCUIT FEES ev (4 Date: 15A,or 20A. 120V.Lighting or Recept. Z 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits Exemption for Reg.Maint.Elect, 15A,20A,2DBV To 277V Lighting Sr.Circuits SINGLE FAMILY Temp. Power Pole&Appurtenances L HOME OWNERBUILDERDECLARATION Sign with One Branch Circuit - A4�•T°F I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5. Business and Professions Additional Sign Branch Circuits — . Code): �;�jq r__:i� ❑ 1, as owner of the property,will do the work and the structure Misc.Conduits&Conductors = ITEMS is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule)_ D TOTAL 3 - j` 5 and Professions Code). CONSTRUCTION LENDING AGENCY CHECK 6-.45 I hereby affirm that there is a construction lending agency for the CHANGE performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total) . Civ.C.) PLAN CHECKING FEE i Lender's Name- PERMIT ISSUING FEE 1 All IA o Lender's Address TOTAL FEE I certify that 1 have read this application and under penalty of purjury state that the 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 ' for inspection purposes. / SEE REVERSE FOR EXPLANATORY LANGUAGE aIG�E F E ITTEf�d E D E ION r ' WORKER-have a ENSATate of consent to 76A663 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT I hereby alarm Chal I'have a certificate of consent to sell insure. or A certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec.3800 Lett,C.) Policy N0. - Company FOR APPLICANT TO FILL IN OB ADDRESS Sq 26 NGt N i rAT /AVE ❑ Certified copy is hereby furnished. New Residential Slogs.&Pools NO. $ EACH $ FEE LOCALITY TEMPLE G i Y CAQ('7 g ❑ Certified copy is filed with the county building inspection 1 &2-Family,Sq.Ft. NEAREST department. Multi-family Sq.Ft. — CROSS ST. LA TU0,46 A"D -6NCiWrrk Date Applicant Residential Swimming Pools ASSESSOR p vy ��GG Oa PAGE 0�� PARCEL ��4 CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rea 1.L Light�Sw, w j ORM NAME �iAN/� � N OR COMPENSATION INSURANCE b IZA First 20 MAIL rn+'�! c (This section need not be completed if the work Involved by the Total No. Additional ADDRESS r`7 Z6 Ef\)CWC f� AV E permit is for one hundred dollars($100)or less.) I certify that in the performance of the work for which this permit CITY ILMrLf7 i-i Tel'N gjd) 2-96--70-3-0 is issued, I shall not employ any person in any manner so as to PLAN CHECK _TKA ' 4-J become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANT 'pIilNA TI J'� Total No. Additional ADDRESS S 26 SEK%, RA h-Ub Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP. p r� NOTICE TO APPLICANT: If, after making this Certificate of CITY -rE"PLZ; CtTy TaI.No.Ql O)2J 6— '7030 Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. PERMIT provisions of the Labor Code, you muss forthwith comply with such APPLICANT provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 101nc1. (commencing with Section 7000) of Division 3 of the Business and CITY Tel.No. Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. LICENSE OR } Over 50 to 100 Incl. REG.NUMBER Class, d Over 100 DISTRICT NO. PRO SSED BY 0 License Number Lic.Class ' - Services,Swbtl.,MCC 8 Panelbcards O Contractor _ Date 0-399 Amp.Under 600 V FINL 0 DATE 0 ❑ - 400-1000 Amp.Under 600 V '1 L ALIDATION W I am exempt under Sec. Over 1000 Amp.Or Over 600 V FINAL BY a B.BP.C.for this reason BRANCH CIRCUIT FEES BY U) Date: 15A.or 20A.120V,Lighting or Recept. V' Z 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits F-141 Or More Branch Circuits Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits 41 v4 SINGLE FAMILY Temp.Power Pole 8 Appurtenances - •c HOMEOWNER BUILDER DECLARATION 4.�I]�; 72 45 I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits _ 1 !TEM'-:r Code I; Misc.Conduits&Conductors TOTAL 7245 as owner of the property, will do the work and the structure _ is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) D [NECK'. 72,4` and Professions Code). - cNaNGt 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) Q q000-0001 O/ (/y Civ.C.) PLAN CHECKING FEE _ 113 ,75 i Al :07 Lender's Name PERMIT ISSUING FEE Lender's Address TOTAL FEE QQ I certify that I have read this application and under penalty of purely state Q'. that the 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 for inspeFtion purposes. _ J SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATOR[OF IiMIT OA F/ ' ' - COUNTY OF LOS ANGELES TEMPLE CITY N 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1207190059 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: I FEES PAID BUILDING ADDRESS: ITR: 6561 LT: 379 BL: .001 UN: .002 1 5926 ENCINITA AV I IEEE DESCRIPTION: QUANTITY: DOM: AMOUNT:I TEMP CA 917801931 1 jASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: T 18587-001-018 TAI PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, Cl IJX MOTORS, LT 3 HP 1.00 MOT 15.30 (TENANT I TOTAL FEES 43.10 (ISSUED ON: PROCESSED BY: PLAN BY: T 107/19/12 SR T TOWNER: TEL. NO: F `AL DATE FINAL BY: CODE: ICHEN, ARNOLD (805) 259-8420- 15926 59-8420-T5926 ENCINITA AV i ITEMP 917801931 j DTSCR PTI N OF WORK \ j IBUILD ONE CIRCUIT FROM ELECT ICAL PANEL TO THE AUTO GATE 1APPLICANT: TEL. NO: j I SAME AS OWNER 1- T j jSPEi IAL CONDITIONS: (CONTRACTOR: TEL. NO: jAPPROVALS DATE INSPECTOR SIGNATURE (SAME AS OWNER - T j_ j LIC. NO (TEMPORARY POWER POLE I j T jUNDERGROUND CONDUITy (ARCHITECT OR ENGINEER: TEL. NO: jUFER GROUND LIC. N0: TROUGH CONDUIT j IROUGH WIRING I 1 (MAIN WATER LINE PLASTIC YIN METAL YIN jUTILITY COMPANY NOTIFIED( I I II I I I I I I I I I I I I I I I T ! I I I I I I I_ I I jl IRE PORT ID: DPR265 ROUTE TO: BS 0508 j j T COUNTY OF LOS ANGELES TEMPLE CITY p 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1112210006 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: ITR: 6561 IT: 379 BL: .001 ON: .002 5926 ENCINITA AV I IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT: TEMP CA 917801931 (ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 18587-001-018 1A1 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, Cl TF1 120V, 15/20A BR CKTS 2.00 BR 34.60 (TENANT: I TOTAL FEES 62.40 (ISSUED ON: PROCESSED BY: PLAN BY: I 112/21/11 SR TOWNER: TEL. N0: FINAL DATE FINAL CODE: ZHANG, XUAN (626) 757-6685- 19168 LAS TUNAS DRIVE (TEMP 917801931 1 (DESCRIPTION OF WORK ADD TWO BRANCH CIRCUITS FOR LAUNDRY ROOM APPLICANT: TEL. NO: IPUN, PETER (626) 572-9181- 12714 STINGLE AVE (SPECIAL CONDITIONS: ROSEMEAD CA 91770 I I I I (CONTRACTOR: TEL. N0: (APPROVALS DATE INSPECTOR SIGNATURE IJ P CONSTRUCTION (626) 572-9181- 12714 STINGLE AVENUE LIC. NO TEMPOPARY POWER POLE ROSEMEAD, CA 91770 642751 B (UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. N0: 1 1OFER GROUND I LIC. NO: I (ROUGH CONDUIT I ROUGH WIRING MAIN WATER LINE PLASTIC YIN METAL YIN I (UTILITY COMPANY NOTIFIED( 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 I I I I I I I I I I I I I I I I (REPORT IN: OPR255 ROUTE TO: 850508