The URL can be used to link to this page

Home My Public Portal About6314 ENCINITA AVE_Electrical__ WORKERS'COMPENSATIONDECLARATION 63 CE 80fiG 12-601 APPLICATION FOR. ELECTRICAL PERMIT {I CE 806G u 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 JOB Policy No. Company EACH NO. 'FEE ADDRESS • New Residential Bldgs.&Pool s Certified copy is,hereby furnished. • 1 &2-Family,Sq. Ft. $' — $ LOCALITY O. Multi-family Sq. Ft. NEAREST Q Certified copy is filed with the county building inspection \ yV )� CROSS ST11 department. Residential Swimming Pools OWNER OR FIRM NAME Date Applicant Outlets: Rec._Light— Sw. MAIL / First 20 ADDRESS 'K� f� CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional, CITY fp L v Le'j(�Tel No. } COMPENSATION INSURANCE '. PLAN CHECK ll 'tr } l� APPLICANT 0 (This section need not be completed if the work involved Lighting Fixtures First 20 by the permit is for one hundred dollars ($100) of less.) g g Additional ADDRESS � 1' certify that in the performance of the work for which this Total No. CITY Tel No. r0 Fixed Appliances Not Over 1 HP IF- 'permit is issued, I shall m[ employ any person in any manner• PERMIT � •� U so as to become subject to the Workers' Compensation Laws. 'Range_ Heater_D.W. APPLICANT N A y Z 7v �f. Oven _ Dryer_W.M. ADDRESS (n L^�/!J Gl,t/'/ Date Applicant t;&&Df/ � r Top FAU _W.H.. Hood _ Fan —Other_ CITY ��? /: •el No. 2 6_. l NOTICE TO APPLICANT: If, after making this Certificate of Disp. _ Room Air Cond,_ LICENSE OR O m� l _ Exemption, you should become subject to the Workers' REG.NUMBER O 4 lassef —Jo Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances r DISTRICT NO. P C 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 Over 1 to 10 Ind. DIATEL LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl. •��` VALI DATIO I hereby affirm that I am licensed under provisions of Chapter Over 50 lo 100 Inc. BIN t 9 (commencing with Section 7000) of Division 3 of the Busi- Over 100 ness and Professions Code, and my license is in full force and - effect. Service �) -200 Amp. oder 600 V 6 License Number?—Lu. Class 20 - mp. Under 600 V Contra ctorage&L R7P F/&bate 7—/1 `f'1 B 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 „� • !'2 5 0 mess and Professions Code): ' Misc.Conduits& Conductors 'e e e 2 5 59 6 O1, as owner of the property, will do the work and the Other (See Complete Fee Schedule)— structure is not intended or offered for sale (Section O 7.1 A 8 8 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY 1 I batch), affirm that there is a construction lending agency for the performance of the work for whichthis permit is PERMIT FEE ISub-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 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 --m//entioried property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE SiggR e o Permittee Date ' COUNTY OF LOS ANGELES TEMPLE CITY N 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1304230010' BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: (LEGAL ID: FEES PAID BUILDING ADDRESS: ON FILE �I 6314 ENCINITA AV 1 IEEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 TEMP CA 917801316 (ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET: 5382-017-037 IA1 PERMIT ISSUANCE FEE 27,80 THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY CAI I - IG1 OUTLETS-LGT,SW,RECP 21.00 OUT 40.30 I I ITENDET: IG2 LIGHTING FIXTURES 14.00 EGG 28.00 (ISSUED ON: PROCESSED BY: PLAN BY: IHA FAU LESS 3HP 1.00 FAU 11.00 104/23/13 SR ISE RES GREG DISP LT 3HP 1.00 DIS 11.00 I OWNER: TEL, NO: IH4 RES RANGE INS LT 3HP 1.00 BOO 11.00RAL DATE FINAL BY: CODE: ITRUONG, KEN (626) 862-8745- IH5 RES WASH MACH LT 3HP 1.00 WAS 11.00 1 16314 ENCINITA AVE H7 RES EXHAUST FANS 1.00 EX 11.00 11.00O TEMPLE CITY CA 91780 IJS AC UNITS +3-10HP 1.00 AC 19.70 IDESCRI PTION OF WORK IN OTHER PNL 0-399 AMPS 1.00 PAN 38.90 121 OUTLETS, 14 LIGHT FIXTURES, FAU/AC, GARBAGE DISPOSAL, TOTAL FEES 209.70 1RANGE HOOD, WASHING MACHINE, EXHAUST FAN, SUB-PANEL 125 AMP 1 1APPLICANT: TEL. NO: SAME AS OWNER - - SPECIAL CONDITIONS: I I I 11 CONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - LIC. NO ITEMPORARY POWER POLE I I - IUNDERGROUND CONDUIT 111 ARCHITECT OR ENGINEER: TEL. NO: IUFER GROUND 1 11 LIC NO IROUGH CONDUIT ROUGH WIRING MAIN WATER LINE (PLASTIC YIN METAL YIN (UTILITY COMPANY NOTIFIED( II II 111 II II I 1 I I I I I I I II d I II 1 I I I I I 1iI 111 i II 111 111 I 111' I I I IREPORT I0: DPR265 ROUTE TO: BS0508 - I I I I I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1307110002 BUILDING AND SAFETY ( LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0486 EXT: ILEGAL ID. FEES PAID BUILDING ADDRESS: ON FILE 6314 ENCINITA AV IEEE DESCRIPTION: QUANTITY: DOM: AMOUNT: I TEMP CA 917801316 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 15382-017-037 1A1 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 596 GRID: S2 LOCALITY: TEMPLE CITY CAI IG1 OUTLETS-LGT,SW,RECP 20.00 OUT 40.00 1 (TENANT: IG2 LIGHTING FIXTURES 16.00 LOT 32.00 (ISSUED ON: PROCESSED BY: PLAN BY: TOTAL FEES 99.80 107/11/13 SR TOWNER: TEL. NO: FINAL DATE FINAL BY: CODE: ITRIEU, KAREN (626) 489-2779- 16314 ENCINITA AVE �`E/ �l—��`/ ITEMPLE CITY CA 91780 DES CRIPTION'OF WORK 120 OUTLETS AND 16 LIGHT FIXTURES 1 APPLICANT: TEL. NO: SAME AS OWNER — I ISPECIAL CONDITIONS: I I I I I 1CONTRACTOR: TEL. N0: I (APPROVALS DATE INSOECTOR SIGNATURE '1 SAME AS OWNER — I I— LIC NO TEMPORARY POWER POLE UNDERGROUND CONDUIT I I I (ARCHITECT OR ENGINEER: TEL. NO: I JUPER GROUND I I I I I LIC. NO: IROUGH CONDUIT I I I I 1 TROUGH WIRING 1 1 1 NAI:d WATER LINE (PLASTIC YIN METAL YIN I I I I (UTILITY COMPANY NOTI FIED 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 II 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 I I I I I I J I I I I I I I I I RE PORT I➢: DPR265 ROUTE T0: 050508 I I I I I I