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Home My Public Portal About9865 FLAHERTY ST_Electrical__ WORKERS'COMPENSATION DECLARAT40N CE-806 tQ/Bt APPLICATION FOR ELECTRICAL PERMIT I reby affirm that I have a certificate of consent to self CE-806G f� sure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY ce[[rr�tif ed coy there f ec. 36Leb-C ) olicy No 3Company FOR APPLICANT TO FILL IN JOB J ❑ Certified copy is hereby furnished v New Residential Bldgs. & Pools EACH NO FEE ADDRESS _y �� / 1 & 2-Family, 5 Ft. $ — $ LOCALITY Eertified cop is filed with the county building inspec- Y- 9 — h a art t Multi-famil .S Ft. NEARESTl�- p �/� Y 9 CROSS ST. C� Residential Swimming Pools OWNER OR Date Appl cant FIRM NAME CERTI CATE OF EXEMPTION FROM WORKERS" Outlets- Ref3Li t • `" Sw L2 MAIL COMPENSATION INSURANCE .7 (� First 20 ADDRESS (This section need not be completed if the work involved by Total No. J Additional CITY Tel. No.Z_gZ-06;T 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. 1D Additional i CITY Tel. No Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT If, after making this 'Certificate of APPLICANTO S �. � �/ !.G Exemption, you should become subject to the Workers' Range_ Heater D W. — Compensation,provisions of the Labor Code, you must forth- Oven _ Dryer T W.M.— ADDRESS IC'C? with comply with such provisions or this permit, shall be Top _ FAU _W.H .— deemed revoked / CITY el. N LICENSED CONTRACTORS DECLARATION Hood _ Fan /�— Other-- Room Air Cond. Q LICENSE OR Class; . l 4 j hereby affirm that I am licensed under provisions of Chapter 9 REG NUMBER (commencing with Section 7000) of Division 3 of the Business DISTRICT NO PROCESSED BY and Professions Code,and my license is in full force and effect Power Apparatus 8 Large Appliances Q� 0. Z/ • Size &Type HP, KW, KVA, or KVAR XP O �� -/ � 0 License Number Lic Class L/ Up to 1 Incl. FINAL V 09 Contractor ��+ Date Over 1 to 10 Incl DATE r VALIDATION 0 Over 10 to 50 Incl FINAL 11,_I am exempt under Sec Over 50 to 100 Inc. BYE_. d ❑ B.&P.0 for this reason Over 100 to Date Services, Swbd , MCC & Panelboards I ► '} 0 -200 Amp. Under 600 V Signature 201 - 1.000 Amp. Under 600 V ❑ Over 1000 Amp. or Over 600 V Exemption for Reg. Moint 'Elect SINGLE FAMILY Temp Power Pole &Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit �'5'5 3 8 A I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits '0,0;'.o;o`0 0 2 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 structureis not intended or offered for sale (Section Other (See Complete Fee Schedule)_ O'ojo'(�'] 5 = 7044, Business and Professions Code). , . O` CONSTRUCTION LENDING AGENCY 0 9,2'6'-'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) o (Sec 3097, Civ C ) 37 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 SIM abov information is correct I agree to comply with all County ord' nces and State jaws re ulatin Electrical wiring, and he y authorize repre t s of t ' County to enter upon t above- on op _for i s ection purp ses. SEE REVERSE FOR EXPLANATORY LANGUAGE ignature of Permittee 1Y Date / WORKER'S COMPENSATION DECLARATION9 DPW 9/69 APPUCAT.ION FOR ELECTRICAL PERMIT 76A66 I hey by affirm that I have a certificate of consent to self insure, 76A663 ora certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Se 800 Lab.C.) :, `- ' " Policy No. Company FOR APPLICANT TO FILL IN'_ JOB . ADDRESS _ El I - Certified copy is hereby furnished.'' -' New Residential Bldgs &Pools EACH NO FEE-' $ _ $ LOCALITY Certified co Is filed with the count buildi Ins ection 1 &2-Family,Sq.Ft PY Y' 9 P _ NEAREST d partment.,, ` Multi-family Sq Ft CROSS ST' Date 'L Applicant 12 Residential Swimming Pools ASSESSOR SS SSORc o•, ._ _ PAGE PARCEL ` CERTIFICATE OF EXEMPTION OM WORKERS: Outlets:Rec _Light Sw. FlRWNER OR M NAME �ejy F, COMPENSATION IN RANCE First 20 (This section need not be completed if the work,involved by the ADDRESS permit is for one hundred dollars"($100)or less:) Total No Additional I certify'that in the performance of the work for which'this permit _. CITY, Tel No is issued, I shall not employ any'persori in"any'manner so as to 'PLAN CHECK become subject to,the Workers' Compensation Laws. - Lighting Fixtures First 20 APPLICANT Total No. Additional • ` '' ADDRESS , Date Applicant 95 OR 20A-120V BRANCH CIRCUITS NOTICE TO APPLICANT If, after making this Certificate of CITY _ Tel No Exemption,you'should become,sublect to the,Workers;Compensation 1 TO 10 INCLUSIVE EACH provisions of the Labor Code, you must forthwith comply with such 11 TO 40 INCLUSIVE EACH PERMIT P Y P Y APPLICANT provisions,or this permit shall be deemed revoked: 41 OR MORE BRANCH CIRCUITS EACH LICENSED CONTRACTORS DECLARATION _ ADDRESS ` S a i -•• I hereby affirm that I am 15 OR 20A,208V TO 277V LIGHTING EACH licerised under`provisions of Chapter 9 d (commencing with Section 7000) of Division 3 of the Business and _ CITY r Tel No 8 V Professions Code,and my license is in full force and effect RESIDENTIAL APPLIANCES UP TO 3HP LICENSE OR (M }n(' Power Apparatus&Large Appliances REG NUMBER Class ` W O License Number v Lic Class_ice Size&Type HP,KW,-KVA,Or KVAR DISTRICT NO PROCESSED BY U Up to 3 Incl. 5 CJ N S LU Over 3 to 10 InclFINAL U) Contracto Date _. _ DATE ❑ Over 10'to 50 Incl.- 8J�2 Z I am a mpt under Sec. Over 50 to 100 Incl. VALIDATION -- - FINAL 4, BP C.for this reason - - Over 100 BYYBAP Services,Swbd,MCC&Panelboards_ Date: �. t 0-200 Amp.Under 600 V Signature 201 -1000 Amp.Under 600 V - ❑ - Over 1000 Amp.or Over 600 V _ Exemption for Reg.Maint Elect SINGLE FAMILY Temp. Pole&Appurtenances T•h�r�- I' HOME OWNER-BUILDER DECLARATION "' 1 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 Code) El t d &C d Conuits Conductors I,as owner of the property,will do the work and the structure Misc - ""` `" ��`'•i• is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) ;j ';= and Professions Code). -- - - _ _ ®- -;,"t;,• :'-•` 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) CIV. C.) PLAN CHECKING FEE Lender's Name �~ " PERMIT ISSUING FEE 2 ¢ S Lender's Address TOTAL FEE 34 ,75 I certify that I have read this application and 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 prop rt6ffec�bo ses SEE REVERSE FOR EXPLANATORY LANGUAGE 3/,)Z SIG ATU V F APPLICANT OR AGENr DATE -54 APPLICATION FOR ELECTRIC PERMIT DBS-5A IZDIVISION OF BUILDING AND SAFETY Department of County Engineer 1� MEMO County of Los Angeles BUILDING WM. J. FOX, COUNTYENGINEER ADDRESS Go CASSATT D. GRIFFIN, SUPT OF BUILDING " FOR APPLICANT TO FILL IN LOCALITY L C PERMIT FEES NEAREST CROSS ST. FEE NUMBER EACH LIGHT OUTLETS p OWNER MAIL RECEPTACLES ADDRESS •'.-� I1 WALL SWITCHES, of t TOTAL OUTLETS - 5C $ .ate_ CITY f�_ TEL NO. -T s) ELEC. RANGES 25 ELECTRICI N ELEC. HEATERS 25 ADDRESS 1 " KW EA - CITY TEL NO. FIXTURES �' S LICENSE NO. NUMBER OF LIGHT CIRCUITS DISTRICT NO GROUP-1 ZONE READY FOR INSPECTION NUMBER OF RECEPTACLE CIRCUITS � MOTORS �, 4- 1 NUMBER HORSEPOWER . FEE INSPECTION RECORD NEW MVD HP OVER INC. EACH DI12&LESS .25 � a 1 2 .50 t. t 2 5 1.00 5 '15 1.50 15 50 2 50 50 200 5.00 misc. NO SIGNS NO TRANS. NO SIGNS NO. LAMPS FOR EACH PERMIT: WIRING $1•:00 FIXTURES $100 SUPPLEMENTARY .50 ' n �5 APPROVALS , TOTAL FEE $ 6� DATE INNS7PECTOR!S SIGNATURE . 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION 'CONDUIT ��r .ex AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY .. 6• " (,��1N vat'it.N WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING ELECTRICAL WIRING.' 1HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES LICENSEDAS REOUI D BY LOS ANGELES COUNTY AND STATE OF POWER CALIFORNIA OR TH 1 AM THE LEGAL NER OF THE ABOVE DESCRIBED REST DEN IA PROPERTY. � UTILITY CO. NOTIFIED SIGNATUREOro / OF PERMITTEE FINAL WILLIAM J. FOX OUNTY ENGINEER VALM�T �`2`� FS-l" 2 2. 5 ®• 1?1�PUTY �' �76A663 DBS 5A 7-s,_ , APPLICATION FOR PERMIT DkPIARTMENT OF BUILDING AND SAFETY optmamwift OMAN , COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRICIAN Walton Electric Coo —_ RECEIVED BY READY FOR DATE ISSUED ADDRESS 2454 N. Rosemead Blvd., FIRST INSPECTION CITY El Nionte l,�t TEL. ND.FO 65679 ✓ •t/S COUNTY LICENSE NO. 1104 EXPIRES BUILDING 65 Flaherty NG 98 PERMIT FEES Temple NUMBER EACH FEE LOCALITY City LIGHT OUTLETS NEAREST RECEPTACLES 2 CROSS ST WALL SWITCHES _OWNER Creative_Builder_s Inc. TOTAL OUTLETS 2 5c 10 MAIL ELEC. RANGES 25 ADDRESS ELEC. HEATERS 25 CITY TEL. NO. _ FIXTURES 5 1 HEREBY ACKNOWLEDGE THAT I HAVE "READ THIS MISC. APPLICATION AND STATE THAT,THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING-. MOTORS 1 CERTIFY THAT I POSSESS THE ABOVE VALID LDS NUMBER HORSEPOWERFEE AN COUNTY LICENSE, OR I AM THE LEGAL OWNER NEw MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROPjgjjY DESCRIBED ABOVE. %2 s LESS $ .25 SIGNATURE O 1/2 2 .50 PERMITTEE `� ' 2 5 1.00 INSPECTION RECORD 5 is 1.50 _ is sD 2.50 50 200 5.00 _ 200 500 10.00 500 1 000 15.00 Q Z OVER 1000 20.00 M.G. SET/FREQ. CHANGER-HP WELDERS: AC-KVA }j� GT�jj� C, GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF ORIB.) 1�' MOVED MTORS (75% OF ORIG.) ��•�-I - 1' X /�=�•'pr�i d®/1/ O MISC. — ` t f rA A ' SIGNS _ I NO. NO.TRANS. ' NO. NO. LAMPS I .-r..cC. APPROVALS FOR EACH PERMIT. DATE INSPECTOR'S NAME WIRING T=. Power 7pole $1.00 1 DO CONDUIT G FIXTURES r $1,00 WIRING /.- OA/sou✓ t SUPPLEMENTARY ,50 FIXTURES 1 10 POWER TOTAL FEE $ UTILITY CO.NOTIFIED FINAL 76A663.:DBS'.JA 7'5'r'- APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN' DISTRICT NO. GROUP I ZONE PERMIT NO. ELECTRICIAN r Walton Electric CO. RECEIVED BY READY FOR DATE ISSUED I/ ADDRESS 2454 N. Rosemead Blvd.,- L FIRST INSPECTION CITY El Monte TEL. NO. FQ 85672_ ~ J COUNTY LICENSE NO. 1101i EXPIRESBUILDI G 9865 Flaherty PERMIT FEES FEE Temple City NUMBER EACH LOCALITY LIGHT OUTLETS 11` NEAREST RECEPTACLES 6 CROSS ST. WALL SWITCHES OWNER Creative _Builders Inc. TOTAL OUTLETS h2- Sc $ 2 TO MAIL ELEC. RANGES 25 ADDRES9 _ ELEC. HEATERS _ 1 25 CITY TEL. NO. FIXTURES _�_ 'S - I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS Z/G AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWERFEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER NEW MVD. HP OVER JNC. EACN OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. I/y 6 LESS $ .25 SIGNATURE OF i I/2 2 .50 PERMITTEE 2 5 1.00 INSPECTION -RECORD 5 15 1.50 15 50 2.50 50 200 5.00 200 _500 500 1 000 1 5.00 Z OVER 1000 20.00 M.G. SET/FREQ. CHANGER-HP Q' WELDERS: AC-KVA O GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF ORIG.) _ MOVED MOTORS (75% OF ORIG.) MISC. SIGNS NO. NO.TRANS. APPROVALS NO. NO. LAMPS DATE INSPECTOR'S NAME FOR EACH PERMIT: WIRING $1.00 i 00 CONDUIT FIXTURES $1,00 _ Lon WIRING `//J•�r' J /} 1�,4.:1/� SUPPLEMENTARY .50 FIXTURES POWER J A TOTAL FEE $ 90 UTILITY CO.NOTIFIED `i)_1 FINAL 1 / V C/(�✓ •• .w^"'L