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Home My Public Portal About9249 GARIBALDI AVE_Electrical__ °" COMPEN °�°' �'°" - '0'B1 APPLICATOON FOR ELECTRICAL PERMIT ' I hereby affh that I have a oerttfloebe of oormettt to self Hale, or a �de of VYkrkwa' CortipwvmWon Insurance, or a certfW COUNTY OF LOS ANGELES BUILbiNG AND SAFETY COPY (Sea 3800,Lab,C1 Pdlcy Na cbrt;dany PM APPLICANT TO HLL NADIXIE ❑ Coctt Dopy Whereby fyrr sl-d.- EACH'. NO. FE S New Raeiderttiel Bldgs S Pooh' Eertffletl oopy 16 Mod with tt» courtly tx Wd p nepeorion 1 8 2-FnmBY,Sq.Ft��r $: = d NEAREST TY deparm-TL Muitf-}amity 94 Ft CFlO>38 8T. Residential swlrrunlrtp Pooh CYNER OR ;Apt "'- •.GERTTkCATE OF EXEMPTION FROM WCORKERS'. MAL - COMPENSATKIN MURANGE Outiels Rao—LJgtt — 3w. — rev (Vile pactlow nemd net be—0stad It the work Vwohmd by the Total Na Addttiorral . v^ � ' - Tel.Na per t In for one hundryd"Isrq 4$100)or iwe.) Pw+a-EeK -• I cwdfy-that In the Performer-oce.of:the work fgr.whiph this,permkAPPUCMT Is lamed, I shall,not employ any person In arty manner eo as t, beoorrre abod to.the,.Rbrkere'C6Riperreetbn Laws. Lditfng Fbchaee_ Flret 20 ` r'` ' ADDRESS C� s Total No.T� Additiooal CtTI A feL ' Dere t Fbced Appfanoee Not Over 1 HR PEF T NO TO APPLICANT: lf, after making; ttd¢ of: E��aAnrptipn,you"#beoome sub}eot to the.Wodcera'Cortperreatbn Rave Heater— 0.W. —T r r pr-emboris of tt>a labor rode,y'0-U'n uet forthwtth corn* with such Oven Dryer — W.Mt ADDRt=- 2 provkiorm or this permit shall be Top. —. FArU — W1-L . ol c{T1 Tek:-No. I-CEN,$ED COKMA:CTRf}9[}ECL.A LIMON Flood — Fan Other— I hereby afflr'n thea-! am Ilcermed urr provteforrs of Clurpter 9 Dyep,.-- Room Air Cord.' T - (oornmmoft wfth Sectidn 7000) of bmakon 3 of the Bpovas and slEcj Nu /D/d.� a�G'-✓l5 Profeesione Code,and rrry license Is In h4 foroe and effebiPpiAr rpp��.S Ver➢e App�rlces DtSTTnar N0. �j O t- 7"CE ,U T� size d Type HP,KW,KA or KMkR [/ Number //D f d� Lk Clave G�- Up to hok. FINAL . .. _ C7 b —T^Over 1 to 10 Ind. D'TE/ .6 Cher 10 to 60 Incl. FINAL ❑ I erh exempt under Sea Over 60•fo,100-no- BY IF B.SrC,for this reapw Over 1p0 Slxn re 201- 10 015 Amp.Lhtder 800 V 1000 ar 800 V O%w Amp- ,Oy ❑' Exemption for flog-Mahn,Rleat SINGLE FAM9LY Temp.Power Poke d Appurtel� I ACCT• HOME OWNH-R-BUILDER-D C-( WIION .Sign with dna&-er h CiroLtt ,7ti71,F,�1 -65■30 1 hereby efitrm that I-em exmgA from the Contras or`s LJcertee Lew for the foD3Kkp reasn(Sectn 7031.6, Buereea'ad Ptosplce es B!el .G� a - 1 ITEMS Code): Mlsc carrdutm' :,condudbre T�TA� . 65-313 ❑ 4 ea owner of the property,wC do the work and the struohae +�mayi Isnot Herded or offered for Bale (Sebtiorr 7044, Bistrreea Omer(-see Compkeie Fee sdredr�e) Poo .end Profeask)m code). v UQ CONSTRUM)N UENINNO AGENCY _ I hereby affirm that there Is a correL'rxrt larrdbV agenoy for.the performance of the work for wtct tfrls pbrmft Is Issued(sea 3097, PER MTF FEE.:. -(Sub-Total) 00ou-ow1 10/. c v.c.).. PLAN CHEUCING FEE 2659 _ 1_: .A1' 7=51 LwK re Name - PE-RMfT JW$ NG FEE p� L-erdera Address / r I cor#fy that I have read this application and state that the above TOS FEE 0orrrrat1on be oorred.I agree to con#y'WM all County ordnerrcea and State t§we regulating Ekxtioel wldrp, and hereby autt o d thio to errier upon the above-mentioned'_ . SEE REVERSE FOR EXPLANATORY LANGUAGE QJ Date WORKERS' rtATION DECLARATION CE-806G to/st APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have ave a a certificate certificate of consent to self insure, or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec.3800,Lab.C.) Policy No. Company FOR APPLICANT TO FILL IN JOB ❑ Certified copy is hereby furnished. New Residential Bldgs.& Pools EACH NO. FEE ADDRESS Certified copy is filed with the county building inspection 1 & 2-Family,Sq.Ft. $ — $ LOCALITY department. Multi-family Sq.Ft. — NEAREST CROSS ST. Date Applicant Residential Swimming Pools OWNER OR FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:RecLight_ Sw. MAIL COMPENSATION INSURANCE ADDRESS This section need not be completed if the work involved ( b the p y First 20 CITY Tel.No. permit is for one hundred dollars ($100) or less.) Total No. Additional PLAN I certify that in the performance of the work for which this permit APPLICANT CHECK 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 Additional r � Total No. CITY Tel.No. Date Applicant Fixed Appliances Not Over 1 HP NOTICE TO APPLICANT: If, after making this Certificate of PERMIT Exemption,you should become subject to the Workers'Compensation Range_ Heater_ D.W. _ APPLICANT provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer _ W.M. _ ADDRESS provisions or this permit shall be deemed revoked. Top — FAU _ W.H. _ CITY Tel.No. LICENSED CONTRACTORS DECLARATION Hood _ Fan _ Other_ I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. LICENSE OR Class. (commencing with Section 7000) of Division 3 of the Business and REG.NUMBER W Professions Code,and my license is in full force and effect. Power Apparatus& Large Appliances DISTRICT NO. PROCESSED BY U Size& Type HP,KW,KVA,or KVAR W License Number Lic.Class Up to 1 Incl. FINAL --I Over 1 to 10 Incl. DATE VALIDATION N. Contractor Date ❑ Over 10 to 50 Incl. FINAL I am exempt under Sec. Over 50 to 100 Inc. BY BAP.C.for this reason Over 100 Services,Swbd.,MCC&Panelboards , f1 Date: 0-200 Amp.Under 600 V � W Signature 201 - 1000 Amp.Under 600 V H ❑ Exemption for Reg.Maint. Elect. Over 1000 Amp.or Over 600 V 2 SINGLE FAMILY Temp.Power Pole& Appurtenances `^p' HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 47;• 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 Brandh Circuits 4 Iwo Code): i ❑ Misc.Conduits& Conductors TT OL 60.3 10 3# I,as owner of the property,will do the work and the structure L is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) ► >) ,K p and Professions Code). O 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) w ,3,.tw1 10/ Civ.C.). y�� PLAN CHECKING FEE 2 f Lender's Name PERMIT ISSUING FEE Lender's Address I certify that I have read this application and state that the above TOTAL FEE 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 Signature of Permittee Date CON OF LOS ANGELES TEMPLE CITY - f 0508 ELECTRICAL PERMIT >� DEPARTMEJfT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 9909020004 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: ---FEU-MD BUILDING ADDRESS: ON FILE 9249 GARIBALDI AV FEE DESCRIPTION: QUANTITY: UDM: AMOUNT: TEMP CA 917801626 ASSESSOR INFORMATION NUMBER� NEAREST CROSS STREET: 5385-003-016 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT,SY RECD 3.00 OUT 5.85 G2 LIGHTING FIXTU�ES 1.00 LGT 1.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES TOTAL FEES 35.55 09/02/99 UT Q2/29/00OWNER: -TEL. NO: FINAL DATE F I WAL B CODE: . TAT•JOHN (626) 286-4615- 9244 GARIBALDI AV r TEMP 917801676 DESCRIPTION OF WORK LIGHT FOR INSIDE OF GARAGE APPLICANT: TEL. NO: SAME AS 06 NER - SPECIAL CONDITIONS: PNGELES C CONTRACTOR: TEL. -NO: APPROVALLS DATE INSPECTOR SIGMTUffF- SAME AS 06I NER LIC. NO TMUNY-MM POLE UNDERGROUND MUTr- LIC. 111111 MAIN WATER LINE � g � PLJST I C YIN METAL Y/N �vaull-,SLJC VO�K Q G ❑ 3 O� Service That REPORT ID: DPR265 ROUTE TO: BS0508