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Home My Public Portal About9520 GARIBALDI AVE_Electrical__ WQRKER'8 COMPENSATION Df consent to 2X�DOto DP1y(,2-9,) APPLICATION FOR ELECTRICAL PERMIT I hereby affirm'that I have ■ certificate of consent to self Insure, 7t1A003 or a certlflcate of Worker's Compensation Insurance, or a certlfled COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Seo.3800 Lab.C.). Pollcy No. Company POR APPLrANr TO 737.7.7H •OB ❑ A7 Certlfied Dopy V hereby fumlehed. New Residential B{dgs.d Pools NO.rzOR FEE j LOCALITY ❑ CerUW copy is filed with dhe county building lnspeotlon 1 8 2-FemQy,Sq.Ft _ T departrnent Multi-family Sq.PL ,pgg8 ST. Rooklentlal Swimming Pooh ,A,�� Date App6caM laAP BOOK P� PAPACa CERTIFICATE OF E)CBIPTIOfJ FROM WOR}<ERS' Outlets:Ree-_Ught Sw. AME COMPENSATION INSURANCE Ps�l1 (Thls.eectlon need not be completed H the work Involved by the AddI to 11 AppgE88 permit In for one hundred dollars(S1 0-0)or lase.) TOS�' � O I certify that In the performance of the work for which this permit crry Na Is Issued, I shall not employ any person In any mariner so as to PLAN CHECK become subject to the Workers'Compeneatlon Laws. Ughting Futures F1 rat 20 APPurwr Total No AddRional ADDRESS Date AP~ RESDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: If, after making this Certificate of CITY TeLto+ Exemption,you should become subject to the Workers' Compensatlon OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code, you must forthwtth comply with such PERMIT provisions or this permit shall be deemed revoked. Power Apparatus 8 Largo Appllancee LICENSED CONTRACTORS DECLARATION Stze 8 Type HP,KW,KVA,or KVAR ADDRESS I hereby afflrm that I am 116onsed under provisions of Chapter B Over 3 to 10 Ir1ol. (commencing with Section 7000) of Division 3 of the Business and CITY Tet No. Professions Code, and my license Ia In full force and effect. Over 10 to 50 Ind. Over 50 to 100 Ind. � �' d Over 100 DtBTFnCT NO. BY Lbense Number Uo.Class / o C4ntrdCtDrDate O-U= DATE DATE ❑ 400-1 Amp.Under 000 V ( 9 VAUDAMN �+ I am exempt neer Sec. Over 1000 Amp.or Over 800 V FINAL W B.BP.C.for this reasonBRANCH CIRCUIT FEES BY fa Date: 15A,or 20A,1XV,Ughting or Recept. Z 1 To 10 Brarroh Clroults Stgnature 11 To 40 Branch Clrcub 41 Q Mas ench Circuits Exemption for Reg.Melnt Elect 1Cyk 2 208V To 2T7BBr.Ctor tts l FAMILY Temp.Power Pee A Appurtenances HOME OWNER BUILDERDECLARATION ACCT.r I hereby affirm that I am exempt from the Contractor's Uoense Law SIgn with One Branch aroult for the following reason (Seotion 7031.8, Business and Professions Addtdonal Sign Branch Ctroulb 33W 63.45 Code): k, ❑ . LAILm Condutts a Conductors - I ITEM I,as owner of the property,will do the work and the structure u la not Intended or offered for sale (8ectlon 7044, Buslness Otic(See Complete Fee Schedule) TOTAL 63 - 4-5 and Profeealons Code). , Cac1'y, 63.q5 CONSTRUCTION LENDING AGENCY {U4yT _ I hereby affirm that there la a construction lending agency for the performance of the work for which this permit Is Issued (8eo. 3087, PERMFr FEE (SutrTo* - Cly.C.) PLAN CHECKING FEE — I 81f 5 1J Lender s Nemo PERMIT ISSUING FEE IIIA,,° I (M 7:38 Lend*rs Address — I oerttfy that I have read this application and under penalty of pudury shads TOTAL FEE t}rt the above Infonruad n is oorreot I agree to compty wrfth all County ordlnano"and State laws regulating Electfool wtrIng,and hereby authortze repreeeetadvas of thMy to enter upon the above-merrtloned property for 1 p S SEE REVERSE FOR EXPLANATORY LANGUACIE OF P&aw= DATE DEC 20-M 19 A WORKERS'that COMPENSATION cafe of cons 7&6463 D°W V� APPLICATION FOR ELECTRICAL PERMIT I hereby affJrm that I have a certificate of consent to self •.Q4106G Insurd, or-Q certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS orco certified copy thereof (Sec. 3800, Lab. C-) PgJJNo Company FOR A"UCANf TO PILL IN I cya Certified copy Is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. ❑Certified copy Is filed with the county building Inspec- 1 8 2-Family, Sq. Ft. S = $ LOCALITY AREST tlon department. Multl-family Sq. Ft. CROSS 5T �•T Z�3 QL t Date Applicant Residential Swimming Pools OYMER OR FIRMNAUb1E CERTIFICATE OF DT.MPTION FROM WORKERS' � MAUL COMPENSATION INSURANCE Outlets: R fight Sw. ADDRESS First 20 (This section need not be completed IF the work Irtvohr d byCITY Tel. No the permtt Is for ona hundred dollars ($100)or lees.) Total No. Addltional PLAN 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 Lighting Fixtures First 20 ADDRESS so as to become subject to the Workers Compensation Laws. Additional Total No. CITY Tel. No. Date Ilcant Fixed Appliances Not Over 1 HP PEST NOTICE TO APPLICANT: If, after making this Certificate of APPLICATION 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 A'✓ with comply with such provisions or this permit shall be Top — FAU —W.H. — deemed revoked. Hood — Fan _Other— CITYhCgA�M I. No. ,b LICENSED CONTRACTORS DECLARATION UCENSE OR - 1 I hereby affirm that I am licensed under provltlons of Chapter 9 Dlsp.. — Room AJr Cond. — REG. NUMBER-4-Of Z- C1 (commencing with Section 7000)of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NO. BY �> and Professions Code,and my license Is In full force and effect. . D 0 Size 8 Type HP, KW, KVA, or KVAR License Number '1Llj —Uc. Clash , Up to 1 Incl. FIS U ControdVOver 1 to 10 Incl. DATE VALIDATION El Over 10 to 50 Incl. FINAL I am exempt under Sec. Over 50 to 100 Inc. BY U W B.BP.C. for this reason Over 100 0- Services, Swbd., MCC 8 Panelboards , U) Date: Z 0-200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600V ElExemption 1000 Amp. or Over 600 V Exemption for Reg. Malnt. Elect. SINGLE FAMILY Temp. Power Pole 8 Appurtenances HOME OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors License Sign with One Branch OrcultCT Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits �� Professions Code): ❑ I, as owner of the property, will do the work and the Misc. Conduits 8 Conductors I ITOS structure Is not Intended or offered for sale(Section 7044, Other (See Complete Fee Schedule. Poo. TOTAL 55 - 10 � - 1� Business and Professions Code). CONSTRUCTION LENDING AGENCY UEM 55.Ill 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 O JCI-C![C11 5/ 2/5`1 PERMIT ISSUING FEE Lender's Address 676-� 1 AM 7' 1 certify that I have rood this application and state that the I TOTAL FEE above Informatlon 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 51gnatur of a Date �� COUNTY OF LOS ANGRTES TEMPLE CITY # 0508 ELECTRICAL PERMIT ' DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1012150025 BUILDING AND'SA= / LAND DEVPIDPKsyr TH4PLE CITY CA 91780 PHONE: (626) 285-0488 ETT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 6561 LT: 263 UN: .002 9520 GARIBATDI AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801649 ASSESSOR I1Q 04ATION NUMBER: NEAREST CROSS STREET: TEM4PLE CITY 5385-007-002 Al PERMIT ISSUINCE FEE 27.80 THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY, C G1 OUT=-LGT,SW,RECP 6.00 OUT 11.60 TENANT: G2 LIGHTING FIZTURFS 18.00 IAP 34.90 ISSUED ON: PROCESSED BY: PLAN BY: H2 RES GRBG DISP LT 3HP 1.00 DIS 10.90 12/15/10 SR H3 RES DISH%A—H LT 3HP 1.00 DIS 10.90 OWNER: TEL. NO: HS RES MASH MACH LT 3HP 1.00 WAS 10.90F� � F Y: CODE: HPHC PROPERTI&S LLC (626) 382-168&- TOTAL FEES 107.00 19223 OOLI14A RD.#972 ROWLAND HTS 91748 DkSCRIPTICRI OF WORE ELECTRICAL LPTQDW REMODEL THREE BATHROOM RRNODRL APPLICANT: TEL. NO: WEI, LI (626) 696-0003- 517 N. CHANDLER AVE SPECIAL CONDITIOiNS: MONTEREY PARE 91754 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE LI WEI CONSTRUCTION- (626) 696-OOQ3- 517 N. CHANDLER AVENUE #D LIC. NO TEMPORARY PO1fER POLE MONTEREY PARI, CA 91754 837977 B UNDERGROUND CONDUIT ARCHITECT OR ENGILIRER: TEL. NO: UFRR GROUND LIC. NO: ROUGE CONDUIT ROUE WERJ:.PG MAIN ?1ATER T.TTPP PLASTIC Y/N METAT, Y/N UTIISTY COMPANY NOTIFIID REPORT ID: DPP-265 RO= TO: 1390508