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Home My Public Portal About5717 GOLDEN WEST AVE_Electrical__ 'GA669-C960610-60 ,APPLICATION FOR ELECTRI SAL PERMIT 1 COUNTY OF LOS /ANGELES DEPARMENT OF COUNTY ENGINEER BUILDING/�°� �J BUILDING AND SAFETY DIVISION ADDRESS�i / C1 JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. PERMIT FEES OWNER 1 T E M WUMBER EACH I FEE MAIL OUTL �j S $ ADDRE LIGHT RECE SW .10 CITY TEL. NO. LIGHTING FIXTURES 10 ELEC. RANGES CLO. DRYERS ELECTRICIA s,'I. '' ��'✓�✓ � WATER H EATERS .50 ADDRESS i J '�✓ ELEC.SPACE HTRS DISHWA_SHER9 CITYad"ATEL NO - -�� osERs AUTO.- ; STATE J WASHERS STA.COOKING UNITS ,25 LICENSE NO. / 7-17� MOTORS, OVER INC H.P. tY DIO, Z I P CESSED Y 0' 1/2 25 2 .50 INSPKTI IN R'ECORrS- 2— 5 1.00 O 5— 15 1.50- V 15— 50 2.50 Ix O 50— 200 Soo w NO TRANS SIGNS: NO.LAMPS SERVICE 0-600V -100 SERVICE OVER 600V - 500 misc. WIRING PERMIT 1 00 / FIXTURE PERMIT 100 SUPPLEMENTARY PERMIT 50 TOTAL FEE S 7 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS {DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPL WITH ALL COUNTY-ORDINANCES AND STATE LAWS REGULATINGY CONDUIT ELECTRICAL WIRING I HEREBY CE THAT 1 AM PROPERLY EGISTERED AND�OR WIRING LICENSED AS E0 IRED BY LOS ANGELES UN AND STATE OF FIXTURES CALIFORNIA O TAT 1 M THE LE AL NE OF THE B VE r DESCRIBED RESI E IAL OPERT POWER SIGNATURE 11 FINAL UTILITY CO.NOTIFIED f rQ� fy'/� /J��/S OF PERMITTE Y //,7 U /" �VVI4LIDATION AR-jHUR C. VEIT cK Mo cases SUPERVISING ELECTRICAL ENGINEER LF',I-' r C, 4 2 D WORKERS' COMPENSATION DECLARATION 76A66vaPw3ie7 APPLICATION FOR ELECTRICAL PERMIT O I �reby affirm that I have a certificate of consent to self ;�EA� , in u or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS ora cer ed copy thereof (Sec 3800, Lab C )�. , Policy No Company FOR APPLICANT TO FILL IN SOB FICertified co ✓�/ copy is hereby, New Residential Bldgs & Pools EACH NO FEE ADDRESS S Certified copy is filed with the county building inspec- 1 & 2-Family, Sq Ft $ —Is LOCALITY £ �� hon department - r Multi-family Sq FT NEARESTSS . CR Date ` Applicant' Residential Swimming Pools OWNER OR, CERTIFICATE OF EXEMPTION FROM WORKERS' c F �T JOr _ ' COMPENSATION INSURANCE' First 20 M Outlets ReLight Sw IRANAME IL- ADDRESS 5"717 &g60vVwES? (This section need not be completed if the work involved by Total No Additional CITY �� 0'1' Tel No7— 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 - AdditionalDate Applicant Total No CITY Tel No NOTICE TO APPLICANT If, after making this Certificate of Fixed Appliances Not Over 1 HP _ vt PERMIT Exemption, you should become subject to the Workers' Range— Heaters 8 W — ` APPLICATION Compensation provisions of the Labor Code, you must forth- Oven — Dryer —✓W M v ADDRESS with comply with such provisions or this permit shall be Top — Dry —W H — deemed revoked Hood — Fan —Other_ CITY Tel No LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp — Room Air Cond REG NUMBER Class commencin with Section 7000 of Division 3 of the`Busmess ( 9 ) Power Apparatus& Large Appliances DISTRICT NO PPPGESSED BY >_ and Professions Code,and my license is in full force and effect tD 0- Size Size &Type HP, KW, KVA, or KVAR d // Q License Number Lic ClassU Up to 1 Incl FINAL Over 1•to 10 Incl DATE VALIDATION 10� Contractor DateV 0 ❑ Over 10 to 50 Incl FINAL j Q I am exempt under Sec Over 50 to 100 Inc BY r/G� 0 B&P C for this"reason LLI Over 100 I/ a 0 Date Services, Swbd , MCC & Panelboards / Oth ' Z 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 Power Pole &Appurtenances HOME OWNER-BUILDER DECLARATION - Sign with Once Branch Circuit I hereby affirm that I am exempt from the Contractor's License g Law for the following reason (Section 7031 5, Business and Additional Sign Branch Circuits _r _ Professions Code) - - - I, as owner of the property, will do the work and the Misc Conduits &Conductors j !i7 structure is not intended or offered for saleSection 7044, Other (See Complete Fee Schedule)— Business and Professions Code) ' ( �I_IT;iL -6 ® 00 _ CONSTRUCTION LENDING AGENCY w1 �°-{ =�}-';J 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) 3 4• {i:+3. (Sec 3097, Civ C ) 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 above information is correct I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby a horize represent fives of this County to enter upon the menti e pr rty for inspection purposes r/� SEE REVERSE FOR EXPLANATORY LANGUAGE azure Permittee Date Os 1 • WORKERS'COMPENSATION DECLARATION CE-806 10ie1 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self CE-806G insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec. 3800, Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE ADDRESS ❑ S —Certified copy is filed with the county building inspec- 1 8 2-Family, 9 Ft. $ $ LOCALITY — Multi-family NEAREST tion department, P S . Ft.9 CROSS ST. Date Applicant Residential Swimming Pools OWNER OR FIRM NAME r" CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw._ MAIL COMPENSATION INSURANCE ADDRESS This section need not be completed if the work involved b First 20 ( tip Y Total No. Additional CITY Tel. No. 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. Additional CITY Tel. No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT ' 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 with comply with such provisions or this permit shall be Top — FAU —W.H. CITY Tel. No. deemed revoked. Hood Fan _ Other_ 1 LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. REG, NUMBER Class. (commencing with Section 7000) of Division 3 of the Business DISTRICT NO. PR OC SSED BY d and Professions ode and m license is in full force and effect. Power Apparatus 8 Large Appliances o ession s C Y O Size &Type HP, KW, KVA, or KVAR V License Number Lic. Class Up to 1 Incl. FINAL LU DATE Over 1 to 10 Incl. VALIDATION LL Contractor Date Over 10 to 50 Incl FINAL >_❑ I am exempt under Sec. Over 50 to 100 Inc. BY <Q Over 100 ce B.&P.C. for this reason O Date: Services, Swbd., MCC & Panelboards , d 0 - 200 Amp. Under 600 V LU Signature 201 - 1000 Amp. Under 600 V ElExemption for Reg. M int. Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY Temp. Power Pale 8 Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits Law for the following reason (Section 7031.5, Business and + r + s Professions Code): ❑ I, as owner of the property, will do the work and the Misc. Conduits&Conductors structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ 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 issued PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). 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 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 Signature of Permittee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701'LAS TUNAS EL 0508 0907200002 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT ILEGAL ID I FEES PAID I BUILDING ADDRESS 1 ITR 6561 LT 81 BL 001 I I 5717 GOLDEN WEST AV 1 I IFEE DESCRIPTION QUANTITY UOM AMOUNT I TEMP CA 917802504 (ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET 18587-023-004 IA1 PERMIT ISSUANCE FEE 27 75 I THOMAS PAGE 597 GRID A3 LOCALITY TEMPLE CITY, Cl I IG1 OUTLETS-LGT,SW,RECP 8 00 OUT 15 60 I 1 ITENANT IG2 LIGHTING FIXTURES 4.00 LGT 7 80 (ISSUED ON PROCESSED BY PLAN BY EXPIRES ON 1 1 TOTAL FEES 51 15 107/20/09 SR 07/20/10 (OWNER TEL NO IF ALS J/pAT FINAL BY CODE 1 IHOU, KWEIT SHUNG - (626) 320-3301- - 15717 GOLDEN WEST AV ITEMP 917802504 - 1 lDffSCRTPTIOk OF WORK (ELECTRICAL FOR ADDITION I (APPLICANT TEL NO ICAI (626) 780-7959- I 1 1502 DE LA FUENTE ST 1 ISPECIAL CONDITIONS 1 IMONTEREY PARK 91754 - I I ICONTRACTOR _ TEL. NO 1 (APPROVALS DATE INSPECTOR SIGNATURE 1 THOU, KWEIT SHUNG (626) 320-3301- 1 1 15717 GOLDEN WEST AVENUE -LIC NO I - ITEMPORARY POWER POLE I I I ITEMPLE CITY, CA 917_80 NONE I I I 1UNDERGROUND CONDUIT I I I 1ARCHITECT OR ENGINEER- TEL NO1UFER GROUND I _ I I I 1 LIC NO I IROUGH CONDUIT I I I I I I IROUGH WIRING (MAIN WATER LINE 1 1PLASTIC YIN METAL YIN I (UTILITY COMPANY NOTIFIEDI 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 IREPORT ID DPR265 ROUTE TO BS0508 I I I I I I I