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Home My Public Portal About5806 GOLDEN WEST AVE_Electrical__ WORKERS'COMPENSATIONDECLARATION CE-806G (2-80) APPLICATION FOR ELECTRICAL PERMIT Thereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY insure, or a certificate of Workers'•Com sation Insurance,or �+ a certified copy thereof(Sec 3800,L ` FOR APPLICANT TO FILL I JOB /,p/� Policy No Compan ADDRESS ,� (!p yQ�,��+ ew Residential Bldgs &Pools EACH NO FEE WC tified copy whereby furnished 1 &2-Family,Sq Ft. $ — $ LOCALITY Multi-family Sq Ft NEAREST ertified copy is filed with the county building inspection CROSS ST dep tin t Residential Swimming Pools OWNER OR 7— D / /,.� FIRM NAME �/ � Date' Applican /-F dh W Outlets Rec—Light Sw MAIL. to- First 20 ADDRESS CERTIFICATE OF EXEMPTION FROM WORKERS' Total No _ d Additional CITY I( Tel N } COMPENSATION INSURANCE' PLAN CHECK 0- (This section need not be completed if the work involved APPLICANT 0 by the permit is for one hundred dollars ($100) or less.) Lighting Fixtures First 20 ADDRESS Additional Total No i - Q I certifythat in the performance of the work for which this Fixed Appliaraces Not Over 1 HP CITY Tel No � permit is issued, I shall not employ any person in any manner /- PERMIT // yy�� / U so as to become subject to the Workers' Compensation Laws Range_ Heater D W APPLICANT h AW-, !%N •a Oven Dryer�`W M ADDRESS (�/� Z Date- Applicant Top FAU.•—W H �f�' Hood Fan' Other_ CITY �L - Tel NoZ� "� NOTICE TO APPLICANT If, after-making this Certificate of D i s p Room Air Cond.— LICENSE 09 ,,tt _ Exemption, you should become subject to the Workers' REG NUMBER 4! Class Compensation provisions of the Labor Code, you,must,forth- Power Apparatus& Large Appliances DIST IC WPROESD BY with comply with such provisions or this permit shall be A deemed revoked. Size&Type HP,KW, KVA,or KVAR e Up to 1 Incl ga Over 1 to 10 Incl FINAL DATE LICENSED CONTRACTORS DECLARATION f VALIDATI N Over 10 to 50 Incl �"- F� I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc FINAL 9 (commencing with Section 7000) of Division 3 of the Busi- Over 100 BY ness and Professions Code, and my license is in full force and effect Services _ io �se Num�er Lic Class 0-200 Amp Under 600 V 201-1000 Amp Under 600 V ��i-� 'Contractor //YC, Date � 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 0-2 k 2 A License Law for the following reason (Section 7031 5, Busi- Additional Sign Branch Circuits , # o o•0 2 ness and Professions Code) - � � ` I,•as owner of the property, will do the work and the Other (See Complete Fee Schedule)—Misc Conduits&Conductors 2I ,a 047.00 ,structure is not intended or offered for sale c(Section G•7 O O= 7044, Busmess and Professions Code) °y° ° v CONSTRUCTION LENDING AGENCY 'I hereby dffirin that there is a construction lending agency 0'6, 1 ,7'—8 for the performance of the work for which this permit is PERMIT FEE (Sub-Total) issued (Sec 3097,Civ C) ii Q Lender's Name PLAN CHE&ING FEE .(One-Fourth Permit Fee) . Lender's Address PERMIT ISSUING FEE 1 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 here uthorize re sentatives of this County to enter upon t abo -mentio roperty for inspection purpo es SEE REVERSE FOR EXPLANATORY,LANGUAGE gnature of Permittee Daf e COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0204110010 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ADDRESS:LEGAL ID: FEES PAID BUILDING TR: 6561 LT: 452 5806 GOLDEN WEST AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802203 ASSESSOR INFORMATIONNEAREST CROSS STREET: LAS TUNAS 8587-027-024 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT,SW,RECP 15.00 OUT 29.25 TENANT: G2 LIGHTING FIXTURES 5.00 LGT 9.75 ISSUED S : P ON: H4 RES RANGE HDS LT 3HP 1.00 HOO 10.95 04/11/02 JK 10/08/02 LB 200 AMP PANELS, MCC 1.00 PAN 38.85 TEL. 0: TOTAL FEES 116.55 FINAL AT CODE: MACHMULLER FRED;WILHELMINA H (626) 285-8219- �l1 5806 GOLDEN WEST AV �Z TEMP 917802203 UMMMON _ . ELECTRICAL FOR KITCHEN REMODEL APPLICANT: TEL. 0: L & W KITCHEN & BATH - 8812 LAS TUNAS SPECIAL CONDITIONS: SAN GABRIEL ��,GELES C® CONTRACTOR: TEL. NO: O� ��A APPROVALS DATE INSPECTOR SIGNATURE L AND W KITCHENS AND BATHS (626) 287-1131- 8812 LAS TUNAS DR. LIC. NO TEMPORARY POWER POLE SAN GABRIEL, CA 91776 205344B UNDERGROUND CONDUITs_ ARCHITECTG LIC. NO: 11II1� ROUGH CONDUIT n �] n/, GWIRING MAIN IP )' S L V C W O�I�\ PLAST I PLASTIC N 19 ❑ O 0 •. A 0 ® ®� - REPORT ID: DPR265 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0102220036 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL FEES PAID BUILDING DRE TR: 6561 LT: 452 5806 GOLDEN WEST AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802203 ASSESSOR WOPATION NUMBER: NEAREST CROSS STREET: WOODRUF 8587-027-024 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY HA FAU LESS 3HP 1.00 FAU 10.95 TENANT: JB AC UNITS +3-10HP 1.00 AC 19.65 ISSUED P PLAN BY: EXPIRES ON: TOTAL FEES 58.35 02/22/01 UT 08/21/01 OWNER: TEL. NO: FI AL DAT F In BY: CODE: MACHMULLER FRED;WILHELMINA H 5806 GOLDEN WEST AV Z c�(� TEMP 917802203 I I OF WOK V61 INSTALLATION OF CENTRAL HEATING AND AC APPLICANT: . NO: CAL WEST HTG AND AC (626) 574-9300- 9737 VAL ST _ SPECIAL CONDITIONS: TEMPLE CITY CONTRACTOR: TEL. N0: �j�o.�- %��4�\ APPROVALS DATE INSPECTOR SIGNATURE CAL WEST HEATING AND AIR COND. (626) 574-9300- 9737 VAL ST. LIC. NO TEMPLE CITY 505986 C20 r `, ��\ TEMPOROWER POLE i UNDERGROUND CONDUIT I r--�F�� ARCH GI 0: '/ I "� ��, �� UFER GROUND LIC. NO� ROUGH CONDUI - ROUGH WIRING 6- � MAIN WATER LINE PLASTIC Y/N METAL Y/N -' UTILITY COMPANY NOTIFIE REPORT ID: DPR265 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0102020015 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: BUILDINGADDRESS: TR: 6561 LT: 452 5806 GOLDEN WEST AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802203 ASSESSOR IO NUMBER: NEAREST CROSS STREET: LAS TUNAS 8587-027-024 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY F1 120V, 15/20A BR CKTS 1.00 BR 17.25 TENANT: G1 OUTLETS-LGT,SW,RECP 4.00 OUT 7.80 ISSUED PROCESSED BY: EXPIRES . G2 LIGHTING FIXTURES 3.00 LGT 5.85 02/02/01 UT 08/01/01 H7 RES EXHAUST FANS 1.00 EX 10.95 OWNER: TEL. NO: TOTAL FEES 69.60 FINAL DAT _ Y: CODE: MACHMULLER FRED;WILHELMINA H - 5806 GOLDEN WEST AV 11 TEMP 917802203 DESCRIPTION OF WOR ELECTRICAL FOR REMODEL APPLICANT: TEL. L & W KITCHENS & BATHS (626) 287-1131- 8812 LAS TUNAS DR SPECIAL CONDITIONS: SAN GABRIEL, CA LO ANDA WT KITCHENS AND BATHS (626)N287-1131 � ®��9� APPROVALS DATE INSPECTOR SIGNATURE 8812 LAS TUNAS DR. LIC. NO TEMPORARY POWER POLE SAN GABRIEL, CA 91776 205344B / UNDERGROUND CONDUIT ARCHITECT NEER: T L. N0: // i UFER GROUND LIC. NO /' 1111111 ROUGH CONDUIT ROUGH WIRING II! 4+ � r� MAIN WATER LINE .' , O ��C w�J� PLASTIC Y/N METAL Y/N l-- ---- LITY COMPANY NOTIF O L Ell REPORT ID: DPR265 ROUTE TO: BS0508