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Home My Public Portal About5818 GOLDEN WEST AVE_Electrical__ • . WORKERS' COMPENSATION DECLARATION 76A663 DPW 3/87 APPLICATION FOR ELECTRICAL PERMIT •"I fiereby affirm that I>have a certificate of consent to self ,cE eo�cc insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or-a certified copy thereof (Sec. 3800, Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB B r Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS Q El Certified copy is filed with the county building inspec- -1 &2-Family, Sq. Ft. Ia�fl $ — $ LOCALITY tion department. Multi-family Sq. Ft, NEAREST CR05S ST Dare . Residential Swimming Pools OWNER OR ��/ Applicant FIRM NAME k(h��tP� CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec:_Light -Z Sw. G MAIL COMPENSATION INSURANCE 0 First 20 r7 ADDRESS , 67 (This section need not be completed if the work involved by ' Total NoCITY C Tel. No. . Additional -? 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 Additional Total No. 3' CITY Tel. No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT 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 with comply with such provisions or this permit shall be Top FAU —W.H. — deemed revoked. Hood Fan J__Other— CITY Tel. No. LICENSED CONTRACTORS DECLARATION � o LICENSE OR I hereby affirm that'I ain licensed under provisions of Chapter 9 Disp. Room Air Cond. — REG. NUMBER Class. (commencing with Section 7000)of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO. R?RP.CESSED BY >_ and Professions Code,and my license is in full force and effect. t1 Size &Type HP, KW, KVA, or KVAR Q License Number Lic. Class Up to 1 Incl. FINAL V Contractor Date Over 1 to 10 Incl. DATE /�Z VALIDATION 0 aOver 10 to 50 Incl. FINAL lt– I am exempt under Sec. Over 50 to 100 Inc. gY U Over W B.&P.C. for this reason � Date: Services, Swbd., MCC & Ponelboards , 0-200 Amp. Under 600 V Z Z Signature 201 - 1000 Amp. Under 600 V aExemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Temp. Power Pole &Appurtenances I hereby affirm that I am exempt from,the Contractor's License Sign with One Branch Circuit Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits Professions Code): ..-'; ® Misc. Conduits &Conductors 't T I, as owner of the property, will do the work and the i structure is not intended or offered for sale(Section 7044, Other (See Complete Fee iSchedule)_ _z Business and Professions Code). ;. r'f F1L 00 t CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for / 4t 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 /!1 00u]— PERMIT ISSUING FEE ^}z_ Lender's Address TOTAL FEE 7 �� 'r i f rl ,- 1 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 property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE VSiture of Permit Date WORKERS'COMPENSATION DECLARATION 76A663CE-806 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that 1 have a certificate of consent to self insure, CE-806G or a c:;tificate oaf Workers' Compensation Insurance, or a certified CO YO F LOS ANGELES BUILDING AND SAFETY copy thereof(Sec. 3800,Lab.C.) eL Policy No. Company FOR APPLI NT TO FILL IN JOB ❑ Certified copy is hereby furnished. New Residential Bldgs.& Pools EACH NO. FEE ADDRESS ❑ 1 & 2-Family,Sq.Ft. $ — $ LOCALITY copy is filed with the county building inspection — NEAREST department. Multi-family Sq.Ft. CROSS ST. Date Applicant Residential Swimming Pools OWNER OR FIRM NAME /f CERTIFICATE OF EXEMPTION FROM WORKERS' 10- Li MAIL Outlets:R2C Light — SW. h �1 ADDRESS COMPENSATION INSURANCE First 20 (/ (This section need not be completed if the work involved by the Total No. Additional CITY Tel.No. permit'is for one hundred dollars ($100)or less.) PLAN CHECK I certify that in the performance of the work for which this permit APPLICANT 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 �a ADDRESS Additional Total No. . f— CITY Tel.No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of 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 LICENSE OR (commencing with Section 7000) of Division 3 of the Business and Disp. — Room Air Cond. REG.NUMBER ' Class. Professions Code,and my license is in full force and effect. Power A DISTRICT NO. POC SSED BY Apparatus& Large Appliances �� Q ILI Size& Type HP,KW,KVA, or KVAR �( License Number Lic.Class Up to 1 Incl. FINAL ` Over 1 to 10 Incl. DATE VALIDATION Contractor Date Over 10 to 50 Incl. FINAL V ❑ I am exempt under Sec. Over 50 to 100 Inc. BY 6aJ B.&P.C.for this reason Over 100 N Services,Swbd., C rds ILI Q 2Date: 0Q_.�'P Signature 201 - 1000 Amp 00 V ACCT. ❑ Exemption for Reg.Maint.Elect. Over 1000 Amp.or Over 600 V 3303 . 115060 ITEMS SINGLE FAMILY Temp.Power Pole& Appurtenances 1 ITEMS HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit TOTAL 1-5 . 60 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 Branch Circuits CHECK 115060 Code): Wut n�� I,as owner,of the property,will do the work and the structure Misc.Conduits& Conductors CHANGE o00 is not intended or offered for sale (Section 7044, Business. Other(See Complete Fee Schedule) and Professions Code). 0000-0001 3/ 4/96 CONSTRUCTION LENDING AGENCY n M I hereby affirm that there is a construction lending agency for the 5101 1 AM 9'57 performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total) Civ. C.). v PLAN CHECKING FEE , Lender's Name `� O PERMIT ISSUING FEE Lender's q1ve I certify tharead this application and state that the above TOTAL FEE J/ 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 urposes. SEE REVERSE FOR EXPLANATORY LANGUAGE ign re of Permitte Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS EL 0508 9709110013 ----------BUILDING-AND-SAFETY-/-L-AND-DEVELOPMENT--- -DUPL-ICATE -- ------ ----- PHONE: (818) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 6561 LT: 450 5818 GOLDEN WEST AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802203 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LAS TUNAS 8587-027-022 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY, C G1 OUTLETS-LGT,SW,RECP 25.00 OUT 45.75 TENANT: G2 LIGHTING FIXTURES 7.00 LGT 13.65 ISSUED ON: PROCESSED BY: PLA BY: EXPIRES ON: TOTAL FEES 87.15 09/11/97 VG 09/11%98 OWNER: TEL. NO: FINAL DATE FINAL BY: CODE: YU CHING KWAN;ZHI JUAN LU GUAN (818) 286-1598- 5818 GOLDEN WEST AV TEMP 917802203 DESCRIPTION OF WORK ELECTRICAL FOR ADDITION APPLICANT: TEL. NO: SAME AS OWNER SPECIAL CONDITIONS: CONTRACTOR: TEL. N0: SAME AS OWNER �, / _`��J� APPROVALS DATE INSPECTOR SIGNATURE LIC. NO /� ' � j \�\C � TEMPORARY-POWER POLE UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO UFER GROUND i LIC. N0: - ROUGH CONDUIT ROUGH WIRINGMAIN /$ Q PLASTICTER Y/NLINE METAL Y/N _ i UTILITY COMPANY NOTIFIED k REPORT ID: DPR265 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 9911090015 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 -" PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 6561 LT: 450 5818 GOLDEN WEST AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802203 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LAS TUNAS 8587-027-022 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY, C HA FAU LESS 3HP 1.00 FAU 10.95 TENANT: JB AC UNITS +3-10HP 1.00 AC 19.65 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: LB 200 AMP PANELS, MCC 1.00 PAN 38.85 11/09/99 UT 05/07/00 TOTAL FEES 97.20 OWNER: TEL. NO: FINAL DATE FINAL BY: CODE: YU CHING KWAN;ZHI JUAN LU GUAN (818) 286-1598- �/)`& 5818 GOLDEN WEST AV TEMP 917802203 DESCRIPTION OF WORK NEW SERVICE PANEL UPGRADE AND NEW HEATING AND COOLING SYSTEM APPLICANT: TEL. NO: SAME AS OWNER SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: � �A APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO TEMPORARY POWER POLE j UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: // UFER GROUND LIC. N0: 1111111 ROUGH CONDUIT - , ROUGH WIRING fl �� ) MAIN WATER LINE jjLo-) U\\,- PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED Ll** REPORT ID: DPR265 ROUTE TO: SS0508 :a COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 9812290001 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (818) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 6561 LT: 450 5818 GOLDEN WEST AV, FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802203 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LAS TUNAS 8587-027-022 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT,SW,RECP 6.00 OUT 11.70 TENANT: G2 LIGHTING FIXTURES 2.00 LGT 3.90 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: TOTAL FEES 43.35 12/29/98 UT 12/29/99 OWNER: TEL. NO: FINAL DATE FINAL BY: YU CHING KWAN;ZHI JUAN LU GUAN (626) 286-1598- f1�� (,1, 5818 GOLDEN WEST AV i l TEMP 917802203 DESCRIPTIO OF WORK ELECTRICAL FOR GARAGE WITH ATTACHED OPEN COVERED PATIO APPLICANT: TEL. NO: SAME AS OWNER SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: ®� ��1i APPROVALS DATE INSPECTOR SIGNATURE SAMELIC. NO TEMPORARY POWER POLE UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: EL. N0: /// UFER GROUND LIC. N0: L 1111111 ROUGH CONDUIT ROUGH WIRINGMAIN U �� 1 9 L ��IOo �� PLASTIICTY%NL INE METAL Y/N UTILITY COMPANY NOTIFIED O 0 0El el t�, — REPORT ID: DPR265 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701. LAS TUNAS -EL 05.08 9907300010 BUILDING AND SAFETY. / LAND DEVELOPMENT — TEMPLE.CITY CA 91780. PHONE:.(626) 285-0488.. EXT: ' LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 6561 LT: 450 5818 GOLDEN WEST AV FEE.DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802203 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LAS TUNAS 85.87-027-022 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 4.00 LGT 7.80 ISSUED ON:: PROCESSED BY: PLA BY: EXPIRES ON.: TOTAL FEES 64.80 07/30/99. UT 01/26/ OWNER: .TEL. NO: fINAL DATE: FINAL BY* i CODE: YU CHING KWAN;ZHI JUAN LU GUAN 5818 GOLDEN WEST AV TEMP 917802203 DESCRIPTION OF WORK ELECTRICAL FOR GUEST HOUSE APPLICANT: TEL. NO: SAME AS OWNER - SPECIAL CONDIT.IONS:, CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO TEMPORARY POWER POLE -. / UNDERGROUND CONDUIT RCHITECT OR ENGINEER: TEL,. NO: � UF,ER..GROUN LIC. NO:I ROUGH CONDUIT �� ROUGH. WIRING ' U DILI(� � TVMAIN WATER LINE L PLASTIC-Y/N METAL-Y/N --- UTILITY COMPANY NOTIFIED In r El �L�c �e rlr, 1T1ty V RCPORT .I,D: DPR265 ROUTE TO: BS0508