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Home My Public Portal About6126 GOLDEN WEST AVE_Electrical__ A 76,$663C- CE80613 12/75 . APPLICATION FOR ELECTRICAL PERMIT BUILD AND SAFETY ISION FOR APPLICANT TO FILL IN JOB' rRee Bldgs.& Pools EACH NO. FEE ADDRESS �� Ey L!lf�S ✓-"` Sq. Ft. $ — $ LOCALITY q. Ft. NEAREST CROSS ST. wimming Pools OWNER OR FIRM NAME ¢ S` ) /•�/'� ,TiQ Outlets: Light,Switch& Receptacle MALL AI L First 20 ADDRESS lf• v Additional : a CITY ��! ��f! Tel. No. PLAN CHEC Lighting Fixtures APPLICANT First 20 ADDRESS Additional CITY Tel. No. PERMIT Fixed Appliances Not Over 1 HP APPLICANT p« Range Heater D.W. ADDRESS Oven Dryer W.M. y'` p Top FAU W H. T CITY Zz'_VAL Tel. No.' . Hood Fan LICENSE OR O —& REG. NUMBER/ ��'� Class. Disp. A.C. Q V 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION Q AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY V Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING W Size&Type HP, KW, KVA,or KVAR ELECTRICAL WIRING. � Up to 1 Incl. 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR Over 1 to 10 Incl. LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE C Over 10 to JO Incl. DESCRIBED RESIDENTIA RO PER TY. Over 50 to 100 Incl. PERMITEE , Over 100 1 SIGNATURE Services DISTRICT NO. PR D BY 0-200 Amp. Under 600 V I o u i 201 - 1000 Amp. Under 600 V APPROVALS DATE INSPECTOR'S Over 1000 Amp.or Over 600 V SIGNATURE POWER POLE Temp. Power Pole&Appurtenances SLAB WORK Sign with One Branch Circuit Additional Sign Branch Circuits H CONDUIT (Other) G RES AUTHORIZED PERMIT FEE (Sub-Total) YCO.NOTIFIED. qq J pp PLAN CHECKING FEE (One-Fourth Permit Feel Cc% - 7 PERMIT ISSUING FEE TOTAL FEE PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK: M.O. CASH V6, WORft COMPENSATION1havecerciDECLARATION CE-806 10/81 APPLIOTION FOR ELECTRICAL PERMIT l heieby°aff"' t I have a certificate of consent to self CE-806G it insure, or a cerci icate 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. & Pools EACH NO, FEE ADDRESS 01-2-itt, ^ ❑ Certified copy is filed with the county building inspec- 1 & 2-Family, Sq. Ft. $ — $ LOCALITY >�` �' 1 tion department. Multi-family Sq. Ft. — 'NEAREST CROSS ST. I; ,? r- 1.�(. `•f��t_ Residential Swimming Pools Date_; �� Applicant OWNER OR FIRM NAME 1✓..� �i(f CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw. ,MAIL fiDDRESS -1) COMPENSATION INSURANCE First 20 NH l03 (This section need not be completed if the work involved by Total No. Additional CITY LCL C 1'N Tel. No.- '� 3� 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 Worker 'Compensation Laws. Lighting Fixtures First 20 ADDRESS Total No. Additional CITY I. No. Date U $S Applicant Fixed Appliances Not Over I 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 KV with comply with such provisions or this permit shall be Top, _ FAU —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. (commencing with Section 7000) of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT O. PROCESSED and Professions Code,and my license is in full force and effect. A Size &Type HP, KW, KVA, or KVARO License Number Lic. Class Up to 1 Incl. FINAL Contractor Date Over 1 to 10 Incl. DATE VALIDATION ❑ Over 10 to 50 Incl. FIN L I am exempt under Sec. Over 50 to 100 Inc. BY LU B.&P.C. for this reason Over 100 Date: Services, Swbd., MCC & Panelboards. , 0 -200 Amp. Under 600V W1 Aa D ;22063A Signature 201 - 1000 Amp. Under 600 V bki!tpb W :taG ❑ Over 1000 Amp. or Over 600 V # 0 0 0 0 0 2 Exemption for Reg. Maint. Elect. ° SINGLE FAMILY Temp. Power Pole&Appurtenances ° 2 5 5 0 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 0 o•o 2 S 5 0 v 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 0520-85 Professions Code): ❑ I, as owner of the property, will do the work and the Misc. Conduits&Conductors structureis 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 � Q Lender's Address 1 certify that I have read this application and state that the TOTAL FEE ,so above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby aut orize representatives of this County to enter upon the ob :)netRroperty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Da e WORKERS'COMPENSATION.DECLARATION 76A663 10/81 APPLICATION FOR ELECTRICAL PERMIT hereby affirm that I have a certificate o'f'consent to self insure, CE-806G or a certificate of Workers' Compensation Insurarice, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY c9py thereof (Sec.3800,Lab.C.) ROIiC No.y �Gompany— =�Y, FOR APPLICANT TO FILL IN JOB �l EACH NO. FEE ADDRESS Certified copy is hereby furnished. New Residential Bldgs. & P LOCALITY ❑ 1 & 2-Family, Sq.Ft. DD $ _ $ Certified copy is filed with the county building inspection NEAREST department. . Multi-family Sq.Ft. CROSS ST. .eC ` Residential Swimming Pools OWNER OR Date Applican /r.� FIRM NAMEAL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec�r v Light Sw. ADDRESS ,- Q COMPENSATION INSURANCE This section need not be completed if the work involved First 20 ( b p Y the CITY permit is for one hundred dollars($100)or less.) Total No. Additional If I certifythat in the performance of the work for which this permit PLAN CHECK p 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 ADDRESS Additional Total No. CITY• Tel.No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT r NOTICE TO APPLICANT: If,. after making this Certificate of / APPLICANT C e d G Exemption,you should become subject to the Workers'Compensation Range_ Heater_ D.W. provisions of the Labor Code, you must-forthwith comply with such Oven Dryer J— W.M._ ADDRESS e provisions or this permit shall be deemed revoked. Top FAU j W.H. LICENSED CONTRACTORS DECLARATION Hood Fan Other_ I hereby affirm that I am licensed under provisions of Chapter 9LICENSE 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 Apparatus& Large Appliances DISTRIC 0. PRO D BY n, � Size& Type HP,KW,KVA,or KVAR 0 License Number Lic.Class v� Up to 1 Incl. FINAL r Over 1 to 10 Incl. DATE .� / VALIDATION 0 // 4 0 Contractor Over 10 to 50 Incl. FINAL U ❑ I am exempt under Sec. Over 50 to 100 Inc. BY 1.1 B.&P.C.for this reason Over 100 N r - Services,Swbd.,MCC & Panelboards ► Z � //pp�� Date: 0- 200 Amp.Under 600 V Signature lT/1)? A 201 - 1000 Amp.Under 600 V ❑ ' 6 Over 1000 Amp.or Over 600 V Exemption for Reg.Maint.t.Elect. SINGLE FAMILY Temp.Power Pole& Appurtenances ,q HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ACCT nv I hereby affirm that I am exempt from the Contractor's License Law it h Ci B Sign Branch Circuit s 7-+ c for the following reason(Section 7031.5, Business and Professions Additional3307 110.50 Code): E] 1, Conduits& Conductors 1 ITEMS I,as owner of the property,will do the work and the structure Other(See Complete Fee Schedule) TOTAL 1 x.01 5" is not intended or offered for sale (Section 7044, Business , m-.�O and Professions Code). (HECK 110.50 CONSTRUCTION LENDING AGENCY �r I hereby affirm that there is a construction lending agency for the C t f�p��GE .00 performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total) Civ.C.). PLAN CHECKING FEE 0000-0001 11/ 2/89 Lender's Name PERMIT ISSUING FEE 6534 1 AM11:56 J6 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 pro7;7 ti purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE E ((-z- Signature o� rm ee Date W ,RS'COMPENSATION DECLARATION 76-6 6 3 10/81 CE-806806G APPLICATION FOR ELECTRICAL PERMIT P I herby affirm that 1 have a certificate of consent to self insure, or fin`ertificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY cp,-A re(?4(Sec.3 00, ab. C.) /4 /� / / �`i Pdl icy NOS- COmpany��0"8 /�-' ', FOR APPLICANT TO FILL IN JOB ,L. V DF11" ❑ Certified copy is hereby furnished. New Residential Bldgs.& Pools EACH NO, FEE ADDRESS � 1 & 2-Family,Sq.Ft. $ — $ LOCALITY. Certified copy is filed with the y building i spection — NEAREST d artment. Multi-family Sq.Ft. r]�7 CROSS ST. Date b / Applicant Residential Swimming Pools OWNER OR FIRM NAME 7�/�" CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec— Light _ Sw. — MAIL �'p COMPENSATION INSURANCE ADDRESS3 • A / lg9'/p (This section need not be completed if the work involved by the First 20 / t� permit is for one hundred dollars ($100)or less.) Total No. Additional CITY s,�}�G k�L 'G'l Tel.No. that in the performance of-the work for which this permit PLAN CHECK I certify P 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 ADDRESS Additional Total No. 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'Compensation Range_ Heater_ D.W. _ 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. Hood Fan Other LICENSED CONTRACTORS DECLARATION _ I hereby affirm that Cond. REG.NUMBER Class. I am licensed under provisions of Chapter 9 LICENSE OR (commencing with Section 7000) of Division 3 of the Business and Disp. — Room Air Professions Code,and my license is in full force and effect. DISTRICT NO. PR ED BY Power Apparatus& Large Appliances �j , �+ R 4-1 Size& Type HP,KW,KVA,or KVAR �•/ U License Number O Lic.Class 1 Up to 1 Incl. FINAL 0), Over 1 to 10 Inc[. DATE VALIDATION 0 Contractor G'a""^ "/ �A ate S Over 10 to 50 Incl. FINALU ❑ I am exempt under Sec. Over 50 to 100 Inc. BYYN W BAP.C.for this reason Over 100 N Services, Swbd.,MCC& PanelboardsPoo. Z Date: 0- 200 Amp.Under 600 V Signature 201 - 1000 Amp.Under 600 V ❑ Exemption for Reg.Maint. Elect. Over 1000 Amp.or Over 600 V J SINGLE FAMILY Temp.Power Pole& Appurtenances / 0 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law Additional Sign Branch Circuitsa for the following reason (Section 7031.5, Business and Professions ACCT.� Code): 7. . 3. 1 ❑ Misc.Conduits & Conductors I,as owner of the property,will do the work and the structure q is not intended or offered for sale (Section 7044, Business Other (See Complete Fee�Schedule) 1_ ITEMS and Professions Code). TOTAL, }r5. .50 CONSTRUCTION LENDING AGENCY CHECK 25. 1 hereby affirm that there is a construction lending agency for the / .FV50 performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total) t►11l7tK Civ. C.). .00 PLAN CHECKING FEE .- . .••--.-• ¢'e Lender's Name PERMIT ISSUING FEE, 5/8e� 1 7� Lender's Address AM10 54995 1 0� I certify that I have read this application and state that the above TOTAL FEE .. 1'u�1V tJ� information is co t. I agree to comply with all County ordinances and State laws gulating Electrical wiring, and hereby-authorize representative of this Courtly to enter upon the above-mentioned proper t inspec lon Kses. � R,:) SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS EL.0508 9608080008 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: ON FILE 6126 GOLDEN WEST AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801702 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 5385-026-019 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT,SW,RECP 8.00 OUT 15.60 TENANT: G2 LIGHTING FIXTURES 2.00 LGT 3.90 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: TOTAL FEES 47.25 08/08/96 TC 08/08/97 OWNER: TEL. NO: FINAL DATE FINAL B DE: LAU LINDA KWAI LIN;LAWRENCE' SHU WOO (818) 291-2252-'- 6126 GOLDEN WEST AV TEMP.917801702 DESCRIP ION OF WORK ELECTRICAL FOR PATIO ENCLOSURE APPLICANT: TEL. NO: L. J. HAUSNER CONT. (714) 544-3100- SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: �� = - � APPROVALS DATE INSPECTOR SIGNATURE L. J. HAUSNER CONSTRUCTION (714) 544-3100- 205 FASHION LN #108 LIC. NO � � l/�/� TEMPORARY POWER POLE TUSTIN CA 92680 3216317 B ✓" UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. N0: %�l�/ "` -- a(��J ,, � UFER GROUND LIC. N0: M '_+ i \` ROUGH CONDUIT - - -- — - - --- ----------�' ROUGH WIRING MAIN WATER LINE PLASTIC Y/N METAL Y/N - fl UTILITY COMPANY NOTIFIED REPORT ID: DPR265 ROUTE TO: BS0508