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Home My Public Portal About6421 GOLDEN WEST AVE_Electrical__E) WORKERS'COMPENSATION DECLARATION 76A6t13 . CE-6066 (2-80) APPLICATION FOR ELECTRICAL PERMIT I hereby affirm 4}+at k a cartfficate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY insure, or a cerdfIcate of orkers'Compensation Insurance,or a certified copy thereof(Sec.-3&00,Lab. C.) FOR APPLICANT TO FILL rN JOB Policy No. Company New Residential Bldgs.&Pools FE EACH NO. E ADDRESS I�y Certifled copy Is hereby furnished. 1 &2-Famliy,Sq. Ft. LOCALITY Multl-famlly Sq. Ft. Cettlfled copy fY filed with the county building Inspection CROSS ST department. Residential Swimming Pools OWNER OR I /,. FIRM NAME Dal. pug Ogtlets: Rec.^Light SW.�[� MAIL / Irwt-z? ADDRESS CERTIFICATE OF EXEMPTION FROM WORKERV Total No. Addlt(bnal CIT Tel N COMPENSATION rNSURANCE PLAN CH K (This "n need'aot be �mp luted if,the work Involved APPLI A T Lighting Fixtures First 20 by the permit Is for one hapdred 4dlyrs (31,00) or len•) o ADDRESS Total No. Addittnel I certify that in the performance of the work for which this Fixed Applla�t Over 1 HP CITY Tel No. Q• PaTmft 12 lssued,'I shall not employ any pamn In any mariner PERMIT so as to become subject to the Wgrkenr' Compensation taws_ Range_ Heeter—D.W. _ PPLICANT Oven Dryer_W.M._ ADORE bate_.• A Top _ FAU —W.H. Z PPU�t Hood Fan _Other C-ITY Tel N NOTICE TO APPLICANT: If, after making ttils.fertiflca•te ofDI Room Alr Cond— HNSE Exemption, you should become subject to the Workors' REQ. NLIMBE 'Clea Compensation provisions of tee Labor Code, ypu molt forth- Power Apparatus& Large,Appl lances D18TR1CT NO. PFIOC ED BY kf with comply witfl such provoos dr this permit shoji be Size&Type HP,KW, KVA,or KVA /�� deemed revoked. Up to 1 Incl. "(�` ¢ver 1 to 10 Incl. FINAL DATE LICENSED CONTRACTORS DECLARATION Ova 10 to 60 Incl. -VALIDATION I hereby affhm'that I.am lkersaed trader provisions of Chapter Over 50 to 100 Inc. FINALBy 9• (commencing with Section 7000) of"Dtvision 3 of the Buld- T— Over 100 zeas and Profensiom,Code,and my license L In full force and - affens Q Services License Numbe Li I$97LIc Class 13-1 0200 Amp. unser soo V 56 Q'3 q F 201-1000 Amp. Under 800 V Contr0ctof 16nk WD'R1P5 Data r Z.— �— Over 10Q0 Amp'.or Over 600 V �/ #Lo 0 0 0 0 2 HOME-OWNER-BUILDER DECLARATION 'romp..Power Pole 8i Appurtenances 2 0 - 3680 I hereby affirm thYt I Sign with Ofka Branch Circuit Y am exempt hom the Contractor's .puidltlQnar Sign Branch Circuits Q G'' 0.0 0 3.6 8 0 ii License Law for the following reason (Sectlon 7031.51 Bust- , no"and Professions Code): '�Isc.Conduits&AConducto'rs 0 8 1 2-8 2 I, as owner of the property, wilt h do the ware and the �Jther(See Complete Fee Schedule)— structure not Intended or offered for ole (Section � C_,(` ,� � • 7044, Business and professions Code). r, CIONSTRU 'TION LENDING AOEI;ICY l I hereby ■ffjrm that there is a construction lending agency 1 for the performance of the work for whlch this permit is PERMIT FEE (Sub-Total) / issued (Sec. 3097,Civ.C.)_ • JJJ Lender's.N,aina PLAN CHECKING FEE (One-Fourth Permit Fee) Lender's Addreas PERMIT ISSUING FEE I certify that 3 have read this application and state that the TOTAL FEE above fhfotmation L correct.I hgtee to comply with all County ordinances and State hrw► regulating Electrical wiring, and hereby authorise reproaentattves of this County tq enter upon th bovo-mentioned property for Inspection purposes. SEE'R$VERSE FOR EXPLANATORY LANGUAGE Signature of hermlttea Data -CaA TY OF LOS ANGELES TEMPLE CITY 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC (ARKS 9701 LAS TUNAS EL 0508 0105140024 BUILDINJG AND SAFETY X LAND DEVELOPMEIUT TEMPLE CITY CA 91780 PHONE: {626) 285-0488 EXT: LEGAL ID: FEES PAID BUrLDIN-G ON FILE 6421 GOLDEN WEST:AV FEE DESCRIPTION: QUANTITY: UOM: AMOL T: TEMP CA 917801423 NEAREST CROSS STREET: LAS TL AS DRIVE 5383-017-018 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: Al LOCALITY: TEMPLE CIYT G1 OUTLETS-LGTSW RECD 13.00 OUT 25.35 G2 LIGHTING FIkHA ES 2.00 LGT 3.90ISSUED PR(XESSED BY: PLAN BY: EXPIRES . . TOTAL FEES 57.00 05/14/01UT 11/10/01 . OWWER: TEL. NO: FI CODE: MR. CHEN - `- 6427 GOLDEN WEST 1p TEMPLE CITY CA 91780 DESCRIPTION OF ADD 1-READING AND 1-PER RECORDING ROOM. 301SO.FT. DAVID (626) 286-1867- 5559 EARLTE ST SPECIAL CONDITIONS: SAN GARRIEL CA 91776 P�yGELECONTRACTOR. TEL. NO: APPROVALS DATE INSPECTOR SIGN-ATURE S CSV JING-LING KO (626) 286-1867- 5559 EARLE ST LIC. NO --ER POLE SAN GABRIEL CA 91776 671176 CO ARCHITECT TEU-70: UFER GROUND LIC NO `d 111111 1ROUGH CONDUIT UV �,�� PLASTIC Y/N METAL Y/N Service Th�� i EPORT ID: DPR265 ROUTE TO- BS0508 i COUNTY OF L09 ANG3 Ra TEMPLE CTTY y 0508 ELECTRICAL PERMIT DEPARTNENP OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1007080012 BU=.DING AND SAFETY / LAND DEVELOPMENT TRmPLE CITY CA 91780 PHONE: (626) 285-0488 ETT: LEGAL ID: FEES PAID B=INQ ADDRESS: ` ON FILE 6 FRE DESCRIPTION: QUANTITY: DOM: AMOUNT: TEMP CA 91701� AV 178014423 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LONGDSN 5383-017-018 Al PERMIT ISSUANCE FEE 27.80 TUC64 S PAGE: 597 GRID: Al LOCI.LSTY: TEMPLE CTTY, C LB 200 AMP PANELS, MCC 1.00 PAN 38.80 TOTAL FEES 66.60 ISSUEa ON: PROCESSED BY: PLAN BY: 07/08/10 SR O1(NER: TEL. NO: _ ) CST. RI« (626) 445-1565- F22a4L-L1ATE/T BY: CODE: 6421 GOLDEN WEST AVE J /7 V TFAfPLE CITY CA 91780 D PTICN OF "ORK UPGRADE 200 AMP ELECTRICAL PANEL APPLICANT: TEL. NO: SUN YUAN SUPPLY INC. (626) 926-4016- 6448 OAK AVENUE SPECIAL CONDITIONS: TEMPLE CIT7 CA 91780 , I CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNIN.TURE SON YOAN SUPPLY INC. (626) 926-4016- 6448 OAK AVENUE LIC. NO TE24PORARY POKER POLE TEMPLE CITY, CA 91780 799549 C10 UND CONDUIT ARCHITECT OR ENGIEER: TEL. NO: - UFER LIC. NO: CONDUIT ROUGE W-ZLEN} MAIN WATER LINT PLASTIC YIN METAL YIN UTILITY COMPANY MOTIF 8 * ADDITIONAL DATA ON FILE i REPORT ID: DPR265 ROUTE TO: BS0508 4 COUNTY OF LOS ANGELES ■PLE CITY 0508 ELECTRICAL PERMIT . DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0008140038 BUILDING AND-SICFETY / LAND DEVELOPMENT TEMPLE CITY CA 91 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: ON FILE 6421 GOLDEN WEST AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEW CA 917801423 ASSESSOR INFORMATION (NEAREST CROSS STREET: LEMON 5383-017-018 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: Al LOCALITY: TEMPLE CITY G1 OUTLETS-LGT SW RECD 61.00 OUT 94.35 G2 LIGHTING FI"ES 25.00 LGT 45.75 . HA FAU LESS 3HP 1.00 FAU 10.95 08/14/00 UT 02/11/01 H2 RES GREG DISP LT 3HP 1.00 DIS 10.95 H3 RES DISHWASHR LT 3HP 1.00 DIS 10.95 FINAL DATE B CHAN;SUNNY (626) 574-8083- H4 RES RANGE HDS LT' 3HP 1.80 HOO 10.95 228 W. PAMELA R.D. H7 RES EXHAUST FANS 1.00 EX 10.95 ARCADIA, CA JB AC UNITS +3-10HP 1.00 AC 19.65 DESCRIPTION OF WORK TOTAL FEES 242.25 ELECTRICAL FOR ADDITION AND REMODELING APPLICANT: TEL. NO: RAN (626) 796-5899- 9051 E. VALLEY BLVD. SPECIAL CONDITIONS: ROSEMEAD, CA CONTRACTOR: TEL. P�GELES CO SUNNY ELECTRIC AND CONSTRUCTION (562) 809-1549- 11561 E. 169TH ST. LIC_ NO TEMPORARY POWER POLE ARTESIA, CA 90701 751194 UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: UFER GROUNDi HAN FREEMAN (626) 796-5899 9051 VALLEY BLVD. #104 LIC. NO 111111 ROSEMEAD, CA 91770 C2197RXTW79TER LINE6 �[IDUBUC 1111 h(J ORl l« S PLA8TI-C Y/N METAL Y/N Q A4G/�c ibSr ❑ at�ot e vice Tt► REPORT ID: DPR265 ROUTE TO: RS0508 COUNTY OF LOS ANGELES TEMPLE CITY 0508 EId3,,=CAL PERM= DEPARTMENT OF PUBLIC WORKS 9701 LAS TURAS EL 0508 0712070011 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLF} CITY CA 91780 PHONE: (626) 285-0488 ETT: L GAA, ID: FEES PAID BUDDING ADDR&SS: ON FILE 6421 GOLDEN MEAT AV FEE DESCRIPTION: QUANTITY: QOM: AMOUNT: TEMP CA 917801423 ASSESSOR INDOR)- ti ON NUMBER: NEAREST CROSS STREET: LONCDEN 5383-017-018 Al PERI{IT ISSUANCE FEE 27.75 THOOKpS PAGE: 597 GRID: Al LA(7LLITY: TEMPLE CITY, C G1 OUTLE'T'S-L[TT,SM,RRCP 2.00 OUT 3.90 TSdaFT: G2 LIGHTTNG FIXTORE.9 3.00 LGT 5.85 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: TOTAL FEES 37.50 12/07/07 SR 06/04/08 OWRKR: TEL. NO: FINAL r&E FINAL 13Y: CODE: MR. CBSB (626) 445-1565- ' 6421 GOLDEN WST AVE r TEMPLE CITY CA 91780 DESCRIPTION OF WORK 2 LIGHT FIXTURES, 3 OUTLETS APPLICANT: TEL. NO: DAVID KU (626) 672-8768- 5559 EAGLE ST. SPECIAL CONDITIONS: SAN GABRIEL CA 91775 CONTRACTOR: TEL. NO: - - APPROVALS DATE INSPECTOR SIGMA= EVAN CHEN (626) 445-1565- 6421 GOLDEN WEST AVENUE LIC. NO TEARY PO*ER POLE TIDPLE CITY, CA 91780 NONE UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. PO: UFER C[iOUMD LIC. NO: ROUGH CONDUIT ROUGH WIRING MAIN NA= L,SDiE PLAI.STIC Y/N METAL Y/N UTILITY COMPANY NOTIFLED �• REPORT ID: DPR265 ROUTE TO: B80508