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Home My Public Portal About5003 HELEO AVE_Electrical__ 76A63C-`CE806B 12/75 .&PPUC87M FOR ELEVREA PERM . BUILD AND SARETYVISION FOR APPLICANT TO FILL IN JOB New Residential Bldgs.& Pools EACH NO. FEE ADDRESS Hel.eo AVa 1 &2 Finaily Sq. Ft. $ — $ LOCALITY Multi-family Sq. Ft. CROSS ST. Tg H,os Residential Swimming Pools OWNER OR FIRM NAME Henderson Outlets: Light, Switch&Receptacle MAI L First 20 ADDRESS Additional CITY "t Tel. No. PLAN CHECK Lighting Fixtures APPLICANT First 20 ADDRESS Additional CITY "" '' Tel..-No. Fixed Appliances Not Over 1 HP APPLICANT Nlore,les Electric Range Heater_ D.W. ADDRESS Oven Dryer'_ W.M. 8843 Mission Drive Top FAU W.H. CITY Rosemead Tel. No. 280.x•14260 a Hood Fan LICENSE OR o Disp. A.C. REG. NUMBER 227962 Class.CjasjO U � I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CD AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY U Power.Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING W Size&Type HP, KW, KVA,or KVAR ELECTRICAL WIRING, d Up to 1 Incl. z �� f� � I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR j^�L�/®ver 1 to 10 Incl. O LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF G ---- '"-. CALIFORNIA OR THAT 1 AM THE LEGAL O R OF THE ABOVE Over 10 tO 60 Incl. DESCRIBED RESID PROPER Y. Over 50 to 100 InCI. PERMITEE t Over 100 SIGNATURE Services DISTRICT NO. PRO SSED BY 0-200 Amp. Under 600 V 0 5/y 0 e5 201 - 1000 Amp. Under 600 V APPROVALS DATE INSPECTOR'S Over 1000 Amp.or Over 60O.V SIGNATURE TEMP. POWER POLE Temp. Power Pole&Appurtenances UNDER SLAB WORK Sign with One Branch Circuit Additional Sign Branch Circuits ROUGH CONDUIT (Other) WIRING FIXTURES POWER AUTHORIZED PERMIT FEE (Sub-Total) UTILITY CO.NOTIFIED PLAN CHECKING FEE (One-Fourth Permit Fee) FINAL PERMIT ISSUING FEE TOTAL FEE NOTES $13 e50 RK E L IIy1PG1�Idft CAS e. () ERI I�VEj1;IDA N� CK. M.0. CASH !y9 A- til �t7 ; 11 1 3.5 POLICYHOLDER.-��¢a t4ca � POL1CY NUMRF-P- 7GA663-CEB06-7.56 'APPLICATION. tl ®D Y . L: LEC Y RIC PERMIT .� BUILDING AND SAFETY DIVISION Department of County Engineer BUILDING County of Los Angeles ADDRESS 5 O 6 3 JOHN A. LAMBIE, COUNTY ENGINEER CASSATT D. GRIFFIN, SUP'T OF BUILDING LOCALITY a NEAREST ti FOR APPLICANT TO FILL IN CROSS sT. PERMIT-FEES. o. NUMBER OWNER (,•(C(i� LIGHT OUTLETS MAIL ADDRESS" RECEPTACLES ) WALL SWITCHES - FEE CITY 6 TEL. NO. / •0�j TOTAL OUTLETS- @ 54 S ELECTRIdfAN ELEC. RANGES 25 ADDRESS ELEC. HEATERS ' 25. CITY TEL. NO. KW EA STATE FIXTURES 5 LICENSE NO. MOTORS'' DISTRICT NO. GROUP NE. READY FOR INSPECTION NUMBER HORSEPOWER .FEE ..I NEW MVD. HF OVER • INC. I EACH O 1/2&LESS - S .25 INSPECTION RECORD 1 I/2 2 -.50, 2 5 1.00 5 15 1.50 15 50 2.50 1S �1�D• / ,�[` � . 50 200 5.00 M ISC:. , NO. SIGNS NO. TRANS. NO. SIGNS NO. LAMPS - FOR EACH PERMIT: - WIRING-PERMIT $1.00 FIXTURE PERMIT $1.00 G. �> SUPPLEMENTARY .50 - APPROVALS } TOTAL FEE $ DATE INSPECTOR'S SIGNATURE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CONDUIT AND STATE THAT THE-ABOVE IS CORRECT AND AGREE TO COMPLY - WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING z1' WIRING y. ELECTRICAL WIRING. FIXTURES v I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF POWER CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE - DESCRIBED RESIDENTIAL PROPERTY �1 ci UTILITY CO.NOTIFIED `'�� f't9�-ls�•Cnlll"J7/^•�.®...+ SIGNATURE OF PERMITTEE vvvi FINAL J. JOHN A.LAMBIE. VALIDATION ARTHUR C.VEIT. COUNTY ENGINEER SUPERVISING ELECTRICAL ENGINEER CK MO CASH � �8.7 9.1 JUS! 3 2 4.2 0 1n i WORKERS'COMPENSATION DECLARATION 710i8t '*affirm that I hpve a certificate of consent to self CE-806G hnnCnYMV FOP, S �ECTRECiL ��7U 4reb insure, or a certificate of Workers' Compensation Insurance, COUNTY; OF LOS ANGELES BUILDING AND SAFETY or a certifiedy/mop tthhpe�rJeof (Sec. 3800, Lab. C.) Policy No "��• /si Company -� FOR APPLICANT TO FILL IN JOB ❑ Certified copy is he furnished. New Residential Bldgs. &'Pools,. EACH NO. FEE ADDRESS Certified copy is filed with'the county building inspec- i 1 & 2-Family; Sq. Ft. $ _ $ LOCALITY NEAREST tion department. Multi-family'Sq. Ft. CROSS ST. PP Residential_Swimming Pools' OWNER OR �J Qd Date Applicant FIRM NAME /l- CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL COMPENSATION INSURANCE Outlets: Rec Light Sw._ ADDRESS s section need not be completed if the work involved b First / (Thitip Y Total No. Additional CITY Tel. No the permit is for one hundred dollars ($100)or less.) performance of the work for which this PLAN CHECK I certify"that in the P 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 �� ey� -�� Additional Total No. -w CITY Tel. No-,3�.- Date Applicant Fixed Ap liances Not Over t HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT' Exemption, you should become subject to the Workers' Ran gHeater—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. — deemedrevoked. CITY Tel. No. - LICENSED CONTRACTORS DECLARATION Hood Fan —Other_ Dis .. LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 P L Room Air Cond. REG. NUMBER Class. i (commencing with Section 7000) of Division 3 of the Business Power Apparatus•&.Large Appliances DISTRICT NO. PROCEt�BY and Professions Code, and my license is in full forceand effect. :�� /7 J Size &Type HP, KW, KVA, or KVAR' �• O License Number, ? Lic. Class to.l Incl. FINAL �� Over 1 to 10 Incl. DATE VALIDATION Contract e-✓ `'v' Date Over 10 to 50 Incl. 01 FINAL ~ ❑ I am exempt under Sec. Over 50 to 100 Inc. BYUJI B.&P.C. for this reason Over 100 Services, Swbd:, MCC& Panelboards 3 2 Q 6 A Date: 0 -200 Amp. Under 600 V D # o o:0 0 0 2 00 Signature 201 - t000 Amp. Under 600 V 2 o o 3+8,.2'5 ❑ Over 10Amp. or Over 600 V Exemption for Reg. Maint. Elect. o lo 0 3 8 2'5.' SINGLE FAMILY Temp. Power Pole& Appurtenances u ' HOME OWNER-BUILDER DECLARATION Sign.with One Branch Circuit 8 0 3:—.8'4 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- Professions Code): ❑ I, as owner of the property, will do the work and the Misc. Conduits&Conductors structure is not intended or offefed for sale (Section Other (See Complete.Fee Schedule)_ D 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) 75 (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address 3 I certify that I have read this application and state that the TOTAL FEE v 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 ab -mentioned prop rty for ' spection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE S'illghfature of Permittee Date T COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT - DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0901070009 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: FEES PAID { BUILDING ADDRESS: { ITR: 13329 LT: 5 BL: .001 1 5003 HELEO AV 1 I .IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 TEMP CA 917803825 (ASSESSOR INFORMATION NUMBER: ''I I NEAREST CROSS STREET: 18590-023-024 _ 1A1 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J5 LOCALITY: TEMPLE CITY, Cl I ILB 200 AMP PANELS, MCC 1.00 PAN 38:85 1 (TENANT: - I TOTAL FEES 66.60 (ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: I I 101/07/09 SR 07/06/09 1 I I { I (OWNER: TEL_ NO: I IF NAL DATE FIN CODE: - IHENDERSON, ELIZABETH (818) 287-8219- 1 + 15003 HELEO AV ITEMP 917803825 I .IDE CRI TION 0 WORK (INSTALL 200 AMP SERVICE - 1 { I I I (APPLICANT: TEL. NO: 1 1. 1 IGURROLA (310) 836-8076 I I I 15625- W. WASHINGTON - I ISPECIAL CONDITIONS: ILOS ANGELES CA 90016 ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE I IPOWELL ELECTRIC (800) 660-8076- 1 1 15625 W. WASHINGTON BL LIC. NO I ITEMPORARY POWER POLE I I I ILOS ANGELES CA 90016 631836C10- I 1 1-1 I I 'I 1UNDERGROUND•CONDUIT I I { { I (ARCHITECT OR ENGINEER: - TEL. NO: I IUFER GROUND I I - LIC. NO: '; ROUGH CONDUIT �- IW 4 IROUGH WIRING 1 MAIN WATER LINE. 1 ' (PLASTIC Y/N ME Y/N r I.J I IUT- LITY COMPANY NOTIFIED( il 1 I I I I I I i { I I I I I I I I I I I I { I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I (REPORT ID: DPR265 - ROUTE TO: BS0508 I I I I I I A