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Home My Public Portal About5039 HELEO AVE_Electrical__ TION 20 :•Wfirm that I have acertNcate of corse 76A663 DPW 3/87 APPLICATION. FOR ELECTRICAL PERMIT O I hereby affirm that I have a certificate of consent to self [CeAe�obG insure, or,a certificate of Workers' Compensation Insurance, CXO COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a cerci led copy�tthe'.{regf,(Sec. 3800, L C. 7 _ P No. JAL Company FOR APPLICANT TO FILL IN JOB —ertified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE ADDRESS C.LOCALITY ertified copy is filed with the o my wilding inspec- 1 8 2-Family, Sq. R. $ — $ Fi �E hon der me Multi-family Sq. Ft. — NEAREST Residential Swimming Pools L CROSS ST. Date i Applica ,f 9 OWNER OR FIRM NAME CERTIFICATE OF EXEM TION FROM WORKERS' Outlets: Rec_LightSw._ MAIL COMPENSATION INSURANCE First 20 ADDRESS - (This section need not be completed it the work involved by Total No. Additional CITY 1 ° 567-1 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. CITY Tel. No. Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT 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 �l�3 with comply with such provisions or this permit shall be Top — FAU —W.H. — deemed revoked. Hood LICENSED CONTRACTORS DECLARATION ' — Fan —Other— to Disp. _ Room Air Cond. — uCEN OR !� I hereby affirm that I am licensed under provisions of Chapter 9 REG. NUMBER S 3 /. Class.,6' (commencing with Section 7000)of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NO. PROC S BY Y and Professions Code,and my license is in full force and effect. 0 0- Size 8 Type HP, KW, KVA, or KVAR ("'�(GJ\J Q License Number 3 Lic. Class Up to 1 Incl. FINAL U �i Over 1 to 10 Incl. DATE VALIDATION Q Contractor Date❑ Over 10 to 50 Intl. 0 FINAL Q am exempt under Sec Over 50 to 100 Inc. BY U Over 100 Ul 8.8P.C. for this reason d Services, Swbd., MCC 8 Ponelboards z Date: 0-200 Amp. Under 600 V Z Signature 201 - 1000 Amp. Under 600 V ❑ Exemption for Reg. Mainz. Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Temp. Power Pole 8 Appurtenances 2 I hereby affirm that I am exempt from the Contractor s License Sign with One Branch Circuit ACCT.i Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits Professions Code): 3307 30.9) Ell, as owner of the property, will do the work and the Misc. Conduits 8 Conductors 1 ITEM structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ Business and Professions Code). , TOTAL 30 a C® CONSTRUCTION LENDING AGENCY CHECK 30.50 I hereby affirm that there is a construction lending agency for �, •I�I] 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 - f 0000-0001 6f 9/89 PERMIT ISSUING FEE Lender's Address /r 38976 1 An 9:35 '1 certify that I have read this application and state that the TOTAL FEE J\ above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and here authorize presentatives of this County to enter upon the ave-ment' n pr p for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature o ermi tee Date es ERS' COMPENSATION DECLARATION 76ASD6 ,D,e, APPLICATION FOR ELECTRICAL PERMIT {� . Ina y affirnT<hat I have a certificate of consent to self insure, OF LJ or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec.3800,Lab. C.) ' Policy No. Company FOR APPLICANT TO FILL IN. JOB ADDRESS 5o�y eo .❑. -Certified copy is hereby furnished. New Residential Bldgs.& Pools EACH NO. FEE ❑ 15 — LOCALITY Certified copy is filed with the county building inspection 1 & 2-Family, Sq.Ft. 219 $ 'O — $ department. Multi-family Sq. FL NEAREST / ,n��S D� . Date Applicant - Residential Swimming Pools OWNER OR CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Ree 39.Light �Lls CROSS ST L-Sw. ` MAIM NAME '' - COMPENSATION INSURANCEADDRESS (This section need not be completed R the work involved by the Q First 20` permit is for one hundred dollars($100) or less.) Total No._167 Additional - CITYTervi C11Z I Tel.No. 6622y I-'certify that in the'performance of the work for which this permit PLAN CHECK APPLICANT is issued, I shall not employ any, person 'n any manner so as to became suPjeY to the-Workers'Compen tion Laws. Lighting Fixtures First 20 ADDRESS / Additional, 4 Total No.� CITY - Tel.No. Date E O Applicant r Fixed Appliances Not Over 1 HP NOTICE TO APPLICANT: a ea making s ertipens of PERMIT & Exemption,you should become subject to the W ke Compensation Range_ Heater_ DW. APPLICANT 2 7 I CNS C•c�'T72/ provisions,of the Labor Code,you must forthwi comply with such Oven Dryer _ W.M._ ADDRESS Toy �,QQ,�j�FL �1V17, provisions or this permit shall be deemed revoked. Top FAU W.H. _ CITY LOS "4t�Es TeL No. LICENSED,CONTRACTORS DECLARATION Hood Fan Other_ 1 I hereby affirm that I,am licensed under provisions of Chapter 9 Room Air Cond. LICENSE OR L' (commencing with Section 7000)of Division 3 of the Business and Disp. — REG.NUMBER T57�y'B 'Class. Professions Code,and my license is in full force and effect. DISTRICT NO. PR SSED BY Power Apparatus& Large Appliances ,1 Si & Type HP, KW,KVA,or KVAR �, // �/ 0 License Number S Lia Class Up to 1 Incl. FINAL - - •U ml µ /� CJS ?� ever 1 to 10 Ind. _ DATEj ^ VALIDATION 0 Contractor//77 �7 Date Over 10 to 50 Incl. Tp{ FIN V I am exempt under Sec. Over Soto 100 Inc. B W B.&P.C. for this reason Over 100 U) r _ DateServices & Panelboards ®' Z : 0 200 A . nder 600 V ' _ Signature 201 - 1000 Amp.Under 600 V - ❑ 1 Over 1000 A p.ar Ov r 600 V 1 Exemption for Reg.Maim.Elect. _ -40A i liho r6 SINGLE FAMILY Temp.Power Pole& Appur notes r_ _ HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit Fr I hereby affirm that I am exempt from the Contractor's License Law Additional Sign Branch Circuits - - —^� ' - t + for the following reason (Section 703 1.5, Business and Professions v, , _.113 Code): ❑ - '- - Itw-• ` I,as owner of the property,will do the work a70 Misc.Conduits & Conductors the structure —y,- is not intended or offered for sale (Section 7044, Business �Other (See Complete Fee Schedule) '0, � _ ❑ f—' — 10 and Professions Code). CONSTRUCTION LENDING AGENCY _ `,_•�,-.r I hereby affirm that there is a construction lending agency for the - •t'U performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total) 6 Civ. C.L PLAN CHECKING FEE - ,I;'�I Lender's Name PERMIT ISSUING FEE �O � � ], �3f y>[t3 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 StatX laws regulating Electrical wiring, and her by authorise represe fives of Ihi unty to enter upon the a ve-m banetl grope foectio pu s SEE REVERSE FOR EXPLANATORY LANGUAGE SZY Signature of Per tee9 D e I " '1r COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0403290007 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGA I EES PAID BUILDING ADDRESS: TR: 13329 LT: 1 UN: .002 5039 HELEO AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803825 SSESSO INFORMATION NUMBER: NEAREST CROSS STREET: LA ROSA 8590-023-001 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J5 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT,SW,RECP 3.00 OUT 5.85 TENANT: G2 LIGHTING FIXTURES 1.00 LGT 1.95 ISSUED ON: PROCESSED BY: PLAN 8 -EXPIRES ON: IA N-RES EX FANS LT 3HP 1.00 EX 15.30 04/02/04 VG 09/29/04 TOTAL FEES 50.85 OWNER: TEL. NO: FINAL DAT FINAL BY: CODE: CHEN;KENT (626) 282-1389- 5039 HELEO AV TEMP 917803825 DESCRIPTION OF WORK ELECTRICAL FOR NEW BATHROOM APPLICANT: TEL. NO; SAME AS OWNER - SPECIAL CONDITIONS: CONTRACTOR: TEL. N0: APPROVALS DATE INSPECTOR SIGNATOR SAME AS OWNER - LIC. NO TEMPORARY POWER POLE UNDERGROUND CONDUIT ARCHIT CT OR E GINEER: TEL. NO: - UFER GROUND LIC. NO: I ROUGH CONDUIT ____//__�� ROUGH WIRING // I MAIN WATER LIN PLASTIC Y/N METAL Y/N UTILITY COMPS NOTIFIED REPORT ID: DPR265 ROUTE TO: BS0508