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Home My Public Portal About8903 HERMOSA DR_Electrical__ DEC TION 76A66 WORKERS'that t I have a certificate cafe of corse CE-806 ID,BI APPLICATION FOR ELECTRICAL PERMIT affirm That I have o certificate of consent to self CE-8066 insure, or a certificate 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, 8 Pools EACH NO. FEE ADDRESS d ❑ Certified copy is filed with the county building inspec- 18 2-Family, Sq. Ft. $ — $ LOCALITY lion department. Multi-family Sq. Ft. — NEAREST CROSS ST. Residential Swimming Pools OWNER OR Dote Applicant FIRM CERTIFICATE OF EXEMPTION FROM WORKERS' OutlMAIL A COMPENSATION INSURANCE ets: Rec_LightSw. ADDRESS 76717 ( completed(f the work involved by This section need not be comFirst 20 Total No. Additional Tel. No. the permit is for one hundred dollars ($100)or less.) l CITU S/Q r CK CHE PLAN I certify that in the performance of the work for which this PLANC HE permit is issued, I shall not employ any person in any manner NT so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS � �'D�� Additional CITY Tel. No. Date��-�7- T: IOzer` Total No.Fixed Appliances Not Over I HP PERMIT r NOTICE TO APPLICANT; f, after making this Certificate of APPLICANT �/ Yd/. S EC /G Exemption, you should become subject to the Workers" Range— Heoter_D.W. _ Compensation provisions of the Labor Code, you must forth- Oven — Dryer _ W.M._ ADDRESS R3r 3L with comply with such provisions or this permit shall be Top _ FAU —W.H. — deemed revoked. Hood _ Fan _ Other_ CITY (G G' Tel. No�_/3Y2 LICENSED CONTRACTORS DECLARATION ''LICENSE OR �/' I hereby affirm that I am licensed under provisions of Chapter 9 Disp. _ Room Air Cond. REG. NUMBER ip 3 Class.G�0 (commencing with Section 7000) of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NO. PROCES D BY y and Professions Code,and my license is in full farce and effect. ,I 6 Size 8 Type HP, KW, KVA, or KVAR L (� O License Number (�3 q Lic Class C'~ Up to 1 Incl. FINAL V W//� r Z^2 9�fr� Over 1 to IO Incl. DATE / / C7 VALIDA ON 0 119 Controcto / S L/eC[r/L Lpa1e Over 10 to 50 Incl. 6 �7 _ ❑ FINAL am exempt under Sec. Over 50 to 100 Inc. BY /�J 116 B.BP.C. for this reason Over 100 T "��r� ue Date: Services, Swbd., MCC 8 Ponelboards , d L L s ZP( #-S t 'J L O ? Q�w F / 0 - 200 Amp, Under 600 V 0 V 6 6 V 6 Signature/l/f�__^� dlt4_w_ 201 - 1000 Amp. Under 600 V ( e - 2S50 ❑ Over 1000 Amp. or Over 600 Ve r� Exemption for Reg. Maint. Elect. i' 2 5 L} Q SINGLE FAMILY - Temp. Power Pole 8 Appurtenances N O 4 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 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 8 Conductors structure is 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 _Lender's Address I certify that I have read this application and state that the TOTAL FEE above information is correct. I agree to comply with all County ordinances and State lows regulating Electrical wiring, and hereby authorize representatives of this County to enter upon the above �--mme�en'tioned property ,for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE �e r�wy6G 1Z_Z 7_ Signature of Permittee—�� Dale 1. WORKER'S COMPENSATION DECLARATION DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT 6A663 I hereby affirm that I have a certificate of consent to sell insure, 7BA60 or a ce{tificate c:.Workar's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec.3800 Lab.C.) Policy No. Company FOR APPLICANT TO FILL IN g00RESS Polia Certified copy is hereby furnished. New Residential Bldgs.8 Pools NO. EACH FEE ❑ Certified co 1 &2-Family,Sq.Ft. — $ $ LOCALITY L�+ [i copy is tiled with the county builtling inspection NEAREST department. Multi-family Sq.Ft. — CROSS 5i. Residential Swimming Pools ASSESSOR Date Applicant MAP BOOK PAGE PAFCEL CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER OR -��s COMPENSATION INSURANCE Outlets:Rec. Light Sw. iv /,0e01 O FIRM NAM flr5f 20 O MAIL (This section need not d completed D the work involved by the Total No. Additional ��]] •�'� AOORESS C! permit is for one hundred dollars(5100)or less.) Or I certify that in the performance of the work for which this permit CITU C� Tel.No. ry7 -0 is issued, I shall not employ any person in any manner so as to t..c� become sub' t to the orkers'Compe satin Laws. 9htin Fixtures First 20 PLAN CHECK I P 9 .,/ APPLICANT � Total No.. LFJ-- Adtlitional ADDRESS DateAVK��/� Applicant BIDENTIAL APPLIA S NOT OVER HP. '� NOTICE TO APPLICANT: If, after making this Certificate of CITY iei.No. Exemption, you sh DUId become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code, you must forthwith comply with such PERMIT provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances APPLICANT LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS I hereby affirm that I am licensed under provisions of Chapter 9 Over 310 10 Ind.(commencing with Section 7000)of Division 3 of the Business and CITY T.I.No. Professions Code,and my license Is In full force and effect Over 10 t0 50 Ind. LICENSE OR >_Ovef 80 t0 100 In . REG.NUMBER Clazs' d Over 100 DISTRICT NO. a PgpCESSED BY O License Number Lia Class �O gCES Services,Swbd.,MCC&Panelboards up�a..��J Q Contractor Date 0-393 Amp.Under 600 V FINAL DATE / r ❑ 400-1000 Amp.Under 600 V //am exempt under Sec. 'Zt�% VALIDATION V Over 1000 Amp.Of Over 600 V FINAL W B.&P.C-for this reason BRANCH CIRCUIT FEES BY Date: 15A,or 20A. 120V,Lighting or Recept. Z Signature m0t 1 To 10 Branch Circuits 11 To 40 Branch Circuits M — 41 Or More Branch Circuits Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Sr.Circuits SINGLE FAMILY ' I ^T Temp.Power Pole c Appurtenances HOME OWNER-BUILDER DECLARATION -CIO I hereby affirm that I am exempt from the Contractors License Law Sign with One Branch Circuit -`I)� _LI; for the following reason (Section 7G31.5. Business and Professions Additional Sign Branch Circuits 6eaa): i ITEti6 I, as owner of the property,will tlo the work and the structure Misc.Conduits&Conductors :CIFH_ 109- 50 is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) ► r�I and Professions Code). ' tHECK 1N. .-HAN61" CONSTRUCTION LENDING AGENCY i'Il I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total) Q Cm. C.) 90001-13001 1/27/94 PLAN CHECKING FEE ? �,�. 1 �,� Ce jc Lender's Name // '�''' PERMIT ISSUING FEE p2(D Q Lender's Address I certify that t have read this application and under penalty of perjury state TOTAL FEE 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 i ctio urpo4es & DDn/1 SEE REVERSE FOR EXPLANATORY LANGUAGE COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS EL 0508 9809160021 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: LEGAL ID: EES PAID BUILDING ADDRESS: TR: 5904 LT: 149 8903 HERMOSA DR FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801819 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 5384-017-017 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY, C JX MOTORS, LT 3 HP 1.00 MOT 15.30 TENANT: TOTAL FEES 43.05 ISSUED ON: PROCESSED BY: PLAN EXPIRES ON: 09/16/98 VG 09/16/99 OWNER: TEL. NO: FINAL DATE FINPL/ B CODE: ATWOOD JOHN W;EILEEN F (626) 309-0267- Z 8903 HERMOSA DR 6( ` 0 TEMP 917801819 D- S� ION OF WORK ELECTRICAL FOR A/C APPLICANT: EL. N0: BRYANT HEATING AND AIR CONDITIONING (626) 286-1141- SPECIAL CONDITIONS: P<i1GELES CO CONTRACTOR: TEL. NO: OS �R/j. APPROVALS DATE INSPECTOR SIGNATURE BRYANT HEATING AND AIR CONDITIONING (818) 286-1141- �. 1350 E LAS TUNAS DRIVE LIC. NO TEMPORARY PO4ER POLE SAN GABRIEL CA 91776 221751 C20 UNDERGROUND CONDUIT ARCHITECT OR NGIN R: L. N0: � - R GROUND LIC. N0: - I� 111171 - ROUGH CONDUIT Ir1� L ROUGH WIRING � �UJ/I�',=C� '7 � PMAIN NE LASTICTY/NER LIMETAL Y/N Un-LTrTCOMPANY NOTIFIED f4. y �o Service Thae REPORT ID: DPR265 ROUTE TO: BS0508