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Home My Public Portal About9014 HERMOSA DR_Electrical__ t WORKERS'COMPENSATION DECcafe of TIONcorse CE-806 ,D,B, APPLICATION FOR ELECTRICAL PERMIT I hereby afRrm thaPLi have a certificate of consent to self CE-6066 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 cry Certified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE ADDRESS Q r �� ✓7 U< ' ❑ LOCALITY d Certified copy is filed with the county building inspec- 18 2-Family, Sq. Ft, $ — $ e 7 tion department. Multi-family Sq. Ft. NEARESTCROSS ST. p s DoteApplimnt Residential Swimming Pools OWNER OR I FIRM NAME ,* v/?C 'o CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: RecLight_Sw.` MAIL �,�/ COMPENSATION INSURANCE ADDRESS / /fan/5 qrp First 20 (This section need not be completed if the work Involved by Total No. FirstAdd20nal CITY v/� ' Tel. oat the permit is for one hundred dollars ($100) or less.) PLAN CHECKgi certify that in the performance of the work for which this APPLICANT' permit is issued, I shall not employ any person in any man ne.. so as to become subject to the War rs'Compensa ' n To s:/ Lighting Fixtures First 20 ADDRESS _ Z Total No. ate 7�licant Additional CITY Tel. No. Fixed Appliances Not Over I HP PERMIT NOTICE TO APPLICANT: If, of making this Certificate of APPLICANT L 2 � ' G { Exemption, you should be e subject ro the Workers' Range_ Heater_D.W. Compensation provisions of a Labor Code, you must forth- Oven _ Dryer — W.M._ ADDRESS U with comply with such provisions or this permit shall be Top — FAU —W.H. —_ deemed revoked. Hood — Fan _ Other_ CITY. ,c Tel. No.11Y9-e57-2- LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. REG. NUMBER Class , -/(/ (commencing with Section 7000) of Division 3 of the Business power Apparatus 8 Large Appliances DISTRICT NO. PROCE$ D BY Y and Professions Code,and my license is in full force and effect. d /�� Size 8 Type HP, KW, KVA, or KVAR �'S c O License Number �10 yUfS` Lic. Class �% tl Up to 1 Incl. FINAL V {/�� G2J=Nr JZ- 2J-�U'Z Over 1 to 10 Incl. DATE / z �� VALIDATION Contractor c mate _ Over 10 ro 50 Incl. ✓ - H FINAL am exempt under Sec. Over 50 to 100 Inc. BY ` .�_ �ti�,y� w B_.BP.C. for this.reason Over 100 raiz 2- i7-3r'Z Services, Swbd., MCC 8 Ponelboards v ? Pe: I v L�0 �/ 0 -200 Amp, Under 600 V 100. Signature 201 - 11x70 Amp. Under 600 V ❑ Over 1000 Amp. or Over 600 V Exem i for Reg. MOint. Elect. SINGLE FAMILY Temp. Power Pole 8 Appurtenances HOME OWNERBUILDERDECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits Low 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)— " pop- 7044, Business and Professions Code). j•r. 0 7 : C E, t - � CONSTRUCTION LENDING AGENCY I hereby affirm that there is o 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 U PERMIT ISSUING FEE Lender's Address I certify that I hove read this application and state that the TOTAL FEE above information is correct. I agree tc comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize representatives of this County to enter upon H4 above-mentio ed or Jperty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE l f L- 2-7-.r Z" I Signature o Permittee Dote t _ WOFKERS-COMPENSATIONDECLARATION 76-803 10/81 APPLICATION FOR ELECTRICAL PERMIT ffirm that I have a certificate of c -. ce-eosG eSy c .e ws�nP to self insure, or certificate of Workers'Compensation insurance, ora certified • COUNTY OF LOS ANGELES BUILDING AND SAFETY cop 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 Certified copy is filed with the county building inspection 1 & 2-Family, Sq.Ft. $ — $ LOCALITY eiry PG•L' C. t department: Multi-family Sq.Ft. CROSS ST . Q„$'e - Date Applicant' Residential Swimming Pools OWNER OR q.f� /� �/� FIRM NAME !//y G /Y" CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL COMPENSATION INSURANCE Outiels:RecLight'— Six. - ADDRESS / (This section need not be completed if the work involved b the - ' - .. ...First 20 P Y - - CITY Tell No. permit is for one hundred dollars ($100)or less.) Total No. Additional P I certify that in the performance of the work for which this permit PLAN CHECK 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 ' Total No.///p/� Additional 7 ' CITY - - Tel.No. Date Applicant 'V 'Yli'4 �✓L(ti% � Fixed Appliances Not Over 1 HP ,y APPLICANT: If, after making this Certificate of PERMIT EKe � Ezemptiortyou should become subject to the Workers'Compensation Range_ HeaterW._ D. APPLICANT U /c' 5 y 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 WYNI .H. LICENSED CONTRACTORS DECLARATION Hood — Fan Other_ CITY �0'G ® el.No. `-� I hereby affirm that I am licensed under provisions of Chapter 9LICENSE OR Disp. ROOM Air Cond. REG.NUMBER [� class.0 (commencing with Section 7000) of Division 3 of the Business and Professions Code,and my license is in full force and effect. Power Apparatus& Large Appliances DISTRICT ND.. PROCESSED BY n Size&.Type HP,KW,KVA,or KVAR r Q License Numper 2_2Z# ,/�_Lia Class G .�_ Up to*1 Incl. 0 FINAL DATE hr' Contractor) • Cr 0 Over 1 to 10 Incl. VALIDATION O l�j�-/L /i!/i Date ! 3�o Over 10 to 50 not. U E] FINAL r///n��I'� am exempt under Sec. Over 50 to 100 Inc. BY /��MM�./' � d B.&P.C.for this reason Over 100 CVVI 1 U) _. DateServices, Swbd.,MCC& Pacelboards : 0- 200 Amp.Under 600 V Signature 201 - 1000 Amp.Under 600 V - ❑ Exemption for Reg.Maine Elect Over 1000 Amp.or Over 600 V 2 SINGLE FAMILY Temp.Power Pole & Appurtenances a - HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ACCT.a I hereby affirm that I am exempt from the Contractor's License Law Additional Sign Branch Circuits _ - 31.013 for the following reason (Section 7031.5, Business and Professions g '3307 Code): Misc.Conduits& Conductors - 1 ITEMS I,as owner of the property,will do the work and the structure Other (See Complete Fee Schedule) _ TOTAL 3 1• -00 is not intended or offered for sale (Section 7044, Business and Professions Code). CASH 31.a= CONSTRUCTION LENDING AGENCY CHANGE . •1313 I hereby affirm that there is a construction fending agency for the performance of the work for which this permit is issued(Sec.'3097, PERMIT FEE (Sub-Total Civ.C.). PLAN CHECKING FEE ' - 0000-0101 4/13/90 Lender's Name PERMIT ISSUING FEE -- 0093 1 AM 9'1O 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 propert for' spec'an u, oses. SEE REVERSE FOR EXPLANATORY LANGUAGE gnature of Permittee to COUNTY OF LOS ANGELES TEMPLE CITY - k 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0507200002 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 5905 LT: 126 9014 HERMOSA DR FEE DESCRIPTION: QUANTITY: DOM: AMOUNT: TEMP CA 917801837 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 5387-014-023 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY, C G1 OUTLETS-LGT,SW,RECP 37.00 OUT 61.95 TENANT: G2 LIGHTING FIXTURES 8.00 LOT 15.60 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: TOTAL FEES 105.30 07/20/05 SK 01/16/06 OWNER: TEL. NO: FINAL DATEFI HY: CODE: REYNA RAYMOND S (626) 286-7466- / ' 7 9014 HERMOSA DR - �J TEMP 917801637 DESCRIPTION OF WORK ADD 37 OUTLETS, 8 LIGHT FIXTURES APPLICANT: TEL. NO: ROYAL BUILDERS (323) 464-4625- 5419 SUNSET BLVD 227 SPECIAL CONDITIONS: LOS ANGELES 90027 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE ROYAL BUILDERS (323) 464-4625- 5419 SUNSET BLVD. x{227 LIC. NO TEMPORARY POWER POLE LOS ANGELES, CA 90027 803030B UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: UFER GROUND LIC. NO: ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE PLASTIC YIN METAL YIN UTILITY COMPANY NOTIFIED REPORT ID: DPR265 ROUTE TO: BSO50B COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0507130036 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 5905 LT: 126 9014 HERMOSA DR FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801837 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 5387-014-023 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY, C G1 OUTLETS-LGT,SW,RECP 10.00 OUT 19.50 TENANT: G2 LIGHTING FIXTURES 5.00 LOT 9.75 ISSUED ON: PROCESSED HY: PLAN HY: EXPIRES ON: H2 RES GRBG DISP LT 3HP 1.00 DIS 10.95 07/13/05 SX 01/09/06 TOTAL FEES 67.95 OWNER: TEL. NO: FINAL DATE FINA.1, BY: CODE: REYNA RAYMOND S (626) 286-7466- //✓C 9014 HERMOSA DR TEMP 917801837 DESCRIPTION OF WORK ELECTRICAL FOR KITCHEN REMODELING APPLICANT: TEL. NO: ROYAL BUILDERS (323) 464-4625- 5419 SUNSET BLVD 227 SPECIAL CONDITIONS: LOS ANGELES 90027 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE ROYAL BUILDERS (323) 464-4625- 5419 SUNSET BLVD. #227 LIC. NO TEMPORARY POWER POLE LOS ANGELES, CA 90027 803030B UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. N0: DEER GROUND LIC. NO: ROUGH CONDUIT ROUGH WIRING �- MAIN WATER LINE PLASTIC YIN METAL YIN UTILITY COMPANY NOTIFIED REPORT ID: DPR265 ROUTE TO: BS0508 COUNTY OF C= ANGELESTEMPLE CITY 4 0508 DEPARTMENT OF FJBLIC WORKS 9701 LAS TUNAS EL 05.O_ ^`900021 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285 0488 EXT: -AL ID: - eEES PAID �-C1Ui LDING ADDRESS: TR: 5905 LT: 126 1 9014 HERMOSA DR FEE DESCRIPTION: 31JANTITY; UOM: AMOUNT'i TEMP CA 917801837 ASSESSOR INFORMATION NUMBER: - I NEAREST CROSS STREET- 538.7-Q14-023 A! PERMIT ISSUANCE FEE - 27.75 I THOMAS PAGE: 596 Gnib; H3 LOCALITY: TEMPLE CITY, C G! OUTLETS-LGT,SW,RECP 1.00 OUT 1.95 TENANT: 62 LIGHTING FIXTURES 3.00 LGT '5.85 (ISSUED ON: PROMS-SED GY: P.�iN e. EXPIRES ON: TOTf.1 FEES 35.55 �OL?/10,`C14 JK - - 02/06/05 OLINET; _NO_ jf!NF.! UNE FIPAL OYo� CODE: REYNA RAYMOND S (018) 286-7466- /). ' / 9014 HERMOSA OR �,/ y TEMP 917£0,1337 iGE CRI,'ION CF IORK 'J I BATHROOM (3) REC. LIGHTS (1) -,Fl APPLICANT: TEL. NO: MORAD .:818) 519-7706- 12512 CHANDLER BL - ESPECIAL CONDITIONS: NORTH HOLLYWOOD 1 I I ' DD?iTB CONST — D 3 B CONSTRUCTION 5 =.P'rROVAI.j ,nnT"c 1NSPEC70R SI G %+ UnE (800) 01-3334- 1 f 14411 YSA STREET LIC. NO ITIPCRnRYO�.: PER POLE I VAN NUYS, CCA EF 91401 3401248 U;JRr:OUND CONDUIT AR .ITIECT OR ENGINEER: TEL. JI- LIC- IPOUG4 :;�;YOUIT I 1 � (MAIN 'eaT ER LINE PLASTIC Y/>' 1-.ETAL Y,:;: UfILIT;' CCMPAi?Y kOT IfiED� � I-- � — ' I I 1 I I REPORT ID: DPR265 ROUTE TO: BS0508