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Home My Public Portal About9061 HERMOSA DR_Electrical__ c WORKERS'COMPENSATION DECLARATION CE-806 1D,B1 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self CE-8066 insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or o certified copy thereof (Sec. 3800, Lab. C. Policy No. Company FOR APPLICANT TO FILL IN JOB '1_p/� ^^Q (` Certified co is hereby furnished. EACH NO. FEE ADDRESS 061 4e P, 1r` J PY Y New Residential Bldgs. 8 Pools ❑ Pr Certified copy is filed with the county building inspec- 18 2-Family, Sq. FL $ — 8 LOCALITY '(Q, tion department. Multi-family Sq. Ft. — 'NEAREST CROSS Residential Swimming Pools ST. Date Applicant - OWNER OR FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS" Outlets: Rec_Light_Sw._ t 'MAIL COMPENSATION INSURANCE ADDRESS O h4l,0 S* (This section need not be completed If the work involved by First 20 the permit is for one hundred dollars($I00)or less.) Tool No. Additional CITY �k l ff G T.I. N.1919574 I certify that in the performance of the work for which this PIAN CHECK Permit is issued, I shall not em APPLICANT p to an employ y person in any manner so as to become subject to the WorkersCom ensatlon Laws. Lighting Fixtures First 20 ADDRESS T n Y Additional CITY' Tel. No. ,L��7T .YSF�/�d"IL•Id-cS�� Total No. Date ('0 V `v Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE T A u should If, after sub c this Certificate of APPLICANT Exemption, you should become sub' cf to the Workers' Range_ Healer_D.W. �^ Compensation provisions of the Labor Code, you must forth- Oven _ Dryer _ W.M._ ADDRESS 103 S . �'fC., 4'Dfr with comply with such provisions or this permit shall be Top — FAU —W.H. — n^ deemed revoked. CITY it Pj" Tel. No. LICENSED CONTRACTORS DECLARATION Hood _ Fan — Other_ Disp. — Room Air Cond. LICENSE '2/ Class. rjI Q� I hereby affirm that I am licensed under provisions of Chapter 9 REG. NUMBER TG (commencing with Section 7000) of Division 3 of the Business DISTRICT NO. _ PROCESSED 8Y and Professions Code,and my license is in full force and effect. Power Apparatus 8 Large Appliances I D D�/" J y (1 �' Size 8 Type HP, KW, KVA, or KVAR' b t 'sC`-"µ/''L/_ G License Number Lic. Class C.IL_ Up to 1 Incl. g V oQ FINAL �. O d Over-1 to IO Incl. DATE /`. �,__G VALIDATION 0 Contractor Date '0 Over 10 to 50 Incl. OO � ❑ FINAL (� am exe i under Sec.--. Over 50 to 100 Inc.. BY d B.BP.C. for this reason Over 100 art Services,"Swbd., MCC 8 Ponelboords Z Date: ✓0 -200 Amp, Under 600 V' Signature 201 - 1000 Amp. Under 600 V �/ - ❑ Exemption for Reg. Mainz. Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY Tem PPole 8 A HOME OWNER-BUILDER DECLARATION p' ower Appurtenances I hereby affirm that exempt from the Contractor's License Law for the followingg r Sign with One Branch Circuit reason (Section 7031.5, Business and Additional Sign Branch Circuits Ell 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)— ► - 2538 4 A 7044, Business and Professions Code). #to o e o o 2 CONSTRUCTION LENDING AGENCY2'-1- 2 5 5 0 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) / 'o,0 0 2 rJ. 5 0 5 (Sec. 3097, Civ. C.). Lender's Name PLAN CHECKING FEE - 09, 20-83 PERMIT.ISSUING FEE L% 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 +a �e-me horize representatives of this County to enter upon the boned property for`nspection purpo s. SEE REVERSE FOR EXPLANATORY LANGUAGE f Permittee Date/ 'COUNTY OF LOS ANGELES TEMPLE CITY k 0506 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9901 LAS TUNAS EL 0508 1002220003 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: FEES PAID BUILDING ADDRESS: ITR: 5904 LT: 332 9061 HERMOSA DR I IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT: ( TEMP CA 917801917 III (ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET: LOMA I53B4-015-030 IA1 PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY, Cl I F1 120V, 15/20A BR CKTS 5.00 BE 86.25 I 1 1 TENANT: IG1 OUTLETS-LGT,SW,RECP 18.00 OUT 35.10 (ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: I J IH2 RES GREG DISH LT 3HP 1.00 DIS 10.95 102/22/10 SR 02/22/11 1 I IH4 RES RANGE HDS LT 3HP 1.00 BOO - 10.95 1 IOWNER: TEL. N0: I TOTAL FEES 171.00 F$NAL_DATE FINAI.F$Y: CODE: IVINTHER WILLIAM H (928) 938-0540- I 1 //'y�11/� `/�/1ylj I 19061 HERMOSA DR I `� ITEMP 917801917. IDES RIPTION OF WORK (ELECTRICAL FOR KITCHEN REMODEL I 1APPLICAN T: TEL. NO: 1 IOWENS (626) 285-7725- 15924 N. RENO AVE. I ISPECIAL CONDITIONS: ITEMPLE CITY CA 91780 1 1 CONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE IRON OWENS (626) 285-7725- 1 1 1 15924 N. RENO AVENUE LIC. NO I ITEMPORARY POWER POLE I I ITEMPLE CITY, CA 91780 276346 1 IUNDERGROUND CONDUIT IARCHITECT OR ENGINEER: TEL. NO: I UFER GROUND I - I I LIC. NO: I IROUGH CONDUIT I I I IROUGH WIRING I . I I IMAIN WATER LINE I I I I PLASTIC Y/N METAL Y/N I _ (UTILITY COMPANY NOTIFIEDI I II I I I 111 I II I I I 11111 I I I I I I I I I I I I 111 I I I I I I I I I II (REPORT ID: DPR265 ROUTE TO: BS0508 I + COUNTY OF LOS ANGELES TEMPLE CITY # 0508 [EL'ECTRICAL PERMIT t DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS EL70508-9803200026 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: LEGAL D: F S PAID BUILDING ADDRESS: TR: DD SS:TR: 5904 LT: 332 9061-HERMOSA-DR— FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP-CA 917801917 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 5384-015-030 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY LB 200 AMP PANELS, MCC 1.00 PAN 38.85 TENANT: TOTAL FEES 66.60 ISSUED ON: PROCESS Y: PLAN BY: XPIRE . 03/20/98 UT 03/20/99 OWNER: —TEL.--NO: FINAL DATE FIyAL Y: CODE: 9061VINTH HERMOSAER IAM DR H (626) 309-1319- TEMP 917801917 DESCRIRT. ON-OF-WORK—N - - . .- NEW-200-AMP-SERVICE-PANEL UPGRADE-(HOUSE)-- - - - APPLICANT: TEL. NO: SAME AS OWNER SPECIAL CONDITIONS: GES CO CONTRACTOR: TEL. NO: oco APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO MPO ARY POWER POLE 3 UNDERGROUND CONDUIT ARCHITECT ORENGINEER: TEL. NO: ( % L \� U GROUND LIC. NO: _ ? '��1 it 1111 it ROUGH CONDUIT ROUGH WIRING /r MAIN WATER LINE PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED REPORT ID: DPR265 ROUTE TO: BS0508 y COUNTY OF LOS ANGELES TEMPLE CITY # 0508 �EL•ECTRICAL PERMIT, _ DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS EL\�0508..9711200063' BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING A DRESS: TR: 5904 LT: 3329061'HERMOSAIDR FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 'TEMP-CA'917801917 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 5384-015-030 G1 OUTLETS-LGT,SW,RECP 16.00 OUT 31.20 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY G2 LIGHTING FIXTURES 18.00 LGT 35.10 TENANT: LA 100 AMP PANELS, MCC 1.00 PAN 38.85 -19-SUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: TOTAL FEES 105.15 11/20/97 UT 11/20/98 OWNER: TEL. NO: FINAL DATE FINAL BY: CODE: VINTHER WILLIAM H (626) 309-1319- .4.27c/1°, Na.o4- 9061 HERMOSA DR TEMP 917801917 DESC I ION OFWORK ELECTRICAL FOR NEW RESIDENTIAL GARAGE-100 AMP SER. PANEL APPLICANT: TEL. NO: SAME AS OWNER SPECIAL CONDITIONS: C®C� CONTRACTOR: - TEL. N0: P�&eLES APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO a A TEM150RARY POWER POLE (_^✓ �G/��a UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: L. NO: ® UF5R GROUND LIC. NO: ROUGH CONDUIT n i ROUGNIRING PUBLIC IC W®rKS MAIN WATER LINE !N� HL.J_ PLASTIC Y/N METAL Y/N rk UTILITY COM NY NOT-17 E ` �L D 0 ( 0 ,. �_a In REPORT, ID: DPR265 ROUTE TO: BS0508