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HomeMy Public PortalAbout9451 1/2 LAS TUNAS DR_Electrical__ WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self insure, 76A663 or a certificate of Worker'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 JOB El : Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE ADDRESS(�` D • _ $ $ LOCAL ❑' -Certified copy is filed with the county building inspection 1 &2-Family, .F Ft. department. Multi S Ft. NEAREST P, Y 9• CROSS SL Date` Applicant Residential Swimming Pools ASSESSOR MAP BOOK 'PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec._Light Sw. OWNER NAMET' COMPENSATION INSURANCE First 20 MAIL n� (This section need not be completed if the work involved by the ADDRESS'\a permit is for one hundred dollars($100)or less.) Total No. Additional I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to PLAN become,subject to the Workers' Compensation Laws. Lighting Fixtures First 20 APPLICANT K Total No. Additional ADDRESS Date Applicant .RESIDENTIAL APPLIANCES NOT OVER 3 HP NOTICE TO APPLICANT: If, after making this Certificate of CITY Tel.No. Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code, you must forthwith comply with such PERM' provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances APPLICANT LICENSED CONTRACTORS DECLARATION - Size&Type HP,KW,KVA,or KVAR ADORE. O I hereby affirm that I am licensed'under provisions of Chapter 9 Over 3 to 10 Incl (commencing with Section 7000) of Division 3 of the Business and CITY TeI�` Ooo.C�I.Sri�Z-1 Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. EOR n Over 50to100 Incl. REG NNUMBER Z Clas ^I - a License Number f� /� /n �\� Lic.Class \b Over 100 DISTRICT NO. P OC SSED BY { 0 -�Y �i V Services,Swbd.,MCC&Panelboards �v Contracto - 0 Date 0-399 Amp. Under 600 V FINAL DATE 0 ❑ 400-1000 Amp.Under 600 V ~ I am exempt under Sec. VALIDATION V Over 1000 Amp.or Over 600 V FINAL W B.&P.C.for this reason BRANCH CIRCUIT FEES ev Dater 15A,or 20A, 120V,Lighting or Recept. Z 1 To 10 Branch Circuits Signature` 1-1 To 40 Branch Circuits ❑ _ 41 Or More Branch Circuits Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits SINGLE FAMILY Temp. Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits Code): ❑ I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) and Professions Code). CONSTRUCTION LENDING AGENCY t(_'••_i , I hereby affirm that there is a construction lending agency for the j. _SC. performance of the work for which this permit is issued (Sec. 3097,.• PERMIT FEE (Sub-Total) 00 Civ. C.) PLAN CHECKING FEE Lender's NamPERMIT •`_'_.p '-a y PERMIT.ISSUING FEE Lender's Address y s.4 ?J1 ;L[r I certify that I have read this application and under penalty of purjury state TOTAL FEE y� �'''If ti3L __f 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 inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE SIG WMR SF PERMITT6r DATE - WORKERS' COMPENSATION DECLARATION "76A669oFw3 87 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self ,ce e�� insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certified copy thereof (Sec. 3800, Lab. C.) Policy No. Company FOR APPL,CANT TO FILL IN JOB \ ♦) N ❑Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS ❑Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. $ — $ LOCALITY tion department. Multi-family Sq. Ft. — NEAREST CROSS Residential Swimming Pools OWNERST.OR Date Applicant FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw._ MAIL 6 COMPENSATION INSURANCEFirst 20 ADDRESS Total (This section need not be completed if the work involved by No. CITp�\. Tel. No. Z. the permit is for one hundred dollars (:100)or less.) Additional 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 PP �� —\�S Total No. CITY Tel. No. Date A licant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate ofoC, Exemption, you should become subject to the Workers' Range— Heater—D.W. — APPLICATION 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. — deemed revoked. Hood — Fan —Other_ CIT Tel. No. LICENSED CONTRACTORS DECLARATION LICENSE OR Disp. — Room Air Cond. REG. NUMBER Z. Class. I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO. 'PEESSED BY d and Professions Code,and my license is in full,force and effect. II Size&Type HP, KW, KVA, or KVAR �D p �� �j 0 ,1 License Numbers 0Lic. Class Up to 1 Incl. FINAL Q _ho�1e [�_`�� Over 1 to l0 Incl. DATE /� ``a/ VALIDATION 0 Contractor Ut`u Over 10 to 50 Inel. b `d/ ~ ❑ FINAL C) I am exempt under Sec. Over 50 to 100 Inc. BY W B.&P.C. for this reason Over 100 f' d Services, Swbd., MCC& Panelboards � Z Date- Z p�f 0-200 Amp. Under 600 V, Signature 201 - 1000 Amp. Under 600 V El Ex 1000 Amp. or Over 600 V Exemption for Reg. Maint. Elect. SINGLE FAMILY Temp. Power Pole&AppurtenancesHOME OWNER-BUILDER DECLARATION I hereby affirm that I am exempt.from the Contractor's License Sign with One Branch Circuit Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits _• !� Professions Code): ❑ I, as owner of the property, will do the work and the Misc. Conduits&Conductors _ P P y SII 3 47 � 1_�' structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)— r K i(_s Business and Professions Code). =`.r�a,;y•. Poo CONSTRUCTION LENDING AGENCY _SLUC' et{i tis= 1 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 {!{!{i{- +,!['L _. Lender's Name > c�1 + Hr :r;` L. PERMIT ISSUING FEE -` Lender's Address - j7i o I certify that I have read this application and state that the TOTAL FEE �f 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 inspection purposes: SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee ate` ©s WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT I hereby affirm•that I have a certificate of consent to self insure, 76A663 or a certificate of Worker'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 JOB ADDRESS .Ao'k `fQv Certified copy is hereby furnished. New Residential Bldgs.& $ $ LOCALITY Pools NO. EACH FEE �. El _ Certified co Is filed with the.county g Insp buildin ection 1 &2-Family,Sq.Ft. NEAREST Multi-famil S Ft. department. Y q CROSST. Date Applicant Residential Swimming Pools ASSESSOOR K MAPPAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER OR COMPENSATION INSURANCE Outlets:Rec._Light Sw. FIRM NAME First 20 MAIL (This section need not be completed if the work involved by the ADDRESS permit is for one hundred dollars($100)or less.)' Total No. Additional I certify that in the performance of the work for which this permit CITY Tel.No. is issued, I shall not employ any person in any m ner so as t0 PLAN CHECK become subject to the WorkersC ,pe ation L s Lighting Fixtures First 20 APPLICANT Total No. Additional ADDRESS 2 Date ` _ 7 ppli RESIDENTIAL APPLIANCES NOT OVER 3 HP. g NOTICE TO APP (CANT: If, in I e.of CITY`_ Tel N- - Exemption,you Old become ubject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code, you must forthwith comply with Such PERMIT e_ p p y 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 3 to 10 Incl. (commencing with Section 7000) of Division 3 of the Business and CITY Tel.No. Professions Code, and my license is in full force and effect. Over 10 to 50 Incl. LICENSE OR (7 Over 50 t0 100 Incl. REG.NUMBER �d �• �� ClassCl.S,h.S a l (� Over 100 DISTRICT NO. PR C ED BY �v 0 License Number \ ` ��3� Lic.Class Services,Swbd.,MCC.&Panelboards. ��O e�ez 4-r� � cc 0-399 Amp.Under 600 V FINAL 0 Contractor• �t Date Z� DATE ggA cfa�r ❑ ' 400-1000 Amp.Under 600 V �— Z(U -!� lam exempt under Sec. / VALIDATION V Over 1000 Amp.or Over 600 V FINAL n a B.&P.C.for this reason BRANCH CIRCUIT FEES BY Lh�'1/ CO Date: 15A,or 20A,120V,Lighting or Recept. _J Z_ 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits 41 Or Or More Branch Circuits 4 Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits Ham_S.t. es SINGLE FAMILY Temp.Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION L= I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit `''�'"' -i o'er-` for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits I iTEN Code): El TOTAL 61 m 65t d &C it d Conus Conductors I,as owner of the property,will do the work and the structure Misc. CHECK is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) `)i e�.CK 6ja65 and Professions Code). CHANGE A 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 (Sec. 3097, PERMIT FEE (Sub-Total) JI�Ct ()—M) �I �( ?ti 1g" v. _ii .s Civ. C.) ,-,-, PLAN CHECKING FEE jam,r`i i PM •'.• AL n'17 Lender's Name - PERMIT ISSUING FEE 5 Lender's Address I certify that I have read this application and under penalty of purjury 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 repre ntati sof this County to enter upon the above-mentioned property fo ec urp s. SEE REVERSE FOR EXPLANATORY LANGUAGE I Tl1RE F ERMITT7� DATE WORKERS' COMPENSATION DECLARATION 76A669ovwaiaz APPLICATION FOR ELECTRICAL PERMIT O I hereby affirm that I have a certificate of consent to self CE 8006G insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certified copy thereof (Sec. 3800, Lab. C-.) Policy No. Company FOR APPLICANT TO FILL IN JOB r,l A. �.. ❑Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRES ElCertified copy is filed with the county building inspec- 1 & 2-Family, Sq. Ft.' $ — $ LOCALIT tion department. Multi-family Sq. Ft. NEAREST ' Residential Swimming Pools CROSS ST.OWNER OR Date Applicant FIRM NAME _ CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw._ MAIL COMPENSATION INSURANCE ADDRESS First 20 (This section need not be completed if the work involved by Total No. Additional CITYO'�� Tel. No. -S 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 Lighting Fixtures First 20 ADDRESS so as to become subject to the Workers'Compensation Laws. Additional Date�,LA�Applicant A�2S �P�V►G Total No. CITY Tel. No. Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to The Workers' Range— Heater—D.W. APPLICATION 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. — deemed revoked. Hood — Fan —Other— Cll'"Ic' e0 xku Tel. No. LICENSED CONTRACTORS DECLARATION Disp. — Room Air Cond. — LICENSE O Class.c-- L I hereby affirm that I am licensed under provisions of Chapter 9 REG. NUMBER •' (commencing with Section 7000)of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO. SSED BY >_ and Professions Code,and my license is in full force and effect. p D O (� ��[� Size &Type HP, KW, KVA, or KVAR �J; Girt � � License Number�1�2 Lic. Class�.e—]� Up to 1 Incl. FINAL U �^` -n Over 1 to 10 Incl. DATE 4T 1 p VALIDATION 0 Contract., L�a��..J� Date Z v ❑ Over 10 to 50 Incl. FINAL I am exempt under Sec. Over 50 to 100 Inc. BY U Over 100 UJ B.&P.C. for this reason CL.. Services, Swbd.,'MCC& Ponelboards Z Z Dat 0-200 Amp. Under 600 V Signature _ 201 - 1000 Amp. Under 600 V ❑ Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY Temp. Power Pole &Appurtenances - HOME OWNER-BUILDER DECLARATION 8 I hereby affirm that I am exempt from the Contractor's License Sign with One Branch CircuitY•:_f:3,g Law for the following reason Section 7031.5, Business and Additional Sign Branch Circuits \ 75 Professions Code): ❑ I, as owner of the property, will do the work and the Misc. Conduits&Conductors f ITEMS S structure is not intended or offered for sale(Section 7044, Other,(See Complete.Fee Schedule)_ , TOTAL 4-5 � 75 Business and Professions Code). -,5 CONSTRUCTION LENDING AGENCY X5 d S'{�Er"iii f t� _t L• F. d'i_i I hereby affirm that there is a construction lending agency for •�li�t3t the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) (Sec. 3097., Civ. C.). PLAN CHECKING FEE _F� `. Lender's Name ' PERMIT ISSUING FEE 970 1 Arl rfi'LI Lender's Address 1 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 laws regulating Electrical wiring, and hereby authorize representatives of this County to enter,upon thea ve- ntion�property spection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Dote ©s �-, W�ORKERS' COMPENSATION'DECLAR4TION 76-663 10/81 APPLICATION FOR ELECTRICAL PERMIT I 112beby'afttrm that I I'have a certificate of consent to self insure, CE-806G ,. or a certifical'e of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec.3800,Lab, C. Policy No. COmpany �lO,MJ(,1 vruy�t 1-� FOR APPLICANT TO FILL - ..JOB ADDRES94 / - ❑ Certified copy is hereby furnished. New Residential Bldgs.&Pools. EACH w NO. ' FEE S �� a'S fV NCtS Certified copy is•filed the county building inspection t& 2-Family;Sq. Ft.. $ _ $ LOCALITY . department.� Al Multi-family Sq.Ft NEAREST " Residential Swimming Pools °t OWNER OR, Date'� . �"t e' y ppi ant .. _ • . . € ',FIRM NAME.. rc t'4 Core- W..OF EXEMPTION FROM.WORKERS', Outlets:Rec Light Sw+ ''r ) MAIL p COMPENSATION INSURANCE' First 20 V ADDRESS 1 77g( ��r�/A-Aj S (This section need not be.completed if the work involved by the Total No. ;, Additional CITY Sr v� �� . TeL N -17 ermit is for one hundred,dollars ($-100)or..less) 1 certify that in the performance of the-work for which this permit PLAN PLICANT CHECK is issued,'I shall'not employ any person in any manner so to become subject,to the Workers'Compensation Laws. Lighting Fixtures First 20 .ADDRESS Additional Total No. CITY Tel.No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT " NOTICE TO APPLICANT: If, ,after making this Certificate of" Exemption,you should become subject to the Workers'Compensation Range_ Heater_ D.W. APPLCANT. - et�1jJLS OW�T provisions of the'Labor Code,:you must forthwith comply with such Oven Dryer _ W.M._ ADDRESS 3210 cfz) provisions or this permit shall be deemed'revoked. Top —.FAU _ W.H." LICENSED CONTRACTORS DECLARATION Hood Fan Other_ 'r CITY 4L Tel.N t �5 I hereby affirm that'I am licensed under provisions of`Chapter 9 Dis — Room Air Cond. LICENSE OR (commencing.with'Section 7000) ot_Division,3-of the Busjness and p REG.NUMBER• (�7 jZJ - ClassC(p 4S Professions Code,and my license is in full force and effect. Power Apparatus.& Large Appliances DISTRICT NO PROCESSED BY a Size•& Type HP,KW,KVA,or KVAR' Y V License Number -77 Lie:Clas 6C(� Up to 1 InclO . FINAL U Over 1 to 10 Incl. DATE _ C,ontrac r �� Date �'1 It ��13V -TION O Over 10 to 50 Incl. FIN- I am.exempt.under Sec. Over 50 to 100 Inc. BY ( W B.&P.C.for this reason Over 100 N r Services,,.Swbd:;MCC & Panelboards Date: 0-200 Amp.Under 600 V Signature 201 - 1000-Amp.Under 600 V Over'1000 Amp.or Over 600 V y, ❑. Exemption for Reg.Maint.Elect. . � 1 J 1.2A "SINGLE FAMILY Temp.Power Pole'.& Appurtenances # 0 0 0 ® 0 2 HOME OWNER-BUILDER DECLARATION, o o.' Sign with One Branch Circuit 2 9 2 5 ' I hereby affirm that l am exempt from the Contractor's.License Law - • for the.followjng reason(Section 7031.5, Business and.Professions Additional Sign Branch Circuits' o o- o 29.256 .x. Code) El -88 Misc.Conduits''& Conductors - 1 3 1l,as owner of the property,will do the work and the structure is not intended or offered for sale Section 7044, Business Other(See Complete Fee Schedule) 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(Sec.3097, PERMIT FEE (Sub-Total).: Civ.C.).. PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address_ - .. ' TOTAL FEE I certify that I have read this application and state that the above If 5 information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize r ntatives of this Co to enter upon the above-mentioned ty or inspe tion pur s SEE REVERSE.FOR.EXPLANATORY LANGUAGE graafure of Permittee Date r WORKERS'COMPEN•ATION DECLARATION44;]i' 76A663 10/81 . r CE-806G APPLICATION' FOR ELECTRICAL PERMIT I herebu affirm that I have a certmcate of consengt;� sen'insure, or a c,.3rtifioate of Workers' Compensation Insurance, or a.certified COUNTY OF LOS-ANGELES _BUILDINP AND SAFETY copy there f Sec.3800,Lab. C:) KWOo'oL rt^A� (1�r�p� Policy No: Company tr ��—�;igA(A0 FOR APPLICANT TO FILL IN -JOB - Certified copy is hereby,furnished �Ws x� EACH NO.. FEE. ;ADDRESS Y, New Residential Bldgs:& Pools LOCALITY Certified copy is,filed with the county budding inspection 1 &2-Family,Sq.Ft. $' NEA department. Multi-family Sq,Ft. `�.: CROS SST. Residential Swimming PoolsLL OWNER OR. S Date' 9-a0—Q.q Applican FIRM NAME jj C tJ� r_- CERTIFICATE OF EXEMPTION;FROM RKERS' Outlets:Recce_ Light Sw. ` MAIL COMPENSATION INSURANCE VV ADDRESS IIIIA15 . , (This,section need not be completed,if the work involved by the t^1, / p U First 20 Total No., �. b,V Additional . CITY Tel.N permit Is for one hundred dollars ($100)or less.)' * - - PLAN CHECK-- L certify that in the.performance of the work for which this permit U 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 (� v 0/ -ADDRESS Additional 9- 0 ' i� c R pp Total No. CITY Tel.No. Date A lican NOTICE TO APPLICANT: If, after. ma his Certificate of Fixed Appliances NotOver 1 HP PERMIT Exemption,.you should become subject.to the Workers'Compensation Range_ Heater_ D.W. APPLICANT ' provisions of the Labor Code, you must forthwith comply with such Oven Dryer _ W.M._ ADDRESS y provisions or this permit shall be deemed revoked` Top FAU W.H. CITY Tel.N. •LICENSED CONTRACTORS DECLARATION Hood — Fan, Other_ d I,hereby affirri ,that I am licensed under provisions of Chapter 9 a' LICENSE OR (commencing with Section 7000) of Division 3 of the Business and Disp. —.Room.Air Cond. REG.NUMBER Class. _ Professions Code,and my license is in full force and effect:. Power Apparatus& Large Appliances DISTRICT NO. PROCESSED BY ' —\O: Size& Type HP,KW,KVA,or KVAR ,p+ J License Nu be r N 4 f�(. Lic.Class � Up to 1 Incl FINAL���777 /} V DATE Over 1 to 10 Incl. Contract- Date I2''r1 O—A - (J "VALITTION O Over 10 td 50'lncl. FINAL ~ • ❑ I am e empt under Sec. Over 50 to 100 Inc. BY W B.&P;C.for this reason Over 100 ' N Services,Swbd.,.MCC & Panelboards Date: 0- 200 Amp.•Under 600 V xLB Signature. 201 - 1000 Amp.Under 600 V _ Over 1000 Amp. or Over 600 V ❑, Exemption for Reg..Maint.Elect. - SINGLE FAMILY Temp.Power Pole& Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law s for the following reason(Section 7031.5, Additional-Sign Branch Circuit Business and Professions 1.3 9.9 A Code): Misc.Conduits&Conductors # o o e m o 2 I,as owner of the property,will do the work.and the structure is not intended or offered for sale..(Section.7044, Business ' Other(See Complete.Fee Schedule) _ I ° 2'4 2 0 0 and Professions Code). CONSTRUCTION LENDING AGENCY. o o 24 20 0 5 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) Civ.C.). 12'2 3 8 8 PLAN CHECKING FEE Lender's Name • PERMIT ISSUING FEE_ 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 5�� D and State laws regulating Electrical wiring, and hereby authorize r representatives of this County to,enter upon the above-mentioned pro rty for inspection purp es. SEE REVERSE FOR EXPLANATORY LANGUAGE a e o rer itt Date WORKERS' COMPENSATION DECLARATION 76A663 DPW 3/87 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self CE 806G insCre, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certified copy thereof (Sec. 3800, Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB E]Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS f 1 LAS TUNAS(POTOMAC Certified copy is filed with the county building inspec- 1 LOCALITY&2-Family, Sq. Ft. $ _ $ TEMPLE CITY CA. tion department. Multi-family$q. Ft. NEARESTCROSS ST. OAK Date Applicant Residential Swimming Pools OWNER OR PP FIRM NAME T.Q. NAT t L.LI TTLE LEA CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw._ MAIL COMPENSATION INSURANCE First 20 ADDRESS 9116 E.. LEROY p (This section need not be completed if the work involved by Total No. Additional CITY SAN GABRIEL Tel. No.206-5 5 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 n Total No. Additional CITY Tel. No. Date 4-23—go DALES ELECTRIC NOTICE TO APPLICANT: If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT Exemption, you should become subject to the Workers' Range— Heater—D.W. _ APPLICATION S ELECTRIC Compensation provisions of the Labor Code, you must forth- Oven — Dryer —W.M.— ADDRESS 672 ARDILLA ST. with comply with such provision's or this permit shall be Top — FAU —W.H. -- deemed revoked. CITY Tel. N LICENSED CONTRACTORS DECLARATION Hood — Fan —Other— LA PUENTE CA. a287—$62� Disp. — Room Air Cond. — LICENSE OR 276218 Class. C-10- -10 I hereby affirm that I am licensed under provisions of Chapter 9 REG. NUMBER (commencing with Section-7000)of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO. �/ PRO D I >-. and Professions Code,and my license is in full force and effect. 1t a 2 6218 ' I C:--1 0, Size &Type HP, KW, KVA, or KVAR ® Q License Number r Lic. Class . U _ , Up to 1 Incl. FINAL DALES ELECTRS 4-23-90 Over 1 to 10 Incl. DATE- VALIDATION Contractor a e Over 10 to 50 Incl. F_ FINAL I am exempt under Sec. Over 50 to 100 Inc. BY U L B.&P.C. for this reason Over 100 a- Services, SWbd.,.MCC& Ponelboards �OoeZ ate: 0-200 Amp. Under 600 V0 Signature 201 - 1000 Amp. Under 600 V QOver 1000 Amp. or Over 600 V Exemption for Reg. Moint. Elect. SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Temp. Power Pole &Appurtenances Sign with One Branch Circuit s I hereby affirm that I am exempt from the Contractor's License ACC' Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits 3 Professions Code): •LI'' 13.010 I, as owner of the property, will do the work and the Misc. Conduits&Conductors I ITEMS structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ 'l i` 13 - 00 Business and Professions Code). TEMPORARY CONSTRUCTION LENDING AGENCY L°it!_Y: I hereby affirm That there is a construction lending agency for ;•' �!I the performance of-the work for which this permit is issued PERMIT FEE (Sub-Total) ���� _i_ (Sec. 3097, Civ. C.). PLAN CHECKING FEE 1,1000-0001 jl ; —i l� 1 �� `�; (3 Lender's Name PERMIT ISSUING FEE [I� 3 i �i • ` 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 laws regulating Electrical wiring, and hereby authorize r resentatives of this County to enter upon thea e-m do d roperty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE )( 4-23-90 i. ©s gnotur o Permittee Date E WORKERS'COMPENSATION DECLARATION ;76A6ieDPw3ie7 I hereby affirm that I have a certificate of consent to self CE eooc APPLICATION FOR ELECTRICAL PERMIT O insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certified copy thereof (Sec. 3800, Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB 91+-51 LAS. TUNAS(POTONA C ❑Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS ❑Certified copy is filed with the county building inspec- 1 & 2-Family, Sq. Ft. $ 1 $ LOCALITY TEMPLE CITY tion department. Multi-family Sq. Ft. NEAREST �7� CROSS ST. OAK Date Applicant Residential Swimming Pools OWNER OR r7� RP FIRM NAME NA'T I L. LITTLE LEAGUE CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light . Sw._ MAIL COMPENSATION INSURANCE ADDRESS 9116 E. LEROY s section completed if the work involved b First 20 (Thiction need not bP Y Total No. Additional CITY SAN GABRIEL CAIeI. Na.286-5458 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 ernploy any person in any manner so as to:become.,subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS . Additional Date 5-8-91 Applicant DALES ELECTRIC Total No. CITY Tel. No. NOTICE TO APPLICANT: If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT Exemption, you should become subject to the Workers' Range— Heater—D.W. — APPLICATION DALES ELECTRIC Compensation provisions of the Labor Code, you must forth- Oven — Dryer W.M._ ADDRES9923 E. LIVE OAK with comply with such provisions or this permit shall be Top . — Fan —Other— — FAU —W.H. — O deemed revoked. CITY TEMPLE CITY CALel. No.287-8627 LICENSED CONTRACTORS DECLARATION Disp. — Room Air Cond. — LICENSE OR NUMBER .276218 Class.C-10 (commencing with Section7000)of Division 3 of the Business Power Apparatus&•Large Appliances DISTRICT NO. ESSED BY >_ and Professions Code,and my license is in full force and effect, IL Size &Type HP, KW, KVA, or KVAR ��� 0 Lic. License Number 276218 Class' C-1'0 U Up to 1 Incl. FINAL �+ Contractor DALES ELECTRI 5-8-91 Over 1 to 10 Incl. DATE VALIDATION Cr ❑ Over 10 to 50 Incl. FINAL I I am exempt under Sec. Over 50 to 100 Inc. BY U Over 100 W B.&P.C. for this reason d Z Date' Services, Swbd., MCC& Ponelboards Z 0-200 Amp. Under 600 V loop. Signature 201 - 1000 Amp. Under 600 V ❑ Exemption for Reg. Moint. Elect. Over 1000 Amp. or Over.600 V SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Temp. Power Pole 8 Appurtenances I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit „ Additional Sign Branch Circuits Law for the following reason (Section 7031.5, Business and g Professions Code): ❑ I, as owner of the property, will do the._work and the Misc. Conduits&Conductors 3'R_ structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ _ _ Business and Professions Code). , ! 11 HL 3 � 01- CONSTRUCTION LENDING AGENCY TEMPORARY L;`.; <<Ijs 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) `-fi f'�`�L" =I !I (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name /. ?I shE—it `_li 'PERMIT ISSUING FEE Lender's Address1 Ail i(j= 3 j 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 laws regulating Electrical wiring, and hereby au"retatives of this County to enter uponthe abo perty fo inspection purposes.' SEE REVERSE FOR EXPLANATORY LANGUAGE Signature Date ©s WORKERS' COMPENSATION DECLARATION 76A66vocwaie7 APPLICATION FOR ELECTRICAL PERMIT I h,�reby afiircm�that I have a certificate of consent to self .,Ce eoa� insure,or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certified copy thereof (Sec. 3800, Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB 91+51-1 LAS TUNAS (POTOMAC Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS El Certified copy is filed with the county building inspec- 11 & 2-Family, Sq. Ft. $ _ $ LOCALITY TEMPLE CITY tion department. Multi-family Sq. Ft. NEAREST Date A licant Residential Swimming Pools CROSS R S ST. OAK PP FIRM NAME/NAT'L.LITTLE LEAGUE CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw._ MAIL ADDRESS 6 22 N. ENCINITA AV. COMPENSATION INSURANCE First 20 (This section need not be completed if the work involved by Taal No. Additional CITY TEMPLE CITY Tel. No.285'-57 62 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 5-28-92 DALES ELECTRICTotal No. Additional CITY Tel. No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of APPLICATION DALES ELECTRIC 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 9923 E. LIVE OAK with comply with such provisions or this permit'sholl be Top — FAU —W.H. — deemed revoked. Hood — Fan —Other— CITY TEMPLE CITY Tel. No.287-8627 LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. — REG. NUMBER 276218 Class.C-10 (commencing with Section 7000)of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO. PIR BY >_ and Professions Code,and my license is in full force and effect. a- Size &Type HP, KW, KVA, or KVAR ���� O License Number 276218 Lic. Class C-10Up to 1 Incl. FINAL U DALES ELECTR��'1e 5-28-92 Over 1 to 10 Incl. DATE (0- `1 ,�_ VALIDATION 0 Contractor ❑ Over 10 to 50 Incl. FINAL F" I am exempt under Sec. Over 50 to 100 Inc. BY 0 LU B.&P.C. for this reason Over 100 d Services, Swbd., MCC& Panelboards e' 0- 200 Amp. Under 600 V Z Signature 201 - 1000 Amp. Under 600 V Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Temp. Power Pole&Appurtenances I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit __ Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits f E' •i = ' Professions Code): -F lw t _ I, as owner of the property, will do the work and-the Misc. Conduits&Conductors Complete Fee Scheduleom lSee C Other . structure is not intended or offered for sale(Section 7044, ( P )— i."r' Business and Professions Code). _ CONSTRUCTION LENDING AGENCY TEMPORARY, FIREWORKS1 I hereby affirm that there•is a construction lending agency for 6 TAN D - t1 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 � or _ I certify that I have read this application and state that the TOTAL FEE T /,o above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and d hereby authorize representatives of this County to enter upon theaA-m e tione pr perty fo inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE 2 Sign ture of Permittee Date ©s WORKER'S COMPENSATION DECLARATION 20-0019 76A663 DPW(12 91) AL PERMIT APPLICATION FOR ELECTRICAL I hefeby affirm that I have a certificate of consent to self insure, C or a certificate of Worker'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 JOB ADDRESS Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE EJ Certified &2-Family,Sq.Ft. $ $ LOCALITY _ Certified copy is filed with the county building inspection NEAREST department. Multi-family Sq.Ft. CROSS ST. Residential Swimming Pools ASSESSOR Date Applicant MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec._Light Sw. OWNER OR NAME COMPENSATION INSURANCE FIRM First 20 MAIL (This section need not be completed if the work involved by the Total No. Additional ADDRESS permit is for one hundred dollars($100)or less.) I certify that in the performance of the work for which this permit CITY Tel.No. is issued, I shall not employ any person in any manner so as to PLAN CHECK become subject to the Workers' Compensation Laws. Lighting Fixtures First 20 APPLICANT Total No. Additional ADDRESS Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: If, after making this Certificate of CITY Tel.No. Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code, you must forthwith comply with such PERMIT P Y P Y 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 3 to 10 Incl. >' (commencing with Section 7000) of Division 3 of the Business and CITY Tel.No. Il Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. Over 50 to 100 Incl. R GLICENSE NU BER Class. License Number Lic.Class Over 100 DISTRICT NO. PROCESSED BY W J_ Services,Swbd.,MCC&Panelboards LL FINAL �- 0-399 Amp. 600 V >' Contractor Date P DATE ❑ 400-1000 Amp.Under 600 V < I am exempt under Sec. VALIDATION Q Over 1000 Amp.or Over 600 V FINAL cc B.&P.C.for this reasonBRANCH CIRCUIT FEES B 0 Y a Date: 15A,or 20A, 120V,Lighting or Recept. 1 2 1 To 10 Branch Circuits W Signature 11 To 40 Branch Circuits ~ ❑ 41 Or More Branch Circuits Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits SINGLE FAMILY Temp.Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits Code): ❑ I,as owner of the property, will do the work and the structure Misc.Conduits&Conductors is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) , 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 (Sec. 3097, PERMIT FEE (Sub-Total) Civ.C.) PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address I certify that I have read this application and under penalty of purjury 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 inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE OF PERMITTEE DATE 4COUNTY OF LOS ANGELES TEMPLE CITY # 0508 t•sELECTRICAL PERMIT . DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ','lEL^0508'_9707220067 BUILDING AND SAFETY /LAND DEVELOPMENT. TEMPLE CITY CA PHONE: (818) 285-0488 EXT: LEGAL ID: FEES PAID �.9451D ` TUNA3DR INGADDR " TR: 8526 LT: 1 .` BL: .001 FEE DESCRIPTION QUANTITY: UOM: AMOUNT: TEMP CA 917802100 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: OAK 8587-008-018 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE:. 596. GRID: J3 LOCALITY:.TEMPLE CITY K1 SIGNS, OUTLINE LGT 1.00 SIG 38.85 TENANT: TOTAL FEES 66.60 ISSUED 9&L—PRAN BY: EXPIRES-ON: L. P. CLOTHING WAREHOUSE 0 TC /22/98 OWNER: TEL. NO: FINAL DATE FINAL B CODE: TEMPLE CITY PROPERTIES 533 14TH ST !! SANM 904022927 DESCRIPTION-Of WORK 2jCHANNEL LETTER ILLUMI.NAT-ED-STGNS APPLICANT: TEL. N0: FIRST SIGN CO. (626) 448-1616- SPECIAL CONDITIONS: C CONTRACTOR: TEL. NO: OQ APPROVALS DATE INSPECTOR SIGNATURE FIRST SIGNS CO. (818) 448-1616- �/ 1 9647 E. RUSH ST. LIC. NO �('� r'? TEMPORARY POWER POLE SOUTH EL MONTE, CA 91733 605688C45 \� (((%%% '5A , UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. O: UFER GROUND LIC. NO: ROUGH CONDUIT ROUGH W / E MAIN WATER LINE ti PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED o iM - �\ REPORT ID: DPR265 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1201170022 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: FEES PAID I BUILDING ADDRESS: I ITR: 8526 LT: 1 BL: .001 1 1 9451 1/2 LAS TUNAS DR J I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: J TEMP CA 917802100 I (ASSESSOR INFORMATION NUMBER: I - NEAREST CROSS STREET: 18587-008-018 1A1 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, Cl I IG1 OUTLETS-LGT,SW,RECP 15.00 OUT 29.10 I I.TENANT: JG2 LIGHTING FIXTURES 25.00 LGT 45.70 ISSUED ON: PROCESSED BY: PLAN BY: 1 JUS FINE ART TOTAL FEES 102.60 101/17/12 SR 1 I I I I DOWNER: TEL. NO: 1 (FINAL DATE . FINAL BY: CODE: JZHAO, JIAN XIN 1 (626) 673-6368- 19451 1/2 LAS TUNAS ITEMPLE CITY CA 91780 IDESCRIPTION OF WORK I ITENANT IMPROVEMENT ELECTRICAL 15 OUTLETS AND 25 LIGHT FIXTURI I IES I (APPLICANT: TEL. NO: 1 I IGEORGE ZHANG (626) 945-8612- 1 1448 W. CAMINO REAL 1 ISPECIAL CONDITIONS: 1 1ARCADIA, CA 91007 I 1 ICONTRACTOR: TEL. NO: I JAPPROVALS DATE INSPECTOR SIGNATURE 1 ZUNI-GLORY DEVELOPMENT INC. (626) 945-8612- i 1 1448 W CAMINO REAL AVE LIC- NO 1 ITEMPORARY POWER POLE I 1ARCADIA, CA 91007 383572B i I I (UNDERGROUND CONDUIT I (ARCHITECT OR ENGINEER: TEL. NO: 1 - IUFER GROUND I I J IMAD IT (626) 945-8612- 1 I 1 1448 W. CAMININO REAL AVE. LIC. NO: 1 1ROUGH CONDUIT D I 1ARCADIA, CA 91007 NONE I 1 TROUGH WIRING ��L I (MAIN WATER LINE IPLASTIC Y/N METAL Y/N (UTILITY COMPANY NOTIFIED( I I I I I I I I I I I I I I I I I I 1 1 I I I I I I I I I I I I I I I I I I I I I I 1 I I I I I IREPORT ID: DPR265 ROUTE TO: BSO508 1 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 �EUECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS EL 0508-9706130019 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA. ' PHONE: (818) 285-0488 EXT: LEGAL ID: FEES PAID ,BUILDING ADDRESS: . TR: 8526 LT: 1 BL: .001 ,9451.:,1/2 1AS.TUNAS✓DR FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 9178021'00 ASSESSOR,INFORMATION NUMBER: NEAREST CROSS STREET: OAK 8587-008-018 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY E3 TEMP.XMAS TREE, ADDT 1.00 TEM 21.60 TENANT: TOTAL FEES 49.35 ISSUED ON: PROCESSED BY: PLAN BY: EXP RES ON: T.C. NATIONAL LITTLE LEAGUE 06/13/97 TC 06/13/98 OWNER: TEL. 0: FINAL DATE FINAL.BY: ,6ODE: TEMPLE CITY PROPERTIES 533 14TH ST SANM 904022927 DESCRIPTION OF WORK FIREWORKS STAND BOOTH LIGHTING APPLICANT: TEL. NO: DALE'S ELECTRIC (818) 287-8627- SPECIAL CONDITIONS: CONTRACTOR: TEL. N0: R jam_ APPROVALS DATE INSPECTOR SIGNATURE DALE'S ELECTRIC (818) 287-5064-, \`U� 9923 E. LIVE OAK LIC. NO � TEMPORARY POWER POLE TEMPLE CITY, CA 276218C-10 s �� UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. N0: UFER GROUND LIC. N0: Q- �41 �. ROUGH;CONDUIT il ROUGH WIRING Com`( ✓/ �� MAIN WATER LINE PLASTIC Y/N METAL Y/N ---7 0 721;- UTILITY COMPANY NOTIFIED ry REPORT ID: DPR265 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0006150029 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 8526 LT: 1 BL: .001 9451-LAS TUNAS DR FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802100 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: OAK 8587-008-018 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY D3 BOOTH LGT, SYSTEM 1.00 BOO 16.20 TENANT: TOTAL FEES 43.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: T.C. NATIONAL LITTLE LEAGUE 06/15/00 UT 12/12/00 i OWNER: TEL. NO: FINAL DATE FINAL BY CODE: TEMPLE CITY PROPERTIES 533 14TH STL�`�� SANM 904022927 DESCRIPTION OF WORK FIREWORKS STAND BOOTH LIGHTING-2000 APPLICANT: TEL. NO: C N S ELECTRIC CO. (626) 836-5881- 130 E. MONTECITO _ SPECIAL CONDITIONS: SIERRA MADRE, CA CONTRACTOR: TEL. N0: APPROVALS DATE INSPECTOR SIGNATURE C N S ELECTRIC CO. 626 836588 -1 130 E. MONTECITO LIC. NO �f^� TEMPORARY POWER POLE SIERRA MADRE, CA 91024 630482 UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. N0: -'� 11f-',- �` -� UFER GROUND LIC. NO. r � _ � 1� AROUGH CONDUIT ROUGH WIRING MAIN WATER LINE PLASTIC Y/N METAL Y/N - - - - - - UTILITY COMPANY NOTIFIED tic 3 REPORT ID: DPR265 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 9912220023 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 8526 LT: 1 BL: .001 9451 1/2 LAS TUNAS DR FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802100 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: OAK 8587-008-018 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY D3 BOOTH LGT, SYSTEM 1.00 BOO 16.20 TENANT: TOTAL FEES 43.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: TEMPLE CITY JOB'S DAUGHTERS #179 12/22/99 UT 06/19/00 OWNER: TEL. NO: FINAL DATE FINAL BY: COD TEMPLE CITY PROPERTIES Iz.-z 'd 533 14TH ST SANM 904022927 DESCRIPTION OF WORK FIREWORKS STAND BOOTH LIGHTING-MILLENNIUM APPLICANT: TEL. NO: G G HESTER AND SONS (909) 392-4949- 588 LANTANA SPECIAL CONDITIONS: LA VERNE, CA CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE G G HESTER AND SON ELECTRIC (909) 392-4949 588 LANTANA ST LIC. NO TEMPORARY POWER POLE LA VERNE CA CA 91750 474648 C10 UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. N0: �� l �I! I �� �� �� UFER GROUND LIC. N0 ice,,;� i.;� � ROUGH CONDUIT - - - -- ROUGH WIRING !� MAIN WATER LINE PLASTIC Y/N METAL Y/N - - - UTILITY COMPANY NOTIFIED REPORT ID: DPR265 ROUTE TO: BS0508 ' e _ • e ' COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL-'PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL- 0508 9905260041 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDINGADDRESS: TR: 8526 LT: 1 BL: .001 9451;1/2,LAS TUNAS DR FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 91.7802100 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: OAK AVE. 8587-008-018 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY K1 SIGNS, OUTLINE LGT 2.00 SIG 77.70 TENANT: TOTAL FEES 105.45 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: U.S. ARTS EDUCATION CENTER 05/26/99 UT 11/22/99 OWNER: TEL. NO: FINAL DATE FINAL BY- CODE: TEMPLE CITY PROPERTIES 533 14TH ST SANM 904022927 DESCRIPTION OF WORK ELECTRICAL FOR TWO NEW SIGNS APPLICANT: TEL. NO: FORTUNE SIGNS CORP. (626) 579-9446- 2458 LEE AVE. _.-_ SPECIAL CONDITIONS: EL MONTE CA CONTRACTOR: TEL. NO: �� �� APPROVALS DATE INSPECTOR SIGNATURE FORTUNE SIGNS (626) 579-9446- / d 2458 LEE AVE. LIC. NO TEMPORARY POWER POLE SOUTH EL MONTE, CA 608549C-45 / UNDERGROUND CONDUIT J, ARCHITECT OR ENGINEER: TEL. NO: / r UFER GROUND LIC. N0: __ i 11II,�� �1 ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE I` L C C'�� C' WA '`` J�� PLASTIC Y/N METAL Y/N -----_-- `J "---_ --J' UTILITY COMPANY NOTIFIED 0 / Q '� _ Ali= REPORT ID: DPR265 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL'PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 9906100046 BUILDING AND SAFETY./ LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL D: FEES PAID BUILDING ADDRESS: TR: 8526 LT: 1 BL: .001 9451 1/2 LAS TUNAS DR FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP-CA 917802100 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: OAK AVE. 8587-008-018 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT,SW,RECP 17.00 OUT 33.15 TENANT: G2 LIGHTING FIXTURES 1.00 LGT 1.95 ISSUED ON: PROCESSED Y: PLAN BY: EXPIRES ON: U.S. ARTS EDUCATION CENTER IA N-RES EX FANS LT 3HP 1.00 EX 15.30 06/10/99 UT !2,,10/99 TOTAL FEES 78.15 OWNER: TEL. NO: FINAL DATE FINAL BY CODE: GEWERTZ, HARRY R (310) 393-0848- 9-14:m 533 14TH ST SANTA MONICA 90402 DESCRIPTION OF WORK ELECTRICAL FOR TENANT IMPROVEMENT APPLICANT: TEL. NO: ZHAO (626) 287-7961- SPECIAL CONDITIONS: GIE[LkS C()CONTRACTOR: TEL. NO: ®� APPROVALS DATE INSPECTOR SIGNATURE: A J L DEVELOPMENT, INC. (909) 860-8530- 21481 COLD SPRING LANE LIC. NO TEMPORARY POWER POLE DIAMOND BAR CA 91765 762775 B UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: UFER GROUND ZHANG, GEORGE (626) 945-85111- 21481 COLD SPRING LANE LIC. N0:` / 1111111 ROUGH CONDUIT DIAMOND BAR, CA NONE f L � ROUGH WIRING n n O ��� �0�K MAIN WATER LINE PLASTIC YIN METAL YIN UTILITY COMPANY NOTIFIED z 0 0 0 0 El ®tom REPORT ID: DPR265 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 :-E'LECTRICAL PERMIT., DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS -0508-9708200006 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: LEGA D: FEES PAID BUILDING_ADDRESS:— TR: DD ESS:.--TR: 8526 LT: 1 BL: .0019451 1/2`LAS TUNAS_'DR FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: V,JEMP,-.CA-917802100--•-� ASSESSOR INFORMATION NUMBER: '-NEAREST-CROSS-STREET: 8587-008-018 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY A5 PLAN CHECK 218.70 DOL 218.70 TENANT: G1 OUTLETS-LGT,SW,RECP 6.00 OUT 11.70 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: G2 LIGHTING FIXTURES 18.00 LGT 35.10 08/20/97 TC 08/20/98 TOTAL FEES 293.25 OWNER: TEL. NO: FINAL DA E FINALB TEMPLE CITY PROPERTIES ' /. 533 14TH ST bbb g��= SANM 904022927 DESCRIPTION OFWO ELECTRICAL FOR TE rNT IMPROVEMENT APPLICANT: TEL. NO: ERIC HAKANSON CONS. (714) 256-2887- SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE ERIC HAKANSON CONSTRUCTION (714) 256-2887- 908 WILLOW DR. LIC. NO % TEMPORARY POWER POLE BREA, CA 92821 727818 B UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. N0: UFER GROUND LIC. N0: ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED REPORT ID: DPR265 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508ELTRj'CAL PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS . "'` -EL 0508-9806050034 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: LEGAL ID: FEES PAID BUIL_DING.ADDRESS: TR: 8526 LT: 1 BL: .0019451 1/2 LAS TUNAS DR", FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP-CA 977802100 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: OAK 8587-008-018 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY D3 BOOTH LGT, SYSTEM 1.00 BOO 16.35 TENANT: TOTAL FEES 44.10 ISSUED ON: PROCESSED BY: PLAN BY: XPIRES ON: T.C. NATIONAL LITTLE LEAGUE 06/05/98 UT /06/05/99 OWNER: TEL. NO: FINAL DATE,,/,, FINAL CODE: TEMPLE CITY PROPERTIES &2� 533 14TH ST �" PU SANM 904022927 DESCRIPTION-OF--WORK- FIREWORKS STAND BOOTH LIGHTING APPLICANT: TEL. NO: WEST END ELECTRIC (213) 225-4840- SPECIAL CONDITIONS: CONTRACTOR: TEL. N0: ,/ ��.�" `� ��', APPROVALS DATE INSPECTOR SIGNATURE WEST END ELECTRIC (626) 793-8790- � 1523 1/2 BRIDGE CT. LIC. NO / ' � �,'� TEMPORARY POWER POLE LOS ANGELES, CA 90033 722246 C10 UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: � I, - A LIFER GROUND LIC. N0: - --� -� I ���� j ; ;. ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED REPORT ID: DPR265 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 9906090037 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 8526 LT: 1 BL: .001 9451 LAS TUNAS DR FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802100 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: OAK 8587-008-018 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY D3 BOOTH LGT, SYSTEM 1.00 B00 16.35 TENANT: TOTAL FEES 44.10 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: T.C. NATIONAL LITTLE LEAGUE 06/09/99 UT 12/06/99 OWNER: TEL. N0: FIN D �_! FINAL BY CODE: TEMPLE CITY PROPERTIES - C/ 533 14TH ST d / SANM 904022927 D CRIPTION OF WOR FIREWORKS STAND BOOTH LIGHTING APPLICANT: TEL. NO: WEST END ELECTRIC (213) 225-4840- SPECIAL CONDITIONS: CONTRACTOR: TEL. N0: ��EJ� APPROVALS DATE INSPECTOR SIGNATURE WEST END ELECTRIC (626) 793-8790- 1523 1/2 BRIDGE CT. LIC. NO .✓ TEMPORARY POWER POLE LOS ANGELES, CA 90033 722246 C10/ UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: . UFER GROUND LIC. NOr:' Iylrn( �illllll , ROUGH CONDUIT ROUGH WIRING ,r } U �� l ��� MAIN WATER LINE �I1 R << J) PLASTIC Y/N METAL Y/N 1;- -- --- -/ --- UTILITY COMPANY NOTIFIED ti• C, v C(a REPORT ID: DPR265 ROUTE TO: BS0508 APPLICATION FORPERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS I hereby affirm that I.have a certificate of consent to self insure, BUILDING ADDRESS 45- ///�� or a certificate of Workers' Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) CITY ZIP !i 70 O Policy No. Company / LOCALITY SIZE LOT .OF BLDGS.NOW ON LOTta ❑ Certified Copy is hereby furnished. NEAREST CROSS ST. - ❑ Certified copy is filed with the county building inspection. TRACTBLOCK' LOT NO. department. USE ZONE MAP NO. 777 Date Applicant ASSESSOR MAP BOOK PAGE PARCEL. ' SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' owN R' TEL NO.. COMPENSATION INSURANCE e WITHIN 1000 FT OF SCHOOL?• YES NO (This section need not be completed if the permit is for one hundred- ADDRESS y dollars ($100)or IBSS.) L (f s DISTRICT GROUP TYP CONST. FIRE ZONE PROCESSED BY CITY/' ZIP G, - I certify that in the performance of the work for which this permit ��O _ is issued, I shall not employ any person in any manner so as to ARCHITECT 01 ENGINEER TEL NO: - become subject to the Workers'Com/peensatiorr,L,.aws. STATISTICAL CLASSIFICATION APT CONDO Date2-ZZ� /3 Applicant c.0 SrV'/' ADDRESS CLASS NO. 1S9sT fDWELL UNITS NOTICE TO APPLICANT.' If, after making this Certificate Of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become Subject to the Workers' CONTRACT0113 TFL NO. - SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith. �Q FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS L C. O. PL LICENSED CONTRACTORS DECLARATION I SIDE CITY LI CLAS P.L I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE .OF STORIES - NO.OF FAMILIES Professions Code,and my license is in full force and a ct. License NumbeLic.Class. `' NEW BK PG a a C g DESCRIP ION OF WORK ADD - ❑. VALUATION A •� °F O r _ Contractor Date 2--Z2-9 WSk. ALTER El $ �+ ) ❑ I am exempt under Sec. REPAIR ❑ $ 1 $ U BAP.C.for this reason DEMOL- O Hi`• LDMA P/C# Date: USE OF EXISTING BLDG. URM ❑ - 3303 SignatureAPPLICANT(PRINT) TEL NO. LDMA Perm# - T T EM'_: Z ❑ 1,as owner of the property, or my employees with wages as Z their sole compensation, will do the work and the structure is. ADDRESS O TOTA 2.J2® 832 not intended or offered for sale (Section 7044, Business and FINAL DATE Q CHECK Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A.HAZARDOUS MATERIAL OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE L )��i f ❑ I, as owner of the property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BYlle �' A "GE licensed contractors to construct the project (Section 7044, YES[I ' NO❑ a Business and Professions Code.) WILL THE INTENDED USE,OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING i„ :� OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH tl, ll�l-.I �it �Cyay f i CONSTRUCTION LENDING AGENCY COAST AIR QUAUTY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKUST FOR - GUIDELINES. t �t PM I hereby affirm that there is a construction lending agency for YES 1:1 NO❑ t� _ rn the performance Of the Work for Which this permit Is Issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING 3097, Civ.C.) CHECKLIST,I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, - - r TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS Lender's Name MATERIALS REPORTING AND FOR OBTAINING.A PERMIT FROM THE SCAQMD. - o Lender's Address �. OWNER OR AGENT ' o I certify that I have read this application and state under penalty of perjury that the above information is correct.I agree to comply F.C.FEE - / �j/ PERMIT FEE o with all county ordinances and State laws relating to building cons ctio nd h eby authorize representatives of this County ISSUANCE FEE I� - t u ve-mentioned property for inspection purposes. 27'G - INVESTIGATION FEE TOTAL FEE fq Dale SEE REVERSE FOR EXPLANATORY LANGUAGE