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HomeMy Public PortalAbout9459-9473 LAS TUNAS DR_Electrical__ WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) I hereby affirm that I have a certificate of consent to self insure, 76A663 APPLICATION FOR ELECTRICAL PERMIT or a cersificate 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!a �Pf�'. Company FOR APPLICANT TO FILL IN - JOB ADDRESS . Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE - — $ $ LOCALITY Certified co is filed with the count building inspection 1 &2-Family,Sq.Ft. ❑•' copy y g p NEAREST department. Multi-family Sq.Ft. CROSS ST. Date2— P, Applicant ,� �. ��� Residential Swimming Poolsq$SESS0R PAG MAP BOOK E PARCEL CER TI CATE OF EXEMPTION,FROM WORKERS' ' OWNER OR COMPENSATION INSURANCE Outlets:Rec./P_Light Sw. flFIRM NAME First 20 /" �� FI (This section need not be completed if the work involved by the MAIL permit is for one hundred dollars($100)or less.) Total No. Additional ADDRESS 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 become subject to the Workers' Compensation Laws. Lighting Fixtures First 20 PLAN ICCHECK 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 provisions or.this permit shall be deemed revoked. Power Apparatus&Large Appliances APPLICANT L &/152— , '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. Over 50 to 100 Incl. LICENSE / Class. 13 REG.NUMBER a ss. a Over 100 DISTRICT NO. PROCESSED BY Q License Number Sry' Lic.Class Services,Swbd.,MCC&Panelboards 'eO ' !� cc l , Contractor fL Date -0 399 Amp.Under 600 V FINAL O til . C►� — DATE 400-1000 Amp.Under 600 V 1 EJ1 am exempt under Sec. `�— L VALIDATION V Over 1000 Amp.or Over 600 V FINAL LU B.&P.C.for this reasona. BRANCH CIRCUIT FEES BY U) te: STT 15A,or 20A, 120V,Lighting or Recept. Z 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits Exam or Reg.Ma' t. lett. 15A,20A,208V To 277V Lighting Br.Circuits '} LE FAMILY Temp.Power Pole&Appurtenances { 7 s HOME OWN -BUILDER DECLARATION i"IC•i o8 I hereby affirm that I amexempt from the Contractor's License Law Sign with One Branch Circuit a_ 7 for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits ii. TTT M� 4, ° _r Code) . _ - t 1 1�t fa ❑ I, as owner of the property,will do the work and the structureMist.Conduits&Conductors TOTAL -- eC is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) 4�TAL 43 ®6-_ and Professions Code). CHECK. Et.1'teWLc CONSTRUCTION LENDING AGENCY �ry I hereby affirm that there is a construction lending agency for the CHANGE ' performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total) Civ. C.) PLAN CHECKING FEE 0000-0001 3f 3/93 Lender's Name -_. - 8473 -- ac PERMIT ISSUING FEE 1 A�11'.tb Lender's Address I certify that I have read this application and under penalty of purjury state TOTAL FEE , �s✓ 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 u on the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE ``�' SIGN E OF PE ITT DAT WORKER'S COMPENSATION DECLARATION 9 DPW(t2-91) APPLICATION FOR ELECTRICAL PERMIT 76A66 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 l /V Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. - EACH FEE $ $ LOCALITY ❑, Certified copy is filed with the county building inspection 1 &2-Family,Sq.Ft. NEARESTdepartment, Multi-family Sq.Ft. CROSS ST. Residential Swimming Pools ASSESSOR Date Applicant _ f MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' O OWNER OR COMPENSATION.INSURANCE Outlets:Rec. Light S 2 FIRM NAME �/ 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)on 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 t0 PLAN CHECK become subject to the Workers' Compensation Laws. Lighting Fixtures First 20 APPLICANT Total No. Additional ADDRESS Date r� T-0Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: If, a er making thi 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 provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances APPLICANT rAJ Wj IA L . LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS iJ S P 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 < �� II Tel.No. C7! �, Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. } LICENSE OR • Over 50 to 100 Incl. (p� Class.�P� /� REG.NUMBER �. License Number��� LIC.Class l r ` t Over 100 DISTRICT NO. may/ (� PROC SED BY O Q Services,Swbd.,MCC&Panelboards Contractor z � Date J '• 0-399 Amp.Under 600 V. FINAL Q / _��� O DATE ❑ I~am exempt under Se 400-1000 Amp.Under 600 V (�j VALIDATION LU Over 1000 Amp.or Over 600 V FINAL d B.&P.C.for this reason BRANCH CIRCUIT FEES BY � 11A Date: 15A,or 20A,120V,Lighting or Recept. z 1 To 10 Branch Circuits 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 r HOME OWNER-BUILDER DECLARATION * - •-- I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit tvz•�.I of for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits - - - .,,,-,• -- - [2 �{5 Code): u5U; C}io l.r F1 11, as owner of the property,will do the work and the structure Misc.Conduits&Conductors 1 t EF i:1 is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) - . - 5 and Professions Code). ® f`�?��1W �� � �--a CONSTRUCTION LENDING AGENCY CHECK 62.15 I hereby affirm that there is a construction lending agency for the `' E E10 performance of the work for which this permit is issued (Sec.3097, PERMIT FEE (Sub-Total) Civ. C.) Lender's NamPLAN CHECKING FEE [j0 {j —0001 1 *17/93 eAL PERMIT ISSUING FEE -- .................... .. I �+a Ah O/a: 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 PER E DATE WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91)76A663 APPLICATION FOR ELECTRICAL PERMIT hereby affirm that I have a certificate of consent to self insure, . 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 ADDRESS ® Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE LOCALITY �1 ❑ $ $Ft Sq. . — Certified copy is filed with the county building i pection 1 &2-Family, _ NEAREST department. Multi-family Sq.Ft. CROSS ST. Date Z Applicant Residential Swimming Pools ASSESSOR '{MAP BOOK I PAGE PARCEL 08 CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec. Light Sw. FFIIRM NAME COMPENSATION INSURANCE First 20 (This section need not be completed if the work involved by the go�RESS permit is for•one hundred dollars($100)or less.) Total No.� Additional Air I certify that in the performance'of the work for which this permit CITY Z Tet.No. is issued, I shall not employ any person in any manner so as to PLAN CHECK L. 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 O CITY Tel.No.. Exemption,.you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisionPERMIT ­ ,s of the Labor Code, you must forthwith comply with such APPLICANT r jC provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances � � S T 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 Over 50 to 100 Incl. REG.NUMBER a" 3 Class. O rQOver 100 . P ESSED BY License Number 7 $ DISTRICT NO Lic.Class V Services,Swbd.,MCC&Panelboards �� C �% Cc Contractory( ' Fi rM/ 5- Date -?_2 0-399 Amp.Under 600 V FINAL O _ DATE ++ F_ ❑ I am exempt under Sec. 400-1000 Amp.Under 600 V 1�23—a W Over 1000 Am or Over 600 V VALIDATION . P• FINAL /� ♦2 B.&P.C.for this reason BRANCH CIRCUIT FEES BY I/K`/UA�CLN, (1)Date: 15A,or 20A,120V,.Lighting or Recept z 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits y " Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits SINGLE FAMILY Temp.Power Pole&Appurtenances :(•'T = HOME OWNER-BUILDER DECLARATION '=`" ° Sigh with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law Sig - - - -- C,-2 for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits ^= - s Code): 1 t1C{'? I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors ,- ITA- 91B. m ^'�0 is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) d _ and Professions Code). ;°' °-7 ::} � r :C CONSTRUCTION LENDING AGENCY - " _.H1;NGE °U{� 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 =1'-f ") ` Lender's Name - 7t�t{': �! PERMIT ISSUING FEE _' djsti°_� 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 al�'A­,� ton p poseSEE REVERSE FOR EXPLANATORY LANGUAGE 'y7 SI NATURE F PERMITTEE DATE "WORKERS'COMPENSATION DECLARATION 76- 10/81 CE-806806G APPLICATION FOR ELECTRICAL PERMIT I • I {?teby,affirm that I have a certificate of consent to self insure, , 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 �,. •�� Certified copy.is hereby furnished. EACH NO. FEE ADDRESS New Residential Bldgs.& Pools — Certified copy is filed with the 1 & 2-Family,Sq.Ft. $ $ LOCALITY county building inspection NEAREST I' department. Multi-family Sq.,Ft. — Residential Swimming Pools'. CROSS ST. Date Applicant ' OWNER OR !' ` FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec Light S. ` MAIL T, _ — - COMPENSATION INSURANCE - � ADDRESS • (This section need not be completed if the-work involved by the First 20 CITY el.No. 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 PLAN CHECK_ APPLICANT is issued, I shall not employ any person in ny manner so as to becomes jec to the Workers'Comp i Laws. Lighting Fixtures First. '�✓ S Ud ADDRESS Total No. ,�G Additional Date 0 Applicant CITY Tel.No. NOTICE TO APPLICANT: If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT `� � Q n Exemption,you should become subject to the Workers'Compensation Range_ Heater= D.W. APPLICANT f LT /wD �.=.ih eT�le,` provisions of the Labor Code,you must forthwith comply with such Oven _ Dryer_ W.M._ ADDRESS a 1 3� provision's or this permit shall be deemed revoked. Top — FAU _ W.H. — LICENSED CONTRACTORS DECLARATION CITY t_'�k l+4 /9� Tel.No. 2 Hood — Fan . _ Other_ I hereby affirm that ['am licensed under provisions of Chapter 9 Disp. Room Air Cond. I LICENSE ORL / Class.C— ( commencing with Section 7000)of Division 3 of the Business and REG.NUMBER (p Professions Code,and my license is in full force and effect. DISTRICT NO. PROCESSED v Power Apparatus&Large Appliances / Q Size&Type HP,KW,KVA,or KVAR 'D 0 License Number O Lic.Class ^� Up to 1 Incl. FINAL U ~ / Over 1 to 10 Incl. DATE -� Contracto Date [ 1�9 VA DATION 10 ❑ Over 10 to 50 Incl. FINA I am exempt under Sec. Over 50 to 100 Inc. BY W B.&P.C.for this reason Over 100 p. Services,Swbd.,MCC&Panelboards N Date: 7- 0 0-200 Amp.Under 600 V Signature 201 - .1000 Amp.Under 600 V Over 1000 Amp.or Over 600 V 8 8 9.6 A Exemption for Reg.Maint.Elect. # o 0 0 0 ® 2 SINGLE FAMILY Temp.Power Pole& Appurtenances o o 510 0 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit r� hereby affirm that I am exempt from the Contractor's License Law 'o o o 5 a1,0 0,0 for the following reason(Section 7031.5,Business and Professions Additional Sign Branch Circuits Code): 0 2 0 2 8 8 ❑ 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) pop. 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 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 representativ of this.Count to enter upon the above-mentioned pr or spection qur o es. SEE REVERSE FOR EXPLANATORY LANGUAGE Sign ture of ermittee Date WORKERS'COMPENSATION DECLARATION 20-0019 DPW 3/87 hereby affirm lhaiF I have a certificate of consent to self 76A663 6G APPLICATION FOR ELECTRICAL PLKivvA _ 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 '0B ❑Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS10 104rs ❑Certified copy is filed with the county building inspec- 1 & 2-Family, Sq. Ft. LOCALITY $ — $ ! % Com( a $O tion department. Multi-family Sq. Ft. -- NEAREST L^CROSS ST. VMe Residential Swimming Pools , `• OR Date Applicant "QQ ORM NAME L.�r .> CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: RecLL Light�Sw._S_ MAIL COMPENSATION INSURANCE ADDRESS (This section need not be completed if the work involved by First 20 D CITY the permit is for one hundred dollars ($100)or less.) Total No. Additional s�¢Xf Te(No. I certify that in the performance of the work for which this PLAN CHECKAPPLICANT 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 3 ADDRESS Additional '°? j(( " Total No. � CITY _ Tel. No. Date Applicant Fixed Appliances Not Over 1 HP NOTICE TO APPLICANT: If, after making-this Certificate of PERMIT Exemption, you should become subject to the Workers' Range— Heater—/ D.W. APPLICATION C Compensation provisions of the Labor Code, you must forth- Oven — Dryer l—W.M._ ADDRESS arkb with comply with such provisions or this permit shall be Top — FAU —W.H. AL deemed revoked. Hood — Fan Other— CITY Tel. LICENSED CONTRACTORS DECLARATION — Disp. — Room Air Cond. LICENSE OR NUMBER Closs. —(� (commencing with Section 7000)of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO. PROCED BY, r and Professions Code,and my license is in full force and effect. /� a- �� Size &Type HP, KW, KVA, or KVAR l/ Q License NumberA Lic. Classst r Up to 1 Incl. FINAL 11 hU Contractor `1 -r. ��ate / LGL Over 1 to 10 Incl. DATE /ALIP4TL0CC 2 CC Over 10 to 50 Incl. FINAL ❑ I am exempt under Sec. Over 50 to 100 Inc. BY .o C, 4225 w B.&P.C. for this reason Over 100 0 0 0 Services, Swbd., MCC& Panelboards 4.2 2 5='Q (A Date: 0-200 Amp. Under 600 VZ Signature 201 - 1000 Amp. Under 600 V 0 7r1 5, 88 ❑ Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY Temp. Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION I hereby affirm that 1 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 structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ 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.). i PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE I Lender's Address 1 certify that I have read this application and state that the TOTAL FEE a.2 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 ©s WORKERS'COMPENSATION DECLARATION 76- 10/81 CE-806G APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self insure, SoB 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 ❑ Certified copy is herebyfurnished. ADDRESS New Residential Bldgs.& Pools EACH NO. FEE ❑ — LOCALITY 1 r. f % ,r•� y Certified copy is filed with the'zdounty building inspection 1 &,2-Family,Sq.Ft. $ — $ F >f- f x ! depa tment:- Multi-family Sq.Ft. NEAREST 1 CROSS ST. - •_ S. Residential Swimming Pools OWNER OR Date Applicant FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec Light ,' w. MAIL COMPENSATION INSURANCE ADDRESS' This section need not be completed if the work involved First 20 ( b P Y the CITY Tel.No. permit is for one hundred dollars ($100)or less.) Total No. Additional I certifythat in the performance of the work for which this permit PLAN CHECK p p APPLICANT is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. k Lighting'Fixtures First 20 ADDRESS F {¢� y r �•- �* Total No. Additional CITY Tel.No. Date Applicant +`.f Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after makingthis Certificate of a,1 Range— Heater_ D.W. APPLICANT ,%€j '• 7";r aJ �m*• r Exemption,you should become subject to the Workers'Compensation g 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 _ W.H. CITY rf# �`• . Tel.No. ' ! « � �Y LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other_ r't. t.i`: Q f1. .' f I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. LICENSE OR d^{ f / p ti•• (commencing with Section 7000) of Division 3 of the Business and REG.NUMBER Class. ! to d Professions Code,and my license is in full force and effect. Power Apparatus& Large Appliances DISTRICT NO. PROCESSED BY U / Size& Type HP,KW,KVA,or KVAR V License Number -ty 1► Lic.Class f Up to 1 Incl. FINAL 't e r f "•,: i DATE Over 1 to 10 Incl. � VALIDATION Contractor <�' ;„µ, ��„' k Date Over 10 to 50 Incl FINAL 0 I am exempt under Sec. Over 50 to 100 Inc. BY BAP.C.for this reason Over 100 Od Services,Swbd.,MCC& Panelboards Date- 0- 200 Amp.Under 600 V , W Signature '^-°'''` ` 201 - 1000 Amp.Under 600 V ❑ Over 1000 Amp.or Over 600 V Exemption for Reg.Maint.Elect. i SINGLE FAMILY Temp.Power Pole& Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit A 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 }r Code): rs.! Misc.Conduits& Conductors a) t I,as owner dproperty,will do the work and the structure ' • is not intended' d'o 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.CJ. . i PLAN CHECKING FEEtt' t,y Lender's Name PERMIT ISSUING FEE Lender's Address I certify that 1-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 gnter upon the above-mentioned property for inspection purposes: z r� p i• SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date Z_"y 5 OCI W rr"'th' COMPENSATION DECLARATION 76A663 DPW 3/87 APPLICATION FOR ELECTRICAL PERMIT :76A663 I her any c# rm that I have a certificate of consent to'self CE-806G insure, or a certif icate of Workers' Compe ajion Insurance, COUNTY OF LOS ANGELES DEPTNF /B 1Wor a certified coec. 3B00, La C. h` /� C'T Polis No. Company FOR APPLICANT TO FILL IN JOB Q��//�� L ❑Certified cof rni yed. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS ( YlJ✓ r ��J I U/01 $ _ $ LOCALITY f— c r (�Certified coi _the county building inspec- 1 &2-Family, Sq. FT. _ �� / I i—�tion departMulti-family Sq. Ft. Residential Swimming Pools CROSSNEAREST. CJ �(L Date licant WNER OR FFIIRM NME / �/ / 'C/(CERTIFICPTION FROM WORKERS' Outlets: RecLight Sw._ MAILION INSURANCE ADDRESS First 20 (This section need not be completed if the work involved by Total No. Additional CITY, Tel. No. 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 man r so as to become subject to the Worker 'Compensation La 's. Lighting Fixtures First 20 ADDRESS Additional Total No. CITY Tel. No. Date r Applica Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, aftermakin this ' fi ate of APPLICATION �C � lk(�fi Cr Exemption, you should become subject to the , orkers' Range— Heater—D.W. — Compensation provisions of the Labor Code, you b st 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— CITY LICENSED CONTRACTORS DECLARATION LICENSE OR Disp. Room Air Cond. REG. NUMBER 7 lass. 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. PROCE ED.BY d and Professions Code,and my license is in full force and effect. lO ����7 • e_/Q Size'&Type HP, KW, KVA, or KVAR J (J U License Number �_� Lic. Class Up to 1 Incl. FINAL Contractor �` ^ Date �—�g^ Y Over 1 to 10 Incl. DATE h V IDATION Cr ❑ Over 10 to 50 Incl. FINAL 0 I am exempt under Sec. Over 50 to 100 Inc. BY U B.&P.C. for this reason a Z Over 100 Services, Swbd., MCC & Panelboards Z Date: 0-200 Amp. Under 600 V — 0. Signature — 201 - 1000 Amp. Under 600 V EJExemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY Temp. Power Pole &Appurtenances HOME OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit Low for the following reason (Section 7031.5, Business-and Additional Sign Branch Circuits 2 9 9 Q 8-A Professions Code): # 0 0 0 • 02 ❑ I, as owner of the property, do the work and the Misc. Conduits&Conductors structure is not intended or of red for sale(Section 7044, Other (See Complete Fee Schedule)_ .o °;1 5.0 Business and in de). CONSTRUCTIO LENDING AGENCY o 0 011 3J. 5 0= I hereby affirm that they is a construction lending agency for y- the performance oft work for which this permit is issued PERMIT FEE (Sub-Total) 3 Ob16•` 88 (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 laws regulating Electrical wiring, and hereby authorize represent i sof this County to enter upon t�vmentianecl prpper for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature o-- erm`it Date WORKERS'COMPENSATION DECLARATION 7EA663 10/81 CE-806G APPLICATION FOR ELECTRICAL PERMIT 1 hereby affirm that I have a certificate of consent to self insure, or a certificate of Workers' Compensation Insurance„or a certified COUNTY OF LOS ANGELES BUI�,D ND SAFETY copy thereof(mac.3800,Lab. C.) ��7 M Policy No. Company FOR APPLICANT TO FILL IN JAOB 1:1EACH NO. FEE DDRESS Certified copy is hereby furnished. New Residential Bldgs.&Pools 1 & 2-Family,Sq.Ft. $ — $ LOCALITY ❑ '"'•Gertified copy is filed with'the unty building i spection — depar a Multi-family Sq.Ft. NEAREST CROSS ST. Date, Applicant Residential Swimming Pools OWNER OR - FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec— Light — Sw: 1 AIL COMPENSATION INSURANCE ADDRESS (This section need not be,completed if the work involved by the First 20 _ Total No. Additional CIT Tel.No. permit is for one hundred dollars($100)or less.) , HECK I certify that in the performance of the work for which this permit PLAN is issued, I shall not.employ any person in an manner so as to J APPLICANT become su ject o the Workers'Compen tion ws. Lighting Fixtu First 20 ADDRESS Total No. Additional b 00 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. _ APPLICAN IF Q provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer _ W.M._ ADDRESS a 0.,Z� provisions or this permit shall be deemed revoked. Top — FAU W.H. _ CITY L^ �4 Tel.No.015 �� LICENSED CONTRACTORS DECLARATION Hood — Fan Other_ I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. LICENSEOR U ice_ Class.. /� (commencing with Section 7000) of Division 3 of the Business and REG.NUMBER J Professions Code,and my license isinfull force and effect. Power Apparatus& Large Appliances DISTRICT NO. 7X/ PROCESSE Y �� / Size& Type HP,KW,KVA,or KVAR -> U Q License Numb Lic.Class! Up to 1 Incl. FINAL f // Over 1 to 10 Incl. DATE �// VALIDATION 0 Contracto Date O Over 10 to 50 Incl. FINAL, ❑ I am exempt under Sec. Over 50 to 100 Inc. BY L. B.&P.C.for this reason Over 100 C•� U) Services,Swbd.,MCC& Panelboards , Z Date: 0-200 Amp.Under 600 V Signature 201 - 1000 Amp..Under 600 V Over 1000 Amp. or Over 600 V '998Z4 A. ❑ Exemption for Reg.Maint.Elect. SINGLE FAMILY Temp.Power Pole& Appurtenances # o.°'® 0 2 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ° 0 4 Q 2 5 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): o o�° 4 Q 2.5 5 ❑ O 1,as owner of the property,will do the work and the structure Misc.Conduits&Conductors b 14-88 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 J 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 f. and State laws Aegulating Electrical wiring, and hereby authorize represen ti s this Co t to enter upon the above-mentioned prop in ection ku es. SEE REVERSE FOR EXPLANATORY LANGUAGE natu e Permittee Date WORKERS'COMPENSATION DECLARATION 76A663 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby°affirm that I have a certificate of consent to self insure, _ CE-806G or a gerti€icate 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 EACH' NOFEE . ADDRESS. . Certified copy is hereby furnished. New Residential Bldgs.& Pools . 1 & 2y,Sq. — LOCALITY-T-;4 -FamilFt. $ S Certified copy is filed with the county building inspection _ NEAREST department.. Multi-family Sq.Ft. CROSS S7. Date Applicant Residential Swimming Pools OWNER OR ` _ FIRM NAME �1;�(�� �'j'I C07 CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec 4 Light Sw. MAIL COMPENSATION INSURANCE- ADDRESS (This section need not be completed if the work involved by the ddit20 CITY J•-ylTel.No. permit is for one hundred dollars,($100)or less.) Total No. Additional I certifythat in the performance;of the,•work"anner 'permit PLAN CH CK P - APPLICANT is issued, I shall not.employ any person in subject to th Workers'Compe tiLighting Fixtures First 20 ADDRESS'- become Additional Total No. j- CITY Tel.No. Date �� pplicant Fixed Appliances Not Over 1 HP �� NOTICE TO APPLICANT: If, after' making this .Certificate of 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 provisions'or this permit shall be deemed 'revoked.. Top — FAU _ W.H. - Tel.No. ✓'�=�^ r" LICENSED CONTRACTORS DECLARATION• Hood — Fan _ Other_ CITY � /� I hereby.affirm that I am licensed under provisions of Chapter 9 LICENSE OR , Disp. - Room Air Cond. REG.NUMBER v S Class. (commencing,with Section 7000) of Division Tof,the Business and Professions Code,and my license is in full force and effect. DISTRICT NO. PRO E BY •� Power Apparatus&Large Appliances h 7 �y I Size&Type HP,KW,KVA,or KVAR l]6 0 License Numb 91 v Lic.Class 62 Up to 1 Incl. FINAL V a` Over 1 to 10 Incl. DATE r .... Y13r �1 VALIDATION 0 Contract Date Over 10 to 50 Incl. FINAL V LJ I am exempt under Sec. - Over 50 to,100 Inc. BY, W B.&P.C.for this reason, Over 100 N' Services,Swbd.,MCC & Panelboards " Z t 0-200 Amp.Under 600 V .e.0 Signature 201 - 1000 Amp.Under 600 V - - - OJ 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 CircuitAG '�°' ' m I hereby affirm that I am exempt from the Contractor's License Law p for the following reason(Section 7031.5,Business and Professions Additional Sign Branch Circuits 330"1 Code): 35. ❑' I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors -.1 ITEMS -- is not intended or offered for sale (Section 7044 Business Other (See Complete Fee Schedule) Y�lyAi- 35- 5 and Professions Code). h n CONSTRUCTION LENDING AGENCY `L��1,�1t,���K•s- 3.5.25 1 hereby affirm that there is a construction lending agency for the ��nttlyGE o(10 performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total) Civ. C_). l PLAN CHECKING FEE -C'000—'00131 VV5/889 Lender's Name PERMIT ISSUING FEE 1vS' 1 AM `t�`27 Lender's Address r ave read this application and state that. above TOTAL FEE � -2`J 1 certify that I h information is correct. I agree to comply with all County ordinances and State law regulating 'Electrical wiring, and hereby authorize representative of this Co to enter upon the above-mentioned " pr r' spectior p r es. / .SEE REVERSE FOR EXPLANATORY LANGUAGE u of Permittee Date WORKERS'COMPENSATION DECLARATION 76- 10/81 APPLICATION FOR ELECTRICAL PERMIT L�2J \► I hereby affirm that I have a certificate of consent to self insure, CE-806G 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 J }- s ❑ Certified copy is hereby furnished. New Residential Bldgs.&Pools EACH NO. FEE ADDRESS 7 1 $ `, art ❑ $ — $ f LOCALITY'^' Certified copy is filed with the county building inspection 1 & 2-.Family,Sq.Ft. — department. Multi-family Sq. Ft.'- NEAREST CROSS ST. Date Applicant Residential Swimming Pools OWNER OR �.• r � y� j t FIRM NAME r' !s"t: f�"~ � .i''l J:: o CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec Light r 3 Sw. MAIL COMPENSATION INSURANCE ADDRESS This section need not be completed if the work involved by the First 20 r ( P Total No. Additional CITY ��"'��.;.�.Z�w �Y�'%tfleTel.No. permit is for one hundred dollars ($100)or less.) I certifythat in the performance of the work for which this permit PLAN CHECK P APPLICANT is issued, I shall not employ any person in any#manner so,as to become sub7 ., t tthef Workers Compensatlo""L ws. ;d Lighting Fixtures First 20 ADDRESS ) Additional Total No. CITY Tel.No. Date 7 /Applicant Fixed Appliances Not Over 1 HP PERMIT + J NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT j F" "J ,r ;apt, , W T- Exemption,you should become subject to the Workers'Compensation Range_ Heater_ D.W. — provisions of the Labor Code, you must forthwith comply with such Oven — Dryer — W.M.— ADDRESS �> h �; .• � F% �, provisions or this permit shall be deemed revoked. Top — FAU — W.H. — _ !^' +f j F ' LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other_ CITY k) Tel.No. I hereby affirm that I am licensed under provisions of Chapter 9 LICENSE OR J�r f ^' Disp. ROOM Air Cond. REG.NUMBER t,✓ Class. y: (commencing with Section 7000) of Division 3 of the Business and Q.� Professions Code,and my license is in full force and effect. Power A DISTRICT NO. _,. PROCESSED BY Apparatus& Large Appliances U Size&Type HP,KW,KVA,or KVAR LL1 License Number w 4-E f' a' Lic.Class t^ j Up to 1 Incl. FINAL --I r'• r �i i ryr'"4 rf� Over 1 to 10 Incl. DATE VALIDATION a r Contractor �� Date Over 10 to 50 Incl FINAL I am exempt under Sec. Over 50 to 100 Inc. BY Q B.&P.C.for this reason Over 100 O Services,Swbd.,MCC&Panelboards ► a1 Datei' 0- 200 Amp.Under 600 V W Signature ' y• �d 'k 201 - 1000 Amp.Under 600 V El Exemption 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 Additional Sign Branch Circuits " for the following reason (Section 7031.5, Business and Professions } Code): ElMisc.Conduits& Conductors I,as owner of the property,will do the work and the structure 5:• , is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule)._ Qtt*iM t ry •a..is w� css•a.: and Professions Code). ► f. rtr;. CONSTRUCTION LENDING AGENCY s'vu I hereby affirm that there is a construction lending agency for the jperformance 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 1� ertify 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 property for InspectioNpurposes. 4y i SEE REVERSE FOR EXPLANATORY LANGUAGE -'Signature of Permittee Date !Jr WORKERS' COMPENSATION DECLARATION 76A66e°Pw3ie7 APPLICATION FOR ELECTRICAL PERMIT �� L1 I hereby affirm that I have a certificate of consent to self cee06c insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS ( ✓V( or a c_ert,fied copy thereof (Sec. 3800, Lab. C.) Policy.No. Company FOR APPLICANT TO FILL IN JOB i' ❑Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS v $ _ LOCALITY ❑Certified copy is filed with the.county. building inspec- 1 &2-Family, Sq. Ft. $ — tion department. Multi-family Sq. Ft. NEAREST Residential Swimming Pools OWNER CROSS SOR T. �����/Z Date Applicant [[�� FIRM NAMF�/7- (� z`N 6- �`�• CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw._ MAIL _ COMPENSATION INSURANCE First 20 ADDRESS M l` (This section need not be completed if the work involved by Total No. Additional CITY Tel. No. 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'Co pensation Law 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 t is Certi e of APPLICATION X\ (T12!Gs C.. 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.— ADDRESSWE with comply with such provisions or this permit shall be Top — FAU —W.H. — deemed revoked. Hood. — Fan —Other— CITY /,:Ii Tel. No.21- 6— LICENSED CONTRACTORS DECLARATION LICENSE OR Disp. — Room Air Cond. REG. NUMBER O 4 (J 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 ! PROC SED BY/ d and Professions Code,and my license is in full force and effect. C_/ Z) Size &Type HP, KW, KVA, or KVAR 0 License Number Lic. Class Up to 1 Incl FINAL ^ U Contractor �� `� � Date —e 10 I DATE /�—/ V LIDATION rr ❑ Over 10 to 50 Incl. FINA zzzl ~ I am exempt under Sec. Over 50 to 100 Inc. BY U i d B.&P.C. for this reason Over 100 loop. Z Services, Swbd., MCC 8 Panelboards � Date: 0-200 Amp, Under 600 V Signature 201 - 1000 Amp. Under 600 V y 2 9? 8 8 A ❑ Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V #'o.o o;e o 2 SINGLE FAMILY Tem Power Pole &A HOME OWNER-BUILDER DECLARATION p' ppurtenances - I .o 0 2 U 5;O 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 o;o -2 Q,5,0;0 Professions Code): 0606-88 ❑ I, as owner of the property, will do the work and the Misc. Conduits&Conductors structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)— , 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 v 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 representativ sof this County to enter upon %-b.-ve-Nen.ti.rIed propert for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature o ermi6� Date�� ©s ` p WORKERS'COMPENSATION DECLARATION 76A663 10/81 L�i eby affirm that I have a certificate of consent to self insure, CE-806G APPLICATION FO.R ELECTRICAL PERMIT I fl or'a certificate of Workers' Compensation•Insurance, or,a certified COUNTY OF LOS ANGELES. BUILDING AND SAFETY sl copy thereof(Sec.3800;Lab. C.) �{ L�" Policy No. Company, FILL IN .'. JOB ti _ • - FOR APPLICANTTO • ' ❑ Certified copy is hereby,furnished.' EACH 'NO. FEE ADDRESS + ,, -New Residential Bldgs.,-& ❑.,k Certified copy is filed with the county building 'inspection 1 & 2-Family,Sq.Ft.' $ —, $., LOCALITY department.. Multi-family Sq.Ft. NEAREST CROSS ST.' Residential Swimming Pools r OWNER OR bate APPI(cant .FIRM•NAME . - -CERTIFICATE OF EXEMPTION.FROM WORKERS Outlets:Rec Light _ Sw. ADDRESS COMPENSATION INSURANCE ` First 20 t 1 (This section need not be.completed if the work involved_bythe f ,,W, i'� CITY ! a- Tel No permit is,for one hundred dollars($100) or less.). Total No.'" Addlponal "s' u- .1 certify that in the performance of,,the work for which this permit ' a PLAN CHECK is issued;_I'shall.not employ an n' PPLICANT p y y person in.any anner §o'as to become subject to the Workers Compe ti L s. Lighting Fixtures First*20ADDRESS `y Additional • .; Total No. � - CITY Tel.No. . Date Applican Fixed Appliances Not Over,1 HP NOTICE TO APPLICANT: If, after-.making this ,Certificate `of PERMIT Exemption,you should become subject to the Workers'Compensation Range_ Neater D.W. APPLICANT provisions of the Labor Code, you,must forthwith comply with such Oven.-•Dryer` W.M._ ADDRESS �LC p _ provisions.or this permit shall be deemed revoked. Top FAU-, W.H. _ CITY �yy�1 Tel.No. LICENSED CONTRACTORS DECLARATION Hood Fan Other_' I hereby affirm that I am licensed'under provisions of Chapter 9 Disp. Room.Air Cond. LICENSE OR �1 (commencing with Section 7000) of Division 3 of the Business and REG.NUMBEROCIass".,'�Professions Code,and my licensd is in full force and effect. Power Apparatus&LargeAppliances DISTRICT NO. PR Size&Type HP,KW,KVA,or KVAR License Numberd T> Lic.Class (J Up to Incl: FINAL' tf Over 1 to 10 Inc]. �C/ f� 0 l/ DATE ��'( Contract Date !lIJJJ VALIDATION Over 10 to 50 Incl FIN H. ❑ I am exempt under Sec. Over 50 to..100Inc. BY W BAP.C..for this reason Over 100 IL .' Services,Swbd.,MCC& Panelboards Date: 0- 200 Amp.Under 600 V, Signature 201 -,1000 Amp.Under 600 V 'Over 1000 Amp.or Over soo.v 09-322A ❑ Exemption for-Reg.Maint.Elect:, SINGLE FAMILY Temp.,Power Pole& Appurtenances` # o 0-0 o HOME OWNER-BUILDER DECLARATION Sign.with One Branch Circuit' ° ° 2 8'50 I hereby affirm that I am exempt from the Contractors License Law f, for the following reason(Section 7031.5,Business and Professions Additional Sign Branch Circuits Code): ❑ Misc.Conduits&,Conductors. Q'4,0 6'1, 8 8 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) ' and,Professions Code). CONSTRUCTION LENDING AGENCY - • - I hereby'affirm.that there is a construction lending agency for the L, performance of the work for which this permit is issued'(Sec.3097, PERMIT FEE " (Sub-Total) i Civ.C.). PLAN CHECKING:FEE 'a Lender's Name PERMIT ISSUING FEE . 56 Lender's Address T I certify that I have read this application and state that the above, TOTAL FEE 2�5 C3 6. information is correct. I agree to comply with all County ordinances and State laws regulating Electrical'wiring, and hereby authorize representative f`this'County.to enter upon the above-mentioned " prop i ectiion pur S. SEE REVERSE FOR.EXPLANATORY LANGUAGE Ign e o ermittee Date WORKER'S COMPENSATION DECLARATION 20-0019 DPW 9/89 76A663 APPLICATION FOR ELECTRICAL PERMIT 76A66 I hereby affirm that I have a certificate of consent to self insure, 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 NOI_a Company i�Y/. ./'LJ�iY' FOR APPLICANT TO FILL IN - --- - JOB ADDRESS Certified copy is herebyr . New ental Bdgs.furnishedResidential &Pools EACH- NO. FEE ❑ $ _ $ LOCALITY �l Certified co Is filed with the count building inspection 1&2-Family,Sq.Ft. PY' Y 9 P — NEAREST department.,. // Multi-family Sq.Ft. CROSS ST. MA Date �!•Applicant 1 LH�'I.. Residential Swimming Pools ASSESSOR _ _ P BOOK _ PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' S� n OWNER OR COMPENSATION INSURANCE Outlets:Red. Light SW. FIRM NAME First 20 G) 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.- Tei.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' -15 OR 20A,120V BRANCH CIRCUITS NOTICE'TO'APPLICANT: If, after making this Certificate of CITY Tel.No. Exemption,you should become subject to the Workers'Compensation 1 TO 10 INCLUSIVE EACH provisions of the Labor.Code, you must forthwith corr I .with such 11 TO 40 INCLUSIVE EACH __ _ _ ERMI7 P Y P Y; •� APPLICANT provisions or this permit shall be deemed revoked.. 41 OR MORE BRANCH CIRCUITS EACH LICENSED CONTRACTORS DECLARATION - _ ADORE SSd hereby affirm that I am licensed under provisions of'Chapter 9 15 OR 20A,208V TO 277V LIGHTING EACH (commencing with Section 7000) of Division 3 of the Business and _ _ CITY Tel.No. 0 Professions Code,and my license is in full force and effect. RESIDENTIAL APPLIANCES UP TO 3HP LICENSE OR r. Power Apparatus&Large Appliances REG.NUMBER Class. f2 /�/ O License Number �/CY��� Lic.Class Size&Type HP,KW,KVA,Or KVAR DISTRICT NO. PR06E SED BY -- Up to-3 Incl. - - _ ID�.. �tA!�r W —. 4/1 /�- I Over 3 to 10 Incl. FINAL d Contractor G � � Date,- � -. -_ _ _..-_ .DATE _ (D over 10 to-50-Ind. �1 Z ❑ I am exempt under Sec. Over 50 to 100 Incl. VALIDATION _. FINAL B.&P.C.forthls reason Over 100 BY � 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 Exempti for Reg.Ma' t. ct. SINGLE FAMILY Temp.Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit g 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 �(,�;To e _. Code): s �� , 307 s-- ❑ 1, as owner of the property,will do the work and the structure Misc.Conduits&-Conductors -- - 1 ITEM`1 is,not intended or offered for sale (Section 7044, Business Other(See Complete Fee-Schedule) TOTALand Professions Code). -- -_ _.- _.. . ._- 11 l t1L "-k' CONSTRUCTION LENDING AGENCYC �.`+, nLr I hereby affirm that there is a construction lending agency for the �t7lY�7GF 9 performance of the work for which this permit is issued (Sec. 3Gf•' .097, PERMIT FEE _(Sub-Total) _ AN Civ.C.) PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE 11000-0001 w/?4/92 v' Lender's Address 5166 q � 153 ,yt �+o 1 certify that 1 have read this application and state that the above TOTAL FEE 1 All information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize repr;T�� .F sentatives of this County to enter up n the above-mentioned prorty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE SIG APP I DATE I —UtZLARAT'oN CATION FOR ELECTRICAL PERMIT I hereby affirm thi3t I have a certificate of consent to self CE CE-806G insure, orb certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy therecA,(Sec. 3800, Lamb.yC.)s 4 Vu27 C Com ar �" ) I FOR APPLICANT TO FILL IN JOB 7r-licy No. p �y Certified copy Whereby furnished. New Residential Bldgs. & Pools EACH NO, FEE ADDRESS !✓„���/�����J �✓' '+Certified copy is filed with the co my building inspec- 1 & 2-Family, Sq. Ft. $ — $ LOCALITY tion epartment. Multi-family Sq. Ft. — NEAREST Grp _ ��/ Residential Swimming Pools' CROSS 5T. Gj V OWNER OR U0 te �/ Applicant FIRM NAME CER IFlCATE OF EXEMPTI N O WORKERS' MAIL COMPENSATION SURANCE Outlets: Rec Light Sw.� � ADDRESS (This t bcompleted if the work involved b First 20 ( s section neenoe com p Y Total No. Additional CITY Tel. No. the perfit is for one hundred dollars ($100)or less.) ` the performance of the work for which this PLAN CHECK I certify that in e P 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 Total No. Additional CITY Tel. No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT [� n NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT Exemption, you should become subject to the Workers' Range_ Heater--7—D.W. — Compensation provisions of the Labor Code, you must forth- Oven _ Dryer — W.M.— ADDRESS 7,;7 3Z with comply with such provisions or this permit shall be Top _ FAU —W.H. — deemed revoked. CITY G Tel. o: 1 d Hood _ Fan _Other_ �7 � ��` 7� LICENSED CONTRACTORS DECLARATIONLICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. _ Room Air Cond. REG. NUMBER �� / C�' / Class. G�J (commencing with Section 7000) of Division 3 of the Business DISTRICT NO. PROCES ED BY 1 Power Apparatus & Large Appliances and Professions Code,and my license is in full force and effect. � /J� � � / Size &Type HP, KW, KVA, or KVAR' V 0 License Number)) " "/( Lic. Class Up to 1 Incl. FINAL u /r `7� Date // Over l to 10 Incl. DATE ti/L — VA ATION Contractor Over 10 to 50 Incl. V ❑ FINAL I am exempt under Sec. Over 50 to 100 Inc. BY eat B.&P.C. for this reason Over 100 H Date: Q ' Services, Swbd., MCC & Panelboards 2 Z'G�� I L 0 -200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V Over 1000 Amp. or Over 600 V Exemption for Reg. Maint. Elect. SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Temp. Per Pole &Appurtenances z O;1 2 A Sign .Powerwith Branch Circuit #.o'o o e'0 2 1 hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits o,o Low for the following reason (Section 7031.5, Business and I 2 5,0 Professions Code): El = I, as owner of the property, will do the work and The Misc. Conduits& Conductors e,e',c 2 5 5 Qv structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ , 7044,Business and Professions Code). O 7. 1 4 8 8 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 A"�— PERMIT ISSUING FEE. _Lender's AddressI 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 the.above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Sig&j e of Ptrmittee D to WORKERS'COMPENSATION DECLARATION GE-Bose-803 10/81 CE APPLICoi4TION FOR ELECTRICAL PERMIT l"hereby"affirm that 1 have a'certificate of consent to self insure, 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 ' E Certified,copy is hereby furnished. EACH NO. FEE ADDRESS uJll ,• New Residential Bldgs.& Pools . $ LOCALITY j " f/ Certified copy is filed with th �/q/ $ e unty he inspection — r depar mer // Jp Multi-1 & 2-family Sq.Ft. CROSSFamily,Sq.FtSST. Date' - Applicant Residential Swimming Pools, OWNER OR PP, FIRM NAM • E CERTIFICATE OF EXEMPTION FROM WORKERS' �/' LiMAIL COMPENSATION INSURANCE Outlets:Rec T Light w. ADDRESS completed ifthe work involved by the First 20 (This section need not be ' Total No. � Additional . CITY Tel.No. permit is for one hundred dollars($100) or less.) PLAN CHECK I certify that in the performance of the work forwhich this permit APPLICANT is issued, I shall not employ any person in any manner,so as to become sub' ct to the•Workers'Compensation La Lighting Fixtures First 20 ADDRESS r , Additional Total No.�� CITY Tel.No. Date Applicant Fixed Appliances Not Over 1 HP .NOTICE -TO APPLICANT.: If, after, making this Certificate of PER Exemption,you should become subject,to the Workers Compensation Range_ Heater__D.W. _ APPLICANT / L,7"Q provisions of the Labor Code;you must forthwith comply with such Oven _ Dryer _ W.M._ ADDRESS1 17k provisions or this permit shall be deemed revoked. Top — FAU _ W.H. CITY ~L LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other_ A-�61V6/i �, Tel.No. I.hereby affirm that I am licensed'under provisions of Chapter 9tLICENSE OR �- (commencing with Section 7000) of Division-.3 of the,Business and Disp. — Room Air Cond. — REG.NUMBER Class. C46. Professions Code,and my license is in full force,and effect. DISTRICT NO. • PROC SS BY .Power Apparatus& Large Appliances 6 Size& Type HP,KW,KVA,or KVAR License,Numb I Lin.Class Up to 1 Incl. FINAL U Over 1 to 10 Incl. DATE s VALIDATION Contracto ate Over 10 to 50 Incl. FINAL I am exempt.under Sec. Over'50 to 100 Inc. . BY W Over 100 d B.&P.C.for this reason Cl) Services,Swbd.,MCC&Panelboards , Z 0-200 Amp.Under 600 V Signa ure Aie 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. IL I hereby affirm that'I am exempt from the Contractor's License Law A='CT.T for the following reason (Section 703Additional Sign Branch Circuits 1.5, Business and Professions -,•. c Code); ,�311 35.25 °'7.s� ❑ Misc.Conduits & Conductors ITEM 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) , s --° 5 and Professions Code). O t AL '�'5 "O'"•--_ CONSTRUCTION LENDING AGENCY CHECK '` ° • I hereby affirm that there is a construction lending agency for the CHANGE °013 performanceof the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total) Civ.C.). n PLAN CHECKING"FEE Lender's Name lJu `LEI ICS 3/i5/8? ,,+/^� PERMIT•ISSUINGIFEE / v 139 1 All ':22 Lender's Lender's Address b 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 reg Prig Electrical wiring, and hereby authorize representatives of County nter upon the above-mentioned_ prop f sp f n puMo SEE REVERSE FOR EXPLANATORY LANGUAGE Signature.of Permittee Date 76A66 1 •VdOrm that I have a certificate DECLARATION CE-806 10/81 OPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self CE-606G {� insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY U or a certified copy thereof (Sec. 3800, Lab. C.) 2-4O-314®'-3 �/ Te )5�},eY✓k- Polic No. Company FOR APPLICANT TO FILL IN JOB Ste+ p_ IN Certified co is hereb furnished. EACH NO. FEE ADDRESS �— 7_1411/04,S pY Y New Residential Bldgs. & Pools ❑ 1 8 2-Famil S Ft. $ — 8 LOCALITY e/7" Certified copy is filed with the count b ding ins e - Y. q tion d part ent. Multi-family Sq. Ft. — NEAREST CROSS ST. Date Applicant Residential Swimming Pools OWNER OR ��QQQ 11 pp FIRM NAME nrw c7 a CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec ��ight4aSw.� MAIL COMPENSATION INSURANCE First 20 ADDRESS 7 02-! 6116 7/ �IA/Q4 57 (This section need not be completed if the work involved by Total No. 6 'f CITY J doQ�7�{r Tel. No. the permit is for one hundred dollars ($100)or less.) Additional 3 �s G I certify that in the performance of the work for which this PLAN CHECKAPPLICANT permit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Lows. Lighting FixturesFirst 20 ADDRESS Total No.— ! 22L Additional CITY Tel. No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT L d 'L c �e 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 with comply with such provisions or this'permit shall be Top — FAU —W.H.' — 9604i — deemed revoked. Hood _ Fan _Other_ CITY. `j����� Tel. No.IVQJ ,. LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. _ Room Air Cond. REG. NUMBER 2 Class.a.— (commencing with Section 7000) of Division 3 of the Business DISTRICT NO. PRO 5 D BY d and Professions Code,and my license is in full force and effect. Power Apparatus& Large Appliances O / (j_ / � Size 8 Type HP, KW, KVA, or KVAR' � V License Nu—k.1 v ` Lic. Class C l _ Up to 1 Incl. 06 FINAL Over 1 to 10 Incl. DATEtractor 7.-- 9 VALID ON C' ConDate ~ ❑ Over 10 to 50 Incl. W FINAL I am exempt under Sec. Over 50 to 100 Inc. BY B.BP.C. for this reason JrL Z_ Services, Swbd., MC 8 PanelS oards ► 6 6 6 8'A Date: 0 -200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V U #,o e o'•,• 2 ' ❑ Over 1000 Amp. or Over 600 V '�;fEzemption for Reg. Maint. Elect. '( 0 329.5 D SINGLE FAMILY Temp. Power Pole &Appurtenances = HOME OWNER-BUILDER DECLARATION •,0 3,2 9,5 0 25 Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License n Branch Circuits Law for the following reason (Section 7031.5, Business and Additional SigQ 3 131-- 87 Professions Code): ❑ I, as owner of the property, will do the work and the Misc. Conduits&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) AA (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE 5O Lender's Address I certify that I have read this application and state that the TOTAL FEE q above information is correct. I agree to comply with all County ordinancesMrepre gulating Electrical wiring, and hereby es of this County to enter upon for inspection pur ses. SEE REVERSE FOR EXPLANATORY LANGUAGE ate KER$'COMPENSATIONDECLARATION ' 76A663 10/81 APPLICATION FOR ELECTRICAL'PERMIT ` rm that I hove a certificate of consent to self CE-806G P COUNTY OF LOS ANGELES BUILDING ANDS FETY assure, or a certificate of Workers' Com ensation Insurance; or a certified copy thereof (Sec. 3800,Lab. C.) Polity No.—' Company FOR APPLICANT TO.FILL IN JOB �. .�� Ly o Certified copy Y is hereby furnished. EACH NO. FEE ADDRESS -New Residential Bldgs. & Pools ' ❑ Certified copy is filed with the county building'inspec- Y, q• $ — $ LOCALITY 1 & 2-Family, S Ft. department. Multi-family Sq. .' — NEAREST tion de MltiilFt !', P CROSS ST. �.=� >.->�> � G'!'Y•" is � . Residential Swimming Pools OWNER OR Date Applican FIRM NAME Gv 114- �rE.�4 t. .� CERT KATE OF EXEMPTION FROM W R RS' MAIL' COMPENSATION INSURANCE Outlets: Rec Light Sw. ADDRESS s section neecompleted if•the work involved b First 20 �Thitid not be com p Y Total No. CITY i..��'� Tel. No. the permit is for one hundred dollars($100)or less.) Additional 4+ ` „ I:certifythat in the erformonce of the work for which this PLAN C ECK P 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 Fixed Appliances Not Over 1 HP PERMIT , NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT • i-z,r4 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 with comply with such provisions or this permit shall be Top FAU —W.H. — deemed revoked. CITVr .(f + � Tel. No. LICENSED CONTRACTORS DECLARATION LICENSE OR Hood _ Fan —Other_ I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. REG. NUMBER ,� Clossb, (commencing with Section 7000) of Division 3 of the Business DISTRICT NO. PROCESSWB and Professions Code,and my license is in full force and effect. Power Apparatus& Large Appliances (� Size & Type HP, KW, KVA, or KVAR' 6 Q License Number Lic. Class / Up to 1 Incl. FINAL U %) • 0 DATE Over 1 to 10 Incl. _ VALIDATION Im Contract Date l� Over 10 to 50 Incl f Iv FINALa ❑ / U I am exempt u r Sec. Over 50 to 100 Inc. BY yr /f a B.&P.C. for this reason Over 100 Z, Date: Services, Swbd., MCC & Panelboards ► 0 200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V ❑ Over 1000 Amp. or Over 600 V 6 2 9,Q A Exemption for Reg: Maint. Elect. #'e e o o 0 2 SINGLE FAMILY Temp. Power Pole & Appurtenances- r v ) o,- 2S50 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ® I hereby affirm that I am exempt from the Contractor's License o o 5 Law for the following reason (Section 7031.5, Business and Additional Sign-Branch Circuits 0 1.Q Professions Code): ❑ I, as owner of the property, will do the work and the Misc. Conduits&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 S 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-me tioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Perqti a ate • COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 9903250013 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 8526 LT: 10 BL: .001 9473 LAS TUNAS DR FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802126 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: CLOVERLY 8587-008-017 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT,SW,RECP 36.00 OUT 60.60 TENANT: G2 LIGHTING FIXTURES 12.00 LGT 23.40 ISSUED ON: PROCESSED BY: PLAN BY: EXPIR 'ON: IA N-RES EX FANS LT 3HP 2.00 EX 30.60 03/25/99 UT 03/ /00 JX MOTORS, LT 3 HP 2.00 MOT 30.60 OWNER: TEL. NO: TOTAL FEES 172.95 FINAL DATE FINAL B CODE: WANG JAW J;JEAN TRS 580 OLD MILL RD ✓ `/ SMAR 911081652 DESCRIPTION OF WORK ELECTRICAL FOR T. I. IMPROVEMENT APPLICANT: TEL. NO: PHAM (714) 550-9228- 515 N. FAIRVIEW ST _-- SPECIAL CONDITIONS: SANTA ANA, CA92703 CONTRACTOR: TEL. NO: �� APPROVALS DATE INSPECTOR SIGNATURE LONG CONSTRUCTION (714) 281-3731- 515 N. FAIRVIEW ST. LIC. NO / \\ TEMPORARY POWER POLE SANTA ANA, CA 92703 38418 UNDERGROUND CONDUIT n ARCHITECT OR ENGINEER: TEL. NO: ` UFER GROUND C LIC. NO: / 111111 UI ROUGH CONDUIT L i ROUGH WIRING uFLCQ)) OQ L�� `�1 0 ��r _ MAIN WATER LINE -� _ u� � PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED 0 - nic V.0 0 --f REPORT ID: DPR265 ROUTE TO: SS0508 + COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0705090030 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 DUPLICATE PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: ITR: 8526 LT: 10 BL: .001 9453 LAS TUNAS DR I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 TEMP CA 917802126 IASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: CLOVERLY 18587-008-017 IA1 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, Cl I IG1 OUTLETS-LGT,SW,RECP 103.00 OUT 151.05 (TENANT: IG2 LIGHTING FIXTURES 20.00 LGT 39.00 JISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: IREMAX 1000 REALTY I TOTAL FEES 217.80 105/09/07 VG 11/05/07 (OWNER: TEL. NO: I IFINAL DATE FINAL BY: CODE: IWANG JAW J;JEAN TRS - 107/24/07 STEVE PAN 1580 OLD MILL RD I I ISMAR 911081652 IDESCRIPTION OF WORK v1 I I (ELECTRICAL FOR TI 1 (APPLICANT: TEL. NO: 1 ILIN (626) 287-7896- ISPECIAL CONDITIONS: 1 I I I I CONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE (KONG, WOK TUNG (626) 289-5539- I I 12168 S. ATLANTIC BLVD., #511 LIC. NO I ITEMPORARY POWER POLE I I IMONTEREY PARK, CA 91754 702065B I I I I I 1 (UNDERGROUND CONDUIT I I I I I I I I (ARCHITECT OR ENGINEER: TEL. NO: I JUFER GROUND I I IKT CONSTRUCTION ENGINEERING CO. (626) 289-5539- I 12168 S. ATLANTIC BLVD. LIC. NO: I TROUGH CONDUIT 1 1#511 NONE I r IMONTEREY PARK, CA 91754 I IROUGH WIRING IMAIN WATER LINE 1 1PLASTIC Y/N METAL Y/N I 1UTILITY COMPANY NOTIFIED( I 1 I I 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 I I I I I I I I I I I I I I I I I I IREPORT ID: DPR265 ROUTE TO: BS0508 I 1 I I I I I I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0312230013 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: _ FEES PAID BUILDING ADDRESS: TR: 8526 LT: 10 BL: .001 9463 LAS TUNAS DR" FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802126 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: CLOVERLY 8587-008-017 Al PERMIT ISSUANCE FEE 27.75, THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT,SW,RECP 31.00 OUT 53.85 TENANT: G2 LIGHTING FIXTURES 11.00 LGT 21.45 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: JEI (LEARNING CENTER) TOTAL FEES 103.05 12/23/03 VG 06/20/04 OWNER: TEL. NO: FINAL DATE FINAL BY: CODE: WANG JAW J;JEAN TRS V 580 OLD MILL RD SMAR 911081652 DESCRIPTION OF WORK ELECTRICAL FOR TENANT IMPROVEMENT APPLICANT: TEL. NO: CHU MONDY S (626) 272-8709- 4951 ROBINHOOD AVE SPECIAL CONDITIONS: TEMPLE CITY 91780 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE LEAVON DEVELOPMENT (626) 260-4600- 428 PARK AVE LIC. NO TEMPORARY POWER POLE MONTEREY PARK CA 91754 613257 B UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: UFER GROUND LIC. NO: ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED REPORT ID: DPR265 ROUTE TO: BS0508 r COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1102070008 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: FEES PAID BUILDING ADDRESS: ITR: 8526 LT: 10 BL: .001 I 9471 LAS TUNAS DR 1 I _(FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 TEMP CA 917802126 1 (ASSESSOR INFORMATION NUMBER: I I - NEAREST CROSS STREET: CLOVERLY I 18587-008-017 1A1 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, Cl _1F1 120V, 15/20A BR CKTS 1.00 BR 17.30 I (TENANT: G1 OUTLETS-LGT,SW,RECP 5.00 OUT 9.70 (ISSUED ON: PROCESSED BY: PLAN BY: IFELICIA TSAI IG2 LIGHTING FIXTURES 5.00 LGT 9.70 102/07/11 SR 1 I .I TOTAL FEES 64.50 1 1 (OWNER: TEL. NO: 1 IFINAL DATE FINAL BY: CODE: 1 ICENTURY PLAZA - IDL7CRIPTION OP WORK ITENANT IMPROVEMENT ELECTRIC I I I I I 1APPLICANT: TEL. NO: IJIMMY LEE (909) 590-8807- 113841 ROSWELL AVE 1 ISPECIAL CONDITIONS: I (CHINO, CA 91710 1 I I I I I I I I I I ICONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE ISIPENG XIN (626) 848-2736- I I I 12468 1/2 DEL MAR AVENUE LIC. NO ITEMPORARY POWER POLE I I 1 IROSEMEAD, CA 91770 890143 I 1 I' I I (UNDERGROUND CONDUIT I I (ARCHITECT OR ENGINEER: TEL. NO: 1 IUFER GROUND I I IPETER LEE ENGINEERING INC. (626) 280-9000- .I 1 i 18748 E. VALLEY BLVD. #L LIC. NO: 1 - IROUGH CONDUIT I' I IROSEMEAD, CA 91770 S3948 1 I IROUGH WIRING I IMAIN WATER LINE I I . IPLASTIC Y/N METAL Y/N I I (UTILITY COMPANY NOTIFIED( I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I IREPORT ID: DPR265 ROUTE TO: BS0508 I I I I i I I I "moo. COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT r DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0805120020 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: (LEGAL ID: I - FEES PAID I BUILDING ADDRESS: ITR: 8526 LT: 10 BL: .001 I I 9471 LAS TUNAS DR I .IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( TEMP CA 917802126 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: CLOVERLY I 18587-008-017 - IA1 PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, Cl IF1 120V, 15/20A BR CKTS 2.00 BR 34.50 I (TENANT: IG1 OUTLETS-LGT,SW,RECP 12.00 OUT 23.40 (ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: I IPOLYGOLD INC. IG2 LIGHTING FIXTURES 4.00 LGT 7.80 105/12/08 SR 11/08/08 1 1 1 TOTAL_FEES 93.45 1 1 (OWNER: TEL. NO: I IFINAL DATE FINAL BY: CODE: IINVESRVE (MANAGEMENT COMPANY) (626) 407-6270- I 11300 E. MAIN ST.#210 I - l IALHAMBRA, CA 91803 1 1DESCRIPTION OF WORK yI .. I1 12 BRANCH CIRCUITS, 12 OUTLETS AND 4 LIGHT FIXTURES I I I I (APPLICANT: TEL. NO: I I IRED SUN ELECTRICAL INC. (626) 589-1430- I I 1 14948 RYLAND AVE. I (SPECIAL CONDITIONS: ITEMPLE CITY CA 91780 I I I I I I I I I ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE 1 IRED SUN ELECTRICAL INC. (626) 589-1430- 1 1 14948 RYLAND AVE. LIC. NO ITEMPORARY POWER POLE I ITEMPLE CITY, CA 91780 799524C10 I I 1 I - I 1 I (UNDERGROUND CONDUIT I I 1 (ARCHITECT OR ENGINEER: TEL. NO: IUFER GROUND 1 LIC. NO: I IROUGH CONDUIT I 1 i II I I I IROUGH WIRING 1 IMAIN WATER LINE I 1 I IPLASTIC Y/N METAL Y/N I I I I I I I I I 1UTILITY COMPANY NOTIFIEDI 1 I I I I I I I I I I I I I I I I I I I I I I 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 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 1 I 1 I I I I I I I I I I I I I IREPORT ID: DPR265 ROUTE TO: BS0508 1 I 1 I I I I I I z. 1 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0708060029 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: - I ITR: 8526 LT: 10 BL: .001 9453 9455 LAS TUNAS DR I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802126 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 18587-008-017 IA1 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, Cl I IK1 SIGNS, OUTLINE LGT 1.00 SIG 38.85 I 1 (TENANT: I TOTAL FEES 66.60 (ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 1 IRE/MAX 1000 REALTY 108/06/07 SR 02/02/08 I 1 TOWNER: TEL. 8- i iFINAL DATE Y: CODE: INVE SERVE INC. (626) 458-3435- 9455 LAS TUNAS DR. ITEMPLE CITY CA 91780 i IDESCRIPTION OF WORK 1 I 1 INEW WALL SIGN CHANNEL LETTERS SIGN I 1APPLICANT: TEL. NO: 1 IWEI MAN QUAN (626) 288-6872- 18919 E. GARVEY AVE. 1 ISPECIAL CONDITIONS: 1 IROSEMEAD, CA 91770 I I I I ICONTRACTOR: TEL. NO: I 1APPROVALS DATE INSPECTOR SIGNATURE 1 (ARTIST SIGN AND ART SERVICE CORP. (626) 625-2888- 1 1 18919 E GRAVEY AVE #C3 LIC. NO ITEMPORARY POWER POLE I I IROSEMEAD CA 91770 811413 C45 I I I I I (UNDERGROUND CONDUIT I 1 I (ARCHITECT OR ENGINEER: TEL. NO: I IUFER. GROUND I I _ I I I LIC. NO: IROUGH CONDUIT I I I I I I I IROUGH WIRING I I I I 1 I IMAIN WATER LINE I 1 IPLASTIC Y/N METAL Y/N I I I 1 1 1UTILITY COMPANY NOTIFIEDI I I I I I I I I I I I I I I I I I I II I I I I I I I I I I I I I I I I I I I I I I I I 1 (REPORT ID: DPR265 ROUTE TO: BS0508 1 1 1 1