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Home My Public Portal About9569 LAS TUNAS DR_Electrical__ 76A669-Cff806 12/75 APPLICATION F' LECCAL. PERMIT COUNTY OF LOS ANGELES .f. ' ' r DEPARTMENT OF COUNTY ENGINEER4 r BUI,LDIN•GDANID SAFETY DIVISION , ADDRESS 6 4.F9,ff,'APPL4LCANT-TO FILL IN LOCALITY � 'll�Je 6/7y New Residentlal/Bldgs°'& Pools EACH NO. FEE NEAREST 1 & 2-Family, Sq. Ft $ .025 — $ CROSS ST. Multi-family Sq. Ft ,0P OWNER OR s — { y FIRM NAME v /�O�SC� � e/IZ— � -Residential Swimming Pools 20.00 • MAIL ADDRESS Outlets. Light,Switch & Receptacle CITY7e4, le Tel.No. First 20 •50 PLAN CHECK Additional .30 APPLICANT �GD ADDRESS Lighting Fixtures q First 20 .50 20CITY Tel.No. Additional .30 PERMIT APPLICANT !j A Fixed Appliances Not Over 1 HP ADDRESS 3?1,ye Range_HeaterLD.W.i CITY L,4 CJ •�� Tel.No. O Oven_Dryer_W.M._ / LICENSE OR +� Top _ FAU W. _ REG.NUMBER��f Class.C 1D Hood_ Fan I HEHEBI ACKNOWLEDGE THAT I HAVE READ,THIS'APPLICATION DISp._A.C. 2.00 AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY , WITH 'ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING Power Apparatus& Large Appliances Size& Type HP, KW, KVA, or KVAR I HEREBY CERTIFY THAT,I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF Up to 1 Incl 2.00 1 CALIFORNIA OR THA1 I AM THE LEGAL OWNER OF THE ABOVE 0 Over 1 to 10 Incl. 5.00 DESfRIfED RESIDENTIAL PROPER V Over 10 t0 50 Incl. 10.00 PERMITEE Over 50 to 100 Incl 20.00 SIGNATURE ✓ �A Over 100 30.00 DISTRICT"NO. :ROC SED B Services ` W 0 200 Amp Under 600 V 12.50 INSP TOR'S N 201-1000 Amp. Under 600 V 25.00 APPROVALS DATE SIGNATURE Z Over 1000 Amp. or Over 600 V 50.00 TEMP.POWER POLE Temp. Power Pole'& Appurtenances 10.00 UNDERSLAB WORK Sign with One Branch Circuit 10.00 ROUGH CONDUIT Additional Sign Branch Circuits 2.00 WIRING (Other) FIXTURES POWER AUTHORIZED UTILITY CO.NOTIFIED (� FINAL • e PERMIT FEE (Sub-Total) NOTES PLAN CHECKING FEE (One-Fourth Permit Fee) PERMIT ISSUING FEE $600 TOTAL FEE �J PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. MO. CASH SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE r �� I DS a—A 4-40 10M APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY ELECTRIC COUNTY OF LOS ANGELES 2 WM J. FOX, CHIEF ENGINEER _ NATURE OF INSTALLATION DISTRICT NO. GRo PFNE PERMIT No. WIRING FIXTURES SERVICE I A RECEIVED BY READY FO DISSU RANGE HEATER POWER FIRST INSPECTION 76 // SIGNS MISCELLANEOUS APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY Z JOB Q NAME --, J iI.%.+ "'. Y. -7/ y ADDRESS -069 U / ADDRESS '`f,!`► "�• LOCALITY r 1" NEARES f r,.. " 1 W CITY , TEL N CROSS ST. ' wCO Y �f P; .v dc A CERT. NO. EXPIRES K NAME DES RI15TION OF WORK Z MAIL NUMBER OF OUTLETS ON CIRCUITS 3 ADDRESS O LOCATION BY ROOMS CITY TEL No. LIGHT OUTLETS JII SW.I PLUGS IFIXT. 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS CIRCUIT I A I B C I D I E h I F I G I HI ANGELES COUNTY CERTIF, ATTEOFQUALIFICATION. LIVING ROOM __ ELECTRICtAN. T 1 AM THE LEGAL OWNER OF THE PRd¢ERTY DESCRIBED DINING ROOM ___ _ ABOVE. BRFST. RM. OWNER. BATH CORRECTIONS ENT. HALL _-I}- HALL NO. I FRONT PORCH OUTSIDE _KITCHEN _ SERV. PCH. W BDRM. No. V --�j� J CLOSET IVI a —— Z) BDRM. NO. CLOSET TOTAL NO. OF OUTLETS .41 $ APPROVALS NO. OF FIXTURES $ DATE INSPECTOR'S NAME NO. OF MOTORS H. P. $ CONDUIT NO. OF SIGNS TRANS. $ WIRING NO. OF RANGES OR HEATERS $ FIXTURES MISCELLANEOUS $ POWER PERMIT FEE $ UTILITY CO. NOTIFIED TOTAL FEE $ FINAL DB'E-A 7-40 25M APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY ELECTRIC COUNTY OF LOS ANGELES WM J. FOX. CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP I Z NE PERMIT NO. WIRING FIXTURES SERVICE 3 RECEIVED BY 'READY F DATE SSUED RANGE HEATER POWER / FIRST INSPECTION r SIGNS MISCELLANEOUS APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY �r ,y r" < NAME ,,_-_, /� �a/( ADDRESS E ADDRESS �;'- Y LOCALITY F ,�` NEAREST r°' • CITY l .r�i'M+1.7 'I TEL No.,rwr4'ie' g" CROSS ST. tcs.elJ COUNTY W CERT. NO. EXPIRES W NAME DESCRIPTION OF WORK 3 MAIL ADDRESS NUMBER OF OUTLETS ON CIRCUITS 0 LOCATION BY ROOMS CITY TEL No. LIGHT OUTLETS III SW.1 PLUGS IFIXT• 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS CIRCUIT I I A I I ANGELES COUNTY CERLYTIC TE OF QUALIFICATI I A B C D E n F G H �,.-, ,- LIVING ROOM I� I I �` uCTRICIwN. I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED DINING ROOM ABOVE. BRFST. RM. I -- OWNER. BATH CORRECTIONS ENT. HALL tt HALL NO. 1 FRONT PORCH OUTSIDE _KITCHEN _ SERV. PCH. J Q Z BDRM. NO. CLOSET BDRM. NO. CLOSET TOTAL NO. OF OUTLETS s APPROVALS NO. OF FIXTURES Q DATE INSPECTORS NAME NO. OF MOTORS H. P. Q CONDUIT NO. OF SIGNS TRANS. s WIRING NO. OF RANGES OR HEATERS s FIXTURES MISCELLANEOUS a POWER IPERMIT FEE S (./ UTILITY CO. NOTIFIED TOTAL FEE S FINAL / DDEPARTMENT OF BUILDING AND SAFETY g APPLICATION FOR PERMIT COUNTY OF LOS ANGELES ELECTRIC WM. J. FOX CHIEF ENGINEER NAME v% Cp DISTRICT NO, GROUP ZONE PERMIT NO. ADDRESS C7 2/M 1v,-, �^ J WU • CITY ? TEL.NO. /f` RECEIVED BY READY FOR DATE ISSUED J COUNTY ,� I C L FIRST INSPECTION L O W CERT.NO. EXPIRES J 1� O S APP CANT FILL IN HEAVILY OUTLINED PORTION ONLYJOB 7 DESCRIPTION OF WORK ADDRESS / G aS ,fir• NUMBER OF OUTLETS ON CIRCUITS LOCALITY e i7? P Cj/ - LOCATION BY ROOMS 7 NEAREST LIGHT OUTLET JSW.I PLUGS FIXT CROSS ST. CIRCUIT A B C D E F G IH w NAME 6- lT OV S'f e/ C Z MAIL ADDRESSoZ/7/ -1o5 v/✓.?aS ,�f� CITY /en P C r� TEL.NO. 1✓on I AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OFJ`��ON.. ELECTRICIAN. I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE OWNER. CORRECTIONS J Q Z 2 R O TOTAL NO. OF OUTLETS ffi APPROVALS NO. OF FIXTURES ffi DATE INSPECTOR'S NAME NO. OF MOTORS H.P. ffi CONDUIT NO. OF SIGNS TRANS. $ WIRING NO. OF RANGES OR HEATERS ffi FIXTURES MISCELLANEOUS ffi S POWER PERMIT FEE ffi ` , UTI LITY CO.NOTI FI ED 04l TOTAL FEE FINAL 09 5-A 4-40 10. '�•`• -�` -- - . APPLICATION FOR PERMIT DEPARTMENT` OF BUILDING AND SAFETYELECTRIC 1 COUNTY OF LOS ANGELES 14 _� 2 7 WM. J. FOX. CHIEF ENGINEER DISTRICT NO. GROUP ZONE PERMIT No. NATURE OF INSTALLATION , P WIRING FIXTURES SERVICE RECEIVED BY READY FOR DATEIS9UED RANGE HEATER POWER FIRST INSPECTION , SIGNS MISCELLANEOUS APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY JOB - Q NAME •:�%.%/.: ( _ t•Ii ADDRESS ;.7.j ADDRESS /..C..4./.�+c4-rc.P�-: LOCALITY Y - T- •�'` f•' 7 NEAREST W CITY !�,'. .� r -- TEL No. �,J -( CROSS ST. W COUNTY CERT. NO. /-v EXPIRES r' K NAME DESCRIPTION OF WORK Z ADDRESS /(? r .1� NUMBER OF OUTLETS ON CIRCUITS 30 �j LOCATION BY ROOMS CITY "3'!/ ..G- (.L TEL NO. LIGHT OUTLETS III SW.I PLUGS IFIXT. I AM THE LEGAL POSSESSOR OF THE ABOVE LO CIRCUIT I A I B C I D I E k I FIG H I ANGELES COUNTW CERTIFI OF Q1„ILIFtCAT LIVING ROOM `— '- - ELECTRICIAN. I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED DINING ROOM _ ABOVE. BRFST. RM. 1 OWNER. BATH ——I I CORRECTIONS ENT. ALL HALL NO. FRONT PORCH OUTSIDE KITCHEN SERV. PCH. ..1 BDRM. No. __ Q Z CLOSET __ 0 BDRM. NO. _I CLOSET 0 TOTAL NO. OF OUTLETS S APPROVALS NO. OF FIXTURES ,y /- t $ �5• DATE INSPECTOR'S NAME NO. OF MOTORS y S yr CONDUIT NO. OF SIGNS TRANS. S WIRING NO. OF RANGES OR HEATERS $ FIXTURES MISCELLANEOUS $ POWER 7�j IPERMIT FEE S �1 UTILITYCO. NOTIFIED AGO r' TOTAL FEE IS ` S`� FINAL �� DS a-A 4-40 IOM APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY ELECTRIC 1 COUNTY OF LOS ANGELES WM J. FOX, CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GR ZONE P RMIT No. WIRING FIXTURES SERVICE REC IVE4 BY READY FOR DATEISSUED RANGE HEATER POWERFIRST INSPECTION SIGNS I 1AISCELLANEOUS 4�1' /Ld I *PPHfADWFI IN HEAVILY OUTLINED POS ON ONLY Z JOB ,�y Q NAME < ' ADDRESS t F 4 - � ADDRESS V� � LOCALITY - 1- NEAREST 'OWN A yUj CITYTELL I ir' CROSS ST. J COUNTY W CERT. NO. EXPIRES NAME DESCRIPTION OF WORK z MAIL NUMBER OF OUTLETS ON CIRCUITS 3 ADDRESS O LOCATION BY ROOMS CITY TEL No. LIGHT OUTLETS I SW.I PLUGS IFIXT. I AM THE LEGAL POSSES§IbR OF THE ABOVE LQb CIRCUIT I B C I I I I ANGELES COUNTY CERTIFIC D+O QUA (CATION.;' IA D E F G H ' ELECTRICIAN N- ^ 1 AM THE LEGAL OWNER OF THE PROPERTY DESCRIB6Id DINING ROOM *�T ABOVE. BRFST. RM. ter. _� OWNER. BATH _I¢ CORRECTIONS ENT. HALL HALL NO. _ t FRONT PORCH OUTSIDE L •' T _KITCHEN I J SERV. PCH. __ Q Z BDRM. NO. _ CLOSET O BDRM. NO. CLOSET TOTAL ..�^ APPROVALSNO. OF OUTLETS r $ NO. OF FIXTURES T DATE INSPECTOR'S NAME NO. OF MOTORS H. P. $ CONDUIT NO. OF SIGNS TRANS. $ WIRING NO. OF RANGES OR HEATERS $ FIXTURES MISCELLANEOUS $ POWER 7 1940 IPERMIT FEE $ `� UTILITY CO. NOTIFIED TOTAL FEE $ j{' FINAL DB S-A 4-40 10m APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY ELECTRIC COUNTY OF LOS ANGELES WM. J. FOX, CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP I ZONE PERMIT NO. WIRING FIXTURES SERVICE .� RF, RIVED BY READY FOR DATE ISSUED RANGE HEATER POWER FIRST INSPECTION SIGNS MISCELLANEOUS APPLICANT FILL, IN HEAVILY OUTLINED PORTION ONLY JOB NAME i / ADDRESS K ADDRESS LOCALITY NEAREST / W CITY TEL NO. S CROSS ST. 'i COUNTY _ N CERT. NO. - -- ! EXPIRES . NAME DESCRIPTION OF WORK 3 � MAIL ADDRESS NUMBER OF OUTLETS ON CIRCUITS O LOCATION BY ROOMS CITY ; r /TEL NO. LIGHT OUTLETS III SW.I PLUGS IFIX'L 1 AM THE L AL POSSESS OF THE ABOVE LOS CIRCUIT I A I B I C I D I E k I F G HH ANGELES COUYY CERTIFICAT 5r- QUALIPICATION. LIVING ROOM ELECTRICIAN. 1 AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED DINING ROOM ABOVE. BRFST. RM. OWNER. BATH ( CORRECTIONS ENT. HALL i HALL NO. FRONT PORCH OUTSIDE KITCHEN SERV. PCH. BDRM. NO. J Q Z CLOSET BDRM. NO. CLOSET I O TOTAL NO. OF OUTLETS s APPROVALS NO. OF FIXTURES $ DATE INSPECTOR'S NAME NO. OF MOTORS H. P. $ CONDUIT NO. OF SIGNS TRANS. $ •"� WIRING NO. OF RANGES OR HEATERS $ FIXTURES MISCELLANEOUS $ POWER S �� I PERMIT FEE $ r= UTILITY CO. NOTIFIEDI / ✓ ��"— �� TOTAL FEE a $ FINAL I �te^L''� ,✓,'� OB s-A 4-40 10M APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY ELECTRIC 1 COUNTY OF LOS ANGELES WM J. FOX. CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP I ZgNE PERMIT No. ter- (/;. WIRING FIXTURES SERVICE t- `�-�' F RECEIVED BY READY FOR'- DAT ISSUED RANGE HEATER POWER r" FIRST INSPECTION SIGNS I MISCELLANEOUS ` ii ' r i 2- ~ APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY :r JOB a- Z NAME -::.+` ADDRESS . a_ U ADDRESS .fi.r�k '6`-: i`„ '�.. ,' t' LOCALITY C I- •'j f - NEAREST W CITY . . TEL No. �, ,, .., ;r' CROSS ST. ILII COUNTY r, CERT. NO. EXPIRES K NAME DESCRIPTION OF WORK 3 MAIL 51— NUMBER OF OUTLETS ON CIRCUITS 0 ADDRESS LOCATION BY ROOMS CITY TEL No. LIGHT OUTLETS ISWJ PLUGS JFIXT. I AM THE LEGAL POSSESSOR OF THE ABOVE LOS CIRCUIT IA B C I D E F G H I I I I ANGELES COUNTY CERTIF ATE OF QUALIFICATION. I LIVING ROOM ��-��a_...�.. ELECTRICIA Z. 1 AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED DINING ROOM __ ABOVE. BRFST. RM. OWNER. BATH CORRECTIONS ENT. HALL T� HALL NO. I FRONT PORCH OUTSIDE KITCHEN J SERV. PCH. __ a Z BDRM. NO. 0 CLOSET BDRM. No. __I CLOSET i TOTAL NO. OF OUTLETS s APPROVALS NO. OF FIXTURES $ �� DATE INSPECTOR'S NAME NO. OF MOTORS H. P. S CONDUIT NO. OF SIGNS TRANS. S WIRING NO. OF RANGES OR HEATERS $ FIXTURES MISCELLANEOUS $ POWER I , PERMIT FEE $ TILITY CO. NOTIFIE TOTAL FEE $ I~ FINAL -1 - �'� 1 LAI OB 5-A 7.35 25M DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PER31IT COUNTY OF LOS ANGELES ELECTRIC NATURE OF INSTALLATION DISTRICT No. I GROUP TYPE PERMIT No. I i WIRING FIXTURES SERVICE 3 /63 READY FOR RECEIVED BYMR DATE issurD RANGE HEATER I—I POWER_ FIRST INSPECTION SIGNS MISCELLANEOUSI APPLICANT ILL IN HEAVILY OU LINED PO TIOi ONLY JOB NAME U�'�"�� .6 - ADDRESS U y ADDRESS\, LOCALITY p?..•-t-r-t. 1... - ��' c- NEAREST W CITY �E'; Qs�fEL No. CROSS ST. STATE COUNTY W LICENSE No. -1 REG. No. W NAM .�,.•'�- ✓4t.� DESCRIPTION OF WORK z MAIL NUMBER OF OUTLETS ON CIRCUITS p ADESS LOCATION BY ROOMS �.•' i`: .,_ {� CITY •`""��' TEL No. LIGHT OUTLETS SW, PLUGS FIXT. CORRECTIO CIRCUIT ( A I BI C_ I D I El ( F I G I H I S I LIVING ROOMI I I I I I Ll I I DINING ROOMI I I I I I I I I I I _ BRFST. RM. BATH LL ENT. HALL HALL No. 41 FRONT PORCHI I I I I 'r I I I I I < Q Z OUTS DR I I I I I KITCHEN I I FI - dI �IIr ' I -i ,� I I y•� Y 1 y.. ' ' O SERV. PCH. BDRM. No. CLOSET I f'_II_ •1ITJ��" I I _ BDRM. No. CLOSET I I I I I I I APPROVALS DAT$ INSPSCTOR', N+.ME - I II i I I I I CONDUIT -- WIRING A0 f�^' tip,} I I I ( I I I I I TOTAL I I II I FIXTURES NO. OF OUTLETS $ J "7 -POWER T6 I NO. OF FIXTURES UTILITY CO. NOTI FLED rol r _ _ $ -----'-?'*— - I FINAL I,7,1 ' r, NO. OF MOTORS H. P. O� �, ��'' $ - IAM THE LEGAL OWNER OF THE ABOVE LOS ANGELES NO. OF SIGNS TRANS. $ COUNTY REGISTRATNUM NO. OF RANGES OR HEATERS $ _(jamwool�CTRICIAN.MISCELLANEOUS $ 1 AM THE LEGAL OWNER OF THE PROPSDESCRIBED PERMIT FEE 8 / ABOVE �f-` TOTAL FEE $ 3 C �µ OWNER. WORKERS'COMPENSATION DECLARATION C -663 io/si APPLICATION FOR ELECTRICAL PERMIT /� I hereby affirm that I have a certificate of consent to self Insure, E-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)IDQ4041-9/ompany 5/ ,O TC AUALO FOR APPLICANT TO FILL IN JOB Certified copy is herebyfurnished EACH NO FEE ADDRESS New Residential Bldgs & Pools ❑ 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 OWNER OR Date Applicant FIRM NAME CERTIFICATE OF EXEMPTION FRO WORKERS' Outlets Rec Light _ Sw MAIL COMPENSATION INSURANCE ADDRESS (This section need not be completed If the work involved b the First 20 p y Total No Additional CITY —�_--` Tel No 7 -3 7 permit is for one hundred dollars ($100) or less.) - PLAN HECK I certify that in the performance of the work for which this permit APPLICANT is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws Lighting Fixtures First 20 ADDRESS . Total No Additional 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'Compensation Range_ Heater_ D W APPLICANT X/�f7,S .L e LC provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer _ WM _ ADDRESS �N S7- provisions or this permit shall be deemed revoked Top — FAU _ WH LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other_ CITY No ,5 Z I hereby affirm that I am licensed under provisions of Chapter 9LICENSE OR (commencing with Section 7000) of Division 3 of the Business and Disp — Room Air Coad REG NUMBER Class G S Professions Code,and my license Is in full force and effect Power Apparatus& Large Appliances DISTRICT NO PRO ED BY Size &'Type HP,KW,KVA,or KVAR �QO a'rt U License Numbery �Q�o� C7 9 Lic Class�_ Up to 1 Incl FINAL Contractor kms d- E�� Over 1 to 10 Incl DATE 0 -'j VALIDATION Q Over 10 to 50 Incl FINAL U ❑ I am exempt under Sec Over 50 to 100 Inc gy W B&PC for this reason Over 100 .e � 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 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 for the following reason (Section 7031 5, Business and Professions Additional Sign Branch Circuits Code) -330 55".5" ❑ [i I,as owner of the property,will do the work and the structure Misc Conduits & Conductors I is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schgdule) , TOTAL 547 55 and Professions Code) i tt t_O cW CONSTRUCTION LENDING AGENCYL + f 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)-Total) iu [i'i Civ C) Lender's Name PLAN CHECKING FEE 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 representatives of this County to enter upon the above-mentioned property for inspe tion purposes SEE REVERSE FOR EXPLANATORY LANGUAGE gnatu ofermitt Date WORKERS'COMPENSATION DECLARATION 76-663 10/81 APPLICATION FOR ELECTRICAL PERMIT I herby affirm that I have a certificate of consent to self insure, CE-Bose or•a ce+tificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec 3800,Lab C) flJ Policy NO Company S FOR APPLICANT TO FILL IN JOB Certified co is hereby furnished EACH NO FEE ADDRESS PY Y New Residential Bldgs & Pools $F $ S l Famiy, q t — Certified copy is filed with the county building ins ection 1 & 2- LOCALITY departure t Multi-family Sq Ft — Residential Swimming Pools CROSS OWNER O G Date� Applicant OR • FIRM NAME ` CERTIFICATE OF EXEM TIONSFItYM WORKERS' Outlets Rec— Light _ Sw MAIL l COMPENSATION INSURANCE ADDRESS l (This section need not be completed If the work Involved by the Firs' 20 }1 permit Is for one hundred dollars($100)or less.) Total No Additional CITY I No PLAN CHECK I certify that in the performance of the work for which this permit APPLICANT is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws Lighting Fixtures First 20 ADDRESS Total No Additional 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'Compensation Range_ Heater_ DW _ 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 _ WH _ LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other_ CITY Tel No I hereby affirm that I am licensed under provisions of Chapter 9 Disp — Room Air Cond LICENSE OR Class (commencing with Section 7000) of Division 3 of the Business and REG NUMBER y.�73yZ G Professions Code,and my license is in full force and effect DISTRICT NO PR;M6A-.t—� BY Power Apparatus& Large Appliances Size& Type HP,KW,KVA,or KVAR O 0 License Number ��73�Z Lic Class Up to 1 Incl FINAL V _ Over 1 to 10 InclDATE , 4 VALIDATION Contractor— Date O E] 4 66 Over 10 to 50 Incl FINAL O I am exempt under Sec Over 50 to 100 Inc BY W B&P C for this reason Over 100 a C/) Services, 200 Amp C &er 600 V? / , Z Date 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 Sign with One Branch Circuit I hereby affirm that i am exempt from the Contractor's License Lawir• for the following reason(Section 7031 5, Business and Professions Additional Sign Branch Circuits r`.:l'I °T -�-� Code) { 4, ° 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) , ri + L 6:3 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the t performance of of the work for which this permit is issued(Sec 3097, PERMIT FEE (Sub-Total) Civ C) PLAN CHECKING FEE Lender's Name I Lender's Address PERMIT ISSUING FEE I certify that I have read this application and state that the above TOTAL FEE information is correct I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize representatives of this Count to enter upon the above-mentioned properties SEE REVERSE FOR EXPLANATORY LANGUAGE Permittee p Y WORKERS' COMPENSATION DECLARATION 20-0019 DPW 3/87 663 APPLICATION FOR ELECTRICAL PERMIT O • I CE-806G herebA y affirm that I have a certificate of consent to self %�!nsuFe, 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 ompany !27547-415-- ////'�1V!J FOR APPLICANT TO FILL IN JOB 1:1Certified co y is hereby furnished �jj /y� 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 ST Date_ 3�r P�plicant C7S004/ { Residential Swimming Pools OWNER OR It / RM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' FI Outlets Recta Light � Sw� MAIL S a COMPENSATION INSURANCE First 20 D ADDRESS (This section need not be completed if the work involved by Total No 31S) Add itional CITY Telwe the permit is for one hundred dollars ($100)or less.) PLAN C ECK 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 Total No �� Date Additional CITY Tel No Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT If, after making this Certificate of APPLICATION 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 Hood — Fan Other— 9 /C� CITY OQ� Tel K LICENSED CONTRACTORS DECLARATION Disp — Room Air Cond — '" / / LICENSE OR Class G j> j 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 SSED BY >_ and Professions Code,and my license is in full force and effect ��O �/ ` 13- O A //� Size &Type HP, KW, KVA, or KVAR �f c License Number (��Ol44(2'_Lic Class C-l0 Up to 1 Incl FINAL U Contractor/ �C-�f� Date Over 1 to 10 Incl DATE BIZ VALIDATION 0 —r Over 10 to 50 Incl FINAL F- U -y I am exempt under Sec Over 50 to 100 Inc BY _ _ LLI B&P C for this reason Over 100 Services, Swbd , MCC& Ponelboards , Z Date 0- 200 Amp Under 600 V — Signature 4 201 - 1000 Amp Under 600 V Over 1000 Amp or Over 600 V Exemption for a Maint ect 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 ri s o a Law for the following reason (Section 7031 5, Business and Additional Sign Branch Circuits Professions Code) i r ):i•_e i Misc Conduits&Conductors i ITEM': I, as owner of the property, will do the work and the - structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)— TU Business I Business and Professions Code) i€" - 10 = 25 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for E•- e 1 1 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 ` €J! i F1 _l it l �;` i_,•''``_ PERMIT ISSUING FEE !f Lender's Address I certify that I have read this application and state that the TOTAL FEE /d a above information is correct I agree to comply with all County ordinances and State jaws 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 r ^ 30 I �-- Si a e of P IT ttee Date I Os COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0501060027 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: S PAID BUILDING ADDRESS: TR: 6561 LT: 236 BL: .001 9569 LAS TUNAS DR FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802107 ASSESSOR R: NEAREST CROSS STREET: 8587-014-012 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, C G1 OUTLETS-LGT,SW,RECP 19.00 OUT 37.05 G2 LIGHTING FIXTURES 1.00 LGT 1.95 ISSUED 0 : PROCESSED EXPIRES 0 : T1 NO PERMT OTHER OCCUP 257.00 DOL 257.00 01/06/05 JK 07/05/05 TOTAL FEES 323.75 OWNER: TE 0: FI y DA FINAL BY: CODE: WUNG HEE LEE (626) 827-5628- J _ 14603 BLUE SKY RD b��Y�bF�� HACIENDA HTS, 91745 19 RECESSED LIGHTS FOR TENANT IMPROVEMENT. APPLICANT: TEL. NO: E T CONTRACTOR (626) 287-8223- 5057 SULTANA AVE SPECIAL CONDITIONS: TEMPLE CITY CA 91780 CONTRA 0 : TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE E T CONTRACTOR INC. (626) 287-8223- 5057 SULTANA AVE LIC. NO L TEMPLE CITY CA 91780 757795010 UNDERGROUND CONDUIT ARCHITECTOR ENGINEER: L. NO: UFER GROUND LIC. NO: ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE PLASTIC YIN METAL YIN UTILITY COMPANY NOTIF1515 REPORT ID: DPR265 ROUTE TO: BS0508