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Home My Public Portal About9228 LONGDEN AVE_Electrical__ WORKERS'COMPENSATION DECLARATION 76AW 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self CE-8066 insure, or a certificate of Workers'Compensation Insurancevi COUNTY OF LOS.ANGELES BUILDING AND SAFETY or a�erttfiec f(Sec. 3800, C.) Policy No. pony FOR APPLICANT TO FILL IN .JOB Certified copy is hereby furnished. New Residential Bldgs. &Pools PC. NO. FEE ADDRESS 1 &2-Family, S Ft. — $ LOCALITY Certi ted coy is filed with 4FROMRKERS' ng inspec- y� q• NEAREST L. ti n e art ent. Multi-family Sq. Ft. CROSS.ST. Date Applicant Residential Swimming Pools OWNER OR FIRM NAME ERTIFI ATE OF EXEMPTIOOutlets: Rec LightjaSw._ MAR COMPENSATION ADDRESS ;,r (This section need not be completed if the work involved by TotaFirst l No. Add20 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'Compensation Laws. Lighting Fixtures. First 20 ADDRESS Total No. Additional CITY A. 1pI. No. Date Applicant Fixed Appliances Not-Over 1• HP PERMIT NOTICE TO APPLICANT: If, after making t1his Certificate of APPLICANT 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. — CITYel. No. deemed revoked. Hood — Fan _Other_ LICENSED CONTRACTORS DECLARATION LICENS.OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. _ Room Air Cond. REG. NUMBER S Class. (commencing with Section 7000)of Division 3 of the Business DISTRICT NQ_ PROCES D Y. and Professions Co ,and.my license is' full force o effect. Power Apparatus&Large Appliances Size&Type HP; KVII, KVA, or KVAR.' � O License Number / -A� Lic. Class Up.to 1 Incl. FINAL Over 1,to 10 Incl. DATE D VALI ON Contract Date: tm ❑ Over 10 to 50 Incl. FINAL I am exem t nde Sec. Over 50 to 100 Inc. BY 6 9 a. A 0 o 0 0 0 2 BAP.C. for this reason.' Over 100 55 U)Date: Services, Swbd., MCC&Panelboards 3V 0 0 0 rj(� 0 -200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V 0 IL 3 0`F 8 7 ❑ 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 Additional Sign Branch Circuits Low for the following reason (Section 7031.5; Business and , Professions Code): ❑ I,.as owner of the property, will do the work and the M'isc. Conduits 8 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 construct!on'lend.ing 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 to Lenders Address I certify'.that I have read this application and state that the TOTAL.FEE A50 above information is.correct. i-agree to comply with all County ordinances and State laws. regulating Electrical wiring, and i hereby,oputhorize representatives of this County to nte'r upon the a o e- entione ro4elnsp tion pur oses SEE REVERSE FOR EXPLANATORY LANGUAGE Signature.of Permittee ate ' 1fUQRKERS''CbMPENSATION DECLARATION 76.663 10/91 CE-8066 APPLICATION FOR ELECTRICAL PERMIT I !�`ereby affirm that I have a certificate of consent to self insure, or a.certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof(Sec. 3800, Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB �6 Certified co is hereby furnished. ADDRESS iAN TJ I�— Py y New Residential Bldgs. $ Pools EACH NO. FEE • F-1 $ $ LOCALITY � _ @ y+ Certified copy is filed with the county building inspec- 1 $2-Family, Sq. Ff. eM � Ci( tion department. Multi-family Sq. Ft.. — NEAREST Residential Swimming Pools. CROSS ST. Q , Date Applicant OWNER OR FIRM NAME S.4&-j 1 I CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw._ MAIL COMPENSATION INSURANCE First 20 ADDRESS �'q�hY�► �11��QT (This,section need not be completed if the work involved by Total No. ,�,e•Additional CITY �ATel. No.� . i the permit is for one hundred dollars($100)or less.) I certify that in the performance of the work for which this PLAN CHECK permits issued, I shll not employ any person in any manner APPLICANT so as to become subject to the Workers�pe�iows. Lighting Fixtures. First 20 ADDRESS Additional Total No. CITY Tel. No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this CertificateAPPLICANT Exemption, you should become subject to the Workers' Range._ Heater_D.W. Compensation provisions of the Labor Code, you must forth- Oven —Dryer' _W.M.— ADDRESS with comply with.:such provisions or this permit shall be Top _ FAU —W.H. — deemed revoked. a CITY Tel. IVa. LICENSED CONTRACTORS DECLARATION Hood _ Fan _Other— . Disp. _ Room Air Cond. LICENSE M Class I hereby affirm that I am licensed under provisions of Chapter 9 REG. NUMBER (commencing with Section 7000)of Division 3 of the Business DISTRICT NO PROCESSE Y �- and Professions Code,.and my license is in full force and effect. Power Apparatus$Large Appliances �1 0 Size$Type HP, KW, KVA, or KVAR' L V + License Number Lic.. Class Up to 1 Incl. FINAL 1%. Over 1.to 10 Incl'. DATE 6 O VALID. Contractor Date FINAL g N w Over 10 to 50 Incl. 9 ;Z^ I am exempt under Sec. Over 50 to 100 Irrc. BY Q//%J N B.$P.C. for this reason Over 100 Date: Services, Swbd„MCC$Ponelboards , ` 0 -200 Amp. Under.600 V Signature 201 - 1000 Amp. Under 600 V ❑ Over 1000 Amp. or Over 600 V Exemption for Reg. Maint. Elect. SINGLE FAMILY Temp. Power Pole$Appurtenances HOME OWNER-BUILDER DECLARATION 3 7 7.3 A 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 # 0 0 0 0 0 2' Professions Code): 12w Ni I, as owner of the property, will do the work and the Misc. Conduits$Conducto,rs -( o o25-50 structure is not intended or offered,for sale (Section Other(See Complete Fee Schedule)_ , 7044, Business and Professions Code). o 0 o2550;2 CONSTRUCTION LENDING AGENCY 0 t 0 _$6 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 �f 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 wirings and hereby authorize representatives of this County to enter upon Ike above-mentioned property for inspection Aur SEE.REVERSE FOR EXPLANATORY LANGUAGE .Signature of Permittee F, Oate T KERSCOMPET3A!ION DECLARATION 3APP�IC4TCtEA6 l�' V F® ELEeTRIC�I PERMI' 2 , I 6:dreby alfi that 1•fiave a certificate of consent to self + COUNTY OF LOS,ANGELES 7'� a BUILDING AND SAFE Y insure,or a c t i a e'of VVorkers'��ompensation Insurance,or a certified copy thereof,Vec.3800,Lab.C.) FOR APPLICANT TO FILU,IN JOB ( 1 Policy No. ;Company ADDRESS ,. EACH NO. FEE New Residential Bldgs.&Pools Certified copy is hereby,furnished. )1 &2-Fami1y,Sq.Ft. $ — $ LOCALITY �►� ��T !' r, CROSS ST O � Mylti-family Sq:Ft. �.. Certified.copy is filed with the county building inspection T— �� Residential Swimming Pools FIRM NAME. �e /- department. OWNER OR Date Applicant Outlets: Red. Light Sw. /.. ,�d ,! �� MAIL 2-2a �,�G&C First 20 ADDRESS ,CERTIFICATE OF EXEMPTION FROM WORKERS' Total Noi.� Additional o CITY'1b^106le G,/ Tel No. / COMPENSATION INSURANCE PLAN CHECK a APPLICANT .(This section need not be completed if the workI involved J V by the-permit is for one hundred dollar ($100) of less.) -fighting Fixtures. First 20 ADDRESS Additional i Total No. '' CITY Tel No. O ` ,l certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP permit is issued,'I shall not employ any person in any manngr PERMIT Qef, .(i. �U so as to become subject to the Workers'Compensation Laws. Range_Heater Q.W._ APPLICANT Y �17� a Oven _ Dryer_W.M._ ADDRESS q.zZ00 1,p„/�'/�� z Date Applicant, Top — FAV _W.H.._ " Hood _ Fan _Other— CITY_72,,I,� L.0- el No 9 NOTICE TO APPLICANT: If, after making this Certificate of Disp. —Room Air Cond. LICENSE OR Exemption, you should become subject to the Workers' REG.NUMBER Class Compensation provisions of`the Labor Code;you must forth- Power Apparatus&Large Appliances DISTRICT NO. PROCESSED.pY. with comply-with such provisions or this permit shall be deemed revoked. Size&Type HP,KW,KVA,or KVAR ,Q Up to 1 Incl. FINAL Over 1 to 10 Incl. DATE LICENSED CONTRACTORS DECLARATIONOver 10 to 50 Incl: vZ VALIDATION I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FIN 9 (commencing with Section 7000)of Division 3 of the Busi- Over 100 BY ` nets and Professions.Code,and my license-is in full force and effect. Services ' License Number Lic.Class 0-200 Amp.'Under 600 V 201-1000 Amp.Under 600 V Contractor Data Over 1000 Amp.or Over 6.00 V HOME OWNER-BUILDER DECLARATION -' 1 I Temp..Power Pole.&Appurtenances `�.7 7 1:G-E � I hereby affirm. that I am exempt from the Contractor's Sign with One Branch Circuit � o'0 0 0 a2 , License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits ness and Professions Code): 2 0•o 2290 Misc.Conduits&Conductors 'I, as owner of the-property, will do the work and the Other(See Complete Fee Schedule)— 0 0 0 structure is not intended or offered for sale (Section 7044,Business and Professions Code). ! 1,.1 2-8.1 CONSTRUCTION LENDING AGENCY 'I hereby affirm that there is a construction lending agency ; for the performance of thb work for which this 'pernitt is PERMIT FEE (Sub-Total) �D 1 issued(Sec.3097,Civ.C.). /_<_ I Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) Lender's.Address PERMIT ISSUING FEE f i 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 representatives of this County to enter upon the above-mentioned property fori spection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE ' Signature of Permittee Date 71p COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS EL 0508 9703130012 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT:-IEj GAL FEES PAID B G RESS: ON FILE 9228 LONGDEN AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801606 ASSESSOR INMORNMATTMN NUMBER: NEAREST CROSS STREET: OAK 5385-001-003 Al PERMIT ISSUANCE FEE 27.75 i THOMAS PAGE:'596 GRID: J2 LOCALITY: TEMPLE CITY LB 200 AMP PANELS, MCC 1.00 PAN 38.85 TENANT: TOTAL FEES 66.60 ISSUED ON: PROCESSED EXPIRES . 03/13/97 TC 03/13/98 . OWNER: TEL. O: FINAL DATE FINAL BYl CODE: LEVY ANGELINA C - 9228 LONGDEN'AV I r/ TEMP 917801606 DESCIIPTION OF WORK UPGRNDE ELECTRICAL SERVICE PAN TO 200'AMP APPLICANT: EL. O: RABELLO ELECTRIC CO. (818) 352-2131-. SPECIAL CO.DITIO S: y Cc- J L E CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE RABELLO ELECTRIC (818) 352-2131- 8330 JAYSELL STREET LIC. NO TEMPORARY POWER POLE SUNLAND, CA 91040• 661129/C10• _ NDERGROUND CONDUIT ' RCH C ENGINEER: —TE—. N6: �.. FE GROUND LIC. N0: OlJZiH ONDUI n�� 0 RI G �U L�C TI C7 O"Fi'S M� WATER LINE ll Il PLASTIC Y%N METAL Y/N 0 co LTI� COMPANY 61 u Gq o 0c(� r REPORT ID: DPR265 ROUTE TO: BS05O8 , I�