The URL can be used to link to this page

Home My Public Portal About5512 MCCULLOCH AVE_Electrical_9/2/1986_ �. YORKERS'COMPENSATION DECLARATION I� 76A66310/81 i ` hereby affirm that I have a certificate of consent to self CE-806G APPLICATION FOR ELECTRICAL PERMIT 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. I Company FOR APPLICANT TO FILL IN JOB � , i D ) Certified copy is hereby furnished. � New Residential Bldgs. EACH NO.. FEE ADDRESS 8 Pools � LOCALITY ❑" Certified copy is filed with the county building inspec-i 1 &2-Family, Sq. Ft. $" — $ tion department. Multi-family Sq. Ft. — NEAREST Residential Swimming Pools CROSS ST. OWNER OR /y DJate Applicant FIRM NAME i Q 1'w-ba CERTIFICATE!OF EXEMPTION FROM WORKERS' ' Outlets: Rec Light . Sw._ MAIL COMPENSATION INSURANCE First 20 � ADDRESS �J�� (This section need not be completed if the work involved by. Total'No. Additional CITY Tel. No. G; 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 y person' y manner so as to become subject to the o rs'Co en SL aws., Lighting.Fixtures First 20 - ADDRESS J Total No. Additional CITY Tel. No. Date pplicant Fixed Appliances Not Over 1 HP PERMIT :NOTICE TO APPLICANT:.If, aft making t :is Certificate of APPLICANT Exemption, you should become subject to the Workers' Range_ Heater_D.W. — Compensation provisions of the Labor Code, you must forth-'1 Oven —Dryer —W.M.— ADDRESS with comply with such provisions or this permit shall be! Top _ FAU —W.H. — deemed revoked. ICITY Tel. IVo. LICENSED CONTRACTORS DECLARATION Hood _ Fan _Other— _ Room Air Cond. LICENSE I hereby affirm that I am licensed under provisions of Chapter 9 p' REG.NUMBER Class. (commencing with Section 7000)of Division'3 of the Business', Power Apparatus&Large Appliances DISTRICT NO. ^ P ED BY p� and Professions Code,and my license is in full force and effect. r O r Size&Type HP, KW, KVA, or KVAR i �/` d 0 -License Number Lic. Class Up to 1 Incl. FINAL Over 1 to 10 Incl. DATEq�4VALIDATION Contractor Date Over 10 to 50 Incl. FI L) ❑ I am exempt under Sec. Over 50 to 100 Inc. L iB.&P.C. for this reason Over 100 Z vices, Swb'cl:, MCC&Panelbbards 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 1 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 Law for the following,reason (Section 7031-:5, Business and, 1 Fee ScheduleSee.Com tete Other 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 ( P )— P-535-1 A 7044, Business and Professions Code). / , # 0.0 0 0 02 CONSTRUCTION LENDING AGENCY I - 2550 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) 0 0 0 251 5�� (Sec. 3097, Civ. C.). PLAN CHECKING FEE 0 Q 92"-86 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 ! her by authorize representatives of this County to enter upon bove-me 'on p y for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of ermittee Da e COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0412200006 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL D: ES PAID BUILDING ADDRESS: BK: 60 PG: 40 PC: 1 5512 MCCULLOCH AV FEE DESCRIPTION: QUANTITY: UDM: AMOUNT: TEMP CA 917802943 ASSESSOR -INFORMATION NUMBE NEAREST CROSS STREET: DAINES 8573-013-036 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: D3 LOCALITY: TEMPLE CITY, C G1 OUTLETS-LGT SW,RECP 2.00 OUT 3.90 TENANT: G2 LIGHTING FIXTURES 1.00 LGT 1.95 ISSUED ON: PROCESSED BY: PLAN . EXPIRES 0 H2 RES GRBG DISP LT 3HP 1.00 DIS 10.95 12/20/04 JK 06/18/05 TOTAL FEES 44.55 OWNER: TEL. NO: FI AL DATE ,FINAL BY: CODE: MINGKI TSUI/RUOKUN GUO (626) 354-9201- /tJ 5512 MCCULLOCH AV -?-;7- TEMP 917802943 J ESCR P IO OF OR ADD 1 OUTLET, 1 SWITCH, & 1 GARBAGE DISPOSAL APPLICANT: TEL. O: SAME AS OWNER - SPECIAL CONDITIONS: CONTRACTOR: TEL. N0: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - LIC. NO TEMPORARY POWER POLE UNDERGROUND CONDUIT ARCHITECT OR ENGINEER- TEL. N0: 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: BS05O8 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0504140007 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL D: FEES BK: 60 PG: 40 PC: 1 P 5512 MCCULLOCHSAV FEE DESCRIPTION: QUANTITY: USM: AMOUNT: TEMP CA 917802943 ASSESSOR INFORMATION N B R: NEAREST CROSS STREET: DAINES 8573-013-036 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: D3 LOCALITY: TEMPLE CITY, C G1 OUTLETS-LGT,SW,RECP 4.00 OUT 7.80 TENANT: G2 LIGHTING FIXTURES 4.00 LGT 7.80 ISSUED 0 DA . HA FAU LESS 3HP 1.00 FAU 10.95 04/14/05 JK 10/11/05 . H4 RES RANGE HDS LT 3HP 1.00 HOD 10.95 OWNER: TEL. 0: JA HEAT PUMPS +3-10HP 1.00 HT 19.65 FIFINAL Y: CODE: MINGKI TSUI/RUDKUN GUO (626) 354-9201- TOTAL FEES 84.90 5512 MCCULLOCH AV TEMP 917802943 DESCRIPTION ELECTRICAL FOR AIR CONDITIONING AND HEATING SYSTEM APPLICANT: E 0: SAME AS OWNER - SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGMA UR SAME AS OWNER - LIC. NO TEMPORJkRY POWER POLE UNDERGROUND CONDUIT ARCHITECTOR R: R GROUND LIC. NO: ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE PLASTIC Y/N METAL Y/N UTILITY C PA I REPORT ID: DPR265 ROUTE TO: BS0508