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Home My Public Portal About9808 MILOANN ST_Electrical__ WORKER'S COMPENSATION DECLARATION 7BAS68 DPW(72-91) APPLICATION FOR ELECTRICAL PERMIT ll I here.bj a9tirrg..that I have a certificate of consent To self insure, 76A868 dr a certifica,S'Xo6%rrei's Compensation Insurance, or a certified COUNTY OF LOS ANGELES -v ., ,. DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec.3800 Lab.C.) Policy No. Company . FOR APPLICANT TO FILL IN ADDRESS e . NO. EACH FEE Certified copy is hereby furnished. New Residential Bldgs.&Pools COCALI, d ❑ 1 &2-Family,Sq.Ft. — $ $ Certified copy is filed with the county building Inspection I. _ 'NEAREST. department. Multi-family Sq.Ft. CRoss ST. Date Applicant Residential Swimming Pools ASSESSUK MAP BOO PAGE PARCEL CERTIFICATE OF EXEMPTION.FROM-WORKERS' Outlets:Rec._Light Sw. FIRM NAME COMPENSATION INSURANCE I First'20 MAIL (This section need-not be completed if the work Involved by the ADDRESS ` permit is for one hundred dollars($100)or less.) Total No. Additional Q. T.I.; N . it I certify that in the performance of the work for which this permit 1 Cl Fj� Q 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 r l Total No. Additional ADDRESS Date Applicant I NOTICE TO APPLICANT:.If, after making this Certificate of RESIDENTIAL APPLIANCES NOT OVER 3 HP. 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 suchPERMIT I provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances APPLICANT LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,.or KVAR ADDRESS I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. (commencing with Section 7000):of Division 3 of the Business and CITY Tel.No. Professions Code,and my license Is in full force and effect.. Over 10 to 50 Incl. }' LICENSE Class. Over 50 to 100 Incl. REG.NUMBER d License Number Over 100 DISTRICT NO. P C SED BY V Lid.Class p Services bd.,MC. &Pane ards ? -�p Amp. P4 e 600 V Contractor Date / 0.�� DAT L I U .400-1000 Amp.Under 600'V �'��✓ � VALIDATION ~ I am exempt under Sec. 4 Over 1000 Amp.or Over 600 V FINAL 11 B.&P.C.for this reason BY IL BRANCH CIRCUIT:FEES Date: 15A,or 20A,120V,Lighting or Recept. I Z 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits- 41.Or More Branch Circuits Exemption for Reg.Maint.Elect. 15A,20A,.20BV To 277V Lighting Br.Circuitslie SINGLE FAMILY Temp.Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ACCT=''e' 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 3303 65.60 Code): , M I,as owner of the property,will do the work and the structure �--y 1 ITEMS Misc.Conduits&Conductors Is not intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule) , TOTAL 455.,450 and Professions Code). CHECK beb� CONSTRUCTION LENDING AGENCY CHS o60 I hereby affirm that there is a construction lending agency for the p performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total) a Civ.C.) PLAN CHECKING FEE I 0000--0001 4/29/96 Lender's Name PERMIT ISSUING FEE o?/ 10981 �M c° { 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 ordina ces and State laws regulating Electrical wiring,and hereby authorize repro tatives of this County to enter upon the above-mentioned property for insp ction purposes, SEE REVERSE FOR EXPLANATORY LANGUAGE for OF PE ITT -DATE COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECT 11 M PERMIT_ DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS EL 0-5-0"6TTT300 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: i LEGAL ID: FEES P IDpJLDIi G-ADB TR: 12830 LT: 31 �lt0 Mil(]ANNRgT�� FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TAMP CA 917803925 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 8589-008-022 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT,SW,RECP 1.00 OUT 1.95 E HA FAU LESS 3HP 1.00 FAU 10.80 SS EDti0 : PROCESSED B LAN BY: EXPIRES ON: JB AC UNITS +3-10HP 1.00 AC 19.65 11/13/96 TC 11/13/97 TOTAL FEES 60.15 OWNER: TEL. NO: FINAL D TE FINAL BY: CODE: TINSLEY DANIEL P;SHALOM J - O Icy 7 9808 MILOANN ST V // V TEMP 917803925 DESC PTION OF WORK NEW HEATING AND A/C SYSTEM IN RESIDENCE PLI 0: SAME AS OWNER LE C SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: ® APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER . LIC. NO Cb �® TEMPORARY POWER POLE cUNDERGROUND CONDUIT ARCHITECT OR ENGINEER: 0: UFER GROUND LIC. NO: �y,� ROUGH CONDUIT RO WIRING PU L C W 0 Vl K Sj- MAIN WATER LINE PLASTIC Y/N METAL Y/N co UTILITYCOMPANY NOTIFIED 69r o REPORT ID: DPR265 ROUTE TO: BS0508 i COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS EL 0508 9708060019 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: I - LEGALS PAID BUILDING SS: TR: 12830 LT: 31 9808 MILOANN ST FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TAMP CA 917803925 ASSESSOR INFORMAT0N NUMBER: NEAREST CROSS STREET: 8589-008-022 Al PERMIT ISSUANCE FEE 27.75 TjIONAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY LN OTHER PNL 0-399 AMPS 1.00 PAN 38.85 I TOTAL FEES 66.60 issuhu ON: PROCESSED BY: PLA RES ON: 08/06/97 TC 08/06/98 OWNER: , TEL. 6- FIN D TE NAL BY: CODE: TINSLEY DANIEL P•SHALOM J (626) 286-2696- 9808 MILOANN ST TEMP 917803925 CRI 0 F R NEW SUB PANEL IN GARAGE 50 AMP APPLICANT: E 0: SAME AS OWNER - SPECIALiCONDITIONS: CONTRACTOR: TEL. N0: ` `�3"'. -_-- y''• a', APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO a r: ` . k TEMPORARY POWER POLE ":� r` '• r !'=� ;'~ ^' UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. 0: 5 t:E; , _ FER GROUND ' I LIC. N0: ROUGH CONDUIT ROUGH RING 14AIN WATER LINE PLASTIC;Y/N METAL Y/N UTILITY C P Y OTI D i i i I I ' i I I REPORT ID: DPR265 ROUTE TO: BS0508 I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0807140019 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: I FEES PAID I BUILDING ADDRESS: 1 ITR: 12830 LT: 31 I [ 9808 MILOANN ST [ IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:[ TEMP CA 917803925 1 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 1 18589-008-022 IAl PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY, Cl I IG1 OUTLETS-LGT,SW,RECP 3.00 OUT 5.85 1 .1 TENANT: 02 LIGHTING FIXTURES 6.00 LGT 11.70 (ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: H2 RES GRBG DISP LT 3HP 1.00 DIS 10.95 107/14/08 SR 01/10/09 1H3 RES DISHWASHR LT 3HP 1.00 DIS 10.95 1 1 [OWNER: TEL. N0: [ TOTAL FEES 67.20 IFINAL DATE- /JP pp BY: CODE: 1 19808 MY DAN (626) 705-1930- i i IL-If I'oil 19808 MILOANN ST IILLIIWJII ITEMP 917803925 [ IDESCRIPTION OF WORK [ 13 OUTLETS, 6 LIFHT FIXTURES, GARBAGE DISPOSAL AND DISHWASHER (APPLICANT: TEL. NO: SAME AS OWNER 1 1 ISPECIAL CONDITIONS: I I I I I ICONTRACTOR: TEL. NO: [ [APPROVALS DATE INSPECTOR SIGNATURE [ ISAME AS OWNER - I I 1 LIC. NO i (TEMPORARY POWER POLE I I I I I [UNDERGROUND CONDUIT I I I [ARCHITECT OR ENGINEER: TEL. NO: 1 1UFER GROUND I I I _ I I I LIC. NO: [ [ROUGH CONDUIT 1 I 1 TROUGH WIRING [ 1 [ I IMAIN WATER LINE [ I IPLASTIC Y/N METAL Y/N 1 I I I [ I [UTILITY COMPANY NOTIFIE51 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 [ IREPORT ID: DPR265 ROUTE TO: B80508 [ I 1 I I I I I I I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 iELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS 'EL 0508 9904280007' BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 r " PHONE: (626) 285-0488 EXT: LEGA ID: FEES PAID --B _ LDI G-A DR SS: TR: 12830 LT: 31 9808 MILOANN ST FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803925 ASSESSOR-INFORMATION NUMER: NEAREST CROSS STREET: GOLDEN WEST 8589-008-022 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT,SW,RECP 10.00 OUT 19.50 TENANT: G2 LIGHTING FIXTURES 5.00 LGT 9.75 ISS ON: PROCESS BY: EXPIRES 0 : H7 RES EXHAUST FANS 2.00 EX 21.60 04/28/99 UT 10/25/99 TOTAL FEES 78.60 OWNER: TEL. NO: FINAL DATEFI BY: CODE: TINSLEY DANIEL P;SHALOM J (626) 286-2696- 9808 MILOANN ST TEMP 917803925 SC IP ON OF OR ELECTRICAL FOR BATH ADDITION APPLICANT: . NO: SAME AS OWNER - SPECIAL CONDITIONS: P�GElill Es C® CONTRACTOR: TEL. NO: SCS �/�/Ay APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - LIC. NO TEMPORARY POWER POLE UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: �� 0: - ER GROUND LIC. NO / 1111111 ROUGH CONDUIT � O G I G n/1� I llKS MAIN ATE/ LINE � �J �v�v PLASTIC Y/N METAL Y/N UTILITY COMPANY OTIF ED 0 ❑ �I f�rrli +. El Q ty El 46��C Service REPORT ID: DPR265 ROUTE TO: BS0508