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Home My Public Portal About6228 MUSCATEL AVE_Electrical__ WORKERS'COMPENSATIONDECLARATION I76A663 APPLICATION FOR ELECTRICAL PERMIT ICE-806G (2-80) I hereby affirm that I have a certificate of consent to self ; COUNTY OF LOS ANGELES BUILDING AND SAFETY insure,or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) Policy No. Company FOR APPLICANT TO FILL IN JOB ADD ESS New Residential Bldgs.&Pools EACH NO. FEE Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ — $ LOCALITY EJMulti-family Sq. Ft. — NEAREST Certified copy is filed with the county building inspection Residential Swiriiming Pools CROSS department. ST , FIRM NAME E-•Ci � £ �J Date Applicant Outlets: Rec.—Light Sw. MAIL First 20 ADDRESS CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITYr I No. COMPENSATION INSURANCE } PLAN-CHECK Os (This section need not be completed if the work involved APPLICANT U by the permit is for one hundred dollars (5100) or less.) Lighting Fixtures First 20 ADDRESS i Total No. Additional I certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No. permit is issued, I shall not employ any person in any manner PERMIT W so as to become subject to the Workers'Compensation Laws. Range_Heater D.W. _ APPLICANT r1 _ I c' Oven _ Dryer_W.M._ ADDRESS Z Date Applicant^ sZCl Top _F U —W.H..— _ Hood an Other_ ��,) �v CITY s, e , Tel No. S NOTICE TO APPLICANT: If, after making this Certificate ofDisp. m Air Cond._ (/rf cam/ LIC OR Ex ption, you should become subject to the Workers' REG.NUMBER Class Co pensation provisions of the Labor Code, you must forth- Power Apparatus&Large Appliances DISTRICT NO. PRE BY with ,comply with such provisions or this permit shall be Size&Type HP,KW,KVA,or KVAR ,} deemed revoked. ,(! Up to 1 Incl. FINAL. Over 1 to 10 Incl. DATE` ' 'LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl. VALIDATION I herlby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FBINAL 9 (commencing with Section 7000)of Division 3 of the Busi- Over 100 ness 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 Date Over 1000 Amp,or Over 600 V 1 HOME OWNER-BUILDER DECLARATION Temp.Power Pole&Appurtenances I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit Additional Sign Branch Circuits License Law for the following reason (Section 7031.5', Busi- 2 9 0.6 A ness and Professions Code): Misc.Conduits&Conductors 0 0 0 0 0 I, as owner of the property, will do the work and the Other(See Complete Fee Schedule)— structure is not intended or offered for sale (Section 7044,Business and Professions Code). 2 ° a 1 1.50 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency ° ° ° 1 1,J 0 u for the performance of the work for which this permit is PERMIT FEE (Sub-Total) pie issued(Sec. 3097,Civ.C.). 0209—82 Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) Lender's Address PERMIT ISSUING FEE I certify that I have read this application and state that the TOTAL FEE r 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 S gnature of Permitt ate - ti 76A663A=CE8Q5A 4/72 APPLICATIONF R ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER FEA G BUILDING AND SAFETY DIVISION S Y 0 T FOR APPLICANT TO FILL IN T. OUTLETS N0. EACH FEE OWNER � ✓� � RECEPT. / $ $ AMAIL DDRESS ( -.r �� SWITC� TFIRST 20 3AL OVER 20 CITY + ' TEL. NO. /s PLAN CHECK APPLICANT LIGHTING 1 FIRST 20 /7/ )} TOTAL ADDRESS FIXTURES OVER 20 RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT RANGE DRYER_WTR. HTR. / APPLICANT STA. COOK DI SP. F.A.U._L_ ADDRESS „ 2 2,e IV, M// SPACE HTR. AIR COND. CITY. „r,� L TEL. N0. I_l CLOTHES WASH. DISHWASH. LICENSE NO. CLASS. !. FAN OTHER QI HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY CD MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING C.3 IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR 0 - 1 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF C� CALIFORNIA OR THAT I/AM THE LEGAL OW R OF, AND INTEND TO ' - 10 RESIDE IN, THE ABO E DES RI R SIDENTIAL PROPERTY. y Z 70 - 50 'SIGNATURE. OF PERMITTEE / SO - 100 DISTRICTNO. IM-464- NZ� E/ OCE 5 D BY 100 - S00 �✓V �C SIGN, GAS SIGN AND ONE CIRCUIT NOTES: 'I`GC�' ,t1d 9- �t/,- �y_ .: TUBE, OR MARQUEE ADDITIONAL CIRCUITS SERVICE NOT OVER 600 VOLTS OR 200 AMP S V APPROVALS DATE INSPECTOR'S SIGNATURE SERVI CE OVER 600 VOLTS OR 200 AMP TEMP.POWER POLE TEMP SERVICE,POLE,&APPURTENANCES UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM ROUGH CONDI UT WIRING FIXTURES PERMIT FEE (SUB TOTAL) POWER AUTHORIZED UTILITY CO. NOTIFIED PLAN CHECK FEE. PERMIT ISSUING FEE (J FINAL q TOTAL FEE / �j PLAN CHECK VALIDATION CK. M.O. CASH- PERMIT VALIDATION CK. M.O. OCAS. 2 :3 li'gsm .20 2 D: 1 2:1 0 A98 '6a663CE-e0e(6r7I111)• APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN JOB New Residential Bldgs..&Pools EACH NO. FEE ADDRES LOCALITY 1 &2-Family,Sq.Ft. $ .025 — $ Multi-family Sq.Ft. .02 — NEAREST 25.00 c _ !SXR—s'v Residential Swimming Pools CROSS ST. OWNER OR FIRM NAME Outlets:Rec Light Sw. MAIL First 20 •50 _ ADDRESS Total No. Additional .30. CITY Tel No. PLAN CHECK APPLICANT Lighting Fixtures First 20 •50 ADDRESS Additional .30 Total No. CITY Tel.No. Fixed Appliances Not Over 1 HP PERMIT Range_Heater_DAPPLICAN..W._ - ADDRESS Oven_Dryer=W.M. j--8 7 Top _FAU —W.H._ CITY , Ad Tel.No. Hood—Fan _Other_ LICENSE OR Disp.—Room Air Cond. 2.50 REG.NUMBER /9 04 7 Class.0— I I HEREBY ACKNOWLEDGE THAT VE READ THIS APPLICA- Power Apparatus&Large Appliances TION AND STATE THAT OVE. C RECT.AND AGREE..TO' Size&Type HP,KW,KVi4,or KVAR COMPLY WITH ALL UNTY RD AN AND STATE LAWS Yp REGULATING ELE L WIRI Up to 1 Incl. 2.50 I HEREB IFY T IAM R ER REGISTERED AND/OR Over 1 to 10 Incl. 5.00 LICENSED AS IRE LOS A ES UNITY AND STATE OF Over 10 to 50 Incl. 12.50CALIFORNI / T I AM THE GAL WNER O HE ABOVE Over 50 to 100 Inc. 25.00 DESCRIBED TIA OPE.RT 40.00 PER ITE Over 100 SIGWD NA R Services DIST ICT NO. PRO ED 0-200 Amp.Under 600 V 12.50 8 201-1000 Amp. Under 600 V 25.00. Over 1000 Amp.or Over 600 V 50.00 •Z Temp.Power Pole&Appurtenances 10.00 n / a Q �'� C"Sign with One Branch Circuit 10.00 lam• L/ / q Additional.Sign Branch Circuits 2.p0 INSPECTION / ao.00 INFORMATION W Misc.Conduits&Conductors ON REVERSE x Other(See Complete Fee Schedulel SIDE u 9 2 0 IL 4 A Z 0000a2 , d 2 - ° 3200 PERMIT FEE (Sub-Total) 32005: PLAN CHECKING FEE (One-Fourth Permit Feel O PERMIT ISSUING FEE $7.00 �' 0 03-79 r TOTAL FEE ry - � INSPECTION FINALED a date: ^ 6 Os i n I hereby affirmORn ERat I�haveMa certificate IclON ate oEconsen Oto self insure, 20.0019 DPW(12.91)78A883 APPLICATION FOR ELECTRICAL PERMIT lul or 14certificale of Worker's Compensation Insurance,or a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy there ec.3800 Lab. Policy Nc.F Company � �/ r FOR APPLICANT TO FILL IN JOB ❑ Certified copy is hereby furnished. ADDRESS New Residential Bldgs.&Pools NO. EACH FEE _ LOCALITY Certified copy is filed with the county buildinginspection 1 &2-Family,Sq.Ft. $ $ tNEARESTde artmen. Multi-family Sq.Ft. CROSS ST.. Date �� Applicant Residential Swimming Pools 1 ASSESSOR MAP BOOK PAGE [PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Light Sw. OWNER OR Outlets:Rec._ COMPENSATION INSURANCE FIRM NAME pC Q j (This section need not be completed If the work Involved by the First 20 —'MAIL �y permit is for one hundred dollars($100)or less.) Total No. Additional ADDRESS Ci (JS 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 PLAN CHECK become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 -!APPLICANT Total No. Additional i 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 such IPERMIT provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances APPLICANT LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR Q 1 ADDRESS -to )4 I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. /U �a (commencing with Section 7000)of Division 3 of the Business and ,CITY Tel.No. �H Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. LICENSE OR Cl REG.NUMBER IN Zn. } Over 50 to 100 Inc,. ? AS� ass: , �/ a Over 100 DISTRICT NO. SSED BY V License Number v Lie.Class POC Services,Swbd.,MCC&Panelboards Contractor Date �• 0-399 Amp.Under 600 V I I DATE 7 Q 2 0 El I am exempt under Sec. 400-1000 Amp.Under 600 V VALIDATION V Over 1000 Amp.or Over 600 V 'FINAL L� � N B.&P.C.for this reason BRANCH CIRCUIT FEES Date: 15A,or 20A,120V,Lighting or Recept. Z_ 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits n F-141 Or More Branch Circuits '= Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.CircuitsA ;1�1wieS SINGLE FAMILY Temp.Power Pole&Appurtenances e HOME OWNER=BUILDER DECLARATIONSign with One Branch Circuit 9-Ue 10 I hereby affirm that I am exempt from the Contractor's License Law 33-0" for the following reason (Section 7031.5, Business and Professions I Additional Sign Branch Circuits i iTj1' Code): ❑ I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors I TOTAL 45 s 15 Is not intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule) , CHECK 45.15 and Professions Code). �+,{,�-_ ��'� fw�E"ri7yi_ 0 SJtI 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.) i�� ` _ 0Q1.j PLAN CHECKING FEE I [1763, i 10 15 Lender's Name PERMIT ISSUING FEE 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 or ' unty toe the above-mentioned property insp ,on p as. / SEE REVERSE FOR EXPLANATORY LANGUAGE SIGN RE OF PERMI DATE WORKERS'COMPENSATIONDECLARATION 76A663 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent' to self CE-806G (2.80)COUNTY OF LOS ANGELES BUILDING AND SAFETY insure,br a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800 b.C.) Policy N�/roQmpan �' FOR APPLICANT TO FILL IN JOB New Residential Bldgs.&Pools EACH NO. FEE ADDRESS K ❑ Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ — $ LOCALITY Multi-family Sq. Ft. NEAREST Certified copy is filed with the county building inspection CROSS ST //department. Residential Swimming Pools OWNER OR pplicant -- /, FIRM NAME Outlets: Re�3L.ight Sw. MAIL /L� First 20 ADDRESS CERTIFICATE OF EXEMPTION FROM WORKERS' Total No.�.3_ Additional CITY Tel No. COMPENSATION INSURANCE O PLAN CHECK (This section need not be completed if the work involved PPLICANT V Fixtures First 20hting by the permit is for one hundred dollars ($100) or less.) LigADDRESS Total No. Additional 0 I certify that in the performance of the work for which this CITY Tel'No. H permit is issued, I shallnot em Fixed Appliances at Over 1 HP U p ' employ y an y person in any manner PERMIT �� Lu so as to become subject to the Workers'Compensation Laws. Range_Heater D.W. _ APPLICANTA'-16-,-0-' a N Oven — Dryer_W.M._ ADDRESS o2Z Date Applicant Top FAU _W.H.._ Y Tel Hood Fan —Other CIT ""�. . NOTICE TO APPLICANT: If, after making this Certificate of Disp. _Room Air Condom LICENSE OR Exemption, you should become subject to the Workers' REG.NUMBE Class e-?—.-V Compensation provisions of the Labor Code, you must forth- Power Apparatus&Large Appliances DISTRICT NO. PROCESSED BY with comply with such provisions or this permit shall be Size&Type HP,KW,KVA,or KVAR ¢� deemed revoked. Up to 1 Incl. f V Over 1 to 10 Incl. FINAL f LICENSED CONTRACTORS DECLARATION DATE Gw C:. VALIDATION Over 10 to 50 Incl. - I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL 9 (commencing with Section 7000)of Division 3 of the Busi- Over 100 BY ness and Professions.Code, and my license is in full force and effect. , Services WE �� License Nu a;3/o7.S79 Lic.Class �/� 0-200 Amp.Under 600 V !/ !� p 201-1000 Amp.Under 600 V Contrac A2-,2 7— ; Over 1000 Amp.or Over 600 V HOME OWN Xg,JTT.n DECLARATION Temp.Power Pole&Appurtenances I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits ness and Professions Code): Misc.Conduits&Conductors Ell, as owner of the property, will do the work and the Other(See Complete Fee Schedule)— structure is not intended or offered for sale (Section 7044,Business and Professions Code). - _,�(>L-4 R CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency ` ' o. o of o n 2 for the performance of the work for which this permit is i PERMIT FEE (Sub-Total) issued(Sec.3097,Civ.C.). j , c 65 7,S Lender's Name ; PLAN CHECKING FEE (One-Fourth Permit Feel o Lender's Address PERMIT ISSUING FEE I certify that 1-have read this application and state that the i 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 I the ab"mentionedr rty f r inspection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE Sigoerme_i.,- Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS 8L 0508 0511140024 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 ERT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 5904 IT: 6 UK: .002 6228 MUSCATEL AV N FEB DESCRIPTION: QUANTITY: UOM: AMOUNT: SGAB CA 917752627 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LONGDEN 5386-010-012 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY, C G1 OUTLETS-LGT,SW,RECP 34.00 OUT 57.90 TENANT: G2 LIGHTING FIXTURES 31.00 LOT 53.85 ISSUED ON: PROCESSID BY: PLAN BY. EXPIRES ON: LB 200 AMP PANELS, MCC 1.00 PAN 38.85 11/14/05 JR 05/13/06 TOTAL FEES 178.35 OWNER: TEL. B DaTE FINA BY: OWNCEO, DENNIS (626) 292-2-6921- 6228 MUSCATEL AV _ SGAB 917752627 MISCRIIPTION OF WORK ELECTRICAL FOR ADDITION, REMODEL AND UPGRADE SERVICE TO 200 AMP APPLICANT: TEL. NO: TSUSHIMA - 317 W. MAIN ST #417 SPECIAL CONDITIONS: ALHAMBRA, CA 91801 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE MAR GERALD WAYNE (626) 646-1988- 8835 EMPEROR AVENUE LIC. NO TEMPORARY POWER POLE SAN GABRIEL, CA 91775 4392978 UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: UFER GROUND TSUSHIMA, RICK K (626) 282-3417- 317 W MAIN ST #417 LIC. NO: ROUGH CONDUIT ALHAMBRA, CA 91801 439297B ROUGH WIRING MAIN WATER LINE PLASTIC YIN METAL YIN UTILITY COMPANY NOTIFIED Q * ADDITIONAL DATA ON FILE REPORT ID: DPR265 ROUTE TO: BS0508