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Home My Public Portal About6258 MUSCATEL AVE_Electrical__ WORKERS'COMPENSATION DECLARATION i 7DPw3/f17 6A663 ELECTRICAL FOR ELRICAL PERMIT .'.`oroby affirm that I have a certificate of consent to self CE-88066 irS.re, or a cortificate of Workers'Compensation Insurance, I COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a rertIf.ed copy thereof(Sec. 3800, Lab. C.) y P-licy No. Company FOR APPLICANT TO FILL IN JOB ADDRESS Certified copy is hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE ❑Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. $ — $ LOCALITY Y tion department. Multi-family Sq. Ft. — NEAREST L Residential Swimming Pools OWNERSOR Date Applicant FIRM NAME 9 A elnt CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL Outlets: Rec Light Sw._ /p ADDRESS COMPENSATION INSURANCE First 20 ` G (This section need not be completod if tho work Involved by I Total No. Additional CITY Tel. No. tho pormit is for ono hundrod 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 Wor, ers' pensation Laws. Lighting Fixtures First 20 ADDRESS \ Additional Dote Applicant J L Total No. CITY Tel. No. NOTICE TO APPLICANT: If, after oking this Certificate of Fixed Appliances Not Over 1 HP PERMIT Exemption, you should becom subject to the Workers' Range— Heater—D.W. — APPLICATION Compensation provisions of the Labor Code, you must forth- Oven — Dryer —W.M.— ADDRESS �" e,6eCJAd A4,4AI with comply with such provisions or this permit shall be Top — FAU —W.H. — deemed revoked. Hood — Fan —Other— CITY �° Tel. No ,_ LICENSED CONTRACTORS DECLARATION LICENSE OR Disp. — Room Air Cond. — Class. �t I hereby affirm that I am licensed under provisions of Chapter 9 � REG. NUMBER � D C..: '— a (commencing with Section 7000)of Division 3 of the Business Power Apparatus&Large Appliances DISTRICT NO. P ESSED BY >_ and Professions Code,and my license is in full force and effect. O O Size&Type HP, KW, KVA, or KVAR !1 License Number --2!! � Lic. Class Up to 1 Incl. FINAL Over 1 to 10 Incl. DATE /� VALIDATION 0 Contractor 01'404 Date X30 Over 10 to 50 Incl. FINIAL,, A U ❑ I am exempt under Sec. Over 50 to 100 Inc. BY � W B.&P.C. for this reason i Over 100 0_ Services, Swbd., MCC&Panelboards ® fn Date: 0-200 Amp. Under 600 V I- 0 Z Signature 201 - 1000 Amp. Under 600 V ❑ I Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V 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 Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits __ '7 Professions Code): ❑ 1, as owner of the property, will do the work and the I Misc. Conduits&Conductors — structure is not intended or offered for sale(Section 7044, i Other(See Complete Fee Schedule)_ _ Business and Professions Code). 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 PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address I certify that I 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 authoriz representatives of this County to enter upon the abo a-me Toned property fo spection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Sign" a of Permittee Date Os O I • 10' .4hat I COMPENSATION DECLARATION 7SA019,DPW(72.91) APPLICATION FOR ELECTRICAL PERMIT < '' 'ff 76A663, 4 I hereby affirm.ihat I have a certificate of consent to self insure, iI or a cltrtificdte of Workbr's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. i, copy thereof(Sea$800 Lab.C.), P❑oliCy N0. Company FOR APPLICANT TO FILL IN JOB yy� c/t l. Certified copy Is hereby furnished. ADDRESS 1-t8 'i/ J(Ap ri(, New Residential Bldgs:&Pools NO. EACH FEE LOCALITYu r F1Certified copy Willed.with the-county building inspection 11&2-Family,Sq.Ft. _ $ $ tM �" w1 e rtment. Multi-family S .Ft. NEAREST P q cRoss sr. Al Date Applicantlf`�L { � Residential Swimming Pools ASSESSOR' 6 MAP BOOK PAGE �d PARCEL D CERTIFICATE OF EXEMPTION FROM WORKERS' 20 1•I OWNER OR 149 COMPENSATION INSURANCE' Outlets:Rec._Light sY—Sw.First 20 MAIL FIRM NAME (This section need not be completed If the work Involved by the Total No.� Additional O ADDRESS 6 ark, permit Is for one hundred dollars($100)or less.) I certify that in the performance of the work for Which this permit CITY rmter ar Wit! ✓O Is Issued, I.shall not employ any person In any manner so as to PLAN CHECK become subject,.to the Workers`Compensation Laws. Lighting Fixtures First 20 APPLICANT Total No,D3_ Additional ADDRESS Date Applicant - RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: If, after making'this Certificate of CITY Tel.No. Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. / G. provisions of the Labor Code,you must forthwith comply with such APPLICANT G,A ,{�/[G , Pert(, provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or WAR y ADDRESS 14f S 4 .McAr .Vic p I hereby affirm,that I am licensed under provisions of Chapter 9 Over 3 to 10 InA j �a (commencing with Section 7000) of Division 3 of.the Business and CITY Tel f Z Professions Code,.anal m license!is in full force and effect. Over 10 to 50'Incl. Y � LICENSE OR Over 50 t0 100 Incl, REG.NUMBER ��V✓='I ' Claes' C�()f C- ��2 C_(.6Over 100 DISTRICT NO. PROCESSED BY V• License Number. Lic.Class p jl U. /i�J Services,Swbd.,MCC&Panelboards Contractor Date 0-399 Amp.Under 600 V ATE O ❑ 400-1000 Amp.Under 600 V V'I am exempt'under Sec. � � � VALIDATION. (L Over 1000 Amp.or Over.600 V FINAL (L B.&P.C.for this reason BRANCH CIRCUIT FEES BY CO) Date: 15A,or 20A,120V,Lighting or.Recept. Signature 1 To 10 Branch Circuits 11 To 40 Branch,Circuits ry I El 41 Or More Branch.Circuits Exemptiori for Reg.Meint.:Elect. 15A,2-DA,20 VV To 277V Lighting Br.Circuits } fy a I.CCt=$ SINGLE FAMILY Temp.Power Pole&Appurtenances pr? ct HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit r6 .7e I hereby affirm that I.am exempt from the Contractor's.License Law a r • ' for the following,reason(Section.7031.5, Business and Professions Additional Sign Branch Circuits , 1 ITEMS Code).:.. �� P ❑ Misc.Conduits&Conductors T�-()Ar- -22 ® d _� ;I,as owner of the property,will do the work and the structure rt is not intended or offered for.sale(Section 7044, Business Other(See Complete Fee Schedule) ® 11 19Il=75 and Professions Code). 0101 ( CONSTRUCTION'LENDING AGENCY CHANGE I hereby affirm,that there is a construction lending agency for the i performance of the work for which this permit is Issued(Sec. 3097, PERMIT FEE Sub-Total �! Civ.C.) ( ) lL£�— OCf1 fit/10/ PLAN CHECKING FEE `) AM .9 11 09 Lender's Name i 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 of this County to enter upon the above-mentioried property i for inspe c-tion murp ose r O I SEE REVERSE FOR EXPLANATORY LANGUAGE 'SIONA EOFPE MI EE DA COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS EL 0508 9711250044 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: -LEGAL SS: TR: 5904 LT: 3 6258 MUSCATEL AV N FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: SGAB CA 917752627 ASSESSOR BER: NEAREST CROSS STREET: 5386-010-006 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT,SW,RECP 4.00 OUT 7.80 G2 LIGHTING FIXTURES 4.00 LGT 7.80 ISS 0 SS : P EXPIRES ON: TOTAL FEES 43.35 11/25/97 UT 11/25/98 OWNER: TEL. NO: FINAL DATE FINAL BY: CODE: HUANG CHING H;MAR SHEREE 6258 MUSCATEL AV I SGAB 917752627 DESCRIP OF WORK ELECTRICAL FOR NEW STORAGE AREA APPLICANT: . NO: ALEX TAO & BUILDERS ASS. (626) 441-9718- SPECIAL CONDITIONS: I- r CONTRACTOR: TEL. N0: ��'�_-_ - - - �? APPROVALS DATE INSPECTOR SIGNATURE ALEX TAO AND ASSOCIATES (818) 441-9718- 1936 HUNTINGTON DR. #218 LIC. NOi \y,Z ��' E P0. 0 ER OL SO. PASADENA, CA 91030 463108 �'yr;� .�%� �� `•`, y,• UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. N0: ` , ? R GROUND LIC. NO: ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED REPORT ID: DPR265 ROUTE TO: BS0508 DEPARnIENT OF,•I3UILDINa ;�:?:'�^APPRIOATIOR FOR PSRia�' • COUNTY OF ANGE1 '! ..a F N...t-& 'I LOS ANY �' 'se .y�ZA �.r `:. r '.a•' �`ti 1 .. tii aKa• V. - NATURr'OF INSTALLATION• CIaTRIcr No., O P q zoVs plan r w. tiM1111MO YI i ..•{r:•a rwi. ��' ! ,;��(+ P Y �ANOt .NtATtR nR RdNt101r T FOR AICt([y��O/ -APPLICANT FILL IN-HEAVILY OUTLINED PORTION ONLY Nara Lzza JOEDDII ' NQ .1. ADORt9f { _ a'.� •r 3 •:v '� . CItiOD1 pTr® 4tL k �_ CROSS ST.�• -a d R . NO NMIS a;r DESCRIPTION OF WORK• NUNNIM OF cmmcm ON CmCu I • LOCATION RT RboMSerrr a+' uaNT ountrf fw v�uaf wn. TEL Na '• • R CnecuRo H 4 : CORRECTIONS . y • EMIL I Lm Roots I_ _ OININ�ROOM 1 jam•• ' ., PATH fi ,•i • tNT. MALL NA NO. 3 OUTSIDE RITCMtN ,• .'1 � SfRr.NpCN. A os ' '• a 'If: i.;s:'APPROVALS',. . c �•Y�•+.v,' `1 .sr •�: = CONDUIT •Y' RING" r •r� s�aa men NO, OYTL i POW00. Op FINMR98 F UTILITY e OM MOTORS' N. P FINAL •r Q ! •O F Stan@ TRANS. !; 1 AN TMR RGAL OYINim O/THE ASOTt LOS ANO� COUNTY RWISTRATION NUM N04 OF RANGZB On N[AT[RS •�r r ',,1," ANfOUf .Y •'.:•'.`. •`: 5 -:y ...'.... BI.iL'IR�C �,, Kllr•T ASOYt•TNt LtaALa1rNt1!OP TNR MlOPGITY DlSCawIStQ ~iwoowe ru NOW All J•• IN MW FAM 4161ft pm MEMBER! dr I w MR24-4 - 1.11. ..1\'.'1 CA DESCMPTION OF WORK it v• �_ IN 2MI FIMMI■ '. ■EtM Emu g ..-._ MEIN - FAME MEC .N. NE ..r ... IMMINow mMlfflMMI MMINMIIIIMIMh ■.■m■■na■ .. NNE MENEMMMIM MMI� ME ME MENAn Win? .. ��f�Vii"- APPROVALS omw �AM31rr __ - SCSI-.tcl-+t�xP1��traat.'^.�fif.?,.:J•S_':�m� `�'t,r�r,�t.`F l"t�^'i-5��'-...�.: _"S"-�C?_�° i.�.'_:�r+' .wrb F., rt. .'Q� �� :Y.x. r^_l�ta—.�..L _�-i-. '•i'� .1'`4`�� :I�*��v�*�d�o�t�c tF�CT3Y*s4�'*Y�}'t`h..y-.'r•`--rle�`!f7¢'��..�..� CSf��?�,�' % ..•M •..e.:s62wa_ .• ' .\.1...�1�+�'•tl r�l. jt� R• ,.., II��,.V,.YP�, po-i1-'+ ".. 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