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Home My Public Portal About6018 OAK AVE_Electrical__ (2) WORKERS COMPENSATION of consent to CE 0BG 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self insure or 8 ber�lfoate of Wbrkem Compensation Insurance or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy It"(Seo 3800 Lab C) Policy No I Company FOR APPLICANr TO FILL IN JOB ❑ Certified copy a hereby furnished New Residential Bldgs &Pools EACH NO FEE ADDRESS60 x/ ❑ Certified copy is bled with the county building inspection 1 &2 Family Sq Ft $ —is LOCALITY department Muth family Sq Ft — NEARCROSS Date Applicant Residential Swimming Pools OWNER OR ry FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS Outs Rec_Light—Sw MAIL COMPENSATION INSURANCE ADDRESS (This section need not be completed If the work Involved by the First 20 permit Is for one hundred dollars($100)or less) Total No Additional CITY Tel No I certify that in the performance of the work for which this permit PLAN CHCK is issued I shall not employ any person in any manner so as to APPLICANT become subject to the Workers Compensation Laws Lighting Fixtures First 20 ADDRESS Total No Additional CITY Tel No Date APPI�nt Appliances Not Over 1 HP PERMIT NOTICE 70 APPLICANT If after making this Certificate of Fixe!AppAPPLICANT Exemption you should become subject to the Workers Compensation Range— Hester DW provisions of the Labor Code you must forthwith comply with such Oven — Dryer— W M — ADDRESS provisions or this permit shall be deemed revoked Top _ FAU — WH — LICENSED CONTRACTORS DECLARATIONCITY Tel No Hood — Fan Other— I hereby affirm that 1 am Incensed under provisions of Chapter 9 Dlsp — Room Air Cond LICENSE OR Gss. e (commencug with Section 7000)of Division 3 of the Business and REG NUMBER Professions Code and my license is in full force and effect Power Apparatus&Large Appliances USTRICT Sae&Type HP KW KVA or KVAR j�� D License Number Lo Class Up to 1 Incl FINAL01 Contr�tor Date Over 1 to 10 Incl DATE VALIDATION Over 10 to 50 Incl FINAL /00 `❑ I am exempt under Sec Over 50 to 100 Inc BY B&P C for this reason Over 100 &NO DateServices Swbd MCC&Panelboards , 0 200 Amp Under 800 V Signature 201 1000 Amp Under 600 V ❑ Exemption for Reg Mamt Elect Over 1000 Amp or Over 600 V SINGLE FAMILY Temp Power Pole&Appurtenances 2 HOME OWNER BUILDER DECLARATION Sign with One Branch Circum a I hereby affirm that I am exempt from the Contractors License Law A4GT■ �th)e following reason(Section 70315 Business and Professions Additional Sign Branch Circuits Mnsc Conduits&Conductors 1 INN 49.011 ❑ I as owner of the property will do the work and the structure is Other(See Complete Fee Schedule) _ TOTAL �- QQ not intended or offered for sale (Section 7044 Business and Professions code) , �� 4q. CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the � j performance of the work for which this permit Is Issued(Sec 3097 PERMIT FEE (Sub Total) Civ C) Lenders Name PLAN CHECKING FEE tin-WO1 10/18/9Q Lenders Address PERMIT ISSUING FEE 3M 1 AM 7:27 1 certify that I have read this application and state that the above TOTAL FEE nrlforrrato correct 1 agree to comply with all County ordinances and8 reg latrng Electnpf wiring and hereby authorize re ntat s of JIAZI County r upon the above mentioned arty Is pu SEE REVERSE FOR EXPLANATORY LANGUAGE c Stow ofDBte WORKER S COMPENSATIONate ofconsentDECLARATION to DPW(12 91) APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self insure or a certificlSe of Worker a Compensation Insurance or a certified COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV copy thereof(Sec 3800 Lab C) Policy No Company FOR APPLICANT TO FILL IN JOB ADDRESS ❑ tertifled copy is hereby furnished New Residential Bldgs &Pools NO EACH FEE ❑ 1&2 Family Sq Ft — $ $ LCA OLITY Certified copy is bled with the county building Inspection — NEAREST department Muhl family Sq Ft CROSS ST Date Applicant Residential Swimming Pools EggpR BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERSOutlets Rec lSw RL OWNER OR r� COMPENSATION INSURANCE t9ht•4--L-_First FIRM NAME20 d7-0S (This section need not be completed If the work Involved by the MAIL Total No _� Additional • ADDRESS permit is for one hundred dollars($100)or lose) 11�4 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 toPLAN CHECK become subject to the Workers Compensation Laws Lighting Fixtures 7 First 20 APPLICANT ' Total No � 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 provisions of the Labor Code you must forthwith comply with such PERMIT 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 OVer 50 t0 100 Incl REG LICENSE area d License Number Lic Class Over 100 DISTRICT NO PROCEMED BY V O 7— Services Smiled C&Panelboards ern D O Contractor Date Amp Under 800 V o` FDATE INAL Q I am exempt under Sec ❑ 400 1000 Amp Under 800 V Over 1000 Amp or Over 800 VFINAL VALIDATION W B &P C for this reason BRANCH CIRCUIT FEES BY N Dote 15A or 20A 120V Lighting or Recept Z 1 To 10 Branch Circuits Signature 11 To 40 Branch traits ❑ Exemption for Reg Maint Elect 15A 20A,208V To 2771/More Branch cC Circuits SINGLE FAMILY Temp Power Pole&Appurtenances HOME OWNER BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractors License Law for the following reason(Section 7031 5 Business and Professions Additional Sign Branch Circuits Code)/ l i , as owner of the property will do the work and the structure Misc Conduits&Conductors _3 is not intended or offered for sale(Section 7044 Business Other(See Complete Fee Schedule) , 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(Sec 3097 PERMIT FEE (Sub-Total) Civ C) –t PLAN CHECKING FEE ' Lender s Name �,. PERMIT ISSUING FEE Lender a Address 1 certify that I have read this application and under penalty of puqury state TOTAL FEE that the above information is correct I agree to comply with all County ordinances and State laws regulating Electrical vinnng and hereby authorize rep n vas of this Coun enter upon the above-mentioned property for sped rpoees SEE REVERSE FOR EXPLANATORY LANGUAGE NA OF PERMITTEE WORK hereby affirm HulRLhm COMPENSATION DSCLAof �to a& dsure * CE 806 ,Doti, APPLICATION FOR ELECTRICAL PERMIT CE 80aG or a oertrfo of Workers Compensation Insurance or a certified COPY thereof�Sec 3800 Lab Com) COUNTY OF LOS ANGELES BUILDING AND SAFETY ` Poho,*10 Company FOR APPLICANT TO FILL IN JOB ADDRESS �� / ❑ C�ntrfi9d copy is hereby furnished New Residential Bldgs &Pools EACH NO FEE ❑ — $ LOCALITY Certified copy is filed with the county building inspection &2 Family Sq Ft $ department Multi family Sq Ft — NEAREST CROSS Si Date Applcand Residential Swimming Pools OWNER OR �� FIRM NAME 204rw Z, CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec Vis.Light�Sw MAIL COMPENSATION INSURANCE i90 ADDRESS (This section need not be completed H the work Involved by the Fm3t 20 CITY Tel No permit Is for one hundred dollars($100)or leas) Total No� Additional I certify that in the performance of the work for which this permit PLAN CHECK APPLIC/W7 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 Tel No Date Applicant NOTICE TO APPLICANT If after making this CertificateofFixed Appliances Not Over 1 HP PERMIT Exemption you should become subjectto the Workers Compensation Range_ Heater DW _ APPUCANT provisions of the Labor Code you must forthwith comply With such Oven _ Dryer_ W M _ ADDRESS provisions or this permit shall be deemed revoked Top FAU WH _ LICENSED CONTRACTORS DECLARATION CITY Tel No I hereby affirm that I am licensed under provisions of Chapter 9 Hood _ Fan _ Other_ Disp — Room Air Cond LICENSE OR Cess ti (commenng with Section 7000)of Division 3 the Business and REO NUMBER Professions Code and my Incense is in full force and effect Power Apparatus&Large Appliances W DISTRICNO T ESS D Size&Type HP KKVA or KVAR112111.0,d License Number Lic Class Up to 1 Incl FINAL Centrectar Date Over 1 to 10 Ind DATE 1-- VA Over 10 to 50 Ind LIDATIO N FINAL ❑ 1 am exempt under Sec Over 50 to 100 Inc BY B&P C for this reason Over 100 Services Swbd MCC&Panelboards , H Z Date 0 200 Amp Under 600 V Signature 201 1000 Amp Under 600 V ❑ Over 1000 Amp or Over 600 V Exemption for Reg Mannt Elect SINGLE FAMILY Temp Power Pole&Appurtenances 2 HOME OWNER BUILDER DECLARATION Sign with One Branch Circuit ; I hereby affirm that I am exempt from the Contractors License Law ACCTAT T forthefollowing reason(Section 7031 5 Business and Professions Adddonal Sign Branch CircuitsCode3M7 27��pp � " .20 E I as owner of the property will do the work and the structure Mnsc Conduits&Conductors 1 ITM is not intended or offered for sale (Section 7044 Business Other(See Complete Fee Schedule) _ and Professions Code) , TOTAL 29.20 CONSTRUCTION LENDING AGENCY OEM 29.20 1 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) 74—Te Civ C) Lenders Name PLAN CHECKING FEE ' 0000-mi 10/15/90 PERMIT ISSUING FEE Lender a Address 3301 1 Ali 8:02 1 certify that I have read the application and state that the above TOTAL FEE 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 props r nnsp on purpoa SEE REVERSE FOR EXPLANATORY LANGUAGE Ar- 8111001111Wof peftittee Date . r COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT • DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 9907060001 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT LEGAL 10 ---Rrrs PAID BUILDING ADDRESS TR 6561 LT 330 UN 002 6018 OAK AV FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917802029 ASSESSOR INMWICU NUMBER NEAREST CROSS STREET WOODRUFF 5385-006-019 Al PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID J3 LOCALITY TEMPLE CITY F1 12OV, 15/208 BR CKTS 1 00 BR 17 40 TENANT TOTAL FEES 45 15 ISSUED ON PROCESSED BY PLAN BY PIRES OR 07/06/99 UT 01/02/00 OWNER TEL NO FINAL DATE F'HAL pl: 4=1,r� CODE YAMAGATA SHIGETO,KAYOKO (626) 265-5507 6018 OAK AV TEMP 917802029 MWIPTION OF WORK ELECTRICAL CIRCUIT FOR LAUNDRY ROOM APPLICANT TEL NO SANE AS OWNER SPECIAL CONDITIONS �p5 ANGELECONTRACTOR TEL NOS Cpp T APPROVALS DATE INSPECTOR SIUMTUKF— SAME AS OWNER - N y LIC NO TEMPORARY POWER POLE ARCHITECT ENGINEER TEL NO UFER GROUND LIC Nj0J MAIN TER LINE 111111ROUGH DUIT ROUGH WIRING UBLICIPLASTIC Y/N METAL Y/N UTILITY COMPANrlRffTM ,t. 9 46�rc Service That�ot REPORT ID DPR265 ROUTE TO BS0508