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Home My Public Portal About9634 OLIVE ST_Electrical__ A4, WORKERS'COMPENSATION DECLARATION 76A663 10/81 P. 4.��affir that I have a certificate of consent to self insure, CE-806G ;APPLICATION FOR ELECTRICAL PERMIT or ce%ficat�.of`Workers'Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec.3800,Lab.C.) Policy No. Company FOR APPLICANT TO FILL IN ADDRESS ❑ Certified copy is hereby furnished. New Residential Bldgs.& a $EACH NO. $ FEE E] Certified copy is filed with the county building inspection 1 &2-Family,Sq.Ft LOCALITY NEAREST J• / /�� department. ; Multi-family Sq.Ft. CROSS ST. �� <e L✓� G Date Applicant Residential Swimming Pools• 'OWNER OR .1 FIRM NAME /?J' /�/ CERTIFICATE OF EXEMPTION FROM WORKERS' ,} MAIL COMPENSATION INSURANCE Outlets:Re Light Sw. (f ��7 e�1me r f� ADDRESS (This section need not be completed if the work Involved by the First 20 CITY �, Tel.N � permit Is for one hundred dollars($100)or less.) Total No.. Additional PLANI certify that in the performance of the work for whic his permit Q� APPLICANT a/vly Cl is issued, I shall not employ any persoh in any, so as td become subject to the Workers'Compensafw Lighting Fixtures First 20 ADDRESS Additional Total No. CITY Tel.No. Date � Applica '"�— ' NOTICE TO APPLICANT: I r akm tis Certificate of Fixed Appliances Not Over 1 HP PERMIT P/ Exemption,.you should becom subject to the Workers'Compensation Range_ Heater D.W. APPLICANT 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 _ W.H. _ i CITY Tei. LICENSED CONTRACTORS DECLARATION Hood _ Fan. — Other_ /7�/f �, I hereby affirm that 1 am licensed under provisions of Chapter 9 Disp. — Room Air Cond. LICENSE OR Class (commencing with Section 7000)of Division 3 of the Business and I REG.NUMBER �Q� Professions Code,and my license is in full force and effect. Power Apparatus&Large Appliances DISTRICT NO. /� PROCE BY Size&Type HP,KW,KVA,or KVAR t/` `� Q License Number Lic.Class Up to 1 Incl. FINAL 8 Over 1 to 10 Incl. DATE J�� LIDATION Contractor Date j Over 10 to 50 Incl. C FINAL V� V ❑ I am exempt under Sec. I Over 50 to 100 Inc. BY, taJ B.&P.C.for this reason i Over 100 V N Date (Services,Swbd.,MCC&Panelboards ► Z 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. c 9 4 1, 0 A SINGLE FAMILY (Temp.Power Pole&Appurtenances # o b o 0 0 2 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law o for the following reason(Section 7031.5,Business and Professions Additional Sign Branch Circuits I o89.50 Code): _ ❑ 'Misc.Conduits&Conductors o 0 0 8 g 5 0 57 I,as owner of the property,will do the work'and the structure Q 1 8�;8 8 is not intended or offered for sale (Section 7044, Business Other(See.Complete Fee Schedule) and Professions Code). 0 /� /✓� •CONSTRUCTION LENDING AGENCY i 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.). PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address 1 certify that I have read this 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 County toter u on the above-mentioned property for i ion purpos SEE REVERSE FOR EXPLANATORY LANGUAGE i ature of Permittee Date , V�IOrm that COMPENSATION DECLARATION CE-806 10181 APPLICATION /�TION F ® ELECTRICAL PERMIT. I�ieby affirm that I have a certificate of consent to self CE-806G /"\IrI� /`i !� 1� G 1�1Q 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. Company FOR APPLICANT TO FILL IN JOB ADDRESS ®�� ® ✓e �� 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 tion department. Multi-family Sq. Ft. — NEAREST Residential Swimming PoolsCROSS ST. y ��J Date Applicant OWNER OR FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' OutMAIL lets: Rec LighT Sw._ 1 COMPENSATION INSURANCE ADDRESS (This need not be com lotod if the work involvod First 20 ( s section P b T Total No. Additional CITY Tel. No the pormtt is for one hundrad dollars($100)or loss.) I certify that in the performance of the work for which this PLAN CHECK APPLICANT permit 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 Date Applicant CITY Tel. No. NOTICE TO APPLICANT: if, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT Exemption, you should become subject to the Workers' Range_ Heater_D.W. _ APPLICANT Compensation provisions of the Labor Code, you must forth- Oven —Dryer _W.M.— ADDRESS 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 I hereby affirm that I am licensed under provisions of Chapter 9 Disp. _ Room Air Cond. REG. NUMBER Class. (commencing with Section 7000)of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NO. PR CE ED BY IL and Professions Code,and my license is in full force and effect. �`' O Size 6 Type HP, KW, KVA, or KVAR '�/ fJ�9 License Number Lic. Class Up to 1 Incl. FINAL DATE Over 1 to 10 Incl. VAILIDATIOP I' Contractor Date❑ Over 10 to 50 Incl. FINA 1.1 CL I am exempt under Sec. Over 50 to 100 Inc. BY � � U)B.BP.C. for this reason Over 100aZZ Z Date: Services, Swbd., MCC 8 Ponelb / 'r 0 -200 Amp. Under 600 V®—a ` i I'9 15 L 11-, Signature 201 - 1000 Amp. Under 600 V Over 1000 Amp. or Over 600 V ( o 02-550 Exemption for Reg. Maint. Elect. 0 0 0 SINGLE FAMILY =5 J Temp. Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 07,23—C6 1 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 Professions Code): I, as owner of the property, will do the work and the Misc. Conduits 8 Conductors structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)_ 7044, 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 TOTAL FEE above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and representatives of this County to enter upon tioned pro afo inspection purposes.�� SEE REbERSE FOR EXPLABdATORY LANGUAGE ,�e �—� 0" Tnature of Pe it Date If �ORKERS'COMPENSATION DECLARATION 76A663 10/81 APPLICATION FOR ELECTRICAL PERMIT 1'he offu9n that I have a certificate of consent to self CE-8066 ® Ooi'® !� insure, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec. 3800, Lob. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB �4 Certified copy is hereby furnished. NEACH NO. FEE ADDRESSWY ®ew Residential Bldgs. 8 Pools Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. $ — $ LOCALITY tion department. Multi-family Sq. Ff. — NEAREST CROSS ST. Date Applicant Residential Swimming Pools OWNER OR CERTIFICATE OF EXEMPTION FROM WORKERS' -�—Light FIRM NAME Outlets: Re Sw._ AIL COMPENSATION INSURANCE First 20 / � Q� ADDRESS � (This soction nood not bo complotod if tho work involvod by Total No. Additional _ i CITY Tel. Nqe� !. tho pormit is for ono hundrod dollars($100)or loss.) PLAN CHECK I certify that in the performance of the k for which this APPLICANT permit is issued, I shall not employ a rson in on nner so as to become subject to the rs'Compe Laws. Lighting Fixtures First 20 ADDRESS Total No. Additional Date / CITY Tel. No. NOTICE TO APPLIC If�ter making is Certificate of Fixed Appliances Not Over 1 HP PERMIT Exemption, you uId become subject to the Workers' Range_ Heater—D.W. _ APPLICANT Compensation provisions of the Labor Code, you must forth- Oven — Dryer _W.M.— ADDRESS with comply with such provisions or this permit shall be Top FAU —W.H. — deemed revoked. CITY Tel. No. LICENSED CONTRACTORS DECLARATION Hood _ Fan _Other— Room Air Cond. LICENSE OR 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 DISTRICT NO. P SED BY and Professions Code,and my license is in full force and effect. Power Apparatus 8 Large Appliances LL Size&Type HP, KW, KVA, or KVAR a License Number Lic. Class Up to 1 Incl. FINAL (te Contractor Date Over 1 to 10 Incl. DATE /<///-9 VALIDATION Ems- Over 10 to 50 Incl. FINA W I am exempt under Sec. Over 50 to 100 Inc. BY n_ B.&P.C. for this reason Over 100 Z Date: Services, Swbd., MCC&Ponejboardse2 0 -200 Amp. Under 600 V Z J Signature 201 - 1000 Amp. Under 600 V ;-',5 1 35 A ❑ Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V I� o o e o c SINGLE FAMILY Temp. Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION0 0 5 6,b O Sign with One Branch Circuit I hereby affirm that I exempt from the Contractor's License Additional Sign Branch Circuits o o - 66,507, Law for the followingg r reason (Section 7031.5, Business and Professions Code): 0 7.28-1- y 5 6 I, as owner of the property, will do the work and the Misc. Conduits&Conductors structure is not intended or offered for sale (Section a (S a Co ete Fe Sche�yJe)_ 7044, Business and Professions Code). ? l +� CONSTRUCTION LENDING AGENCY 'rte I hereby affirm that there is a construction lending agency forCA) figH' the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) (Sec. 3097, Civ C.). PLAN CHECKING FEE Q �. 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 jaws regulating Electrical wiring, and hereby author' a represen of this County to enter upon the ab entioned pr, r ert nspecfion purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of PerrKittee Date WORKERS'COMPENSATION DECLARATION 76-663 10181 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self CE-8066 {� insure, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY Iul or a certified copy thereof(Sec. 3600, Lab. C.) Policy No.—Company FOR APPLICANT TO FILL IN JOB r Certified copy is hereby furnished. EACH NO. FEE ADDRESS New Residential Bldgs. &Pools Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. $ — $ LOCALITY tion deportment. Multi-family Sq. Ft. — NEAREST Residential Swimming Pools CROSS ST. Date Applicant WNER OR FFIIRM NAME aG� CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Z Sw._ --yy MAIL COMPENSATION INSURANCE First 20 °/�`7 � ADDRESS (This soetion noed not ba eomplotod if the work lnvolvod by Total No._LL— CITY Tel. Na.?tho permit is for one hundred dollars($100)or less.) Additional I certify that in the performance of the work for which this PLAN C ECKAPPLICANT r permit 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 Z Additional Total No. CITY el. No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after ma ing t ertificate o APPLICANT Exemption, you should become subject to the Workers' Range_ Heater_D.W. Compensation provisions of the Labor Code, you must forth- Oven —Dryer _W.M.— ADDRESS 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 Room Air Cand. _ I hereby affirm that I am licensed under provisions of Chapter 9 Disp. REG. NUMBER-3:76 2Z-S Class. (commencing with Section 7000)of Division 3 of the Business power Apparatus&Large Appliances DISTRICT NO. P SSED BY and Professions Code,and my license is in full force and effect. CT . r Q Size&Type HP, KW, KVA, or KVAR License Number Lic. Class Up to 1 Incl. FINAL Over I to 10 Incl. VALIDATION DATE 0 Contracfor� �i�-- Date Over 10 to 50 Incl. ~L l FIN W I am exempt under Sec. Over 50 to 100 Inc. B n B.&P.C. for this reason Over 100 Z Date: Services, Swbd., MCC&Panelboards 0 -200 Amp. Under 600 V Signature ' 201 - 1000 Amp. Under 600 V ❑ Over 1000 Amp. or Over 600 V Exemption for Reg. Maint. ect. r r SINGLE FAMILY Temp. Power Pole&Appurtenances J 14 . Gh HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit u c c c o 2 1 hereby affirm that I am exempt from the Contractor's License it Branch s Additional Sign Brah Circu Law for the following reason (Section 7031.5, Business and o o G�,/'_J Professions Code): I, as owner of the property, will do the work and the Misc. Conduits&Conductors :: . 5 o o �(�r• ��,_-- structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)_ 7044, Business and Professions Code). G v is 6 CONSTRUCTION LENDING AGENCY 0 1 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 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 the a ove-mentioned ro rty for 7pection pu oses. ..� P SEE REVERSE FOR EXPLANATORY LANGUAGE t gnature of Per Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1103020027 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID' 1 FEES PAID I BUILDING ADDRESS: I 1 ON FILE I I 9634 OLIVE ST 1 I (FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:1 TEMP CA 917803249 1 (ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: TEMPLE CITY 1 18589-002-015 IAl PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY, Cl I IC2 SPAS, HOT TUBS, OTHR 1.00 SPA 54.50 1 I ITENANT: IG1 OUTLETS-LGT,SW,RECP 54.00 OUT 84.60 (ISSUED ON: PROCESSED BY: PLAN BY: 1 IG2 LIGHTING FIXTURES 16.00 LGT 31.00 103/02/11 SR 1 I 1LN OTHER PNL 0-399 AMPS 1.00 PAN 38.80 1 I IOWNER: TEL N0: I TOTAL FEES 236.70 1FINAL PATE FIN BY: CODE: I IHOCCOM LAWRENCE D CO TR HOCCOM TRUS - 19634 OLIVE ST I 1TEMP 917803249 I IbESCRIPTIONIOF WORK ITO FINALIZED EXPIRED PERMIA FOR ADDITION, SPA AND SUB-PANNELI I (APPLICANT: TEL IPFEIFFER, BRUCE L (626) 278-2187- 1409 78-2187- 1 409MEAADOW LN. i (SPECIAL CONDITIONS: IMONROI I (CONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE I IPFEIFFER, BRUCE (626) 446-5999- I I 1409 MEADOW LANE LIC. NO I ITEMPORARY POWER POLE I I I (MONROVIA, CA 91016 NONE UNDERGROUND CONDUIT I 1ARCHITECT OR ENGINEER- TEL. NO: 1 IUFER GROUND I I I I - LIC. NO: 1 IROUGH CONDUIT I I I I I I 1 I IROUGH WIRING I I I � I IMAIN WATER LINE I I I IPLASTIC YIN METAL YIN I I I (UTILITY COMPANY NOTIFIED( 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 I I I 1 I I I I I I I I I IREPORT ID: DPR265 ROUTE TO: BS0508 I I I I I I I I I