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Home My Public Portal About9707 RICHMOND WAY_Electrical__ 'WC�RKER6'COMPENSATION DECLARATION CEA8�06G 10/81 ��p B��j ®�pl ®gpy ELECTRICAL PERMIT I heftby'aftirin that I hove a certificate of consent to self L� fl I]Cl Ili EL C C 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.55U115 3lalND FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE ADDRESS 976f RIS MY I &2-Family, Ft. 7ti3(1 LOCALITY Certified copy is filed with the county building inspec- Y� Sq. $ — $ CI'I.'Y tion department. Multi-family Sq. Ft. — NEAREST CROSS ST. Date 12-1-86 Applican%TEM'S Rf.FY'RW2TC• Residential Swimming Pools OWNER OR FIRM NAME QIIAW DEW ILIMEW CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw._ MAIL COMPENSATION INSURANCE First 20 ADDRESS 2035 MEME (This section need not be completed If the work Involved by Total No. Additional CITY Tei. No.359-3211 _ the permit Is for one hundred dollars($1100)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 Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS Total No. Additional Date Applicant CITY Tel. No. Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT ass T''r. rRTC INC. 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. — 3876 DMUM Rn- deemed revoked. Hood _ Fan _Other_ CITY RATDWM PARR Tel. No. 38-2558 3 LICENSED CONTRACTORS DECLARATION LICENSE OR Disp. _ Room Air Cond. Class I hereby affirm that I am licensed under provisions of Chapter 9 REG.NUMBER (commencing CA a with Section 7000 of Division 3 of the Business ) Power Apparatus&Large Appliances DISTRICT NO. PROCES D Y D_ and Professions Code,and my license is in full force and effect. `,� O Size&Type HP, KW, KVA, or KVAR r v U License Number 259475 Lic. Class C-10 Up to 1 Incl. FINAL Over 1 to 10 Incl. DATE VALID ON ❑ Contractor s Date 12 1 96- Over 10 to 50 Incl. FI V L�i�j I am exempt under Sec. Over 50 to 100 Inc. B D: B.&P.C. for this reason Over 100 0 Services, Swbd., MCC&Panelboards Date: 0 -200 Amp. Under 600 V ' Signature 201 - 1000 Amp. Under 600 V #?6 1, 7.2 2 ❑ Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V I ° ° 7244 SINGLE FAMILY Temp. Power Pole&Appurtenances - 72445 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits 1224-86 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 F-1 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) 61 9 (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE 1O 5 Lender's Address I certify that I have read this application and state that the TOTAL FEE 72.4 above information is c rect. I agree to comply with all County ordinances and Stat I ws regulating Electrical wiring, and hereby t orize re a ntotives of this County to enter upon the a -mentio ropert for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE /? --e 5'7b_ Signature of Permittee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1110040023 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: I FEES PAID I BUILDING ADDRESS: ITR: 43189 IT: 17 I 1 9707 RICHMOND WY I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:1 TEMP CA 917803932 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 18589-019-051 IAl PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: A5 LOCALITY: TEMPLE CITY, Cl I G1 OUTLETS-LGT,SW,RECP 16.00 OUT 31.00 1 1 (TENANT: ILIGHTING FIXTURES 1090 110/041 3HP 18.00 OVE 34.90 � ON: PROCESSED BY: PLAN BY: H1 OVEN 1 SR [H2 RES GRBG DISP LT 3HP 1.00 DIS 10.90 1 1 (OWNER: TEL. NO: 1H3 RES DISHWASHR LT 3HP 1.00 DIS 10.90 IFINAL DATE FINAL BY: CODE: 1 IKERSHAW, ALLAN - IH4 RES RANGE HDS LT 3HP 1.00 HOO 10.90 1 1 19707 RICHMOND WA 1 TOTAL FEES 137.30 1 /I� 1 ITEMP 917803932 1 IDESCRIPTION OF WORK 1 I (ELECTRICAL FOR INTERIOR REMODEL 1 1APPLICANT: TEL. NO: I 1 1HYLTON, DONALD (626) 938-1595- 1 1 1 1228 E. BADILLO ST. 1 ISPECIAL CONDITIONS: COVINA, CA 91723 1 1 I I ICONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE 1 1PROTECH CONSTRUCTION (626) 359-8283- 1 1 1 111626 GOLDRING ROAD LIC. NO 1 ITEMPORARY POWER POLE I I I ARCADIA, CA 91006 452024 B * 1 I (UNDERGROUND CONDUIT I I I ARCHITECT OR ENGINEER: TEL. NO: 1 JUFER GROUND I I 1 (ANDERSON, BRUCE (626) 938-1595- 1 1 I 1 1 1228 E. BADILLO ST. LIC. NO: I IROUGH CONDUIT I I 1COVINA, CA 91723 3341 I I A I IAW WIRING Y`\ AZA le, L-1-11 ' 1 1 I [MAIN WATER LINE ' 1 1 IPLASTIC YIN METAL YIN 1 1 I 1 I (UTILITY COMPANY NOTIFIED( I I I 1 1 I 1 1 I 1 1 1 1 1 1 1 1 I 1 1 I I 1 1 I 1 I I I 1 1 1 1* ADDITIONAL DATA ON FILE I I I 1 I 1 1 1 I 1 1 I 1 1 1REPORT ID: DPR265 ROUTE TO: BS0508 I 1 1 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1109220030 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: ITR: 43189 LT: 17 ! 9707 RICHMOND WY (FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803932 ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 8589-019-051 JAI PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 597 GRID: A5 LOCALITY: TEMPLE CITY, Cl ILA 100 AMP PANELS, MCC 1.00 PAN 38.80 TENANT: I TOTAL FEES 66.60 (ISSUED ON: PROCESSED BY: PLAN BY: 109/22/11 SR ' OWNER: TEL. NO: �F pATB� FINAL BY: CODE: KERSHAW LEONA L - I � 9707 RICHMOND WA IA TEMP 917803932DESCRIPTION OF WORK INSTALL TEMP POWER PLUG-IN ADAPTER (PIGGY BACK) METER APPLICANT: TEL. NO: ) �JD DENWIDDIE ELECTRIC (714) 827-3391- SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: JAPPROVALS DATE INSPECTOR SIGNATURE JJD DINWIDDIE ELECTRIC (714) 827-3391- 16220 SAN RAMON WAY LIC. NO ITEMPORARY POWER POLE BUENA PARK CA 90620 637722 C10 UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: I IUFER GROUND LIC. NO: IROUGH CONDUIT (ROUGH WIRING MAIN WATER LINE PLASTIC YIN METAL YIN UTILITY COMPANY NOTIFIED I REPORT ID: DPR265 ROUTE TO: BS0508 I i