The URL can be used to link to this page

Home My Public Portal About4930 ROSEMEAD BLVD_Electrical__ s 76AS63 085 5A 7-51 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY � � �� COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMIT NO. ELECTRICIAN - RECEIVED BY READY FOR DATE ISSUED ADDRESS FIRST INSPECTION G �y yya CITY _J ti , TEL NO, COUNTY LICENSE'NO. - EXPIRES i"BUILDING PERMIT FEESADDRESS NUMBER EACH FEE LOCALITY LIGHT OUTLETS NEAREST RECEPTACLES CROSS ST. WALL SWITCHES g' _OWNER_ Q TOTAL OUTLETS 5c _ MAIL ELEC. RANGES 25 _ ADDRESS ELEC. HEATERS +i 25 .t CITY ' TEL. NO. f FIXTURES / 5 I HEREBY•ACKNOWLEDGE THAT I HAVE READ THIS MISC, APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS �y �F 4ND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT I POSSESS THE ABOVE VALID LOS _NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER NEW MvD. HP OVER INC. EACH OF THE RESIDENTIAL PR ERTY DESCRIBED ABOVE. %y 6 LESS $ .25 SIGNATURE RMIT EE %p 2 .513 PERMITTEE ___ 2 5 1'130 INSPECTIOW RECORD 5 is 1.50 is 50 2.50 SO 200 5.00 200 500 10.130 J 500 1000 15.00 Z OVER 1000 20.00 M.G. SET/FREQ. CHANGER-HP WELDERS•AC-KVA O GENERATORS - KW TRANSFORMERS - KVA _ TEMP. MOTORS (75% OF ORIG.) MOVED M17TORS (75% OF CRIS.) MISC. SIGNS NO. NO.TRANS. APPROVALS NO. NO. LAMPS FOR EACH PERMIT: DATE INSPECTOR'S NAME / WIRING $1.00 CONDUIT - -r— FIXTURES $1.00 I WIRING SUPPLEMENTARY .50 FIXTURES >.,POWER j! TOTAL FEE $� ` UTILITY CO.NOTIFIED CG�GGJJJJ FINALIry WORKERS'COMPENSAiTON DECLARATION 76A663 10/81 APPLICATION FOR ELECTRICAL PERMIT y a}firm that I have a certificate of consent to self insure, CE-806G I �ereb or a certificate 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 �gJOB rr /��o� X � ❑ Certified copy is hereby furnished. New Residential Bldgs.& Pools EACH NO. FEE ADDRESS ❑ 1 & 2-Family,Sq.Ft, $ _ $ LOCALITY Certified copy is filed with the county building inspection _ department. Multi-family Sq.Ft. NEAREST / S� CROSS ST. Date Applicant Residential Swimming Pools OWNER OR . NSU. NUv FIRM NAME Gf�rG%LHS! CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:'Rec Light — Sw. — MAIL 11.?5 U COMPENSATION INSURANCE ADDRESS completed if the work involved b the First 20 (This section need not be com p y Total No. Additional CITY �. 4 Tel.No.Z 6 permit is for one hundred dollars($100)or less.) PLAN CHECK I certify that in the performance of the work for which this,permit APPLICANT -is issued, I shall not employ,any,-person in any manner so as to become subject to the Workers'Compensation Lawsb Lighting Fixtures First 20 ADDRESS Additional Total Total No. CITY Tel.No. Date IfApplican Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT. If, after making this Certificate of APPLICANT Exemption,you should become subject to the Workers'Compensation Range_ Heater_ D.W. 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. _ CITY Tel.No. LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other_ I hereby affirm that I am licensed under provisions of Chapter 9LICENSE OR (commencing with Section 7000) of Division 3 of the Business and Disp. — Room Air Cond. REG.NUMBER Class. Professions Code,and my license is in full force and effect. Power Apparatus& Large Appliances DISTRICT NO. PROCESSED BY Size&Type HP,KW,KVA, or KVAR 6ZV 0 License Number Lic.Class Up to 1 Incl. FINAL U Over 1 to 10 Incl. n r DATE VALIDATION 0 Over 10 to 50 Incl. FIN O ContractoDate ❑ W I am exempt under Sec. Over 50 to 100 Inc. B Ov r 100 d• BAP.C. for this reason Date: �"1 r Services.Swbd., q C`g ane r s e , 0- 200 Amp.Under 600 V Signature E 201 - 1000 Amp.Under 600 V ❑ Over 1000 Amp. or Over 600 V Exemption for Reg.Maint.Elect. SINGLE FAMILY Temp. Power Pole& Appurtenances ;2 82 1.3 A HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law Additional Sign Branch Circuits o;0 0 0 0 2 for the following reason(Section 7031.5,Business and Professions Code):. A ° o25,50 o 0 I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors 0 2 5 5 0 is not intended or offered for sale (Section 7044, Business Other (See Complete Fee Schedule) , and Professions Code). p 27-87 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.). PLAN CHECKING FEE Lender's Name V d PERMIT ISSUING FEE. Lender's Address I 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 this County to enter upon the above-mentioned property foinspectiog purposes. Iw __� SEE REVERSE FOR EXPLANATORY LANGUAGE . . Signature of Permittee YY+'� Date WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self insure, 76A663 or a cgrtificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND D SAFETY DIV. copy thereof(Sec. 3800 cab.}C.-.,.)I�)�/'// ) ryA POIiC No. m l ,Jany �^—'�L� FOR APPLICANT TO FILL IN JOB ADDRESS _ C? �lJ r CeYtified copy is hereby furnished. /V/7 New Residential Bldgs.&Pools NO. EACH FEE ❑ — _ $ $ LOCALITY Certified co is filed with the count building inspection 1&2-Family,Sq.Ft. PY Y 9 P — NEAREST department. Multi-family Sq.Ft. CROSS ST. Date Residential Swimming Pools ASSESSOR Applicant '22— - MAP BOOK PAGE d ��"� PARCEL 14e::1 CERTIFICATE OF EXEMPTI N FROM WORKERS' Outlets:Rec. Light—/_Sw.L 3 OWNER OR COMPENSATION INSURANCE G FIRM NAME / --� First 20 MAIL r � n _ (This section need not be completed if the work involved by the ADDRESS (�/ �G�� permit is for one hundred dollars($100)or less.) Total No. Additional 1 certify that in the performance of the work for which this permit CITY Tel.No. 4= is issued, I shall not employ any person in any manner so as tor/(� �Q PLAN CHECK O become subject to the Workers'Compensation Laws.; Lighting Fixtures First 20 �'a / 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 provisioris 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. r (commencing with Section 7000) of Division 3 of the Business and CITY Tel.No. 3;w4 . Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. LICENSE } Over 50 to 100 Incl. REG.NUMBB ER 2 Class. 0- Over Over 100 DISTRICT NO. PRO ESSED BY Q License Number !/!/ Lic.Class �t 7 Services, �Sp�d.,MCC&Panelboards r� 4r �v cc Contractor - Date 'ZL O 399 Amp.Under 600 V DATE ❑ la exempt under Sec. 400-1000 Amp.Under 600 V r} ~ VALIDATION Over 1000 Amp.or Over 600 V FINAL W B.&P.C.for this reasonBRANCH CIRCUIT FEES BY CD Date: 15A,or 20A,120V,Lighting or Recept. Z_ 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits El 41 Or More Branch Circuits = Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits SINGLE FAMILY Temp.Power Pole&Appurtenances (; ; na HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 7/ I hereby affirm that I am exempt from the Contractor's License Law , 1- .y.,, _t for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits Code): 1 � := ❑ 5 Conduits&Conductors --.r•• ' I, as owner of the property,will do the work and the structure Misc. _ :e -•( >< � � '_. __a is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) I I . _._ and Professions Code). (_ ;:`•; ;` n +' CONSTRUCTION LENDING AGENCY �' - .. '•:�F�I�t3 0.0 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) �� g Civ. C.) PLAN CHECKING FEE s09/x-1 -'1 Lender's Name i / _;( i Ai'; 9:03 PERMIT ISSUING FEE �!A 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-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE C� -If SIGNATr OF PERMITTEE DATE COUNTY OF LOS ANGELES TEMPLE CITY -# 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0509140001 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: ON FILE 4930 ROSEMEAD BL FPERMIT N: QUANTITY: UOM: AMOUNT: SGAB CA 917762203 ASSESSOR INFORMATION NUMBER: - NEAREST CROSS STREET: PENTLAND 5388-021-003 ANCE FEE 27.75 THOMAS PAGE: 596GRID: H5 LOCALITY: TEMPLE CITY, C ELS, MCC 1.00 PAN 38.85 TENANT: TOTAL FEES 66.60 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 09/14/05 JK 03/13/06 OWNER: TEL. NO: FINAL A FINAL BY: CODE: CHI LAP YIM (626) 287-1698- 4930 ROSEMEAD BL -.z- SGAB 917762203 DESC TIO OF WORK UPGRADE S VICE METER 200 AMP APPLICANT: TEL. NO: TAO ELECTRICAL CO (626) 318-4718- 833 DUARTE ROAD SPECIAL CONDITIONS: ARCADIA, CA 91780 _ CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE TAO ELECTRICAL CO (626) 318-4718- , 833 DUARTE ROAD LIC. NO TEMPORARY POWER POLE - ARCADIA, CA 91077 773868C-10 UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: UFER GROUND LIC. NO: ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED REPORT ID: DPR265 ROUTE TO: BS0506 -