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Home My Public Portal About5535 ROSEMEAD BLVD_Electrical__ affirm that I have COMPENSATION DECLARATION 70AM DPW(12 91) APPLICATION FOR ELECTRICAL PERMIT 70401 1 hsrsD9 afllrm that I have a certificate of consent to self Insure or a certificate of Worker a Compensation Insurance or a certified COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV copy thereof(Sae 3800 Lab C) O No S�jd 12 company-MAAs 1 All"I'S ,04 FOR AtNR1CAKT TO s IN ADDRESS t+ Candled copy is hereby hmmhetl New Residential Bldgs 8 Pooh NO EACH FEE d ly Sq FI LOCALITY ❑ department Copy u Asad with the county,building Inapinspection1 8 2 Fertu n depenment Multi lertary NEAREST$q FI — CROSSST WR Data APpizium&TnGTQ1^ &t'Fi Residential Swimming Pools ASSESSOR ''''��yy CL MAP BOOK PAGE Pum CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec,=Light Sw y0 0 OMER OR NAME COMPENSATION INSURANCE F et 20 MNL W4 air two M1 Fr� (TRIS asMlon need not be completed If the work Involved by the Total No Additional / � N]ORESS I permit Is for one hundred dollars($100)or Is") w T I certify that In the performance of the work for which this permit CITY do LI e.Q,- ra No L9 is Issued I shall not employ any person In any manner so as to become subject to the Workers Compensation Laws Llphung Futures Fist 20 0 �' APPLOCAO4i PLANCNIrK Total No Add,2wow ADDRESS Date-Applicant NOTICE TO APPLICANT It alter making this Certificate of RESIDENTIAL APPLIANCES NOT OVER 3 HP CrtV 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 Power Apparatus 8 Large Appliances APPLICANT provisions or this permit shall be deemed revoked LICENSED CONTRACTORS DECLARATION Sae a Type HP KW KVA or KVAR ADDRESS I hereby affirm that 1 am licensed under provisions of Chapter 9 1';_ 0.3 to 10 lrld ' (commencing with Section 7000)of Dlvtelon 3 of the Business and /^ CrtV nI� ( Tel No LZ Professions Code and my license Is In lull force end effect Over 10 to 50 IW } Q Over 50 to 100 Intl G l,tUMFBER G'" a Lxame Number(Q7GL4—'T Va Class Over lDoO• D DISTRICT NO PRocE pBr Services Sad MCC A PanMboards -51 0 8 Q ConbaclorCbWgismJe, SO i<♦-Date x-31-CrS 0 3119 Amp Under Boo V ,3 ,30 O �, p ❑ I am exempt under Sec `400 1000 Amp Under 1100 V O &— VALIDATION W Over 1000 Amp or Over Boo V FINAL d B aP C for this reasonBY TA BRANCH CIRCUIT FEES Date ISA Or 20A 120V Lighting or Recept z I To 10 Branch Circuhs Signature11 To 40 Bran d Cansb a 2Yrs��W.oV � ❑ xmptlan la 41 Or Mars Branch Chants Fe * Reg Mount Elect ISA, 20BV To 277V Br Circuits SINGLE FAMILY Tamp Power Pole&Appunenerross HOME OWNER BUILDER DECLARATION Sign with One Branch Grcun TM 1 hereby affirm that I am exempt from the Contractor a License Law 2 11 Gtt� for the following reason (Section 7031 5 Business and Professions Adddomil Sign Branch Circuits Code) .'m ❑ 1 as owner of the property will do the work"d the structure Mae Condee u 8 Condt uctors 'inAwyy I 1�y5420.20 42 a 20 Is not intended or offered for sale (Section 7044 Business Other(See Compete Fee Schedule)_ , DECK 5420.20 and Professions Code) CONSTRUCTION LENDING AGENCY kyr .001 hereby affirm that there is a construction lending agency for the ONE performance of the work for which this permit Is Issued (Sec 3097 PERMIT FEE (Sub-Total) IO On, c) Larders Nemo (�V" ___�p 1 PLAN CHECKING FEE a / Q 000 -=1 8/31/95 PERMIT ISSUING FEE p� O Lander a Address TOTAL FEE 3�X00 (,Q 2132 1 N 4:11 I certify that I have read Ilan appbcabon and under penalty of purjury.lair that the above Information a correct I agree to comply with as County ordinances and State laws regulabrp Electrical wrong and hereby authorae representative of thus County to anter upon the abovamenhoned property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE rmuTluaa oP Pum DATE WORKER Save a c COMPENSATION DECLARATION 7 M DI'V.'(t2 81) APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I here a certificate of consent to self insure or•ceniicate of Worker a Compensation Insurance or a certified COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV copy thereof(Seo 3800 All C 1 ❑oi No Eby��37•C IJ��y—tli.Ln � con APvtrwKr TO Pu w I�ss Cenified copy is hereby furrusned ,` NO EACH FEE O New Ret Farull Bldgs 8 Poole _ S S LOCALITY v! CruUhedde"an b filed with we CouVdch fauN �,SgSFI FICCROSS SST Date Applcent Residential Swunmi g Pods ASSESSOR MAP BOOK PI of PARCELCERTIFICATE COMPF EXE PTTION IN NSUOutlets Fac _Light_Sw =ElL1ME (This section need not be completed It the work Involved by the Firer 20 A permit Is for one hundred dolbrs($100)or len) Total No AdcharW ADDRESS V I certify that in the performance of the work for which this permit CITY �� L ` Tet No Is Issued I shell not employ any person in any manner so as to become subject to the Workers Compensation Lew Lghdrlp FxhRrea Flier 20 HECK �A Total No Addnbnal Date Applicant ADDRESS NOTICE TO APPLICANT If after making this Certificate of RESIDENTIAL APPLIANCES NOT OVER 3 HP CITY TN W Exemption you should become subject to the Workers Comperaetlon OTHER APPLIANCES NOT OVER 3 HP prowemns of the Labor Code you must forthwith comply with such PERS \ provisions or this permit Mall be deemed revoked Power Apparatus 8 Large Appliances APPLICANT LICENSED CONTRACTORS DECLARATION Sax,8 Type HP KW KVA or KVAR ADDRESS ,O e O I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl fC (commenctng with Section 7000) of Division 3 of the Business and ^ q S Professions Code and my license is in full force and effect Over 10 to 50 Incl CITY �^. NTet ��77 .+e/^L Over 50 b 100 Incl RM NUMBER �/7 7 Cm. d License Number r1 77 r Lic Case C" 1 Over 100 MSTRICT NO By Services,Swed MCC 6 PanelOoartla ' �. {/ Q y,,,,,,,,d,,, _ Date ! 0 389 Amp UMW ego V w1E 0 ❑ 1 am exempt under Sac coo 1000 Amp r O er 800 V VAUDATTON W Over 1000 Amp or Over 800 V A SPC for dile reason G. BRANCH CIRCUIT FEE B y Date ISA or 20A 120V Lighting or Recept Z 1 To 10 Branch Cucab 6prmuia 11 To 40 Branch Cuaas ❑ Exern11 Of Mors Bracht Clrcints Exemption for Rep Maim Elect 154,20A 2D6V To 2744 Sr Cackle BINDLE FAMILY 2 Tena Power Pole 9 Appurtenants, HOME OWNER BUILDER e DECLARATION Contractor a License Lew Sign with One Branch Circuit ACCT.` I hereby affirm that I am exempt from the . L for the following reason (Section 7031 5 Business and Professions Addrxona)Sign Branch Circuits J.]I/./�}y1�] c W.60 Code) E] I as owner at the property will do the work and the structure Msec Conduits 8 Conductors TOTAL1 'T%5.60 Is not intended or offered for sale (Section 7044 Business Other(See Complete Fee Schedule)_ , and Professions Code) OECK cC Lis CONSTRUCTION LENDING AGENCY w�W I hereby affirm that there is a construction lending agency for the C .00 performance of the work for which this permit is issued (Sac 3097 PERMIT FEE (Sub-Total) Civ C) PUN CHECKING FEE 000D-=1 9nim LnrlMr•Name PERMIT ISSUING FEE 0 2403 1 AM 8142 LerWr a Address I cert8y,that I have reed true applsudlon and under penalty of purjury sate TOTAL FEE that the above information Is coned I agree to comply with all County ordinances and Stab laws regulating Elxaral unnrg and hereby eutharua rspresantewes ot b Coumy to enter upon the ebow-menWned property, lir ani zi SEE REVERSE FOR EXPLANATORY LANGUAGE Bq M MME TION WORKERS him a caSAcate DECLARATION to 761683 oAe, APPLICATION FOR ELECTRICAL PERMIT I MrebY affum that I I� a certdcate d torment to sect Insure �e0°O I 1 or a oenacate 4f Vilorkem Compensation Insurance or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY ILJI copy thereof(Sec.�38 Leh.G) Ploy No I D •' ro`tea Company ,_v�'/w l r FOR APPLICANT TO FILL IN JOB n_ ❑ Candied copy,m hereby lurnlat— f/f6 New Resdentml Bldgs d Pods EACH NO FEE ADDRESS N /CosL� Certified copy is filed with the county budding inspection 182-Famiy Sol Ft S = $ LOCALITY -ram L� rted Multi-fai Sq Ft NEAREST Orross ST Date 1 Residential Svnmming Pools =,:MOR Applicant FMI gAA/E /h CERTIFICATE OF E%EMPRON F RKEF13 k1AA COMPENSATION INSU Outlets Rec—Light —Sw =,EsS 6 (This potion nee not be completed If the wont Involved by the First 20 v permll Is for ons hundred dollars($100)or Iep) Total No Additional Tel NO 1 certify that in the performarce of the work for which that permd PLAN DECK 0 iesied I shall not employ any person in any manner so as to APPLICANT become eublect to the Nlrkera Compensation Lew$ Lighting Futures First 20 ADDRESS Total No Additional CITY Tel No Date Applicant NOTICE TO APPLICANT C after making this Certacete of Fixed Applancea Not Over 1 HP Exempton you should became subject to the Workers Compensation Range_ Hester_ DW _ zPL1_ cANTFe O S h v provisont of the Labor Code you must fordewdh comely with such Oven _ Dryer _ WM _ ADDRESS 3 / G�b p Zn, (N� .,,+ prorsons or tin permit ehdl be deemT ed revoked F _ LICENSED CONTRACTORS DECLARATION jtppd _ an _ Other— GTY A TelNo (c {//Y I hereby affirm that I aril licensed under provswnMap — oom or e of Chapter B DRAir Cd LICENSE ommencuq with Sector,7000)d DNson 3 a the Busneen and = HUMBER / Q Proles$ionm Code and my Ikense m in full force and effect Power Apparatus 8 Large Appliances uSrA%:T NO SEED BY 1 l ^ 3O Sao 6 Typo HP KW KVA or KVAR �/' D" t�� License NuLc Claes CA Up to 1 not FINAL / Over 1 to 10 Ind DATE ID _ [ VALATION Date O.er 10 to 60 Ind �l 131 am Sec Over 50 to 100 Inc FlNAL BY SAPC for reason Over 100 N Date Services Swbd MCC 8 Panelboards PON. eZ+ 0-200 Amp Under 800 V Srgnetere 201 - 1000 Arte Under 600 V ❑ Exempt.for Reg Maim Elect Over 1000 Amp or Over 600 V SINGLE FAMILY Temp Power Pole d Appurtenances, HOME OWNER-BUILDER DECLAR41ION2 1 hereby affum that I am exempt from the Contractor a License Lew Sign with One Branch Cucud A�y.� I`�; following reason(Section 7031 6 Business and Hdes0orut Additional Sign Branch Circuits AMA 65.65.60. ❑ I tee owner of the property,will and do the work athe structure Mao Conduits 8 Cordnctons 1 ITF11S a not intended or offered for sale (Section 7044 Business Otter(see Complete Fee Schedule) _ , � 65.60 and Piofeasons Code) CONSTRUCTION LENDING AGENCY OEC( 65.60 1 hereby affum that there te a construction ending agency for the �j ns�wurt pepeAvmance,d the work for which this penia m Issued(Sec 3087 PERMIT FEE (Sub-Total) Q W1770G .00 PLAN CHECKING FEE Lendara Name n OOOD-Ml 8/ 9/95 PERMIT ISSUING FEE pS Lender s Address 1750 1 AN MO 1 cerbly, that I have read the application and state that the above TOTAL FEE /o udorma(Ion Is correct I epee to coney vwth as County ordinances and State laws regulating Electrical wnnrig and hereby euthorhe reprepntat d ihm my to enter upon the above-mentioned properly 1 Iona — SEE REVERSE FOR EXPLANATORY LANGUAGE SigntwiLm o Date r COUNTY OF LOS ANGELES TEMPLE CITY N 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 IAS TUNAS EL 0508 1212120036 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 ERT LEGAL ID FEES PAID BUILDING ADDRESS IBK 105 PG 86 PC 9 5535 ROSEMEAD BL I FEE DESCRIPTION QUANTITY DOM AMOUNT TEMP CA 917801802 1ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET 5397-032-058 Al PERMIT ISSUANCE FEE 27 80 I THOMAS PAGE 596 GRID H4 LOCALITY TEMPLE CITY CAI F1 120V, 15/20A BR CKTS 2 00 BR 34 60 I 1 TENANT G1 OUTLETS-EGT,SW,RECP 2 00 OUT 4 00 ISSUED ON PROCESSED BY PLAN BY HOMETOWN BUFFET G2 LIGHTING FIXTURES 3 00 LOT 6 00 112/12/12 SR I I TOTAL FEES 72 40 1 I IOWNER TEL NO i IIFINAL DATE(�' � PBY CODE IBUPPSTS INC - I1020 DISCOVERY RD SAGAN MN 55121 I DESCRIPTION OF FORK fH I I 12 BRANCH CIRCUITS, 3 LIGHTING FIXTURES ANO 2 OUTLETS (APPLICANT TEL NO I I ISCHNIERE, STEVEN (951) 241-6876- 125251 ALESSANDRO BL ISPECIAL CONDITIONS I MORENO VALLEY 92553 I ICOK1TiACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE I ISD DEACON CORPORATION OF CALIFORNIA (949) 222-9060- 1 117681 MITCHELL NORTH SUITE 100 LIC NO IT04POPARY POWER POLE I II IIRVINR CA 92614 760475 I_ I (UNDERGROUND CONDUIT II I (ARCHITECT OR ENGINEER TEL NO - I IUFER GROUND ILIC NO I IROUGH CONDUIT IROUGH WIRING VT I I I IMAIN WATER LINE i I IPLASTIC Y/N METAL YIN (UTILITY COMPANY NOTIFIED I I I I I I J-1 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 II 1 I I I i I (REPORT ID DPR265 ROUTE TO BS0508 I I I I 1 I I I I