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Home My Public Portal About5797 ROSEMEAD BLVD_Electrical__ WORKERS'COMPENSATION DECLARATION 78-883 10/81 LL,APPA ICATION FOR ELECTRICAL PERMIT I.hereby affirm that I have a Certificate of consent to self insure, CE-806G APPLICATION Al or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY 1u' copy thereof(Sec.380/ Comp 0, Policy No. ' mg- D O �� <'� '7�-f.rin FOR APPLICANT To FILL IN JOB ADDRESS sQ �� p T any ❑ Certified copy is hereby furnished. New Residential Bldgs.&Pools EACH NO. FEE 1577 L y� 1 &2-Family,Sq.Ft: $ _ $ LOCALITY �� l Certified copy is filed with the county building inspection. department. Multi-family Sq.Ft. NEARESTCROSS ST. —A S- 141410k DateJ2-:: 0 2--Applicant;r-ru4 t%M.s Residential.Swimming Pools 1 ' ' FOWNER OR IRM NAME fi\ L L . CERTIFICATE OF EXEMPTION FROM WORKERS' -MAIL COMPENSATION INSURANCE Outlets:Rec—Light_Sw.-- 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 G_ Tel.No. IL l`23 1 certify that in the performance of the work.for which this permit i PAPP ICANT K 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 Ave_ e_ Additional Total No. CITY S H� Tel,N SZ Date .Applicant Fixed Appliances Not Over'1 HP PERMIT 1i NOTICE TO. APPLICANT. If, after making this Certificate of APPLICANT A v k Exemption,you should become subject to the Workers'Compensation Range_ Heater D.W. _ provigioris of the Labor Code,you must forthwith comply with such Oven Dryer_ W.M._ ADDRESS provisions or this. shall be deemed revoked. I: Top FAU W.H. _ CITYS` (-ttwfO_ Tel.No. LICENSED CONTRACTORS DECLARATION .Hood — Fan Other_ �1 I hereby affirm that I Arn licensed under provisions of Chapter 9LICENSE OR ,I Disp. Room Air Cond. REG:NUMBER T Class• (commencing with Section 7000)of Division•3 of the Business and Professions Code,and'my license is in full force and effect. power Apparatus&Large Appliances DISTRICT NO. I P OC SSED BY lJ. Size&Type HP,KW,KVA,or KVAR License Number v" ' Lic.Class Up to 1 Incl. FINAL C� Over 1 to 10 Incl. DATE _ � f VALIDATION � Contractor Y �' Date i L Over 10 to 50 Incl. FINAL I am exempt under Sec. Over 50 to 100 Inc. BY W 00 ILI B.&P.C.for this reason Over 1. • N Services,Swbd.,MCC&Panelboards ® 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.Maint.Elect. SINGLE FAMILY Temp.Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law i Circuts for the following reason(Section 7031.5,Business and Professions Additional Sign Branch +rt Code): 1'- MISC.Conduits&Conductors ❑ I,as owner of the property,will do the work and the structure is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) "E'r apoll. nd Professions Code). - Imo`- , = �, 70 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency fog the - performance of the work for which this permit is issued(Sec.3097,. PERMIT FEE (Sub-Total) s- Civ.C.). PLAN CHECKING FEE _ Lender's Name � PERMIT ISSUING FEE Lender's Address A.` 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 p ty for insp flon p poses. SEER RSE FO E PLANATORY GUAGE U� ul' NAtt'V _ Signature of Permittee Date WORKERS'COMPENSATION DECLARATION. 76A663 10/81 'APPLICATION FOR ELECTRICAL PERMIT, I hsreby affirm that I have a certificate of consent to self insure, CE-806G or a certificate of"Workers' Compensation Insurance, or a certified COUNTY OF,LOS ANGELESBUILDING AND SAFETY copy thereof(Sec.3800,Lab.C.) Policy No. Company FOR APPLICANTTO FILL IN JOB ❑ Certified copy is hereby furnished. EACH NO. FEE ADDRESS 0 It o. O � 4 & New Residential Bldgs: Pools $ _ $ LOCALITY /( (�f ❑ Certified copy Is filed with the county building inspection 1 &2-Family,Sq.Ft: - — department. Multi-family Sq.Ft. NEAREST CROSS ST. Date Applicant ` Residential Swimming Pools OWNER OR qdrFIRM NAME. rC7/ '/ CERTIFICATE OF EXEMPTION FROM WORKERS' � � MAIL COMPENSATION INSURANCE Outlets:Rec LightSw. ADDRESS "L/ —z�Axro+ � %t ./3 �� o (This section need not be completed if the work involved by the First ion CITY ,� Tel.No. permit Is for one hundred dollars($100)or less.) Total No. - Additional O�C�C'/y!F'�[/ CHECKPLAN I certify that in the performance of the work for which this permit APPLICANT is issued, I shall not.employ any person .in any manna so as to become'subject to the Workers'Compensatio Laws. Lighting Fixtures First 20 ADDRESS c Total No. Additional CITY Tel.,No., , Date�d�� '�� Applicant �' Fixed Appliances of Over 1 HP PERMIT l NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT ` ` rel. Exemption,you should become subject to the Workers'Compensation Range_ Heater— D.W. — provisions bf the Labor Code,you must forthwith comply with such Oven — Dryer— W.M.— ` ' ADDRESS ' War— 10joGlly-ry .fes je provisions or this permit shall be deemed revoked. j Top — FAU — W.H. — LICENSED CONTRACTORS DECLARATION CITY �� /+ud G Tel.No.; Hood — Fan Other— I hereby affirm that I am licensed under provisions of Chapter 9 LICENSE OR Disp. — Room Air Cond. REG.NUMBER Class (commencing with Section 7000)of Division 3 of the.Business and Professions Code,and my license is in full force and effect. PDISTRICT No. P SSED BY . ower Apparatus B,Large Appliances i Size&Type HP,KW,KVA.,or KVAR ./G1 0, License Number Lic.Clas> G l D Up to 1 Incl. FINAL V ev` �� 1 « Date Over 1 to 10 Incl: DATE l Z g.' VALIDATION Cbritractor pJ Over 10 to 50 Incl. FINAL 0 ❑ I am exempt under Sec. 2.3 Over 50 to 100 Inc. BY / W B&P.C.for this reason Over 100 `✓ Services,Swbd.,MCC&Panelboards , Z D e: 0-200 Amp.Under 600 V Signature 1 201 - 1000 Amp.Under 600 V Over 1000 Amp.or Over 600 V ❑ Exemption for Reg.Maint.Elect. SINGLE FAMILY Temp.Power Pole&Appurtenances 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 for the following reason(Section 7031.5,Business and Professions = Code): + �._''�.:. "T.s 7 Misc.Conduits&Conductors ❑ I,as owner of the property;will do the work and the structure Complete Fee Schedule is not intended or offered for sale (Section 7044, Business Pther(See ► and Professions Code). . �'�� - �' 4' -r 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(Seo.3097, PERMIT FEE (Sub-Total) a Civ.C:). PLAN CHECKING FEE ` Lender's Name PERMIT ISSUING FEE ;�?i' AN '; - � r Lender's Address I certify that I have read this application and state that the above TOTAL FEE I 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. ;6L,' ,t •.�a•` ` '` SEE REVERSE FOR EXPLANATORY LANGUAGE 611`llD�4 y„ Signature of Permittee Date .d 11 1 I.N 1 V i S f b?, A, COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0709110003 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: ON FILE I 5797 ROSEMEAD BL FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 91780 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: LAS TUNAS 5397-012-043 jA1 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: GRID: LOCALITY: TEMPLE CIYT, Cl lG1 OUTLETS-LGT,SW,RECP 15.00 OUT 29.25 ITENANT: TOTAL FEES 57.00 JISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: YAO KELVIN 09/11/07 SR 03/09/08 OWNER: TEL. NO: IFINAL DATE FIN CODE: IYAO, KELVIN (626) 215-7999- 15797 ROSEMEAD BLVD. TEMPLE CITY CA 91780 1 IDIEStRIPTION OF WORK TENANT IMPROVEMENT ELECTRICAL 15 OUTLETS APPLICANT: TEL. NO: jWU (626) 524-3164- 14205 E. LIVE OAK AVE + SPECIAL CONDITIONS: IARCADIA, CA 91006 CONTRACTOR: TEL. NO: JAPPROVALS DATE INSPECTOR SIGNATURE ICASTLINK ARCHITECTURAL GROUP (626) 461-0566- 1 217 SOUTH FIRST AVENUE LIC. NO ITEMPORARY POWER POLE JARCADIA CA 91006 677550 C36 *� (UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: JUFER GROUND jWU, JACK (626) 524-3164- 1 4205 E. LIVE OAK AVE. LIC. NO: IROUGH CONDUIT �ARCADIA, CA 91006 C21951 ROUGH WIRING MAIN WATER LINE PLASTIC Y/N METAL YIN UTILITY COMPANY NOTIFIED 1* ADDITIONAL DATA ON FILE (REPORT ID: DPR265 ROUTE TO: BS0508 _ r COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0710170025 'BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: I FEES PAID BUILDING ADDRESS: I I ON FILE 1 I 5797 ROSEMEAD BL 1 IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT:1 TEMP CA 91780 I (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: I 15397-012-043 1A1 PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY, Cl 1 1K1 SIGNS, OUTLINE LGT 1.00 SIG 38.85 1 (TENANT: I TOTAL FEES 66.60 (ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: IREGAL COSMETICS INC. 1 110/17/07 SR 04/14/08 (OWNER: TEL. NO: 1 (FINAL DATE m Y: CODE: 1 3709 CALAC INVESTMENT 1 I I� n I ISAN DIEGO, CA9211137 I IDESCRIPTION OF WORK I I I (ILLUMINATED CHANNEL LETTER 1 (APPLICANT: TEL. NO: I I I IJ & H SIGN INC. (626) 448-1166- 1 1 19441 VALLEY BLVD. I ISPECIAL CONDITIONS: IROSEMEAD, CA 91770 1 1 1CONTRACTOR: TEL. N0: 1APPROVALS DATE INSPECTOR SIGNATURE I IJ AND H SIGN (626) 448-1166- I 1 I 19441 VALLEY BLVD. LIC. NO ITEMPORARY POWER POLE I I I IROSEMEAD, CA 91770 873439 C45 1 1 1-1 I I I (UNDERGROUND CONDUIT I I 1 (ARCHITECT OR ENGINEER: TEL. NO: I 1UFER GROUND I I I LIC. NO: I IROUGH CONDUIT I I I IROUGH WIRING IMAIN WATER LINE I I 1 I I 1PLASTIC Y/N METAL Y/N I I 1 I I 1UTILITY COMPANY NOTIFIEDI I 1 I I I I I I 1 I I I I I 1 i I I i i I I I I I I I IREPORT ID: DPR265 ROUTE TO: BS0508 I I I I I I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0907200027 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: [LEGAL ID: I FEES PAID I BUILDING ADDRESS: [ [ ON FILE [ [ 5797 ROSEMEAD BL [ IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:[ TEMP CA 91780 [ [ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 15397-012-043 1A1 PERMIT ISSUANCE FEE 27.75 [ THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY, Cl I 1K1 SIGNS, OUTLINE LGT 1.00 SIG 38.85 [ [ [TENANT: I TOTAL FEES 66.60 [ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 1 107/20/09 SR 07/20/10 [OWNER: TEL. NO: [ IFINAL DAT FINAL BY: CODE: [ 1LEW, SUSAN (858) 565-8333- [ 1 [ 5797 ROSEMEAD BLVD. ITEMPLE CITY CA 91780 [ IDE RIPTION OF WORK I I [ [ELECTRICAL OR WALL SIGN I 1APPLICANT: TEL. NO: [ [ I IFARGO ADVERTISING, INC. (626) 733-2960- 1 12213 SASTRE AVE. [ ISPECIAL CONDITIONS: IS. EL MONTE CA 91733 1 I I I I I I CONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE 1 FARGO ADVERTISING, INC. (626) 733-2960- I 1 I 12213 SASTRE AVE. LIC. NO 1 ITEMPORARY POWER POLE I I [ IS. EL MONTE, CA 91733 932785 C45 [ I 1 I I I (UNDERGROUND CONDUIT I I I 1ARCHITECT OR ENGINEER: TEL. NO: 1 1UFER GROUND I I I [ LIC. NO: I 1ROUGH CONDUIT IROUGH WIRING I 1 I 1 IMAIN WATER LINE 1 I I I 1PLASTIC YIN METAL YIN 1 I I I I (UTILITY COMPANY NOTIFIED[ I I I I I I 1 I I I I 1 I I I I I I I I I I I I 1 I I I I I I IREPORT ID: DPR265 ROUTE TO: BS0508 I I I I I I I I I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0303050026 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PALO BUILDING ADDRESS: ON FILE 5797 ROSEMEAD BL FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 91780 ASSESSOR IN 0 0 NEAREST CROSS STREET: LAS TUNAS 5397-012-043 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY K1 SIGNS, OUTLINE LGT 1.00 SIG 38.85 TENANT:- TOTAL FEES 66.60 ISSUED 0 0 : PLAN B EXPIRES 0 : NINA CHAN 03/05/03 JK 09/01/03 OWNER: TEL. N0: FINA TFC ® NA BY: CODE: CALAC INVESTMENT (626) 292-6638- 3709 CONVEY ST 0300 SAN DIEGO, CA9211137Y OWORK ILLUMINATED CHANNEL LETTER SIGN APPLICANT: TEL. NO: CHRISTINA YU (626) 444-8181- 2812 PECK RD SPECIAL CONDITIONS: EL MONTE 91731 CONTRACTOR: TEL. NO: APPROVALS DATE I SPECTOR SIGNATURE SUCCESS SIGN PRINTING INC. (626) 444-8181- 2812 PECK RD LIC. NO TEMPORARY POWER EL MONTE CA 91731 739177C45 UNDERGROUND CONDUIT ARCHITECT O ENGINEER: 0: UFER GROUND LIC. NO: ROUGH CONDUIT ROUGH RI G MAIN WATER LINE PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED' REPORT ID: DPR265 ROUTE TO: BS0508