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Home My Public Portal About5807 ROSEMEAD BLVD_Electrical__ ' WORKERS'COMPENSATION DECLARATION 7&AM9DPW 3/87 APPLICATION FOR ELECTRICAL PERMIT O I hereby affirrn, that I have a certificate of consent to self ,cl¢�soa3G insure. or a certificate of Workers'Compensation Insurance,. COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or o,certified cop there f(Sec. 3800, Lab. C.)) Policy No. />��Company <T�L �; FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished. rNewResidential Bldgs. &Pools EACH NO. FEE ADDRESSCertified copy is filed with the county buildin Inspec- mily, Sq. Ft. $ $ LOCALITY tion depart mily Sq. Ft. NEAREST Residential Swimming Pools NEARSCROSS ST. Date 2 .Applicant OWNER OR FIRM NAME r L( CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw._ MAIL COMPENSATION INSURANCE First 20 ADDRESS (This•section need not be completed if the work involved by Total No. Additional CIN ^Z'�-/I// Tel. N the permit is for one hundred dollars($100)or less.) I certify that in the performance of the work for which this PLAN CHECK NT permit is issued, I shall not employ any person in any manner Lighting Fixtures First 20 ADDRESS so as to become subject to the Workers'Compensation Laws. Date Applicant Additional Total No. CITY Tel. No. Fixed Appliances Not Over 1 HP PERMIT �j�/ NOTICE TO APPLICANT: If, after making this Certificate of APPLICATION T/,-e/�G� 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 1,-5-1346 G7, with comply with such provisions or this permit shall be Top — FAU —W.H. — /�, �,�T deemed revoked. Hood — Fan —Other— CITY G (T•'el. N LICENSED CONTRACTORS DECLARATION LICENSE OR Disp. _ Room Air Cond. — v�� Class. I hereby affirm that I am licensed under provisions of Chapter 9 REG. NUMBER (commencing with Section 7000)of Division 3 of the Business Power Apparatus&Large Appliances DISTRICT NO. PROCE and Professions Code,and hnse is in full force and effe t 0 O e—� Size&Type HP, KW, KVA, or KVAR License Number Lic. Class Up to 1 Incl. FINAL U f� Over 1 to 10 Incl. DATE / `2 VALIDATION 0 Contractor `Date Over 10 to 50 Incl. �! F- ❑ FINAL U I am exempt under Sec. Over 50 to 100 Inc. BY W B.&P.C. for this reason Over 100 1d ® Z Services, Swbd., MCC&Panelboards D te: 0-200 Amp. Under 600 V Z Signature a 201 - 1000 Amp. Under 600 V Over 1000 Amp. or Over 600 V Exemption for Reg. Maint. Elect. SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Temp. Power Pole 8 Appurtenances I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuitu; • j : Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits _ Professions Code): 3.:A0r `fie 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, Other(See Complete Fee Schedule)_ Business and Professions Code). - CONSTRUCTION LENDING AGENCY ': k:'••:'r 5? I hereby affirm that there is a construction lending agency for t'H.6 07 the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). Lender's Name PLAN CHECKING FEE 24.1 Lender's Address PERMIT ISSUING FEE �•69�' I certify that I have read this application and state that the TOTAL.FEE aboveinformation is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize representative§of this County to enter upon the above-men on roperty Ar inspection purpose SEE REVERSE FOR EXPLANATORY LANGUAGE ®s Signature of Permittee ate WORKER'S COMPENSATION DECLARATION 20-00:19 DPW 9/89 I hereby affirm that I have a certificate of consent to self Insure, 7BA663 APPLICATION FOR ELECTRICAL PERMIT or a certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec.3800 Lab.C.) Policy No. O&Jt<oe.2 12Company FOR APPLICANT TO FILL IN ADDRESS ._ ff I►� JOB ❑ Certified copy is hereby furnished. New Residential Bldgs.&Pools EACH NO. FEE $ _. $ LOCALITY ❑ Certified copy Is filed with the county building inspection 1&2-Family,Sq,Ft. NEARF od�epartment. Multi-family Sq.Ft. — CROSS ST. Date T / Z —Applicant � Residential Swimming Pools ASSESSOR MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec.—9LITht Sw. OWNER OR COMPENSATION INSURANCE 0Oa FIRM NAMEr � First'20 AIL .(This section need not be completed if the work Involved by the Total No. Additional -� •ADDRESS�•0 permit Is for one hundred'dollars($100)or less.) I certify that in the performance of the work for which this permit CITVY Is issued, I shall not employ any person in any manner so as to PLAN CHECK become subject to the Workers'Compensation Laws. Lighting Fixtures 2 First 20 APPLICANT Total No. ✓ Additional b ADDRESS Date Applicant 15 OR 20A,120V BRANCH CIRCUITS NOTICE TO APPLICANT:. If, after making this Certificate of CITY Tel.No. Exemption,you should become subject to the Workers'Compensation 1 TO 10 INCLUSIVE EACH• provisions of the Labor Code,you must forthwith comply with such 11 TO 40 INCLUSIVE EACH APPLICCANTy` t.l lti provisions or this permit shall be deemed revoked. 4.1 OR MORE BRANCH CIRCUITS EACH >_ LICENSED CONTRACTORS DECLARATION ADDRESS -4— - a I hereby affirm that I'am licensed under provisions of Chapter 9 15 OR 20A,208V TO 277V LIGHTING EACH (commencing with Section 7000):of Division 3 of the Business and CITY Te..No: G� V Professions Code,and my license.is in full force and effect. RESIDENTIAL APPLIANCES UP TO SHPLICENSE OR Class Q Power'Apparatus&Large Appliances REG.NUMBER License Number Lic.Class Size&Type HP,KW,KVA,or KVAR DISTRICT No. f� POO C SED BY 0 Up to 3 Incl. V-4;- 119 e' W ��- �]A.l�)�A Date Over 3 to 10 Incl. FINAL d Contractor❑ Over 10 to 50 Incl. DATE CO)z Z I am exempt under Sec: Over 50 to 100 Incl. VALIDATION Z� VALIDATION O100 BY AL Over Dater B.&P.C.for this reason- �! Services,Swbd.,MCC A Panelboards 0-200 Amp.Under 800 V Signature -S . 201-1000 Amp.Under 600 V � ❑ Over 1000 Amp.or Over 000 V Exemption for Reg.Maim.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 ae":� it J, for the following reason(Section 7031.5, Business and Professions Additional Sign Branch Circuits �' Code): t '} ❑ I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors Is not Intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule) and Professions Code). , T•ji CONSTRUCTION LENDING AGENCY �; � o i ( I hereby,affirm that there is a construction lending agency for the H1 performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total) Civ.C.) PLAN CHECKING FEEs_.«l 4 f Lender's Name , PERMIT ISSUING FEE -q;/ ~u-: Lender's Address I certify that I have read this application and state that the above TOTAL FEE 192. 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 SIGNATURE OF APPLICANT OR AGENT 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 certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec.3800 Lab.C.) //��// policy No. Company 4�'V=li. 7J� ADDRESS FOR APPLICANT TO FILL IN JOB poli ,�, •� Certified copy is hereby furnished. New Residential Bldgs.&Pools NO.1 EACH FEE 13 $ $ LOCALITY �� / CA copy is filed with the county building inspection 1 &2-Family,Sq.Ft. _ NEAREST department. Multi-family Sq.Ft. CROSS ST. Date Applicant y r Residential Swimming Pools ASSESSOR MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec.—Light Sw. FIRM NAME COMPENSATION INSURANCE First 20 (This section need not be completed if the work Involved by the MAIL Total No. Additional ADDRESS permit Is for one hundred dollars(S100)or less.) 1 certify that in the performance of the work far which this permit CITY Tel.No. is issued, I shall not employ any person in any manner so as to PLAN CHECK become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 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 p Y P Y APPLICANT provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances LD LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS �!LA I hereby affirm that I am licensed under provisions of Chapter 9 �_ Over 3 to 10 Incl. 11Q� (commencing with Section 7000)of Division 3 of the Business and CITY < -� t,? Tel.No. w-141L Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. �. Over 50 to 100 Incl. LICENSE Cl REG.NUMBER �� JAI ass. C'� O P License Number 4A S(.�49 Lic.Class C '�� Over 100 DISTRICT NO. CCSED BY V Services,Swbd.,MCC&PanelboardsG7 y 1 0-399 Amp.Under 600 V DATE O Contractor "/ �� Data 3 U ❑ I am exempt under Sec. 400-1000 Amp.Under 600 V VALIDATION W Over 1000 Amp.or Over 600 V FINAL a B.&P.C.for this reason BRANCH CIRCUIT FEES BY Z Date: 15A,or 20A,120V,Lighting or Recept. _ 1 To 10 Branch Circuits If Signature i 11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits V Exemption for Reg.Maim.Elect. 15A,20A,20 VV To 277V Lighting Br.Circuits SINGLE FAMILY Temp:Power Pole&Appurtenances , a HOME OWNER-BUILDER DECLARATION :yrs'_I°rr I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit _, _ for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits :_r l! 79.5- Code): ❑ 1TEE�€1 I,as owner of the property,will do the work and the structure Misc..Conduits&Conductors _ is not intended or offered for sale(Section 7044, Business Other(SeeComplete Fee Schedule) pool. TOTAL 79.80 and Professions Code). �( I� -7- N�,IE •t7 .1 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 j,l 3C.—C-031 :}/14/9L Lender's Name 1_, PERMIT ISSUING FEE 's't'1Q 1 AN 8:1357 Lender's Address TOTAL FEE �} I certify that I have read this application and under penalty of purjury state 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 -& 3 SIGNATURE OF PERMITTE I PATE 0 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1401220049 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: I FEES PAID BUILDING ADDRESS: 1 ON FILE 1 5807 ROSEMEAD BL 1 IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:] TEMP CA 91780 1 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 15397-012-043 LAW PC CITY $109.35 MIN 0.00 352.60 I THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY CA� IA1 PERMIT ISSUANCE FEE 27.80 TENANT: IGl OUTLETS-LGT,SW,RECP 45.00 OUT 72.60 11SSUED ON: PROCESSED BY: PLAN BY: CHUAN-S RESTAURANT 1G2 LIGHTING FIXTURES 276.00 LGT 382.80 105/13/14 SR IH3 RES DISHWASHR LT 3HP 1.00 DIS 11.00 1 1 ]OWNER: TEL. NO: [H7 RES EXHAUST FANS 2.00 EX 22.00 IF A FINAL Y: CODE: 1 ICHEN, QU (626) 616-5089- [IB N-RES WTR HTR LT 3HP 1.00 WTR 15.30 1 13042 SYCAMORE AVENUE I TOTAL FEES 884.10 1 ILA CRESENTA CA 91214 1 ID SCRIPTION OF WORK [ 1 (TENANT IMPROVEMENT -ELECTRICAL FOR CHUAN'S RESTAURANT (APPLICANT: TEL. NO: 1 I I IZHANG, BINGYING (626) 570-9978- I I I 1119 S ATLANTIC BLVD i ISPECIAL CONDITIONS: I (MONTEREY PARK 91754 I [CONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE 1 [JY CONSTRUCTION GROUP INC. (626) 332-6789- 1 1 I 11214 E EDNA PLACE LIC. NO 1 [TEMPORARY POWER POLE I I I ICOVINA CA 91724 963661 1 1 1 I I [ I (UNDERGROUND CONDUIT I I I ]ARCHITECT OR ENGINEER: TEL. NO: 1 ]LIFER GROUND I I I ]DRP INC. (626) 570-9978- 1 1 I I I 11119 S. ATLANTIC BLVD. #119 LIC. NO: i ROUGH CONDUIT I I MONTEREY PARK, CA 91754 NONE 1 ROUGH WIRING ! I [ I IMAIN WATER LINE I [ I I I (PLASTIC Y/N METAL Y/N 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 1 I I I I I I I I I [ IREPORT ID: DPR265 ROUTE TO: BS0508 ] 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 1405070034 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: I FEES PAID I BUILDING ADDRESS: 1 ON FILE I 1 5807 ROSEMEAD BL I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT-1 TEMP CA 91780 1 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 1 15397-012-043 1A1 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY CAI I [K1 SIGNS, OUTLINE LGT 2.00 SIG 77.80 I 1 ITENANT: TOTAL FEES 105.60 (ISSUED ON: PROCESSED BY: PLAN BY: 1CHUAN'S RESTAURANT 1 105/07/14 SR [ ]OWNER: TEL. NO: 1 ]FINAL DATE FINAL CODE: 1 IS LEW & ASSO. (858) 565-8332- [ 13709 CONVOY ST #300 1 I ISAN DIEGO CA 92111 1 IDE OF WORK Vi [ I I 12 SETS CHANNEL LETTER SIGNS (LED) ILLUMINATED 1 (APPLICANT: TEL. NO: [ I I IYU JINCHENG (626) 443-9288- I I I 19468 GARVEY AVE 1 ISPECIAL CONDITIONS: [ S. EL MONTE CA 91743 ICONTRACTOR: TEL. NO: JAPPROVALS DATE INSPECTOR SIGNATURE 1 [NEW SIGNS AND PRINTING (626) 571-9288- 1 1 I 19468 GARVEY AVENUE LIC. NO I ]TEMPORARY POWER POLE I I I [SOUTH EL MONTE CA 91743 956512 I 1 I ] I I [ ]UNDERGROUND CONDUIT I I I ]ARCHITECT OR ENGINEER: TEL. NO: - 1 1UFER GROUND I I I 1 LIC. NO: 1 IROUGH CONDUIT 1 I 1 ] I TROUGH WIRING I 1 I I MAIN WATER LINE 1 I 1 PLASTIC YIN METAL YIN I I I [ I (UTILITY COMPANY NOTIFIED] I [ I I I ] I I I I ] I 1 I I I I I I I I I ] ] ] I I I 1 I I I 1 ] 1 I I i I IREPORT ID: DPR265 ROUTE TO: 13S0508 I I I I I I I I �yt• •t ' COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0009180031 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL D: FEES PAID BU LD NG ADDRESS: ON FILE 5807 ROSEMEAD BL FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 91780 ASSESSOR 0 MATIO NUMBER: NEAREST CROSS STREET: LAS TUNAS 5397-012-043 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY JX MOTORS, LT 3 HP 2.00 MOT 30.60 TENANT: TOTAL FEES 58.35 ISSUED 0 PROCESSED BY: PLA PIRES ON: 09/18/00 UT 03/18/01 OWNER: TEL. NO: FINAL DATE FINAL BY: CODE: CALAC INVESTMENT // SAN DIEGO, CA9211137 �S�CR P�N�pF / EJECTION PUMP REPLACCEMENT FOR GREASE TRAP (SUMP PUMP) APPLICANT: TEL. NO: \ ROBO ONE PLUMBING (909) 902-5454- 1940 S. GAREY AVE. -#' SPECIAL CONDITIONS: POMONA, CA p,R1GELES co CONTRACTOR: TEL. NO: �O�j �/v APPROVALS DATE INSPECTOR SIGNATURE ROBO ONE PLUMBING (800) 649-7626- 1940 S. GAREY LIC. NO TEMPORARY POWER POLE POMONA, CA 91766 639506C-36 UNDERGROUND CONDUIT ARCHITECT OR ENG E -T-E- . N0: UFER GROUND LIC. NO: / 1111111 ROUGH CONDUIT L ROUGH IRING I'ID fl —4 MAIN WATER LINE lu+ % PLASTIC Y/N METAL Y/N �J 7C, 0 ---E1'(- -L — � � TILITY COMPA Y NOTIFIED 07 /—e�lwi7J}`Y a REPORT ID: DPR265 ROUTE TO: BS0508