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Home My Public Portal About5817 ROSEMEAD BLVD_Electrical__ WORKER'S COMPENSATION DECLARATION 2G-0019 DPW 9/88 APPLICATION FOR ELECTRICAL PERMIT " 76A66 t76A663 hereby affirm that I have a certificate of consent to self Insure, ' or a certificate of Worker's Compensation In rance, or a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec.$800 Lab.C.) Policy Nott Company FOR APPLICANT TO RLL IN JOB > . ❑ Certified copy is hereby furnis d. New Residential Bldgs.&Pools EACH NO. FEE LOCALITY Certified copy is filed with the w 1 &2-Family,Sq.Ft. $ —Is inspe 'on NEAREST d partm nt. Multl-family Sq.Ft. CROSS ST. Date esidential Swimming Pools ASSESSOR • MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' . Outlets:,Rec._Light Sw. OWN NAME FIRMCOMPENSATION INSURANCE (This section need not be completed if the work involved by the First 20 MAIL permit is for one hundred dollars($100)or less.) Total No. Additional ADDRESS I certify that in the performance of the work for which this permit CITY Tel.No. Is issued, I shall not employ any person in any manner so as to PLAN C ECK become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANT i Total No. Additional ' ADDRESS Date Applicant 20V BRANCH CIRCUITS 1 ,15 OR 20A NOTICE TO APPLICANT: If, after making this Certificate of 1 TO 200,1 INCLUSIVE EACH CITY Tel.No� Exemption,you should become subject to the Workers'Compensation PERMIT provisions of the Labor Code,you must forthwith comply with such 11 TO 40 INCLUSIVE EACH APPLICANT provisions or this permit shall be deemed revoked. 41 OR MORE BRANCH CIRCUITS EACH } LICENSfD CONTRACTORS DECLARATION ADDRES 4 I hereby affirm that am licensed under provisions of Chapter 9 15 OR 20A,208V TO 277V LIGHTING EACH O (commencing with S tion 7000)of Division 3 of the Business and CITY a AkA(3121g6, Tel.No—• V Professions Code,an my License is in full force and effect. RESIDENTIAL APPLIANCES UP TO 3HP Power Apparatus&Large Appliances REGNNUOR Class. Q Li m r Lic.Class C45P Size&Type HP,KW,KVA,or KVAR DISTRICT NO. PROC SSED BY V Up to 3 Incl. �� (�Y� ✓1�i� d Over 3 to 10 Incl. FINAL ontractor Date-2/1-7/92. I DATE W Over 10 to 50 Incl. , i `Q Z l I am exempt under Sec. I Over 50 to 100 Incl. f VALIDATION W 100 FINAL B.&P.C.for this reason Over BY Services,Swbd.,MCC&Panelboards Date: 0-200 Amp.Under 600 V Signature 201-1000 Amp.Under 600 V ❑ Over 1000 Amp.or Over 600 V Exemption for Reg.Maim.Elect. Z re SINGLE FAMILY Temp.Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit A C I°s I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits ti,�17 94.35 Code): ' ❑ Misc.Conduits&Conductors 1 � �� 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) i„-LITAL 94.35 and Professions Code). , CHECK 94.35 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the CHANGE '00 performance of the work for which this permit is issued(Sec.3087, PERMIT FEE (Sub4otal) Civ.C.) Lender's C PLAN CHECKING FEE L�i1 �E-[I �j/17 f 9 e _ PERMIT ISSUING FEE ,;�'��•,7 i (� �}'_�.+3 At <h-ave ss TOTAL FEE 3 havVdthis application and state that the above ,i correto comply with all County ordinances ws rectrical wiring, and hereby authorize of to enter upon the above-mentioned ' pecs. SEE REVERSE FOR EXPLANATORY LANGUAGE p DATE COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0312120014 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING 5817 ROSEMEAD BL � ON FILE FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 92780 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LAS TUNAS 5397-012-043 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY Gl OUTLETS-LGT,SW,RECP 44.00 OUT 71.40 TENANT: G2 LIGHTING FIXTURES 26.00 LGT 47.10 ISSUED ON: PROCESSED BY: PLAN B : EXPIRES ON: TEN JU TEA HOUSE JE WATER HEATER +3-10HP 1.00 WTR 19.65 12/12/03 JK 06/09/04 JF REFRIG CBNT +3-10HP 3.00 REF 58.95 OWNER: TEL. NO: K1 SIGNS, OUTLINE LGT 1.00 SIG 38.85 FINAL D E F AL BY: CODE: CALAC INVESTMENT (858) 565-8333- TOTAL FEES 263.70 2 r 3709 CONVOY ST #300 SAN DIEGO, CA92111 DESORIPT,40N Or WORK ELECTRICAL FOR T.I. & SIGN APPLICANT: TE O: DANIEL TAI (626) 359-3568- 11921 GOLDRING RD SPECIAL CONDITIONS: ARCADIA 91006 CONTRACTOR: TEL. N0: APPROVALS DATE INSPECTOR SIGNATURE IMPACT CONSTRUCTION (626) 821-5308- 15902 HALLIBURTON RD 125A LIC. NO TEMPORARY POWER POLE HACIENDA HEIGHTS CA 91745 479410 B UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: 0: U ER GROUND LIC. NO: ROUGH CONDUIT ROUGH WIRING Y MAINVA-TER LINE PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED REPORT ID: DPR265 ROUTE TO: BS0508 i • COUNTY OF LOS ANGELES I TEMPLE CITY # 0508 I ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0106140031 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: L LEGAL D: FEES PAID BUILDING ADDRESS: ON FILE 5817 ROSEMEAD BL FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 92780 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LAS TUNAS DRIVE 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 ON: PROCESSED BY: PLA EXPIRES ON: KIDS WEAR AND TOYS 06/14/01 UT 12/11/01 OWNER: TEL. NO: FINAL ATINAL BY: CODE: CALAC INVESTMENT - g �� 3709 SAN DIEGO, CA9211137 SC IP 0 FWO;;:::� INSTALL ONE SET OF CHNN ETTERS ILLUM. W/NON ILLUMINATED "MARY'S" PIN MOUNT APPLICANT: MOEN ROSS (818) 842-5221- 2545 N ONTARIO ST SPECIAL CONDITIONS: BURBANK CA 91504 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE ELECTRICAL ADVERTISING, INC. (818) 842-5221- 2545 N ONTARIO ST LIC. NO' PORAR POWER PE BURBANK, CA 91504 97986 C45i UNDERGROUND CONDUIT ARCHITECTR ENGINEER: TEL. NO: UFER GROUND LIC. NO:' ROUGH CONDUIT ROUGHR G MAIN WATER LINE PLASTIC Y/N METAL Y/N UTILITYCOMPANY NOTIFIED I 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 0012010006 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 DUPLICATE PHONE: (626) 285-0488 EXT: LEGAL D: FEES PAID BUILDING ADDRESS: ON FILE 5817 ROSEMEAD BL FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 92780 ASSESSOR NFORMATION B R: NEAREST CROSS STREET: 5397-012-043 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY K1 SIGNS, OUTLINE LGT 1.00 SIG 38.85 TE TOTAL FEES 66.60 ISSUED ON: PROCESSED B BY: EXPIRES ON: LUCKY GALLERY 12/01/00 UT 05/31/01 OWNER: TEL. NO: FINAL DATE FINAL BY: CODE: TSAI JIN L;SYOU H;CHIN ZONG;CHIN CH - 15801 VALLEY BL �/�/3��1y DQE CIS PWORK ILLUMINATED WALL SIGN APPLICANT: TEL. NO: FIRST SIGN CO. (626) 448-1616- 9647 E. RUSH ST. SPECIAL CONDITIONS: SO EL MONTE, CA GELES co CONTRACTOR: TEL. NO: �ocJ APPROVALS DATE INSPECTOR SIGNATURE FIRST SIGN CO. (818) 448-1616- 9647 E. RUSH ST. LIC. NO TEMPORARY POWER POLE SOUTH EL MONTE, CA 91733 605688C45 UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: L. O: UFER GROUND LIC. NOE 1111111 ROUGH CONDUIT L , ROUGH WIRING Ir�n n D (o wO1n�J MAIN WATER LINE lur Il`JfJ lF,luR`� PLASTIC Y/N METAL Y/N UTILITY CO P NY OTIFI D C 0El ,; � O 0 A El 48��c Service Yhat�� REPORT ID: DPR265 ROUTE TO: BS0508 P • ` COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT) DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS -EL 0508 99110800041 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: r LEGAL ID: FEES PAID , `BUI•LD3NG ADDR SS:' ON FILE - 5817 ROSEMEAD BL-' FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 92780 ASSESSOR INFORMATION NUMBER: 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 ON: PROCESSED BY: PLAN BY: EXPIRES ON: ANTIQUE GALLERY 11/08/99 UT 05/06/00 OWNER: TEL. NO: FINAL DATE FINAL BY: CODE: CALAC INVESTMENT - 3709 SAN DIEGO, CA9211137 DESCRIPTION OF WOR ELECTRICAL FOR WALL SIGN APPLICANT: TEL. NO, FIRST SIGNS CO. (626) 448-1616- 9647 E. RUSH ST. SPECIAL CONDITIONS: S. EL MONTE, CA ��GELES CO CONTRACTOR: TEL. NO: X05 /�Ay APPROVALS DATE INSPECTOR SIGNATURE FIRST SIGN CO. (626) 448-1616- 9647 E. RUSH ST. LIC. NO TEMPORARY POWER POLE SOUTH EL MONTE, CA 91733 15640 UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: . NO: U ER GROUND LIC. N 1111111 ROUGH CONDUIT RO G RI G Ilrr�n n pD ��i w0 �� MAIN WATER LINE L1 U 11v„ �lu^uS PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIF ED 0 >Ii ' O ❑ �+ 1 -�d t A El 46��c ❑ �ervice'fhat��t * ADDITIONAL DATA ON FILE REPORT ID: DPR265 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0106140031 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL—ID: FEES PAID G AD SS: ON FILE 5817 ROSEMEAD BL FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 92780 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LAS TUNAS DRIVE 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 PROCESSED B L EXPIRES N: KIDS WEAR AND TOYS 06/14/01 UT 12/11/01 OWNER: TEL. N0: FINAL DATE FINAL BY: CODE- CALAC INVESTMENT - 3709 SAN DIEGO, CA9211137 SCR 0 INSTALL ORE SET OF CHNNEL LETTERS ILLUM. W/ ILL INATED "MARY'S" PIN MOUNT APPLICANT: NO: MOEN ROSS (818) 842-5221- 2545 N ONTARIO ST SPECIAL CONDITIONS: BURBANK CA 91504 --�� CONTRACTOR: TEL. NO: / ��J1F\��' APPROVALS DATE INSPECTOR SIGNATURE ELECTRICAL ADVERTISING, INC. (818) 842-5221- 2545 N ONTARIO ST LIC. NO TEMPORARY E POLE BURBANK, CA 91504 97986 C45 f ' i UNDERGROUND CONDUIT , IT-, 1� ti ARCHITECTGI 0: � `I - I I 1 1 r� `� _ i Ifs' �'��_ UFER GROUND LIC. NO�I'r ! _ _ � !1,�.i I ; j � �, —� �� k ROUGH CONDUIT ij -�j i ELL _j I ROUGH WIRING hTMAIN WATER LINE PLASTIC Y/N METAL Y/N L7 -- --— -- -—— UTILITY CO P 0 I IED Fl i I REPORT ID: DPR265 ROUTE TO: BS0508 I