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Home My Public Portal About5818 ROSEMEAD BLVD_Electrical__ 76AGIIS DNS.SJ%I 1.55 APPLICATION FOR ELECTRIC PERMIT DIVISION OF BUILDING AND SAFETY Department of County Rm&eor .BUILDING. C of Los Angeles D88 JOHN A.C&LIE,COUNTY ENGINEER CASSATT D.GRIFFIN.SUPT HUILDiNB OF11 LOCALITY mmowmamm .'N;; - FOR APPLICANT TO FILL IN NEAREST PERM FUS CROSS ST. NUMBER OWNER LIGHT OUTLETS_ MAIL f--RECEPTACLES ADDRESS -WALL SWITCHES FEE CITY TEL.NO. TOTAL OUTLETS 0 ¢ ELECTRICIAN In. ELEC.RANGES 2S ADDRESS ELEC.HSATERS' 25 TEL. CITY KW EA STATE FIXTURES S LICENSE NO. /Z UL Ife READY FOR INSPECTION MOTORS ZONE DISTRICT GROUP NUMBER HORSEPOWER Paz OIF-77- NEW mvp. HP OVER INC. EACH INSPECTION UMORD $ .25 1h a .50 2 s 1.00 a is 1.00 15 so 2.50 so P.00 5.00 MISC. 2 oa N _iN I YK 12 GNS NO.TRANS. NO.SIGNS NO.LAMPS FOR EACH PERMIT: WIRING $1.00 FIXTURES SLOO SUPPLEMENTARY •Sol I MPROVALS TOTAL FEE Is. DATE INSPECTOR'S SIGNATURE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE: THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING ELECTRICAL WIRING., I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE Or CALIFORNIA OR THAT I AM THE LEGAL R OF THE ABOVE POWER DESCRIBED RESIDER I OPE UTILITY U.TIL17Y CO.NOTIFIEr) '0 OIGNATUI k.01rA OF PicITTE FINAL, 1OHN A.LAMB/ COUNTY ENGINEERVAM ARTHUR C.VEIT.CHIEF ELECT.INSPECTOR CX NO CAM, %0 2 0 In LAgo;5 o b Ln 76A663 DBS-9A 9.99 APPLICATION ION F®R• ELECTRIC PERMIT ri DBS- DIVISION OF BUILDING AND SAFETY Department of County Engineer Connie of LOS Angeles BUILDADDRESNG S WM.J. FOX,COUNTY ENGINEER CASSATT D.GRIFFIN.SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST PER1ViIT FEES CROSSST. 'i NUMBER EACH FEE � ! LIGHT OUTLETS OWNER 6 RECEPTACLES . t MAIL .ADDRESS r WALL SWITCHES TOTAL OUTLETS 5¢ $ CITY TEL.NO. ELEC.RANGES 25 ELECTRICIAN ELEC. HEATERS 25 ADDRESS f9 KW EA r- CITY ' TEL.NOO e.713 FIXTURES 5 LICENSE NO. IF � / I I NUMBER OF LIGHT CIRCUITS , - DISTRICT NO. 1GROUP1 ZONE I READY FOR INSPECTION NUMBER OF RECEPTACLE CIRCUITS ;,71 MOTORS NUMBER HORSEPOWER FEE INSPECTION RECORD NEW MVD. HP OVER INC. EACH 1h a LESS $ .25 ✓ / �+ / 2 5 1.00 5 t5 1.5o cJlpl�f y' Flt�{{lr� h 15 50 2.50 /`2�//y f N/F _ �� c-! �f{I',) so 200 1 5:00. ell if k 6*' MISC. NO.SIGNS NO.TRANS. NO.SIGNS NO.LAMPS FOR EACH PERMIT: WIRING $1.00 FIXTURES $1.00 •: SUPPLEMENTARY .50 APPROVALS TOTAL FEE $ V DATE IrIrpNNSPPQQQQECCCC�TTOOR-'SS,SIGNATURE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CONDUIT � ��.�9dLrj..I AND STATE THAT THE;ABOVE 15 CORRECT AND AGREE TO COMPLY ,r WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING 7 -�S S d /- �.� �.�. lf_/1l ELECTRICAL WIRING. �.a/ � 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES - Altle r&L LIA'J b CENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT i AM THE LEGAL OWNER OF THE ABOVE POWER DESCRIBED RESIDENTI ROPER UTILITY CO.NOTIFIED i •f�/ .1�•. / /.r� SIGNATURE I OF PERMIFINAL em WILLIAM J.FOX.COUNTY ENGINEER VALIDATION A.C.VEIT..CHIEF ELECT.INSPECTOR _.-kC0 6 0 2 2 v MAY15 2 6.8 0 P � WORKERS'COMPENSATION DECLARATION PE-806 i0/at APPLICATION FOR ELECTRICAL PERMIT I I hereby affirm that I have a certificate of consent to self insure, � PE-806G or a certificate of Workers' CompensatWn f'nsurance,or a certified s 1 COUNTY OF LOS ANGELES BUILDING AND SAFET copy thereof(Sec.3800;Lab.C. �nyl—1 1 M��n e�yy 'Policy No. /ll1/ JL FOR APPLICANT TO FILL IN JOB jt2 IQ Certified copy is hereby furnished. EACH NO. FEE ADDRESS ❑ New Residential F .&~Pools � G� ❑ Certified copy is filed with the county building inspection 1 &2-Family,Sq.Ft.-L $ _ $ LOCALITY deparfinent. Multi-family'9q.Ft. NEAREST / V �� • Residential Swimming Pools CROSS ST. L- Date ApplicantOWNER OR FIRM NAME CERTIFICATE OF EXEMPTION FROM.WORKERS' Outlets:Rec—Light—Sw._ MAIL COMPENSATION INSURANCE ADDRESS i (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 CIT �G Tel.No. I certify that in the performance of the work for which this permit PLAN C ECK is issued, I shall not employ any person in any manner so.as to APPLICANT become subject to the'Workers'Compensation Laws, Lighting Fixtures First 20 ADDRESS Total No., Additional. CITY Tel.No. Date Applicant Fixed Appliances Not Over 1 HP NOTICE TO APPLICANT: If, after making this Certificate of PERMIT Exemption,you should become subject,to the Workers'Compensation Range_ Heater D.W. APPLICANT provisions of the Labor Code,you must forthwith comply with such Oven._ Dryer_ W:M,_ ADDRESS .—goo 'f provisions or this permit shall be deemed revoked. Top _,FAU W.H. LICENSED CONTRACTORS DECLARATION Hood — Fan Other_ CITY G_ `�" Tel.No. I hereby affirm that'I am licensed Under provisions of Chapter 9• LICENSE OR: • (commencing with Section 7000)of Division 3 of the Business and Disp. — Room Air Cond. Class. REG.NUMBER Professions.Code,and my license.is in full force and effete " DIs rwT N PROCESS Powe[Apparatus&Large Appliances C Size&Type HP,KW,KVA,or KVARO License Number kIc.Class. 8 . Up to 1 Incl. FINAL 'Contractor e r Over 1 to 10 Incl. DATE (; VALIDATION p Over 10 to 60 Incl. FINAL ° ❑ I am exem t under Sec. Over 50 to 100 Inca BY d Over 100' B&P.C,for this reason es,Swbd.,.MCC&Panelboards Date: 0-200 Amp.Under 600 V Signature 201 - 1000 Amp.Under 600 V El Exemption 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 7 \I hereby affirm that I am exempt from the Contractor's License Law ACCT.r for the following reason(Section 7031.5,Business and Professions Additional Sign Branch Circuits .r Code): Misc.Conduits&Conductors 3303 136.9.0 ❑ I,as owner of the property,will do the work and the structure Other(See Complete Fee Schedule) _ 1 ITEMS is not intended or offered for sale (Section 7044, Business and Professions Code). Poo. TOTAL 136o 90 CONSTRUCTION LENDING AGENCY y� � CHECK 86.90 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) CHANGE °00 , Civ.C.). PLAN CHECKING FEE Lender's Name 0000-0001 9/ 7/95 PERMIT ISSUING FEE o 2185 1 Ali 9031 Lender's Address. f I certify that I have read this application and state that the above TOTAL FEE 3G., information is correct.I agree to comply with all County ordinances C G and State laws regulating Electrical wiring,. and hereby authorize represent s this Coun 3o enter upon the above-mentioned 7 l b prope f ion p SEE REVERSE FOR EXPLANATORY LANGUAG�ZZ Z i ignature bf Permittee ate WORKER'S COMPENSATION DECLARATION 20.0019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT IJ I hereby affirm that I have a certificate of consent to ..If Insure, or j�certtftcate of Worker's Compensation Insu nce, or a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec.3800 L b.C. i/ — ;�f Com -y / _ FOR APPLICANT TO FILL IN ADDRESS LGA copy is hereby furnished. i/� 'New Residential Bldgs.&Pools NO. EACH FEE$ $ LOCALITYco Is filed with the count bui in Ins action 1&2-Family,Sq.Ft. copy y 9 p — NEAREST lop— Apartment. Multi-family Sq.Ft. CROSS ST. • Residential Swimming Pools ASSESSOR Date Applicant _ Sji • MAP BOOK PAGE DI PARCEL 3l CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER oR COMPENSATION INSURANCE Outlets:Rec.._Light SW- n,®� D FIRM NAME First 20 d MAIL J (This section need not be completed if the work involved by the Total No. Additional ADDRESS O• �i•. permit Is for one hundred dollars($100)or less.) I certify that in the performance of the work for which this permit CITY � T T.I.No. is issued, I shall not employ any person,In any manner so as to become subject to the.Workers'Compensation Laws. Lighting Fixtures First 20 App ICANTK Total No. Additional C� ADDRESS Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: If., after making this Certificate of CITY Tel.No. Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code,you must forthwith comply with suchPERMIT provision's or this permit shall be deemed revoked. Power Apparatus&Large Appliances 'APPLICANT LICENSED CONTRACTORS DECLARATION Size&Type HP,KIN,KVA,or KVAR ADDRESS %�.,� Q _' I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 70 Incl (commencing with Section 7000)of Division ...3 of the Business and CITY ��Z• T I..No. �71 � d Professions Code,and my license is in full.force and effect. Over 10 to 50 Incl. LICENSE OR i clam. . •� Over 50 to 100 Incl. REG.NUMBER (p �Z� 1L License Number 36f�Zy Lic.Class Over 100 DISTRICT NO. P SSED BY V Services,Swbd.,MCC&Panelboards ontr�, ® A..00, Date •�T 0-399 Amp.Under 800 V DATE 0 ❑ I am exempt under Sec. 400=1000 Amp.Under 600'V W Over 1000 Amp.or Over 500 V to YY VALIDATION P FINAL a- B.&P.O.for this.reasonBY co BRANCH CIRCUIT FEES Date: 15A,or 20A,120V,Lighting or Recept. Z 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits Exempti/0 . Mont.tie 15A,20A,20 VV To 277V Lighting Br.Circuits SING FAMILY Temp.Power Pole&Appurtenances GST a 4 HER - ILDER DECLARATION Sign:with One Branch Circuit I hereby affirm a pt from the Contractor's License Law for the followinaction 7031.5, Business-and Professions Additional Sign Branch Circuits 7.l , 9aQ Code): ❑ I,as owproperty,will do the work and the structure Misc.Conduits&Conductors CUAEITEM$ ,q.3 is not in offered for sale(Section 7044, Business Other(See Complete Fee Schedule) , and Proode). CIr CONSTRUCTIONLENDING ENCY 54 I hereby affirm that there is a construc n lending agency for the performance of the work for which th permit is issued(Sec. 3097, PERMIT FEE (Sub-Total) Civ:C.) PLAN CHECKING FEE Lender's Name ` PERMIT ISSUING FEE iito Lender's Address TOTAL FEE 2 Q 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 I representati es of this.County to enter upon the above-mentioned property for inspe on purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE 1 SI ATURE MITTEE DATE COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0305130008 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL10: S D 8 TR: 5905LT: 131 5818 ROSEMEAD BL- FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801831 ASSESSOR IN0 BE NEAREST CROSS STREET: LAS TUNAS 5387-014-028 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H3• • LOCAL•ITY: TEMPLE CITY G1 OUTLETS-LGT,SW,RECP 8.00 OUT 15.60 TENANT: G2 LIGHTING FIXTURES 3.00 LGT 5.85 ISSUED 0 C : PLAEXPIRES ON: TOTAL FEES 49.20 05/13/03 JK 11/09/03 OWNER: TEL. NO: FIN D TE FINAL BY: CODE: SALAMA;ADEL A (626) 533-2734- /}) 5818 ROSEMEAD BL % •7 �— TEMPLE CITY 91780 ADD BEDROOM AND BATHROOM, t.Drt,e v+Amtl U.GLfa_fin to JAAI,.3 PP ET. 0: TOTAL WHEN DONE:3BR/3BA ADEL A SALAMA (626) 533-2736- 5818 ROSEMEAD BL SPECIAL CONDITIONS: TEMPLE CITY 91780 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAN MICHAEL GENERAL CONTRACTOR (626) 533-2734- 5818 ROSEMEAD BLVD. LIC. NO TEMPORARY POWER POLE TEMPLE CITY, CA 91780 777203 B UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: T GROUND LIC. NO: ROUGH CONDUIT ROUGH R G MAIN WATER LINE PLASTIC Y/N METAL Y/N UTILITYCOMPANY NOTIFIED REPORT ID: DPR265 ROUTE TO: BS0508