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HomeMy Public PortalAbout6300 ROSEMEAD BLVD_Electrical__ 76A663 C6`'!806(6/78) APPLICATION FOR ELECTRICAL PEA. i , COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN JOB J --D-r f 33 '�"7_��r) EACH NO FEE . ADDRESS/ /�(J f�j �^ �CL� New Residential Bldgs &Pools LOCALITY'S ' 1 &2-Family,Sq Ft $ 025 — $ /'/Lj � 7� Multi-family Sq Ft 02 — NEAREST r _ Residential Swimming Pools 25 00 CROSS ST L—o _ - OWNER OR - FI RM NAME �D,CZM r�. Outlets Rec Light Sw MAIL /� First 20 50 ADDRESS�3 A z_,..,& c- Total No Additional 30 CITY Tel N# Q PLAN CHEC APPLICAN d' 6jq,0 OMC Lighting Fixtures First 20 .50 1 ADDRESS 12 6 E 1 �' Additional 30 _ Total No CITY N Tel No SIL Fixed Appliances Not Over 1 HP APPLICANT PERMI Range_Heater_ D W ADDRESS Oven—Dryer-_ W M— - Top _FAU W H CITY Tel No Hood_Fan _Other_ LICENSE OR // Disp -Room Air Cond 2 50 REG NUMBER Z Y Closs G S IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND'AGREE TO Size&Type HP, KW,'KVA,or KVARCOMPLY WITH ALL COUNTY- ORDINANCES AND STATE-LAWS ` 2 50 REGULATING'ELECTRICAL WIRING Up to 1 Incl I HEREBY CERTIFY THAT I.AM PROPERLY REGISTERED AND/OR _ Over 1 to 10 Incl 5 00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF Over'10 to 50 Incl 12 50 CALIFORNIA OR T_H4T I AM THE kEnL OW ER OF THE ABOVE Over 50 to 100 Inc 25 00 DESCRIBED RESID TI L PR Over 100 - 40 00 PERMITEE � SIGNATURE 11S1 Services - DISTRICT N ESSE Y 0-200 Amp Under 600 V 12 50 201-1000 Amp Under 600 V 25 00 Over 1000 Amp or Over 600 V _ 50 00 Z Temp Power Pole&Appurtenances 1000 Sign with One Branch Circuit 1000 Additional Sign Branch Circuits 200 INSPECTION > INFORMATION u Misc Conduits&Conductors 1000 ON REVERSE S Other(See Complete Fee Schedulel SIDE v Z ;93988A 6 • # 0 0 0 0 0 2 PERMIT FEE (Sub-To1ol) 2'0 0 ']7 Q Z , PLAN CHECKING FEE (Orie-Fourth Permit Fee) Q o 0 0.7 7 Q Q PERMIT ISSUING FEE • $7 00 7 [I 2 5—7 9 TOTAL FEE 7 > r , INSPECTION FINALED W - ode 7 date i By ©s 78A663 CE 808R 1077 All Il l� C Q MN FOR EII I�QOTRIe ® L PERN'T U 'COUN IITYIY OF LOS ANGELES tl�\yl II IS ILS?(�O{01 tyW� i/��11 OYa/IYI IM/tp1 'DEPARTMENT OF COUNTY ENGINEER JOB C. BUILDING AND SAFETY DIVISION ADDRESS �� bS�M'e�b � FOR APPLICANT TO FILL IN LOCALITY • 0 t':n C_ME C l New Residential Bldgs &Pools EACH NO FEE CNEAREST ROSS ST 1 &2-Family,Sq' Ft $ 025 — $ OWNER OR Multi-family Sq Ft .02 — FIRM NAME - Residential Swimming Pools 25.00 MAIL ADDRESS Outlets RecLight_Sw CITY Tel No First 20 50 PLAN CHECK Total No Additional 30 APPLICANT ADDRESS Lighting Fixtures First 20 50 CITY w Tel.No Total No Additional 30 APPLICANT AL1 F Fixed Appliances Not Over 1 HP ADDRESS iRange—Heater—' D.W CITY Tel.No gS7-23 J` Oven _Dryer.—W M_ _ LICENSE Top —FAU —W H R GNUMOBER I �� Class Hood'Fan _Other_ I HEREBY ACKNOWLEDGE THAT I.HAVE READ THIS APPLICATION AND STATE Disp Room Air Cond 2.50 THAT THE ABOVE IS CORRECT AND'AGREE TO COMPLY WITH ALL COUNTY ORDIN- ANCES AND STATE LAWS REGULATING ELECTRICAL WIRING Power Apparatus&Large Appliances Size&Type HP, KW, KVA,or KVAR I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM Up to 1 Incl 2.50 THE LEGAL OWNER F THE ABOVE DESCRIBE IDENTIAL PROPERTY 0 Over,1 to 10 Incl 5.00 v Over 1 Oto 50 Incl 1250 PERMITTEE Over 50 to 100 Inc 25.00 SIGNATOR o U Over 100 40.00 DISTRICT NO SED BY a z '• Services 0-200 Amp Under 600 V 12.50 I ECTOR S 201-1000 Amp.Under 600 V 2500. APPROVALS DATE GNATURE Over 1000 Amp.or Over 600 V 50.00 TEMP POWER-POLE UNDERSLAB WORK Temp Power Pole&Appurtenances 10.00 Sign with One Branch Circuit 10.00 ROUGH CONDUIT 2.00 WIRING Additional Slg'n Branch Circuits Mlsc Conduits&Conductors 1'0.00 FIXTURES Other(See Complete Fee Schedule) POWER AUTHORIZED f 1 .& LA UTILITY CO NOTIFIED 1 SIX I FINAL PERMIT FEE 66b-Total NOTES PLAN CHECKING FEE (One-Fourth Permit Fee) PERMIT ISSUING FEE $7.00 i TOTAL FEE PLAN CHECK VALIDATION CK'- M O CASH PERMIT VALIDATION CK' M O CASH 9 3 •5 r JUN 13 2 u. r 1 8..5 0.A% BAC�c OF APPLICA ON FOR COMPLETE SCHEDUI. 76A663 CE-806(11-/.78) AMU • .- , :COUNTY OF LOS ANGELES - ILDING AND SAFETY. FOR APPLICANT TO FILL IN JOB EACH 'NC) - F.EE, ADDRESS_ �_.��.. .KS.�/�C.. - '.•-- New`ResideA�ial'Bldgs'&-,Pools .. LOCALITY, 1 &2-F_6mily,'Sq Ft $' '025 — $ Multi;family Sq.Ft .*.02 ' NEAREST CROSS ST �?/v Residential Swim25 00 mi g Pools p, •. - -- ,- ._ OWNER OR,.q.• _ _ ;••--c z FIRM NAME �7C Outlets Rec Light ' Sw' _ MAIL'.- First 20' 50 ADDRESS, U- _.Total No Additional 30 C�T.Y. . ,(i A a_ ' _• Tel„No..:.,_.�.. :y.. E' r;j• - PLAN CHECK AP,PLICANT.: N Tl Lighting'Fixtures' First 20 v50 ADDRESS ti Additional =30- _ Total-No - _ CITY. -j, Tel. No Fixed•Apphonces Not Over-•1-HP - u- - - PERMIT-- ERMIT• - - Range_Heater D`W -APPLICANT ~�. _ Oven_Dry'er_. W.M— ._ z.- ,�. ADDRESS - Top' _'`FAU W H`_ 'CITY _Tel No ` Hood-'Fane =Other_ LICENSE OR t Disp_:-Room'Air 6'd2 50 _REG,NUMBER L�„_ (•,F; . _CI_ass — .w y IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA- Rower Apparatus&'Lorge Applionces TION AND STATE THAT'THE-ABOVE IS'CORRECT•AND'AGREE:TO COM PLY;WITH'ALL"COUNTY'ORDINANCES-AND'GSTATE•`CA'WS ""Y Size&Type HP, KW, KVAR REGULATING'ELECTRICAL WIRING' •a.' 2.50 o,1 InceKVA,or - Up,t . ' -1 HEREBY CERTIFY THAT-I'A'M'PROPERLY REGISTERED•AND/OR Over 1,to 10 Incl , 5 00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY-AND'STATE OF' . . Over,10 to 50 Incl- 12:50.. _ CALIFORNIA OR THAT I'AM THE LEGAL OANER OF THE ABOVE; *. 25 00 DESCRIBED RESIDEN L PROPERTY. Over 50-to 100 Inc 5 ' - .Over 100 t .40:00- eERMITEE , SIGNATURE. v ®' Services - - - - - 1,2 50 DISTRICT' O. PR B , 0,200 Amp Under 600 V - 20'1-1000 Amp Under 600 V 2'S 00=-• .(/_ Oveir 1000.Amp' or;Over 600 V 5000 ! g ; Temp Power Pole'&Appurtenances 10,00• -• -2 r Sign with One Branch Circuit. ° 10 00 Y I, J Addrfionol Sign Branch.Circuits• 2 00 INSPECTION. ,. INFORMATIONy� Misc'Conduits&Conductors • i __1.0 00'' ^'ON REVERSE x Other(See Complete Fee Schedule) _. SIDE Z {y' 823�4A •fir._ -0..,.. - .. - _ „'A•p ., •' "tt:O O,0.0 o.2 ' PERMIT FEE Sub-Total) f. 2 °Jo 1 7'd a - PLAN CHECKING FEE'7' (One-Fourffi Permit_Feel p ro'o'0 1'� 0.0 Cr-,_,!, PERMIT ISSUING FEE $7 00 c 3:-7 9 J TOTAL FEE j rr INSPECTION FINNAALEEDUj ' dare L• L ��� BY APPLICATION ppogY p�q_® q��q , PERMIT qpo� p�q( DBS-5A 9.55 DIVISION OF BUILDING AND'SAFETY Deportment of County Engineer BUTLDING y� y' County of Los Angeles ADDRESS �!� �"�6 WM.J. FOX, COUNTY ENGINEER CASSATT D.GRIFFIN.SUPT OF BUILDING 1LOCALITY FOR APPLICANT TO FILL IN NEAREST PERMIT FEES CROSS ST. - ..� NUMBER EACH FEE LIGHT OUTLETS OWNER �, "� 7" MAIL ! RECEPTACLES _ADDRESS J C.JGT�74� WALL SWITCHES TOTAL OUTLETS 5¢ $ - CITY ��' - _r T TEL._NO ELEC. RANGES 25 _ELECTRICIAN _ELEC. HEATERS 25 ADDRESS - KW EA CITY �/'1` fYL'-'LI -T" TEL. NO. FIXTURES 5 LICENSE NO. •� •^ NUMBER OF LIGHT CIRCUITS - DISTRICT O. GROUP�I{.-ZO E READY FOR INSPECTION NUMBER OF RECEPTACLE CIRCUITS G'���u�'/� ,S , MOTORS, I ! Xa 22-5• NUMBER I HORS(POWER I FEE _ INSPECTION RECORD NEW MVD. HP OVER INC. EACH I12&LESS $ .25 % 2 .50 2 5 1.00 5 15 1.50 t �r 15 50 2.80 _ x M�}-$ -rgG� 5,qL FS 50 200 5.00 ' MISC. � � � � l 7V J� - • NO.SIGNS NO.TRANS. • _ NO.SIGNS NO LAMPS FOR EACH PERMIT: WIRING 51.00 FIXTURES $1.00 — SUPPLEMENTARY - .50 APPROVALS 7 TOTAL FEE $ DATE INSPECTOR'S SIGNATURE 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS'APPLICATION CONDUIT _ 'tom /77j, AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY v 1!V •, — WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING 1NIRING ELECTRICAL WIRING. — IHEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND.STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER 'OF THE ABOVE POWER DESCRIBED RESIDENT( L PROPERTY. UTILITY CO.NOTIFIED Z SIGNATURE OF PERMITTEE FINAL /2'Z` Y WILLIAM J. FOX.COUNTY ENGINEER' VALIDATION A.C.VEIT,CHIEF ELECT. INSPECTOR • �..�. �; ; 9`9'x. DEC 1 2 1 .10 76A663 GE-806(6/78) APPLICAm/�R UkTffl CAL PERMIT / COUNTY OF LOS ANGELES 'BUILDING AND SAFETY FOR APPLICANT TO FILL IN' JOB ADDRESS New Residential Bldgs'&Pools EACH NO FEE 1 &2-Family,Sg Ft $ . 025 — $, LOCALITYC—,P-^ G 'T Multi-family Sq Ft 02 _ CROSS ST " Residential Swimming Pools 2500 OWNER OR -. FIRM Outlets.Rec Light Sw - MAIL ,. ff nn� First 20 50 ADDRES (7 l ' Total NoAdditional. 30 CITY Tel No PLAN CHECK APPLICANT Lighting Fixtures First 20 50 ADDRESS Additional 30 Total No CITY Tel No Fixed Appliances Not Over 1 HP , - PERMIT I APPLICANT jj C;6 ; lR. , Range_Heater_D W Oven L Dryer_W M— ADDRESS I t_ D`63, -5T _ Top _FAU —W H CITY L Tel NoZZI_(0 f Hood Fan _Other_. LICENSE OR Clas Disp,—Room Air Cond 2 50 REG NUMBER 2 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA. Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO Size&T COMPLY WITH ALL-•COUNTY ORDINANCES AND-'STATE- LAWS ype HP, KW, KVA,or KVAR REGULATING ELECTRICAL WIRING Up to 1 In2 50 cl I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR Over 1 to 10 Incl 5 00 LICENSED AS REQ ' RED BY LOS ANGELES COUNTY AND STATE OF Over 10 to 50 Incl 1250 CALIFORNIA OR AT I AM THE LEG OWNER OF THE ABOVE Over 50 to 100 Inc 25.00 . DESCRIBED REST TIAL PROPERTY Over 100 4000 PERMITEE SIGNATURE Services DISTRICT NO CE ED BY 0. 200 Amp. Under 600 V 12 50 O 201-1000 Amp Under 600 V 25 00 Over 1000 Amp or Over 600 V 5000 1 Temp Power Pole&Appurtenances 1000 Sign with One Branch Circuit 1000 ,v Additional Sign Branch Circuits 2 00 INSPECTION > -v Misc Conduits&Conductors 1600 INFORMATIONON REVERSE i Other(See Complete Fee Schedule) SIDE _ u 0 4 8(1 8 A Z o o'o o o'2 d 2.0'0 i'•9,0 0 PERMIT FEE (Sub-Totah t ao;o190013 PLAN CHECKING FEE (One-Fourth Permit,Feel O PERMIT ISSUING FEE i $7 00• c 0-79 J TOTAL FEE > F INSPECTION FINALED t W IL date q �fBy es 76A663CE-80616/78) APPLICATION F R ELECTRICAL PERMIT ' COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN JOB EACH NO FEE ADDRESS OO New Residential Bldgs'&Pools LOCALITY /V- New � 1 &2-Family,Sq .Ft - $ - 025 - $ Multi-family Sq Ft. ' 02 — NEAREST 25 00 CROSS ST Residential Swimming Pools OWNER OR c. FIRM NAME Outlets.Rec Light Sw MAILa First 20 50 ADDR -' Total No Additional 30 CITY Tel No PLAN CHECK _ APPLICANT Lighting Fixtures First 20 50 ADDRESS Additional 30" Total No CITY Tel-No Fixed-Appliances Not Over 1.HP PERMIT Range_Heater_D W ^� APPLICANT _ y Oven_Dryer=W M— ADDRESS Top —FAU — WH, _ CITY Tel. No Hood—Fan —OtherOR Disp —Room Air Cond 2 50 R GNSE NUMBER HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA. Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO Size&T COMPLY WITH ALL" COUNTY ORDINANCES -AND STATE LAWS ype HP,'KW, KVA,or KVAR REGULATING ELECTRICAL WIRING ' Up to 1 Incl 2 50 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED-AND/OR Over'1 to 10 Incl 5 00 LICENSED AS REQUIRED BY LOS ANGELS COUNTY AND STATE OF Over 1,0-to 50 Incl 1250 CALIFORNIA OR THAT I AM THE 1_5KAY OWNE OF THE ABOVE Over 50 to 100 Inc 25 00 DESCRIBED RE ERTY ' PERMITEE 40 00 Over 100 SIGNATURE Services1'2 50 DISTRICT NO .� OCESSE BY 0-200 Amp Under 600 V 201"-1000 Amp' Under 600 V 25 00 J r7 Over 1000 Amp or Over 60 V 500010 Z O Temp'Power Pole&Appurtenances 10.00 Q Sign with One Branch Circuit 1000 D Additional Sign Branch Circuits 2 00 INSPECTION > l 0 00 INFORMATION W Misc.Conduits&Conductors ON REVERSE x Other(See Complete Fee Schedule l SIDE Z 2 5 0 0 3 A # O O'O O O 2 2 - - 1000 PERMIT FEE (Sub-Totol) Z 0 0 0 0 0 0 PLAN CHECKING FEE IOne-Fourth Perm rt Feel O PERMIT ISSUING FEE. $7••00 — Q 0619-79 TOTAL FEE > INSPECTI N LED + W date B ®s COUNTY OF LOS ANGELES APPLICATION FOR PERMIT DEPARTMENT OF COUNTY ENGINEER' -a 'DIVISION OF BUILDING & SAFETY E C` 3 �DC W=AM J. FOX, COUNTY ENGINEER FOR APPLICANT TO FILL� DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRICIAN ADDRESS r 1 d ��- RECEIVED BY READY FOR DATE ISSUED CITY .�✓);E {� FIRSTTrINSPECTION TEL. COUNTY LICENSE NO. EXPIRES BUILDING PERM FEES ADDRESS le NUMBER EACH FEE LOCALITY- /-..��/�t�Z6 �' ./ OUTLETS LIGHT V I NEAREST RECEPTACLES CROSS ST WALL SWITCHES OWNER TOTAL OUTLETS 5C $ MAIL _ ELEC. RANGES 25' ADDRESS - ELEC. HEATERS 25 CITY TEL. NO. ' FIXTURES S MISC. _ I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT ,NUMBER OF L CIRCUIT'S- AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE PTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I 'CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER New MVD. HP �OVER' INC. MACH OF THE RESIDENTIAL PROPERTY DESCRIBE N)ABOVE.AA a/ a LESS $ .25 �J `•%� - SIGNATURE OF Vz •E .50 PERMITTEE 2 5 1.00 INSPECTIONRECORD V 5 15 1.50 is so 2.50 50 200 5.00 200 Soo 10.00. J 500 1000 15.00 Q Z OVER 1000 20.00 M.G. SET/FRED. CHANGER-HP R' WELDERS: AC-KVA. O GENERATORS -KW TRANSFORMERS-KVA TEMP. MOTORS (75% OF OR1G.) MOVED MOTOR (75% 97 ORIG.) MISC: I 0 SIGNS NO. NO. NS. APPROVALS NO. NO. LAMPS FOR EACH PERMIT: DATE INSPECTOR'S NAME WIRING $1.00-gQ12 CONDUIT \ n •C FIXTURES -- $1.00 WIRING SUPPLEMENTARY .50 FIXTURES POWER* �i, TOTAL FEE- - $• /t UTILITY CO. NOTIFIED �ti -1 FINAL ' 76A eea DBS# SA. 4-e2 WORKERS' COMPENSATION DECLARATION I '20A019DPW 3/B7 AI�I��IC�TI®N FOR EL EC�TRWAL PERMIT I hereby affirm that 1 have a certificate of consent to self CE-906G�76A663 ' insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certified copy thereof (Sec 3800, Lab C.)) \/ / . Poli No.Ly,1gp/o3J G ht Af 9�1� Ci� �y ( Company c t FOR APPLICANT TO FILL IN JOB � g�� Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO FEE ADDRESS 6 .0b 4246,iK" D L•'v`°^' El Certified copy is filed with the county building ins 1 & 2-Family, Sq. Ft $ _ $ LOCALITY tion eyrt en t Multi-family Sq Ft. NEAREST l '/_ G1 Residential Swimming Pools CROSS ST �ONf6b� t ;�L)K- Date Applicant OWNER OR , )j �j FIRM NAMFirst 20 J�/ L CERTIFICATE OF EXEMPTION FROM OR RS' Outlets. Rec Light SW.— MAIL COMPENSATION INSURANCE ADDRESS' ' (This section need not be completed if the Work involved by Total No. CITY Tel. IN P the permit is for one hundred dollars ($100)or less.) Additional c J�3 PLAN CHECK, ,,^ I certify that in the performance of the work for which this APPLICANT fJ t permit 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- 7VO Additional y,3 DateApplicant Total No CITY �p,�,���y- Tel. NoY Fixed Appliances Not Over 1 HP PERMIT �� �7 � NOTICETO APPLICANT. If, after making this Certificate of APPLICATION Exemption, you should become subject 'to-the Workers' Range— Heater—D W — Compensatjon provisions of the Labor Code, you must forth- Oven — Dryer,—W.M.— ADDRESS with comply with such provisions or this permit shall be Top FAU —W.H. deemed revoked. r ! CITY , + Tel.'No. HoodFan, —Other' r' LICENSED CONTRACTORS DECLARATION ; LICENSE OR s� �y I hereby affirm that I am licensed under provisions of Chapter 9 Disp Rbo'm Air Cond; — REG NUMBER G 7 Set(/ Class. (commencing with Section 7000)of Division 3 of the Business Power Apparatus&Large Appliances I DISTIRS,1O PR ED BY and Professions Code,and my,license is m full force and effect t—ti t'/ CL Size &Type HP, KW, KVA, or KVAR `J (} Q License Number Lic. ClassUp to 1 Incl. FINAL V Contract 1 Date `ply Over 1 to 10 Incl DATE O G� VALIDATION cr ❑ Over 10 to 50 Incl. FINAL V1 I am exempt under Sec Over 50 to 100 Inc BY W B.&P C for this reason Over 100 Il D Date Services, Swbd., MCC& Ponelboards Z Z 0-200 Amp Under 600 V Signature 201 - 1000 Amp. Under 600 V DOver 1000 Amp. or Over 600 V Exemption for Reg Maint Elect SINGLE FAMILY Temp. Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION - ,.• a I hereby affirm that•I am exempt from the Contractor's License Sign with One Branch Circuit At..CT.ir Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits �7 nc.•. i•. SCI Professions Code): .1 ITEMS 1, as owner of the property, will do the work and the Misc. Conduits&Conductors structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)— TOTAL 25-5(3 Business and Professions Code). CONSTRUCTION LENDING AGENCY - CHECK 25.50 I hereby affirm that there is a construction lending agency for CHANGE .CI I the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). PLAN CHECKING-FEE2 d� Lender's Name I3000-�1 - ' 1/39 PERMIT ISSUING FEE ,O ?1a� i AM11�C1 Lender's Address I certify that I have read this application and state that the TOTAL FEE above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby author a representatives of this County to enter upon the abo e-' do d operty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE -;X Signature o ermittee Date ' WORKERS'COMPENSATION DECLARATION 76A663 DPW 3/87 76-663 b1___,k �1?PUC H0N FOR ELECTWICAL PERMIT I hereby affirm that 1 have a certificate of consent to self I 'CE-806G insure, or a certificpte of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or•a cert4fied copy thereof (Sec 3800, Lab C ) Policy No. • Company FOR APPLICANT TO FILL IN JOB 3DP ❑Certified copy is hereby furnished. New Residential Bldgs & Pools EACH NO FEE ADDRESS Cfrtified copy is'filed with the county building inspec- 1 &2-Family, Sq. Ft. $ — $ LOCALITY Le tion department. CROSS ST / � i Multi-family Sq, Ft NEAREST / A hcan l/ Residential Swimming Pools,4/0->0599 7G wioo �0.v6,l7P�L pp ` �,n OWNER OR Date !�' FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec LightSw.= MAIL COMPENSATION INSURANCE ADDRESS First 20' (This section need not be completed if the work involved by Total No –sem Additional 'CITY Tel. No the permit is for one hundred dollars ($100)or leas.) + 1 t PLAN CHECK I certify that in the performance of the work for which this 1/ y ;.'X i APPLICANT permit 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 Additional Total No. CITY. Tel. No Date Applicant NOTICE TO APPLICANT If, after'making this Certificate of Fixed Appliances Not Over 1 HP PERMIT, APPLICATION 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 OWI ,with comply with such provisions or this permit shall be Top — FAU —W H. — deemed revoked Hood — Fan —Other— CITY �iu�/6972� Tel. No. 7-999 6,5' (7 LICENSED CONTRACTORS DECLARATION LICENSE OR Disp — Room Air Cond REG NUMBER j�$9o� Class.G=l0 I hereby affirm that I am licensed under provisions of Chapter 9 (commencing-with Section 7000)of Division 3 of0he Business Power Apparatus& Large Appliances DIST I T NO • P ESS Y Y and Professions Code,and my license is in full force and effect. D / .,Size &-Type HP, KW, KVA, or KVAR i License Number Si �dol Lic. Class C_/0 Up to 1 Incl. FINAL 0 A,,f wf 115tfl e 6 xv,/ J9 Over 1 to 10 Incl DATE JIN� VALIDATION �Contractor Date 0 ❑ Over 10 to 50 Incl. FIN I am exempt under Sec. Over 50 to 100 Inc. BY U B.&P.C. for this reason Over 100 LCL L1 W ' - Services, Swbd , MCC& Panelboards � � D � Z Date: 0-200 Amp. Under 600 V Signature 201-- 1000 Amp. Under 600 V Over 1000 Amp. or Over 600 V I Exemption for Reg. Maint. Eject SINGLE FAMILY *Temp. Power Pole &Appurtenances N0� FEE HOME OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit Law for the following reason (Section 7031.5, Business and, Additional Sign Branch Circuits ' Professions Code): –000 • 11/ 6�85' ❑ I, as owner of the property, will,do the work and-the Misc. Conduits&Conductors 6594 1 AM11:4 structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ 2 Business and Professions Code). CONSTRUCTION LENDING AGENCY ACCT.T I hereby affirm that there is a construction lending agency for 3307 43.50 the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). 1 ITEMS' PLAN CHECKING FEE Lender's Name TOTAL 43 -50 PERMIT ISSUING FEE A Lender's Address _ CHECK 43J.50 j certify that I have read this application and state that the TOTAL FEE CHANGE ,off above information is correct. I agree to comply with all County ordinances and State jaws regulating Electrical wiring, and hereb authorize representatives of this County to enter upon the ove- ntioned operty for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE 11/ 639 6 A101 �y 6595 1 AM 11:45 na a Permittee Date Os WORKER'S COMPENSATION DECLARATION , o 0-0019 DPW( 2-917 ` A��L9CA��®� ®� ELECTRICAL �ERIVi9T 76A663 I hereby affirm that I have a certificate of consent to self Insure, 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 Policy NO J� eny ^""� FOR APPLICANT TO FILL IN JOB ❑ ADDRESS ® �. Certified co is hereby furnished. NO If $ EACH $ FEE- LOCALITY -�^� f copy y New Residential Bldgs &Pools 1 &2-Family,Sq Ft NEAREST Certified copy is bled with the coupAV budding i pecUon - _ department. Q„C I f Nn�n ��q� Multi-family Sq Ft. CROSS ST ff•p ca ^W�✓„r (� Residential Swimming Pools ASSESSOR Date `' Applicant�QYIZ��� MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec._ ht Li Sw, OWNER OR COMPENSATION INSURANCE g FIRM NAME First 20 MAIL (This section need not be completed if the work involved by the ADDRESS permit is for one hundred dollars($100)or less.)' Total No. Additional 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 8s l0 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 provisions or this permit shall be deemed revoked Power Apparatus&Large Appliances APPLICANTR t LICENSEDyCONTRACTORS DECLARATION ' Size&Type HP,KW,,KVA,`or KVAIR ADDRESS 1 hereby affirm that I am libensed under provisions of Chapter 9 Over 3 to 10 Incl. (commencing with Section 7000) of Division 3 of the Business and CITY I/V- Tel W. Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. } LICENSE OR A Over 50 to 100 Incl. REG NUMBER �j S Class 616 101- License ('�Y'i^"_`� (���� ol,rr � I•� Qq � a LicenseNumberLic Class Over 100 DISTRICT N.9-f PROCESS O � ` -Services,Swbd.,MCC&Panelboards 0-399 Amp.Under 600 V FINAL O Contractor 1 Date - DATE 400-1000 Amp.Under 600 V ` V VALIDATION ❑ I am exempt under Sec. ! W Over 1000 Amp.-or Over 600 V FINAL - Q. B.&P.0 for-this reason BRANCH CIRCUIT FEES BY _ U1 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 Exemption for Reg Mamt.Elect: 15A,20A,208V To 277V Lighting Br.Circuits 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 for the following reason (Section 7031 5, Business and Professions Additional Sign Branch Circuits i Code): ❑ 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) 'rt3 D, °DJ and Professions Code). z E r CONSTRUCTION LENDING AGENCY j ALa 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) '-`f° i'-I Civ.C.) _ f 1 PLAN CHECKING FEE !)_i• �i (7� z Lender's Name + PERMIT ISSUING FEE O _ Lender's Address (fir ?I E—( 1 � 1 E 1•f yu'r a t I certify that I have read this application and under penalty of purjury state TOTAL FEEP11r 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 - 0 infor ct�n purposespurposes SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNA E OF PERMI E DATE WORKER'S COMPENSATION DECLARATION 9 DPW 9/89 APPLICATION FOR ELECTRICAL PERMIT 76A66 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.) < Polic o.IDGt-55/b Company lT6///42 FOR APPLICANT TO FILL IN JOBEir � / . OSC Fad Certified copy is hereby furnished. New Residential Bldgs.&Pools EACH NO. FEE i� ADDRESS 6300 $ _ $ LOCALITY ❑ Certified copy is filed with the county building inspection 1 &2-Family,Sq.Ft. department. / LMulti-family Sq Ft CROSS T ST- Date {C�^ r^I Z Applicant Yf Z4`1�GL 44N7RJC Residential Swimming Pools ASSESSOR MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER OR COMPENSATION INSURANCE Outlets:Rec _light Sw. ; FIRM NAME to (This section need not be completed if the work Involved by the First 20 MAIL,Total No. Additional ADDRESS permit Is for one hundred dollars($100)or less.) ,' I certify that in the performance of the work.for which tfiis permit CITY Tel.No is Issued, I shall not employ p y an y 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 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 PERMIT t G TO APPLICANT $ V �. LZb+cT�tG provisions or this permit shall be deemed revoked. 41 OR MORE BRANCH CIRCUITS EACH LICENSED CONTRACTORS DECLARATION - - ADDRESS Z 17 I t1C a`� } I hereby affirm that I am licensed under provisions of Chapter 9 15 OR 20A,208V TO 277V LIGHTING EACH IN. L- ha (commencing with Section 7000) of Division'3 of the Business and _ CITYMo��-�— �v Tel No Z�_ 0 Professions Code,and my license is in full force and effect RESIDENTIAL APPLIANCES UP TO 3HP- LICENSE OR IV Power Apparatus&Large Appliances - REG NUMBER 4F 70'/ Class G.tet 0 License Number. Llc.Class Size&Type HP, , KW,KVA,Or KVAR DISTRICT NO, P OCESSED BY v Up to 3 Incl. �P) W R� it r cZo�c � Over 3 t0 10 Incl. FINAL Li- Contractor 1 Contractor �43ate ' 6 DATE /Over 10 to 50 Incl. � yn - - (n ❑ Z I am exempt under Sec. Over 50 to 100 Incl. S°~ L' VALIDATION Over 100 FINAL - B.&P C.for this reason BY Services,Swbd.,MCC&Panelboards _ Date' cep ! 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 It-fz HOME OWNER-BUILDER DECLARATION ' - - I•-a.•� ,-p ' I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit i for the following reason (Section 7031 5, Business and Professions Additional Sign Branch Circuits -3 t(t Code): ❑ - L 1�.i i0 I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors s _ is not Intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) I? i YiI_ and Professions Code). /'.'�C.f•l CONSTRUCTION LENDING AGENCY _ I E I hereby affirm that there is a construction lending agency for the �- k rt performance of the work for which this permit Is issued (Sec. 3097, PERMIT FEE - (Sub-Total).- Civ.C.) PLAN CHECKING FEE _ j _jj-••j)i;LEi Lender's Name Zy 75 j_ PERMIT ISSUING FEE 'i `!i } Ali! u=1l Lender's Address 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 property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE OF APPLICANT OR AGENT DATE f WORKERS'COMPENSATION DECLARATION 76-806 10/81 q PP CATION F®® ELEC U R�C IL PERMIT I hereby affirm that I have a certificate of consent to self Insure, CE-806G 6W 11— lL ?'� II�'1 Ifs 6�9 fi�V! or a certificate of Workers'%Compensation Insurance, or a certified COUNTY OF LA,S'i4-ELES BUILDING AND SAFETY A�G.opp(y thereof(Sec.3800,Lab. C) F�� - I'011cy N�d7�� Company "" —"`°r FOR APPLICANT TO FILL IN JOB 41 F1Certified copy is hereby furnished. New Residential Bldgs & Pools EACH NO FEE ADD EACH p ❑ 1 & 2-Family,Sq Ft $ _ $ NEAREST LOCALITY Certified copy is filed with the county building Inspection department Multi-family Sq Ft. �� p rCROSS ST Date '9 A Tr Residential Swimming Pools OWNER OR ppIlca FIRM NAME 6 CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec— Light — Sw MAIL COMPENSATION INSURANCE ADDRESS (This section need not be completed if the work involved by the First 20 CITY Tel No permit is for one hundred dollars($100)or less.) Total No. Additional PLAN CHECK I certify that In the performance of the work for which this.permit APPLICANT 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 Additional Total No. - CITY Tel No Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT If, after making this Certificate of APPLICANT 1216H Exemption,you should become subject to the Workers'Compensation Range_ Heater_ DW. provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer _ W M ADDRESS .4'� provisions or this permit shall be deemed revoked. Top — FAU _ W.H. CITY Z)L, Tel No � - LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other_ I hereby affirm that I am licensed under provisions of Chapter 9 LICENSE OR Dlsp Room Air Cond ' REG NUMBER v �+� 712— Class v'/O (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 �-- PROCESSED BY 51.? 7/1— y Size&Type HP,KW,KVA,or KVAR r 0 License Number J L— Lic.Class l� G/ Up to 1 Incl FINAL 9/4U" A4140')/ j�/f/6, f�l n� Over 1 to 10 Incl DATE i Q� VALIDATION X Contractor Date /J7 Over 10 to 50 Incl { 1 U ❑ FINAL lam exempt under Sec. Over 50 to 100 Inc BY W Over 100 a- B&PC for this reason CA Services,'Swbd,MCC& Panelboards D Z Date. 0-200 Amp.Under 600 V Signature 201 - 1000 Amp Under 600 V Over 1000 Amp or Over 600 V '7 ❑ Exemption for Reg.Maint Elect. *HCCT.a SINGLE FAMILY Temp Power Pole& Appurtenances HOME OWNER-BUILDER DECLARATION8. Sign with One Branch Circuit �3 48.60 1 hereby affirm that I am exempt from the Contractor's License Law n B Sign Branch Circuits reel for the following reason(Section 7031.5, Business and Professions Additional1 ITEMS Code) I ' ❑ Misc Conduits& Conductors TOTAL 48 .60 I,as owner of the property,will do the work and the structure is not intended or offered for sale (Section 7044, Business Other(S Complete Fee hedule) CHECK 48.60 and Professions Code). CHANGE .00 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) MM—Ml 12/ 1/95 Civ.C) PLAN CHECKING FEE 3.533 1 - AM1103 Lender's Name PERMIT ISSUING FEE o� Q Lender's Address O I certify that I have read this application and state that the above TOTAL FEE 7O l0� 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 pro for Inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE XSignature of P Ittee x Date WORKERS'COMPENSATION DECLARATION CE-806G toi8t y -FOR ELL MICAL PERMIT I hereby affirm that I have a certificate of consent to self insure, or a geri::cate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec.3800,Lab.C)• Policy No +Company FOR APPLICANT TO FILL IN ' - JOB :❑ Cin AWD ertified copy is hereb furnished, EACH NO' FEE ADDRESS � oo - y New.Residential Bldgs & Pools ❑-- Certified copy is filed with the,county. building Inspection, 1 & 2-Family,Sq Ft,• $ — $ LOCALITY L .r NEAREST department Multi-family Sq:Ft CROSS ST LGN 6D �- Date Applicant Residential-Swimming Pools OWNER OR• .�._,. FIRMNAME CERTIFICATE.OF' WORKERS' Outlets Rec— Light, Sw.. "' MAIL COMPENSATION INSURANCE• ADDRESS' - (This,section need not bei completed if the work Involved by the First 201` permit is for one hundred dollars,($100)or less.)' 'Total No Additional.-^ CITY Grill^ T -No -fig7k-z- I certify that in the performance ofhthe work for.which this permit. '' APPLICANT . is issued, 1,shall not employ APPLICANT - p y•any�person In,any manner so as to _ become sutilect,to the,Workers'Compensation Laws Lighting Fixtures First 20 - ADDRESS „ "• '" Additional.- Total No. - CITY -Tel No. Date tApplicant Fixed Appliances Not Over 1 HP NOTICE,' TO APPLICANT .If, .after.making„this-6Certificate of PERMIT,_ Exemption,you should become sublect,to the Work,S;Compensation Range_ Heater_ DW APPLICANT' ' proyisions of the Labor Code, you'must forthwith'comply with such, 'Oven _ Dryer _'{ W M:_ ADDRESS, J S provisions o'r,this permlt,shall be deemed revoked ;Top, FAU, WH LICENSED CONTRACTORS DECLARATION Hood Fan ' — Other CITY - Tel Na I hereby affirm that I em licensed.under,provisions' of•Chapter,9 ^ LICENSE OR , '-Dlsp Room Air Cond REG NUMBER Class (commenting with Section 7000) of'Division 3;c' the-Business and „ Professions Code;and my license is in full force andeffect DISTRICT NO. PRO ES D BY Power Apparatus& Large.Appliances a.- =• ° + � - Size& Type HP,KW,KVA,or KVAR - - �!� �. License'Number Lic Class Up-to 1'lhcl' ' " ;' 'FINAL Over 1 to 10 Incl DATE 'Contractor'' ' " ' Date• v VALIDATION ❑ Over 10 to 50 Incl FINA f -I am exempt under Sec ' Over 50 to 100-Inc. gY V Over 100 .. - d B.&PC.for this reason. � 1 'Services, Swbd,MCC&`Panelboards.. N Date 0- 200 Amp•Under 600 V �s Signature' 201 - 1000 Amp Under 600 V L' �O 0 Q,7 A' Over 1000 Amp or,Over 600 V ❑" Exemption for Reg'Maint Elect: ;#�o o•o;0 0 2 SINGLE FAMILY A Temp Power Pole& Ap'purtenances HOME OWNER-BUILDER DECLARATION• ' '' Sign with One Branch'Circuit o 0,0 5 O 1-- Sign 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, O 6 3,O 8.8 Code) ❑ 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) _- 'and,Professions Code)' -• CONSTRUCTION LENDING AGENCY,' I hereby affirm that there'is•a'construction'lending agency for the performance of the,work,for_which this'perrrit•is issued(Sec 3097, PERMIT FEE (Sub-Total) Civ C.). I ." . PLAN.bHECKINd FEE Lender's-Name *_- PERMIT ISSUING FEE QSZ „ Lender's Address /�� 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 property,for inspection purposes • SEE REVERSE FOR EXPLANATORY'LANGUAGE ; Signature of Permittee Date WORKERS'COMPENSATION DECLARATION 76-663 10/81 ;q PPLICy MON FOR ELECTRICAL ECTRI A PERMI T I-.:- CE-806G'CE-806G' ¢p �1.v6'� ��'1 6� 'ls tl� �'11!!II tl I hereby affirm that I have'a certificate of consent to self insure, or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec 3800,Lab C) Policy NO - Company FOR APPLICANT TO FILL IN ADDRESS C9 ❑. Certified copy is hereby furnished.' ' New Residential Bldgs & Pools EACH" NO. ., FEE ❑ LOCALITY- �QXW V- Certified copy is'filed,with the bounty building inspection 1 & 2-Family,Sq Ft department Multi-family Sq Ft.' 4 — NEAREST,qROSS ST ►�E -Residential Swimming Pools OWNER OR - Date Applicant r. - - ," FIRM NAME CERTIFICATE OF-EXEMPTION FROM WORKERS' Outlets:Rec Light P MAIL — Sw. — COMPENSATION INSURANCE' - ADDRESS 21(o 'N'. CD4,oc�::: This.'section.need not be coin leted if the,work involved b 'the First 20' ( P Y CITY 'No. permit No. ��]7S, permit is for one hundred dollars($100)or less.) Total No. Additional' I.certify,that:in the,performance,of tfie work'for which this permit" PLAN CHECK ' Y P '� "APPLICANT is.issued, l•shall not employ any,person,in any,manner so.'as tj;A2-� become subject to(the 'Workers'Co e sation Laws. Lighting Fixtures: First•20, ADDRESS .' l r •a�'V V ... . I �iQ� - Additional: ,r- - , - Total No CITY Tel.No. " Date Applicant Fixed Appliances Not Over"YHP NOTICE,, TO.APPLICANT:-If,.•after, making, `this. Certificate of PERMIT Range_'Heater_ D W APPLICANT Exemption,you,should become subject to'the,Workers'Compensation �l/C!\e S Q ;•,provisions of the Labor Code, you must'forthwith comply with such, 'Oven Dryer _,-W.tv1._ ADDRESS P.o: �3ox.42q oZ$►�117(0 provisions or this permit,shall'be'deemed,revoked. Top FAU '__W H. LICENSED',CONTRACTORS DECLARATION-,, - ,,Hood Fan Other_ CITY�� t�Q` Tel No I hereby,affirm that I•am'licensed under provisions of,Chapter 9 ,. REG'NU OR. Disp. Room Air Cond. 2-] 2�$ Class C- (commericmg with Section 7000) of,,Di'vision•3,.of,the'Business and REG'NUMBER Professions Code,grid my license-is in full force and effect. Power Apparatus& Large Appliances 'a DISTRICT NO PROCESSED BY License Nu er �`�� �' Class Size&,Type HP,KW,KVA,or.KVAR Up to 1 Incl FINAL' p Over 1 to 10 Incl: - DATE f a4-'88 :,, .. _ .-1 VALIDATION •0 Contract Date Over 10 to.50 Incl FIN ❑ I am exempt under Sec Over 50 to 100 Inc. gY W Over 100ZZZ 0- B&P.0 for this reason � o Services,Swbd,MCC& Panelboards 0 7 9,'4 Z a 0- 200 Amp Under 600 V 'Signature � � 201 - 1000 Amp.Under 600 V' •' � � # 0.0 0.0 0 Over 1000-Amp or Over 600 V o � ❑ Exemption for Reg Maint.Elect r ' I' 1 �T�'0. . +' SINGLE FAMILY Temp Power-Pole:& Appurtenances— HOME ppurtenances ° ° 5a505' HOME OWNER-BUILDER DECLARATION •:_ Sign�with•One Branch Circuit 9, �•�8 8 I hereby affirm that I am exempt from the Contractor's License,Law additional Sign Branch Circuits for the following reason(Section•7.031.5,Business and Professions 1 ht' Code) S ❑ - o Misc Conduits& Conductors I,as owner of the property,will do the•wrk and,the structure• , is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) and Professions Code): I? 4w"` k"^' D'• ' # ;2,133 9.5 A.' CONSTRUCTION LENDING AGENCY . . I 6'0Y1 '5 5 Q I hereby affirm that there'is a,construction lending agency for the_ performance of the work for which this permit is issued•(Sec.3097, PERMITTEE (Sub-Tofal) 0 0 0 5 �' Civ C). PLAN CHECKING FEE L O.9.2 H'`H 8 Lender's Name • > � PERMIT ISSUING FEE - - _ . '• i -. - - - . , •. Lender's'Address• p 7 9 6A I certify that I have read this'application and state that the above TOTAL FEE inform �4 ation is correct. I agree'to'comply with all County ordinances # o'0 0 0 0 'Z and State laws regulating Electrical wiring, and,hereby authorize _ t: representatives of this County to cintQr upon the above-mentioned 1• o 01i ri,n p per for ns ection p poses. - o 0 0 SEE REVERSE FOR EXPLANATORY LANGUAGE ignature of-Permittee Date WORKERS'COMPENSATION DECLARATION 10ie1 Qpp��QATMN FOR L LEcrmtAL PERM? 'S hAreby�affirm that I have a certificate of consent to self CE-806G =insure, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec. 3800, Lab C.) , Policy No. Company FOR APPLICANT TO FILL IN JOB 6130-01V �G �J ��� A ��v . Certified copy is hereby furnished. New Residential Bldgs & Pools EACH NO FEE ADDRESS 6 ec Y ❑ Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. $ — S LOCALITY _r6H LIE C1 7-4 tion department. Multi-family Sq Ft. — 'NEAREST + '�,o EP- Residential Swimming Pools CROSS ST bOWNER OR Date Applicant- ' FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets- Rec Light Sw_ MAIL COMPENSATION INSURANCE ADDRESS (This section need not be completed if the-work involved by First 20 the permit is for one hundred dollars ($100)or less.) Total No Additional, CITY Tel. No I certify that in the performance of the work for which this PLAN CHECK permit(s issued, I shall not employ any person in any manner APPLICANT so as to become subject to the Wor ers'Com nsation Laws. lighting Fixtures First 20 ADDRESS Total No 2 Additional Date —L'� ..�� Applicant CITY Tel. No NOTICE TO APPLICANT: If, after making thi Ce ifi ate of Fixed Appliances Not Over 1 HP PERMIT f Exemption, you should become subject to .the Workers' Ra _ Heater_D;W APPLICANT O� L L.. j }'.' Compensation provisions of the Labor Code, you must forth- Oven ryer W.M.— ADDRESS 6 L. S', — with comply with such provisions or this-permit shall be Top FA —WH — deemed•revoked Hood _ Fan Other_ CITY "t° `� Tel No. Z6 Z LICENSED CONTRACTORS.IDECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. _ Room Air C REG NUMBER Class. (commencing with Section 7000) of Division 3 of the Business DISTRICT NO. PROCESSED BY Power Apparatus& Large Appliances and Professions Code,and my license is m full force and effect. � 'Siz &Type HP, KW, KVA, or KVAR' Q 0 License Number: Lic Class Up to 1 Incl FINAL n V Over 1 to 10 Incl DATE Contractor Date VALIDATION 0 0 to 50 Incl FIN V ❑ I am exempt under Sec Over 50 to Inc. BY W B.&P C for this reason Over 100 H Date Services, Swbd., MCC& Panelboards D Z 0 -200 Amp. Under 600 V Signature 201 - 1000 Amp Under 600 V ❑ Exemption for Reg Maint. Elect. Over 1000 Amp or Over 600 V 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 Additional Sign Branch Circuits Law for the following reason (Section 7031 5, Business and Professions Code)• ❑ I, as owner of the property, will,do the work and the Misc Conduit's&Conductors structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ D 7044, Business and Professions Code) 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 PERMIT FEE (Sub-Total) (Sec 3097, Civ. C ) 2.3 0, 1q PLAN CHECKING FEE Lender's Name I - ;#,olo 0 0,0 2 PERMIT ISSUING FEE �� (,° o. 550 Lender's Address y� " 1 certify that I have read this application and state that the TOTAL FEE l V` rn 'o o_o 1550,F2 above information is correct I agree to comply with all County ordinances and State jaws regulating Electrical wiring, and '0621 t 8 5 reby outhonz0 re rese tative of this County to enter upon above -m noon d pro erJy r ins ction purposes SEE REVERSE FOR EXPLANATORY LANGUAGE 60-zi-$s Signature o Pe)fn rttee Date WORKER'S COMPENSATION DECLARATION 20-0019 DPW(t2-91) APPLICATION FOR ELECTRICAL PERMIT P'41r IT PP ' 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 3,800 Lab CJOB ) Policy No •�Q.77 Company � _�y� FOR APPLICANT TO FILL IN ADDRESS 3 O Q �V SF M (•r✓�• . ❑ 'Cerbfied copy is hereby furnished New'Residential Bids &Pools NO EACH FEE � g — $ J^$ LOCALITY u OAW PFe_1K•1- Certified copy is filed with the county,bullding Inspection 1 &2-Family,Sci Ft. NEAREST department Multi-family Sci Ft — CROSS ST Date ' -3 •Applicant /7•� Y!�'L� �' Residential Swimming Pools ASSESSOR MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' owNER OR Outlets Rec —Light Sw. FIRM NAME COMPENSATION INSURANCE O /QLJ .t�., - 1.,' •s,'-.,.'. 'rr-.,- First 20 MAIL " (This section,need not be completed If the work Involded by the ADDRESS permit is'fo�"one hundr"ed dollars($100)or'less.)' Total No. Additional I'cerhfy thaf'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 become sub ect to the Workers' Com ensap?h Laws Lighting Fixtures-: First 20 PLAN CHECK J _ p 9 APPLICANT Total No. Additional ' ADDRESS ' Date o- Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP NOTICE TO APPaking APPLICANT. If; after mthis Certificate Of CITY Tel No Exemption,you should become subfect,to the-Workers' Compensation OTHER APPLIANCES NOT OVER 3 HP provisions of'the Labor.Code, you must forthwith comply with such -PERMIT provisions or this permit shall'be deemed revoked Power Apparatus&Large Appliances APPLICANT,A / LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS I hereby affirm•that I am licensed underprovisions of'Chapter 9 ` �• �� �E• Over 3 to 10 Incl � (commencing with Section 7000) of Division 3 of the,Business and CITY !p Tel 481 Professions Code, and my license is- full force and effect Over 10 to 50 Incl LICENSE B Cl >_Over 50 t0 100 Inc], • -- m REG NUMBER �J � ass � d 'd _ Over 100 D BY O License Number C'�• Lic Class /O DISTRICT NO PRO - -Services,Swbd,MCC&'Panelboards A,g• yf,(,f py( � Date 6i`-2-5 0-399 Amp Under 600 V• FINAL 0' • - DATE COnt(aCtor ❑ I am exempt under Sec 400-1000_Amp.Under 600 V ` Z�- VALIDATION LU Over 1000 Amp or Over 600 V FINAL a B&P C.for this reaso BRANCH CIRCUIT FEES eY Z Date .15A,'or,20A, 120V,Lighting or Recept. _ _ - -,- 1 To 10 Branch Circuits Signature •11 To 40 Branch Circuits ti 41 Or More Branch Circuits ❑ - Exemption for-Reg'Maint.Elect - 15A,20A,208V-To 277V Lighting Br Circuits SINGLE FAMILY Temp.Power Pole&Appurtenances HOME OWN ER-BUILDER•DECLARATION ��. .T�g I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit ; for the following reason (Sectiori 7031.5, Business'and Professions Additional Sign Branch Circuits 303 � -75 Code): _ . _._T- r�t,� ❑ Misc. ITEMS- Conduits Conductors 1�GI E - 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 CompletelFee Schedule) t i 11 tyL ® 75 and Professions Code). _ _. r L•�{Et•�i fit. ; _r CONSTRUCTION LENDING AGENCY_ nr�ss t�3�' I hereby affirm that there is a construction.lending agency for thetti ` I performance of the work for which this.permrt Is Issued (Sec 3097, PERMIT FEE (Sub-Total) _Civ. C.) PLAN CHECKING FEE 13000-0100 1 Lender's Name 7 PERMIT ISSUING FEE . �/` 0471 •. .1 AM10'.17 Lender's Address ' - - -. I certify that I have read this application and under penalty of purJury state TOTAL FEE 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 SIGNATURE OF PE MITT E DATE - ' affirm I COMPENSATION DECLARATION 76-806 tout APPLICATION PP IC/TION FOR ELECTRIC L g�ERMT J"� I hereby affirm that I have a certificate of consent to self Insure, CE-806G /� I!"fL /'••9 CAH Q� 61 9"' 611/9 "fl I or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BIJILDING AN AFETY Ju' copy thereof(Sec. 3800.Lab C) 3 GD rL.cs-•2 Policy NO. Company ' FOR APPLICANT TO FILL IN JOB /+_e ❑ Certified copy,is hereby furnished i EACH NO FEE ADDRESS p £ �b �� C ci► .• New Residential'Bldgs &Pools $ _Is' LOCALITY ❑ 'Certified copy is'filed with the county building inspection 1 & 2-Family, Sq Ft — NEAREST ' depaftment. Multi-family Sq Ft GROSS ST Residential Swimming Pools OWNER OR, —y Date Applicant - FIRM NAMEP o t CERTIFICATE OF EXEMPTION FROM WORKERS', Outlets Rec Light — Sw MAIL ^ COMPENSATION INSURANCE 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 `'r G, Tel No A certify that`in the performance of the'work for which this,permit PLAN CHECKAPPLICANT- is, PPLICANT-iis.issued, I shall not employ any person in any manner, so_as to become subject to the Workers'Compensation Law Lighting Fixtures First 20" ADDRESS Additional Total No. CITY Tel No Date ,Apphcant NOTICE ;TO APPLICANT. If, after making,this 'C t icate of Fixed Appliances Not Over 1 HP PERMIT I Exemption,you should become subiect•to the Workers'C mpensation, Range_ Heater_ D.W. _ APPLICANT QI1 � Q T O provisions of the-Labor.Code, you,must forthwith comply,with such Oven Dryer ; W M _, ADDRESS q O At)lAic S-� r ,provisions or this permit shall be deemed revoked Top FAU.•— W H _ 'LICENSED CONTRACTORS DECLARATION .i •� Hood — Fan _ Other_ CITY I C Tel No L�Z "el hereby affirm-that I am licensed under.proyislons•of Chapter 9LICENSE OR DISp Room Air COnd REG NUMBER Class (commenting with Section 7000) of Division 3 of the Business and Professions Code,and my license is in full force and effectPower Apparatus& Large Appliances DISTRICT NO Pn:��, � Q Size& Type HP,KW,KVA,or KVAR ✓ C d U 0 License Number Lic Class -Up to 1 Incl FINAL U Over 1 to 10IndDATE — • VALIDATION Contractor Date Over 10 to 50 Incl - L ❑ "1 am,exempt under Sec Over 50 to 100 Inc / W Over'100 B&PC'for this reason N Services,Swbd,MCC'& Panelboards Date 0-20D Amp Under 600 V r Signature 201 - 1000 Amp Under 600 V Over 1000 Amp or Over 600 V Exemption for^Reg Maint.Elect. SINGLE FAMILY' .'Temp Power Pofe& Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 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 - Code) Misr Conduits&'Conductors ' 'as owner of the property,will do'the work and the structure !!!!!! s not'intended'or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) and,Professiohs'Code) 7 3 514 A CONSTRUCTION LENDING AGENCY #,0•o 0'0 02 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) ih1.0 0 5 5.0 Civ C.) PLAN CHECKING FEE -0-0 1 5 5 0 Lender's Name PERMIT ISSUING FEE 0 6 2 9 8 7 Lender's Address I certify that I have read this'application and state that the above TOTAL FEE Z 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 pr erty for ins ection pu oses SEE REVERSE-FOR EXPLANATORY LANGUAGE­ Signature of Per tee Date WORKERS'COMPENSATION DECLARATION 06G 81 APPLICATION FOR ELECTRICAL PERM17 I hereby affirm t�iaill hive a certificate of consent to self (� insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES B (WING A SAFETY IL JI or a certified copy thereof (Sec 3800, Lab C ) aa.d to -M Policy No Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished New Residential Bldgs. & Pools EACH NO FEE ADDRESS.t4jiE7, COL7, b Certified copy is filed with the county building inspec- 1 & 2-Family, Sq Ft. $ — $ LOCALITY C—C CITY A tion department. Multi-family Sq Ft — NEAREST CROSS ST Residential Swimming Pools OWNER OR Date Applicant FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets- Rec Light Sw._ MAIL COMPENSATION INSURANCE ADDRESS (This section need not be completed if the work involved by First 20 CITY Tel. No. No Additional the permit is for one hundred dollars ($100)or less.) Tota , PLAN CHECK I certify that in the performance of the work for which this APPLICANT permit is issued, I shall not employ any person in any manner so as.to become subject to,the Wo ers' Total No CITY Tel. No.am nsgti aw Lighting Fixtures First 20 ADDRESS Additional N Date A"+o pplicant ' Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT- If, after making this Ce if ate of APPLICANT N I 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 I N£ s with comply with such provisions or this permit shall be Top — FAU —W.H. — Other— deemed revoked. Hood _ Fan _Other_ CITY�— LC C Tel. No LICENSED CONTRACTORS DECLARATION LICENSE OR Disp — Room Air Cond 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 8 Large Appliances DISTRICT NO' , PROCE BY IlL and Professions Code,and my license is in full force and effect Q Size &Type HP, KW, KVA, or KVAR -> C) License Number Lic Class, Up to 1 Incl. FINAL Contractor Date Over 1 to 10 Incl DATE 7 1?16 JADATION Over 10 to 50 Incl FINA W I am exempt under Sec Over 50 to 100 Inc. BY LL Over 100 V) B&P C for this reason Z Dote- Services, Swbd., MCC& Ponelboards 0 -200 Amp Under 600 V Signature 201 - 1000 Amp. Under 600 V Exemption for Reg. Maint. Elect Over 1000 Amp. or Over 600 V' 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 Additional Sign Branch Circuits Law for the following reason (Section 7031.5, Business and 4 8.7 7 A Profeons Code) - I, as owner of the property, will do the work and the Misc Conduits & Conductors 4,o:o„o 0 0 2 structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ ' 7044;,Business and Professions Code). 1 ® .1 o o T5 5 0 CONSTRUCTION LENDING AGENCY 'o o o,1 5 5 Gil,' I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued PERMIT'FEE (Sub-Total) Sod v p624+86 (Sec. 3097, Civ C ). PLAN CHECKING FEE, Lender's Name PERMIT ISSUING FEE Lender's Address I certify that I have read this application and state that the TOTAL FEE s S above information is correct I agree to comply with all County ordinances and State jaws regulating Electrical wiring, and hereby authorize representatives of this County to enter upon above-me t* n pyo ty f r inspection purposes SEE REVERSE FOR EXPLANATORY'LANGUAGE &-Z Signature of P-erTnittee Date _ ” WORKERS'COMPENSATION DECLARATION 26A66,3 oFw3/87 ������ n���nn �O� ����q�n���� ���pno� I hereby affirm 114at I have a certificate of consent to self ;CE-806G ( N u Ili ��/� O insure, or a certificate of Workers' Compensation Insurance, I COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certified copy thereof (Sec 3800, Lab. C.) ' Policy No Company FOR APPLICANT TO FILL IN JOB ❑Certified copy is hereby furnished. New'Residenhal Bldgs & Pools EACH NO FEE ADDRESS 6300 N. ROS 'MEAD BL ❑Ce'rtified copy is filed with the county building inspec- 1 & 2-Family, Sq. Ft. $ —1$ LOCALITY 'I' '+ PLL+' CITY tion department Multi-family Sq. Ft. NEAREST CROSS ST MM LONGDEN Residential Swimming Pools OWNER OR �v Date Applicant FIRM NAME T.C.DIST.OF CAMP FIRE' CERTIFICATE OF EXEMPTION*FROM WORKERS' Outlets: Rec Light Sw._ AMAIL DDRESS 5736 ROWLAND COMPENSATION INSURANCE First 20 (This section need not be completed if the-work involved by Total No Additional CITY TEMPLE CITY Tel. No.287-035 the permit is for one hundred dollars ($100)or less.) PLAN CHECK I certify that in ;he performance of the.work for-which this APPLICANT permit 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 Additional � 4-2 0 ELECTRIC Total No. CITY Tel. No Date 3—A Fixed Appliances Not Over 1 HP PERMIT ApplicanDALES ELE t NOTICE TO APPLICANT: If, after making this Certificate of APPLICATION DALES ELECTRIC 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 672 ARDILLA ST. with,comply with such provisions or this permit shall be -Top — FAU —W H. — deemed revoked. ` - Hood Fan —Other- CITY LA PUENTE CA. Tel. No. 287-862 LICENSED CONTRACTORS DECLARATION LICENSE OR p Disp. _ Room Air Canal — REG NUMBER 276218 Class. C-10 'I hereby affirm that I am licensed under provisions of Chapter 9 - (commencing with Section 7000)of Division 3 of the Business Power Apparatus&.Large Appliances DISTRICT N0.., 08_ PR ESSkDB)b and Professions Code,and my license is in full force and effect, Size &Type HP, KW, KVA, or KVAR 0 License Number 276CL 218 Lic. Class C-10 Up to 1 Incl. FINAL DALES ELECTRI 4-23-90 Over 1 to 10 Incl. DATE <M1 . _(] VALIDATION 0 Contractor a Over 10 to 50 Incl. FINAL9/1 ~ ❑ I am exempt under Sec. CiVer 50 to 1'00 Inc. BY LLi B.&P.0 for this-reason ' 'Over 100 d Services, Swbd.; MCC& Panelboards U) 4;4 44 ol Date: Z 0-200 Amp Under 600•V X Signature 201 - 1000 Amp. Under 600 V ❑ Exemption for Reg Maint Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY Temp. Power Pole.&Appurtenances HOME OWNER-BUILDER DECLARATION- I hereby affirm that I am exempt from the Contrcictor's License Sign with One Branch Circuit ACCT.s Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits _33071L,anl !j Professions Code): 1 ITEMS ❑ I, as owner of the.property,-will do the work and the Misc. Conduits&Conductors �^ structure is not intended or offered for sale(Section 7044,• Other (See Complete Fee'Schedule)_ TOTAL 33 = 00 Business and Professions Code) HECi'. W.iUI CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for FTRRWQRXCHANGE .00 the performance of the work for which this permit is issued PERMITTEE, (Sub-Total) (Sec 3097, Civ. C ). PLAN CHECKING FEE I—i:101 c/?3/YE.! Lender's Name PERMIT ISSUING FEE 0870 1 AN 3:33 O Lender's Address a ]� " I certify that I have read this application and state that the TOTAL FEE sl�v above information is correct I agree to comply with all County ordinances and State'jaws regulating Electrical wiring, and , hereby authorize r&eE,��srentatives of this County to enter uponthe abov me i rty f�, ectonpurposes SEE REVERSE FOR EXPLANATORY LANGUAGE 4-21-90 Os Signature 4Pm&,ttee Date WORKERS'COMPENSATION DECLARATION 76A663 10/81 APPUc mON' FOR ELECT IC L PERMIg I hereby,affirm that I have a certificate of,consent to self insure, CE-806G ¢\` ��f �W �!/9 u or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec 3800,Lab. C) Policy No. Company FOR APPLICANT TO FILL IN JOB ❑ - ADDRESS Certified copy is hereby furnished New Residential Bldgs & Pools EACH NO. - FEE ' Certified copy is ;filed with the.county building inspection 1 & 2-Family,Sq Ft $ — $ LOCALITY C' department Multifamily Sq Ft NEAREST CROSS ST Residential Swimming Pools OWNER OR Date Applicant - - FIRM NAM CERTIFICATE'OF EXEMPTION FROM WORKERS' Outlets Rec— Light Sw MAIL i��Q COMPENSATION INSURANCE ADDRESS c� (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 `JI No I certify that in the'performance of'the work.for which this permit PLAN CHECK is issued, I shall not.,employ any person in any,manner.so as-to t - - - APPLICANT - - become subject to the Workers'Co:Pa ws Lighting Fixtures First 20 ADDRESS e Additional �C'rl Total No CITY, - Tel No Date v^ Applicant Appliances Not Over .1 HP NOTICE TO APPLICANT. If, .after 'making this- Certificate �—f&TFixecl PERMIT Exemption,you should become subjeot_to the Workers'Compensation Range_ Heater_ DW APPLICANT provisions of the,Labor Code, you must forthwith comply with-suoh Oven _Dryer W M ADDRESS 2� 6 provisions or this permit shall be deemed revoked" Top FAU W.H. / LICENSED CONTRACTORS DECLARATION Hood — Fan _.Other_ J CITY 'Q e1 -6� I hereby affirm that I am licensed under provisions of Chapter 9 LICENSE,OR z Disp. Room Air Cond.- REG NUMBER Class / - (coinmencing with'Section 7000) of Division 3 of the Business and L Professions Code,and'my license is'in full force and'effect - DISTRICT ry0 PROCE D BY -Power Apparatus.& Large Appliances 5 ' /r'� Size & Type HP,KW;KVA,or KVAR •� • ` ' Q Li eq nse Number Lic Class �1` v Up;fo 1.Incl "' FINAL -U l/.P�9 n1 �D Over 1"to 10 Incl. DATE O Contractor Date V VALIDATION ❑ d2Over 10 to 50 Incl I am exempt under Sec Over 50 to 100 Inc BY AL W B.&P.0 for this reason Over,100 Q„ Services,Swbd.,MCC-& Panelboards• / Date 0- 200 Amp Under 600 V r- 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 FEE 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 t 030 f' Code) I — 1 =f : / 13 _ I,as owner of the property,. ' Misc.Conduits& Conductors -1567 1 AM l 7;1 will do the work and'the structure- , is not intended'or offered for sale (Section 7044, Business. Other(See Complete Fee Schedule) and Professions Code) i CONSTRUCTION LENDING AGENCY ' ACCTI.s I hereby affirm that there is a construction lending agency for the � �7V� performance of the work for which this permit is issued(Sec.3097, PERMIT FEE. (Sub Total), ° CIV C) PLAN CHECKING FEE ,` ^ I ITEC{ , Lender's Name TOTAL ��e 00 PERMIT ISSUING FEE �� Lender's Address CHECK 18.10 I certify that 1 have read this application and state that the above TOTAL FEE L information is correct I agree to comply with all County ordinances HA 00 and State laws regulating Electrical wiring, 1 �� CHANGE. .ing, and hereby authorize representative _o this County to enter upon the above-mentioned 71 ;ProSpVfonscoon purposesSEE REVERSE FOR EXPLANATORY LANGUAGE 00010-0001 b7?"/9+I-9f� 1' 58 1 Aid 7=1E. of Permittee Date WORKERS'COMPENSATION DECLARATION CE 806G (2-80) APPLICATION FOR EUCTRICAL PERMIT I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec 3800, Lab C) FOR APPLICANT TO FILL IN SOB Policy No Company New Residential Bldgs &Pools EACH NO FEE ADDRESS 3&,;1,5) , ❑ Certified copy is hereby furnished 1 &2-Family,Sq Ft $ — $ LOCALITY e61 CA ❑ Multi-family Sq Ft NEAREST Certified copy is filed with the county building inspection CROSS ST department Residential Swimming Pools OWNER OR Date ApPhcant s FIRM NAME Outlets Rec—Light–Lo— Sw MAIL ADDRESS •CERTIFICATE OF EXEMPTION FROM WORKERS' First 20 COMPENSATION INSURANCE Total No 1� Additional CITY 7�� LEerfTel No } PLAN CHECK CL O APPLICANT (This section need not be completed if the work involved U by the permit is for one hundred dollars ($100) or less.) Lighting Fixtures First 20 ADDRESS Additional cc Total No Q I certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No U permit is issued, I shall not employ any person in any manner PERMIT W'so as to become subject to the Workers' Compensation Laws Range_ Heater—D W APPLICANT 4 a y Oven _ Dryer_W M ADDRESS— — 19 to Date Top FAU W H_ OL!v 94 Z phcant 41 Y 6 .► CITY r�jy�lOL€�� Tel \ Hood _ Fan _Other NOTICE TO APPLICANT. if, after making this Certificate of \ LICENSE OR Exemption, j Disp _ Room Air Cond,_ p you should become subject to the Workers' REG NUMBER- Class Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO PROCE ED BY with comply with such provisions or this permit shall be Size`&Type HP,KW, f,VA,or KVAR deemed revoked. Up to 1 Incl r Over 1 to 10 Incl FINAL LICENSED CONTRACTORS DECLARATION DATE /'—70 �� VALIDATION Over 10 to 50 Incl Cf7 e� I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc FINAL 9 (commencing with Section 7000) of.Division 3 of'the Busi- Over 100 BY ness and Professions Code, and my license is in full force and effect Services c�ense Number � S Lic Class e 0-200 Amp Under 600 V y� n /6 201-1000 Amp Under 600 V contractor 6146c l jed L Date /���Z Over 1000 Amp or Over 600 V HOME OWNER-BUILDER'DECLARATION Temp Power Pole&Appurtenances I hereby affirm that I am exempt from,the Contractor's Sign with One Branch Circuit 4P6 b A License Law for the following reason (Section 7031 5, Busi- Additional Sign Branch Circuits ness and Professions Code) Fj��(,u�Rj�S .6g17W # o�o'o o o 2 ❑ Misc Conduits&Conductors i I, as owner, of the property,'will do the work and the Other (See Complete Fee Schedule)— 2•o o,� 2 5 structure is not intended or offered for sale (Section r 7044, Business and Professions Code) _ 2'5 0 CONSTRUCTION LENDING AGENCY-- ° ° 1 I hereby affirm that there is a constructionlending agency ' for the performance of the work for which this permit is A28-8-2 issued(Sec 3097,Civ'C.) PERMIT FEE (Sub-Total) Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) Lender's Address PERMIT ISSUING FEE I certify that I have read this application and state that the TOTAL FEE 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 Signature of Permittee Date WORKERS'COMPENSATION DECLARATION CE-806 toiet APPLICATION FOR E ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self CE-806G insure, or, or a certifIee�dcoppy,�thereof (Sec 3x8`00, Lab C ) T r 3.0 6 /�� Policy No�(/P=t9ogpa T d!7M4yW- FOR APPLICANT TO FILL IN JOB ❑ EACH NO FEE ADDRESS Certified copy is hereby furnished New Residential Bldgs & Pools ❑ Certified copy is filed with the county building inspec- 1 & 2-Family, Sq Ft $ — S LOCALITY tion department Multi-family Sq Ft NEAREST Date 10/1D 1 83 Applicant /1/�� r-�I; Residential Swimming Pools CROSS ST OWNER T FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec Light Sw_ MAIL COMPENSATION.INSURANCE ADDRESS .section need not be completed if the work involved b First 20 (ThisP Y Total-No Additional CITY Tel No the permit is for one hundred dollars (;100)or less.) PLAN CHECK I certify that in the performance of the work for which this APPLICANT permit is issued,'I shall not employ any person in any manner so as to-become subject to the Workers'Compensationdaws Lighting Fixtures First 20 ADDRESS Total No Additional CITY Tel No Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT If,-after makirig this Certificate of APPLICANT 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 .. 0L/� — -- with comply with such provisions or this permit shall be Top _ FAU —W H — deemed revoked Hood _ Fan _Other_ CITY ` j Tel No LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp Room Air Cond REG NUMBER 46/ } Class C (commencing with Section 7000) of Division 3 of the Business D DISTRICT NO PROCES BYE and Professions Code,.and my license is in full force and effect Power Apparatus& Large Appliances >_ �—,Q Size &Type HP, KW, KVA, or KVAR License Number f�r� �LLic Class �-��/1 Up to 1 Incl FINAL V � �1p Over 1 to 10 Incl DATE �j /J/J VALIDATION 0 Contractor A✓45 5 6G� Date f�T Over 10 to 50 Incl FINAL U ❑ I am exempt under Sec Over 50 to 100 Inc BYw B &P C for this reason Over 100 r h Services, Swbd MCC & Ponelboards Q/S/ 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 Eject 2 3 2.8_3 A SINGLE FAMILY Temp Power Pole & Appurtenances # e o o ° ° 2 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits 2 ° ° 5 5 Law for the following reason (Section 7031 5, Business ' and r 0. Professions Code) - 0 0 0 5 0= El I, as owner of the property, will do the work and the Mi Conduits &Conductors structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ Q 6 3 -83 7044, Business and Professions Code) r CONSTRUCTION LENDING AGENCY f I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued P RMIT FEE (Sub-Total) (Sec 3097, Civ C ) _ PLAN CHECKING-FEE Lender's Name PERMIT ISSUING,FEE Lender's Address \ I certify that I have read this application and state that the TOTAL FEE above information is correct I agree to comply with all County ordinances and State laws regulating Electrical wiring, cind hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE �� a Signature of'Permittee Date � l WORKERS'COMPENSATION DECLARATION 76-663 10/61 APP �'CATa ®N'FOR Imp ECTR t�q L, PERMIT _ CE-806G II"lL G�6 Ir u E IG ILIG '\sF9 iY� I hereby affirm that I have a certificate of consent to self insure, or.a certificate of Workers' Compensation InsurcE,or a•certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy �nthereof,(Sec 3800,Lab C)� Policy No iLVfi Q 3 Company 1'�ry FOR APPLICANT TO FILL IN- JOB ' ® Certified copy Is hereby furnished New Residential Bldgs & Pools EACH NO FEE ADDRESS lv3QD ' t1 & 2-Family,S Ft $ — $ LOCALITY •Certified copy is filed with the count buddi y inspection q departmen Multi-family Sq Ft — NEAREST , CROSS ST Residential Swimming Pools OWNER OR ,Date )to Residential„ t- a+ ' FIRM NAME . CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL / COMPENSATION INSURANCE Outlets Rec Light Sw D ADDRESS /,/lid• /C� �{�- (This section need not be completed if the workiinvolved by the First 20; ,permit is for one hundred-dollars($100)or,lelis), Total No Additional CITY Tel No 7 / 1-certify that�ln the`peeformance.of tfie work,for which this-permit PLAN CHECK is issued,11 shall not empl0 an APPLICANT , y�' y•person in any,manner,so as to , become subject to the Workers'Compensation Laws Lighting Fixtures First 20 ADDRESS at c Addctiorial 4Total No CITY Tel No - Date Applicant Fixed Appliances Not Over 1 HP, .NOTICE TO.,APPLICANT <If, after making this Certificate of PERMIT APPLICANT Exemption,you should become subject to'the W Workers'Compensation Range_ Heater_ D provisions;of the Labor Code,-you must.forthwith comply with such Oven Dryer_ W M ADDRESS se%1 i 'provisions or this permit shall be,deemed revoked Top,- FAU, -WH H LICENSED CONTRACTORS DECLARATION.,• Other_ CITY - o �� Te No Hood Fan rl•hereby affirm that I-am-licensed under provisions of-Chapter 9LICENSEOR Disp' '— Room Air Cond lass C (commencing with Section,7000) of bivision,'3.of,the,.Business and REG NUMBER �45� r Professions Code,and my license is in full force and effectn DISTRICT NO P SSED BY Power Apparatus& Large'Apphances _ .- _ //j Size& Type HP,KW,KVA,or KVAR License'Number '6d-�(YS i L_ic Class /J Up to 1.Incl FINAL U Contractor, ate�/ ���� � Over 1 to 10 Incl r DATE /J .VALIDATION J Q DOver 10 to 50 Ince' . L ❑ - FINAL. U I am exempt under Sec s- r • , ,a Over 50 to 100 Inc - BY04. i W B&P C for this reason Over 100 Services,'Swbd,MCC& Panelboards Z ate 0-200 Amp Under 600 V Signature- 201 - 1*000 Amp Under-600 V " ❑ Over 1000,Amp or Over 600 V T Exemption for Reg Maint Elect _. SINGLE FAMILY 'Temp Power Pole & Appurtenances ' HOME OWNER-BUILDER DECLARATIONs Sign with One Branch Circuit I hereby,affirm that I am-exempt from the Contractor's License Law '�'_- g .7 ' for the following ieason(Section 7031 5,Business and Professions Additional Sign Branch Circuits41 Code) ?�07 7 e jLI Misc Conducts& Conductors I,as owner of the property,will do the work and the structure i NRIS + is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) _ and Professions Code) - N D TOTAL ITAL 26 ® 50 CONSTRUCTION LENDING AGENCY IiG�• . qtr,a=1�1 I hereby affirm that there is•a construction lending agency for the CHANGE Q 00performance of the work for which this permit is issued(Sec 3097, PERMIT FEE (Sub-Total)•,' Civ C). PLAN CHECKING FEE Lender's Name I-I )-) PERMIT ISSUING FEE /� BU �•_ � � '�i Lender's Address 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, prop for inspectioD4urposes SEE REVERSE FOR EXPLANATORY LANGUAGE Y ' Signature of Permittee Date WORKERS'COMPENSATION D � C -806 70/e1 fl PfIZiUCATB®II�'1 Il OR ,E LECTWICAL PGRMI 9 ' I hereby affirm that I have a certificate of consent to self Insure, CE-806G d'�2 IT or a certificate of Workers' Compensation Insurance, or a certified, COUNTY OF LOS ANGELES BUILDING AND,SAFETY copy thereof(Sec 3800,Lab C) 'Policy No-`i ••''' :Company ' FOR APPLICANT TO FILL IN JOB a •� ' ' .❑ .Certified copy,is hereby furnished New Residential Bldgs & Pools EACH `' NO FEE _ ADDRESS ❑ 'Certified copy is filed.with the°county budding Inspection 1 1 & 2-Family,Sq Ft i $ _ $' LOCALITY11 NEAREST department - Multi-family Sq Ft CROSS ST - Date Applicant Residential Swimming Pools OWNER oR -� ``�,1J .'s• - - r i FIRM NAME O Ab CERTIFICATE'OF,EXEMPTION FROM WORKERS' Outlets Rec Sw MAIL — _ �a . ,•• •COMPENSATION INSURANCE -.,• , . ' 'Light �• •�, 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 Tel No PLAN CHECK _ I-certify that In the performance of the'work,for,which this permit - APPLICANT' Is Issued, I•shall not employ any person In any.manner so as to ','• - become subject to he Workers'Co pensation Laws Lighting Fixtures First 20 ADDRESS Total No Additional Date I Applicant '^".T - CITY Tel N Fixed Appliances Not Over 1,HP ` PERMIT <NOTICE O AP LICANT .If, aft r making ;this Certificate,of ,"' Exemption,you should ON 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._t ADDRESS• vmi Ave provisions or this permit shall be deemed revoked Top FAU._ ,W H �P CITY -Cl No LICENSED CONTRACTORS DECLARATION, Hood'— Fan Other_ I hereby affirm that I,am licensed under provisions of Chapter 9 LICENSE OR, v - Dlsp ---Room Alr•Cond :Cies O (commencing'witli Section 7000) of Division 3 of�the'Business and - REG NUMBER • Professions Code,and my license is Iri full force and effectPo � DISTRICT NO PRo ESSED BY, wer,Apparatus&Large�Appllances _ /�/ Size&'Type HP,KW,KVA„orrKVAR —010 1 +Llcen N er' ` Llc Class C) Up to 1 Indl, FINAL” Over 1 to 10 Incl DATE (� �— VALIDATION ` Contractbate ' Over 10 to 50 Incl I FINAL C 1 I•am exempt under Sec Over 50 to,100 Inc BY B&P C for I reas Over 100_ �.' 0 Dat J F -' Services;,Swbd-,MCC&Panelboards 0- 200'Amp Under 600 V Signature 20,1 - 1000 Amp Under 600 V - r -� Over 1000 Amp or Over 600 V ❑ ExemAHOME e •Main E a' ,�•� SINGL FAMILY Temp Power•Pole& Appurtenances N -BUIER DECLARATION, Sign with One Branch Clrcwt + I hereby affirm that I am exe t.from the Contractor's License'Law for+the following reason(Section 7031 5, Business and Professions Additional Slgn'Branch Circuits_„; - Code) } f_iJ t t_v 4t*i 3 Mlsc Conduits&•Conductors - f-�: ❑ I,as owner of the property will do the work and the structure. �' 3. Gi C' Is not Intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule)-_, and Professions Code) l `f)!fL CONSTRUCTION LENDING AGENCY - - •- -• ,. -- -� --, r I hereby,affirm that there Is,a construction lending agency for the C. performance of the work for which this permit Is issued'(Sec 3097, PERMIT FEE r (Sub-Totalj Civ C) } '_PLAN CHECKING FEE _ Lender's Name PERMIT ISSUING-FEE Lender's Addre + 94 i�f `- I c a tify t h e read t applidation and state that the-above TOTAL FEE Info ati I co ect I ag to comply with all County ordinances A Stat s gulatin ctrical wiring, and hereby authorize rip se ti o this C y to enter upon the above-mentioned pr or sp coon r ses SEE REVERSE.FOR EXPLANATORY LANGUAGE Sig ur rm Date WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT LJ 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) PoliPolicy NO Company FOR APPLICANT TO FILL IN .> .!!/' JOB n Certified copy is hereby furnished NO EACH FEE 1fkDDRESS 6300 QuSfi�/ D lgL✓� New Residential Bldgs &Pools LOCALITY F-1 Certified &2-Family,Sq Ft — $ $ Certified copy Is filed with the county building Inspection NEAREST ` � department Multi-family Sq Ft CROSS ST /_O .J 6 Da DateApplicant Residential Swimming Pools ASSESSOR MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets RecLi ht Sw OWNER OR COMPENSATION INSURANCE g First 20 FIRM NAME V,�`L fjQlAr.0 S OG O✓17V (This section need not be completed if the work involved by the MAIL permit Is for one hundred dollars($100)or less.) Total No Additional ADDRESS 8 Sq , 9% I certify that In the performance of the work for which this permit CITY S A q D Shm 1 4-�J17J 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 O/ A� 'y.Y/1I Total No Additional ADDRESS Date O—�" `/� r Applican NOTICE TO APPLICANT If, after making this Certificate of RESIDENTIAL APPLIANCES NOT OVER 3 HP 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 nM1 `�!� provisions or this permit shall be deemed revoked Power Apparatus&Large Appliances APPLICANT o v/„ LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS l L Nco% ,O/f— I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Over 3 to 10 Incl CITY NOW 7r�k11t) T I �_102- Professions Code, and my license is in full force and effect Over 10 to 50 Incl } Over 50 to 100 Incl LICENSE OR q / Class C --/O REG NUMBER L a Q G_ a Over 100 DISTRICT NO woe' R ESSEDD B� 0 License Number- i LIc Class p�/ Services,Swbd,MCC&Panelboards Q �.O . V/GTO& �Lf C- �7.'—`fo 0-399 Amp Under 600 V FINAL O Contractor Date _ DATE /� � r-1 400-1000 Amp Under 600 V �^ I am exempt under Sec Over 1000 Amp or Over 600 V FINAL 1 VALIDATION W B&P C for this reason BRANCH CIRCUIT FEES ev U) Date 15A,or 20A, 120V,Lighting or Recept Z 1 To 10 Branch Circuits Signature 11 To 40 Branch Clrcwts ❑ 41 Or More Branch Clrcwts Exemption for Reg Maint Elect 15A,20A,208V To 277V Lighting Br Circuits 7 L SINGLE FAMILY Temp Power Pole&Appurtenances a HOME OWNER-BUILDER DECLARATION AC•C•t a V 1 hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit �� t n for the following reason (Section 7031 5, Business and Professions Additional Sign Branch Circuits 3303 `f 8.60 Code) ITEMS ❑ I, as owner of the property, will do the work and the structure Misc Conduits&Conductors VITAL ® �—� is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) and Professions Code) Q CHECK 48.60 U CONSTRUCTION LENDING AGENCY CHANIGE s00 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 0000-0001 6/24/96 Lender's Name 70 hd 1 AM Qe C8 PERMIT ISSUING FEE Lender's Address TOTAL FEE l©� 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 "//, Alffig fir- Z-4/::Z6 SIGNATURE OF PE43MITTEE DATE WORKERS'COMPENSATIONDECLARATION _ 76A663 CE-806G (2-80) p�U�PHCATION FOR ELECTRICAL PERMIT ' o I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES f BUILDING AND SAFETY insure, or a certificate of Workers'Compensation Insurance,or < a certified copy thereof(Sec 3800,Lab C) FOR APPLICANT TO FILL IN JOB Pohcy'No Company ADDRESS 1 ❑ New Residential Bldgs &Pools EACH NO FEE ' i Certified copy is hereby furnished 1 &2-Family,Sq Ft $ $ LOCAi_ITY �- G Multi-family Sq Ft — NEAREST Certified copy is filed with the county building inspection CROSS ST- department Residential Swimming Pools OWNER OR FIRM NAME i Datz Applicant Outlets Rec—Light—Sw MAIL First 20 ADDRESS CERTIFICATE OF EXEMPTION'FROM WORKERS' Total No Additional CITY Tel No COMPENSATION INSURANCE PLAN CHECK d , (This section need not be completed if the work involved APPLICANT by the permit is 'for one hundred dollars ($100) or less.) Lighting Fixture First 20 ADDRESS U Total No Additional I, I certify that in the performance of the work for which this CITY Tel No 0 permit is issued;I shall not.employ an Fixed Appliances Not Over 1 HP p p y y person in any maMer PERMIT (,) so to become subject to the orkers' Compensation a s Range_ Heater_D W APPL'ItANT coulee - & .Son Electric W r 1 5� 9 Oven _ Dryer_W M. ADDRESS 2650 N. Sari Gabriel B1, Date 7/2/8 1 Applicant Top _ FAU —' WH _ Hood Fan _Other_ CITY Tel No 2130-2007 NOTICE TO APPLICANT If, after making this Certificate of Disp. _ Room Air Cond. LICENSE R Exemption, you should become subject to -the Workers' REG NUMBER 242432 Class Q—10 Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO PROC SED BY with comply with such provisions'or this permit shall be deemed revoked. Size&Type HP,KW, KVA,or KVAR � Q Up to 1 Incl FINAL • DATE Incl �) LICENSED CONTRACTORS DECLARATION Over 10 to Over 1 to 10 0 Incl l A�-/ �/ VALIDATION, I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc FINAL/) �- 9 (commencing with Section 7000 of Division 3 of the Busi- BY ( g ) Over 100' ness and Professions Code, and my license is in full force and effect Services 0-200 Amp. Under 600 V License Number Lic Class 201-1000 Amp Under 600 V 'Contractor Date Over 1000 Amp -or Over 600 V HOME OWNER-BUILDER DECLARATION Temp Power Pole&Appurtenances I, hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit Additional Sign Branch Circuits . rr License Law for the following reason (Section '7031 5, Busi- ness and Professions Code)- Misc Conduits&Conductors + ElI, as owner of.the property, will do the work and the Other(See CompleW Fe S edule) 2',01'8 1 A structure is not intended or offered for sale (Section l - 7044, Business and Professions Code): #'0,0'0.0 0'2 CONSTRUCTION LENDING AGENCY 1 ' ' ' I hereby affirm that there is a construction lending-agency _ 2 0 0 10.0 i0 for the performance of the work for which this permit is PERMIT FEE (Sub-Total) 1 issued (Sec 3097,Civ C) o 0 0 0.00F2 Lender's Name PLAN CHECKING FEE (One-Fourth Permit Feel �,7, 2—8 Lender's Address PERMIT ISSUING FEE 'I certify that I have read this application and state that the TOTAL FEE D 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 bove-mentioned property fornn pection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Q 7/2/81 Signature of Permittee Date - t WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) 76A663 APPLICATION FOR ELECTRICAL PERMIT ' , I hereby affirm that.1 have a certificate of consent to self Insure, 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 3,800 Lab, C) } Policy No/00551/` Company (/� FW"i� FOR APPLICANT TO FILL IN JOB ADDRESS Q 3Yo- �Evy ❑ Certified copy is hereby furnished'' New Residential Bldgs &Pools NO EACH FEE LOCALITY 1 &2-Family,Sq Ft $ $ Certified copy is filed with the county building Inspection _ NEAREST department Q G Multi-family Sq Ft CROSS ST �Af r / Date I A licant� r� ��L f� Residential Swimming Pools ASSESSOR PP MAP BOOK17 PAGE JOWL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec _Light Sw ORM NAME � COMPENSATION INSURANCE . - First 20 MAIL (This section need not be completed_if the work Involved by the Total No Additional ADDRESS permit is for one hundred dollars($100)or less.) N- 1 certify that in the performance of the work for which this permit CITY T N r 0 is issued, I shall not employ any person in any manner so as to PLAN c OK become subject to the Workers'Compensation Laws Lighting Fixtures First 20 APPLICANT Total No Additional A ADDRESS Date• Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP NOTICE TO.APRLICANT 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 provisions or this permit shall be deemed revoked Power Apparatus&Large Appliances APPLICANT 4. 18; rc-m 1G LICENSED'CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS_ I lieieliy affirm that I am'libensed under provisions of Chapter 9 Over 3 to 10 Incl (commencing with Section 7000) ol"Divlslon 3 of'the Business and CITY Dll/ ;Pav-le Professions Code, and my license is in full force and effect Over 10 to 50 Incl Over 50.to 100 Incl RLICENSE EG NNUMBER " 7/ Class d 0- Q 717 1 C /0 Over 100 DISTRICT NO P SED BY 0 License Number T� _Lic Class ,,QQ �/�, C ; Services,Swbd,MCC&Panelboards Contractor/lA "/e-Pn F 40C Date 49-2_7 0-399 Amp Under 600 V FINAL 0 DATE 400'-1000 Amp Under 600 V (/ ElI am exempt under Sec �lJ~ / VALIDATION V Over 1000 Amp or Over 600,V FINAL W BY co B&P C for this reason BRANCH CIRCUIT FEES Date °15A,or 20A,120V,Lighting or Recept Z_ - 1 To 10 Branch Circuits Signaturee 11 To 40 Branch Circuits 41 Or More Branch Circuits ❑ -Exemption for Reg Mamt Elect 15A,20A,208V To 277V Lighting Br Circuits SINGLE FAMILY Temp Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Ac C;T 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 1 t j ,10 Code) s s^�7 ❑ Misc Conduits&Conductors i 1 1 ct S 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) Ti_1I A 47 = 10 and Professions Code) CONSTRUCTION LENDING AGENCY 0 L•H"-V1 -t °�I I I hereby affirm that there is a construction lending agency for the f-:L( lvij °i]II performance of the work for which this permit is issued (Sec 3097, PERMIT FEE (Sub-Total) �-� 0 Civ C) PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE 53"1 1 -flHi t�13 Lender's Address I certify that I have read this application and under penalty of pur)ury state TOTAL FEE L �D that the above information is correct I agree to comply with all County '7 ordinances and State laws regulating Electrical wiring,and hereby authorize representatives of this County to enter upon the above-mentioned property for insp ction purposes SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE OF PERMITTEE DATE - WORKER'S COMPENSATION DECLARATION DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT 766663 I hereby affirm that I have a certificate of consent to self Insure, 766663 or a certificate of Worker's Compensation Insurance or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV ;pyytn reof(Sec 3800 Lab C) n,�` �t1� -I NO kQ NMPICompany`0&YS Z0. FOR APPLICANT'l' FILL IN JOB ADDRESS Certified copy is hereby furnished New Residential Bldgs &Pools NO EACH FEE LOCALITY El Certified 1 &2-Family,Sq Ft — $ $ copy Is filed with the county building inspection NEAREST dep rtmentMulti-family Sq Ft CROSS ST Residential Swimming Pools ASSESSOR Dates Applicant MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTIOROM WORKERS' Outlets Rec Li ht Sw OWNER OR COMPENSATION INS RANCE g FIRM NAME First 20 (This section need not be completed if the work involved by the MAILTotal No Additional ADDRESS permit is for one hundred dollars($100)or less.) I certify that in the performance of the work for which this permit CITY TeI 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 PLAN CHECK 1 p 9 9 APPLICANT Total No Additional ADDRESS Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP NOTICE TO APPLICANT If, after making this Certificate of CITY � Te i 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 provisions or this permit shall be deemed revoked Power Apparatus&Large Appliances APPLICANT V\ LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl (commencing with Section 7000) of Division 3 of the Business and CITY Tel No Professions Code,and my license is in full force and effect Over 10 to 50 Incl LICENSE OR / •t Class C_l6 a- ,{`-� `'� L n / Over 50 to 100 Incl REG NUMBER ( VV a License Number �+ •/ v LIC CIaSS `� `y Over 100 DISTRICT NO PROCESSED BY 10 Services,Swbd,MCC&Panelboards Q QFINAL Contractor /l - Date —f i 0-399 Amp Under 600 V DATE 0 400-1000 Amp Under 600 V / ~ El I a xempt under Sec VALIDATION V Over 1000 Amp or Over 600 VW B&P C for this reason BY AL a- BRANCH CIRCUIT FEES Date 15A,or 20A,120V,Lighting or Recept Z 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits El41 Or More Branch Circuits Exemption for Reg Maint Elect 15A,20A,208V To 277V Lighting Br Circuits SINGLE FAMILYTemp Power Pole&Appurtenances 2 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ACCT.s I hereby affirm that I am exempt from the Contractor's License Law for the Code) following reason (Section 7031 5, Business and Professions Additional Sign Branch Circuits ; Qi 70.1C1 EJ1,I, as owner of the property,will do the work and the structure Misc Conduits&Conductors ITEMS is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) TOTAL :LC) and Professions Code) CONSTRUCTION LENDING AGENCY CHECK 70.10 C'HA19C7E 1 hereby affirm that there is a construction lending agency for the i917 .00 performance of the work for which this permit is issued (Sec 3097, PERMIT FEE (Sub-Total) y� p Civ C) ` Lender's Name �4 Off` CA,V s } �QIA� PLAN CHECKING FEE OWO-0001 3/ 6/96 , � r c PERMIT ISSUING FEE � ' 5162 1 AM11434 Lender's Address �'lV (Vt+ � 1 certify that I have read this application and under penalty of purjury state TOTAL FEE 0 / O 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-mgntioned property fKpection purposes Y SEE REVERSE FOR EXPLANATORY LANGUAGE SIG A RE OF PERMITTEE DATE ' COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0312050028 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: GA FEES PAID BUILDING DD ON FILE 6300 ROSEMEAD BL FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801544 i ASSESSORFOR ,NEAREST CROSS STREET: LONGDEN 5382-021-026 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H2 LOCALITY.: -TEMPLE CITY E3 TEMP XMAS TREE, ADDT 1.00 TEM 21.60 TOTAL FEES 49.35 I S ON: A S k , y 12/05/03 JK 06/02/04 OWNER: TEL. NO: FINAL DATE FIN BY: CODE: VANNIER WILTON E CO TR VANNIER TRUS (818) 355-1239- /Q 209 OAK MEADOW RD SIER 910242611 RIPT ON OF WORK LIGHTING FOR XMAS TREE LOT APPLICANT: TEL. NO: PRECISION ELECTRIC CO (626) 338-4377- 5454 DIAZ ST SPECIAL CONDITIONS: IRWINDALE CA CONTRACTOR: TEL. NO: - APPROVALS _ DATE INSPECTOR SIGNATURE PRECISION ELECTRIC CO. (626) 338-43-7 + 5454 DIAZ ST. LIC. NO TEMPORARY POWER POLE IRWINDALE, CA 91706 697907C10 1 UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: UFER GROUND LIC. NO: ROUGH,CONDUIT ROUGH(WIRING MAIN 'WATER LINE PLASTIC Y/N METAL Y/N UTILi IIY COMPANY NOTIFIEDp REPORT ID: DPR265 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 9912200034 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: ON FILE 63OO:ROSEMEAD BL FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801544 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET- 5382-021-026 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY D3 BOOTH LGT, SYSTEM 1.00 BOO 16.20 TENANT: TOTAL FEES 43.95 ISSUED ON: PROCESSED BY: PLANBY: EXPIRES ON: RAINBOW GIRLS 12/20/99 UT 06/17/00 OWNER: TEL. NO: FINAL DATE FINAL B CODE: VANNIER WILTON E CO TR VANNIER TRUS (818) 355-1239- Z'Z 209 OAK MEADOW RD SIER 910242611DESCRIPTrUN OF WORM BOOTH LIGHTING FOR FIREWORKS D-MILLENNIUM APPLICANT: TEL. 0: SAME AS OWNER SPECIAL CONDITIONS: ES C® CONTRACTOR: TEL. NO: � �/� APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO TEMPORARY POWER POLE UNDERGROUND CONDUIT CHITECT ORENGINEER: TEL. ER GROUND LIC. N0: 1111111 ROUGH�CONDUIT ROUGH WIRING ti Gln n O (� C n J1 /7®r�'/J � MAIN WATER LINE l U Ilh \11JI11\VIl ILhU{ IL11(� PLASTIC Y/N METAL Y/N i UTILITY COMPANY NOTIFIED Oo 0 L ® ®5 c Service TWA REPORT ID: DPR265 ROUTE TO: BSO5O8 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0006190015 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FE55 PAID BUILDINGADDRESS: ON FILE 6328 ROSEMEAD BL FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801544 ASS IN A ON NUMBER: NEAREST CROSS STREET: 5382-021-026 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY D3 BOOTH LGT, SYSTEM 1.00 B00 16.20 TENANT: TOTAL FEES 43.95 ISSUED ON: PROCESSED BY: PLAN ES ON: JOBS DAUGHTERS 06/19/00 UT 12/16/00 OWNER: TEL. NO: FINAL DATE FINAL BY: CODE: VANNIER WILTON E CO TR VANNIER TRUS (818) 355-1239- 209 OAK MEADOW RD SIER 910242611 DESCRIPTION OF WOR BOOTH LIGHTING FOR FIREWORKS STAND-2 00 APPLICANT: TEL. NO: SAME AS OWNER SPECIAL CONDITIONS: ES �® CONTRACTOR: TEL. NO: APPROVALS�D�A� APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO TEMPORARY POWER POLE UNDERGROUND CONDUIT ARCHITECT ORENGINEER: TEL. 0: ,� UFER GROUND LIC. I0: 1111111 ROUGI{ CONDUIT U ROUGH WIRING G U On �/C Vg00 (—n�� S MAIN WATER LINE UU ILIA f'�J ((��/J��lU~U< C`�J� PLASTIC Y/N METAL Y/N IL 1TY CO N O E3 d� REPORT ID: DPR265 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 9906230061 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGALE A BUILDING D ON FILE 6300 ROSEMEAD BL FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801544 ASSESSOR NEAREST CROSS STREET: 5382-021-026 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY D3 BOOTH LGT, SYSTEM 1.00 BOO 16.20 TOTAL FEES 43.95 ISSUED 0N: PROCESSED : PL Y: EXPIRES ON: RAINBOW GIRLS 06/23/99 LC 12/20/99 OWNER: TEL. NO: FINAL DATE FINAL BY CODE: VANNIER MILTON E CO TR VANNIER TRUS (818) 355-1239- 209 55 1239 209 OAK MEADOW RD SIER 910242611 DES IPTION OF WORK BOOTH LIGHTING FOR FIREWORKS STAND 1999 APPLICANT: L. SAME AS OWNER - SPECIAL CONDITIONS: E C CONTRACTOR: TEL. 0: QCJ ,, APPROVALS TE INSPECTOR SIGNATURE SAME AS OWNER �, LIC. NO TEMPORARY UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: GROUND. LIC. NO 111111 ROUGH CONDUIT ROUGH WIRING TD' 12) L] v s-- ) PLASTICTER NE Y/N IMETAL Y/N IT COMPANY OTIFIED 0 0 IFf a ❑ ® ®5 Q � `�,�c• Sevice o� r' REPORT ID: DPR265 ROUTE TO: BS0508 COUNTY-' OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0111280010 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGALADDRESS: ON FILE 6300 ROSEMEAD BL FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801544 ASSESSORA NUMBER: NEAREST CROSS STREET: LONGDEN 5382-021-026 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY E3 TEMP XMAS TREE, ADDT 1.00 TEM 21.60 TENANT: TOTAL FEES 49.35 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: STEPHANIE ANDERSON (XMAS TREE LOT) FI 12OV 15/2oA $Q Gj ` T Zr) 11/28/01 JK 05/27/02 OWNER: TEL. NO: FLN F CODE: GVD COMMERCIAL PROPERTIES INC 1915A E. KATELLA AVE ORANGE DESCRIPTIO OF WORK TPP FOR XMAS TREE LOT _ APPLICANT: ECM PECO INC (626) 338-4377- 5454 DIAZ ST SPECIAL CONDITIONS: IRWINDALE 91706 ELESCo CONTRACTOR: TEL. NO: � APPROVALS INSPECTOR SIGNATURE E C M PECO, INC. (626) 338-4377 5454 DIAZ ST. LIC. NO TEMPORARY POWER POLE IRWINDALE, CA 91706 697907 C10 UNDERGROUND CONDUIT ARCHITECT 0 UFER'GROUND LIC. N0r 1111111 ROUGH CONDUIT i � ROUGH WIRINU- C) ,n n ��C W0FK3 M INi TER LINE Jflw�ll �u^�< PLASTIC Y/N METAL Y/N f UT L T NOTIFIED �� a a fit ' ervice'ThB REPORT ID: DPR265 ROUTE TO: BS0508 I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS EL-0508-9807160032- BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: GAL I S PTID BUILDING-ADDRESS: ON FILE 6300 ROSEMEAD-BL- FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801544 ASSESSOR INFORMATI NUMBER: NEAREST CROSS STREET: LONGDEN 5382-021-026 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY A5 PLAN CHECK 175.56 DOL 175.56 G1 OUTLETS-LGT,SW,RECP 44.00 OUT 71.40 ISS EXPIRE -ON: CHIEF AUTO PARTS G2 LIGHTING FIXTURES 124.00 LGT 179.40 07/16/98 UT 07/ /99 TOTAL FEES 454.11 OWNER: TEL. NO: FINAL DAT FINAL BY: CODE: VANNIER WILTON E CO TR VANNIER TRUS (818) 355-1239- 209 OAK MEADOW RD S1ER 910242611 -14 DSCR P -ION-OF-WORK ELECTRICAL-FOR-INTERIOR-REMODEL-IN -APPLICANT: TEL. NO: JETTY ELECTRIC (949) 646-5062- 2035 PLACENTIA #D ---_- -- SPECIAL CONDITIONS: COSTA MESA, CA i a tir n �\ CONTRACTOR: TEL. N0: i/� -✓��\\\ APPROVALS DATE INSPECTOR SIGNATURE JETTY ELECTRIC (949) 646-5062- 2035 PLACENTIA #D LIC. NOTEMPORARY POWER POLE COSTA MESA, CA 92627 677322 C10 UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: EL. N0: ��� UFER GROUND r LIC. N0:' - �� �`1vi l l illli ROUGH CONDUIT ROUGH WIRING y MAIN WATER LINE �'/ PLASTIC Y/N METAL Y/N TILITY COMPANY NOTIFIED 117 : ,,7= REPORT ID: DPR265 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL-PERMI-T--- DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS �EL 0508.9806120021 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: LEGAL I : FEES PAID B D ADDR SS: ON FILE 6300 ROSEMEAD BL .T FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP-CA-917801544 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 5382-021-026 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY D3 BOOTH LGT, SYSTEM 1.00 B00 21.60 TENANT: TOTAL FEES 49.35 ISSUED ON: PROCESSED B : PLA EXP . RAINBOW GIRLS 06/16/98 UT 06/16/99 OWNER: TEL. NO: FINAL DATE FINAL BY: CODE: VANNIER WILTON E CO TR VANNIER TRUS (818) 355-1239- L� 209 OAK MEADOW RD SIER 910242611 DESCRIPTION OF WORK C BOOTH LIGHTING FOR FIREWORKS-STAND - APPLIC T E L 735 T. ( - SAME AS OWNER _ SPECIAL CONDITIONS: 'ice i1�o. •�\_'`'it `��� CONTRACTOR: TEL. N0: ��� � `�� APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNERr LIC. NO TEMPORARY POWER POLE UNDERGROUND CONDUIT ARCHITECT OR ENGINEE UFER GROUND LIC. N0:',� _ � ��- � � �`�i11�111� • �� ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED REPORT ID: DPR265 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL-- PERMIT : DEPARTMENT OF PUBLIC WORKS- 9071 LAS TUNAS EL_'0508_9707010027 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: LEGAL I S PAID BUILDING 40DRESS: ON FILE X6300=MP'-ROSEMEADzBL„ FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: �TE 'rCA`91780154 SS NEAREST CROSS STREET: 5382-021-026 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY E3 TEMP XMAS TREE, ADDT 1.00 TEM '21.60 TOTAL FEES 49.35 ISSUED : PROCESSED EXPIRES RAINBOW GIRLS 07/01/97 TC 07/01/98 OWNER: TEL. NO: FIN DATE FINAL BY: CODE: VANNIER WILTON E CO TR VANNIER TRUS (818) 355-1239- 209 OAK MEADOW RD SIER 910242611 - D SCRd -• ON-OF; BOOTH:LA GHTING-FORYFIREWORKS STA APPLICANT: TEL. -- SAME AS OWNER - SPECIAL CONDITIONS: 9 CONTRACTOR: TEL.- N0: O�' APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - LIC. NO j �^ �I� TEMPO I RARY POWER POLE UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: . - UF ER GROUND LIC. N0: , ROUGH1CONDUIT po ( (� j VVr%F FSA N�s1AT R LINE U �J 11 tl S PLASTIC Y/N METAL Y/N J p UTILITY COMPAR7-WOT= l000 oo REPORT ID: DPR265 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0412070038 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAIDBUILDING ADDRESS: ON FILE 6300 ROSEMEAD BL FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801544 ASSESSOR ORM R: NEAREST CROSS STREET: LONGDEN 5382-021-026 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY E3 TEMP XMAS TREE, ADDT 1.00 TEM 21.60 TENANT: TOTAL FEES 49.35 IS : POC B AN BY: ' EXPIRES 0 : 12/07/04 JK 06/05/05 OWNER: TEL. 0: FINAL DAT FINAL BY: CODE: VANNIER WILTON E CO TR VANNIER TRUS (818) 355-1239- C� 209 OAK MEADOW RD Iy f' SIER 910242611SSC IPTION OF WORK LIGHTING FOR XMAS TREE LOT PPL O: PRECISION ELECTRIC CO (626) 338-4377- 5454 DIAZ ST SPECIAL C ND TIONS: IRWINDALE CA CONTRACTOR: TEL. N0: APPROVALS DATE INSPECTOR SIGNATURE PRECISION ELECTRIC CO. (626) 338-4377- 5454 DIAZ ST. LIC. NO T P POWER POLE IRWINDALE, CA 91706 697907C10 UNDERGROUND CONDUIT ARCHITECT ENGINEER: TEL. NO: UFER GROUND LIC. NO: , ROUGH CONDUTT-- ROUGH WIRING IN WATER INE PLASTIC Y/N METAL Y/N UTILITY COMPANY0 I D , REPORT ID: DPR265 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 CEL-ECTRICAL-PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS EL-0508-9803190036 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: LEGAL D: FEES PAIDBUILDING ADDRESS-:- ON R SSON FILE C6300-ROSEMEAD-BL FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801544 ASSESSOR N NEAREST CROSS STREET: LONGDEN 5382-021-026 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY K1 SIGNS, OUTLINE LGT 2.00 SIG 77.70 NA 6 TOTAL FEES 105.45 I S BY: EXPIRES CHf•I �4tl •f- T9-PARTS fro 03/19/98 UT 03/19/99 OWNER: TEL. NO: FINAL DATE FINAL BY: VANNIER WILTON E CO TR VANNIER TRUS (818) 355-1239- 209 OAK MEADOW RD 3-5 SIER 910242611 DESCR _T-IO _0- - t ELECTRICAL-EOR TWO-NEW SIGNS APPLICANT: TEL. NO: AD-ART SIGN CORP. (310) 523-9500- 19603 FIGUEROA SPECIAL COND TIONS: CARSON, CA gaELES CONTRACTOR: EL. N0: ��t�a. APPROVALS 5ATE INSPECTOR SIGNATURE AD-ART ELECTRONIC SIGN CORP (310) 523-9500- 19603 FIGUEROA ST LIC. NO TEMPORARY POWER POLE CARSON CA 90745 711214C45 UNDERGROUND CONDUIT ARCHITECT 0 O: — GROUND LIC. N0: 'J; _�_ _ ( '� �1�11111 '' ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE )Ll i; PLASTIC Y/N METAL Y/N UTILITY C014PANY NOTIFIED REPORT ID: DPR265 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0503 0407060002 BUILDING AND SAFETf / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGA ID: FEES PAID BUILDINGADDRESS: ON FILE - + 6300 ROSEMEAD BL FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801544 ASSESSOR INFORMATION BER: NEAREST CROSS STREET: 5.382-021-026 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY E1 TEMP SERV POWER POLE 1.00 TMP 43.65 TENANT: TOTAL FEES 71.40 ISSUED 0 PROCESSED N BY: EXPIRES ON: RAINBOW GIRLS 07/06/04 JK- 01/02/05 OWNER: TEL. N0: FINTE / FINAL ,SY: CODE: VANNIER WILTON E CO TR VANNIER T2US (81 8) 355-1239- 209 OAK MEADOW RD SIER 910242611 DESCRIPTION OF WOR TEMPORARY POWER POLE FOR FIREWORKS STAND 2004 APPLICAN . NO: SAME AS OWNER SPECIAL CONDITIONS: IGONTP.ACTOR: TEL. NO: t` �� APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO I TEMP�iRARY PO POLE UNDERGROUND CONDUIT ARC ITEC' .OR ENGINEER: TEL. NO: —I Limo GROUND LIC. NO: TROUGH CONDUIT IZUUCF WIRIN — MAIN WATER LINE J PLASTIC Y/N METAL Y/N II UTILITY COMP N NG IIFIED i I � ' i - 1 REPORT ID: DPR265 ROUTE TO: BS0508