The URL can be used to link to this page

Home My Public Portal About5739 ROWLAND AVE_Electrical__ WORKERS'COMPENSATION DECLARATION CE-806 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby 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.) P❑ol"icy No. Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished. New Residential Bldgs. $Pools EACH NO. FEE ADDRESS 41 1.4A,',( 1 $2-Family, LOCALITY Certified copy is filed with the county building inspec- y, Sq. Ft. $ — $ �'�� tion department. — NEAREST �! p i Multi-family Sq. Ft. CROSS ST: (� V Residential Swimming Pools OWNER OR Date Applicant FIRM NAME U. 6S d CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec Light. Sw._ tL COMPENSATION INSURANCE First 20 ADDRESS. 3 lk- jAre- (This section need not be completed If the work Involved by I Total No. Additional CITY �� 6 Tel. No.. ..g� the permit is for one hundred dollars($100)or less.) PLAN CHECK 17 I certify that in the performance of the work for which this APPLICANT permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' mpensa ion Laws. Lighting Fixtures First 20. ADDRESS Total No. Additional CITY Tel. No, Date Z — pplicant Fixed Appliances Not Over 1 HP PERMIT NOTICE`TO-APPLICANT: If, afte. king, this tificate'of APPLICANT Exemption, you should beco e. ubject to a Workers' Range_ Heater_D.W. _ Compensation provisions of the abor Code, you'must forth- Oven —Dryer _W.M.— ADDRESS with comply with such provisions or this permit shall be Top _ FAU —W.H. — deemed revoked. CITY Tel. No. LICENSED CONTRACTORS DECLARATION Hood _ Fan _011ier_ Disp. _ Room Air Cond. — LICENSE OR s I hereby affirm that I bm licensed under provisions of Chapter 9 REG.NUMBER (commencing with Section 7000)of Division 3 of the Businesspower Apparatus$Large Appliances DISTRICT NO PRO SSE Y and Professions Code,and my license is in full force and effect. —i >_ Size$Type HP, KW, KVA, or KVAR• O License Number Lic. Class Up to 1 Incl. FINAL W Over 1 to 10 Incl. DATE. "� - V .DATION 0 29 Contractor Date Over 10 to 50 Incl. ❑ FINAL j I am exempt under.Sec. Over 50 to 100 Inc. BY I B:$P.C. for this reason Over 100 Date: Services, Swbd., MCC.$Parielboards: ► e 0 -200 Amp. Under 600 V1 Signature 201 - 1000 Amp. Under 600 V ❑ Exemption for,Reg. Maint. Elect. Over 1000 Amp. or Over 600 V `; 0 0 0 0 0 ? SINGLE FAMILY Temp. Power Pole$Appurtenances :l i n o.2 h Q HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I o .,o n C:�:` C St I hereby affirm-that I am exempt from the Contractor's License Additional Sign Branch Circuits { j�,' Law for the following reason (.Section 7031.5, Business and g.: _� 1F Professions Code): I, as owner of the property,will do the work and the Misc. Conduits$Conductors structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)_ , 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there.is a.construction.'ending agency for the performance of the work for w.h'i.ch this permit is issued PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address P I certify that I have read this application and state that the TOTAL FEE above information is correct. 1 agree to comply with all County i ordinances and State laws regulating Electrical wiring, and hereby authorize representatives of this County to enter upon ti the.abov ntioned p .erty for inspection purposes. z ✓� SEE REVERSE FOR EXPLANATORY LANGUAGE SI ure ornrrdttee Date I 5� COUNTY'OF LOS ANGELES TEMPLE CITY # 0508 i ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508-9904300015 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: GA FEES PAID - B U I-L I G--AD R SS: TR: 6561 LT: 404 5739 ROWLAND AV- FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802617 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 8587-029-008 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT SW,RECP 17.00 OUT 33.15 TENANT: G2 LIGHTING FIXTURES 5.00 LGT 9.75 ISSUED OW PROCESSED BY: PLA B S ON: H7 RES EXHAUST FANS 2.00 EX 21.60 04/30/99 VG 10/27/99 TOTAL FEES 92.25 OWNER: TEL. 0: FINAL DATE FINAL BY: CO CHANG;SOPHIA (626) 291-2900- 5739 ROWLAND AV l `- TEMP 917802617 DESCRIPTION 0 0 ELECTRICAL FOR ADDITION PLICA 0: L C CONSTRUCTION AND PLUMBING (626) 444-4836- SPECIAL CONDITIONS: ES Co CONTRACTOR: TEL. NO: ®`9 �/� APPROVALS DATE INSPECTOR SIGNATURE L C CONSTRUCTION AND PLUMBING CORP. (626) 444-4836- 10021 E. GARVEY AVENUE LIC. NO TEMPORARY POWER POLE EL MONTE, CA 91733 538151 B j UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: I E ROUND LIC. NO / 1111111 ROUGHCONDUIT LWOUGIrM r!rG- c MAIN WATER LINE U lu^5u u PLASTIC Y/N METAL Y/N UTILITY C P NOT I D d o , " illi O p Servae * ADDITIONAL DATA ON FILE REPORT ID: DPR265 ROUTE TO: BS0508 • COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIt DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS -,EL-0508 98111'90020 • BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILD NGADPRESS: TR: 6561 LT: 404 X739 ROWLAND..AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP-CA-917802617 ASSESSOR INFO MA ON NU R: NEAREST CROSS STREET: LIVE OAK 8587-029-008 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT SW,RECP 12.00 OUT 23.40 TENANT: G2 LIGHTING FIXTURES 4.00 LGT 7.80 ISSUED ON: PROCESSED BY: PLAN EXPIRES ON: TOTAL FEES 58.95 02/04/99 UT 2/04/00 OWNER: TEL. NO: FINAL DATE FI AL 8 CODE: CHANG•SOPHIA (626) 291-2900- 5739 ROWLAND AV TEMP 917802617 DESCRIPTION OFWORK- ZtECTRTCAL -FOR ADD1.I1'.ON-BATHR00 J1IEW-CLOSET APPLICANT: TEL. NO: L C CONS. & PLUMBING CORP (626) 444-4836- 10021 E. GARVEY AVE SPECIAL CONDITIONS: EL MONTE, CA p,NbELES C® CONTRACTOR: TEL. NO: OcJ V/�/l, APPROVALS DATE INSPECTOR SIGNATURE L C CONSTRUCTION & PLUMBING CORP. (626) 444-4836- �. 10021 E. GARVEY AVENUE LIC. NO TEMPORARY POWERPOLE EL MONTE, CA 91733 538151 B *� / UNDERGROUND CONDUIT ARCHITECT OR ENGI EER: TEL. NO: UFER GROUND LIC. N 1111111 ROUGH CONDUIT 0 GH WIRING I�r�U p D MAIN WATER LINE F I v/L C W O K S PLASTIC Y/N METAL Y/N 6F ol` UTILI Y COMPANY NOTIFIED / 7n eg El o El A46''c ❑ �0��5 Service Thai * ADDITIONAL DATA ON FILE REPORT ID: DPR265 ROUTE TO: BS0508