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Home My Public Portal About5822 SULTANA AVE_Electrical__ WQRKERS'COMPENSATION DECLARATION I 78-803.• 10/8'1 APPLICATION FOR ELECTRICAL PERMIT I*'hereby affirm that I have.a certificate of consent to self insure, CE-8066 or of certificate of Workers' Compensation Insurance, or a certified I COUNTY'OF LOS ANGELES BUILDING AND SAFETY loopy thereof(Sec.3800,Lab.iC.) Policy No. Company FOR APPLICANT TO FILL IN JOB' ❑ Certified copy is hereby furnished. New Residential Bldgs.&Pools EACH' NO. FEE ADDRESS $ _ $ LOCALITY ��, Certified copy.is filed with the county building inspection , '1 &2-Family,Sq:,Ft. department. Multi-family Sq.Ft. NEAREST ' cRoss sr. .Date Applicant Residential Swimming Pools � OWN NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec Light—'Sw. MAIL — — COMPENSATION INSURANCE ADDRESS First 20 (This section need not be completed If the work involved by the. f CITY c� � Tel.No.. ' permit is for one hundred dollars($'100)or less.) i Total No. - Additional I PLAN CHECK t' I certify that in the performance of,the work for which this permit j APPLICANT 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 t + S r Total No. Additional ssi CITY Tel.No. Date Applican ! Fixed Appliances Not Over 1 HP. PERMIT t ,., r NOTICE TO- APPLICANT: If, after making this Certific to of- Ir Exemption,.you.should become subject to the Workers'Compensation f Range_ Heater_ D.W. i APPLICANTI Le I provisions of the Labor Code,you must forthwith comply with such Oven _ Dryer_ W.M._ +. ADDRESS IV— LICENSED provisions or this permit shall be deemed revoked. R Top — FAU W.H. — CITY ! q I p Ache Tel.No � f ' LICENSED CONTRACTORS DECLARATION Hood — Fan Other_ I hereby affirm that'I am licensed under provisions of•Chapter 9UCENSE OR (commencing with.Section 7.000)of Division 3 of the Business and i' Disp. — Room Air Cond. _ REG.NUMBER lass.,e Ia Professions Code,and my license is in full force and effect: power Apparatus&Large Appliances 6� ' DISTRICT NO. PRO BY 1) � Size&Type.HP,KW,KVA,or KVAR � 0 License Number !ZLE��—tom Lic.Classe- it Up to 1 Incl.` ` FINAL ;' V Over 1 to 10 Incl.. DATE VALIDATION 0 Contracto. • •"24b te T L , Over 10 to 50 Incl. I U FINAL ❑ n er Over 50 to 100 Inc. �. BY 1� B,&P.C.for this reason. r Over 100' + s IL Services,:Swbd.,MCC&Panelboards ' , 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.,.Elect. SINGLE FAMILY +. Temp.Power Pole&Appurtenances 'HOME OWNER-BUILDER.DECLARATION Sign with One Branch Circuit I hereby affirm that.I am exempt from the Contractor's License Law + Additional Sign Branch Circuits I. , for the following reason(Section 7031.5,Business and Professions Code): t p Misc.Conduits.&Conductors + Till ��:,p•�.•��_�—n® ❑ I,as owner of the property,will do the work and the structure ' 255.50 is not:intended or offered for sale (lection 7044, Business t Other(See,Qomplete Fee Schedule) _. i , - r-(:;r and Professions Code). i i `� �'K f 'CONSTRUCTION LENDING AGENCY S I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued(Sec.3097,1 PERMIT FEE (Sub Total) Civ.C.). , ' PLAN CHECKING FEE Lender's Name i' I 1, • + PERMIT ISSUING FEE V 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 I' representatives of this County to enter upon the above-mentioned l' property for insppption purposes. f SEE REVERSE FOR EXPLANATORY LANGUAGE ; 00, Signature of Permittee Date I +' l WORKERS'COMPENSATION DECLARATION CE-806 APPLICATION FOR E ECTRICAL 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 $ ti c ter of(Sec.3800,Lab.C.) .•! /' 1§ � r Ins, Co. New Residential Bldgs.&Pools FOR:APPLICANTTO•F'ILL IN ( JOB Policy No. . Company ' EACH NO. FEE I ADDRESS 5822 Sultana ❑ Certified copy is hereby furnished. 1 &2-.Family,Sq.:Ft. $.. — $ LOCALITY Temple le Cit jMulti-family Sq. Ft. — - i NEAREST ' L] Certified copy is.'filed with the county building inspection CROSS ST La's Tunas department. Residential Swimming Pools OWNER OR Date -6—g1 Applicant Edwards Electric FIRM,-NAME Outlets: Rec.—Light Sw. I MAIL First 20 ADDRESS CERTIFICATE'OF EXEMPTION FROM WORKERS' I Total.No. Additional y CITY Tel No. �.. COMPENSATION•INSUZtAIVGE ' I PLAN CHECK a 'APPLICANT 0 (This section need not be completed if the work involvedI 0 Lighting Fixtures First 20 by the permit is for one hundred dollars ($100) or less.) Additional ADDRESS cc r Total No. O I certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP I CITY Tel No. permit is issued, I shall not employ any person in any manneri PERMIT W so as to become subject to the Workers Compensation Laws.. Range_Heater D.W._ ; APPLICANT d Oven _ Dryer_W.M._ ADDRESS N I — 2535 S. 3rd Ave. . Z Date Applicant ! Top FAU _W.H.._ Hood _ Fan _Other_ CITY Arcadia Tel No. 447-5096 .NOTICE TO APPLICANT: If, after making this Certificate of ( Disp.._Room Air Cond,I I LICENSE OR C-10 Exemption, 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. PROCESSED BY with comply with such provisions or this permit shall be I Size&Type HP,KW,KVA,or KVAR Q� deemed revoked. Up to 1 Incl. Over 1 to 10.Incl. FINALDATE LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl. VALIDATION I hereby affirm that 1 am,licensed under provisions of Chapter �I Over 50 to 100 Inc. FINAL ' 9 (commencing with Section 7000)of Division 3 of the Busi= Over 100 ness and Professions.Code,and my license is in full. force and effect. I Services License Number 257191 Lic.Class C-10 ` 0-200 Amp.Under 600 V wards Elec},,l e J lgg2 201-1000 Amp.Under 600 V Edw Contractor �g � Over 1000 Amp.or Over 600 V HOME OWNER-BUILDER.DECLARATION Temp.Power Pole&,Appurtenances r I' .hereby affirm that I am exempt from the Contractor's I Sign with One Branch Circuit License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits 4 7 5. 6 N ness and Professions Code): Misc.Conduits&Conductors #'❑ Io e 010 0 , as owner of the property, will do the work and the '� Other(See'Complete Fee Schedule)— structure is not intended or offered for sale (Section 7044;Business and Professions Code). 0 0 0 0.0 0 o C CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency 0 U for the performance of the work for which this permit is issued(Sec.30.97,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 NO 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 ✓ y�• .lrl� 4-6-81 Signature of Permittee, Date ' COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1106150014 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: JTR: 5905 LT: 104I 5822 SULTANA AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT; TEMP CA 917801838 ASSESSOR INFORMATION NUMBER: I INEAREST CROSS STREET: LAS TUNAS 5387-015-020 JAI PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY, Cl JG1 OUTLETS-LGT,SW,RECP 8.00 OUT 15.50 TENANT: JG2 LIGHTING FIXTURES 6.00 LGT 11.60 ISSUED ON: PROCESSED BY: PLAN BY: JH2 RES GRBG DISP IT 3HP 1.00 DIS 10.90 06/15/11 SR TOTAL FEES 65.80 1 OWNER: TEL. NO: IFI DATE FINAL BY: CODE: JHUANG/LEE, JOYCE/THOMAS (626) 840-0333- 1 5822 SULTANA AV I TEMP 917801838 IDYSCRfPTIOf4 OF WORK ELECTRICAL FOR KITCHEN REMODEL AND TWO BATHROOMS APPLICANT: TEL. NO: ICHANG, KUANG K (626) 573-9446- 1724 W. WOODCREST ST ISPECIAL CONDITIONS: IFULLERTON, CA 92822 CONTRACTOR: TEL. NO: I JAPPROVALS DATE INSPECTOR SIGNATURE JXUANG KAI CHANG (626) 573-9446- 1724 W. WOODCREST STREET LIC. NO ITEMPORARY POWER POLE IFULLERTON, CA 92832 674054 C10 UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: TEL. NO: - i JUFER GROUND LIC. NO: IROUGH CONDUIT ROUGH WIRING MAIN WATER LINE PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED REPORT ID: DPR265 ROUTE TO: BS0508