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Home My Public Portal About5002 TEMPLE CITY BLVD_Electrical__ el b; of WORKER I haveCOMPENSATION DECLARATION 76AM DPW(12 a„ APPLICATION FOR ELECTRICAL PERMIT 11 lGO01 I hereby affirm that I have a certificate of consent to sell Insure Of a certificate of Worker a Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV copy thereatl(Sec 3800 Lab C Policy No Company FOR APPLICANT TO FILL IN r ` a Candled copy is hereby furnished New Residential Bidgs 8 Poole NO EACH FEE LOCALITY ❑ Cerufied copy is filed with the countybuilding Inspection, 1 S 2 Family Sq Ft — $ $ r department Muhl family Sq Ft — gr Dat9 Applicant ,. Residential Swimming Poole . ASSESSOR MAP GOOK PAGE I PARCEL Y CERTIFICATEOF EXEMPTION FROM WORKERS O Rec Light Sw — / f � COBRRAOM� COMPENSATION INSURANCE _ (, �Q �_ ` (This section need not be completed If the work Involved by they First o sMAIL Permit is for one hundred dollars(3100)'or leu) - Total No Additional AOomise 0'1. M. s L r I comfy that m the performance of the work'for which this permit CITY Tel No i ie issued I shell not employ any person in any manner so as to ,7D cobecome subject to the Workers Compensation Laws Llghling Flxturea Rrst 20 PUN CHECK APPUCANT Total No Addlbonel ADDRESS Date Applicant RESIDENTIAL APPUANCE OT OVER 3 HP NOTICE TO APPLICANT If alter making this Certificate of CITU - 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 shell be deemed revoked Power Apparatus 8 Large Appliances APPLICANT tlief 4-19,e LICENSED CONTRACTORS DECLARATION Size 8 Type HP KW KVA or KVAR ADDRESS I hereby affirm that I am licensed under provisions of Chapter B 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 Ind } SE OR Over 50 to 100 Ind RREEDENNUMBER License Number Lic Clew Over 1 W DISTRICT NCI p SED BY 0 u Services Swbd, MCC8 anal / - ' Cr A uc-� ci CL PO Contractor Date 0 Amp Under V Ogre ❑ am exempt uMer Sec - 400 1000 Amp Under 800 V Z - Z,S-g VALIDATION U Over 1000 Amp or Over 600 V W FINAL d B 6P C for this reason BRANCH CIRCUIT FEES BY N Date - ISA or 20A 120V Lighting a Recept z 1 To 10 Branch Circuits Signature I I To 40 Branch Circuits EIampum for41 Or More Branch CircuitsReg Mount E)act 15A 20A 208V To 27N & Circuits SINGLE FAMILY Temp Power Pole 8 Appurtenances HOME OWNER BUILDER DECLARATION Sign with One Branch Circuit - - ACCT.i I hereby affirm that I am exempt from the Contractor a License Lew for the fallowing reason (Section 7031 5 Business and Professions Additional Sign Branch Circuits ��07 v4.5.] Code) 1 8 1 I u owner of the property well do the work and the structure �} Misc Conduits 6 Conductors 1 11 GIiT['M S Is not intended or offered for sale(Section 7044 Buamess Other(Sae Complete Fee Schedule)_ TOTAL, 4 - 53 and Professions Code) V4.]r CONSTRUCTION LENDING AGENCY C� I hereby affirm that there is a construction lending agency for the - �� ' CHANGE .(]O performance of the work for which this permit is Issued (Sac 3087 PERMIT FEE (Sub Total ft C) 7. PLAN CHECKING FEE Lenders Nemo 0000-0001 12/1,02 PERMIT ISSUING FEE dT. 7030 1 AM E:51 Lender a Address F ' I cortify that I have reed this application and under penalty of purjury state TOTAL FEE O that the above mformabon is caned I agree to comply with all County O orimarices and State laws regulating Electrical wiring and hereby authorize representatives of this C1punry to enter upon the above mentioned property - lor irre § / SEE REVERSE FOR EXPLANATORY LANGUAGE ,TUBE O PFRNITTEE MM COLNT'Y OF IAS ANGELES TEMPLE CITY a 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 IAS TUNAS EL 0508 0905260004 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT LEGAL ID FEES PAID BUILDING ADDRESS ITR 14467 LT 20 5002 TEMPLE CITY BL PEE DESCRIPTION QUANTITY DOM . AMOUNT TEMP CA 917803829 (ASSESSOR INFORMATION NUMBER - NEAREST CROSSSTREET LA ROSA 18589-014-005 Al PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID AS LOCALITY TEMPLE CITY CI I IIB OTHER PRL 0-399 AMPS 2 00 PAN 77 70 1 TENANT TOTAL FEES 105 45 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON 05/26/09 SR 11/22/09 - I I (FINAL DATE FI Y CODE LEE TUDY (6266)291---2213- SLJ 5002 TEMPLE CITY BL ITEMP 917803829 DFSCRIITIOIV OF WORK 41 1 2 SUB-PANELS 50 AMP EACH 1 APPLICANT TEL NO LIN (626) 353-1528- 1 1 1 425 DANIMERE AVE 1 1SPECIAL CONDITIONS 1 ARCADIA, CA 91006 Q"Moue wt�fer6. CONTRACTOR TEL NO PROVALS DATE INSPECTOR SIGNATURE JOHNNY J LIN ELECTRICAL (626) 446-7852- 1 1 425 DANIMERE AVENUE LIC NO 1TEMPORARY POWER POLE ARCADIA CA 91006 419580 1 1 UNDERGROUND CONDUIT 1ARCHITECI OR ENGINEER TEL NO 1 UFER GROUND LIC NO ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE PLASTIC Y/N METAL YIN UTILITY COMPANY NOTIFIID I I I I I I I I I � I - � I I I I 1 1 I I I I � I 1 1 I I 1REPORT ID DPR265 ROUTE TO BS0508 l COUNTY 0➢ LOS ANGELES TEMPLE CITY 6 0508 ELECTRICAL PERMIT DEPARTMENT' DEPARTMENT OF PUBLIC MORES 9701 LAS TUNAS BL 0508 0508 0606070002 BUILDING AND SAFETY / LAND DEP6I.OPKWNT TEMPLE CITY CA 91780 PHONE (626) 185-0488 EXT ' Liner. ID FEES PAID BUILDING ADDRESS 17I 14{6] LT 10 / FEE DESCRIPTION QUANTITY DOM AMOUNT 5002 TEMPLE 17 L 803829 ASSESSOR INFORMATION HOMBRE NEAREST CROSS STREET puo_naa-pas `% Al PERMIT ISSUANCE IBE 27 75 THOMAS PAGE 591 GRID AS LOCALITY TEMPLE CITY, C 01 OUTLETS-LGT.SW,RSCP 10 00 OUT 19 50 TENANT G2 LIGHTING FIXTURES 8 00 LOT 15 60 ISSUED OB PROCESSED BY PLAN BY EXPIRES ON TOTAL FEES 62 85 06/07/06 JK - 12/04/06 OWNER _ _ TEL NO - - FINAL,DATE FINAL BY _ _ _ CODE LEE, JUDY (626) 629-2213- / Z 5001 TEMPLE CITY BL V I TIDE 917803829 DESCRIPTION OF WORK 10 OUTLETS 8 LIGHT FIXTURES FOR THE WORKSHOP APPLICANT TBL NO SAME AS OWNER - SPECIAL CONDITIONS CONTRACTOR MI. NO APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC NO _ TEMPORARY POWER POLE UNDERGROUND CONDUIT ARCHITECT OR ENGINEER TEL NO UFLA GROUND LIC NO ROUGH CONDUIT J ROCGR WIRING MAIN WATER LINE PLASTIC YIN METAL YIN UTILITY COMPANY NOTIFIED REPORT ID DPR265 ROUTE TO 880508 1 • I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0312310OD4 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT LEGAL ID- BUILDING - TR 14467 LT 20 5002 TEMPLE CITY-BL FEE DESCRIPTION. QUANTITY Udl AMO(#(T TEMP CA 917803829 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET. LA ROSA 8589-014-005 Al PERMIT ISSUANCE FEE _ 27.75 THOMAS PAGE 597 GRID A5 LOCALITY: TEMPLE CITY TENANT GI OUTLETS-LGT,SW,RECP 31.00_OUT 53 85 G2 LIGHTING FIXTURES 7 00 LGT 13 65 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON H7 RES EXHAUST FANS 2 00 EX _ 21 90 12/31/03- VG _ - _ 06/28/04 OWNER TEL NO TOTAL FEES 117 15 FINAL BY CODE: LEE JUDY (626) 291.2213- 5002 TEMPLE CITY BL t/ v /'I TEMP 917803829vtbLNlPlluw ut WURK L ELECTRICAL FOR ADDITION APPLICANT TEL NO SAME AS OWNER - CONDITIONS- CONTRACTOR APPROVALS DATE IHSFrEr6w-9rmv7oRr-- SAME AS OWNER - LIC NO TEMPORARY POWER POLE UNDERGROUND CONDUIT ARCHITECT OR ENGINEER --7n--o LIFER GROIJIND HUNG CHOU ARCHITECTS (626) 574-0101- 511 1ST AVE #161 LIC N0: ROUGH CONDUIT - ARCADIA CA 91006 NONE FWrWWER LINE PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED REPORT ID: DPR265 ROUTE TO BS0508