The URL can be used to link to this page

Home My Public Portal About6445 TRELAWNEY AVE_Electrical__ WORKERS COMPENSATION DECLARATION 76AW 10/81 APPLICATION FOR ELECTRICAL PERMIT affirm that I have a certificate of consent to self CE B06G insure orjr certificate of Workers Compensation Insurance COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec 3600 Lob C )' Pal icy'No Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished New Residential Bldgs 8 Pools EACH NO FEE ADDRESS S 7xEC.�✓� " ❑ — f ?;C Certified copy is fled with the county building inspec- I & 2 Family Sq Ft f LOCALITY hon department Multi family Sq Ft — NEAREST Residential Swimming Pools CROSS ST —lr�H0 Date Applicant OWNER OR FIRM NAME iL.O✓ CERTIFICATE OF EXEMPTION F40M WORKERS Outlets RecZ�Light�,Sw_ IL COMPENSATION INSURANCE ADDRESS S ELA-�✓+✓= (This ss,ct{on ns,s,d not be complats,d R the work Involved by First 20 the ps,rmB re IF for ons,hundred dollars ($I00)or InCITU C, Tel No s ) Total No Additional T 4dr4L7—L yO I certify that in the performance of the work for which this PLAN CHECK AM �j�✓/E /{. B/4</G.L A. permit is awed, I shall not employ any person in any manner so as to become subject to the Workers Compensation Laws Lighting Futures First 20 ADDRESS Total No Additional Date '�i7-F7 Apphc clTv C, Tel No 7-,dw NOTICE TO APPLICANT If for making this Certificate of Fixed Appliances Not Over 1 HP PERMR Exemption you should become subject to the Workers Range_ Heater_D W _ APRJfANT Compensation 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 _WH _ deemed revoked CITY G Tel No CjtsG/2p LICENSED CONTRACTORS DECLARATION Hood _ Fan _Other— Disp _ Room Air Cond REGLICESE ORN I hereby affirm that I am licensed under provisions of Chapter 9 REG NUMBER Class (commencing with Section 7000) of Division 3 of the BusinessDISTRICT NO BV d and Professions Code and my license is in full force and effect Power Apparatus 8 Large Appliances IJ Size 8 Type HP KW KVA or KVAR L U License Number Lic Class Up to I InclFINAL � Over 1 to 10 Incl DATE VA TION 17— Contractor Date W Over 10 to 50 Incl FINAL ❑ I am exempt under Sec Over 50 to 100 Inc BY N B 8P C for this reason Over 100 b, Z Date Services Swbd MCC 8 Ponelboards ► 0 -200 Amp Under 600 V Signature 201 - 1000 Amp Under 600 V ❑ Exemption for Reg MoOver 1000 Amp or Over 600 V mt Elect SINGLE FAMILY Temp Power Pole B Appurtenances 3 6 7 6 0 A HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit # • • • • • 2I hereby affirm that I am exempt from the Contractor s License Additional Sign Branch Circuits I s •i1 9.50 Law for the followingreason Section 7031 5, Business and Professions Code) • • • I as owner of the property wile do the work and the Mix Conduits 8 Conductors 19 500 44 Other (See Complete Fee Schedule)_ ► structure is not intended or offered for sale (Section 70Business and Professions Cade) 0 30 t-8 7 CONSTRUCTION LENDING AGENCY I hereby affirm that there a o construction lending agency for the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) (Sec 3097 Cry C ) PLAN CHECKING FEE Lender s Name PERMIT ISSUING FEE Lenders Address I certify that I have read this application and stole that the TOTAL FEE 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 the abo a mentioned property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date ATION 7WO WORKERS have ceSdcale DECLARATION CE-806 ,oie, APPLICATION FOR ELECTRICAL PERMIT {1 CE-806G LJ I hereb),,eflum that I have� ceridica3e d consent to sett visrve or a„certilcate-of Workers Cornpensatcn Insurance or a certifed COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec 3800 Lab C) Policy No Company FOR APPLICANT TO FILL IN JOB ❑ Certified copy a hereby turretEACH NO FEE ADDRFSB S T�E.L�titi flew Reexlentiel Bldgs 8 Pods E]. Certified copy rs hied With the county hwloirg Inspection 1 E 2-Family Sq Ft $ — $ 1LOCALITY department Multi-family Sq Ft caos.R NEAREST 57 DAV Date Applicant Residential Swumri Pools OWNER OR / tight S. FIRM NAME Outlets Rec CERTIFICATE OF EXEMPTION FROM WORKERS MAIL SS g COMPENSATION INSURANCE ' /Q /� ADDRE (This section head not be completed ll the work lrwolved by the First 20 permit nen Is for one hundred dollars($100)or le ) Total No� Addacnal G CITV i+ Tel No 7—IGu I certify that in the partormance of the work for which the permit AP�IC�NT K is issued I shall not employ any person in arry manner so as to become sublect to the Workers Cominensatxm Laws Lighting Fixtures First 20 ADDRESS Additional Date App, pt Total No CITU Tel No NOTICE TO APPLICANT II er making this Certificate of Fixed Appliances Not Over 1 HP PERMR Exemption you should become Ckaject to the Wo,*,ers Comperisalm Range_ Heater_ DW _ APPLICANT pirmsrwe of the Labor Code you must forthwith comply with such Oven _ Dryer _ W M _ ADDRESS promsrons or the permit shall be deemed revoked Top _ FAU _ WH LICENSED CONTRACTORS DECLARATIONCITY Tel No Hoed — Fan Other_ I hereby affirm that I am licensed under ri 3 of to d Chapter 9 LICENSEm (commencing with Section 70is 00)of Divor 3 of the Bwne sss and Opp — Rooir Cond REO NUMBER Ceue Professions Code and my license is in full force and effectDISTRI T NO PROCESSED BY Power Apparatus 8 Large Appliances o Size& Type HP KW KVA or KVAR rQ a License Number Lc Class Up to 1 Incl FINAL Over 1 to 101nc1 DATE VALIDATION Contract or Date Over 10 to 50 Ind FINAL 0 I em exempt under Sec Over 50 to 100 Inc BY B&PC for the reason Over 100 N Services Swbd MCC Parlelboards oil- Z Date 0-200 Amp Under 800 V `'/' j Signature 201 - 1000 Amp Under 600 V ❑ Exemption Over 1000 Amp or Over 600 V Exemption for Rep Maim Elect SINGLE FAMILY Temp Power Pole E Appurtenances t HOME OWNER-BUILDER DECLARATION Sign with One Branch Cucun ACCT.: I hereby affirm that I am exempt from the Contractors License Law for the following reason(Section 7031 5 Business and Professors Additional Sign Branch Grcwts 07 Code) 38.2I Mac Conduits & Conductors 1 ITEMS ElI as owner of the property do the work end the Buuu ► TOTAL 38 - 20 e not intended a offered laror structure,eels (Seclxm 7044 Business Oyer(See Complete Fee Schedule) and Professions Code) CASH 38.`u CONSTRUCTION LENDING AGENCY u��vr I hereby affirm that there is a construction bending agency for the �S CHANE ,0[1 it performance of the work for which the perma issued(Seo 3087 PERMIT FEE (Sub-Total) Civ C) �r1i��,�� Lenders Name ��7/4-/G Bg�'4 PLAN CHECKING FEE 0000—WU1 10/10/90 Lenders Address G4z4cr PERMIT ISSUING FEE 31 1 AM 80:77 I certify that I have read this application and state that the above TOTAL FEE 3' 8 information is correct I agree to comply With all County ordinances and State lays regulating Electrical wing and hereby authomm representatives of the County to enter upon the above-mantaned property for inepectm purposes SEE REVERSE FOR EXPLANATORY LANGUAGE G—y O —9D ature of Permittee Date _ r WORKERS COMPENSATION DECLARATION 761667 ID,B, APPLICATION FOR ELECTRICAL PERMIT ! hereby affirm that ! have a certificate of consent to self CEAOeC insure, or a certificate of Workers Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or o certified copy thereof (Sec 3800 Lob C ) Pal icy No Company FOR ARLICANT TO RLL IN I t4gDDRE55OTIC-" �. Certified copy is hereby furnished New Residential Bldgs & Pools EACH 0 FEE ❑ Certified copy is filed with the county budding iospec- 1 &2-Family, Sq Fr $ — S LOCALITY tion department Multi-family Sq F —I NEAREST Residential Swimming Pools CROSS S7 A" Date Applicant OWNER OR FIRM NAME .�JL-L_I CERTIFICATE OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE MAIL Outlets Rec_Ughr_Sw_ ADDRESS IFYE? G (This section need not be completed If the work Inwlsed by First 20 the pernilt Is for one hundred dollen ($100)or less) Total No Additional CIN / Tel No I certify that in the performance of the work for which this RACHECK permit is issued I shall not employ any person in any manner APPLICANT s as to become subject to the Workers Compensation Lows Lighting Fixtures First 20 ADDRESS / Total No Additional Doty 4aDI icant.�.0!//� C�iGJLLA CITY tel No NOTICE TO PPLICANT If after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT Exemption, you should become subject to the Workers Range_ Heater_D W — APPLICANT Compensation 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 _WH _ deemed revoked Hood _ Fan _Other_ CITY Tel No LICENSED CONTRACTORS DECLARATION Disp _ Room Air Cond LICENSE OR 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 J SSED BY and Professions Cade,and my license is in full force and effect CQl d Size 8 Type HP KW KVA or KVAR I O License Number Lic Class V U to 1 Incl FINAL / -7 Q Over 1 to 10 Ind DATE [� LQ VALIDATION 09 Contractor Dote Over 10 to 50 Incl ❑ I am exempt under Sec FINAL p Over 50 to 100 Inc BY B 8P C for this reason Over 100 rN Services Sw & Ponelboards = Dote - pp Amp Under Signature 201 - IOUD Amp Under 600 V ❑ Exemption Over 1000 Amp w Over 600 V tar Reg Moint Elect SINGLE FAMILY Temp Power Pale 8 Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuitb 0 5 A I hereby affirm that I am exempt from the Contractor i License Additional Sign Branch Circuits Law for the following reason (Section 7031 5 Business and # • • •e2 Pr f ons Code) I as owner of the property will do the work and the Misc Conduits 8 Conductor structure is not intended or offered far sale (Section Other (See Complete Fee Schedule)— ► 2'e - 2550 7044 Business and Professions Code) s s s 2 ra Jr 0 CONSTRUCTION LENDING AGENCY 1017-83 O ,� 7_8 3 I hereby off rm that there is a construction lending agency far the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) 1S (Sec 3097 Civ C ) PIAN 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 Z 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 t bove-mentioned property f g mspection purposes Y/ SEE REVERSE FOR EXPLANATORY LANGUAGE $ nature of Permit Date COUNTY OF LOS ANGELES TEMPLE CITY 1) 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS EL 0508 9707230008 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: LEGAL ID. FEES PAID -BUILDING ADDRESS TR 32706 LT 16 6445 TRELAWNEY AV FEE DESCRIPTION QUANTITY: UOM: AMOUNT TEMP CA 917801315 ASSESSOR INFORKATION NUMBER NEAREST CROSS STREET LEMON 5382-014-017 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE- 596 GRID: J1 LOCALITY TEMPLE CITY LB 200 AMP PANELS, MCC 1.00 PAN 38.85 TOTAL FEES 66.60 07/23/97 TC 07/23/98 OWNER: TEL NO FINAL DATE FINAL BY CODE: BARILLA LOUIE A;GRACIE A (818) 447-6401- 6445 TRELAWNEY AV f //2�T/� TEMP 917801315 6E4CRIF ON OF�iBFIC' i NEN ELECTRICAL SERVICE PANEL UPGRADE - 200 AMP APPLICANT TEL. NO: SAME AS OWNERSPECIAL CONDITIONS. - CONTRACTOR: TEL NO. nAPPROVALS DATE INOTUMMORTUM SAME AS OWNER - _ _ LIC NO i �� TEMPORARY POWER PULE UNDERGROUND CMMffr— ARCHITECT OR ENGINEER: TEL. NO: UFER GROUND_ LIC NO ROUGH CONDUIT ROWH WIRING KRIM WATER LINE PLASTIC Y/N METAL Y/N - t REPORT ID: DPR265 ROUTE TO BSO508