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Home My Public Portal About9902 WOODRUFF AVE_Electrical__ • COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0111190055 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: F55S PAID BUILDING TR: 6561 LT: 48 UN: .002 9902 WOODRUFF AV: FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801729 ASSESSOR IN0 IO NEAREST CROSS STREET: AGNES 8587-031-022 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY G1 OUTLETS-LGT,SW,RECP 20.00 OUT 39.00 TENANT: G2 LIGHTING FIXTURES 5.00 LGT 9.75 ISSU50 ON: PROCESSED B ON: H7 RES EXHAUST FANS 1.00 EX 10.95 11/19/01 JK 05/18/02 H9 RES APPL LT 3HP 1.00 RES 10.95 OWNER: TEL. LB 200 AMP PANELS MCC 1.00 PAN 38.85 FINAL DATE FIA BY: CODE: TRAN, BIEN HAI - TOTAL FEES 137.25 /'- ��L, 9902 WOODRUFF AV ( TEMP 917801729 DESCRIPTION OF WORK ELECTRICAL FOR ADDITION, UPGRADE PANEL APPLICANT: TEL. NO: HONG A. MIU (626) 281-3881- 1809 S. MONTEREY ST r SPECIAL CONDITIONS: ALHAMBRA 91807 COT CTOR: EL. N0: APPROVALS DATE INSPECTOR SIG OR TE HONG A MIU (626) 281-3881- �•';, 1'�•,•. 1809 MONTEREY ST. LIC. NO %;:� ,fro �^' @� M ER POLE ALHAMBRA, CA 91801 755456 B �`` ' ,' l'�; ','-� `�+• UNDERGROUND CONDUIT ARCHITECTOR ENGINEER: TE GROUND LIC.-ND,:'II ROUGH CONDUIT -I --- -•_J ' L_Li fel tl RO A- — ----- -- ----- --- - --- 7/ MAIN WATER LINE NP PLASTIC Y/N METAL Y/N - _---- -- - - ---- - - - - P NOTIFIED REPORT ID: DPR265 ROUTE TO: OS0508 " WOR` 7 fficE�806(,3 .ERS'COMPENSATION DECLARATION 00019 DPW 3/87 APPLICATION FOR ELECTRICAL PERMIT O I here�y arm that I have a certificate of consent to self insure, or-a ceHificate of Workers'Compensation Insurance, I COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certified copy.thereof(Sec. 3800, Lab. C.) j Policy No. Company FOR APPLICANT TO FILL IN JOB 1 Certified copy is hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE ADDRESS �l�o 0® U d Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. .$ = $ LOCALITY tion department. Multi-family Sq. Ft. NEAREST cRoss O Date Applicant Residential Swimming Pools OW R _ FIRM NAMR E CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec--6—Light Sw._ MAIL COMPENSATION INSURANCE / First 20 0� ADDRESS (This section need not be completed if the work involved by Total No.JL_ Additional CITY L Tel. No, 2� 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 be subject to the Workers'Compensation Laws. lighting Fixtures First 20 ADDRESS Additional Date � Applicant ,S' Total No. , CITY Tel. No. Fixed Appliances Not Over 1 HP I PERMIT NOTICE 40 PPLICANT: If, after maki this Certificate of AM Exemption, you should become subject to the Workers' I Range— Heater—D.W. — I APPLICATION Compensation provisions of the Labor Code, you must forth- Oven — Dryer —W.M.— ' ADDRESS with .comply with such provisions or this permit shall be I Top — FAU —W.H. — deemed revoked. I Hood — Fan —Other— i CITY Tel. No. LICENSED CONTRACTORS DECLARATION f LICENSE OR — I hereby affirm that I am licensed under provisions of Chapter'9 Disp. _ Room Air Cond. ; REG.NUMBER Class. (commencing with Section 7000)of Division 3 of the Business Power Apparatus&Large Appliances DISTRICT NO. PROCESSED BY Or.. and Professions Code,and my license is in full force and effect. J ' Size&Type HP, KW, KVA, or KVAR � License Number Lic. Class I FINAL U i Up to 1 Incl. � j Over 1 to 10 Incl. DATE n VALIDATION O Contractor Date Over 10 to 50 Incl. U QFINAL I am exempt under Sec. I Over 50 to 100 Inc. BY LLI B.&P.C. for this reason Over 100 t1 Services, Swbd., MCC&Ponelboards / ® / Z Date: 0-200 Amp. Under 600 V j I_CID P, Signature I 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 70 (Sign with One Branch Circuit n 1 hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits ACCT°Q Law for the following reason (Section 31.5, Business and g °�� Professions Code): 33Q7 I, as owner of the property, will do the work and the Misc. Conduits&Conductors 1 ITE{ S structure is not intended or offered for sale(Section 7044, 1[Other(See Complete Fee Schedule)— I Business and Professions Code). TOTAL 30 01131°�ti CONSTRUCTION LENDING AGENCY CHECK 1 herebjraffirm that there is a construction lending agency for 00 the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) CHANGE (Sec. 3097, Civ. C.). • PLAN CHECKING FEE 0000-0001 �� ' Lender's Name PERMIT ISSUING FEE d Lender's Address ();A4 1 IM 80-24 1 certify that I Kaye 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 purp ses. SEE REVERSE FOR EXPLANATORY LANGUAGE X15 g� ®S Sign re of Permittee ate I; I 1 ► •WORKERS' COMPENSATION DECLARATION 76a663 tout GE-906G APPLICATION FOR ELECTRICAL PERMIT' 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 cgpy thereof(Sec. 3800.Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB ❑ 1 — ADDRESS 2 Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ❑ 1 & 2-Family, Sq.Ft. $ — $ LOCALITY I� C Certified copy is filed with the county building inspection department. Multi-family Sq. Ft. NEAREST CROSS ST. Date Applicant Residential Swimming Poolsi��1 OWNER OR FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec_ Light �w. — MAIL COMPENSATION INSURANCE ADDRESS S J (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. 2 �L s tr 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 s0 as to APPLICANT 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 NOTICE TO APPLICANT: If, after making this Certificate of PERMIT _ Exemption,you should become subject to the Workers'Compensation Range_ Heater_ D.W. APPLICANT , AAA provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer _ W.M. _ ADDRESS provisions or this permit shall be deemed revoked. Top - FAU _ W.H. CITY Tel.No. LICENSED CONTRACTORS DECLARATION Hood Fan Other_ I hereby affirm that I am licensed under provisions of Chapter 9 Disp. - Room Air Cone. LICENSE OR (commencing with Section 7000) of Division 3 Of the Business and REG.NUMBER Class. Professions Code,and my license is in full force and effect. Power Apparatus& Large Appliances DISTRICT NO. ^ PROGES�D BY Size& Type HP, KW,KVA,or KVAR L' C2 rt iia License Number Lic.Class Up to 1 Incl. FINAL U Over 1 to 10 Incl. DATE VALIDATION O Contractor Date Over 10 to 50 Incl. ❑ AL �, W I am exempt under Sec. Over 50 to 100 Inc. BY Over 100 B.&P.C.for this reason n' Services,Swbd.,MCC & Panelboards 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 for the following reason(Section 703 1.5,Business and Professions 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 permit is issued(Sec.3097, PERMIT FEE (Sub-Total) 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 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 ��e v � _H/Z_�- I&q - Signat e of Permittee Datlb