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Home My Public Portal About9110 WOOLLEY ST_Electrical__ i COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0309260022 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: S PAID BUILDINGADDRESS: TR: 12115 LT: 10 9110 WOOLLEY ST FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801349 ASSESSOR0 NEAREST CROSS STREET: ENCINITA 5382-023-002 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY HA FAU LESS 3HP 1.00 FAU 10.95 TENANT: TOTAL FEES 38.70 TSSUED 0 : P P 09/26/03 JK 03/24/04 . OWNER: TEL. NO: L T F NA B CODE: HSU YUN LIN - 9110 WOOLLEY ST TEMPLE CITY 91780 R ON OF WORK C/O ATTIC FURNACE APPLICANT: O: AIR TRO (626) 357-5311- 1630 S MYRTLE SPECIAL CONDITIONS: MONROVIA CA -` CONTRACTOR: TEL. N0: APPROVALS DATE INSPECTOR SIGNATURE AIR TRO (626) 357-5311- 1630 MYRTLE AVE LIC. NO . TEMPORARY POWER MONROVIA CA 91016 258228CIO UNDERGROUND CONDUIT ARCHITECT OR ENGINEER: N 1 RGROUND LIC. N0: ROUGH CONDUIT ROUGHR WATER LINE PLASTIC Y/N METAL Y/N UTILITY COMPANY D f * ADDITIONAL DATA ON FILE REPORT ID: DPR265 ROUTE TO: BS0508 ��1tlpt&S'CdMPEN�4TION DECLARATION 76A663 10/81 APPLICATION FOR E�EC�RICAL PERMIT I shier y-affirm that T have a'Eertificate of consent to self CE-8066 insure, or-a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy therdbf (Sec. 3800, Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB - �! Certified copy is hereby furnished. EACH NO. FEE ADDRESS New Residential Bldgs. 8 Pools Certified copy is filed with the county building inspec- 1 &2-Family; Sq. Ft. $ — $ LOCALITY tion department. Multi-family Sq. Ft. — NEAREST CROSS ST. Residential Swimming Pools OWNER OR J Date Applicant ^ FIRM NAME ( , CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: RecLightSw.�°� MAIL f COMPENSATION INSURANCE First 20 ® ADDRESS - (This section need not be completed if the work involved by No ; the permit Is for one hundred dollars($100)or less.) Total No. Additional Cl f!aa% Tel. C.&-_1 I certify that in the performance of the work for which this PLAN CHECK permit is issued, I shall not employ any person in any manner APPLICANT so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS Total No.1_ Additional Date- Applicant CITY Tel. No. Fixed Appliances Not Over 1 HP NOTICE TO APPLICANT: If, after making this Certificate of 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 l-)f,,r,LL with comply with such provisions or this permit shall be Top _ FAU Z W.H. — deemed revoked. Hood _ Fan _Other_ CIT :� Tel. No. .;)L LICENSED CONTRACTORS DECLARATION LICENSE R Disp. _ Room Air Cond. 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. PROC BY Mand Professions Code,and my license is in full force and effect. /, 0 Size&Type HP, KW, KVA, or KVAR L�IV( V License Number Lic. Class Up to 1 Incl. FINAL ` 7 O Over 1 to 10 Incl. DATE /A VALIDATION 16- Contractor Date Over 10 to 50 Incl. FINAL W I am exempt under Sec. Over 50 to 100 Inc. BY N B.&P.C. for this reason Over 100 Z Date: Services, Swbd., MCC&Ponelboards „ 0 -200 Amp. Under 600 V U Signature 201 - 1000 Amp. Under 600 V , ❑ Over 1000 Amp. or Over 600 V ;24636A Exemption for Reg. Maint. Elect. SINGLE FAMILY I Temp. Power Pole&Appurtenances # 0 0 0 0 0 2 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License I o o63,50 Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits FProf sions Code): o o,o 6 3�5 0 0 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)_ ® 0 513-86 7044, Business 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 PERMIT FEE (Sub-Total) (Sec. 3097, 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 TOTAL FEE 3y above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and y authorize representatives of this County to enter upon the bove-ment' ed property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE ignature o Permittee Date