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HomeMy Public PortalAbout5213 ARDEN DR_Electrical__ • � y' Ip �Ap� 1...-i./c1���}, I1��y I1y� PIER I�•y�/1�•n1 - 76A:663-C E806 5-62 A UCAT� ll ©R l! LECTMAL Il E11�1❑V❑BT`. COUNTY O LOS ANGELES't DEPARTMENT OF COUNTY'ENGINEER BUILDING - ` IJILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER, WILLIAMA.ANSEN, SiiF'T OF BUILDING LOCALITY - NEAREST FOR'APPLICANT TO FILL IN CROSS ST. RECEPT. . TOTALNO. EACH FEE OUTLET, FIRST 20 $20 $ OWNER' LIGHT . - MAIL ADD'L ADDRESS - :SWITCH. 10 /.,./`. -. OVER 20 .. T - FEL. NO. LIGHTING. TOTAL- 1 FtiRST2O 20 CITY FIXTURES J( 1 . "ADD'L ov R 201OIV' ELECTRICI' � RANGES CLO.DRYERS WTR.HTRS:, 1.00 ADDRESS / ? GARB.. I.P.D . STA.COOKCITY TEL.NO. 5 DISHWASH. AUTO:-WASH. /' STATE' 7 SPACE HTR.. STA.APP.'(+/z H.P.MAX:) ,50 LICENSE NO. MOTORS: OVER NOT OVER H.P. .• - '� DIS�R .. p �GRP19P 0 1 1.00 C , 3 . 1.50 INSPECTION/ RECORD 2.00 3•. 8' 2.00 /. µ8. ti 15 2.50 . , j /� f a A-3 /� 4 O 15 50 3.00 � J " P���t/ •!f f �rtes U 50, 100 5.00 . 0_ .NO TRANS-' � '.- ., .' • SIGNS: NO.LAMPS - • W CL SERVICE 0.600V-NOT OVER,200A 1.00 Z SERVICE,0-60OV-OVER 200 A. 2.00 - SERVICE OVER 600V 5.00 MISC - - , PERMIT ISSUING FEE, ` -2',00 - ✓ - - - SUPPLEMENTARY PERMITSSUING FEE 1,0,0 'I TOTAL FEE "�;I' Y ACKNOWLEDGE THAT 1'HAVE READ THIS APPLICATION " APPROVALS DATE'' INSPECTOR'S SIGNATURE HEREB - - . AND STATE THAT'THE.ABOVE IS CORRECT AND,AGREE TO' COMPLY - - �WITH ALL .COUNTY .ORDINANCES-.AND .STATE LAWS REGULATING CONDUIT ELECTRICAL WIRING. WIRING .--. �— ..,1.HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED-AND/OR - - :L'ICENSED.AS REQUIRED AB OS ANGELES OUNTY AND STATE OF FIXTURESCALIFORNIA OR,THAT 7TH .LEGAL_. WNERTHE VEDESCRIBEDIRESIDENTIAL POWER ,.i' A SIGNATURE - UTILITYCO.-NOTIFIED OF PERMITTEE - _ FINAL. LfDATION ARrHUR C. VETT r C VI ELECTRICAL EE - MO -CASH SUPERVISING LEC CAL ENGIN R'.. l r;,o 8.1. 5 5� .GEC 1{j 2 D 1 &.0-0-1 R /7, , C.� 76A663gc'EPO¢ 1-,68 APPLICATION FOR ELECTRICA PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENq.INEER BUILDING s�j3 BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. NO. EACH FEE $ $ OWNER RECEPT._ MAIL LIGHT TOTAL FIRST 20 .20 ADDRESS (Y/c SWITCH OVER 20 .10--CITY'CITTEL. NO.q`(// Osl PLAN CHECK LIGHTING �TOTAL FIRST 20 .20 APPLICANT FIXTURES OVER 20 .10 ADDRESS RANGE—DRYER—WTR.HTR.— CITY T L. NO. STA.COOKDISP. F.A.U._ Cyt4taz�)j OiJTRACrOR 0-1 SPACE HTR. AIR COND. ADDRESS CLOTHES WASH._DISHWASH. CITY ljfr0-L'w-4 of 1 I=TEL. NO. 33 - /Irk �t-2(j FAN—OTHER 1.00 LICENSE 1.10. 1014 . CLASS. C-e0 MOTORS,TRANSFORMERS RATING IND. HEATERS, ETC. HP. KW. KVA. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION SIZE & TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY W ITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING i /Sra ELECTRICAL WIRING. 0 - 1 1.00 60 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 1 - 10 3.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO 10 - 50 5.00 RESIDE IN, THE ABOVE,DESCRIBED ESIDENT I AL PROPERTY. CL 50 - 100 10.00 SIGNATURE IU f t / O F PERMITTEE �.•�Vif w 100 - 500 15.00 0 DISZ�RICT Gr P I Z PR E. SIGN,GAS SIGN AND ONE CIRCUIT 3.00 C W TUBE, OR r� d MARQUEE ADDITIONAL CIRCUITS 1.00 SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 ONOTES: (,' 246 Z SERVICE OVER 600 VOLTS OR 200 AMP 5.00 TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE. INSPECTOR'S SIGNATURE• TEMP. POWER POLE UNDERSLAB WORK ROUGH CONDUIT PERMIT FEE (SUB TOTAL) WIRING FIXTURES PLAN CHECK FEE (50% PERMIT FEE) I POWER AUTHORIZEDPERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED SUPPLEMENTARY PERMIT ISSUING FEE 7.00 FINAL TOTAL FEE JOSEPH C. ROOHAN SUPERVISING ELECTRICAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH Lnv�J i q r`.Dv Q D 320- SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self insure, 76A663 or a certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec. 3800 Lab. C.) Policy No. Company s FOR APPLICANT TO FILL IN JOB ADDRESS 624/3 Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE LOCALITY -7 ❑ 1 &2-Family,Sq.Ft — $ $ . Certified copy is filed with the county building inspection _ NEAREST department. Multi-family Sq.Ft. CROSS ST. Date Applicant Residential Swimming Pools ASSESSOR PP MAP BOOK / PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec._Light Sw. FORM NAME 6I�E�[r(Q� WNER OR COMPENSATION INSURANCE First 20 (This section need not be completed if the work involved by the ADDRESS '5- ` AIL permit is for one hundred dollars($100)or less.) Total No. Additional I certify that in the performance of the work for which this permit CITY . rF-Ale Ci Tel.No.$?� is issued, I shall not employ any person in any maRpAr s0 as t0 PLAN CHECK /become subject to the Workers' Compensation Law Lighting Fixtures First 20 APPLICANT N hl, Total No. Additional ADDREFS Date r 1 Applicant — RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTI E O APPLICA T: If, after making ertificate of CITY Tel. o. Exempti ,you should become subject to the Wo Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code, you must forthwith comply with such PERMIT provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliance APPLICANT LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVe50 ADDRESS4r �, �l2• I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Over 3 �� C� Tel.No. Professions Code, and my license is in full force and effect. Over 1 >_ LICENSE B Class.Over 5 . REG.NUMBER �� G O / 137Z Over 100 DISTRICT NO. P C £D BY U License Number Lic.Class 6 Services,Swbd.,MCC&Panelboar s b Mgp jDZG�A . �`� �� tJ� - 0-399 Amp.Under 600 V -7 FINAL / Contractor i ate ` DATE O ❑ I am exempt under Sec. 400-1000 Amp.Under 600 V �,- - W VALIDATION Over 1000 Amp.or Over 600 V FINAL d B.&P.C.for this reason q BRANCH CIRCUIT FEES BY U) Date: l '- — 6 15A,or 20A,120V,Lighting or Recept. Z J 1 To 10 Branch Circuits IV Signature 11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits Exemption for Reg.Mai t.EI ct. 15A,20A,208V To 277V Lighting Br.Circuits 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 for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits .,:• I ��r Code): ❑ t d &C it d Conus Conductors I, as owner of the property,will do the work and the structure Misc. � ,,; is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) 1 l a} ., :I: and Professions Code). ---7.:; a =_ E E_'i lis C:1: n '`'�' CONSTRUCTION LENDING AGENCY -•t; r•}, - I hereby affirm that there is a construction lending agency for the =f':`!:t` .y;;=`t;' performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total) CHANGE Civ. C.) PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE l I_Il' _s)iii;y / 4- .`r l tr -i4 Lender's Address °i` I certify that I have read this application and under penalty of purjury state TOTAL FEE G3, that the above information is correct. I agree to comply with all County ordinances and State laws regulatin Electrical wiring,and hereby authorize representatives of this County t e r upon the above-mentioned property for-inspection purposes. JIY SEE REVERSE FOR EXPLANATORY LANGUAGE /SIGNATURE OF PERMITTEE'I � � DATE /�/