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HomeMy Public PortalAbout5328 ARDEN DR_Electrical__ 7aw6'es-cseoe a-ea . Q� II'Cl FOR II -ER 0 V II M II ' AG PL C� ® ® LSC C C� COUNTY OF LOS ANGELES s DEPARTMENT OF. COUNTY ENGINEER ; BUILDING -�� ��,�/ BUILDING AND SAFETY DIVISION ADDRESS UGHN A. LAMBIE, COUNTY ENGINEER, J CASSATT D. GRIFFIN,SUPT OF BUILDING o LOCALITY FOR APPLICANT TO FILL IN NEAREST. -PERMIT FEES, CROSS ST: OWNER17gafige7gt�W-5-6) ITEM NUMBER EACH FEE = OUT LE� •� $- $ ADDRESS - - MAIL, . LIGHT RECE SW. 10 B LIGHTING FIXTURES10 CITY TEL.:NO. ELEC.,RANGES CLO.DRYERS .ELECTRICIAN WATER HEATERS -.50 ADDRESS �i7 i/ ELEC.SPACE HTRS.' DISHWASHERS - CITY ;). TEL. NO _D v`' AGE DISPOS AUTO. STATE- .may ++ _ * WASHERS STA.COOKING UNITS ® .25 LICENSE NO. /wr- L� g MOTORS: OVER ,INC. M.P. DIS TR T NO. I GROUP.I-ZONE I PR ESSED BY INSPECTION RECORD 2—. s 1.00 q s- 1s. 1.50 P 15'' 50 2.50 'a 50:^200 5.00. SIGNS: NO:TRANS. NO.LAMPS - ' SERVICE 0-60OV.. 1.00 SERVICE OVER 600V' 5:00 a MISC, 16 WIRING PERMIT 1.00 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .• `' '- `.50 - - TOTAL FEE.- $ ` 1 HEREBYACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE' INSPECTOR'S SIGNATURE n AND STATE.THAT-THE ABOVE IS.CORRECT AND AGREE TO COMPLY WITH ALL-COUNTY-ORDINANCES ;AND STATE_LAWS' REGULATING .u .CONDUIT j ELECTA RICL`WIRING. - -- -4? 1r.-� �.ff . 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR WIRING _ 1 Yi*se. LICENSED AS REQUIRED BY LOS ANGELES,COUNTY AND.STATE OF CALIFORNIA OR T I AM THE LEGAL NER.OF THE ABOVE FIXTURES /4md 6fd/I `• K.�n4: DESCRIBED RESID N AL OPERTY. - POWER ' SIGNATURE -LJ UTILITY CO.NOTIFIED / t'�j OF PERMIT / D /. FINAL - - I .L ®v. VA ATION ARTHUR C.VETT. CK• Mo CASH SUPERVISING ELECTRICAL ENGINEER LAC03 88 7,3 JUL 2 0. 2 D 10'.6 0 `� WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT I hereby aPtirlp•t45at shave� 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.) /r Policy No. r Company %P 707 ! `� A/J) FOR APPLICANT•TO FILL IN JOB ADDRESS 2 - r�� EJ . New dentgs.Certified copy is hereby furnishedResidential Bld &Pools NO. EACH FEE © _ $ $ LOCALITY �-� �L 7 Certified copy is filed with the county buil ing ins ectiop 1 &2-Family,Sq. Ft. _ NEAREST de artment. Multi-family Sq.Ft. CROSS ST. Q L <' Date Applicant Residential Swimming Pools ASSESSOR . r MAP BOOK / PAGE PARCEL WNER OR CERTIFICATE OF EXEMPTI N FROM WOR Outlets:Rec._Light Sw. FFIIRM NAME COMPENSATION INSURANCE First 20 MAIL (This section need not be completed if the work involved by the ADDRESS permit is for one hundred dollars($100)or less.) Total No. Additional -47 I certify that in the performance of the work for which this permit CITY Tel.No. is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws. Lighting Fixtures First 20 APPLICANT K Total No. Additional ADDRESS Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: If, after making,this Certificate of CITY 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 shall be deemed revoked. - Power Apparatus&Large Appliances APPLICANT 60 PA LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS / I hereby affirm that I am licensed under provisions of Chapter 9 �[, 14P__ ` y I� Over 3 to 10 Incl. (commencing with Section 7000) of Division 3 of the Business andCITY C C li Tel.No. Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. LICENSEClass.�� Over 50 to 100 Incl. REG.NUMBB ER a Over 100 DISTRICT NO. P O SED BY O License Number Lic.Class L��0 R V f n / f `, C/J� Services,Swbd.,MCC&Panelbcards G, Contractor / o I�-"& /l(�I Date ( 0-399 Amp.Under 600 V NTE 0 ❑ I am exempt under Sec. 400-1000 Amp.Under 600 V � ~ Over 1000 Amp.or Over 600 V FINAL Over W B.&P.C.for this reason BRANCH CIRCUIT FEES BY 15A,or 20A, 120V,Lighting or Recept. lLGLfi� Z Date: _ 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits EJ 41 Or More Branch Circuits Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits SINGLE FAMILY Temp. Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION +_.0 i �s I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit — for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits Code): ❑ TE.L"M: I, as owner of the property,will do the work and the structure Misc.Conduits&Conductors is not intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule)and Professions Code). r•: 't C; CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the -"I`1hV__t 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 ��j fes• I:i s _'j's-'- � Lender's Address / I certify that I have read this application and under penalty of purjury state TOTAL FEE that the above information is correct. I agree to comply with all County ordinances adStateAs regul gElectrical wiring,and hereby authorize representativCounty enter upo a above-mentioned property for inspectios. SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE OF PERMITTEE- DATE