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Home My Public Portal About4855 ARDSLEY DR_Electrical__ 76A663-CES09 10-59 APPLICATION FOR ELECTRIC P E R lel o T 1. COUNTY OF LOS ANGELES YC (9 K V DEPARTMENT OF COUNTY ENGINEER Bu1LDING BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A.JENSEN,SUPT of BUILDING LOCALITY + FOR APPLICANT TO FILL IN NEAREST PERMIT FEES CROSS ST. ITEM NUMBERI EACH FEE OWNER OUTLETS: $ MAIL LIGHTS RECEPT. SW. .IO ADDRESS LIGHTING FIXTURES 10 CITY TEL. ELEC.RANGES f,,---CLO.DRYERS ELECTRICIAN�t WATER HEATERS .5O J O ADDRESS �s ELEC.SPACE HTRS. DISHWASHERS CITY L. NO. —O 6 GARBAGE DISPOSERS AUTO.- STATEIf ` WASHERS STA.COOKING UNITS .25 LICENSE NO. MOTORS: OVER INC. H.P. DISTRICT NO. I G P ZONE I PRO ESSED E3 0— 1/2 .25 i 1/2.- 2 .50 INSPECTION RECORD 2— 5 1.00 5— 15 1.50 15— 50 2.50 50—200 5.00 SIGNS: NO.TRANS. )�,. NO.LAMPS rr.� LC A SERVICE 0-600V t 1.00 SERVICE OVER 600V 5.00 misc. 71, WIRING PERMIT 1.00 �_ ' FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .50 I ("pj/V ly rv`,Y/ (,E '°I � p+{• •..,o, TOTAL FEE -,�t/f} 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS 4-7^+d. DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT ELECTRICAL WIRING. 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR WIRING LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT I M THE GAL OWNER OF THE ABOVE DESCRIBED RESIDENT OPERT POWER SIGNATURE UTILITY CO.NOTIFIED OF PERMITTEE ..r FINAL OFCKAl .DCASH TION ARTHUR C.VEIT, SUPERVISING ELECTRICAL ENGINEER COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY WILLIAM J. FOX, County Engineer ELECTRILC .1 FOR APPLICANT TO FILL. IN DISTRICT NO. GROUPZONE PERMIT NO. ELECTRICIAN � a,1 . f - c (.�! r�— -- RE IVED BY READY FOR DATE IBBUED ADDRESS J . r a� FIRST INSPECTION ] CITY '� TE 61 N0. COUNTY LICENSE NO. EXPIRES BUILDING DDRESS � � PERMIT FEES —AS FEE — NUMBER EACH LOCALITY _LIGHT OUTLETS NEAREST CROSS ST. RECEPTACLES WALL SWITCHES T —� TOTAL OUTLETS 5c $ ,OWNER MAIL ELEC. RANGES25 ADDRESS ELEC. HEATERS 25 CITY TEL. NO. FIXTURES 5 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS ��/// AND STATE LAWS REGULATING ELECTRICAL WIRING, MOTORS I CERTIFY THAT I POSSESS THE AMOVE VALID LOS NUMBER HORSEPOWERFEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER NEW MVO. HP OVER INC. EACH OF THE RESIDENTIA PROPERTY DESCRIBED ABOVE. I/2 a LESS_ $ .25 SIGNATURE Of �/2 2 .50 PERMIT --------- z B 1.a0 INSPECTION RECORD 5 15 1.50 15 50 2.50 _ 50 200 5.00 200 500 10.00 J _ SOD 1000 15.00 Z OVER 1000 20.00 _ M.G. SET/FREQ. CHANGER-HP _ WELDERS:AC-KVA 0 GENERATORS - KW TRANSFORMERS - KVA _ TEMP. MOTORS (75% OF aRi O.) _ MOVED MOTORS (75% OF ORIG.) MISC. SIGNS NO. NO.TRANS. NO. NO.LAMPS APPROVALS FOR EACH PERMIT: DAT INSPECTOR'S NAME WIRING $1.00 CONDUIT FIXTURES $1.00 /f a,� WIRING T— FIXTURES SUPPLEMENTARY .50 POWER TOTAL FEE $� UTILITYCO.NOTIFIED `FINAL I 11114 -:sl i 76A663 DBS#5A 4-52 1 1 76AS63 5A 25M SETS 7-46 APPUCATION FOR. PEALT1ai DEPART1dIl•;NT OF BUII.Dm1G ANS sAFErY ��C�� COUNTY OF LOS ANGELES ELECTRIC M. F//O CHI F ENGINEER a NAME > fi (� f s/ DISTRICT NO. GROUP ZONE PERMIT NO. Dt / / M> { l V ADDRESS /E�r� ! �y .GI `/�� 'l�r �i� l3 ' ., ! READY FOR DATE ISSgED U CITY �s� TEL.NO. p�-),�^ � RECEIVED BY � FIRST INSPECTIONCOUNTY LICENSE NO. ( P EXPIRES ��AyP� WORK IFILII IN tFEAVILY OUTLINED PORTION ONLY JOB SCYiII�la®N OF ®lill ADD d➢i� RESS d � �% ^ -_> iJ •P :.r, --'Fi NUMBER OF OUTLETS ON CIRCUITS LOCALITY LOCATION BY ROOMS NEAREST LIGHT OUTLETS SW. PLUGS F17[T CROSS ST. CIRCUIT A R C D E F G JH 0: NAME MAIL -Irp lzf ��. s� +g ADDRESS 1A49ci G� r O CITY TEL.NO. I. �_.',�^ 1 GAM THE LEGAL POSSESSOR—OF THE/.ABOVE LOS / / `� ANELES COUNTY CERTIFICATE 004-QUALIFICATION.. �� / ELECTRICIAN 4% t1 I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE <' OWNER. COMUCTIONS ' J Q Z_ O E O TOTAL I dLl f NO. OF OUTLETS ir= $ APPROVALS NO. OF FIXTURES O O $ DATE INSPECTOR'S NAME NO. OF MOTORS H.P. $ CONDUIT NO. OF SIGNS TRANS. $ ye WIRING G NO. OF RANGES OR HEATERS $ v' FIXTURES MISCELLANEOUS $ POWER PERMIT FEE pry UTILITYCO.NOTIFIED TOTAL FEE �'7 FINAL d WORKER'S COMPENSATION DECLARATION 9 DPW 9/89 APPLICATION FOR ELECTRICAL PERMIT 76A66 I H76A663 Hereby affirm that I have a certificate of consent to self insure, • 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.38800 Lab.C.) /1 Policy No.�/ L'L Company -IA—Ts �J;✓ FOR APPLICANT TO FILL IN JOB /1�r ADDRESS Certified copy is hereby furnished. New Residential Bldgs.&Pools $EACH NO. $ FEE LOCALITY G. Certified copy is filed with the county building inspection 1 &2-Family,Sq.Ft. department. �— Multi-family Sq.Ft. CROSS ST. �✓j Residential Swimming Pools ASSESSOR C /1,� { 7 2 Date �'f// ! Z Applicant - C/ PAGE d( 7 PARCEL G C.J MAP BOOK CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec. Light Sw. � WNER OR First 20 FlRM NAME O 7 COMPENSATION INSURANCE �7Q MAIL (This section need not be completed if the work involved by the -^^ permit is for one hundred dollars($100)or less.) Total No. Additional ADDRESS I certify that in the performance of the work for which this permit CITY is issued, 1 shall not employ any person in any manner so as to PLAN CHECK become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANT Total No. Additional ADDRESS Date Applicant 15 OR 20A,120V BRANCH CIRCUITS NOTICE TO APPLICANT: If, after making this Certificate of CITY Tel.No. Exemption,you should become subject to the Workers'Compensation 1 TO 10 INCLUSIVE EACH provisions of the Labor Code, you must forthwith comply with such 11 TO 40 INCLUSIVE EACH PERMIT APPLICANT provisions or this permit shall be deemed revoked._ 41 OR MORE BRANCH CIRCUITS EACH >_ LICENSED CONTRACTORS DECLARATION ' � 15 OR 20A,208V TO 277V LIGHTING EACH ADDRESS •� �� I hereby affirm that 1'am licensed under provisions of Chapter 9 a (commencing with Section 7000) of Division 3 of the Business and CITY-- C Tel.No/ Professions Code,and my license is in full force and effect. RESIDENTIAL APPLIANCES UP TO 3HP LICENSE OR class Power Apparatus&Large Appliances REG.NUMBER . Size&Type HP,KW,KVA,or KVAR DISTRICT NO. PROCESSED BY License Number Lic.Class?✓ 0 Up to 3 Ind. a O LL! CL ,✓f Over 3 t0 10 Incl. FINAL Contractor ��` ( r) Date Over 10 to 50 Incl. DATE �y Z ❑ 2`3 ! Z VALIDATION I am exempt under Sec. Over 50 to 100 Incl. FINAL y B.&P.C.for this reason Over 100 BY Services,Swbd.,(/�� n/elbo�ardp s Date: 0-200 Amp.Una OQ '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 FY: HOME OWNER-BUILDER DECLARATION 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): ul..__.. 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). 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 ff mspec' pu.poses. SEE REVERSE FOR EXPLANATORY LANGUAGE 2 SI E OF A N AGENT DAT