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Home My Public Portal About6126 AVON AVE_Electrical__ r 76A663 CE6061059 APPLICATION FOR ELECTRIC PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEERBUILDING BUILDING AND SAFETY DIVISION ADDRESS JOHN A LAMBIE COUNTY ENGINEER WILLIAM A JENSEN SUP T OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST PEMWT FEES CROSS ST 1 T E M NUMBER I EACH FEE OWNER OUTLET {�� ) $ MAIL LIGHTS RECEPT (SSW / f0 � ADDRESS LIGHTING FIXTURES to CITY TEL NO ELEC RANGES CLO DRYERS ELECTRICIAN/} WATER HEATERS 5O ADDRE L(J ELEC SPACE HTR DISHWASHERS CITYZk,!29" TEL NO GARBAGE DISPOSER AUTO STATE WASHERS STA COOKING UNITS 25 �O LICENSE NO MOTORS OVER INC H P DISTRI T NO I GROUP P SSED BY 0— 1/2 All 2-5 1/2— 2 1 50 INSPECTION f0doRn 1 2— s ---too / ✓ , �e Q✓G ro �S' 5— 15 150 IS— 50 250 J 50-200 Soo SIGNS NO TRANS NO LAMPS SERVICE O 600V too SERVICE OVER 600V Soo MISC WIRING PERMIT 1 00 FIXTURE PERMIT 100 SUPPLEMENTARY PERMIT 50 TOTAL FEE $ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT ��7 ELECTRICAL WIRING 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR WIRING �c'+ LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OFV 9 V CALIFORNIA OR THAT I THE LEGAL OWNER OF THE ABOVE FIXTURES DESCRIBED RESIDENTIA P OPERTY POWER SIGNATURE / UTILITYCO NOTIFIED OF PERM ITTE FINAL ®FAT MO CASH ON SUPERVISING ELECTRICAL ENGINEER CK 141 �x LKo 0 2 4 61-8 JUL ?0 2 A X 5 5 KER S COMPENSATION DECLARATION 720 00196A663 DPW(12 91) APPLICATION FOR ELECTRICAL PERMIT 76A663 CLI I hereby form th I have a certificate of consent to self Insure or a cert icate of orker s Compensatio sura c or a certified COUNTY OF S ANGELE T OF PUBLIC WORKS BUILDING AND SAFETY DIV copy t er of S 3800 Lab C) � - 22 0_,r_ZP Policy No ompany FOR AP LICANT TO FILL IN JOB ADDRES Certified copy is hereby furnished New Residential Bldgs &Pools NO EACH FEE LOCALITY vk "Certified copy Is filed the cc build g ns a to 1&2 Family Sq Ft = $ $ L NEAREST department Multifamily Sq Ft CROSS ST Date Appllca Residential Swimming Pools ASSESSOR MAP BOOK PAGE ARCEL CERTIFICATE OF EXE M 10 ROM WORKERS w y COMPENSAIN Outlets Rec -Light Sw ME RANCET F r First 20 MAIL (This section need not be co Mp eted i the work Involved by the ADDRES permit is for one hundred dollars($100)or less) Total No Additional t JI certify that In the performance of the work for which this permit �I s issued I shall not employ any person In any manner so as to PLAN become subject to the Workers Compensation Laws t Lighting Fixtures First 20 A PLICANTK - 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 �J provisions or this permit shall be`deemed revoked Power Apparatus&Large Appliances APPLICA LICENSED CONTRACTORS DECLARATION Size&Type HP KW KVA or KVAR ADD I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl e �y (commencing with Section 7000) of Division of the Business and CITY ' Professions Code and my Itcensa is full rce and effect Over 10 to 50 Incl Over 50 t0 100 InLICENSE OR //�� REG NUMBER ClassCLJ 6- Over Over 100 DISTRICT NO PRO SSED BY V Licen 41_\-for�this � Lic Class � Services Swbd MCC&Panelboards A DO 2 0 399 Amp Under 600 V FINAL ContractDate 0 400 1000 Amp Under 600 V 1 V ❑ /// / der Sec Over 1000 Amp or Over 600 V FINAL `� VALIDATION W; &P reasonBY a BRANCH CIRCUIT FEES (n Date 15A or 20A 120V Lighting or Recept z 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits El 41 Or More Branch Circuits Exemption for Reg Maint Elect 15A 20A 208V To 277V Lighting Br Circuits SINGLE FAMILY "f Temp Power Pole&Appurtenances _ HOME OWNER BUILDER DECLARATION Sign with One Branch Circuit 1 ( � I hereby affirm that I am exempt from the Contractors License Law for the following reason (Section 7031 5 Business and Professions Additional Sign Branch Circuits Ti j HL 61 - 65 Code) ❑ I as owner of the property will do the work and the structure Misc Conduits&Conductors ;HE b 61tlte is not intended or offered for sale (Section 7044 Business Other(See Complete Fee Schedule) CHANGE and Professions Code) ` CONSTRUCTION LENDING AGENCY r y /_-- I hereby affirm that there Is a construction lending agency for the I ECJ 1--0 .1,`1 {7 !: performance of the work for which this permit is issued (Sec 3097 PERMIT FEE (Sub Total) Civ C) j7vt 1 1; 110 PLAN CHECKING FEE Lender s Name PERMIT ISSUING FEE Lender s Address I certify that I have read this application an u der penalty of purjury state TOTAL FEE 'mom t at the above Info anon Is correct I re to comply with all County dinanc d S law reg Ing Elec is wiring and hereby authorize rese ative f his u enter u on he above mentioned property f s�tio pu to SEE REVERSE FOR EXPLANATORY LANGUAGE SIG REE OF P R E DATE