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Home My Public Portal About4831 BALDWIN AVE_Electrical__ x6630 CE806B i,76/ APPLICATION FOR ELECTRICAL PERMIT BUIL G AND SAFE DIVISION FOR APPLICANT TO FILL IN New Residential Bldgs &Pools EACH NO FEE ADDRESS 4831 N BALDWIN t-C—_ 1 &2 Finaily Sq Ft $ — $ LOCALITY T LE CITY Multifamily Sq Ft — NEAREST CROSS ST Residential Swimming Pools OWNER OR FIRM NAME GRIFFIN, EARL Outlets Light Switch&Receptacle MAI L ADDRESS SAME First 20 Additional CITY TEMPLE CITY Tel No 448-4057 PLAN CHECK Lighting Fixtures APPLICANT First 20 ADDRESS Additional CITY Tel No PER IT Fixed Appliances Not Over 1 HP APPLICANT TRANE xcc Range Heater DW ADDRESS 2034 N PECK RD Oven Dryer W M Top FAU 3c WH CITY SO EL MONTE Tel No 579-7982 Hood Fan LICENSE OR265094 Class C-10 OU Disp A C 2 50 REG NUMBER I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION 0 AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY V Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING LiJ Size&Type HP KW KVA or KVAR ELECTRICAL WIRING N Up to 1 Incl Z �'1 5 00 I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR l HP Over 1 to 10 Incl LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE Over 10 to 50 Incl DESCRIBED RESIDENTIAL PR RTY r V Over 50 to 100 Incl PERMITEE Over 100 SIGNATURE fDRCT NO IiIIIfROC SED B Services Q 0 200 Amp Under 600 V o 6�/ 201 1000 Amp Under 600 V APPROVALS DATE IN CTOR S Over 1000 Amp or Over 600 V GNATURE POWER POLE Temp Power Pole&Appurtenances SLAB WORK Sign with One Branch Circuit Additional Sign Branch Circuits ROUGH CONDUIT (Other) WIRING FIXTURES POWER AUTHORIZED PERMIT FEE (Sub Total) 7 50 UTILITYCO NOTIFIED-[, ,�- PLAN CHECKING FEE (One Fourth Permit Fee) FINAL PERMIT ISSUING FEE 7 30 ` NOTES TOTAL FEE 14 50 —P-LAN-CH ECK VALID_ATIO 5"°`�CK p".��M10 O)NCASHI?6�Al PERMIT VALIDATION M O CASH 0,,,4&4 �t`(AR 2 3 -e 0 1 4 5 POLICY HOLDER 25;,o -Q, � �� times I f 76A663 CES06 10/74 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER 7FCDROSS ' BUILDING AND SAFETY DIVISION RES J� ALITY REST FOR APPLICANT TO FILL IN ST OUTLETS NO EACH_F E OWNER OR $ S FIRM NAME RECEIPT_ MAIL FIRST 20 25 AE LIGHT TOTAL DDR . J CITY SWITCH OVER 20 10 PLAN CHECK LIGHTING TOTAL FIRST 20 25 APPLICANT FIXTURES OVER 20 10 ADDRESS RESIDENTIAL APPLIANCES CITY TEL NO ) PERMIT RANGE DRYER_WTR HTR_ APPLICANT �Q STA COOK DISP F A U ADDRESS lam'` SPACE HTR AIR COND CITY 0C TEL NO -�ys CLOTHES WASH DISHWASH LICENSE OR D CLASS C ) REG NUMBER FAN OTHER 100I I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS j REGULATING IND HEATERS ETC HP KW KVA ELECTRICAL WIRING SIZE & TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 - I 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF }. CALIFORNIA OR T Al I AM THE LEGAL OWNER OF THE ABOVE 13- 1 - 1O 300 DESCRI PED REST ENTIAL OPERT )} O V PERMITEE ' C 10 - 50 500 SIGNATURE h F- U 50 - 100 1000 W DISTRICT NO ICES DIBY N 100 - 500 1 i 00 O c SIGN GAS SIGN AND ONE CIRCUIT 500 APPROVALS DATE INSPECTOR S SIGNATURE TUBE OR MARQUEE ADDITIONAL CIRCUITS 100 TEMP POWER POLE j i r SERVI CENOTOVER 600 VOLTS OR 200 AMP 300 UNDERSLAS WORK SERVI CEOVER 600 VOLTS OR 200 AMP 1000 ROUGH CONDUIT f TEMP SERVICE POLE &APPURTENANCES 500 WIRING ,N+ 1 TEMP LIGHT OR RECEPT SYSTEM 300 FIXTURES f F i POWER AUTHORIZED I UTILITY CO NOTIFIED ' r FINAL PERMIT FEE (SUB TOTAL) NOTES PLAN CHECK FEE PERMIT ISSUING FEE 300 TOTAL FEE PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION cK M 0 CASH 9 1 7 1 4 2 90'(j A-"3 SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE V �� I! s_••_, -- ;WORKERS'COMPENSATION DECLARATION 76-663 10/81 APPLICATION FOR ELECTRICAL PERMIT �ry I hereby affirm that I have a certificate of consent to self insure, CE-806G or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec. 3800,Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB ❑ Certified copy is hereby furnished. EACH NO. FEE ADDRESS Jul 1 New Residential Bldgs.& Pools ❑ 1 & 2-Family, Sq.Ft. $ _ $ LOCALITY Certified copy is filed with the county building inspection department. Multi-family Sq.Ft. NEAREST e _ Residential Swimming Pools. CROSS ST. I! Date Applicant OWNER OR -FIRM NAME Flu 14 CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec Light Sw. COMPENSATION INSURANCE ADDRESS (This section need not be completed if the work involved by the First 20' permit is for one hundred dollars($100)or less.) Total No. Additional, CITY Tel.No. 4AA 4 iPLAN CHECK I certify that in the performance of the work for which this permit APPLICANT 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 ADDRESS - Date Applicant G Additional "7_11-Cd 1`� 6 — Total No. CITY Tel.No. NOTICE TO APPLICANT: If, after making this Certificat? Fixed Appliances Not Over 4 HP of PERMIT Exemption,you should become subject to the Workers'Compensation Range_ Heater_ D.W. _ APPLICANT provisions of the Labor Code, you must forthwith comply with such Oven Dryer _ W.M._ ADDRESS JA ev provisions or this permit shall be deemed revoked. Top FAU W.H. CITY Tel.No. LICENSED CONTRACTORS DECLARATION Hood Fan Other_ I hereby affirm that I am licensed under provisions of Chapter 9 Disp. Room Air Cond. LICENSE OR Class. (commencing with Section 7000) of Division 3 of the Business and REG.NUMBER Professions Code,and my license is in full force and effect. DISTRICT NO. POC SED BY Power Apparatus& Large Appliances Size& Type HP,KW,KVA,or KVAR License Number Lic.Class Up to 1 Incl. FINAL Over 1 to 10 Incl. DATE, �•r � VALIDATION Contractor Date Over 10 to 50 Incl. UUU 0 ❑ FIN C.1 I am exempt under Sec. Over 50 to 100 Inc. g B.&P.C.for this reason Over 100 !! Services,Swbd.,MCC& Panelboards Date: 0-200 Amp.Under 600 V Signature 201 - 1000 Amp.Under 600 V ❑ Over 1000 Amp.or Over 600 V Exemption for Reg.Maint.Elect. 9 Q 12 6 A SINGLE FAMILY Temp.Power Pole & Appurtenances # 0.0 0 0 0 2 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 2.550 I hereby affirm that I am exempt from the Contractor's License Law o 0 for the following reason(Section 7031.5,Business and Professions Additional Sign Branch Circuits 2 5 Q= Code): ° °10 c5 I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors 0 71 ;1 m 8 8 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 7-61 v I certifythat 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 for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date