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Home My Public Portal About4935 CAMELLIA AVE_Electrical__ 76A863.CESOB 10-E2 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING 3 S � BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A. JENSEN, SUPT of Bu1LDING LOCALITY FOR APPLICANT TO FILL IN NEARESTCROSS ST. RECEPT. TOTAL NO. I EACH FEE OUTLETS FIRST 20 $.20 $ OWNER -G LIGHT' MAIL ADR'L ADDRESS 9W1T[H. OVEq 20 .10 GHTING LTOTAL HAST 20 .20 CITY TEL. NO. I � I FIXTURES AOO'L OVER ADD L 10 ELECTRICIAN 1✓L-iC -G!/��'=v /- - RANGES CLO.DRYERS NTR.MTRS. 1.00 ADDRE96 - C�/G6'R✓l w"O-_,LI GARB.DISP. STA.COOK CITY TEL. DISHWASH. AUTO.-WASH. STATE SPACE MTRS. STA.APP.('A M.P.MAX.) ,50 LICENSE NO. Q MOTORS: OVER NOT OVER H.P. DISTRyT NO GRO UE NE P CE D BY O 1 1.00 1 3 LSO INSPECTION RECORD 3 8 2.00 O 8 IS 2.50 V ad 15 50 3.00 O 50 100 5.00 — a SIGNS: NO.TRANS. H NO.LAMPS SERVICE 0.600V-NOT OVER2ODA 1.00 6 SERVICE 0-60OV-OVER 200 A. 2.00 SERVICE OVER 600V 5.00 MISC. PERMIT ISSUING FEE 2.00 SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE 6 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT J �Y WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING / � ' ELECTRICAL WIRING. WIRING W x O ; 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED ANO/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RE9IOEN PROP POWER / OF PERMITTEE OF CO.NOTIFIED ppI .,PI �q FINAL ��"� lU T� !✓.f� �LI ARTHUR C. VETT CK MOO CAS CABH SUPERVISING ELECTRICAL ENGINEER j1 �p 1 3 8 5 OCT 1 4 2 D 3.0 0~ Q 7—CipLE 'TY I6A663-CE80610-62 AP /M1I/ AQIF4 FOR ELECTRICAL PERMIT �1 u COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE. COUNTY ENGINEER // WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY �( Zt el NEAREST FOR'APPLICANT TO FILL IN CROSS ST. _ RECEPT. 1 TOTAL NO, EACH FEE / J, �Z JII(l OUTLETS r'RST 20 S 2O 5 OWNER /✓AV/ Ll6rlr MAIL � ADDY Ap DRE35 vv..-�n_ SWITCH. OVER 20 10 GHT LTOTAL ING nRST 20 .20 CITY TEL. NO., I FIXTURESa' ADD'L to ELECTRICIAN 'CS' - � VER 20 rtv' L-G_ RANGES CLO.DRYERS WTR.XTR9. 1.00 ADDRESS /_- O( GARB.DISP. .STA.COOK '']] CITV TEL. NO. D19HWA9X. AUTO..WASH, STATE SPACE HTRS. STA.APP.I-/.H.P.MAX.) .50 LICENSE NO, pO MOTORS: OVER NOT OVER H.P. DIST ICT NO. - OU ZONE PR?E ED BY D , ,.DD A- I 3 i.50 INSPECTION RECORD Vv 3 B 2100 B 15 2.50 15 50 3.00 /, 0 ` ni w 0 50 Too 5.00 (/ ' _ gro / 1r. SIGNS: NO.TRANS. I(LJ NO.LAMPS �p IN//��/ .J�y SERVICE O.GOOV.NUT OVER'2OOA 1.00 1�/�/(Ir3C.%r. SERVICE 0-60OV-OVER 200 A. 2.00 SERVICE OVER OVER 600V 5.00 MISC. PERMIT ISSUING FEE 2.00 - SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE •1 HEREBY ACKNOWLEDGE THAT I HAVE:READ THIS APPLICATION APPROVALS DATE INSPECTOR'S 61GNATURE AND STATE THAT THE ADOVE IS CORRECT AND AGR EETO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING y /� �p� ELECTRICAL WIRING. WIRING �. /i fa"F _1;`W 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED ANO/OR LICENSED AS.REQUIRED,BY LOS ANGELES COUNTY AND STATE OF FIXTURES ✓ J— _ CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIA ROPE POWER SIGNATURE UTILITY CO.NOTIFIED OF PERMITTEE , FINAL 0 LIDATION - ARTHUR C. VEIT - CK MO CASH SUPERVISING ELECTRICAL'ENGINEER . LLo96716 SE .3 2 'D .3.60- o WORKERS' COMPENSATION DECLARATION :zo coro ovw 3i87 APPLICATION" � FOR ELECTRICAL PERMIT 4 hereby aFfirm that I hove o,certificate of consent to self IcEO i'x ure, ar a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a,certified copy thereof (Sec. 3800, lab. C.) Policl-No Componyt L tri [ G4IW FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE ADDRESS !V1 <AMUIA4 Certified copy is filed with the county.building inspec- 1 8 2-Family, $q. FtpLOCALITY. $ — $ Ls tion department. Multi-family Sq. Ft. — NEAREST � �[[ � CROSS ST. &n ��-`/ Residential Swimming Pools OWNER OR Dat Applicant 'G ��JJ FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' f Outlets: Recz..,L Light�Sw.L_ 1 MAIL COMPENSATION INSURANCE �j' First 20 U Q ADDRESS (This section need not be completed if the work involved by Total No.L r174q CI TY Additional • lOQ Cs Tel. No. f the permit is for one hundred dollars ($100)or less.) PLAN CHECK I certify that in the performance of the work for which this mPLANCHET' permit 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 Additional � � Total No.� CITY Tel. No. NOTICE TO APPLICANT: If, Date—Applicant,f, after making this Certificate of Fixed Appliances Not Over I HP PERMIT `�•�T Exemption, you should become subject to the Workers' Range'— Heater—D.W. — APPLICATION Compensation provisions of the Labor Code, you must forth- Oven — Dryer —W.M._ ADDRESS with comply with such provisions or this permit shall be Top — FALL W.H. — s deemed revoked. CITY �-�s Tel. No.�7 27 LICENSED CONTRACTORS DECLARATION Hood — Fan ��Otfier_ Disp. _ Room Air Cond. — LICENSE OR Class (commencing with Section 7000)of Division 3 of the Business Power Apparatus&Large Appliances DISTRICT NO. IF PROCESSED BY r and Professions Code,and my license's in full force and ffect, p a Size &Type HP, KW, KVA, or KVAR �0a �itL U License Up to 1 Incl Number Lic. Class . U ! )) CC 10 . FINAL Contractor - Date - C - I Over 1 to 101nd. DATE �I'�jl _C� VALIDATION F] Over 10 to 50 Incl. FINAL L ( `` I am exempt under Sec. Over 50 to 100 Inc. BY w B.&P.C. for this reason - Over 100 d D Date: Services, Swbd., MCC & Ponelboords Z 0- 200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V ❑ Exemption for Reg. Mainz. Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY Temp. Power Pole &Appurtenances HOME OWNER-BUILDER DECLARATION '- Sign hereby affirm that exempt from the Contractor's License Si g Law for the followingg r with One Branch Circuit reason (Section 7031.5, Business and Additional Sign Branch Circuits _ Professions Code)- :1 L;7 •;/ .t_f ❑ 1, as owner of the property; will do the work and the Misc. Conduits& Conductors 1 T SV: structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ _ _ Business and Professions Code). D {1?jAL - 'tF 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 PERMIT FEE (Sub-Total) O CHANGE •f-1 (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name III ILII Y-iliji}1 t.( t;.•YS PERMIT ISSUING FEE Lender's Address 70 7 '7 Arl 9 2 I certify that I have read this application and state that the TOTAL FEE above 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 • -mention yJerty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE i Si nature o Permittee ole Os � s `\ T DEC TION 76A66 WORKERS'that t I have a certificate cafe of corse CE-806 Ioiel APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self CE-806G insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec. 3800, Lab. C.) Policy No. Company FOR APPLICANT TO Flll IN JOB ADDRESS `72 iS; C/ LU Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE � /� q Ir M F16 ❑ Certified copy is filed with the county building inspec- 1 &'2-Family, Sq. Ff. $ — $ LOCALITY 112-WO L6 C+ tion department. Multi-family Sq. Ft. — 'NEAREST Residential Swimming Pools CROSS ST. Date-Applicant OWNER , .. FIRM NAME ITTT L4'E l al.(� J CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL 4�C3 �••CAA yLnr COMPENSATION INSURANCE Outlets: Rec_Light_Sw._ ADDRESS Y F 1'10 (This section need not be completed if the work Involved by First 20 Total No. Additional CITY � I 7LE Ct Tel. No. the permit is for one hundred dollars ($100)or less.) PLAN CHECK I certify that in the performance of the work for which this APPLICANT permit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Com ensation Lo Lighting Fixtures First 20 ADDRESS Total No. Additional _ �J_Q� CITY Tel. No. Date��Applicant Fixed Appliances Not Over 1 HP PERMIT ` F- .�../�/ NOTICE TO APPLICANT: If, after along this Certificate of APPLICANT :1...�Cl (plc Exemption, you should become subject to the Workers" Range_ Heater—D.W.W. Compensation provisions of the Labor Code, you must forth- Oven _ Dryer W.M._ ADDRESS I d �'•'��'Z with comply with such provisions or this permit shall be - Top _ FAU _W.H, — deemed revoked. Hood Fan Other CITV� Tel. No�13J(,j9_d8 LICENSED CONTRACTORS DECLARATION _ _ _ _ Roam Air Cond. LICENSE OR Z Dis 1 hereby affirm that I am licensed under provisions of Chapter 9 p' REG. NUMBER .J Class.C40 (commencing with Section 7000) of Division 3 of.the Business Power Apparatus 8 Large Appliances DISTRICT NO i•c PROCE ED BY Y and Professions Code,and my license is in full force and effect. U d 316 43 C t o Size & Type HP, KW, KVA, or KVAR' � O License Number Lic. Class Up to 1 Incl. `J FINAL U �tU' �( L" ' 1 -2-g'l Over I to 10 Incl. DATE t O Contractor Date V L ATION ❑ Over 10 to 50 Incl. ! t- FINAL / I am exempt under Sec. �Over 50 to 100 Inc. BY W B.&P.C. for this reason Over 100 J d N Services, Swbd., MCC & Panelboards D Z Date: 0 - 200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V ';2 7 8 2.1 A ❑ Exemption for Reg. Mainz. Elect. Over 1000 Amp, or Over 600 V V's a • . • `Z SINGLE FAMILY Temp. Power Pole& Appurtenances ( ,e -2550 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 1 hereby affirm that I am exempt from the Contractor's License 'e'ez Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits v 'e 2 5 5 Q c: Professions Code): ❑ I, as owner of the property, will do the work and the Misc. Conduits&Conductors .0 9. 02 8 7 structure is not intended or offered for sale (Section Other (See Complete Fee Schedule), D 7044, Business 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 PERMIT FEE - (Sub-Total) (Sec. 3097, 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 TOTAL FEE VNC� above information is correct. I agree to comply with all County ordinances and Slate laws regulating Electrical wiring, and hereby authorize representatives of this County to enter upon - th above-me 'oned property inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Si a ure of Permittee Dote ,