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Home My Public Portal About5428 CLOVERLY AVE_Electrical__ 76A669 CES061069 APPLICATIO FOR ELECTRIC PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING �^ BUILDING AND SAFETY DIVISION ADDRESS J 4 Z �' A.-P JOHN A LAMBIE, COUNTY ENGINEER WILLIAM A JENSEN SUP T OF BUILDING LOCALITY– FOR APPLICANT TO FILL IN NEAREST PERMIT FEES CROSS ST OWNER I T E M NUMBER EACH FEE MAIL OUTLETS $ ADDRESS LIGHTS RECEPT SW 10 LIGHTING FIXTURES 10 Q CITY L O i t ELEC RANGES CLO RYERS ELECTRI IAN WATER HEATERS 50 ADDRESS ELEC SPACE HTRS DISHWASHERS CITY ` TEL NO GARBAGE DISPOSER ( AUTO STATE _ WASHERS STA COOKING UNITS 25 LICENSE NO —� MOTORS OVER INC H P DIST5.j�,-T NO GROUP I ZONE P CE SED Y 0— 1/x 25 / 1/2- 2 50 INSPECTION RECORD 2— 5 100 q- 5- 5— 15 ISO 15— 50 250 50-200 Boo SIGNS NO TRANS NO LAMPS SERVICE 0-600V 100 SERVICE OVER 600V Soo MISC WIRING PERMIT too Q FIXTURE PERMIT 100 SUPPLEMENTARY PERMIT 50 TOTAL FEE S S LDESCR BY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR S SIGNATURE TE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY L COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT CAL WIRING WIRING EBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR D AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES NIA OR THAT 1 AM THE LEGAL OWNE OF THE ABOVE ED RESIDENTIAL ERTY POWER URE UTILITY CO NOTIFIED-Z RMITT FINA • ' v 6 ®r .I ON ARTHUR C VETT, cK/) MoO CASH SUPERVISING ELECTRICAL ENGINEER (�,{��,4 7 6 6 ' IPP, 3 2 0 7.65 ry 70A688 CE800 f039 APPLICATION OR Ea LE TRIC PE�INIIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS JOHN A LAMBIE, COUNTY ENGINEER T WILLIAM A JENSEN SUP T OF BUILDING LOCALITY P1I° C.J ` FOR APPLICANT TO FILL IN CROSS sT d PERMT FEES �1 c�a_ha I T fi M NUMBER OWNERMAIL EACH FEE j OUTLETS $ $ ADDRESS L G 1 Q LIGHTS RECEPT SW 10 x ,f LIGHTING FIXTURES 10 CITY / C�Y7�l e. IC4NO ELEC RANGES CLO DRYERS ELECTRICIA WATER HEATERS 50 ADDRESS 0 ELEC SPACEHTRS�D ISHWASHERS CITY TEL NO GARBAGE DISPOSERS AUTO .yt] tSTATE WASHERS STA COOKING UNITS 25 /�`-�µ LICENSE NO MOTORS OVER INC H P DISTRICT N GR UP ZONE P CESS 0— 1/2 25 1/2— 2 50 WSPECTIZ RECORD 2— 5 100 5— 15 150 IS— 50 250 50-200 500 SIGNS NO TRANS NO LAMPS SERVICE 0-600V too SERVICE OVER 600V 500 MISC WIRING PERMIT 100 FIXTURE PERMIT too SUPPLEMENTARY PERMIT 50 TOTAL FEE 1 HEREBY ACKNOWLEDGE THAT 1 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 ELECTRICAL WIRING I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR WIRING S LICENSED AREQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL P RTY i POWER SIGNATURE UTILITY CO NOTIFIED OFPERMITT FINAL/VAPDAT ®r ION ARTH R C VETT' CK Moo cases UPERVISING ELECTRICAL ENGINEER �io 5 1 4 7 r►al; 2 0 .7 5 M 76AGO3 CE8061052 APPLICATION FOR ELECTR C PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING � it Q1 BUILDING AND SAFETY DIVISION ADDRESS 11)�� Oy ewe-- JOHN A LAMBIE, COUNTY ENGINEER r /^a WILLIAM A JENSEN SUP T OF BUILDING LOCALITY P� 1 l C, 7411 FOR APPLICANT TO FILL IN NEAss sT 1 II PERNIIT FEES ' b ile- 1 T E M NUMBER OWNER EACH FEE MAIL OUTLETS $ $ ADDRESS LIGHTS RECEPT SW 10 LIGHTING FIXTURES 70 CITY TEL NO ELEC RANGES CLO DRYERS ELECTRICIAN WATER HEATERS 50 ADDRESS 34440 g°Lit-fAAd ^/ ELEC SPACE HTRS DISHWASHERS CITY TEL NO L 51 RBADISPOSER AUTO- I� ('� STATE �S G 5WASHER STA COOKING UNITS 25 �,J LICENSE NO ` MOTORS OVER INC H P DISTRICNO �$O.I.IP P CES ED BY 0— 1/2 25 �1jfd 1/2— z 1 50 INSPECTION RE ORD 2— 5 100 5— 15 150 is— 50 250 50-200 500 SIGNS NO TRANS NO LAMPS SERVICE 0-600V 100 SERVICE OVER 600V Soo MISC WIRING PERMIT 100 FIXTURE PERMIT 100 SUPPLEMENTARY PERMIT 50 TOTAL FEE $ .S 1HEREBY 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 ELECTRICAL WIRING I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR WIRING LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENT/ PROPERTY POWER SIGNATURE UTILITYCO NOTIFIED , OF PERMITTEE FIN L .1 OF T AR HR C VETT. CK MO CK Mo casesSH /_ SUPERVV ISING ELECTRICAL ENGINEER „ i LAEO 4 9 9 3 -0 APR 6 2 0 1 .2 5 0 L. ��("If KERS'COMPENSATION DECLARATION CE 863 10/e1 APPLICATION FOR ELECTRICAL PERMIT �I herebx `firm that I have a certificate of consent to self CE 8066 ylnswe 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/0Z ,L- Company �'O�'ti�'-' FOR APPLICANT TO FILL IN JOB f 2 C rtified co is hereby furnished EACH NO FEE ADDRESS J PY Y New Residential Bldgs & Pools rtified copy is filed with the county building inspec- 1 & 2-Family Sq FT $ — $ LOCALITY tion department Multi-family Sq Ft NEAREST CROSS ST Date —1i Applicant OWNER O Residential Swimming Pools R �As 'c Sw �� FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets ReLi ht 9 � _1 f MAIL z 7 COMPENSATION INSURANCE .,� First 20 `' >�� ADDRESS 57 J -2 (This section need not be completed if the work involved by Total No 15 Additional CITY Tel No ��G the permit is for one hundred dollars ($100)or less ) that in the performance of the work for which this PLAN CHECK I certify permit is issued, I shall not employ any person in any manner APPLICANT - so as to become subject to the Workers'Compensation Laws Lighting Fixtures First 20 ADDRESS I ,c Additional Total No_ /15 CITY �d;1 el No Date Applicant Fixed Appliances Not Over 1 HP t PERMIT NOTICE TO APPLICANT If, after making this Certificate of I APPLICANT Exemption you should become subject to the Workers Range_ HealerD W 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 FAU —W H deemed revoked CITY Tel No Hood Fan Other- - LICENSED CONTRACTORS DECLARATION _ I hereby affirm that I am licensed under provisions of Chapter 9 Disp Room Air Cond REG NNUMBER I Class (commencing with Section 7000) of Division 3 of the Business DISTRICT NOS PROCE B and Professions Code and my license is in full force and effect Power Apparatus& Large Appliances >_ d ` Size &Type HP, KW KVA or KVAR �1 O License Number (�-7 S F17Lic Class �-' U Up to 1 Incl FINAL V Over 1 to 10 Incl DATE � VA IDATION Contractor-•Oa.&� Date 4-'7 Over 10 to 50 Incl FIN O ❑ I am exempt under Sec Over 50 to 100 Inc BY W B &P C for this reason Over 100 / W 1A Services Swbd MCC & Panelboards Z Date 0 -200 Amp Under 600 V Signature 201 - 1000 Amp Under 600 V ❑ Exemption for Reg Moint Elect Over 1000 Amp or Over 600 V ;27 9 S 7 A SINGLE FAMILY Temp Power Pole &Appurtenances # o o e o a 2 HOME OWNER BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor s License ( o o 7 1. 7 5 Law for the following reason (Section 7031 5, Business and Additional Sign Branch Circuits Professions Code) 0 0 o 7 17 5 6 ❑ I as owner of the property will do the work and the Misc Conduits & Conductors structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ 7044 Business and Professions Code) 0918-87 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 E Lender s Name PERMIT ISSUING FEE D Lender s Address 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 bo e-ment pr erty for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE 1 rl�a�e,c, 31 -1:7 Signature of Permittee Date _ L � �