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Home My Public Portal About10228, 10224 DAINES DR_Electrical__ 7.jG 663-C E*806 3-69 t APPLICATION FOR ELECTRICAL PER AOT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING �9 BUILDING AND SAFETY DIVISION ADDRESS JOHN A LAMBIE, COUNTY ENGINEER �y COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY ,L( /f �jev NEAREST FOR APPLICANT TO FILL IN CROSS ST. !L /y NO. EACH FEE RECEIPT.,! $ $ OWNER MAIL LIGHT TOTAL FIRST 20 ,20 ADDRESS �� TEL NO SWITCH / OVER 20 10 CITY`- 7O, Q PLAN CHECK LIGHTING TOTAL FIRST 20 .20APPLICANT FIXTURES } OVER 20 .10 ADDRESS RANGE_DRYER_WTR. HTR. CITY TEL NO. STA. COOK_DISP F A.U. CONTRACTOR SPACE HTR AIR COND. ADDRESSL CLOTHES WASH._DISHWASH. CITY TEL.NO. FAN OTHER 1.00 LICENSE NO. CLASS MOTORS,TRANSFORMERS RATING 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION IND. HEATERS, ETC. HP. KW. KVA, AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. 0 - 1 1.00 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF } 1 - 10 3 00 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO a RESIDE IN, THE ABOVE DESC IBED RESIDEN TIA OPERTY• O 10 - 50 500 V SIGNATURE 50 - 100 10.00 OF PERMITTEE "�'� O 100 - 500 15,00 DISTRICT NO. GRO ZO PR CE SED V SIGN,GAS SIGN AND ONE CIRCUIT 3 00 v D N TUBE, OR �� .� Z MARQUEE ADDITIONAL CIRCUITS 1 00 NOTES SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00 SERVICE OVER 600 VOLTS OR 200 AMP 5 004 TEMP SERVICE, POLE, &APPURTENANCES - 3.00 PPROVALS DATE INSPECTOR'S SIGNATURE TEMP POWER POLE 11 UND SLAB WORK RO GH CONDUIT IRING i PERMIT FEE (SUB TOTAL) IXTURES 97 POWER AUTHORIZED PLAN CHECK FEE (50% PERMITTEE) PERMIT ISSUING FEE 2 00 UTILITY CO.NOTIFIED SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL �2�� ♦�;j�-nJ TOTAL FEE JOSEPH C. ROOHAN SUPERVISING ELECTRICAL ENGINEER PLAN,CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH Y. 3736 FEB18 2 D 3.40 SEE BACK OF APPLY ATION FOR COMPLFTF FEE SCHFOIILE I 7GA663-CE'806 3-69 . f • APPLICATION FOR ELECTRIC PERMI COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING 7 ' BUILDING AIND SAFETY DIVISION ADDRESS �Z JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W JENKINS, SUPERINTENDENT OF BUILDING LOCALITY g-/ FOR APPLICANT TO FILL IN NEAREST w- � CROSS ST. WG.V„ NO. EACH FEE O $ $ OWNER ll.�Z l�f RECEIPT._ MAIL FIRST 20 .20 ADDRESS 1�L LIGHT TOTAL _ G `^ CITY /Fi TEL N05 7fW0 SWITCH OVER 20 .10 PLAN CHECK LIGHTING TOTAL FIRST 20 ,20APPLICANT FIXTURES } OVER 20 ,10 ADDRESS RANGE DRYER WTR. HTR. CITY TEL NO. STA. COOK_DISP F.A.U. CONTRACTOR SPACE HTR AIR COND. ADDRESS p �V CLOTHES WASH. DISHWASH. CITY ISG 6 j TEL NO FAN OTHER 1.00 LICENSE NQ-.� CLASS. D MOTORS,TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION IND. HEATERS, ETC. HP. KW. KVA. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. O - 1 11 oO 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSEDA5 REQUIRED BY LOS ANGELES COUNTY AND STATEOF 1 - 10 3 OO CALIFORNIA OR THAT I AM THE LEGAL OWNER OF A D INTEND TO a RESIDE IN. THE ABOVE D CRIBED RESIDENTIAL RO ER�T�Y./�� O to - 50 5.00 SIGNATURE � 50 — 100 10.00 OF PERMITTEE O 100 - 500 15.00DISTRICT NO. GRO ZONE PRO Q /�� SIGN,GAS SIGN AND ONE CIRCUIT 3.00 N TUBE, OR Z MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES SERVICE NOT OVER 600 VOLTS OR 200 AMP / 2 00 ! SERVICE OVER 600 VOLTS OR 200 AMP 5.00 TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP POWER POLE UNDERSLAB WORK ROUGH CONDUIT WIRING —7—W PERMIT FEE (SUB TOTAL) FIXTURES POWER AUTHORIZED PLAN CHECK FEE (50% PERMIT FEE) PERMIT ISSUING FEE 2 00 /}%) UTILITY CO.NOTIFIED G�_ q -70 SUPPLEMENTARY PERMIT ISSUING FEE 1 00 1 FINAL TOTAL FEE JOSEPH C. ROOHAN SUPERVISING ELECTRICAL ENGINEER PLAN CHECK VALIDATION CK M.O CASH PERMIT VALIDATION CK. M.0. CASH � A 3 ' o 5C' JAM28 2 0 4.00 'SEE BACK OF APPLICATION FOR COMPLFTF_ FEE =CHEDUI E 76A663 DBS sA 11-49 f APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER ELECTRIC 1 FOR APPLICANT TO FILL IN 1 /Q DISTRICT NO. GROUP ZONE PERMIT NO. c� I l Q ELECTRICIAN.0RECEIVED BY, READY FOR DATE ISSUED ADDRESS `7I10 FIRST INSPECTION . CITY w L. NO ,�� d` r '/ COUNTY LICENSE NO. ` >) EXPIRES BUILDING ADDRESS PERMIT FEES NUMBER OUTLETS EACH FEE LOCALITY LIGHT 5c $ NEAREST CROSS ST. RECEPTACLES 5 FIXTURES 5 OWNER WALL SWITCHES 5 MAIL d ELEC. RANGES 25 I ADDRESS ELEC. HEATERS 25 CITY TEL. NO. MISC. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS NUMBER OF CIRCUITS INALLED: TOTAL �j§� APPLICATION AND STATE THAT THE ABOVE IS CORRECT LIGHTS RECEPTACLES AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES MOTORS AND,STATE LAWS REGULATING ELECTRICAL WIRING. NUMBER HORSEPOWERFEE 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS NEWMvo. HP DYER I INC. EACH - ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER Uz LESS $ ,25 OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. %z 2 .50 SIGNATURE OF _/ 2 5 L00 - PERMITTEE—Z v 5 15 1.50 INSPECTION RECORD 15 50 2.50 50 200 5.00 200 500 10.00 j 500 1000 15.00 J OVER 1000 1 20.00 Z M.G. SET/FREQ. CHANGER-HP ED WELDERS:AC-KVA I m GENERATORS - KW I 0 TRANSFORMERS - KVA TEMP. MOTORS (75% OF DRIG-) MOVED MOTORS (7S% OF ORIG.) MISC, SIGNS TYPE: NO.TRANS. TYPE: NO. LAMPS APPROVALS FOR EACH PERMIT: DATE INSPECTOR'S NAME WIRING $1.'00 CONDUIT FIXTURES $1.00 WIRING SUPPLEMENTARY .50 FIXTURES pp i POWER ��1/ J• TOTAL FEE $ UTILITY CO.NOTIFIED I FINAL ,d ✓✓�� " (Jr� ' � 1 WORKERS' COMPENSATION DECLARATION ;76A663 DPW 3/87 APPLICATION FOR ELECTRICAL PERMIT 'I hereby affirm that I have a certificate of consent to self ,.CE-806676A663 x insure, or a certi icate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certifiad copy thereof (Sec 3800, Lab C ) Policy No Company FOR APPLICANT TO FILL IN _ JOB D A /J ❑Certified co is hereby furnished EACH NO FEE ADDRESS ,f /�/ PY Y New Residential Bldgs 8 Pools ,) ❑Certified copy is'filed with the county building inspec- 1 & 2-Family, Sq Ft $ — $ LOCALIT PLE C / tion department Multi-family Sq Ft — NEAREST Residential Swimming Pools CROSSST OR 1 Date Applicant FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec Light�Frst —Sw J_ �ADDRISS COMPENSATION INSURANCE 20 v (This section need not be completed if the work Involved by Tel No the permit is for one hundred dollars ($100)or less.) Total No Additional I certify that in the performance oPLANf 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'Compensation Laws Lighting Fixtures First 20 ADDRESS Additional Date Applicant Total No CITY Tel No NOTICETO APPLICANT If, after making this Certificate ,of Fixed Appliances Not Over 1 HP PERMIT 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 — FAU W H — deemed revoked . Hood — Fan —Other— CITY Tel No LICENSED CONTRACTORS DECLARATION Disp _ Room Air Cond LICENSE OR REG NUMBER Class I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business Power Apparatus & Large Appliances DISTRICT O PRO SEDB >_ and Professions Code,and my license is in full force and effect d Size &Type HP, KW, KVA, or KVAR A U License Number Lic Class U • Up to 1 Incl FINAL Date Contractor Over 1 to 10 Incl DATE 6_ 7` VALIDATION Cc ElOver 10 to 50 Incl FINAL I am exempt under Sec Over 50 to 100 Inc BY LUII B&P C for this reason Over 100 d Date Services, Swbd , MCC& Panelboards Z Z - 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 SINGLE FAMILY Temp Power Pole 8 Appurtenances �= HOME OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Sign with'One Branch Circuit �. ,Tt =�B Law for the following reason (Section 7031 5, Business and Additional Sign Branch Circuits Professions Code) X1137 1 `13 ❑ I, as owner of the property, will do the work and the Misc Conduits&Conductors 1 ITEMS structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ �•i l � 1 11131 � Business and Professions Code) pool CONSTRUCTION LENDING AGENCY CHEC*,K 18.4=i I hereby affirm that there is a construction lending agency for CHANGE the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) (Sec`3097, Civ C ) N Lender's Name PLAN CHECKING FEE 0CIQC �00i � I—. PERMIT ISSUING FEE Lender's Address 7�� -It 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 4 hereby buthorize representatives of this County to enter upon the bove-mentioned propeAtfLr inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Per ittee Date Oso