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HomeMy Public PortalAbout10608 DAINES DR_Electrical__ °"°BB-DE80812-58 APPLICATION FOR ELECTRIC PERMIT COUNTY OF COSANGELES � " .....-2 ' P-' DEPARTMENT OF COUNTY ENGINEER BUILDING U�1 BUILDING AND SAFETY DIVISION ADDRESS JOHN A.LAMBIE,COUNTY ENGINEER CASSATT O.GRIFFIN,SUPT OF BUILDING LOCALITY c FOR APPLICANT TO FILL` IN CROSSNEAREST Q NEAREST ST PERMIT FEES OVVNE V (ITEMM NUMBER EACH FEE OUTLETS: $ $ MAIL LIGHTS RECEPP. SW. ,10 ADDRESS LIGHTING FIXTURES .10 CITY TEL. O-. 'LEC.RANGES r—: CLO.DRYERS �/ ELECTRICIAN WATER HEATERS .50 ADpRE$$ S�U ELEC.SPACE HTRS, DISHWASHERS CITY TEL. 0, ' �— 6 GARBAGE DISPOSERS pVTO.- STATE WASHERS STA.COOKING UNITS .25 LICENSE NO. MOTORS: OVER INC. H.P. DISTRICT j0. GRO'J,P ZONE W- PRO -SED BY O— 1/. .25 1 �/ v:— 2 .50 INSPECTION RECORD 2— 5 1.00 5— 15 1.50 15— 50 2.50 50—200 5.00 SIGNS: NO,TRANS. NO.LAMPS SERVICE 0-600V 1.00 SERVICE OVER 600V 5.00 M15C. WIRING PERMIT 1.00 ( CI V FIXTURE PERMIT 1.00 SUPPLEMENTARY PERM IT .50 TOTAL FEE $ p a APPROVALS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION "- 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. WIRING IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 1� LICEN5ED AS REQUIRED BY LOS ANGE 9 COUNTY AND STATE OF FIXTURE$ CALIFORNIA OR THAT I AM THE L AL OWN OF THE ABOVE DESCRIBED RES IOENTI ERTY. POWER SIGNATURE UTILITY CO.NOTI FIED _ OF PERM I TTEE — FINAL ®' /VAVDATION ARTHUR C. VEIT.(!K/ K MO CASH SUPERVISING ELECTRICAL ENGINEER [j)r10 8 6 9 4 6 Jird 3 p ? A 3 .00 in ��p7rei�i,r/ 76A66,C- CE8066 12,70 APPd000T0®Mn FOR ELECTMAL PERNIT �ING A I SAFETY D� ION FOR APPLICANT TO FILL IN JOB _ New Residential Sings. & Pools EACH NO. FEE ADDRESS �^ 1 &2 Finally Sq, Ft. $ — $ LOCALITY1 Multi-family Sq. Ft. — NEARSSEST ST. CROA ? Residential Swimming Pools pW NER OR FIRM NAME .t — N Outlets: Light, Switch & Receptacle MAIL First 20 �� ADDRESS Additional CITY T.I. No. 41fY 2 PLAN CHECK Lighting Fixtures APPLICANT First 20 ADDRESS Additional - CITY Tel. No. PERMIT Fixed Appliances Not Over 1 HP APPLICANT Range Heater D.W. n _ - Oven Dryer W.M. ADDRESS 1� Top FAU W.H. CITY A- , +,UA T.I. No. ff e'7O >- Hood Fan LICENSE OR p Disp. A.C. REG. NUMBER 3 2 -G Class.ANDI HEREBY A KNOWLEDGE THAT I HAVE READ T.IC!:P1L1,C.�MP1"STATEv O Power Apparatus& Large Appliances WITH ALL CO NTY ORDINANCES AND STATE LAWS LI, Size&Type HP, KW, KVA,or KVAR ZLE CTe"A``"'N'n`' h Up to 1 Incl. z CERTIFY THAT I A. INCEEALI REGIS' oioR Over 1 to 10 Incl. LICENSED AS r..DL.C. SY LOS E.IJR11 AM. STATE OF Over 10 to 50 Incl, CALIFORNIA ESCR aEo NES,o LEGAL OWNER OF THE Aeen Over 50 to 100 Incl. PER M ITEE �`R THAT I AM E/2E1e Over 100 SIGNATURE RPT M - ff OC SEDServices Q0-200 Amp. Under 600 V � U201 - 1000 Amp. Under 600 V S DATE INSPECTOR'S Over 1000 Amp.or Over 600 V SIGNATURE LE Temp. Power Pole&Appurtenances RK Sign with One Branch Circuit T Additional Sign Branch Circuits (Other) WIRING .� FIXTURES POWER AUTHORIZED PERMIT FEE (Sub-Total) UTI LITV CO.NOTIFIED PLAN CHECKING FEE (One-Fourth Permit Fee) FINAL PERMIT ISSUING FEE TOTAL FEE NOTES PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH 17 1 itMAY 9 2 ©. 1 5.0 0 e a � ✓l57 .. 76A663-CESOS 4-65 APPLICATION FOR E CTR9CA � COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS 0.- JOHN A. LAMBIE.COUNTY ENGINEER COLEMAN.W. JENKINS, SUP'T. OF BUILDING LOCALITY NEAREST f ` FOR APPLICANT 70 FILL IN CROSS 5T. RECEPTACLE TOTAL NO. I EACH I FEE LIGHT OUTLETS FIRST 20 $.20 $ OWNER MAIL ' ADO'L ADDRESS SWITCH OVER 20 f0 TOTAL IFIRST 20 .20 CITY TEL. NO. I LGHTING FIXTURES FXTURES ADD •L OVER 20 10 CONTRACTOR 1 RANGES CLO.DRYERS WTR.HTRS. 11.00 I ADDRESS GARB.BIER. STA.COOK CITY TEL. NO. DIBHWASH. AUTO,-WASH. STATE SPACE HTRS. STA.APP.('/.H.P.MAX.) .5O LICENSE NO. MOTORS: OVER NOT OVER H.P. DIST T N� GROUP ZONE P CE IED BY O 1 1.00 1 3 1.50 INSPECTION RECORD 3 8 2.00 8 15 2.50 a 18 50 I 3.00 1 O 50 100 5.00 L.1 NO.TRANS. O SIGNS: NO.LAMPS r SERVICE O.600V-NOT OVER 200A 1.00 1 6 N SERVICE 0.600V OVER 200 A. 1 2.00 Z SERVICE OVER 600V 5.00 OTHER (SEE COMPLETE FEE SCHEDULE) PERMITISSUIN EE I2.00I SUPPLEMENTARY PERMIT ISSUING FEE 1.00 ' TOTAL FEE $ C APPROVALS OAT! INSPECTOR'S SIGNATURE PLIATION I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APUNDERSLAB WORK AN STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ROUGH CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING _ ELECTRICAL WIRING, O r WIRING I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO POWER I I RESIDE IN,THE ABOVE SCRIBED RESIDENTIAL PERT:. V' _ SIGNATURE UTILITY CO.NOTIFIED OF PERMITTEE FINAL I9�R A7 VAIIDAT JOSEPH C. ROOHAN CK MO CASH SUPERVISING ELECTRICAL ENGINEER al.o6 0 4 SEP30 2 D 4.50 WORKERS'COMPENSATIONDECLARATION 63 CE 806G (280) APPLICATION FOR ELECTRICAL PERMIT {� CE806G lJ I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES C BUILDING AND SAFETY insure, or a certificate of Workers'Compensation Insurance,or e a certified copy thereof(Sec. 3800,Lab. C.) 1 1- FOR APPLICANT TO FILL IN JOB i Policy No. New Residential Bldgs. & Pools en Company EACH NO. FEE ADDRESS oe "fives k'j ❑ - Certified copy is hereby furnished. 1 &2-Famil Sq. Ft. $ — $ LOCALITY ,p Lt, /j ll! �ryT Y. ❑ — Certified copy is filed with the county building inspection Multi-family Sq. Ft. CROSS SNEARESTT �jq /'17 {' t department. Residential Swimming Pools _ OWNER OR r--� Date Applicant r FIRM NAME e5 {�✓) �• PP Outlets: Per. Light Siv ` j! CERTIFICATE OF EXEMPTION FROM WORKERS' Total 20 •'SO V ADDRESS. ��� QQ { A' 1 � COMPENSATION INSURANCE Total No...(✓ Additional CITY Tel No. t1/ Z.7 r PLAN CHECK S APPLICANT 0 (This section need not be completed if the work involved U Lighting Fixtures First 20 by the permit is for one hundred dollars ($100) or.less.) g g O ADDRESS cc Total No.—ii— Additional Fined Appliances Not Over 1 HP I certify that in the performance of the work for which this CITY Tel No. - F- permit is issued, 1 shall not employ any person in any manner PERMIT W so as to become subject to the Workers' Cum ensatiun Laws. Range_ Heater_D.W. , APPLICANT a _ (� Oven Dryer_W.M._ ADDRESS N a' Date ��/ Applicant Top _ FAU,_W.H. — Z Hood Fan —Other— CITY Tel No. NOTICE TO APPLICANT: if, after making this Certificate of Disp. —Room Air Cond.— LICENSE OR Exemption, you should become subject to the Workers' REG.NUMBER Class Compensation provisions of the Labor Code, yon must forth- Power Apparatus& Large Appliances DISTRICT NO. / PRO SSED BY with comply with such provisions or this permit .shall be a(/ , Si &Te HPK deemed revoked. Size Type W, r KVAR KVA,oj 41 Up to 1 Incl. Over 1 to 10 Incl: FINALDATE LICENSED CONTRACTORS DECLARATION —��— Over 10 to 50 Incl. VALIDATION I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL 9 (commencing with Section 7000) of Division 3 of the Busi- Over 100 BY ness and Professions.Code, and my license is in full force and effect. Services License Number Lic.Class 0-200 Amp. Under 600 V 201--1000 Amp.Under 600 V Contractor Date Over 1000 Amp.or Over 600 V HOME OWNER-BUILDER DECLARATION Temp. Power Pole&Appurtenances , I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits ness and Professions Code): 5 1 2. 1 Q I Misc.Conduits&Conductors ag 1, as owner of the property, will do the work and the Other (See Complete Fee Schedule)— # e e'e o e 2 structure is not intended or offered for sale (Section , 7044, Business and Professions Code). 2 ^ ^ 1. 350 CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the performance of the work for which [his permit is PERMIT FEE (Sub-Total) '' ' a 1 3.5 0 v issued (Sec. 3097,Civ.C.). Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) 0,5.,0'5-8'1 Lender's Address PERMIT ISSUING FEE I certify that I have read this application and state that the TOTAL FEE el- above information is correct.1 agree to comply with all County ordinances and State laws regulating Electrical,wiring, and hereby authorize representatives of thisCounty to enter upon the above- -ntioned Property r insp tion purposes. _ SEEREVERSEFOR EXPLANATORY LANGUAGE igr a of Permittee Date