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Home My Public Portal About10634 DAINES DR_Electrical__ APPLICATION FOR ELEC RIC PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS >� _ JOHN A. LAMBIE, COUNTY ENGINEER CASSATT D. GRIFFIN,SUPT OF BUILDING LOCALITY (/ FOR APPLICANT TO FILL IN NEAREST PERMIT FEES CROSS ST. ITEM NUMBER EACH FEE OWNER J/ O U.NT. �a"I ' S S MAIL LIGHT9 RECEPT. SW. IO ADDRE$$ LIGHTING FIXTURES 10 CITY // TEL.NO. EL /Y EC.RANGES CLO.ORYERS ELECTRICIAN WATER HEATERS .50 ADDRESS ELEC.SPACE HTRS. DISHWASHERS CITY TEL. NO. GARBAGE DISPOSERS AUTO.- STATE /1 WASHERS STA.COOKING UNITS .25 LICENSE NO. v ir MOTORS: OVER INC. H.P. DISTR T NO, I GROUP ZONE PROCESSED BY O— Yz .25 % V,— 2 5o INSPECTION RECORD 2— s 1.00 yA, 4 5— Is 1.50 ffi 15— 50 2.50 ev 50-200 5.00 1 �> M .o- ' M i SIGNS: NO.TRANS. AOf ' NO.LAMPS SERVICE 0-600V 1.00 SERVICE OVER GOOV 8.00 MISC WIRING PERMIT 1.00 �) FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .50 TOTAL FEE 8 1 HEREBY 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. f�< Iz /7 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED ANO/OR WIRING / M,. l/ A/ LICENSED AS REQUIRED BY LOS,pNOBLES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT I AM TyjE LEGAL OWNFR OF THE ABOVE DESCRIBED RESIDENTIPRO RTY. POWER n SIGNATURE UTILITY CO.NOTIFIED V^-o // OF PERM ITT E FINAL i / n Lti 14 ®F IONARTHUR C.CA43H SUPERVISING ELI MO CASH CTRICAL ENGINEER C LtiLD= , DEC 1 y o 7 .V 0 F 76A663-CE806 9-67 APPLICATION FOR ELECTRICAL PERMIT U COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING oel' ?�/ - BUILDING AND SAFETY DIVISION ADDRESS �/�F j7 1' .JOHN A. LAMBIE. COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY - NEAREST FOR APPLICANT TO FILL IN CROSS ST. {/ NO. EACH. FEE Vq/ 5 $ OWNER 9 REGEPT.L MAIL �2 LIGHT T TAL FIRST 20 .20 ADDRESS [/ J SWITCH-19- I OVER 20 .10 CITY eUA TEL. NO. LIGHTING 1 T L FIRST 20 .20 CONTRACTOR a ./ FIXTURES )j OVER 20 .10 ADDRESS RANGE_DRYER—WTR.HTR._ CITY TEL. NO, STA.COOK—DISP. F.A.U._ LICENSE NO. SPACE HTR. AIR COND.— HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CLOTHES WASH._DSH WAS H. WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. FAN—OTHER 1.00 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF MOTORS.TRANSFORMERS RATING CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO IND. HEATERS, ETC, HP. KW. KVA. RESIDE IN. THE ABOVE DESCRIBED RESIDE TIAL PROPERTY. SIZE & TYPE OVER TO SIGNATURE 0 1 1.00 OF PERMITTEEGA d 1 - 10 I3.00 0 DISTRICT N GRQtTP ZOME iOR CE D OV 10 - SO 5.00 5 C� < C .O 50 - 10010.00 NOTES: G W 100 - 500 15.00 d - N M&APPURTENANCES GN AND ONE CIRCUIT 3.00 ? DITIONAL CIRCUITS 1 .00 ER 600 VOLTS OR 200 AMP 2.00 0 VOLTS OR 200 AMP 5.00 I'. OLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SWNATUR£ TEMP. POWER POLE UNDERSLAB WORK ROUGH CONDUIT AA-nn WIRING ISSUING FEE 2.00 �p - - FIXTURES SUPPLEMENTARY ISSUING FEE 1.00 POWER AUTHORIZED {s PERMIT FEE UTILITY CO.NOTI FIED J PLAN CHECK FEE (SO% PERMIT FEE) FINAL I._ TOTAL FEED JOSEPH C. ROOHAN SUPERVISING ELECTRICAL ENGIN ER PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION CK. M.O. CASH L&2 4.9 .8-� JAN 8 2D 9.0 0 iEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE A WORKERS' COMPENSATION DECLARATION 76Z ovw aiez APPLICATION ISP IC p TION ll OR ELECTRICAL Ir EY' MIT 0 I hereby'effirm that I have a certificate of consent to self ct aoaG P'i lr Ir IL '�sPY insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certified.copy thereof (Sec. 3800, Lab. C.) A Policy N0, Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished New Residential Bldgs. 8 Pools EACH NO. FEE ADDRESS r Certified copy is filed With the'county building inspec- ^1 8 2-Family, Sq. R. $ — $ LOCALITY G E tion deportment. Multi-family Sq. Ft. — NEAREST CROSS ST. Date - Applicant Residential Swimming Pools OWNER OR IRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: RLi �$w 'WAIL COMPENSATION INSURANCE ec ght .3 ii,at53 (This section need not be completed if the work involved by First 20 ADDRESS lvCITY Tel. No. �jv Q the permit is for one hundred dollars ($100)or less.) Total No. —)� Additional 3 -{Q - PLAN CHECK I certify that In the performance of the workfor which this APPLICANT permit is issued, I shall not employ any person in any manner Q so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 Q J ADDRESS A Total No dditional CITY Tel. No. Date Applicant Fixed Appliances Not Over I HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of APPLICATION Exemption, you should become subject to the Workers' .Range— Heater—D.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. Hood — Fan —Other_ CITY Tel. No. LICENSED CONTRACTORS DECLARATION LICENSE OR Disp. ROOm.AIr Cond. 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 8 Large Appliances DISTRICT NO. P $SED BY aY and Professions Code,and my license is in full force and effect. Size 8 Type HP, KW, KVA, or KVARD� 0 License Number Lic. Class Up to 1 Incl. FINAL _ Over 1 to 10 Incl. DATE S"f d "� VALIDATION cc Contractor Date— Over 10 to 50 Ind. O ❑ FINAL - U am exempt under Sec. Over 50 to 100 Inc. By LU B.BP.C. for this reason Over 100 W Services, Swbd., MCC 8 Ponelboards Z Date'. Services, -200 Amp. Under 600 V .D Signature 201 - 1000 Amp, Under 600 V ❑ - Over i000 Amp, or Over 600 V Exemption for Reg. Maint. Elect. SINGLE FAMILY Temp. Power Pole 8 Appurtenances HOME OWNER-BUILDER DECLARATION --- I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit Low for the following reason (Section 7031 5, Business and Additional Sign Branch Circuits Professions Code): `t"t' '"`° 12rf\as owner of the property, will do the work and the Misc. Conduits$ Conductors - 1 r:=fl?7 _ structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ I� -�j l SAL - _ �,. 5 Business and Professions Code). I✓, i:�3.h;!' :�i-_..,,_..`i CONSTRUCTION LENDING AGENCY ` i "'� 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) r7V (Sec. 3097, Civ. C.). PLAN CHECKING FEE i7i)Jti—''{q7)i 1 ,'ir�•' Lender's Name PERMIT ISSUING FEE j F_jl Lender's Address - ?'= / I H!7�1 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 e , hereby authorize representatives of this County to enter upon the above-mentioned Prop rty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date