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Home My Public Portal About10822 DAINES DR_Electrical__ Jfi A B;�-CEBDG 10/72 APPLsC�, sN9 ELE CAL PERMIT CJUNTY OF LOS ANGELES - _ DEPARTMENT OF COUNTY ENGINEER F9 10$22 l�U. a .�,BUILDING AND SAFETY DIVISION TT,�N- TY TEMPLE U Y FOR APPLICANT TO FILL IN STANITAD LETS NO. EACH FEE RS S ME t SOW RECEP T. FIRST 20 25 ss ID 22 �AINES l LIGHT_ TOTAL CITY TEMPLE CITY TEL. No.579 269"1 SWITCH_ OVER 20 .10 PLAN CHECK FIRST 20 25 FI%TURES APPLICANT LIGHTING 1 TOTAL T OVER 20 ADDRESS .10 RESIDENTIAL APPLIANCES cI TY TEL. NO. PERMIT RANGE-DRYER_WTR. NTP._ APPLICANT STA. COOK OISP._F.A.U._ ADDRESS SPACE HTR. AIR CONI. CI TV TEL. NO. CLOTHES WASH. OISHWAS H._ LICENSE 0 REG. NUM9ER CLASS. FAN_OTHER 1.000 rEREBY ACNNOWLEOGE THAT I HAVE READ THIS APPLICATION PND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES ANO STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR 0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAI I AM THE LEGAL OWNER OF THE ABOVE d 1 - 10 3.00 DESCRIBED RESIDENTIAL PROPERTY. � U PERMITEE � 7 10 - SO 5.00 SIGNATURE ( C ��' cD F- U 50 - 100 10.00 DISTRICT NO. PROCESSE BY 1 100 - S00 15.00 'N Z O SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTO,WSfSIGK4TURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 TEMP. POWER POLE SERVICENOTOVER600VOLTSOR200AMP 300 UNDERSLAB WORK SERVI CE OVER 600 VOLTS OR 200 AM P 10.001 ROUGH CONDUIT TEMP SERVICE, POLE, &APPURTENANCES &00 WIRING TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL PERMIT FEE (SUB TOTAL) NOTES: III eh-117 =a 4Z ffz PLAN CHECK FEE PERMIT ISSUING FEE 300 TOTAL FEE PLAN CHECK VALIDATION CK. M.D. CASH JERMIT VALIDATION CK. M.O. CASH 111 . 3 3 6 6 35 SsEP27 2 D 7.00b v SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE , f 76A663-CEB0: 10/72 APPLICATION FOR ELECTRICAL PERMIT �. COUNTY OF LOS ANGELES DEPARTMENT AND SAFETY Y DIVISION IER AD 09�I Z �Al�Es DF� ADDRESS L LOCALITY ``t=7m P`t C-t y FOR APPLICANT TO FILL IN CROSS NEARESTT. 5Ato 1P\ WTA EXTURES NO. EACH FEE OWNER OR �A'11 y, Q<OA` S S FIRM NAME 1YV 1. l..^J ,V\ IL ADDRESS Z.O ES L� FIRST 20 ,25 �(1 / /� SWITCH OVER 20 CITY �.M PLS. TEL. NO. 5 2"I10 PLAN CHECKFIRST 20 25 APPLICANT OVER 20 ADDRESS .10 RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT RANGE_DRYER_WTR. HTR._ APPLICANT STA. COOKDISP._F.A.U._ ADDRESS SPACE HTR. AIR COND. CITY TEL. NO. CLOTHES WASH, DISHWASH. LICENSE OR CLASS. REG. NUMBER FAN_OTHER 1.00 1 HEREBY ACKNOWLEDGETHAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. S1ZE 6 TYPE OVER TO I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR 0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAI I AM THE LEGAL OWNER OF THE ABOVE y 1 - 10 3.00 DESCRIBED RESIDENTIAL PROPER T. d �(�J CO PERMITEE ry' O 10 - $0 5,00 SIGNATURE YY 5 O H 50 - 100 1000 DISTRICT NO. PROLE EO BY yVj 100 - 600 16.00 [ D O ' Z SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS O DATE INSPECTOR'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 TEMP. POWER POLE SERVICE NOTOVER 600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK SERVICEOVER 600 VOLTS OR 200AMP 10.00 ROUGH CONDUIT TEMPSERVICE.POLE, &APPURTENANCES 5.00 WIRING TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL L PERMIT FEE (SUB TOTAL) NOTES: PLAN CHECK FEE PERMIT ISSUING FEE 3.00 0 TOTAL FEE PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. cesH" 29. ''2 A 3.5 0 SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE VfJRBERS' COMPENSATION DECLARATION BYOA663 DPW 3/87 APPLICATION FOR ELECTRICAL PERMIT O hereby affirm that have a certificate of consent to self .CEAs oc 'insure, ar a certificate of Workers' Compensation Insurance, a COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certified copy thereof (Sec. 3800, Lab. C.) , Policy No- Company FOR APPLICANT TO FILL IN JOB �n1 qq ` ❑Certified copy is.hereby,furnished. New Residential Bldgs. & Pools' EACH NO. FEE ADDRESS 1 V C� L tj I NA t g _ g G N tl'I,C ��ZZq ❑Certified:copy is filed with the county building inspec- 1 8 2-Family, $q, FL LOCALITY tion department. Multi-fomily Sq. Ft. — NEAREST CROSS ST. ' Residential t5wimming Pools Date Applicant �` OWNER OR. AA LN I ZI 1�(i IZGP(q�C''��. FIRM NAME I {�]j II�•tl +�- .CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec__�__Light—/C_$w._ - MAIL COMPENSATION INSURANCE First 20 r O ADDRESS 10`80-O (W cS _ (This section need not be completed If the work involved by Total No. Additional CITY. C �) TeL No.R f��llV'VL o6 the permit is for one hundred dollars ($100)or less.) - - certify that in the performance of the work for which this _ PLAN CHECK APPLICANT Permit Is issued,i shall net employ any person in any manner so as to become subject to the Workers'Compensation Laws, Lighting Fixtures First 20 ADDRESS Total No. Dale -Applicant Additional CITY Tel, No.PERM NOTICE APPLICANT: 'if, Appliances Not Over 1 HP IT f, after making this Certificate of APPLICATION Exemption,n, 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. CITY Tel. No. LICENSED CONTRACTORS DECLARATION Hood — Fan —Other— ' . —Disp. — Room Air CordLICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 REG. NUMBER Class. (commencing with Section 7000)of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO. P SSED BY Y and Professions Code,and my license is in full force and effect. p 0. Size&Type HP, KW, KVA, or KVAR �Q(/ f_C� -a Q License Number ❑c. Class Up to 1 Incl: FINAL U Over I to 10 Incl. DATE -2 -�`�� , VALIDATION 0 Contractor Date Over 10 to 50 Incl. FINAL F_ ❑ I am exempt under Sec. Over 50 to 100 Inc. BY w B.&P.C. for this reason - Over 100 - 'TI �� d D .Date. Services, Swbd., MCC& Ponelboords U' Z 0-200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V ❑ - Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Temp. Power Pole 8 Appurtenances '- I hereby affirm that I am exempt from the Contractor's license Sign with One Branch Circuit Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits' Professions Code)' -- Misc. Conduits 8 Conductors ! F i ❑ I, as owner of the property, will do the work and the structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ D TOTAL A 1t - c0 Business and Professions Code). CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for j(�I the performance of the work for which this permit is issued PERMIT FEE (Sub-Total). (Sec. 3097, Civ. C.). ' PLAN CHECKING TEE Lender's Name ;_1 PERMIT ISSUING FEE Lender's Address TOTAL FEE I certify that I have read this application and state that the - above information is correct. I agree to comply with all County - ordinances and State laws regulating Electrical wiring, and .herebyauthorize representatives of this County to enter upon -th e -mentione prdpert ' inspection purposes. - SEE REVERSE FOR EXPLANATORY LANGUAGE ermilee Date ®'