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Home My Public Portal About9420 DAINES DR_Electrical__ 76A663-CE806 3-69 APPUCAMN FOR ELECTNIC L. R COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER I ING BUILD BUILDING AND SAFETY DIVISION ADDRESS -ag JOHN A. LAIVIBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST NO. EACH FEE $ $ OWNER RECEIPT.- MAIL ADDRESS "1 LIGHT TOTAL FIRST 20 .20 4e 2-0 10,1,1 It 1 0A.- CITY 4,1/ TEL.N0. SWITCH—/— OVER 20 .10 PLAN CHECK LIGHTING TOTAL FIRST 20 .20 APPLICANT FIXTURES FIRST 2 0 .10ADDRESS 1 RANGE_DRYER_WTR. HTR._ CITY TEL.NO. STA. COOK—DISP. —F.A.U. CONTRACTOR SPACE HTR. AIR COND. ADDRESS cC CLOTHES WASH.—DISHWASH.— TEL.NO. 3 3CZ -/71/ FAN—OTHER 1.00 LICENSE NO. CLASS. MOTORS,TRANSFORMERS RATING THEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION IND HEATERS, ETC. HP. KW. KVA. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY IND. & 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 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATEOF is 1 10 4 3.00 .40 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND To -- — RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. 0 10 50 5.00 u SIGNATURE = 50 100 10.00 OF PERMITTEE 0 F- 100 500 15.00 DISTRICT N O. GROUP ZONE PROC :r SED L0 S 1 G N,GAS SIGN 'AND.ONE CIRCUIT 3.00 TUBE, OR I NOTES: z MARQUEE ADDITIONAL CIRCUITS 1.00 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 I TEMP. POWER POLE UNDERSLA13 WORK ROUGH CONDUIT WIRING PERMIT FEE (SUB TOTAL) FIXTURES PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED PERMIT ISSUING FEE 2.00 -7- UTILITY CO.NOTIFIED SUPPLEMENTARY PERMIT ISSUING FEE 1.001 FINAL ff44e-(< JOSEPH C. ROOHAN TOTAL FEE SUPERVISING ELECTRICAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION 0 M.D. CASH 1 Ar... U 8C--' FEB 2 D 5.8 0 SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULEah- 76A663-CE806 8-62 APPUCAMN FOR" ELEC`MICAd °ERNT COUNTY.OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER 1 BUILDING BUILDING AND SAFETY DIVISION ADDRESS Ol JOHN A. LAM'BIE,'COUNTY ENGINEER O WILLIAM A.JENSEN,'SUP'T OF BUILDING LOCALITY INA ��• NEAREST � , U FOR APPLICANT TO FILL IN CROSS ST. TOTAL NO EACH FEE o / REC EPT. FIRST 20 $20 $ OWNER' �..L A W 9 OUTL TSqo LIGHT � MAIL ADO'L 10 ADDRESS .� 4 - Dk SWITCH. OVER 20 LIGHTING TOTAL FIRST 20 20 CITY / EL. NO. �1 FIXTURES } ADD'L OVER 10 ELECTRICIA � �� RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS jDq �[A A A V r GARB.DIS'. - STA.COOK U . CITY AA0��-/� P N O. ASH. AUTO.-WASH.�pj STAT SPACE HT S. STA.AF¢.(+)a-H F.MAX.) .50 p®tJ LICENSE_NO. - DISTRI T�VO- r G OU MOTORS: OVER - NOT OVER. H.P. - P NE P ESSED Y 1..7 O 1 1.00 i 3 1.50 INSPECTION RECORD - 3 8 2.00 1T, 'r lvn DAIig WA-s A18A ir- L 7' . y 8 15 2.50 1 5 '50 3.00 LI/Y7`'I2�.//E�rt �"?] �� •i�-�t!•k ti Via) CS'�l„e_21'•.�.Ak1 •G,e� 1 + - t_ • �IB I._. .. 50 100 5.00 SIGNS:. NO.TRANS. �: a-9 f//;,,. •. /•�� J i.�,f�. �•�' NO.LAMPS S.t" '��_ 'G� F•,i.•!rl^"a`n� `is'��'I .^'da'{52 ..f' O v SERVICE 0.60OV-Nor OVER 200A �" 1.00 ^? SERVICE 0-60OV-OVER 200 A. 2.00 f D_ cA ^. SERVICE OVER 600V 5.00 ? !2 MISC. PERMIT ISSUING FEE 2.00 SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE $ 1 HEREBY ACKNOWLEDGE THAT 1 HA READ THIS APPLICATION I APPROVALS DATE INSPECTOR'S SIGNATURE AND.STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY - CONDUIT 1 . WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING [,`� �/�''/,r1'" y ELECTRICAL WIRING. WIRING' PS 015 T •3/�A:v�i`r-l�-%/'� I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR - "! 11 f•v LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE AB VE ' DESCRIBED RESIDE TIAL P OPE POWER _ SIGNATURE z UTILITY CO.NOTIFIED OF PERMITT r ' mmv� ymm FINAL IDATION r I &49, ARTHUR C. VEIT SUPERVISING ELECTRICAL ENGINEER CK MO CASH r 59u' AUG 12 2 D 6.00- �' WORKERS'COMPENSATION DECLARATION, 76A663 10/81 0nn o0 n 0n /p� n 0 n0 (�/� I hereby affirm that I have a certificate of consent To self CE-806G '• G=�1l�I�L��1i�111 �Ol1V �OO ll� ELECT R5CAL� F)ER1V11�T insure, 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. Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby,furnished. New Residential Bldgs: & Pools EACH NO. FEE ADDRES ❑' l S Ft. —Certified copy is filed with the county building inspec- 1 & 2-FamiY- 9 $ $ LOCALI — tion department. Multi-family Sq. Ft. 'NEAREST Residential Swimming Pools CROSS ST. Date Applicant OWNER OR a FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' � MAIL Outlets: Rec Light Sw. ADDRESS COMPENSATION INSURANCE This section need not be completed if the work involved b First ti ( p Y Total No. CITY Tel. No. the permit is for one hundred dollars ($100)or less.) Additional j I certify that in the performance of the work for which this PLAN CHECK APPLICANT permit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensati n aws. Lighting Fixtures First 20 �" ADDRESS / p Total No. 7 Additional O CITY Tel. No. Date Applican Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If; after king this Certificate of Exemption, you should become subject to the-'Workers' Range_ Heater—D.W. APPLICANT Compensation provisions of the Labor Code, you must forth Oven _ Dryer — W.M.— ADDRESS�LZ� �� L[/9�L� ' �/✓� with comply with such provisions or this permit shall be Top FAU —W.H. CITY rya, , /C9J// Tel. No.� Q� deemed revoked. Hood!_ Fan — Other— LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. REG. NUMBER 3 3 Mass. of-1410Z", (commencing with Section 7000) of Division 3 of the Business DISTRICT NO. PROCESS BY OP, ,; Power Apparatus& Large Appliances and Professions Code, and my license is in full force and effect. � / � Size &Type HP, KW, KVA, or KVAR' O License Number23 13 Lic. Class(f—/02• Up to 1 Inc(. FINAL �� •,�� v ��1 I C-•GL�/4S�s Date S-3'� Over 1 to 10 Incl. DATE /%c--/� (/ VALIDATION 0 Contractor 10 to 50 Incl. FINAL ❑ I am exempt under Sec. Over-50 to 100 Inc._. BY tU B.&P.C. for this reason Over 100 ty , Date: Services, Swbd., MCC& Panelboards 0 - 200 Amp..Under 600 V Signature 201 - 1000 Amp. Under 600 V '31 9,5 A ❑ Over 1000 Amp. or Over 600 V # o o 0 0 0 2 Exemption for Reg'. Maint. Elect. 20 -'3 5 7 5 SINGLE FAMILY Temp:Power-Pole &.Appurtenances ` HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit o'or `3 a 7`5_ U 1 hereby affirm that I am exempt from the Contractor's License .0 3—8`4 Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits Professions Code): ❑ I, as owner of the property, will do the work and the Misc. Conduits&Conductors structureis not intended or offered for sole (Section Other (See Complete Fee Schedule)— D 7044, Business and Professions Code). 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 Lender's Name - - PERMIT ISSUING FEE _cq 1 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 abo mentioned prop rt for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE \ F Signa of Permittee Date