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Home My Public Portal About9561 DAINES DR_Electrical__ 76A666-CE8064-60 APPLICATION' FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING / BUILDING AND SAFETY DIVISION ADDRESS JOHN A.LAMBIE, COUNTY ENGINEER WILLIAM A JENSEN, SUPT OF BUILDING LOCALITY t FOR APPLICANT TO FILL IN CROSS sT PERMIT FEES OWNER ,��f /P/IL� / / 1 T E M NUMBER EACH FEE MAIL OUTLETS $ ADDRESS , LIGHTS RECEPT. SW. .1O LIGHTING FIXTURES 10 CITY TEL N ELEC RAN CLO. DRYERS ELECTRICIAN J WATER HEATERS SO ADDRESS ELEC SPACE HTRS. DISHWASHERS CITY TEL NO. GARBAGE DISPOSERS AUTO.- STATE WASHERS STA COOKING UNITS .25 LICENSE NO. , MOTORS OVER INC H P. DISTR CT,V GR Z N PR nESSED B O — %2 V2 — 2 so SPECTION RECQRD _ 2 S 100 - s — 15 Iso, - l / O V is — So 250 SO — 200 500uj NORANS SIGNS: NO?LAMPS t ;'a— • � T� SERVICE 0.800V 100 SERVICE OVER 600V 500 MISC. WIRING PERMIT 1 00 FIXTURE PERMIT 1 00 SUPPLEMENTARY PERMIT so TOTAL FEE S I HEREBY ACKNOWLEDGE THAT 1 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 WIRING 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED REST E TIAL PROPERTY. / POWER ,r SIGNATURE Q �`� UTILITY CO NOTIFIED OF PERMITTE - FINA VALIDATI ART UFt C VEIT. CK Mo CASH' SUPERVISING ELECTRICAL ENGINEER ( 6.0 3-•4°D �DEc 12 2 D 1 .5 O M f 76A668-CE806-11_515APPLICATION FOR.-ELECTRIC PERMIT � COUNTY OF LOS ANGELES _ DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DMSION ADDRESS (D CM))Offii A.LAMBIE, Couaty En�}naar. ATT D. GERTM.8t1p t of Bdldla�� LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST- PERMT FEES - _ ITEM NUMBERI EACH FEE OWNER OUTLETS S - s MAIL LIGHTS RECEPT SW i0 ADDRESS LIGHTING FIXTURES f0 CITY iv TEL NO �C ELEC RANGES CLO DRYERS _ ELECTRICIA WATER HEATERS 50_ ADDRESS ' ELEC SPACE HTRS DISHWASHERS , GARBAGE DISPOSERS AUTO- _ _ CITY TEL NO. WASHERS STA COOKING UNITS 25 STATE ^ LICENSE MOTORS OVER INC HP o — I/a 25 STRICTNO. IGROUPREADY FOR INSPECTION I/2 — 2 50 2 — 5 too INSPECTION RECORD 5 = Is 150 Is — 50 250 50— 200 Soo, _ SIGNS NO TRANS - - NO LAMPS SERVICE 0-600V 100 SERVICE OVER 600V Soo MISC WIRING PERMIT too FIXTURE PERMIT 100 ' SUPPLEMENTARY PERMIT s0 TOTAL FEE g APPROVALS I HEREBY ACKNOWLEDGE'THAT I HAVE'READ-THIS APPLICATION- DATE,,' INSPECTORS-SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT . WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING I WIRING 1HEREBY CERTIFY THAT 11 AM PROPERLY REGISTERED AND/OR ,er/ LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE POWER DESCRIBED RESIDENTIAL PROPERT SIGNATURE UTILITY CO NOTIFIED OF PERMITTE FINAL ALIDAT ARTHUR C.VEIT.'- SUPERVISING ELECTRICAL ENGINEER .4 CK MO CASH .. L r�S 4%2':8'-3'u' AUG-2'7. 2 -A 2'.60 ; WORKER'S COMPENSATION DECLARATION 9 DPW If 91) APPLICATION FOR ELECTRICAL PERMIT 76A66 I hereby affirm that I have a certiflCat@ bf consent to self Insure, 76A663 or a Certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV copy thereof(See 3800 Lab-L Policy��"'1"❑ � Company FOR APPLICANT TO FILL IN JOB f — Certified copy is hereby furnished New Residential Bldgs &Pools NO EACH FEE ADDRESS ❑ _ $ $ LOCALITY Certified co Is filed with the co building ins ect 1 &2-Family,Sq Ft PY 9 P NEAREST department Multi-family Sq Ft CROSSST /!Z (o Residential Swimming Pools ASSESSOR Date Applicant MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' � / OWNER oR 4 COMPENSATION INSURANCE Outlets Rec _Light Sw t� FIRM NAME 2 First 20 �V V MAIL (This section need not,be completed if the work Involved by the Total No v Additional ADDRESS permit is for one hundred dollars($100)of less} I certify that in the performance of the work for which this permit CITY Tel No is Issued, I shall not employ any'person in any manner so as to PPHN CHECK become subject to the Workers' Compensation Laws Lighting Fixtures First 20 APPLICANT Total No Additional - ADDRESS Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP NOTICE TO APPLICANT If, after making this Certificate of CITY Tel No Exemption,you should become subject to the Workers' Compensation OTHER APPLIANCES NOT OVER 3 HP provisions of the Labor Code, you must forthwith comply with such PERPower Apparatus&Large Appliances APPLICANT MIT provisions or this permit shall be deemed revoked - ' LICENSED CONTRACTORS DECLARATION Size'&Type HP,KW,KVA,or KVAR ADDRESS I hereby affirm that I am licensed under provisions of Chapter 9 AEPOAZ Over 3 to 10 Incl (commencing with Section 7000) of Division 3 of the Business and CITYTel No Professions Code, and my license Is in full force and effect Over 10 to 50 Incl } LICENSE ORClas D O J� //v�9 Over 50 t0 100 Incl REG NUMBER �, Q License Number� v LiC CIaSS V Over 100 DISTRICT NO P O SSED BY U Services,Swbd,MCC&PanelboardsDO Contractor e== 1�/ C/`'��Date 0-399 Amp Under 600 V FINAL DATE OH ❑ 400-1000 Amp Under 600 V I am exempt under Sec LV Over 1000 Amp or Over 600 V FINAL VALIDATION a B&P C for this reason BRANCH CIRCUIT FEES BY Date 15A,or 20A, 120V,Lighting or Recept Z 1 To 10 Branch Circuits Signature11-To 40 Branch Circuits 41 Or More Branch Circuits e. ❑ Exemption for Reg Maint Elect 15A,20A,208V To 277V Lighting Br CircuitsACCT='a tL SINGLE FAMILY Temp Power Pole&Appurtenances J,}U,� 67.8816 HOME OWNER-BUILDER DECLARATION i �I I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit 1 ITEMS for the Code) following reason (Section 7031 5, Business and Professions Additional Sign Branch Circuits TOTAL 67 ®80 1tf�yy F1 1,as owner of the property,will do the work and the structure Misc Conduits&Conductors ��{EC�- g7,�rt is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) ' E :VL and Professions Code) LI7W7 V CONSTRUCTION LENDING AGENCY f I hereby affirm that there is a construction lending agency for the —VVV1 6/12 7/a 6 performance of the work for which this permit is issued (Sec 3097, PERMIT FEE (Sub--Total) �Q 1 ''ge 17 Civ C) PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE , Lender's Address' I I certify that I have read this application and under penalty of purjury state TOTAL FEE that the above information is correct I agree to comply with all County ordinances and State laws regulating Electrical wiring,and hereby authorize representatives of this Coun to enter upon the above-mentioned property for sp cion purposes SEE REVERSE FOR EXPLANATORY LANGUAGE' 11RE A E DATE ,