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HomeMy Public PortalAbout9827 DAINES DR_Electrical__ 76A863-CE808 10,74 APPLICATIONFOR6ELECT C L PERMIT• - •� COUNTY OF LOS ANGELES i- DEPARTMENT OF COUNTY ENGINEER JOB - ` BUILDING'AND SAFETY DIVISION . ADDREss l-1 11 e: LOCALITY, -c Hn l G- •, 7 FOR APPLICANT TO, FILL IN NEAREST CROSS ST wV1 Q OUTLETS , NO EACH I FEE OWNER OR L i $ ' FIRM NAME �� 61- I' SIC RECEPT.'� MAIL LIGHT TOTAL FIRST 20 Ll fD ADDRESS g)- F'• SWITCH �_ OVER 20 ! CITY TC w1 Cid' TEL.YNO PLAN CHECK FIRST 20 n•-� APPLICANT - LIGHTING' 1 TOTAL FIXTURES I OVER 20 ADDRESS RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT ,1 RANGE DRYER_WTR, HTR. APPLICANT STA. COOK DISP. F.A.0 ADDRESS SPACE HTR.• ' AIR COND CITY TEL. NO. CLOTHES WASH. DISHWASH. LICENSE OR CLASS. 'REG. NUMBER FAN OTHER 11 �• ,� I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION 5AND 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 WITH WIRING , SIZE & TYPE OVER TO 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED'AND/OR ' 0 - 1 1p0 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF >. CALIFORNIA OR THAI I AM THE LEGAL OWNER OF THE ABOVE 1 —.10 300 DES CRIPED RES D TIAL PROPERTY U PERMITEE 10 - 50 500 SIGNATURE i O 50 - 100 U 1000 DISTRICT NO. _ PROC SED BY y N 100 - 500 13001 ( Z SIGN AND ONE CIRCUIT 500 SIGN, GAS APPROVALS - DATE INSPEgz6R,s SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS _ '� 100 TEMP. POWER POLE SERVICENOTOVER600VOLTS OR200AMP 300 UNDERSLAB WORK - SERVI CE OVER 600 VOLTS OR 200 AMP 1000 _ ROUGH CONDUIT _ TEMPSERVICE,POLEJ&APPURTENANCES 500 WIRING TEMP-LIGHT OR RECEPT SYSTEM 300 FIXTURES POWER AUTHORfZED UTILITY-CO.-NOTIFIED_ „ FINAL ..2 PERMIT FEE (SUB TOTAL) NOTES. PLAN CHECK FEE PERMIT ISSUING FEE •300 �� TOTAL FEE PLAN CHECK'VALIDATION CK M 0 CASH 'PERMIT'VALIDATION cK M 0 CASH, 1 n 4a,1 1 2 D 2.4 0 �. SEE BACK OF, APPLICATION FOR COMPLETE SCHEDULE (/'�� 768663-CE806 10/72 APPLICA TIP FOR ELE`CTRICALI PERMIT COUNTY OF LOS ANGELES' DEPARTMENT OF COUNTY ENGINEERS JOB G7 j BUILDING AND SAFETY'DIVISION ADDRESS O G- OCALITY NEAREST Q • FOR APPLICANT TO FILL IN CROSS ST OUTLETS NO EACH I FEE OWNER OR S 5 I 'FIRM NAME /�C L-• L>l� RECEPT MAIL LIGHT TOTAL FIRST 20 26 ' ADDRESS ,CI TY TEL NO � SWITCH OVER'20 10 PLANCHECK _ LIGHTING 1 10 FIRST 20 25 APPLICANT v —11 1 TOTAL ADDRESS FIXTURES OVER 20 RESIDENTIAL APPLIANCES CITY TEL No '- - •PER RANGE --DRYERWTR HTR APPLICANT ' STA COOK-DIS P F A U ADDRESS SPACE HTR AIR COND CITY TEL NO CLOTHES WASH DISHWASH. LICENSE REG NUMOB - CLASS. - FAN OTHER 100 1 HEHEBI ACKNOWLEDGE THAT 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 SIZE & TYPE' OVER TO _ - I HEREBY CERTIFY THAT I AM PROPERLY/REGISTERED AND/OR ',O - 1 100 LICENSED AS REOUIR BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR TH I AM THE LEGAL OW R OFr E OVE r 1 - 10300 DESCRY ED RESIDE NTI l' PROPER Y O PERMITEE � V 10 — 'S0 - S00 SIGNATURE O 50 — 100 1000 DISTRICT NO ROCE ED BY W 100,— 500 1500 ©� SIGN, GAS SIGN AND ONE CIRCUIT ,500 APPROVALS DATE INSPECTORS SIGNAnIRE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 TEMP POWER POLE ' SERVICENOTOVER600VOLTSOR200AMP r 300 �G UNDERSLAB WORK SERVICEOVER 600 VOLTS OR 200AMP 1000 ROUGH CONDUIT TEMPSERVICE,POLE, &APPURTENANCES "500 WIRING - TEMP LIGHT OR RECEPT• SYSTEM 300 FIXTURES - •I 6� 04 POWER AUTHORIZED ' UTILITY C0: NOTIFIED FINAL PERMIT FEE (SUB TOTAL) NOTES PLAN CHECK FEE PERMIT ISSUING FEE, - 300 0 �/ TOTAL FEE PQ PLAN CHECK,VALIDATION CK M 0 CASH PERMIT VALIDAT ON CK M O• CASH a 9 2•,6lZSEP, 26 D 2 6.00) 4% 1 SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE -- -- - WORKERS'COMPENSATIONDECLARATION CE-806G (2-80) APPLICATION FOR ELECTRICAL PERMIT � CE-806 I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY' insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec ii 3800, Lab C) Jl p '' FOR APPLICANT TO FILL IN JOB l)"] Policy N O Com any I EACH NO FEE ADDRESS 8oc / e New Residential Bldgs &Pools -Certified copy is hereby furnished 1 &2-Family,Sq Ft $ — $ LOCALITY Multi-family Sq Ft — NEAREST Certified copy is filed with the county building inspection CROSS ST department Residential Swimming Pools OWNER OR // ����++--���� ,,/I FIRM NAME p c' Dated Applicant Outlets Rec JLLight�Sw gDDRESS First 20 CERTIFICATE OF EXEMPTION FROM WOR ERS' Total No Additional CITY'` 'n tv Tel No COMPENSATION INSURANCE PLAN'CHE } U (This section need not be completed if the work involved 4WAPPLICAN by the permit is for one hundred dollars ($100) or less.) Lighting Fixtures First ADDRESS 'AQe Total No Additional I certify that in the performance of the work'for,which this Fixed Appliances Not Over 1 HP CITY Tel No 7� �' permit is issued, I shall not employ any person in any manner PERMIT U so as to become subject to the Workers' Compensation Laws Range_ Heater_D W APPLICANT WW CL Oven Dryer._WM-_ ADDRESS Z Date Applicant Top _ FAU _W.H CITY Tel No Hood Fan _Other NOTICE TO APPLICANT If, after making this Certificate of Disp. _ Room Air Cond._ LICENSE OR7 4V,4 Exemption, you should become subject to the Workers' REG NUMBER Class Compensation provisions df the Labor Code, you must forth- Power Apparatus&.Large Appliances DISTRICT NO PROCE5S.WD BY with comply with such provisions or this permit shall be Size&Type HP,KW, KVA,or KVAR deemed revoked S o1,2:�!> r. Up to 1 Incl � FINAL Over 1 to 10 Incl DATE �_ Z-3 � VALIDATION LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc FINAL - BY C� 9 (commencing with Section 7000) of Division 3 of the Busi- Over 100 ness and Professions Code,'and my license is in full force and effect Se \ it t2 0 Amp. Under b0 License Nu Lic Class y __ 201-1000 Amp Under 600 V Contract ate (n 1]aC 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) % 4`4'5 3 A Misc Conduits&Conductors 1, as owner of the property, will do the work and theO (See Complete Fee Sch dule)— ' structure is not intended or offered for sale (Section 7044, Business and Professions Code) CONSTRUCTION LENDING AGENCY 2'° °'35.50 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit iso 0 0 3,'5 5 0 5 issued•(Sec 3097,Civ C) PERMIT FEE , (Sub-Total) Lender's Name PtLAN CHECKING FEE (One-Fourth Permit Fee) 0.6 2 18 2 Lender's Address PERMIT ISSUING FEE 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 abov -mention property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE igna ure of Permit Date