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Home My Public Portal About9833 DAINES DR_Electrical__ 79A663_CEe.,---9-57 AAP P L i C A T ®N FOR ELECTRIC PERlidiT .1.' 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 -CROSS ST GdL..lz::I PERNIIT FEES I T E M NUMBERI EACH FEE OWNER OUTLETS: $ $ MAIL LIGHTS SRECEPT4 SW. 10 O ADDRESS 42Z.5Pa 'Z�� LIGHTING FIXTURES Az .10 CITY TEL NO t• ELEC.RANGES CLO DRYERS ELECTRICIAN WATER HEATERS 50 'ADDRESS ELEC SPACE HTRS. DISHWASHERS .GARBAGE DISPOSERS AUTO- CITY TEL NO WASHERS STA COOKING UNITS 25 STATE LICENSE NO MOTORS- OVER INC H Pm- 0 �+ DISTRIC O. JGROUP Z NE READY FOR INGP GCTIONr ' o - +i2 z 5 +i2 - z 50 - INSPECTION RECORD 2 — 5 100 5 — 15 150 15 — 50 250 50— 200 500 SIGNS NO TRANS NO LAMPS SERVICE 0-600V 100 SERVICE OVER 600V Boo MISC WIRING PERMIT 1.00 , FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .50 TOTAL FEE' g APPROVALS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY'ORDINANCES AND STATE LAWS REGULATING `ELECTRICAL WIRING. WIRING 1 HEREBY-CERTIFY CERTIFY THAT I 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 RESIDENTIAL PROPERTY. POWER SIGNATURE' UTILITY CO NOTIFIED �} i FINAL OF PERMITTEE " ✓'1�2fr VALIDATION ARTHUR C.�I,EIT, CK Mo CASH SUPERVISINGALL6CTRICAL ENGINEER Li tip. DBS-SA DBS-SA 11.58 Y APPLICATION FOR ELECTRIC PERMIT DIVISION OF BUILDING AND SAFETY Deportment Of County Engineer BUILDINGG /7 County Of LOS Angeles ADDRESS �Q O /(4�E5 �✓/� JOHN A. LAMBIE, COUNTY ENGINEER CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY FOR APPLICANT TO-FILL IN NEAREST • ✓ / - PERMIT FEES CROSS S-r. NUMBER OWNER , 2 LIGHT OUTLETS MAIL RECEPTACLES ADDRESS WALL SWITCHES FEE CITY TEL. NO. TOTAL OUTLETS @ S¢ $ ELECTRICIAN A a—yv,.Vv ELEC. RANGES 25 ADDRESS S U S ELEC. HEATERS 25 KW EA CITY" /✓ T/�/g TEL. NO /t, STATE FIXTURES 5 Jo LICENSE NO. 6�G� MOTORS DISTRICT NO. I GROUP I ZONE I READY FOR INSPECTION NUMBER HORSEPOWER FEE NEW MVD. HP OVER INC. EACH LESS $ .25 INSPECTION RECORD lh 2 .50 2 5 1.00 5 15 1.50 15 50 2.50 50 200 5.00 misc. NO.SIGNS NO.TRANS. NO. SIGNS NO. LAMPS FOR EACH PERMIT: WIRING $1.00 Q FIXTURES $1.00 O SUPPLEMENTARY ,50 APPROVALS TOTAL FEE $✓t DATE INSPECTOR'S SIGNATURE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING Z g Co ELECTRICAL WIRING. I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES 9.OUNTY AND STATE OF CALIFORNIA OR THATI+A E AEGAL OWNER OF THE ABOVE POWER DESCRIBED RESIDENTJALRO, V.SIGNATURE UTILITY CO.NOTIFIED L °QCs OF PERMITTEE FINAL I� �`/ •� JOHN A.LAMBIE.COUNTY ENGINEER �/ ATION ARTHUR C.VEIT.CHIEF ELECT.INSPECTOR T-C CASH 3536 , DEC19 2 2.70In WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT Ll I li0reblyafflrm that I have a certificate of consent to self Insure, 76A663 or acertlfid to of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV copy thereof(Sec 3800 Lab C) Policy No Company FOR APPLICANT TO FILL IN JOB ADDRESS Certified copy Is hereby furnished New Residential Bldgs &Pools NO EACH FEE El LOCALITY — Certified copy Is flied with the county budding inspection &2-Family,Sq Ft $ $_ NEAREST department Multi-family Sq Ft CROSS ST Date - Applicant Residential Swimming Pools ASSESSOR .MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec Light__/_Sw OWNER OR ✓/ COMPENSATION INSURANCE Bp / FIRM NAME First 20 Go MAIL (� (This section need not be completed If the work involved by the Total No 3 Additional ADDRESS (? 3Z /)�S permit is for one hundred dollars($100)or less) S I certify that In the,performance of the work for which this permit CITY a L� Tel No �g , a Is Issued, I shall not employ any persori in any manner so as to PLAN CHECK became subject to the Workers'Compensation Laws Lighting Fixtures First 20 APPLICANT Total No Additionalffiz ADDRESS Date Applicant ID I AP I 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 PERMIT provisions or this permit shall be deemed revoked Power Apparatus&Large Appliances APPLICANT LICENSED CONTRACTORS DECLARATION - Size&Type HP,KW,KVA,or KVAR ADDRESS I hereby affirm'that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl (commencing with Section 7000) of Division 3 of the Business and CITY Tel No Professions Code, and my license Is In full force and effect Over 10 to 50 Incl >_Over 50 t0 100 Incl REG NUMBER LICENSE OR Class d License Number LIC Class Over 100 DISTRICT NO PO EjSSIE_D BY Q Services,Swbd,MCC&Panelboards FINAL Contractor Date 0-399 Amp Under 600 V❑ DATE 0 I am exempt under Sec 400-1000 Amp Under 600 V Over 1000 Amp or Over 600 V FINAL Over W B&P C for this reason BRANCH CIRCUIT FEES BY d Date 15A,or 20A,120V,Lighting or Recept Z_ 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits / El41 Or More Branch Circuits Exemption for Reg Maint Elect 15A,20A,208V To 277V Lighting Br Clrcuds yl SINGLE FAMILY Temp Power Pole&Appurtenances LLL 7 HOME OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law Slgn with One Branch Circuit ACOTes for the-following reason (Section 7031 5, Business and Professions Additional Sign Branch Circuits 46000 �Code) ITEMS chtr ,as owner of the property,will do the work and the structure Mlsc Conduits&Conductors 1 ITEC S is not Intended or offered for sale (Section 7044, Business Other(See Compleie Fee Schedule) TOTAL 46 -00 and Professions Code) CHECK 46.00 CONSTRUCTION LENDING AGENCY CHANGE I hereby affirm that there is a construction lending agency for the CHANGE =00 performance of the work for which this permit is issued (Sec 3097, PERMIT FEE (Sub-Total) Civ C) PLAN CHECKING FEE 0000-0001 2/15/96 Lender's Name PERMIT ISSUING FEE 0 4$$4 1 AN11:10 Lender's Address I certify that I have read this application and under penalty of perjury state TOTAL FEE Q 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 County to enter upon the above-mentioned property for inspection urp ses SEE REVERSE FOR EXPLANATORY LANGUAGE .?-/ _9 SIGNATURE OF PERMITTEE DATE '