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Home My Public Portal About10787 DAINESWOOD DR_Electrical__ s r iBADa9.CEBD6.Tse APPLICATION FOR ELECTRIC PERMIT BUILDING_AND-SAFETY DIVISION Deportment of County Engineer BUILDING County of Las Angeles ADDRESS � JOHN'A. LAMBIE. COUNTY ENGINEER CASSATT D. GRIFFIN, SUPT of BUILDING LOCALITY AREST FOR APPLICANT TO FILL IN - CR sT . -C.• �L / ALJ PERMIT FEES NUMBER OWNER t LIGHT OUTLETS MAIL ADOR ESS RECEPTACLES WALL SWITCHES FEE CITY TEL. NO.. TOTAL OUTLETS .@ 54 It G ELECTRICIAN�, ✓ ELEC. RANGES 25 ADDRESS ("S: ELEC. HEATERS 25 CITY TEL. NO. KW EA STATE / G �C,f C7 LICENSE NO, FIXTURES 5 - - - - MOTORS DISTRICT NO. GROUP. ZONjE REAOY FOR INSIEcn ON NUMBER HORSEPOWER FEE I R�� 1 NEW MVD. HP OVER .INC. EACH I�8 LESS s .25 S; ' INSPECTION RECORD t 1/l 2 .50 _ .. 2 5 1.00 5 15 1.50 15 50 2:50 50 200 5.00 MISC. NO. SIGNS N.O. TRANS. NO. SIGNS NO, LAMPS FOR EACH PERMIT: WIRING PERMIT $1.00 FIXTURE PERMIT S1.00 SUPPLEMENTARY .50 APPROVALS TOTAL FEE $ DATE INSPECTOR'S SIGNATURE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CONDUIT AND STATE THAT THEABOVEIS CORRECT AND AGREE TO COMPLY - ' /' /,//'M /� I ./ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING b /1l 1 ' ilk ELECTRICAL WIRING. FIXTURES HEREBY CERTIFY THAT I AN PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY_ AND STATE OF j; POWER CALIFORNIA OR THAT I AM TH LEGAL OWNER OF THIE ABOVE DESCRIBED RESIDENTI R �r UTILITY CO.NOTIFIED SIGNATURE .0 OF PERMITTEE - FINAL C� G"7 MLC JOHN A. LAMBIE. _ YALIDATION ARTHUR-C. VEIT, COUNTY ENGINEER (/ � SUPERVISING ELECTRICAL ENGINEER CK NO CASH UTo 8 6 7 7, MAY 2 9 , - 2 1 .8 0 Ir, [iMPENSh,TION DECLARATION 63 i0/BI . APPLICATION FOR ELECTRICAL PERMIT I h! p. �I have a certificate of consent to self CE CE-88066 P'91r - msoi.-,,.or y ��_a e o£'WorkersCompensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec.3800, Lab. C.) ADDRESS ., // Policy Na. m iii - Capony - FOR APPLICANT TO FILL IN JOB �/( L UOd ❑ - - Certified copy is hereby fvrnlshed'. Nov, Residential Bldgs. & Pools EACH NO. FEE Certified copy is filed with the county building inspec- 18 2-Family, Sq:FI. ' $ — 8_ LOCALI ir. a ' tion department. Multi-family Sq. Ft NEAREST - CROSS ST. CrJ Q ✓ Residential Swimming Pools Date Applicant ` FFIWNER OR IRM NAME iL He'i _ CERTIFICATE OF EXEMPTION FROM WORKERS' �_ ;j -7 MAIL Outlets: Rec LightSw._ COMPENSATION INSURANCE .ADDRESS Q PJW JJ First 20 (This section nerd not be completed if the work involved by Total No. CITY`-77Tel. the prrmif is for one hundred dollars ($100)or less:) Additional 5(lr - PLAN -HECK certify that in the perfot employ of y pers6he k.for which this APPLICANT _ permit is issued, I shall not employ any person in any manner �/r - - - -so as to become subject to the Workers'Crmpensotian Lows. Lighting-Fixtures. First 20 • � 1'S ADDRESS ' /'� Total No. `� Additional r _ p CITY Tel.No. Date o �Applicanl - - Fixed Appliances Not Over 1 HE .PERMIT NOTLC TO A PLICANT: If, after making this Certificate of , - 'APPLICANT (Y VU Exemption, you should become subject to the Workers' Range_ Heater_D.W. Compensation provisions of the Labor Code, you must forth- Oven _ Dryer �JAr M.— ADDRESS �' with comply with such provisions or this permit shall be Top FAIL) W.H. deemed revoked. • - CITY Tel, Na. LICENSED CONTRACTORS DECLARATION Hood _ Fan _ Other— LICENSED Disp. Room Air Cond. /SU LICENSE OR Class. ffirm I hereby athat I am licensed under provisions of Chapter'9 - REG. NUMBER t }. (commencing with Section 7000) of Division 3 of.the Business Power Apparatus 8 Large Appliances DISTRICT NO PROCE$$ED BY CL and Professions Code,and my license is in full force and effect. /1�' / / p Size'& Type HP, KW, KVA, or KVAR' f/ V\ License Number Lic.Class Up to 1 Incl. FINAL -7 y�/ 1C Over l to 10 Incl. �dU 09 DATE 'L –'i VALIDATIONO Contractor Date Over 10 to 50 Incl. l� ❑ ' W am exempt FINAL under Sec.– - Over 50 to 100 Inc. BY / j �. � B.BP.C. for this reason Over 100 - Z Services, Swbd., MCC'8 Pa nelboords 7 rJ.'2 {� Date: z 0 200 Amp. Under 600 V Signature- '201 -1000 Amp. Under 600,V ' ' • • • 2. - ' Exemption for Reg. Moint.Elect. Over 1000 Amp, or Over 600 V 'I • • 6 1.2 5. SINGLE.FAMILY Temp. Power Pole 8 Appurtenances • • _ • 61.256 HOME OWNER-BUILDER m the Contractor Sign with One Branch Circuit - I hereby affirm that nam exempt from the Co..5, Business License Additional Sign Branch Circuits - - Law for the following reason (Section.7031.5, Business and., -87 PP fe/s3Vn�s Code): - c.6 Q 2 U I, as owner of the property,will do the workand the Misc. Conduits 8 Conductors structure is not intended ar offered for sale (Section Other (See Complete Fee Schedule)_ - ` 7044, Business and Professions Code). D CONSTRUCTION.LENDING AGENCY I hereby affirm that there Is a construction lending agency for theperformance of the work for which this permit is issued PERMIT FEE (5ub-Total) (Sec. 3097, Civ. C.). - PLAN CHECKING FEE Lender's:Name - PERMIT ISSUING FEE . Lender's Address--- I ddress 1 certify that I have read this application and state that the TOTAL FEE , J above information is correct. I agree to comply with all County ordinances and Stale lows regulating Electrical wiring, and r hereby authorize represenjatives of this County to enter upon - the ab /fie nGoned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE l Si noNre of Permittee L�-- Date' .