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Home My Public Portal About5203 DEGAS AVE_Electrical__ 76A663-CEBOB 10-62APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS S O JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A. JENSEN, SUP'T OF BUILDING LOCALITY' S. -- - - NEAREST _ + FOR APPLICANT TO FILL IN cRoss sr. RECEPT. TOTAL NO. EACH FEE OUTLETS FIasT 20 $20 S OWNER LIGHT I �� MAIL ADD•L ADDRESS SWITCH. I DVEa 20 .,0 �3' a^ GHTING LTOTAL PIRST 20 .20 CITY TEL. NO. ' I 1 FIXTURES 1( ` n - ovER 20 .10 ELECTRICIAN RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS 60 GARB 'R1_ STA.COOK /� CITY TEL. NO. Ci DISHWASH.— AUTO.-WASH. y STATE fj SPACE HTRS: ♦ P f% P.MA%) .'j0 p LICENSE NO, aJ MOTORS: OVER NOT OVER H.P. , 1.00 DITB ESSEDBIUN O O — 3 1.50 INSPECTION RECORD (y b 9 8 2.00 /_ '?r �.�•� D lY t 0 r L- d4dSi 1mxrAuHBj m 15 — 50 3.00 m O r 50 100 5.00 a SIGNS: NO.TRANS. NO.CAMPS _ SERVICE O-6OOV.NoT OVER 200A ,.00 SERVICE 0.60OV-OVER 200 A. 2.00 1 SERVICE OVER 600V 5.001 MISC. 1 PERMIT ISSUING FEE 2.00 LP'V SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE $ 15 1HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVAL$ DATE INSPECTOR'SSIGNATURB I' AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING OAIA I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTEREO AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES .1 CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. POWER SIGNATURE UTILITY CO.NOTIFIED OF PERMITTEE FINAL NUra �� .TxTl-PI..II 4l� LIDATION ARTHUR C. VEIT (/ CK MO CASH SUPERVISING ELECTRICAL ENGINEER . LACO 1 4 4 2:a MAY 1.1 2 D 1 5.2 0 ' 4 WORKER'S I have a certificate DECLARATION 26.0019 DPW(,2-9„ APPLICATION FOR ELECTRICAL PERMIT v 70-0163 I hereby affirm that I have a certificate of consent to self insure, 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(Sec.3800 Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JJO�ORESS Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE LOCALITY ❑ Certified copy is filed with the county building inspection 1&2-Family,Sq.Ft. — $ $ NEAREST department. Multi-family Sq.Ft. GROSS ST Date Applicant Residential Swimming Pools ASSESSOR - MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' 1 ' OWNER OR COMPENSATION INSURANCE Outlets:Rec._Light_Sw. FIRM NAME - (This section need not be completed if the work Involved by the First 20 MAIL permit Is for one hundred dollars($100)or less.) Total No. Additional ADDRESS 1 certify that in the performance of the work for which this permit CITY Tet No. is issued, I shall not employ any person in any manner aD as to PLAN CHECK become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANT Total No. Adtlitional 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 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 9Over3to t01nc1 (commencing with Section 7000)of Division 3 of the Business and . CITY Tel.No. a Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. 0 LICENSE OR Clese. Over 50 to 100 Incl. REG.NUMBER 0 License Number LIG.Class Over 100 DISTRICT NO. PROCESSED BY LU Services,Swbd.,MCC&Panelboards LL Contractor Date 0-399 Amp.Under 600 V FINAL >_ ❑400-1000 Amp.Under 600 V DATE VALIDATION Q I am exempt under Sec. Over 1000 Amp.or Over 600 V FINAL Q B.&P.C.for this reason BRANCH CIRCUIT FEES eY (L Date: 15A,or 20A,12OV,Lighting or Recept. 2 1 To 10 Branch Circuits W Signature 11 To 40 Branch Circuits ~ ❑ 41 Or More Branch Circuits Exemption for Reg.Main.Elect. 15A,20A,208V To 277V Lighting Br.Circuits SINGLE FAMILY Temp.Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits Code): IJ I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors is not intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule) ► 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(Sec. 3097, PERMIT FEE (Sub-Total) Civ. C.) PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address 1 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 County to enter upon the aboveTrentioned property for inspection purposes. - SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE OF PERMITTEE / DATE WORKER'S COMPENSATION cap.of consent to 204X119 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT LI 0-001 I hereby,affirm that I have a certificate.of consent to self insure. 71 or a certificate of'Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy(hereof(Sep.3800 Lab.C.) PolicEACH Py No. . Company FOR APPLICANT TO FILL IN ADDRESS .4 v Certified copy is hereby furnished. New Residential Bldgs.8 Pools NO. CH FEE LOCALITY ❑ Certified copy is filed with the county building inspection 1 8 2-Family,Sq.Ft. — $ $ _ department. Multi-family Sq.FL NIAICROSS&T. LIjil G�(✓ Date Applicant Residential Swimming Pools ; ` _ ASSESSOR MAP BOOK `G PAGE PARCEL �y JG CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Bee. +1 Light Sw. 7 OWN NAME T COMPENSATION INSURANCE First 20 /"v �z� (This section need not be completed it the work involved by the - MAIL Total No. Additional ADDRESS ��)y^ /1 - di permit is for one hundred dollars($100)or less.) r�'� 3+ I certify that in the performance of the work for which this permit CITY Tel:No.141y-,Poe is issued. I shall not employ any person In any manner so as t0 PLAN CHECK became 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 PERMIT provisions or this permit shall be deemed revoked. Power Apparatus 8 Large Appliances APPLICANT LICENSED CONTRACTORS DECLARATION Size 8 Type HP,KW,KVA,or KVAR ADDRESS I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Ind.(commencing with Section 7000) of Division 3 of the Business and CITY Tei,No. Professions Code,and my license Is In full force and effect. Over 10 to 50 Incl. LICENSE OR } Over 50 to 100 In . REG.NUMBER Class. a Over 100 DISTRICT NO. P O SSED BY O License Number Lic.Class p Services, bd�yM C P b .5 p '�c-G;4e� T_ Contractor Date ✓" 0 ""^in / pgiE 400-1000 Amp.Under 0 V ❑ I am exempt under Sec. VALIDATION Over 1000 Amp.or Over 600 V FINAL W 8.8P.C.for this reasonBRANCH CIRCUIT FEES BY W Date: 15A,or 20A, 120V,Lighting or Recepi. Z 1 To 10 Branch Circuits Signature11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits Exemption for Reg.Maim.Elect. 15A,20A,208V To 2T7V Lighting Br.Circuits SINGLE FAMILY Temp.Power Pale 8 Appurtenances _ HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit - I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits a Code): _27J i7 I,as owner of the property, will do the work and the structure Misc.Conduits 8 Conductors is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) D and Professions Code), TOTAL CONSTRUCTION LENDING AGENCY ,r,-__ . I hereby affirm that there is a construction lending agency for the � 1 j% ;;Z7 performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total) / `�1"�%5�`'�-� Civ. CJ V- PLAN CHECKING FEE Lender's Name / PERMIT ISSUING FEE Lender's Address ; TOTAL FEE // :I.J t AM E^ I_; I certify that I have read this application and under penalty of purjury slate 1 that the above information is correct. I agree to comply with all County ordinancesand State laws regulating Electrical wiring,and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. / SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE OF PERMITTEE DATE