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Home My Public Portal About5346 EL MONTE AVE_Electrical__ L1 76A663-CE806 10/72 Qppd�C�Q��O�( F0 D. [� Ec'TQp Qd pRNn104 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY C` . NEAREST FOR APPLICANT TO FILL IN CROSS ST. r OUTLETS N0, EACH FEE OWNER OR $ $ FIRM NAME RECEPT._ MAIL "I h ADDRESS 6 C/ LIGHT TOTAL FIRST 20 .25 CITY T TEL. N0. • (- SWITCH OVER 20 ,t0 PLAN CHECK FIRST 20 25 APPLICAN LIGHTING TOTAL FIXTURES OVER 20 .10 ADDRESS ' RESIDENTIAL APPLIANCES CITY TEL PERMIT 1 RANGE DRYER_WTR. HTR. APPLICANT STA. COOK DISP. F.A.U. ADDRESS �3 y.6• c y� 1 SPACE HTR. AIR COND. CITY TEL. NO.y CLOTHES WASH. DISHWASH. LICENSE OR Y f CLASS. REG. NUMBER I FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY 4 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 + 0 - 1 1.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAI I AM THE LEGAL OWNER OF THE ABOVE I - 10 3.00 OESCRIFED REST IAL PROPERT . a O PERMITEE C> 10 - 50 5.00 SIGNATURE O 50 - 100 10.00 F- DISTRICT N6. OCESS BY 1y 100 - 500 15.00 SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTOR: SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE SERVI CENOT OVER 600 VOLTS OR 200 AMP 3.00 Q UNDERSLA.B WORK SERVICE OVER 600VOLTS OR200AMP 10.00 ROUGH CONDUIT TEMPSERVICE,POLE, &APPURTENANCES 5.00 WIRING TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED ... FINAL AI PERMIT FEE (SUB TOTAL) NOTES: PLAN CHECK FEE PERMIT ISSUING FEE 3.00 p TOTAL FEE QU PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH 0 4 4r00 25 2 0 - 6.0 0 ,&98 SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE • WORKERS' COMPENSATION DECLAfZATION 76A663 "t 0/81 n fo P C n S��O H F O R 'E E f U C /tel fl P f2 n 11 57 I hereby affirm that I have a certificate ofconsen't to self CE-806G G�11rU L5 G�1ll I1V l!– Ili ISL�,LS Il ll� 1�1L� LSl1u�V� ll insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES �. BUILDING AND SAFETY or a certified copy thereof (Sec. 3800, Lab. C. 7, 7 Policy No. Company FOR APPLICANT TO FILL IN JOB %l ❑ Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS l� ❑ 1 & 2-Family, S Ft. $ _ $ LOCALITY Certified copy is filed with the county building inspec- Y. q• tion department. Multi-family Sq. Ft. NEAREST CROSS ST. l� Residential Swimming Pools OWNER OR 1 Date Applicant \ I FIRM NAME ( Y CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec�Light_(_Sw.J_ MAIL COMPENSATION INSURANCE ADDRESS I� This section need not be completed if the work involved b First 20 ( P Y Total No. Additional' CITY �'C r Tel. No. I the permit is for one hundred dollars ($100)or less.) / I certifythat in the performance of the work for which this PLAN CHET p APPLICANT permit is issued, I shall not employ any person in any manner so as to b Come subject to the Woy rs'Compensation Law . Lighting Fixtures / First 20 ADDRESS G Total No. / Additional CITY Tel. No. Date Applicant -- Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certi tate of APPLICANT Exemption, you should become,subject to the Workers' Range_ Heater_D.W. Compensation provisions of the Labor Code, you must forth- Oven _ Dryer — W.M.— ADDRESS with comply with such provisions.or this permit shall be Top FAU —W.H. — deemed revoked. Hood Fan _Other_ CITY Tel.,No. LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. _ Room Air Cond. REG. NUMBER Class. (commencing with Section 7000) of Division 3 of the Business DISTRICT NO. PROCE ED BY and Professions Code,and my license is in full force and effect. Power Apparatus& Large Appliances.. . 0. Size & Type HP, KW, KVA, or KVAR License Number Lic. Class Up to 1 Incl. FINAL V Over 1 to 10 Incl. DATE ? I ; VALIDATION 0 Contractor Date Over 10 to 50 Incl. FINAL ❑ I am exempt and Sec. Over 50 to 100 Inc. BY d\ B.&P.C. for this reason Over 100 Date.: Services, Swbd., MCC& Panelboards —. �• 1 0 -200 Amp. Under 600 V Signatu All 201 - 1000 Amp. Under 600 V ❑ Over 1000 Amp. or Over 600 V Exemption for Reg. Maint. Elect. f-0 4 3,5 R SINGLE FAMILY Temp. Power Pole&Appurtenances'. #,o'o;o o-2 HOME OWNER-BUILDER DECLARATION � . Sign with One Branch Circuit 1. � I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits- 2 o`0 17,2'v Law for the following reason (Section 7031.5, Business and Professions Code): '0'0 0 1 17,2 5 s ❑ I, as owner of the property, will do the work and the Misc. Conduits&Conductors structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)— D o /1`1 2;-8'4 7044, Business 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 PERMIT FEE (Sub-Total) 7 (See. 3097, Civ. C.'). PLAN CHECKING FEE Lender's Name PERMIT.ISSUING FEE V Lender's Address I certify that l have read this application and state that the TOTAL FEE o J. ' 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 e bove-menti ned p ty for inspecti n purpddses. L/J C/ SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permitt D/ate ' -� WORKERS'COMPENSATION DECLARATfON - - 76A663 t0i8t vo nip � �p FOR 2A no j � n no �p (�/� Ishereby affirm that I have a certificate of consent toselfCE-806G' J�I�l!-L��G�1��UV lf"011� ISL��h�C��h1L� ll��llllllVll�� ' ,.insure, ora certificate of Workers' Compensation Insurance COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec.3800, La C: Policy NO. Company LG FOR APPLICANT TO FILL IN JOB 7 Certified copy is hereby furnished: New Residential Bldgs; EACH NO. . FEE ADDRESS. 4� S — Certified copy is filed with the'county building inspec- 1 &2-Family, Sq. $ $ LOCALITY tion department. Multi-family Sq. Ft. = CROSS ST. ® C- C�� ,, Residential Swimming Pools Date Applicant JL`'I�'t/ �/ �� OWNER OR, FIRM NAME CERTIFICATEOF EXEMPTION FROM WORKERS' MAIL1 Outlets: R . -. ight Sw.� i COMPENSATION INSURANCE ��y ADDRESS �-�G�. First 20 ,y (This section need not be completed if flie work involved by Total No. Additional CITY G �� Tel. No. �A- the permit is for one.hundred dollars ($100)or less.) PLAN CHECK I certify that in the performance of'the.work for which this - APPLICANT permit is issued, I•shall not employ any person in any manner so as to become subject to the-Workers'Compensation Laws. Lighting Fixtures First 26 ADDRESS Additional Total-No.. CITY Tel. No, Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If; after making this Certificate of APPLICANT Exemption, you should become- subject to the Workers' Range— Heater_D.W. — Compensation provisions of the Labor Code, you.must'forth- Oven _ Dryer — W.M. ADDRESS. with comply' with` such. provisions or this permit shall beTop FAU —W.H. deemed revoked. Hood Fan Other_ CITY' Tel:No. LICENSED CONTRACTORS.DECLARATION LICENSE OR I hereby affirm that I am licensed.under provisions of Chapter-9 Disp. Room Air Cond.- Class: REG. NUMBER (commencing with Section 7000) of Division 3 of the BusinessDISTRICT NO. PROC SED'BY and Professions Code,and,my-license is in full force and effEtt: Power Apparatus &.Large Appliances A Size 8 Type HP, KW, KVA, or KVAR' License Number Lic. Class Up to 1 Incl. FINAL V 2 Over l.to 10 Incl. DATE '- VALIDATION Contractor Date 1/ U o ❑ Over 10 to 50 Incl. FINA U I am exempt under Sec. Over 50 to 100 Inc. BY LU B.&P.C. for this reason Over 1'00 Z �+ . . . Services, Swbd., MCC& Pan6lboards .D — Date: 0 -200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V ' Over 1000'Amp. or Over 600'V Exemption for Reg. Maint. Elect. 00 0 37 A SINGLE FAMILY Temp. Power Pole:&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with"One Branch Circuit o'to, I hereby affirm that I am exempt from the Contractor's License o o .�� F Law for the following reason (Section 7031.5,,Business and . Additional Sign Branch Circuits y 03,28-8G.- I - Professions Code): t Misc. Conduits & Conductors L I I, as owner of the property, will do the work and the structure. is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY 1'hereby.affirm that there is a construction lending agency for the performance of the work•for which this permit is issued PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.).' PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE CLender's Address t+ 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 '7 the- Bove-m tione p�perty for inspection purpII-Zz- halloses. W � SEE REVERSE FOR EXPLANATORY LANGUAGE ./ Signa ure o Per tee Date