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HomeMy Public PortalAbout4857 ENCINITA AVE_Electrical__ 76A663C- CEe06B"12/73 APPLICATIONR ELECTRICAL PERMIT _ V1 fl BUILDING AND SAFETY DIVISION 10 FOR APPLICANT TO FILL IN JOB FResidentialidential Bldgs & Pools EACH NO FEE ADDRESS 8 �' 7 ex / IJ Finaily Sq Ft $ — $ LOCALITYamily Sq Ft — NEAREST ntial Swimming Pools CROSS STWNER OR 0 Q FORM NME I S ,��3Light, Switch & Receptacle MAI L ''aa0 ADDRESS 149a onal CITY7gJZ �"' el No �]PLAN CHECK FixturesAPPLICANT 0 O ADDRESS Additional CITY Tel No , PERMIT Fixed Appliances Not Over 1 HP APPLICANT '© NA I Range Heater— DW ADDRESS Oven Dryer W M Top FAU WH CITY Tel No Hood Fan L— LICENSE OR d Disp A C REG NUMBER Class O U I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY 0 Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING r Size&Type HP, KW, KVA,or KVAR ELECTRICAL WIRING LU CL. Up to 1 Incl 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR N Over 1 to 10 Incl LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE Over 10 to 50 Incl DESCRIBED RESIDENTIAL PROPER T'������AI�9 I _ Over 50 to 100 Incl PERMITEE JAI !I(%u� l Over 100 SIGNATURE Q� DISTRICT NO PR CESS BY Services 0-200 Amp Under 600 V 201 - 1000 Amp Under 600 V APPROVALS D T INSPECTOR'S Over 1000 Amp or Over 600 V SIGNATURE TEMP POWER POLE Temp Power Pole&Appurtenances UNDERSLAB WORK Sign with One Branch Circuli Additional Sign Branch Circuits ROUGH CONDUIT (Other) WIRING FIXTURES POWER AUTHORIZED PERMIT FEE (Sub-Total) UTILITYCO NOTIFIED PLAN CHECKING FEE (One-Fourth Permit Fee) FINAL PERMIT ISSUING FEE NOTES TOTA L F EE a PLAN CHECK VALIDATION CK MID CASH PERMIT VA ID ON CKMCI CASH 5 9 1 C-_FEB Z ® Y 2 G.9 5 Abt, D.B.S.SA 25M SETS 10-47 "PLICATION FOR O PER DEPARTMENT OF BUILDING AND SAFM ELECTRIC COUNTY OF LOS ANGELES WM. J. FOX CHIEF ENGINEER Q NAME DISTRICT NO. GROUP ZONE PERMIT N70. --� U ADDRESS I tr 1' VED BY READY FOR DATE ISSUED U CITY TEL.NO. RC/� FIRST INSPECTION f J COUNTY ! �:- G CERT.NO. EXPIRES // _ .,�. APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY DESCRIPTION OF WORK ADDRESS NUMBER OF OUTLETS ON CIRCUITS LOCALITY _ LOCATION BY ROOMS - NEAREST LIGHT OUTLETS SV✓. PLUGS FACT CROSE'+ST. CIRCUIT A R C D I Ci F G H it NAME � AADDLRESS Q f CITY TEL.NO. AM TrIE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATti OF QUALIFICATIC?N., 1 AM THE jf:GP3.O I;iI`s_mT:.��}Y :�SGRIBED �- OWNER. dQkRFXrIONS I � J Q - Z - L7 Cr I � TOTAL NO. OF OUTLETS 36 $ 'a APPFOVALS NO. OF FIXTURES $ v TATE INSPECTOR'S NAME NO. OF MOTORS H.P. $ CONDUIT NO. OF SIGNS TRANS. $ WIRING NO. OF RANGES OR HEATERS $ FIXTURES MISCELLANEOUS IS $ POWER ' PERMIT FEE $ � UTI LI TY CO.NOTIFIED 'I TOTAL FEE r' FINAL 76A663A-CE806A 4/72 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER ABUILDING DDRESS H BUILDING AND SAFETY DIVISION LOCALITY rn L C/7'NEAHEST FOR APPLICANT TO FILL IN CROSS ST OUTLETS NO EACH FEE [[�� L $ $� OWNER �� S 17 "r ' �E RECEPT/ MAIL L/ y LIGHT �� TOTAL FIRST 20 D A ADDRESS �J 8 5- L Cl TY `/Z hr *�.C�e� EL NO .2 SWITCH • / OVER 20 PLAN CHECK FIRST 20 APPLICANT ow'F104 LIGHTING TOTAL FIXTURES /J OVER 20 ADDRESS RESIDENTIAL APPLIANCES CITY TEL NO PERMIT RANGE DRYER_WTR HTR APPLICANT OCt714 AER STA COOK DISP _jelF A U ADDRESS SPACE HTR AIR COND CITY TEL NO CLOTHES WASH /DISHWASH LICENSE NO CLASS FAN 11" OTHER � IHEREBY ACKNOWLEDGE THAT 1 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 V IND HEATERS, ETC HP KW KVA ELECTRICAL WIRING ' SIZE & TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR O 0 - 1 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF (~j CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO I - 10 RESIDE IN, THE ABOVE DESCR1 0 RES EN IAL P PERTY y SIGNATURE ®\ 10 - 50 OF PERMITTEE 50 - 100 DISTRI CT NO CLASS ONE [,PROCESSED BY 100 - 500 / SIGN GAS SIGN AND ONE CIRCUIT NOTES TUBE, OR MARQUEE ADDITIONAL CIRCUITS SERVICE NOT OVER 600 VOLTS OR 200 AMP APPROVALS DATE INSPECTOR'S SIGNATURE SERVICEOVER600VOLTS OR200AMP TEMP POWER POLE ' TEMP SERVICE,POLE, &APPURTENANCES TEMP LIGHT OR RECEPT SYSTEM UNDERSLAB WORK ROUGH CONDIUT - -�� WIRING FIXTURES POWER AUTHORIZED PERMIT FEE (SUB TOTAL) UTILITY CO NOTIFIED PLAN CHECK FEE PERMIT ISSUING FEE FINAL � t? v TOTAL FEE PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION cK M 0 CASH 7 4'9 qt:T 18 2 1) 24-30 A�;8 WORKERS'COMPENSATION DECLARATION 76- 10/81 APPLICATION FOR ELECTRICAL PERMIT "�.�I.fiereby affirm th'�t I haves a,certificate otrconsent to self insure, CE-806G vG or.9 ciprtificate'6f Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec 3800 Lab C) , Policy No Company -FOR APPLICANT TO FILL IN JOB ` ❑ Certified co Is hereby furnished EACH NO FEE ADDRESS copy Y New Residential Bldgs &Pools �❑ 1 & 2-Family,Sq Ft $ _ $ LOCALITY Certified copy is filed with the county buildinginspection department ° Multi-family Sq Ft NEAREST CROSS ST •/'e n ) Date Applicant Residential Swimming Pools OWNER OR FIRM NAME i S14<1911V CERTIFICATE OF EXEMPTION FROM WORKERS � 1 MAIL Outlets Rec Light Sw ' ADDRESS s7 - ' - COMPENSATION INSURANCE �+ ' (This section need not be completed If the work Involved by the First 20 permit is for one hundred dollars($100)or less) Total No Additional CITY CCK / Tel No 21 �SQ I certify that in the performance of the work for which this'permit PLAN CHECK APPLICANT is issued, I shall not employ any-person in any manner so as to become subject to the Workers'Compensation Laws Lighting Fixtures, First 20" ADDRESS I /qAdditional Total No CITY No Date 3U h, Applicant� Fixed Appliances Not Over 1 HP, PERMIT NOTICE TO APPLICANT If, after making thist-Certificate of, APPLICANT Exemption,you should become subject to the Workers'Compensation Range_ Heater_ DW provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer _ W M _ ADDRESS provisions or this permit shall be deemed revoked Top — FAU _ WH _ CITY Tel No Hood Fan Other_ LICENSED CONTRACTORS DECLARATION chereby affirm that I,am licensed under provisions of Chapter 9 Disp — Room Air Cond LICENSE BE R Class ommencing with Section 7000) of Division 3 of the Business and REG NUMBE Pofessions Code,and my license is in full force and effect Power Apparatus& Large Appliances DISTRICT NO �} PROC ED BY Size& Type HP,KW,KVA,or KVAR v Lic nse Number Lic Class Up to 1 Incl FINAL \` Over 1 to 10 Incl DATEm—/,V 0 LIDATION I= Contactor Date, Over 10 to 50 Incl FINAL 284 5 7 A W ❑ �l am exempt under Sec Over 50 to 100 Inc BY f B&P C for this reason Over 100 ' # 0 0 0 0 0 2 N Services,Swbd,MCC& Panelboards Date f o o24,00 ems 0- 200 Amp Under 600 V t _ Si nature 201 - 1000 Amp Under 600 V = ❑ g Over 1000 Amp or Over 600 V o 0 0 2 a.,O 0 C5 Lemption for Reg Maint Elect ! .>, I 1,30-r87 SINGLE FAMILY Temp Power Pole& Appurtenances I j HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ' I hereby affirm that I am exempt from the Contractors License Law Additional Sign Branch Circuits for the following,reason(Section 7031 5,Business and Professions Code) t 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 I certify that I have read this application and state that the above TOTAL FEE 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 purposes • SEE REVERSE FOR EXPLANATORY LANGUAGE r r. YPda6� G lure of Permittee Date WORKER S COMPENSATION DECLARATION DPW(12 91) APPLICATION FOR ELECTRICAL PERMIT LI 76A663 I hereby affirm that I have a certificate of consent to self Insure, 76A663 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 JOB ADDRESS ` �j ✓� Certified copy is hereby furnished New Residential Bldgs &Pools NO EACH FEE ❑ 57 � _ $ $ LOCALITY Certified copy is filed with the county building inspection 1 &2-Family Sq Ft NEAREST department Multifamily Sq Ft CROSS ST DateApplicant Residential Swimming Pools ASSESSOR f r� MAP BOOK �J PAGE PARCEL Ott9' CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER OR „ COMPENSATION INSURANCE Outlets Rec _Light Sw FIPM NAME A l First 20 MAIL c 404 (Thissection need not be completed if the work Involved by the Total No Additional ADDRESS �J J(z permit is for one hundred dollars($100)or less) I certify that in the performance of the work for which this permit CITY Tel Non� ps�� is issued, I shall not employ any person in any manner so as to become�blec to the Workers Compensation Laws Lighting Fixtures First 20 APPLICANT K Total No Additional �� ADDRESS Date Applicant NOTICE TOA PLICANT If after m RESIDENTIAL APPLIANCES NOT OVER 3 HP ing this Certificate of CITY Tel No Exemption,you should become sublect,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 S �r �U� G 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 S 7 Professions Code, and my license is in full force and effect Over 10 to 50 Incl Over 50 to 100 Incl LICENSE �.. REG NUMBER Class k,� d Over 100 DISTRICT NO PROCESSED BY O License Number � Lic Class 6 V Services,Swbd,MCC&PanelboardsFINALv Contractor a J Date 0-399 Amp Under 600 V DATE r/Q O ❑ 400 1000 Amp Under 600 V �•• 4p�3VALIDATION V I am exempt under Sec Over 1000 Amp or Over 600 V FINAL // W B&P C for this reason BRANCH CIRCUIT FEES BY N / � Date 15A,or 20A, 120V Lighting or Recept Z 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits Exemption for Reg Maint Elect 15A,20A,208V To 277V Lighting Br Circuits 2 SINGLE FAMILY Temp Power Pole&Appurtenances iT.0 s HOME OWNER BUILDER DECLARATION ` C(-t` °0 th C B with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law Sign �il.)tr � E for the following reason (Section 7031 5, Business and Professions Additional Sign Branch Circuits —,31° Code) T��1� ❑ 1,as owner of the property,will do the work and the structure Misc Conduits&Conductors TOTAL f1=L � is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) and Professions Code) CHECK 1.C15 CONSTRUCTION LENDING AGENCY f..kn'ldUE °Ute I hereby affirm that there is a construction lending agency for the performance ofthe work for which this permit is issued (Sec 3097, PERMIT FEE (Sub-Total) Civ C) PLAN CHECKING FEE _ 0,900-0001 51 3/9—L Lender s Name �ca� 1-21.12 PERMIT ISSUING FEE Lender s Address I certify that I have read this application and under penalty of purlury 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 Count en r on the abpropertyfor ins tion purposesSEE REVERSE FOR EXPLANATORY LANGUAGE 3 toe- .2MNATWE OF PERMI DATE