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Home My Public Portal About4924 ENCINITA AVE_Electrical__ 7BA663-CE806 468 APPLICATION FOR ELECTRICAL PERMI Vr COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER FBUILDING BUILDING AND SAFETY DIVISION SS JOHN A LAMBIE. COUNTY ENGINEER y' COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDINGITY ST FOR APPLICANT TO FILL IN ST NO EACH FEE _ $ S RECEIPT OWNER Op f 1 O dC� llv/i� / _ MAIL 7 LIGHT TOTAL FIRST 20 20 ADDRESS J41 SWITCH_ OVER 20 10 CITY TEL NO PLAN CHECK LIGHTING �TOTALFIRST 20 20 APPLICANT FIXTURES OVER 20 10 ADDRESS RANGE=DRYER_WTR HTR CITY TEL NO STA COOK_DISP F A U COPJTRAC SPACE HTR AIR COND ADDRESS 'J ;Z CLOTHES WASH _DISHWASH CITY , TEL NO FAN-OTHER 1 001 LICENSE IJO CLASS MOTORS TRANSFORMERS RATING IND HEATERS ETC HP KW KVA I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION SIZE & TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING 0 - 1 1 00 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 1 - 10 3 00 LICENSED AS RED IRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO 10 - 50 5 00 RESIDE IN, THE AV DESCRIFED RESIDENTIAL PROPERTY SIGNATURE >" CL 50 - 100 10 00 OF PERMITTEE i O 100 - 500 15 00 U DISTFICT G O NEP D SIGN ANo SIGN GAS D ONE CIRCUIT 3 00 H TUBE OR U MARQUEE ADDITIONAL CIRCUITS 1 00 NOTES CL SERVICE NOT OVER,600 VOLTS OR 200 AMP 2 00 SERVICE OVER 600 VOLTS OR 200 AMP 5 00 TEMP SERVICE POLE & APPURTENANCES 3 00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP POWER POLE UNDERSLAB WORK ROUGH CONDUIT PERMIT FEE (SUB TOTAL) WIRING = PLAN CHECK FEE (507 PERMIT FEE) FIXTURES POWER AUTHORIZED PERMIT ISSUING FEE 200 UTILITY CO NOTIFIED -46 SUPPLEMENTARY PERMIT ISSUING FEE 1 00 FINAL TOTAL FEE JOSEPH C ROOHAN SUPERVISING ELECTRICAL ENGINEER _PLAN CHECK VALIDATION _CK —M o CASH PERMIT VALIDATION CK M o ASH r� o 9 s 2 JUL16 2 D 5 0- SEE BACK 0F APPLICATION FOR COMPLETE FEE SCHEDULE �C/ �L � 76A663-CES06 468 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT BU LDING AND SAFETY DIV DIVISION BUILDING 4824 Enci n i to Ave. JOHN A LAMBIE, COUNTY ENGINEER ADDRESS COLEMAN W JENKINS, SUPERINTENDENT OF BUILDING LOCALITY Temple City FOR APPLICANT TO FILL IN NEAREST Lower Azuza & Live Oa CROSS ST NO EACH FEE 2 $ $ OWNER Tools & Production RECEPT MAIL LIGHTTOTAL FIRST 20 20 ADDRESS 4924 Enci ni to Ave. SWITCH_ 20 OVER 20 10 CITY Temple CI ty TEL NO'' 2$6-9031 PLAN CHECK LIGHTING �TOTALI FIRST 20 20 APPLICANT FIXTURES OVER 20 10 ADDRESS RANGE—DRYER_WTR HTR _ CITY TEL NO STA COOK_DISP F A U _ CONTRAC rOR Y J M Kel 1 Electric Co. SPACE HTR AIR COND ADDRESS 3944 W. Slauson Avenue CLOTHES WASH _DISHWASH _ CITY LOS Angeles 90041L NO 295-6396 FAN—OTHER 1 00 LICENSE IJO 152 CLASS CIO MOTORS TRANSFORMERS RATING IND HEATERS ETC HP KW KVA I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION SIZE & TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING o - 1 1 OD 7 00 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 15 1 - 10 ` 3 00 45 00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY Ar{D STATE OF CALIFORNIA OR T!�=� PED' , AND- TEND.TO 10 - 50 5 00 RESIDE IN, THTIAL RTY SIGNATUREd50, - 100 10 00 OF PERMITTEO U 100 - 500 15 00 T T/�N �PNE OC SED Y O TUBE OR SIGN AND ONE CIRCUIT 3 00 •O U MARQUEE LLj ADDITIONAL CIRCUITS 1 00 D_ NOTES GO Z SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00 SERVICE OVER 600 VOLTS OR 200 AMP 5 00 TEMP SERVICE POLE & APPURTENANCES 3 00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP POWER POLE UNDERSLAB WORK ROUGH CONDUIT PERMIT FEE (SUB TOTAL) WIRING PLAN CHECK FEE (507 PERMIT FEE) FIXTURES POWER AUTHORIZED PERMIT ISSUING FEE 2 001 1 UTILITY CO NOTIFIED Q SUPPLEMENTARY PERMIT ISSUING FEE 1 00 FINAL -� TOTAL FEE 58 OO JOSEPH C ROOHAN SUPERVISING ELECTRICAL ENGINEER PLAN CHECK VALIDATION CK , .M o CASH I PERMIT VALIDATION CCK M o CASH a j I_A '_ 2 3 6 4 UG!23 2 D 5 8.00, $EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE �Paee3-CE806 4=68 APPLICATION FOR ELECTRICAL P RMIT COUNTY OF LOS ANGELES ' DEPARTMENT OF COUNTY ENGINEER4NEAREST UILDING BOILDING AND SAFETY DIVISION DDRESS JOHN A LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF B 1LL6OCALITY -- _ c cF_OR APPLICANT TO FILL IN ROSS ST l< ,] Oar NO AC FEE RECEPT73-b $ $ OAWNER '1 MIL L I G H T"ITAL FIRST 20 20 ADDRESS y ENC// I /7)g (J SWITCH_ OVER 20 ! 10 CITY/ TEL NO b PLAN CHE K LIGHTING TOTAL FIRST 20 ;�b 20 oa APPLICANT FIXTURES -AD— OVER 20 Oti 10 _lgjuV ADDRESS RANGE—DRYER_WTR HTR CITY TEL NO STA COOK_DISP _F A U _ CONTRAC FOR SPACE HTR AIR CONDr , ' ADDRESS W CLOTHES WASH —DISHWASH CITY TEL NO - FAN—OTHER 1 00 LICENSE IJO (p CLASS MOTORS TRANSFORMERS RATING IND HEATERS ETC HP KW KVA 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION SIZE-& TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING 0 - 1 1 00 ELECTRICAL WIRING I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 1 - 10 3 00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO 10 - 50 5 00 RESIDE IN, THEA OVE DESCRIPED RESIDE NT;I�PROP 50 - 100 10 00 SIGNATURE O_ OF PERMITTEE O U 100 - 500 15 00 0ISTRJC7FpjGrUPj ZONE 1PROCES,S BY O TUBE OR SIGN AND ONE CIRCUIT 3 00 U MARQUEE ADDITIONAL CIRCUITS 1 00 NOT ;S / C 7 N SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00 Z SERVICE OVER 600 VOLTS OR 200 AMP 5 00 r TEMP SERVICE POLE &APPURTENANCES 3 00 APPROVALS ATE INSPECTOR'S SIGNATURE TEMP POWER POLE UNDERSLAB WORK ROUGH CONDUIT J PERMIT FEE (SUB TOTAL) WIRING PLAN CHECK FEE (507 PERMIT FEE) FIXTURES POWER AUTHORIZED PERMIT ISSUING FEE 2 00 UTILITY CONOTIFIED / SUPPLEMENTARY PERMIT ISSUING FEE 1 00 FINAL TOTAL FEE 1 5 JOSEPH C OOHAN IIIIIIIIIIIIIIIIIIN SUPERVISINGLE CAL ENGINEER PLAN CHECK VALIDATION CK M 0 CASH -PERMIT VALIDATION cK M O CASH t r 1 ,5 -9 71 AUG 2 0 2 D r 1 8.5 0- N SEE BACK OF APPLICATION FOR COMPLETE.FEE SCHEDULE _ ti WORKERS COMPENSATION DECLARATION 76-663 10/61° CE-606G APPLICATION FOR ELECTRICAL PERMIT 1'1 hereby affirm that I have a certificate of consent to self insure, or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec 3800 Lab C) I fl .LfL F:: /LA )Q FOR APPLICANT TO FILL IN JOB Policy No Company ❑ Certified copy is hereby furnished I New Residential Bldgs & Pools EACH NO FEE ADDRESS $ — $ LOCALITY r Certified copy is filed with the county budding inspection 1 & 2-Family Sq Ft — e art ent Multifamily Sq Ft NEAREST t Residential Swimming Pools CROSSSTfd Applicant 1A, Tri', e �. OWNER O 1`�ti } t r •' FIRM NAME L C RTI KATE OF EXEMPTION FROM WORKERS -�- MAIL COMPENSATION INSURANCE Outlets Light Light Sw ADDRESS (This section need not be completed if the work Involved,by the First 20 y ," J� �� CIT Tel No 717 permit Is for one hundred dollars($100) or less) Total No Additional I certify that in the performance of the work for which this permit PLAN CHECK is issued, I shall not employ any person in any manner so as to APPLICANT become subject to the Workers Compensation Laws Lighting Fixtures First 20 ADDRESS ,r Total No ' Additional CITY Tel No Date Applicant Fixed Appliances Not Over 1 HP ' NOTICE TO APPLICANT If, after making this Certificate of PERMIT Exemption,you should become subject to the Workers'Compensation Range= Heater_ DW APPLICANT C I provisions of,the Labor Code,you must forthwith comply with such Oven Dryer W M ADDRESS' r provisions or this permit shall be deemed revoked Top FAU W H ` LICENSED CONTRACTORS DECLARATION Hood Fan Other_ CITY Tel No I hereby 4affirm that I am licensed under provisions of Chapter 9 Disp Room Air Cond LICENSE O (commencing with Section 7000) of Division 3 of the°Business and , REG NUMBER 725�5d g Class Professions Code,and'my license is in full force and effect DISTRICT NO PROE ED BY Power Apparatus& Large Appliances Size & Type HP, KW,KVA,or KVAR License Number Lic Clas D Up to 1 Incl FINAL �-- 8 Over 1 to 10 Incl DAT&W 0 U� rQ Date !l/iVV VALIDATION Contractor- Over 10 to 50 Incl FIN I am exempt under Sec Over 50 to 100 Inc g ;� W B&PC for this reason Over 100 Q. Services, Swbd,MCC& Pane lboards N Date0- 200 Amp Under 600 V Poo. ;2 9 3 Q,6-A Signature 201 - 1000 Amp Under 600 V # 0,0'0 o so '2 Over 1000 Amp or Over 600 V ❑ Exemption for Reg'Maint Elect - I -o,o 2,7,5 0 SINGLE FAMILY Tem Power Pole& Appurtenances S HOME OWNER-BUILDER DECLARATION p' o ° ° 2 Z 5 v Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law () 0 8- 8 8 for the following reason (Section 7031 5,Businessland Professions Additional Sign Branch Circuits Code) ❑ I,as owner of the property,will do the work and the structure Misc Conduits & Conductors s 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) - % 1 t, Lender's Name PLAN CHECKING FEE' , �� • PERMIT ISSUING FEE Ic Lender's Address � I certify that I have read this application and state that the above TOTAL FEE 1SZ 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 ov mentioned Agiojnatuper sp�rti po ssp�rti po s SEE REVERSE FOR EXPLANATORY LANGUAGE _ reof rmi ee ate