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Home My Public Portal About4942 ENCINITA AVE_Electrical__ 76A663-CE80612-65 APPLICATION FOR ELE TRICAL WRMIT COUNTY OF LOS ANGELES DENG BPRTMENT OF COUNTY LDING AND SAFETY DIVISION ADDRESS UISS 4942 N. Encinita JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING, LOCALITY Temple City NEAREST FOR APPLICANT TO FILL IN CROSS ST. RECEPT. 1 TOTAL No. EACH FEE" I OUTLETS $ $ OWNER Frei htcon Inc.LIGHT ll2'j i FIRST 20 - 2 -20 MAIL SWITCHADD'L I 10 ADDRESS dame OVER 20 TOTAL FIRST 20I .20 CITY TEL.NO. S - LIGHTING FIXTURES OVER 20 •10 CONTRACTOR Talbott Electric, RANGES DRYERS WTR.HTRS. 1.00 ADDRESS 1887 E. Washington GARB.DISP. STA.COOK CITY Pasadena TEL. N0798-1105 DISHWASH. AUTO.-WASH. STATE 186541 SPACE HTRS. STA. APPL. .50 LICENSE NO. MOTORS: OVER NOT OVER H.P. DISTRICT O. _UP ZONE PRQCES BY O 1 2'-. 1.00 ��..JJ 1 3 1.50 INSPECTION RECORD 0 3 8 2.00 u 8 15 2.50 ix O IS 50 3.00 V W 50 100 5.00 0. N z NO.TRANS SIGNS: NO.LAMPS _„�� Nc� /.�'•�' SERVICE 0.60OV-NOT OVER 200A 1.00 SERVICE 0-60OV-OVER 200 A. 2.00 SERVICE OVER 600V 5.00 w OTHER (SEE COMPLETE FEE SCHEDULE) PERMIT ISSUING FEE 2.00 SUPPLEMENTARY PERMIT ISSUING FEE 1.00 APPROVALS DATE INSPECTOR'S SIGNATURE TOTAL FEE 8 .8 UNDERS LAB WORK I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ROUGH CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING � ELECTRICAL WIRING. WIRING �4�` 2 ; ✓� � I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS RECUIR BY LOS ANGELES CO NTY AND STATE OF CALIFORNIA OR THAI A LEGAL OWN OF, N INTEND TO ER RESIDE IN,THE ABO E DE RI ED RESIDE AL O SIGNATURE I UTILITY CO.NOTIFIED OF PERMITTEE e A r �C. FINAL V MO CASH LIDATION JOSEPH C. RO HAN SUPERVISING ELECTRICAL ENGINEER CK l %O.8 4 0 2 tl,AY 5 2 0 8.8 0 t�r� WORKER'S COMPENSATION DECLARATION 20-0019 DPW(t2-9t) 76A663 APLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self insure, %W1 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 • ;[`9 C /� - _ 1 i•�;,t ❑ ADDRESS T 9 E(V dt,/ A Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE$ $Ft Sq. . LOCALITY ❑ _ Certified copy is filed with the county building inspection 1 &2-Family, NEAREST y� department. Multi-family Sq.Ft. CROSS ST. �d'VV[� L;ri Date Applicant Residential Swimming Pools ASSESSOR MAP BOOK PAGE PARCEL OR CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec._Light Sw. FFIIRM NAME GtJ COMPENSATION INSURANCE First 20 (This section need not be completed if the work involved by the ADDRESS S;/4 Al 15 permit is for one hundred dollars(5100)or less.) Total No. Additional ' n I certify that in the performance of the work for which this permit CITY % r Tel.No. - , C. is issued, I shall not employ any person in any manner so as to PLAN CHECK become subject to the Workers' Compensatio aws. Lighting Fixtures First 20 APPLICANT O�L Total No. Additional ADDRESS ��`< r�e Date .. Applicant '� RESIDENTIAL APPLIANCES NOT OVER 3 HP. �7 NOTICE TO APPLICANT: If, after making this Certificate f CITY/q f& Tel. Exemption,you should become subject to the Workers'Compensatio OTHER APPLIANCES NOT OVER 3 HP. 777 provisions of the Labor Code, you must forthwith comply with such PERMIT p y Power Apparatus&Large Appliances APPLICANT provisions or this permit shall be deemed revoked. LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS 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 Tel.No. Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. LICENSE OR p // �+ Over 50 to 100 Incl. REG.NUMBER �/J��a� Clas ® CL /t 1 cZ �•',_ J%� Over 100 DISTRICT NO. R ESSED BY 0 License Number U ! / Lic.Class� 0 S. S6��& n o d �fcc ,( r�(( 0 1D(j FINAL Contractor ACKCY �+d . Date �—J a V 7 / 99 mp. MOO DATE 0 ❑ I am exempt under Sec. 400-1000 Amp.Under 600 V —L VALIDATION V Over 1000 Amp.or Over 600 V FINAL W B.&P.C.for this reason BRANCH CIRCUIT FEES BY fn Date: 15A,or 20A, 120V,Lighting or Recept. Z_ 1 To 10 Branch Circuits Signature '11 To 40 Branch Circuits El 41 Or More Branch Circuits Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits _ SINGLE FAMILYTemp.Power Pole&Appurtenancest-�T:z HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit _–, �c 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): s {TI-!T.J ❑ I, as owner of theproperty,will do the work and the structure Misc.Conduits&Conductors �r �.SMg is not intended orof eyred for sale (Section 7044, Business Other(See Complete Fee Schedule) 3 i -= and Professions Code). CHECK a4.3 CONSTRUCTION LENDING AGENCY s.; ; 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 O —"2 ir PERMIT ISSUING FEE V �i r. , Lender's Address I 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 represe tatives of this Co ty to enter upon the above-mentioned property f ctio purposes. �j� �> SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATU OF PERMITTEE DATE 7EA60ECE90610-59 APPLICATION FOR ELECT C PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION ADDRESS 9N art��.-' - JOHN A. LAMBIE. COUNTY ENGINEER WILLIAM A JENSEN SUP T OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST PERMIT FEES CROSS ST J OWNER ITEM NUMBER EACH FEE MAIL OUTLET q $ $ ADDRESS LIGHTS RECEPTD�-� SW �� ® 10 !i LIGHTING FIXTURES t0 CITY TEL NO ELEC RANGES CLO DRYERS ELECTRICIAN /� _ WATER HEATERS 50 ADDRESS Alk,;-,L �7�G.. ELEC SPACE HTRS DISHWASHERS CITY TEL NO GARBAGE DISPOSERS AUTO- STA WASHERS STA COOKING UNITS 25 LICENSE SE NO MOTORS OVER INC H P DISTRICT GR UP ZONE P O O— 1/2 25 a p2 1/2— 2 50 INSPECTION CORD 2— 5 100 /0AA, 5— 15 ISO N 15— 50 250 50-200 Soo SIGNS NO TRANS 1t NO LAMPS SERVICE 0-600V 100 0_6 SERVICE OVER 600V 500 MISC WIRING PERMIT Too FIXTURE PERMIT 100 SUPPLEMENTARY PERMIT 50 TOTAL FEE SID 46 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT ELECTRICAL WIRING 1 HEREBY CERTIFY THAT 1 AM 'PROPERLY REGISTERED AND/OR WIRING LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE - DESCRIBED RESIDENTIAL PROF E T POWER SIGNATURE UTILITYCO NOTIFIED •�� `"�'`�" OF PERMITTElllmsalmm�12111101 FINA 'G LSA OF ATION ARTHUR C VEIT, cK Mo CASH SUPERVISING ELECTRICAL ENGINEER L r'y'a 6 0 5 9 CEP '� 2 D 1 Q .4 0tn � f WORKERS'COMPENSATION DECLARATION CE 806G (2-80) APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES 7—� C, BUILDING AND SAFETY insure, or a certificate of Workers'Compensation Insurance,or Ja certified copy thereof(Sec. 3800,Lab.C.) FOR APPLICANT TO FILL IN JOBPolicy No. Company EACH NO. FEE ADDRESSNew Residential Bldgs.&Poolso Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ — $ LOCALITYMulti-family Sq. Ft.Residential Swimming Pools — NEAREST Certified copy is filed with the county building inspection CROSS ST- department. OWNER OR r_ ;]_C r^ Date Applicant Outlets: Rec.—Light—Sw. ADDRESS �Z //1/ /¢ First 20 CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY - - COMPENSATION INSURANCE PLAN CHECK APPLICANT O (This section need not be completed if the work involved Lighting Fixtures First by the permit is for one hundred dollars ($100) or less.) AdditionalTotal No. � I certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No. permit is issued, I shall not employ any person in any manner PERMIT / � so as to become subject to the-Workers' Compensation Laws. Range_ Heater- D.W. APPLICANT Q6 J— a _ y %� /(7 h/U SQA/��` r�� rK� . z / Oven Dryer_W.M._ ADDRESS � rNOTICE ates ` LU4_d licant — - Top _ FAU _W.H..pp i� Hood _ Fan _Other_ CITYg�� 1/ b. Tel No. �33�'- fRY TO APPLICANT: If,'after makin his Certificate of Disp. _ Room Air Cond, LICENSE ORxemption, you should become subject to the Workers' REG. N U M B E Class Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO. PROCESSED BY with comply with such provisions or this permit shall be �f Size&•Type HP, KW, KVA,or KVAR deemed revoked. SK a Up to 1 Incl. FINAL RIO Over 1 to 10 Incl. DATE ��+/QY LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl. VALIDATION I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inca FINAL . BY/ 9 (commencing with Section 7000) of Division 3 of the Busi- Over 100 ness and Professions_Code, and my license is in full force and effect. Services S ff,, �' - G i. n 0-200 Amp. Under 600 V License Num er �WY" " Lic.Class g j�, 201-1000 Amp. Under 600 V �,-�.y Contracto 4,el l 7rc Date_Sr LCi Over 1000 Amp.or Over 600 V /VIP� HOME OWNER-BUILDER DECLARATION Temp. Power Pole&Appurtenances Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's Additional Sign Branch Circuits License Law for the following reason (Section 7031.5, Busi- ness and Professions Code): Misc.Conduits&Conductors I, as owner of the property, will do the work-and the Other (See Complete Fee Schedule)— ;2 5 3 3,5 A structure is not intended or offered for sale (Section 7044, Business and Professions Code). # 0,0 0 o o 2 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency 2 ° o 1 9,5 0 for the performance of the work for which this permit is PERMIT FEE (Sub-Total) issued (Sec. 3097,Civ.C.). - o 0 0 1 9.5 d Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) Lender's Address PERMIT ISSUING FEE 05.2,0-81 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 the abo a entionedproperty for' spection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE Signature of ermittee Date `