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Home My Public Portal About5627 ENCINITA AVE_Electrical__ 76A6616:E 0068 4./77 �\ F 1 , �. . COUNTYAPPLICATION FOR ELECTRICAL PEWfl OF LOS ANGELESOB DEPARTMENT OF COUNTY ENGINEER ADDRESS �.^ /"/ �'- BUILDING AND SAFETY DIV ISION FOR APPLICANTTO FILL IN LOCALITY C New Residential Bldgs.&Pools EACH NO. FEE NEAREST 1 &2 Family,Sq. Ft. $ .025 — $ CROSS ST. Multifamily Sq. R. .02 — OWNEROR FIRM NAME G Residential Swimming Pools25.00 MAIL C_ ``)) Outlets:Rec Liht— (P g —SW. CITY' TeL No,,?,p6 O First 20 -50 PLAN CHECK Total No.— Additional .30 APPLICANT ADDRESS Lighting Fixtures First 20 .50 CITY Tel. No. Additional .30 PERMIT Total No. APPLICANT Fixed Appliances Not Over I HP ADDRESS Range—theater—D.W.— CITY TeL No. Oven _Dryer_W.M._ LICENSE OR Top —FAU —W.H.— REG.NUMBER Class. Hood_Fan _Other_ HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE Disp. ROOM Air COnd. 2'50 THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDIN. ANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. Power Apparatus&Large Appliances Size&Type HP, KW, KVA,Or KVAR I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BV 5 ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM T Up to t Incl. 2.50 THE LEGAeDw OFTHEABOVEDESCRIBED RESIDENTIAL PROPERTY. Over 1 to 10 Incl. 5.00 c Over 12.50 PERMITTEE o ver 10 to 501n SIGNATURE Over 50 t0 100 Inc 25.00 v Over 100 40.00 DISTRICT NO. ^ P ED BY H � FO67 z Services *° 0-200 Amp.Under 600 V 12.50 INS CTOR'S 201000 Amp.Under 600 V 1 25.00 APPROVALS DATE SI ATURE Over 1000 Amp.or Over 600 V 50.00 TEMP. POWER POLE UNDERSLAB WORK Temp. Power Pole&Appurtenances 10.00 Sign with One Branch Circuit 10.00 ROUGH CONDUIT Additional Sign Branch Circuits 2.00 1 1 1 WIRING A� Misc.Conduits&Conductors 10.00 FIXTURES Other(See Complete Fee Schedulei POWER AUTHORIZED UTILITY CO.NOTIFIED FINAL 7��/J /.C�//L• ,!!^/ PERMIT FEE (Sub-Totall NOTES PLAN CHECKING FEE (One Fourth Permit Feel PERMIT ISSUING FEE $7.00 TOTAL FEE PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION, CK, m.0. CASH 884nJUN 9 "20 D 36.80n SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE V/ COUNTY OF LDS ANGELES APPLICATION FOR PERMIT Dof County Engineer DIVISIONSION OFF BUILDING & SAFETY (�` WILLIAM J. FDX. County Engineer FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. n S AN ELECTRICIAN G 1't�'f' ? ✓J ��.F'vH — �.-� RECEIVED—BY READY FOR DATE SUED ADDRESS U !J � �U/�N FIRST INSPECTIONI O �� CITY �JY/il//✓ TELNO. L� 1- COUNTY LICENSE NO. /,Z-C EXPIRES dlC J`l BUILDING PERMIT FEES AOD RESB —32 - /�G�J�q_�L NUMBER EACH FEE LOCALITY /-!'7- i3s, LIGHT OUTLETS NEAREST L/b'2 UA r RECEPTACLES CROSS ST._ WALL SWITCHES Aa _ OWNER -s—,Z,, � TOTAL OUTLETS 4'0 5e S ..ZS MAIL ELEC. RANGES 25 ry ADDRESS ELEC. HEATERS L 25 ✓---sem _ CITY TEL NO. FIXTURES 5 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS Misc. APPLICATION AND STATE THAT THE ABOVE 19 CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS rN6w ER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER MvO. HP .vER Is A LEBe �enezi OF TMC RESIDENTIAL PROPER/TY DESCRIBED ABOV . SIGNATURE OF �� p 2 .50 -- PERMITTE GGGKKKL 2 5 1.00 INSPECTION RECORD 5 15 l.so15 SO 2.50sG 200 5.00 200 500 10.00 J soo IGDo 15.00 a Z OVER 1000 20.00 M.O. SET/FRED. CHANGER-HP WELDERS•AC-KVA O GENERATORS - KW TRANSFORMERS - KVA _ TEMP. MOTORS (75% or ant..) MOVED MOTORS (75k OF ORI..) _ MISC. SIGNS NO. NO.TRANS. APPROVALS NO. NO. LAMPS FOR EACH PERMIT: DATR INSPECTOR•B NAME WIRING $1.00 sE-a CONDUIT w .1 FIXTURES $1.00 �-p WIRING %a 3 SUPPLEMENTARY .90 FIXTURES (� POWER TOTAL FEE s u2` Y on.NOTIFIED �� 0 /t"a FINAL 76A663 DBS#SA 2-53 URKERS'thCOMPENSATIONDECLARATION CE8� IDiBIAPPLICATION FOR ELECTRICAL PERMITm that I have a certificate of consent to self 'I ihsure, or q certificate of workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec. 3800, Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE ADDRE ❑ Certified copy is filed with the county building inspec- 18 2-Fomily, Sq. Ft. b — 4 LOCALITY tion department. Multi-familyNEAREST Sq. Ft. CROSS ST. (/ Residential Swimming Pools OWNER OR Dote Altai icon FIRM NA _ [l CERTIFICATE OF EXEMPTION FROM WORKERS' tA MAIL � COMPENSATION INSURANCE Outlets- Rec Light Sw. 40 ADDRESS a7 iyCf / First 20 W (This section need not be completed if the work involved by Total N / Additional CITY Tel. No. 7 the permit is for one hundred dollars ($100)or less.) I certif that in the performance of the work for which this PLAN CHECK Y P APPLICANT permit is issued, I shall not employ any person in any manner - so as to bec me ubject t tiers'Com a sation Laws. Lighting Fixtures First 20 ADDRESS Toyal No. —5-- Additional CITY Tel. No. Dat Applicaft Fixed Appliances Not Over 1 HP PERMIT �J'��qr NOTIC TO PPLIChoul If, after making this Certificate of APPLICA,—Z /4, L— (/ Exe lion, you should become subject to the Workers' Range_ Heater_D.W. Compensation provisions of the Labor Code, you must forth- Oven L Dryer W.M.— ADDRESS �N with comply with such provisions or this permit shall be Top FAU —W.her_ 1�� H. — deemed revoked. Hood Fan OW; CITY Tel. No.ZITZ�i"ZV _ 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. PROCESS d and Professions Code,and my license is in full force and effect. Power Apparatus 8 Large Appliances .�� !' 0 Size 8 Type HP, KW, KVA, or KVAR �J L U C,.) License Number Lic. Class Up to 1 Incl. FINAL 01 Contractor Date - Over I to 10 Incl. DATE �dD VALID ION Over 10 to 50 Incl, FIN W ❑ I am exempt under Sec. Over 50 to 100 Inc. Over 100 U).BP.C. Bfor this reason Z Date: Services, Swbd., MCC & Panelboords iJ D 0 -200 Am Under 600 V v Signature 201 - 1000 Amp. Under 600 V ❑ Over 1000 Amp. or Over 600 V L;RQ 2 a-7 Exemption for Reg. Mainz. Elect. iF a e& JLJ e'a SINGLE FAMILY Temp. Power Pole& Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ° -.- 62255 1 hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits Low for the following reason (Section 7031.5, Business and 325-86 Professions Code): I, as owner of the property, will do the work and the Misc: Conduits 8 Conductors ` structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ D 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) (Sec. 3097, Ci, C.). PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE r lender's Addres I certify that I have read this application and state that the TOTAL FEE above information is correct. I agree to comply with ail County ordinances and State laws regulating Electrical wiring, and reby authorize representatives of this County to enter upon t ave-mentiane property for inspection urpos s. SEE REVERSE FOR EXPLANATORY LANGUAGE i Signature of Permittee to