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Home My Public Portal About5942 ENCINITA AVE_Electrical__ 76A653A_CE606A 4/72 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES �( ley DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS LOCALITY NEAREST FOR APPLICANT .TO FILL IN CROSS ST. OUTLETS N0, EACH FEE OWNER S S RECEP T.=� MAIL FIRST 20 ADDRESS LIGHT_ TOTAL OVER 20 CITY TEL. SWITCH ` PLAN CHECK LIGHTING 1 FIRST 20 APPLICANT —` J TOTAL FI%TURES OVER 20 ADDRESS RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT J RANGE_ORYER WTR. HTR._ APPLICANT (iy 0/< l lll• lZ 4.> STA. COOK OISP. F.A.U._ ADDRESSSS^ SPACE HTR. AIR CON O. CITY /yy TEL. NO. s CLOTHES WASH. 01 SHWASH._ LICENSE N0. J CLASS.,'-/p FAN_OTHERL+/T I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION J✓ AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY Q MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING V IND, HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. S1ZE 5 TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED PND/OR 0 - 1 LICE NSEDAS REOUIRED By LOS ANGELES COUNTY AND STATE OF V CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO 1 - 10 RESIDE IN, TXE VE OESCRIP.EO RESIDENTIAL Pfl OPE RT Y. y Z SIGNATURE -9.. 70 - 50 OF PERMITTEE 50 - 100 DISTRICTNO. CLASS ZOf� P CES 5 0 BT , 100 - SOD s-08 J SIGN, GAS SIGN AND ONE CIRCUIT NOTES$. //-7 off L Q TUBE, OR MARQUEE ADDITIONAL CIRCUITS SERVICE NOTOVER 600 VOLTS OR 200 AMP SERVI CEOVER 600 VOLTS OR 200 AMP APPROVALS DATE INSPECTOR'S SIGNATURE TEMP. POWER POLE TEMPSERVICE, POLE, &APPURTENANCES UNDERSLAS WORK TEMP LIGHT OR REC EPT. SYSTEM ROUGH CONDIUT WIRING 71 d7` FIXTURES POWER AUTHORIZED /< PERMIT FEE (SUB TOTAL) 11 UTILITY CO. NOTIFIED PLAN CHECK FEE FINAL / PERMIT ISSUING FEE TOTAL FEE PLAN CHECK VALIDATION CK. M.D. CASH PERMIT VALIDATION CK. M.D. CASH 9 7 4,:MAR � 2 R 1 0.5 0 e% WORKERS'COMPENSATION DECLARATION APPLICATION FOR ELECTRICAL PERMIT CEBO6 (2801 � I hereby affirm that I have a certificate of-consent to self COUNTY OF LOS ANGELES' BUILDING AND SAFETY insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800,Lab.C.) FOR APPLICANT TO FILL IN JOB �' 2 f ✓�J!}r��-7^j, Policy No. Company EACH NO. FEE ADDRESS J7 New Residential Bldgs. &Pools ❑ Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. S — S LOCALITY - Multi-family Sq. Ft. — NEAREST ❑ Certified copy is filed with the county building inspection CROSS ST Residential Swimming Pools depar me t. OWNER OR , ->l, / .7 ,/1. ,f /•fJ/, r,¢, FIRM NAME - .> -Date /•��/ Applicant �� "' Outlets: Rec._Lighi_ Sw._ MAIL �/j/;/ tl First 20 ADDRESS / I 0 CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY 7f{'/ 1C- U 'Tel No. COMPENSATION INSURANCE W PLAN CHECK ...1 APPLICANT (This section need not be completed if the work involved Lighting Fixtures First 20 LL by the permit is for one hundred dollars (SI00) or less) g g Additional ADDRESS ,} Total No. > I certify that in the performance of the work for which thisFixed Appliances Not Over 1 HP CITY Tel No. Q cc permit is issued, 1 shall not employ any person in any manner PERMIT in f�� L/ so as to become subject to the W9r ers' Compensation Laws. Range_ Heater—D.W. APPLICANT �,./G'� 0 ! a Oven _ Dryer_W.M. 'ADDRESS zj� lJJ Dale/' Applicant Top _ FAU _W.H.+J CITY ✓�L' L Tel Hood _ Fan _Other_ NOTICE TO APPLICANT: If, after making this Certificate of Disp. _ Room Air Cond._ LICENSE OR �Z�1✓J Exemption, you should become subject to the Workers' - REG. NUMBER Class Compensation provisions of the Labor Code, you must forth- Power Apparatus&.Large Appliances DISTRICT NQ. PROCESSED BY with comply with such provisions or this permit shall be 3 Size& Type HP, KW, KVA,or KVAR a .deemed revoked. � ' Up to 1 Incl. FINAL -ti{ LICENSED CONTRACTORS DECLARATION Over 1 to 10 lack DATE Over 10 to 50 Incl. �� / VALIDATION I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL ' 9 (commencing with Section 7000 of Division 3 of the Busi- By f ' ( B ) Over 100 ness and Professions.Code, and my license Win full force and ' effect. / Services , 2'��f✓,� .Class / 0400 Amp. Under 600 V License NumberLic f F � 000 Amp. Under 0 V Contractor ��Date /D '�' Over Over 1000 Amp.or Over 600 V HOME OWNER-BUILDER DECLARATION Temp.Power Pole& Appurtenances I hereby affirm that I -am exempt from the Contractor's Sign with One Branch Circuit ' License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits ness and Professions.Code): I Misc.Conduits& Conductors I �'jx,A � ❑ 1, as owner of the property, will do the work and the Other (See Complete Fee Schedule)- - structure is not intended or offered for sale (Section to' 7044, Business and Professions Code). r� CONSTRUCTION LENDING AGENCY ��o I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is Iri Ie��,f CffjLN ' issued (Sec. 3097.Civ.C.). PERMIT FEE (Sub-Total) i „ - , I R. Lender's Name PLAN CHECKING FEE (One-Fourth Permit Feel Lender's Address PERMIT ISSUING FEE oR I certify that 1 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 enterupon the`ayo/ve-mentioned property fotrins ction purposes. l SEE REVERSE FOR EXPLANATORY LANGUAGE `'� Signature of Permittee) Date WORKERS'COMPENSATION DECLARATION 63 CE 8O6G (2-60) APPLICATION - FOR ELECTRICAL PERMIT S1 CE- , LJ I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES - BUILDING AND SAFETY insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800,Lab.C.) FOR APPLICANT TO FILL IN SOB Policy No. Company EACH NO. FEE ADDRESS New Residential Bldgs. &Pools ❑ Certified copy is hereby furnished. , 1 & 2-Family,Sq. Ft. $ — $ LOCALITY Multi-family Sq. Ft. — NEAREST Certified cois filed with the county building inspection CROSS ST ❑ copy Residential Swimming Pools department. OWNER !J/Gj1�n FIRM NAM, /( // Date Ze2t& Applicant / - Outlets: Rec.—Light— Sw._ MAIL First 20, ADDRESS 77 �qf'��c'[/ CERTIFIC.ATE.OF EXEMPTION FR WOR ERS' Total No. Additional CITY �� `� (�., / e1 No. COMPENSATION INSURANCE . PLAN CHECK } APPLICANT 1 (This section'need not be completed if the work involved Lighting Fixtures First 20 ADDRESS OU by the permit is for one hundred deltas ($100) or less.) Additional Total No. 0 1 certifv that in the performance of the work for which this Fixed Appliances Not Over 1 HP !' CITY Tel No. permit is issued, 1 shall not employ any person in any manner PERMIT so as to become subject to the Workers Compensation Laws. Range_ Heater_D.W. APPLICANT �fG L/J L{/� W Oven _ Dryer_W.M._ ADDRESS �/� �G(J�'�j✓G�� z Date�'r7 A/Applicant Top — FAU W.H. CITY Tel No. 77 f�/T _ Hood — Fan — Other-NOTICE TO APPLICANT: If, after making this Certificate of Dista. _ Room Air Cond._ LICENSE OR s/ Exemptions you should become subject to the Workers' REG. NUMBER '/Z,40'7 lass 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 Size&Type HP,.,KW, KVA,or KVAR /��` deemed revoked. - Up to 1 Incl 71 NAL Over 1 to 10 Incl.- DATE LICENSED CONTRACTORS DECLARATION Over 10 to 50 lack �' BJ VALIDATION I hereby affirm-that,l am licensed under provisions of Chapter Over 50 to 100 Inc. - B NAL 9 (commencing with Section 7000) of Division 3 of the Bust- Over 100 ness and Professions.Code, and my license is in full force and / effect. Services ( �� / p.p License Number ,'2��/�� Lie. Class 0-200 Amp. Under 600 V E, V 201-1000 Amp;Under 600 V Contractor C-' j �Lf� Date /� Over 1000 Amp.or Over 600 V HOME OWNER-BUILDERDECLARATIONTemp. Power Pole& Appurtenances' - Sign with One Branch Circuit I hereby affirm that I am exempt from the,Contractor's License Law for the following reason (Section 7031.5, Busi- ness and Professions Code): - Jr IL 4_A Misc.Conduits&Conductors .. 1, as owner of the property. will do the work and'the Other (See Complete Fee Schedulel— ' structure is not intended or offered for sale (Section - 2 7044, Business and Professions Code). - - CONSTRUCTION LENDING AGENCY •2 o a 1 9.50 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is PERMIT FEE (Sub-Total) 9.5.0.m issued (Sec. 3097,Civ.C.). Lender's Name PLAN CHECKING FEE (One-Fourth Permit Feel ,I Q'� 4;�8•� Lender's Address PERMIT ISSUING FEE 0 I certify that 1 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 ab ve-mentioned property for'ns pec tion purposes. - SEE REVERSE FOR EXPLANATORY LANGUAGE 7 IP11S/ . Signature of Permittee 1360 WORKERS'COMPENSATION DECLARATION 76A(363 �Y-� � APPLICATION FOR ELECTRICAL PERMIT CE-806G (2 80) 1 hereby affirm that 1 have a certificate of consent to self COUNTY OF LOS ANGELES 7- C r BUILDING AND SAFETY insure, or a certificate of Workers'Compensation Insurance,or r a certified copy thereyf(Sec. 3800,Lab. C.) �(/NJl 06V 07f(Sec 2.v�/h/f)L�fl'�f/� FOR APPLICANT TO FILL IN JOB Policy No. Company " _ r�V�• EACH NO. FEE ADDRESS / •�/!// �� New Residential Bldgs. &Pools Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ — S LOCALITY L Certified co Multi-family Sq. Ft. — NEAREST copy is filed with the county building inspection CROSS ST L TV departResidential Swimming Pools men . OF RM NAME Date /Applicant Outlets'. Rec.1Liyht=J_1S5.2 w ADDRESS CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional _ CITY (,` Tel No. COMPENSATION INSURANCE PLAN CHECK a (This section need not be completed if the work involved S L APPLICANT / �^ b the permit is for one hundred dollars SI00 or less. Lighting Fixtures First io p` Y P ( ) ) S g ADDRESS ��. `iG./JiG 01!/LC Q Additional Total No. O I certify that in the performance of the work for which this Fixed Applianc s Not Over 1 HP CITY C G�� Tel No. �7/ C U permit is issued, I shall not emplov any person-in any manner PERMIT //,�,,�//�J - W so as to become subject.to the Workers' Compensation Laws. Range_ Heater_D.W. APPLICANT WiGL (r QW5 d Oven _ Dryer_W.M.— In ADDRESB �� CGU 0� �� Z Date Applicant Top _ FAU _W.H. Hood _ Fan _Other_ CITY 9.-�l_ Tel No2.�7/ V NOTICE TO APPLICANT: If, after making this Certificate of Disp. — Room Air Cond._ LICENSE OR Exemption, you should become subject to the Workers' REG. NUMBER Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO. PROC SED BY with comply with such provisions or this permit shall be deemed revoked. Size&Type HKVA,or KVAR U to r Up to 1 Incl. U FINAL 0 Over 1 to 10 Incl. DATE y7 LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl. Z — "�r VALIDATION I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL 9 (commencing with Section 7000 of Division 3 of the Busi- BY ( B ) Over 100 ness and Professions Code, and my license is in full force and effect. Services '7i'Gr) / �J— 0-200 Amp. Under 600 V o (J License Number Lic.Class ��1 J p ry ^I 201-1000 Amp. Under 0 V Contractor 5 Date / // /b Over 1000 Amp.or Over 600 V HOME OWNER-BUILDER DECLARATION Temp. Power pole& Appurtenances 1 hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits ness and Professions Code): Misc.Conduits&Conductors $ � 070 A 1, as owner of the property, will do the work and the Other (See Complete Fee Schedule)— structure is not intended or offered for sale (Section e e o e e `Z 7044, Business and Professions Code). ' CONSTRUCTION LENDING AGENCY 2 0 e •] Q Q I hereby affirm that there is-a construction lending agency for the performance of the work for which this permit is, PERMIT FEE (Sub-Total) - 0 0 0 �, Q issued (See. 3097.Civ.C.). Lender's Name _ PLAN CHECKING FEE (One-Fourth Permit Fee) 0 9.08-81 Lender's Address PERMIT ISSUING FEE I certify that 1 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 herebv authorize representatives of this County to enter upon theeb ve-mentioned property o inspection purposes. ryj SEE REVERSE FOR EXPLANATORY LANGUAGE t �sl bl Signature of Permits � ate - ,