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Home My Public Portal About6005 ENCINITA AVE_Electrical__ L . yyu�Qk$'COMPENSATION DECLARATION 01 76AWaPw3,9) ur ')0.0APPLICATION FOR ELECTRICAL PERMIT 3/3i�8� ]• Rre;y bffirm that I have a certificate of consent to self CE-8066 inse, or a•Eertificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certified copy thereof (Sec. 3800, Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN 'OB TT Certified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE ADDRESS D A ❑Certified copy is filed with the county building inspec- 18 2-Family, Sq. Ft. $ _ $ LOCALITY tion department. Multi-family Sq. Ft. NEAREST /1 c- Residential Swimming Pools CROSS ST. L-0S \4vnG. Date Applicant OWNER OR FIRM NAME ti G`CU CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec_Light_Sw._ MAIL COMPENSATION INSURANCE First 20 ADDRESS (This section need not be completed if the work involved by Total No. Additional CITY C� Tel. No. the permit is for one hundred dollars ($100)or less.) PLAN CHECK I certify that in the performance of the work for which this APPLICANT permit is issued, I shall not employ any person in any manner so as to became subject to the Workerstion ws. Lighting Fixtures First 20 ADDRESS Additional Date� —2� S'F Applicant Total No. CITY Tel. No. NOTICE TO APPLICANT: If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT Exemption, you should become subject to the Workers' Range— Heater—D.W. APPLICATION - Compensation provisions of the Labor Code, you must forth- Oven — Dryer —W.M._ ADDRESS C-7 with comply with such provisions or this permit shall be Top — FAU —W.H. deemed revoked. Hood — Fan Other_ CITY Tel. No. LICENSED CONTRACTORS DECLARATION LICENSE OR Disp. _ Room Air Cond. _ REG. NUMBER \,Oyu D Closs. I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NO. PROC SED B d and Professions Code,and my license is in full force and effect. ♦+,L yL�Q Size 8 Type HP, KW, KVA, or KVAR s O License Number " Lic. Class ( (� Up to 1 Incl. FINAL �f U "\),N ,Z- 2C�t So OC�_Z�_Sfb c Over I to 101ncl. DATE —�!! ALIDATION O Contractor 'A Date Over 10 to 50 Incl. C/ H ❑ I am exempt under Sec. Over 50 to 100 Inc. BY FINAL U B.BP.C. for this reason Over 100 9 9'4.6 A LU CL. Servi< s,tt Swbd.R MCCgg Ponelboards ,Z Z Dote: ISIff �21APoPomp.M Unaer 600 V D #',� s • s 2 Z Signature 201 - 1000 Amp. Under 600 V {) •,' 40 5 0 F] Exemption for Reg. Moint. Elect. Over 1000 Amp. or Over 600 V •,e 4 Q 5 0 U SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Temp. Power Pole 8 Appurtenances �2 f1 Sign with One Brooch Circuit 6 I hereby affirm that I am exempt from the Contractor's License -88 Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits 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 7044, Other (See Complete Fee Schedule)_ D 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, 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 I TOTAL FEE y 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 e-mentio ed property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE ' 'Signature of Permittee Date J APPLICATION FOR ELECTRICAL PERMIT • Q COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION AOO-DIN JOHN A.LAMBIE, COUNTY ENGINEER „ WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY. �. FOR APPLICANT TO FILL IN NEAREST I CROSS ST ' U�/ PERMIT FEES / OWNER ITEM NUMBER EACH FEE MAIL ��jj��,,11 ��,,//�� OUTLETS S $ ADDRESSVIVO w'C/ LIGHTS RECEPT. SW. IO � ry LIGHTING FIXTURES 10 / V CITY TE NO. W o ELEC. RANGES CLO. DRYERS ELECTRIC AN WATER HEATERS .50 ADDRESS //yy ELEC.SPACE HTRS. DISHWASHERS CITY TEL.NOLV ft GARBAGE DISPOSERS AUTO.. STATE WASHERS STA. COOKING UNITS .25 LICENSE NO. MOTORS: OVER INC. H.P. DIST�IC N G UP Z E C ED 0 — Vz .25 /' Q./ V� - 2 .50 INSPECTION RECORD 2 5 1.00 D}. 5 15 1.50 0 15 — so 2.50 a' O s0 0 200 5,00 zs-Gi r L / ii✓ w SIGNS: NO TRANS. n NO. LAMPS FQ CrI� /'AT/O Z SERVICE 0.600V 1,00 SERVICE OVER 600V 5.00 ° MISC. WIRING PERMIT 1.00 FIXTURE PERMIT 1,00 SUPPLEMENTARY PERMIT .50 TOTAL FEE $ Q 1HEREBY ACKNOWLEDGE THAT 1 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. WIRING 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOB ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT A IAM THE LEGAL OWNER F THE ABOVE DESCRIBED RESIDENT PROPERTY (, POWER SIGNATURE ✓ UTILITY CO. NOTIFIED OF PERMITTE "46& FINAL S / (V VALIDATION ARTHUR C.VEIT, OK NO CASH SUPERVISING ELECTRICAL ENGINEER LACIO 1 4 1 7 AN 2)3 2 D 2.2 0 K „wsa,C_CE90e6 II;]S ° D PLICAT ®a FOR ELECTMAL PERM BUILDIN AND SAFETY ISION FOR APPLICANT TO FILL IN New Residential Bldgs.& Pools EACH NO. FEE AD RESS a)CC 1 &2 Finaily Sq. Ft. $ — $ LOCALITY Multi-family Sq. Ft. — NEAREST CROSS ST Residential Swimming Pools _ OWNER O �t tC FIRM NAME g_ Pe Outlets: Light, Switch& Receptacle MAI L L(�I n First 20 S 0 ADDRESS 47 ' Additional CITY A..'. If- Tel. No. PLAN CHECK APPLICANT Lighting Fixtures First 20 ADDRESS Additional CITY 'r Tel. No Fixed Appliances Not Over 1 HP 'PERMIT cn t�.l(LpI'-��, Range_ Heater_ D.W. ADDRESS l �w'J7-K"1L ��°��pp�� _ u�7Vwt� Oven Dryer W.M. Top FAU W.H. _ CITY ki 1 Tel. No Hood Fan LICENSE O o Disp. A.C. REG. NUMBER ZZ ? Class. U I "C"ISI THAT I HAVE"DID THIS APPLICATION O U Power Apparatus& Large Appliances ORDINANCES AND STATE Laws „ecv LariN OU Size&Type HP, KW, KVA,or KVAR ELECTRICAL e1NG' y Up to 1 Incl. Z oroR — Over 1 to 10 Incl. COU”TY AND STATE OF Over 10 to 50 Incl. Es�Nie Eo Nes.o OWNER o oS Over 50 to 100 Incl. pER MITEE Over 100 SIGNATURE DISTRICT NO. PROCE ED Services r/�, 0-200 Amp. Under 600 V 201 - 1000 Amp. Under 600 V ' APPROVALS DATE N CTOR'S Over 1000 Amp.or Over 600 V GNATURE TEMP. POWER POLE Temp. Power Pole& AppurtenancesUNDERS LAB WORK � �j '7p Sign with One Branch Circuit Additional Sign Branch Circuits ROUGH CONDUIT (Other) WIRING t If FIXTURES POWER AUTHORIZED PERMIT FEE (Sub-Total) UTILITY CO.NOTIFIED PLAN CHECKING FEE (One-Fourth Permit Fee) FINAL PERMIT ISSUING FEE NOTES TOTAL FEE V t PLAN CHECK VALIDATION K. M.O. CASH PERMIT VALIDATION M.O. CASH 7 8 a-�FEB 22 2 .80 76A663eCE6083-89 APPLICATION FOR ELECTRIC L PERMIT �] COUNTY OF LOS ANGELES •D$PA RTME NT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADORES JOHN A. LAMBIE, COUNTY ENGINEER F COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY t �, FOR APPLLL ICANT TO FIIN NEAREST CROSS ST. _ F / �p4 NO. EACH FEE no RECEIPT�� $ $ OWNER X {' , MAIL LIGHT TOTAL FIRST 20 0 .20 ADDRESS ao SWITCH--y-' OVER 2010 O CITYPLAN CHECK LIGHTING 1( TOTA FIRST 20 .!7 .20 APPLICANT rs FIXTURES J OVER 20 .10 ADDRESS ,(f RANGE_DRYER_WTR. HTR. CITY TEL.NO. STA. COOK_OISP. F.A.U. CONTRACTOR ow(gby SPACE HTR.A&*AIR COND. ADDRESS (;Oos CLOTHES WASH._015 HW ASH._ CITY / TEL.NO. FAN_OTHER 1.00 LICENSE NO. -- CLASS. �- MOTORS,TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION IND. HEATERS, ETC. HP. KW. KVA. ANO STATE THAT THC. ABOVE IS CORRECT AND AGREE TO COMPLY SIZE & TYPE OVER TO WITX ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. 0 — 1 1'00 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATEOF 1 — 10 3.00 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO 1 RESIDE P. THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. O 10 — 50 5.00 SIGNATURE - !J L 50 — 100 10-00 OF PERMITTEE O 100 — 500 15.00of sT gycTTNO� zoN GRou P o -Ss eYCL U `J! W SIGN,GAS SIGN AND ONE CIRCUIT 3.00 N TUBE, OR Z MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES: 1 SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 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 WIRING PERMIT FEE (SUB TOTAL) FIXTURES ' PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED PERMIT ISSUING FEE 2.00 Ao UTILITY CO.NOTIFIED _ SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL TOTAL FEE 0 f b JOSEPH C. ROOHAN SUPERVISING ELECTRICAL ENGINEER PLAN CHECK VALIDATION CK. M.D. CASH PERMIT VALIDATION CK- M.D. CASH F(' 4 6 4 9R MR2 4 2 0 1 0.60r SEE BACK OF APPLICATICH FnR COMPLFTF FFF F1.1C111.1. ✓,�� ( y ^' /l EVv/✓V