HomeMy Public PortalAbout6329 ENCINITA AVE_Electrical__ TGAGBG.CEBOG. IG.56 APPLICATION FOR ELECTRIC PERMIT
BUILDING AND SAFETY DIVISION
Department of County Engineer BLDING
County of Los Angeles AODREssUI
JOHN A. LAMBIFI COUNTY ENGINEER
C HN A. D GRIFFIN. ENGINEER
LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST, r
PERMT FEES
OWNER
LIGHTS RECEPTACLES SWITCHES
R NUMBER I T E M EACH FEE MAIL
ADDRESS
TOTAL OUTLETS S .10 S r
ELEC. PANG WATER HEATERS. - CITY �� ..rte TEL, NO.
` LOTHC9-rR ERB 50 37-0
ELEC. SPACE HEATERS, STAT-Y.'000H- ELECTRICIAN
ING UNITS, GARBAGE DISPOSERS, ADDRESSj.
AUTO WASHERS, OISHWASHER '.25
t
LIGHTING FIXTURES ,10 CITY TEL. NO
STATE
MOTORS LICENSE NO. 1
HORSEPOWER - _ .. .,
H.P. OVER INC. DISTRICI NO. GROUP ZONE READY FOR INSPECTION
I/i IS LESS .25
h - 2 50 INSPECTION RECORD
2 5, 1.00
5 15 1.50
15 50 2.50
50 200 5.00
MISC.
SIGNS I NO.TRANS
NO. LAMPS
4
SERVICE 0-600V 1.00 DO
SERVICE OVER 600V 5.00 -
LEL,ECTRICAL
G PERMIT 1.00 �Q
RE PERMIT 1.00
EMENTARY PERMIT .50 '{ APPROVALS•
TOTAL FEE $ - l/' - DATE INSPECTOR'S SIGNATURE
CATIdN
ATE THAT HEREBY �HEEABOYEDGE RIS CORRECT T I HAVE RAND AGREEEAD THIS ATOL ICOM PLY CONDUIT _7__G'i (%sI/J/ii i�f C�
LL COUNTY ORDINANCES AND STATE LAWS REGULATING / - v/ (/A'Yrprv� �r
ICAL WIRING. WIRINGREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURESED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
RNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE POWERBED RESIDENTIAL RO➢ERTYTURE - UTILITY CO. NOTIFIED ('/ERMITTEE FINAL
JOHN A. LGINEER _ ALIDATION ARTHUR C.VEIT.
COUNTY ENGINEER crc Mo CASH SUPERVIOING ELECTRICAL ENGINEER
;ado 9 9 0 7 JUL 9 2 2.5 0 L�
71SA663 CE-806 111 /781 APPLIICA- -.F®R ELE RE AC PERMIt
COUNTY OF LOS ANGELES BUILDING AND SAFETY .
FOR APPLICANT TO FILL IN JOB
New Residential'Bldgs.'&"Poo EACH NO: FEE- ADDRESS b`32-'9 �r-t C.lN'✓/ - . .L� - --
1 &2.Family,Sq. Ft: $ .025 - $ LOCALITY
Multi family Sq'Ft. .02 - NEAREST ,
Residential Swimming Pools 25.00 CROSS OWNEROR
-
- /rA. FIRMNAME • �2 C-�N aA- /a.�A•aSFLM
Outlets:Rec 30 Light �7 Sw.✓8 /C/ v AAAIL
DDRESS
First 20 .50
-JotolNo. �'� - Additional .30 _J� CITY _T C' - - r TeI_N.,;;_ 4R'j
PLAN CHECK
APPLICANT.
Lighting Fixtures First 20 .50 / ADDRESS.
Additional - ..30 .
Tgtol No. 'M - CITY ---_ - _- --- Tel No, _ �•
Fixed Appliances Not Over.1 HP-- - :PERMIT .- --- - - --
Range—Heater APPLICANT
+_ S�,I•E�
-Oven.—Dryer W.M. - - ADDRESS-- - - -r- ---'--- --
Tap _FA.0 W.H._ CITY _ _ _ Tel No:•__ -_ �y -_„�_
HoodFan _Other_ LICENSE OR
_Disp._—Room Air Cond 2'50 _ REG.NUMBER -_ Class.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS.APPUCA
-
PowerApparatus&Large Appliances TION AND STATE THAT THE ABOVE 15 CORRECT AND,AGREE TO
* COMPLY WITH ALL-COUNTY•ORDINANCES-AND-STATE-LAWS A
Size 8 Type HE,KW,KVA,or KVAR 'REGULATING ELECTRICAL WIRING. d
Upao 1Incl 2'50 - HEREBY CERTIFY•THACIIAM PROPERLY'REGISTERED'AND/OR --U
Over
1 ro 10 Incl. 5.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF as
- Over l0 to. ncl. -1250 CALIFORNIA OR THAT.I AM THE LEGAL OWNER OF THE ABOVE, _ 0
-25.00 DESCRIBED RESI NTIAL PROPERTY.
Over 50 to 100 Inc. PE"nMITEL A
40.00 -
Over 10Q, - S I G N A T UR -Ib ��_ - ?
Services ff-� - - -• 'DISTRICT NO: - ' -- "i' P5 ES D-BY" ' `--
0 20 Amp. Under 600 V 12.50 f
201-I00b Amp: Under 600'V" - � 25.00- - - "''`� �
00
Over-1000 Amp.or Over 600 V 50. Z
O
Temp. Power Pole&.Appurtenances' 10.00
Sign with One Branch Circuit ... 10.00 -
Additional Sign Branch Circuits t 200 INSPECTION- _>
INFORMATION " t8,2 6 4 A
Misc'Conduits&Conductors. 10:00'•' - ON REVERSE-- " •S '
Other(See Complete Fee Schedule)_ SIDE _ u 0 0 0 0 0 '2
5 2 Is . 4,850
oo64H50E
PERMIT FEE t (Sub-ToraD
---;-Z IP. ]-7-79
PLAN CHECKING FEE , (One-Fourth.Permit Feel
PERMIT ISSUING FEE - -_ $7.00
TOTALIFEE / >
r-
INSPECTION FINALED oar
�J
date: BY
/�ZG �/ •'�✓�-�.J Uds
WORKERS'COMPENSATION DECLARATION 76A66
CE-806G (2-801
• . APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that 1 have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY
insure, or a certificate of Workers'Compensation Insurance,or
a cer i d co y [[hereof(5ec. 3800, Lab. C.
s /:�S i JOB
FOR APPLICANT TO FILL IN '
Poli y o. Company C-� JOB
New Residential Bldgs.&Pools EACH NO. - 'FEE ADORES
Certified copy is hereby furnished. 1 &.2-Family,Sq. Ft. $ — S LOCALITY _ C
_
'etried copy u Multi-family Sq. Ft. NEAREST
filed with the county building inspection CROSS ST G
department. Residential Swimming Pools OWNER OR
FIRM NAME _ 7
Date Applicant Outlets: Rec.—Light—L
SvIvIl._ MAIL
First 20 ADDRESS 63 G'
CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY Tel No.•g(� 777 /
}
COMPENSATION INSURANCE A PLAN CHECK d
F � �� / PPLICANT 0
(This section need not be completed if the work involved S . U
by the permit is for one hundred dollars (SI00) or less.) Lighting Fixtures oat 20 ADDRESS
Additional
Total No.� p
I certify that in the performance of the work for which this - / CITY / Tel No. L0,3 F
ermit is issued, 1 shall not employ an Fixed Appliances Not Over 1 HP
p p y y person in any manner ,PER Ir' U
so as to become subject to the Workers' Compensation Laws. Range_ Heater—D.W. �� - APPLICANT 1 d
Oven Dryer_W.M._ /' / ADDRESS / 2
Top FAU _W.H. / —
Dale Applicant CITY Tel No. 2J
Hood _ Fan —Other— / LL G..�
NOTICE TO APPLICANT: If, after making this Certificate of Disp. Room Air Cond._ LICENSE OR ' s 3
Exemption, you should become subject to the Workers' REG. NUMBER D S lass
Compensation provisions of the Labor Code, you must forth. Power Apparatus& Large Appliances DISTRICT NO. PROCESSED gV '
with comply with such provisions oi this permit shall be
deemed revoked. Size& Type HP,KW, KVA,or KVAR 31-/;
� .L,1
Up to 1 Inc[. . ; �"�--
Over 1 to 10 Incl. FINAL
DATE q VALIDATION
LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl. �Z� —o
I hereby affirm that 1 am licensed under provisions of Chapter , Over 50 to 100 Inc. FINAL
9 (commencing with Section 7000) of Division 3 of the Busi- Over 100 BY ! _ w
ness and Professions.Code, and my license is in full force and 1-
effect. Services t•� v '
.� S^�S— e_r3- 0-200 Amp. Under 600 V
License Nu 'er Lic. Class
201-1000 Amp. Under 600 V
Contract Date Z-2/—s ( 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 7031.51 Busi- Additional Sign Branch Circuits R O O 7.S A
ness and Professions Code):
Misc.Conduits&Conductors �_ # e o 0 0 0 2
El1, 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 2 e e 3 Q 0 O
7044, Business and Professions Code).
CONSTRUCTION LENDING AGENCY e e o 3 Q.0 Q U
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) U 06,08-8 ) r
issued (Sec. 3097,Civ.C.). -
Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee)
Lender's Address PERMIT ISSUING FEE
7j CO
I certify that I have read this application and state that the TOTAL FEE
above information is correct. 1 agree to comply with all County
ordinances and State laws regulating Electrical wiring, and
hereby authorize representatives of this County to enter upon
the abov - enti ned r erty for inspectionpupurposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
F/ 0
ignaf6re of Permitteeof Permittee ate
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