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Home My Public Portal About4907 FIESTA AVE_Electrical__ T�� le- C, fi lea 16A663 CE806 10 61 APPLICATION FOR ELECTRI&L PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING / BUILDING AND SAFETY DIVISION ADDRESS l JOHN A LAMBIE COUNTY ENGINEER I ` WILLIAM A JENSEN SUP T OF BUILDING LOCALITY / NEAREST FOR APPLICANT TO FILL IN CROSS $ 1 T E M NO EACH FEE OUTLETS (FIRST 20) $2O $ OWNER LIGHTS RECEPT SW MAIL OUTLETS (ADD L UNITS) 1O ADDRESS LIGHTS RECEPT SW LIGHTING FIXTURES (FIRST 20) 2O CITY TEL NO,) / LIGHTING FIXTURES (ADDITIONAL) 10 ELECTRICIAN RANGES CLO DRYERS WTR HTRS 100 ADDRESS ` Q GARB DISP STA COOK CITY ( TEL NO '-C' �S DISHWASH AUTO WASH STATE SPACE HTRS STA APP (y¢H P MAX) 50 LICENSE NO MOTORS OVER NOT OVER HP DISTRICT NO GROUP ZONE PROCESSED BY O 1 1 00 LCi 1 3 2 1 150 b INSPECTION RECORD 3 8 200 7/y �1-4* f A kh ) Q 8 15 250 F U ce 15 50 300 0 50 100 500 ' f ( � a SIGNS NO TRANS N NO LAMPS I Z SERVICE O 600V NOT OVER 200A 100 QZ'j SERVICE O 600V OVER 200 A 1200 SERVICE OVER 600V Soo i MISC t r L PERMIT ISSUING FEE 200 00 SUPPLEMENTARY PERMIT ISSUING FEE 100 TOTAL FEE $ IHEREBY ACKNOWLEDGE'THAT I HAVE READ THIS APPLICATION APPROVAL$ DATE INSPECTOR S SIGNATURE ANATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT ,.r // WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING WIRING �p 7 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT 1 THE GAL ER OF THE ABOVE / DESCRIBED RESIDENTI R ERT POWER /�/!/ ♦ i1/ / SIGNATURE UTILITYCO NOTIFIED p U2- OF PERMITTEE Mehl FINAL LIDATION ARTHUR C VEIT o CK MO CASH SUPERVISING ELECTRICAL ENGINEER f 1 5"5 8% .x.13 2 0 4_50- 4 5 R h r I a FOR ELEC -TRiCAL PERMIT i6A663 CE308 S 62 APPLICATION COUNTY OF LOS ANGELES d DEPARTMENT OF COUNTY ENGINEER BUILDING 41 o BUILDING AND SAFETY DIVISION ADDRESS 7 JOHN A LAMBIE COUNTY ENGINEER WILLIAM A JENSEN SUP T OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST RECEPT TOTAL NO EACH FEE OUTLETS FIRST 2O s 20 $ OWNER LIGHT MAIL ADD 10 ADDRESS SWITCH OVER 20 TOTAL CITY TEL O LIGHTING F1Rsr20 20 _ FIXTURES ADD L 10 ELECTRICIAN OVFR 20 RANGES CLO DRYERS WTR HTRS 100 ADDRESS GARB DISP STA COOK CITY (�Qj,& TEL NO DISHWASH AUTO WASH STATE SPACE HTRS BTA APP (/a H P MAX I 50 LICENSE NO MOTORS OVER NOT OVER HP DISTRICT NO GRZ�(1 P ZONE P S�S�ED�B�Y Me 100 �l 1 3 150 INSPECTION RECORD 3 8 200 >- B 15 2 so D_ O 15 50 300 V SO 100 500 O H SIGNS NO TRANS u NO LAMPS UJ Vi SERVICE O 600V NOT OVER 200A 100 Z SERVICE O 600V OVER 200 A 200 SERVICE OVER 600V 500 MISC PERMIT ISSUING FEE 200 SUPPLEMENTARY PERMIT ISSUING FEE 100 TOTAL FEE 3 Q 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR 881GNATUR! AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT /f1 WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING ? WIRING C �� IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR A tY LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES IL CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY POWER A SIGNATURE /(! UTILITY CO NOTIFIED OF PERMITTEE l� L FINAL LIDATION ARTHUR C VEI J CK I MO CASH SUPERVISING ELECTRICAL ENGINEER LAC04 4 4 5"o SEP18 2 D 3.20- Q a ER SZOMPENSATION DECLARATION 20-0019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT IJ 76A663 I hereby affirm that I have a certificate of consent to self insure, � or a certif cat,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.) y- I� Policy Ng Company FOR APPLICANT TO FILL IN JOB ADDRESS (//1 _ Y A4-,-,.- Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE $ $ 1.� G(LOCALITY {{ r 1 &2-Family,Sq.Ft. ❑ _ Certified copy is filed with the county building inspection NEAREST department. Multi-family Sq. Ft. CROSS ST. Date Applicant Residential Swimming Pools ASSESSOR MAP PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec. Light Sw. OWNER OR, COMPENSATION INSURANCE FIRM ell 441 First MAIL (This section need not be completed if the work involved by the ADDRESS / permit is for one hundred dollars($100)or less.) Total No. Additional I certify that in the performance of the work for which this permit CITY Tel.kiFt,6- X07 is issued, I shall not employ any person in any manner so as to PLAN CHECK become subject to the Workers' Compensation Laws. Lighting Fixtures First 20 APPLICANT Total No. Additional ADDRESS Data — Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APP ANT: If, after ma ing this Certificate of CITY Tel.No. Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code, you must forthwith comply with such PERMIT p y p y Power Apparatus&Large Appliances APPLICANT jC/tah provisions or this permit shall be deemed revoked. LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS &11.(A, ws47, I hereby affirm that I am licensed under provisions of Chapter 9 7 Over 3 to 10 Incl. (commencing with Section 7000) of Division 3 of the Business and CITY ,)Q p T015 s-aa775 Professidns Code, and my license is in full force and effect. Over 10 to 50 Incl.- LICENSE OR -..� � 'U d �7 Over 50 to 100 Incl. REG.NUMBER Class. License Number ��r r e 132 Lic.Class C (() Over 100 DISTRICT NO. PROCESSED BY o Ser Swb�i.MCC& ane b rds 2'— — 0�/359�T1TJ FINAL Contractor ate �_�W.Un er 0 V DATE - I— ❑ I am exempt under Sec. A400-1000 Amp.Under 600 V VALIDATION ULI Over 1000 Amp.or Over 600 V FINAL �. B.&P.C.for this reason BRANCH CIRCUIT FEES BY Date: 15A,or 20A, 120V,Lighting or Recept. Z 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits y SINGLE FAMILY Temp.Power Pole&Appurtenances At-"'k HOME OWNER-BUILDER DECLARATION - I I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit =• `Fuz`h ' for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits s Code): ❑ I, as owner of the property,will do the work and the structure Misc.Conduits&Conductors i 1!T A 6 = 45 is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) r;, �(-,;., �:• ' - and Professions Code). -i,•,.e: - r ,IIj CONSTRUCTION LENDING AGENCY `"H44`- E ' °== 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.) 5 ,�;3�.}~fl _i0i 11 /97 PLAN CHECKING FEE22 F ftp Lender's Name 222366 PERMIT ISSUING FEE 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 representa�urposes. ter upon the above-mentioned property for in ect9 SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE OF PERMITTEE DATE