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Home My Public Portal About5021 FIESTA AVE_Electrical__ 76A663 CE 806R,10/77 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES ,r DEPARTMENT OF COUNTY ENGINEER 7ADDRESS,6ro `,�JOB BUILDING AND SAFETY DIVISIONFOR APPLICANT TO FILL IN ITYe Le � eNew Residential Bldgs.&Pools EACH NO. FEE ST. a S1 &2-Family,Sq. Ft. $ 025 — $ R OR Multi-family Sq. Ft. .02 — AME �C Residential Swimming Pools 25.00 MAIL ADDRESS Outlets: Rec _LightALSw. r,- CITY Tel. No. First 20 .50 PLAN CHECK Total No. Additional .30 APPLICANT ADDRESS �/ -t Lighting Fixtures First 20 .50 CIT jC Tel.No. 297 ?8-jir Additional .30 PERMIT Total No. APPLICANT Fixed Appliances Not Over 1 HP ADDRESS Range_Heater_D.W.— CITY Tel.No. Oven_Dryer—W.M. LICENSE OR Top` �� W H.-3, 1 REG.NUMBER Class. Hood—Fan _Other— 01 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE Disp. — Room Air Cond. ' 2.50 THAT THE ABOVE IS 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 KVARHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM Y' Up to 1 Incl. 2.50 THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. CD Over 1 to 101nc1.,A/C5.00 v Over 10 to 50 Incl. 12.50 PERMITTEE O Over 50 to 100 Inc. 25.00 SIGNATURE t LU Over 100 40.00 DISTRICT NO. JVD.BY on � Z Services 0- 200 Amp.Under 600 V 12.50 INSPECTOR'S 25.00 APPROVALS SIGNATURE 201-1000 Amp.Under 600 V AT 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 WIRING _O-�� G�✓v� Misc.Conduits&Conductors 10.00 FIXTURES Other(See Complete Fee Schedules POWER AUTHORIZED UTILITY CO.NOTIFIED g FINAL PERMIT FEE (Sub-Total) NOTES PLAN CHECKING FEE (One-Fourth Permit Fee) /Z PERMIT ISSUING FEE $7.00 TOTAL FEE S PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CAS Q23E.JUL 31 2 24.50a ; SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 76A663-CE806 10/72 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER °DOREss BUILDING AND SAFETY DIVISION LOCALITY NEAREST 7 FOR APPLICANT TO FILL IN CROSS ST. OUTLETS NO. EACH FEE OWNER OR $ $ FIRM NAME RECEPT._ MAIL FIRST 20 25 ADDRESS LIGHT TOTAL CITY TEL. NO. SWITCH OVER 20 10 PLAN CHECK FIRST 20 '' APPLICANT LIGHTING TOTAL 25 �` '- OVER 20 ADDRESS FIXTURES 10 RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT RANGE DRYERWTR. HTR._ APPLICANT STA. COOK DISP. F.A.U. ADDRESS SPACE HTR. AIR COND. CITY TEL. NO. CLOTHES WASH. DISHWASH. LICENSE OR CLASS. REG. NUMBER FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR >- 0 - 1 100 LICENSED AS REQU IRE O BY LOS ANGELES COUNTY AND STATE OF O CALIFORNIA OR THAI I AM THE LEGAL OWNER OF THE ABOVE V 1 - 10 3.00 OE S CRIPED RESIDENTIAL PROPERTY, LLJ J PERMITEE � 10 - 50 5.00 SIGNATURE 50 - 100 10.00 DISTRICT NO. PROCESSED BY 100 - 500 15.00 SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTOR'S SIGNATURE W i- TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 TEMP. POWER POLE SERVICENOTOVER600VOLTS OR200AMP 3.00 UNDERSLAB WORK SERVICEOVER 600 VOLTS OR 200AMP 10.00 ROUGH CONDUIT TEMPSERVICE,POLE, &APPURTENANCES 5.00 WIRING TEMP LIGHT OR RECEPT, SYSTEM 3.00 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL PERMIT FEE (SUB TOTAL) NOTES: PLAN CHECK FEE , PERMIT ISSUING FEE 3.00 TOTAL FEE PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 768663-CE80610/72 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER 7TRESS BUILDING AND SAFETY DIVISION ALI TYRE777 ST FOR APPLICANT TO FILL IN CROSS ST. OUTLETS N0. EACH FEE OWNER OR $ $ FIRM NAME RECEPT._ MAIL LIGHT TOTAL FIRST 20 25 - ADDRESS CITY TEL. NO. SWITCH OVER 20 10 PLAN CHECK LIGHTING TOTAL FIRST 20 25 APPLICANT 1 i, T FIXTURES 10 OVER 20 ADDRESS RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT RANGE DRYER_WTR. HTR._ APPLICANT STA. COOK DISP. F.A.U. ADDRESS SPACE HTR, AIR COND. CITY TEL. NO. CLOTHES WASH. DISHWASH. LICENSE OR CLASS. REG. NUMBER FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR } 0 - 1 1.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAI I AM THE LEGAL OWNER OF THE ABOVE U 1 - 10 300 DESCRIBED RESIDENTIAL PROPERTY. LL! PERMITEE 10 - 50 5.00 SIGNATURE L- 50 - 100 10.00 C= DISTRICT NO. PROCESSED BY C 100 - 500 15.00 C7 CL. SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTOR'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE SERVICENOTOVER600VOLTS OR200AMP 3.00 - UNDERSLAB WORK SERVICEOVER 600 VOLTS OR 200AMP 10.00 ROUGH CONDUIT TEMPSERVICE,POLE, &APPURTENANCES 5.00 WIRING TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL PERMIT FEE (SUB TOTAL) NOTES: PLAN CHECK FEE PERMIT ISSUING FEE 3.00 TOTAL FEE PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE WORKERS' COMPENSATION DECLARATION 76-863 io/ai pP,l�p��[P�g�TB®�@ ®R ELECTRICAL PERMIT I hereby'Affirm that I have a certificate of consent to self insure, CE-Bose !' P9� CA PI N or a certificate of Workers' Compensation Insurance,or.a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof (Sec. 3800,Lab.C.) Policy No. Company' FOR APPLICANT TO FILL IN JOB . / ❑ Certified copy is herebyfurnished. EACH NO. FEE ADDRESS,• iQ'2-/ Ar � °7 New Residential Bldgs.& Pools ❑ Certified copy is filed with the county building inspection 1 & 2-Family,Sq.Ft. $ _ $ EAREST 'department. Multi-family Sq.Ft. NEAREST , CROSS ST. Date Applicant Residential Swimming Pools OWNER OR /meq_ Ap C. FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' -}{��L(- MAIL Outlets:Rec Light ' Sw. COMPENSATION INSURANCE / ADORES$�� (This section need not be completed if the work involved by the // First 20 � /� permit is-for one hundred dollars ($100)or less.) Total No.�(� Additional CITY 7eA.� _ ( )' Tel.i6�'6� I certify that in the performance of the work for which this permit PLAN CHECK APPLICANT is issued; I shall not employ any person in any manner soas to _ ? become subject to the Workers'Compensation Laws. Lighting Fixtures, First 20 J ADDRESS Total No. Additional, CITY Tel.No. Date Applicant Fixed Appliances Not Over 1 HP NOTICE TO APPLICANT: If, after making this Certificate of PERMIT Exemption,you should become subject to the Workers'Compensation Range_ Heater_ D.W. _ APPLICANT provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer _ W.M._ ADDRESS .provisions or this permit shall be deemed revoked. Top — FAU W.H. LICENSED CONTRACTORS DECLARATION Hood — Fan � Other_ CITY Tel.No. I hereby affirm that I am licensed-under provisions of Chapter 9 Disp. — Room Air Cond. o� /iZ d LICENSE (commencing with Section 7000) of Division 3 of the Business and REG.NUMBER ER Class. Professions Code,and my license is in full force and effect. .DISTRICT NOPR ED BY Power Apparatus& Large Appliances Size& Type HP,KW,KVA,or KVAR 0 License Number Lic.Class Up to-1 Incl. FINAL U Over 1 to 10 Incl. DATE _ Ix Contractor Date — j VALIDATION O ❑ Over 10 to 50 Incl. (. FINAL U I am exempt under Sec. Over 50 to 100 Inc. BY W BAP.C.for this reason Over 100 0. U) Services, Swbd.,MCC& Panelboards / Z Date: 0- 200 Amp.Under 600 V Signature 201 - 1000 Amp,Under 600 V ❑ Over 1000 Amp.or Over 600 V Exemption for Reg.Maint.Elect. SINGLE FAMILY Temp.Power Pole& Appurtenances HOME OWNER-BUILDER DECLARATION 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, Business and Professions Additional Sign Branch Circuits = s ry t Code): T^'r r d] Misc.Conduits & Conductors LT I,as owner of the property,will do the work and the structure is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) , ;^'Sf t i g and Professions Code). CHEt Cj'' -t:flid CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the o fir! performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total) Civ. C.). PLAN CHECKING FEE Lender's Name 1€011= 1 311-11 101'i3 PERMIT ISSUING FEE /lp Q ,:; S '�t t _=34 A Lender's Address 9 1 =t1€ r I certify that I have read this application and state that the above TOTAL FEE O n - information is correct. I agree to comply with all County ordinances L— and State laws regulating Electrical wiring, and hereby authorize representatives of this County to enter u0m he above-mentioned proper for' spection purpose . SEE REVERSE FOR EXPLANATORY LANGUAGE _�gn//a' re of-P- 'tte