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Home My Public Portal About9168 FORTSON DR_Electrical__ renews-CEaos. APPLICATION FOR ELECTRO`>,.rA PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING J (� BUILDING AND SAFETY DIVISION ADDRESS / � JOHN A.LAMBIE, COUNTY ENGINEER 7- WILLIAM A.JENSEN, SUP•TOF BUILDING LOCALITY �" J / a, FOR APPLICANT TO FILL IN NEAREST CROSS ST. a PERMIT FEES s OWNER I T E M NUMBER EACHrFEMAILOUTLET $ ADDRESSLIGHTS RECEPT. SW. .10 LIGHTING FIXTURES j 1OCITY TEL.NO. ELEC. RANGES CLO. DRYERS ELECTRICIANWATER HEATERS .50ADDRESS t ELEC.SPACE HTRS. DISHWASHERS CITY i TEL.NO.,10'/ ,:X_7_7 -21 GARBAGE DISPOSERS / AUTO.. STATE j l WASHERS STA.COOKING UNITS .25 LICENSE NO. t MOTORS: OVER INC. H.P. DIST ICT N GROUP ZO E P 771 O — I/2 .25 q +/z 2 .50 INSPECTION RECORD 2 5 1.00 e� p 5 15 1.50 Ifo / +Ca�9'� f'L _ t7 +�h�i �O�J 2.50 Ix111 cl ` f- SO 200 5.00 71' v Lu f NO TRANS. SIGNS: NO.LAMPS SERVICE 0.600V i.00 SERVICE OVER 600V 5.00 MISC. -:i WIRING PERMIT 1.00 d0 FIXTURE PERMIT 1.00 fJl7 SUPPLEMENTARY PERMIT .50 9 TOTAL FEE $ 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY 1 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 LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT I M THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTI tROPERTY. POWER SIGNATURE UTILITY CO. NOTIFIED OF PERmma MITTE FINAL IFA,I IDATION ARTHUR C.VETT. CK MO CASH SUPERVISING ELECTRICAL ENGINEER 1 G5y � : i 3 2D 4 .45 "• . . IBA668-CE8064-60 APPLICATION FOR ELECTRICA PERMIT COUNTY OF LOS ANGELES r DEPARTMENT OF COUNTY ENGINEER FADDRESS DING / C O BUILDING AND SAFETY DIVISION b v JOHN A.LAMBIE, COUNTY ENGINEER _ WILLIAM A.JENSEN. SUP'TOF BUILDING ALITY �Q j77 niC� FOR APPLICANT TO FILL IN NEAREST CROSS ST. PERMIT FEES OWNER o ?�,� 1 T E M NUMBER EACH FEE MAIL OUTLETS: $ $ ADDRESS LIGHTS RECEPT. SW. .10 LIGHTING FIXTURES 10 CITY TEL.NO. ELEC. RANGES CLO. DRYERS ELECTRICIAN p I j n �et� j WATER H EATERS .50 ADDRESS J�� --/C• !;,'y(/ ELEC.SPACE HTRS. DISHWASHERS CITY jl9 / TEL.NO. DO ?S GARBAGE DISPOSERS AUTO.. STATE / fF? WASHERS STA. COOKING UNITS .25 LICENSE NO. MOTORS: OVER INC. H.P. DIS CT77, Fr-TION P ZONE PR C S D Y 0 — I/2 XJ L .25 C) '1Z - 2 .50 EC RD 2 5 1.00 5 is 1.50 0 15 50 2.50 w O 50 — 200 1 5.00 U SIGNS: NO TRANS. Ll.I NO. LAMPH Z SERVICE 0.600V 1.00 SERVICE OVER 600V 5.00 MISC. WIRING PERMIT 1.00 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMI 50 TOTAL FEES 6 $ 1 HEREBY 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 I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE , DESCRIBED RESIDENTI L OPERTY POWER SIGNATURE UTILITY CO. NOTIFIED OF PERMITTE FINA ^LIDATION ARTH U R G.VETT. CK MO CASH SUPERVISING ELECTRICAL ENGINEER 7BASGS-CESOO 10-60 APPLICATION F®R ILECTRICAL PERMIT . - 1 COUNTY OF LOS /ANGELES DEPARMENT OF COUNTY ENGINEER BUILDING / BUILDING AND SAFETY DIVISION ADDRESS C0 JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY _ NEAREST FOR APPLICANT TO FILL IN CROSS ST. PERMIT 'FEES' , OWNER I T E M NUMBER EACH I FEE MAIL 01 ' OUTLETS: $ $ ADDRESS LIGHTS RECEPT. SW. .10. - ' CITY TEL. NO. LIGHTING FIXTURES ,10 ELEC. RANGES CLO. DRYERS ELECTRICIAN , + (✓C�iL9�/��J WATER HEATERS .50 ADDRESS ELEC.SPACE HTRS. DISHWASHERS _ CITY l 4 TEL NO.- GARBAGE DISPOSERS AUTO.- STATIr WASHERS _ STA.COOKING UNITS •25 LICENSE NO. MOTORS: OVER INC. H.P. DISTRICT NO. G_OUP 'ZONE I PR ESSED BY 0— 1/2 25 .�J' ✓I 1/2— 2 5o 'INSPECTION RECORD r 2— 5' 1.00 0 . O "5— 15 1.50 - . u a 15-- so 2.50 O 5o— 200 5.00 a. SIGNS: NO TRANS. e N NO.LAMPS, �Z SERVICE 0-600V SERVICE OVER 600V 5,00 MISC. - - WIRING PERMIT 1,00 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .50 TOTAL FEE $ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING _ I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED 'AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES ' CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE _ DESCRIBED RESIDENTIAL PROPERTY 111 PROPERTY. - POWER SIGNATURE" UTILITY-CO.NOTIFIED OF PERMITTEE FINAL ^LIDATION , ARTHUR C. VEIT• cK Mo cases SUPERVISING ELECTRICAL ENGINEER 7fl74v 2',0 �1 WORKERS'COMPENSATION DECLARATION CE 806G (2-80) APPLICATION FOR ELECTRICAL . PERMIT I here�y affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES ']� BUILDING AND SAFETY 1nsyresorsa certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800,Lab. C.) O ' " FOR APPLICANT TO FILL IN - JOBi Policy No. Company EACH NO. FEE ADDRESS19 " New Residential Bldgs.&Pools " F1 Certified copy is hereby furnished. 1 &2-Family,Sq.,Ft. $ — $ LOCALITY ❑ Multi-family Sq. Ft.• — NEAREST Certified'copy is filed with the county buildirig•inspection CROSS ST department. Residential Swimming Pools OWNER OR FIRM NAME Date Applicant Outlets ReAtghtA Sw. � D �o Q o gAIL First 20DDRESS 5 V-Y\— Q CERTIFICATE OF EXEMPTION FROM WORKERS' Total No Additional 3o CIT kF ej Tel No S 1-! } COMPENSATION INSURANCE PLAN CHECK d APPLICANT O (This section need not be completed if the work involved 6-C U by-the permit is for one hundred dollars ($100) or less.) Lighting Fixtures First 20 ADDRESS Additional 3 Total No. O I certify that in the performance of the work for which thisCITY - Tel No. U Fixed Appliances Not Over'l HP liZ— permit is issued, I shall not employ any person in any manner PERMIT W, so as to become subject to the Workers' Compensation Laws. Range_ Heater_D.W. APPLICANT p Oven Dryer _W.M._ ADDRESS Top _ FAU _W.H. Z Hood Fan Other— CITY Date Applicant , Tel No. 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 Class• 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 i deemed revoked. Size�`ype HP,KW, KVA,or KVAR. Q� Up to 1 Incl. FINAL ' Over 1 to 10 Incl. DATE / v. '� VALIDATION LICENSED CONTRACTORS DECLARATIONa� Over 10 to 50 Incl. FINAL I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. BY 9 (commencing with Section 7000)•of Division 3 of the Busi- Over 100 -1 ness and Professions.Code, and my license is in full force and effect. Services License Number I ic.Class 0-200 Amp. Under 600 V 201-1000 Amp. Under 600 V Contractor Date Over 1000 Amp.or Over 600 V HOME bWNER-BUILDER DECLARATION Temp. Power Pole&Appurtenances I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit A License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits ness and Professions Code): Misc.Conduits&Conductors z 2 3.3 A T-1 I, 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 # 0 0 0,0 o 2• 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY 2 0 o 61.50 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is 6 1, Jr = issued (Sec. 3097 iv. PERMIT FEE (Sub-Total) 0 0 o O U Lender's Name 4E4k of Am•e y+ c A• 11,28-80 PLAN CHECKING FEE, (One-Fourth Permit Fee) L'ender's Address%q b3 E.- L..AS +0 J2flS MY• PERMIT ISSUING FEE -V w. l-e C �� CALit 917QO I certify thaf I 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 above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date