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Home My Public Portal About10243 FREER ST_Electrical__ 76A663A-CER06A 4/72 APPLICATION F R ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS ��ta LOCALITY mg,` NEAREST FOR APPLICANT TO FILL IN CROSS ST OUTLETS NO EACH FEE I OWNER RECEPT $ Is MAIL LIGHT TOTAL FIRST 20 , ADDRESS ^ I !T- CITY / _ r TEL NO � SWITCH OVER 20 PLAN CHECK LIGHTING FIRST 20 APPLICANT _ TOTAL / FIXTURES -2/ OVER 20 ADDRESS e� RESIDENTIAL APPLIANCES CITY TEL NOIR RANGE DRYERWTR HTR PERMIT APPLICANT /� / •/'Il/� -1r STA COOK DISP F A U ADDRESS f Lf SPACE HTR AIR COND CITY TEL NO CLOTHES WASH DISHWASH LICENSE NO CLASS '-c FAN OTHER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY C MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING V IND HEATERS, ETC HP KW KVA ELECTRICAL WIRING SIZE & TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR O - 1 LICENSED AS REQUIRED BY LO ANGELES COUNTY AND STATE OF V CALIFORNIA OR THAT I AM LEG L OW OF, AND INTE D TO Wa 1 - tO RESIDE IN, THE ABO DE SCR E I ED CRENTIA RO YD N 10 - 50 SIGNATURE OF PERMITTEE 50 - 100 DISTRICT NO C1 ASS ZONE ESSED BY 100 - 500 D i' SIGN, GAS SIGN AND ONE CIRCUIT NOTES TUBE, OR _ MARQUEE ADDITIONAL CIRCUITS ?iH� Go72✓Z Np r" Q'l✓V- SERVI CE NOT OVER 600 VOLTS OR 200 AMP APPROVALS DATE INSPECTOR'S SIGNATURE SERVI CE OVER 600 VOLTS OR 200 AMP TEMP POWER POLE TEMP SERVICE,POLE, &APPURTENANCES UNDERSLAB WORK TEMP LIGHT OR RECEPT SYSTEM -'76 7/ - ROUGH CONDIUT fL/i WIRING 1 FIXTURES aL7.7 POWER AUTHORIZED PERMIT FEE (SUB TOTAL) UTILITY CO NOTIFIED PLAN CHECK FEE FINAL PERMIT ISSUING FEE , TOTAL FEE j PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION CI 1 M o CASH 52o�nCT 12 � ,_, 1 2.604 76A663-CE806 10-62 APPLICATION FOR, ELECTRICAL PERMIT �r COUNTY OF LOS ANGELES DEPARTMENT-OF COUNTY ENGINEERBUILDING BUILDING AND SAFETY DIVISION ADDRESS - JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A JENSEN, SUPT OF BUILDING LOCALITY jif NEAREST ^ FOR,APPLICANT TO FILL IN CROSS ST - v RECEPT TOTAL NO EACH FEE OUTLETS FI RST,20 $20 $ OWNER LIGHT O ® -' MAIL SWITCH OV "'L .10 ADDRESS TOTAL CITY` TEL N; LIGHTING FIRST 20 L 20 , FIXTURES /' ADD L ELECT IAN { OVER 20 .10 RANGES_ CLO DRYERS WTR_ HTRS 1 00 _ ADDRESS- / - GARB DISP STA..090 1 ' _CITY 1 EL NO DISHWASH /A AUTO-WASH- STATE' - ^ SPACE HTR 1� STA APP (y¢H P MAX ) 50 LICENSE NO Morons OVER NOT OVER FIP DISTRICT y7NO GROUP ZONE RRQCESS� ED BY o - '1 100 I i QO Y 1 , 3.' 150 - _INSPECTION RECORD - s• '3 a_ 200 _ O B 15 250 - V 15 50 r- 300 50 + _ 100 500 SIGNS NO TRANS NO LAMPS- SERVICE 0.600V-Nor OVER 200A loo SERVICE 0.6o0V,;OVER 200 A 200 SERVICE OVER 600V 5'.00 ` T MISC 'PERMIT ISSUING,FEE + - 200 •* SUPPLEMENTARY PERMIT ISSUING FEE 100 "TOTAL,FEE $ " I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE , INSPECTOR'S SIGNATURE AND STATE THAT TH_E ABOVE yl5 CORRECT AND AGREE 'TO'COMP LY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING _ ELECTRICAL WIRING - 'WIRING } _ 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED B LOS ANGELES LINTY AND,STATE OF FIXTURES CALIFORNIA OR THAT I `THE LEGAL WNE OF H ABOVE DESCRIBED RESIDENTIAL- OP Y POWER II +• '" ,SIGNATURE UTILITY CO NOTIFIED OF PERMITTEE FINAL I.�►I W"tY.B'� [«�6C1J� - LIDATION ARTHUR,C. VEIT . Q'• �" CK MO CASH SUPERVISING ELECTRICAL ENGINEER. ' - . . LJW;C°0,4, 4 JUN 17 2 0 " ' ...•r a�. � y '�_ L - _ 1 _ ' • - ' - . WORKERS' COMPENSATION DECLARATION ;76A6vDPW 3iaz 6APPLICATION FOR ELECTRICAL PERMIT O I hereby affirm that I have a certificate of consent to self CE-806G .insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certified copy thereof (Sec. 3800, Lob.'C ) r1 Policy No II Company Fgrr/NT FOR APPLICANT TO FILL IN JOB ,— ❑Certified copy is hereby furnished. f a` New Residential Bldgs. & Pools EACH NO FEE ADDRESS Certified copy is filed with thei county building mspec- 1 & 2-Family, Sq. Ft $ _ $ LOCALITY / C tion department Multi-family Sq. Ft. CROSSSST AR tL,' Residential Swimming Pools p LFAI Date Applicant L �DRQAZ A2__BrG'T r OWNER OR ,t i FIRM NAMEMilk N CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL COMPENSATION INSURANCE Outlets Rec�Light�Sw. 0,41 OL O ,,0 ADDRESS First 20 ,(This section need not be completed if the work involved by Total No .1 Additional z �• 3 CITY Tel. NyaC Z L 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 become subject to the Workers'Compensation'Laws. Lighting Fixtures First 20 70 ADDRESS Additional Total No CITY Tel. No Date Applicant Fixed Appliances.Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of v APPLICATION (� ^C, Exemption, you should become subject to the Workers' Range— Heater—D.W' L Compensation provisions of the Labor Code, you must forth- Oven Dryer —W.M — % ADDRESS � O J / , with comply with such provisions or this permit shall be Top FAU —W H. — CITY Tel deemed revoked. Hood — Fan —Other— d LICENSED CONTRACTORS DECLARATION' -3 . v? D LICENSE O Disp' Room Air Cond. REG NUMBER "/0 Q � � Class I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business Power Apparatus & Large Appliances DISTRICT NOPROCESSED BY >_ and Professions Code,and my license is in full force and effect. O rj CL Size &'Type HP, KW, KVA, or KVAR O �i� 0 License Number-AJ 0 L-ic Class Up to 1 Incl. FINAL ./C 01 V _A�-aN �` � Over_l_to_10_Incl. DATE 7_ /�G�L CIZjALIDATION ContrCr actor ,_J to Over 10 to 50 Incl FINAL ❑ I am exempt under Sec Over 50 to 100 Inc. BY /� 6 U B&P.C. for this reason Over 100 " ' � LU a Services, cJa C P Ibq�rLds Z Date: i �� / ✓ •� �j Z 0= Amp. ;rdrrO Signature 201 - 1000 Amp Under 600 V ❑ Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V, SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Temp. Power Pole&Appurtenances I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit Low for the following reason (Section 7031 5, Business and Additional Sign Branch Circuits ,,•; Professions Code)- 139'.i- ❑ Misc. Conduits& Conductors` ! 'I, as owner of the property, will do the work and the structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ —: :3 9Business and Professions Code) - 01 L1 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for E 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 --- ° ?' • 7i d- �i PERMIT ISSUING FEEge Lender's Address I certify that I have read this application and state that the TOTAL FEE • / /• Q� 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 Os Signature of Permittee Date