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Home My Public Portal About10531 FREER ST_Electrical__ 7GA663-CES0610-62 APPLICATION FOR ELECTRICAL PERMIT - COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A.JENSEN, SUPT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. j RECEPT.>STOTAL NO. EACH FEE / l OUTLETS FIRST 20 $20 $ OWNER kC " LIGHT MAIL ADD'L ADDRESS SWITCH. OVER 20 .10 , TOTAL CITY TEL. NO. LIGHTING FIRST 20 .20 FIXTURES ADD'L ELECTRICIAN IV OVER 20 .10 RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS 33 GARB.DISP. STA.COOK _ CITY L TEL. NO i V i1/ DISH WASH. AUTO.-WASH. STATE SPACE HTRS. STA.APP.Iyi N.P.MAX.) .50 LICENSE NO. MOTORS: OVER NOT OVER H.P. DIST T NO. GROUP Z NE �P-JQCESSED BY O 1 1.00 i 1 3 1.50 INSPECTION RECORD 3 8 2.00 O 8 15 2.50 V 15 50 3.00 �Q 50 100 5.00 W d SIGNS: NO.TRANS. H NO.LAMPS z SERVICE 0.600V-NOT OVER 200A I:00 Q , SERVICE 0.60OV-OVER 200 A. 2.00 SERVICE OVER 600V 5.00 ' misc. PERMIT ISSUING FEE 2.00 SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE $ T IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS EDATE INSPECTOR'S SIGNATURE ' AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT Y WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING - 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOSP�NGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT 1 AM THE Ar OWNER OF THE ABOVE DESCRIBED RES IDENTIALL,PROPERTY. POWER S / _ IGNATURE / ,•- UTILITY CO.NOTIFIED p- ll/h G ' OF PERMITTEE t_ FINAL V7fi IDATION ARTHUR'C. VEIT CK MO CASH SUPERVISING ELECTRICAL ENGINEER 3 4 9 6'12' DEC 13 2 D 3.40- , 76A663-CE806 10-62 APPLICATI' 4 N ' FOR EL CTRICAL PERMIT�y •1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS �� JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A.JENSEN, SUPT OF BUILDING LOCALITY a f✓{' NEAREST ✓- FOR APPLICANT TO FILL IN CROSS ST. RECEPT. TOTAL NO. EACH 7F�. OUTLETS FIRST 20 $20 $• OWNER lU� LIGHT / Sl• MAIL ' 1 ADD'L ADDRESS SWITCH. / OVER 20 ' •10 TOTAL CITY TEL. NO. LIGHTING FIRST 20 , .20 FIXTURES I ADD'L AD ELECTRICIANG OVER 20 / RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS fp GARB.DISP. STA.COOK _ CITY (?- TEL.NO. DISHWASH. AUTO.-WASH. STATE, [Y 09 Z3Q SPACE HTRS. STA.APR.('/.H.P.MAX.) 1-3 ,50 LICENSE NO. - MOTORS: •OVER NOT OVER H.P. DISL�CTNQ. GROUP Z NE -P ESSED BY O 1 1.00 12 3` 1.50 9 ` INSPECTION RECORD 3• s 2.00 s 15 2.so �,� y O 15 50 :=r 3.00 .1 ��"�.'I�LtI.G'r��Il. �N AI.�-'.I1.i'y I�U(di•C.n.. r'f=.%� .G0 50 100 5.00 �� I I1 hP W NO.TRANS.' - SIGNS: NO.LAMPS- rr,, - SERVICE 0.600V-Nor OVER 200A 1.00 '- •- y�l'` AC-L vV(fti S �7 SERVICE 0-60OV-OVER 200 A. 2.00 -rc GS SERVICE OVER 600V 5.00 - MISC.- A to N V C vz j5',A-A, PERMIT ISSUING FEE - 2.00 SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE $f IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLZATICN APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE.LAWS REGULATING /j////4 A /� ELECTRICAL WIRING., WIRING R 'AY'4 _ - 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR 16 ` ` LLLICEN9EDS REQUIRED BY LOS ANGELES COUNTY•ANDSTATE OF FIXTURES OR THAT i AM-THE LEGAL OWNER OF THE ABOVE RESIDENTIAL ROPERTY. POWER E UTILITY CO.NTTEE FINAL LA CARTHUR C. VETT MO • CK MO � CAA SH SUPERVISING ELECTRICAL ENGINEER L,`j � 3769Go DEC 23 2 D 14.4;0- d WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT I hereb7r,a76A663 ffirm that I have a certificate of consent to self Insure, ' or a certificate of Worker's Compensation Insurance, or a certified �' COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sqc. 3800 Lab C) ' W 951114(0 POIICy NO. Company FOR APPLICANT TO FILL IN JOB ADDRESS �r�J�-V Certified copy is hereby furnished. New Residential Bldgs &Pools NO. EACH FEE ❑ _1$ Is LOCALITY + Certified copy Is filed with the county building Inspection 1 &2-Family,Sq Ft department J - e `,, Multi-family Sq Ft CROSS sT Date Applicant (�' l�� 4-►'C-f Residential Swimming Pools ASSESSOR MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER OR COMPENSATION INSURANCE Outlets Rec —Light Sw. �� FIRM NAME (This section need not be completed if the work involved by the First 20 MAIL ADDRESs 165 � permit is for one hundred dollars($100)or less.) Total No. Additional 16 17 I certify that in the performance of the work for which this permit CITY ' � C Tel No [}•1 3?J is issued, I shall not employ any person in any manner so as to o► become subject to the Workers'Compensation Laws Lighting Fixtures First 20 PLAN CK APPLICANT Total No. Additional ADDRESS Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT. If, after making 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 provisions or this permit shall be deemed revoked Power Apparatus&Large Appliances APPLICANT C— "LICENSED CONTRACTORS DECLARATION Size y�HP,KW,KVA,or KVAR ADDRESS ' I hereby affirm that I am licensed under provisions of Chapter 9Over 3 to 10 Incl. (commencing with Section 7000)of Division 3 of the Business and CITYr el N(��j., Professions Code, and my license is in full force and effect Over 10 to 50 Incl. w /� LICENSE OR Class /x•' r Over 50 to 100 Incl. REG NUMBER ass l'� a License Number LIC Class V 51 �+� Over 100 DISTRICT NO. PROCESSED BY 0 P /A� _1 ,_ 9 Services,Swbd,MCC&Panelboards �p _r � U Contractor L `I�.L�- C- Date 1 3 0-399 Amp. Under 600 V FINAL DATE \ ❑ 400-1000 Amp. Under 600 V I am exempt under Sec Over 1000 Amp.or Over 600 V FINAL VALIDATION W B&P,C.for this reasonBRANCH CIRCUIT FEES BY h`) ri) Date: 15A,or 20A, 120V,Lighting or Recept. C l 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 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 JL L� �� Code). iv ITEMS 't ❑ I, as owner of the property, will do the work and the structure Misc Conduits&Conductors is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) TOTAL .48 _7 0 and Professions Code) CONSTRUCTION LENDING AGENCY 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) CHECK 48070 Civ. C) PLAN CHECKING FEE Lender's Name MANGE .00 PERMIT ISSUING FEE 5� Lender's Address I certify that I have read this application and under penalty of purjury state TOTAL FEE 8• D that the above Information is correct I agree to comply with all County Od�—dt1V1 9/13/95 t-, ordinances and State laws regulating Electrical wiring,and hereby authorize 9/1`/9_t representatives of this County to enter upon the above-mentioned property for inspection purposes. 2271 1 �e7 j1 n�L SEE REVERSE FOR EXPLANATORY LANGUAGE AltltJaa 0 SIGNATURE OF PERMITTEE D#tE '�'• ,