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Home My Public Portal About10607 FREER ST_Electrical__ 7GA663-CE80610-62 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 �7 NEAREST FOR APPLICANT TO FILL IN. CROSS ST. Q �l RECEPT. TOTAL NO. EACH FEE OUTLETS FIRST 20 Qo$20 $ OO OWNER 1/ _ LIGHT MAILADO'L ' SWITCH. OVER 20 Q .10 ADDRESS TOTAL CITY TEL. NO. LIGHTING FIRST 20 `�� .2o a FIXTURES 2ADD'L 10 !ELECTRICIAN Y ll kZ,S- I�L� sC, OVER 20 RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS GARB.DISP. STA.COOK _ 'C I TY_-5; � 6 ' (y L,'j C{rEL.NO. DISHWASH. AUTO.-WASH. STATE ^ 'Z SPACE HTRS. STA.APP. � AX.) a .50 VO LICENSE NO. MOTORS: OVER NOT OVER H.P. DISTRICT_ NO. I GROUP ZONE PROCESSED BY 1 s 1.50 INSPECTION RECORD _ lieo, a. 3 6 2.00 r' V ob►Q asra L P eru B 15 2.50 15 50, 3.00 t C-0 50 foo 5.00 p{� SIGNS: NO.TRANS. co NO.LAMPS SERVICE 0-600V-NOT OVER 200A 1.00 00 SERVICE 0.60OV-OVER 200 A. 2.00 SERVICE OVER 600V 5.00 MISC. PERMIT ISSUING FEE 2.00 Cx (� SUPPLEMENTARY PERMIT ISSUING FEE 1.00 ' TOTAL FEE $ 2 16 1HEREBY ACKNOWLEDGE THAT 1 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 '1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR + LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. POWER SIGNATURE - UTILITY CO.NOTIFIED OF PERMITTEE - FINAL OLIDATION ARTHUR C. VETT CKMO CASH SUPERVISING ELECTRICAL ENGINEER Lrko 6'8 9 27,11" DEC 16 2 D 1 3.6 0 c 0. WORKERS' COMPENSATION DECLARATION ' 76A66eDPw3ie7 APPLICATION FOR ELECTRICAL PERMIT I hereby,affi;m,that I have a certificate of consent to self Ce 8066 ini-ore,.oPo certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or o(ertified,copy thereof (Sec. 3800, Lab. C.) Policy'No. WCP17756:ompanyC-ITATION FOR APPLICANT TO FILL IN JOB 0607 E. FREER ST. ❑Certified copy is hereby furnished New Residential Bldgs. & Pools EACH NO FEE 4DDRES _ Certified copy is filed with the county building inspec- 1 8 2-Family, Sq. Ft. $ $ LOCALITY TEMPLE CITY� ' tion department Multi-family Sq Ft — NEAREST CROSS ST p 2 Z 7 A lica �t/� Residential Swimming Pools OWNER OR Date 4i�r9 0— pp FIRM NAME EDITH NELSON CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec Light Sw_ AMAIL DDRESS 10607 E. FREER ST. COMPENSATION INSURANCE First 20 (This section need not be completed if the work involved by Total No. Additional CITY TEMPLE CITY Tel. No. 818 968 85.41 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 ADDRESS 'Additional N/A Total No. CITY Tel No Date Applicant NOTICE TO APPLICANT If, after making this Certificate Fixed Appliances Not Over 1 HP PERMIT of APPLICATION IRVINEWEST HTG. & A/C Exemption, you should become subject to the Workers' Range—�Heater—D.W. — • Compensation provisions of the Labor Code, you must forth- Oven Dryer —W.M.— ADDRESS638 SOUTHERN AV with comply with such provisions or this permit shall be Top FAU —W.H. — deemed revoked. Hood — Fan —Other_ CITY ORANGE Tel. No.(714) 921 0800 LICENSED CONTRACTORS DECLARATION LICENSE OR Disp. Room Air Cond. Class. C_ hereby affirm that I am licensed under provisions of Chapter 9 REG. NUMBER 468609 C-20 (commencing with Section 7000)of Division,3 of the Business Power Apparatus& Large Appliances DISTRICT NO. PROCESSED BY r and Professions Code,and my license is in full force and effect. 0- Size Size&Type HP; KW, KVA, or KVAR ✓'�e �� 0 License Number 468609 is ClassC-20 Up to 1 Incl. FINAL 4/2392 Over 1 to 10 Incl. DATE /� VALIDATION 0 Contract Date Over 10 to 50 Incl. 7 U ❑ FINAL I am exempt under Sec. Over 50 to 100 Inc. BY LLl B.&P.0 for this reason Over 100 CL Services, Swbd., MCC & Panelboards ' Z Date: 0-200 Amp. Under,600 V Signature N/A 201 - 1000 Amp. Under 600 V ❑ Exemption-for Reg Maint. Elect Over 1000 Amp. or Over 600 V SINGLE FAMILY Temp Power Pole 8 Appurtenances HOME OWNER-BUILDER DECLARATION r•r• _ I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit ::'_'_- Law for the following reason (Section 7031 5, Business and Additional Sign Branch Circuits Professions Code): - I, as owner of the property, will do the work and the Misc. Conduits&Conductors - 47 ❑ structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ _I ! Business and Professions Code) , i. :-, ,•:; CONSTRUCTION LENDING AGENCY r_' `t I hereby affirm that there is a construction lending agency for `L1�;F�3� =`JU the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) 17.48 (Sec. 3097, Civ C.). PLAN CHECKING FEE ;F ;;j. }i Eh, c Lender's Name / PERMIT ISSUING FEE Lender's Address I certify that I have read this application and state that the TOTAL FEE 42.23 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 a ove-mentio ed property for inspection,purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE 4/23/92 i nature.of Permittee Date WORKER'S COMPENSATION DECLARATION 9 DPW 9/89 APPLICATION FOR ELECTRICAL PERMIT 76A66 ' I hereby affirm that I have a certificate of consent to self Insure, 76A663 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(Sec 3800 Lab.C) Policy No - Company " FOR APPLICANT TO FILL IN _ JOB ADDRESS 0607 _ _ �IQ. Certified copy Js,hereby furnished. New Residential Bldgs &Pools EACH NO. FEE. ❑ _Certified copy Is fled with the county building Inspection 1�&2--Family,Sq.Ft. $ $ LOCALITY department Multi-family Sq Ft. CROSS ST Date Applicant' Residential Swimming Pools ASSESSOR MAP BOOK PAG PARCEL CERTIFICATE•OF EXEMPTION FROM WORKERS',. O'utlets Rec. Light Sw. i OWNER OR COMPENSATION INSURANCE g FIRM NAME S- � First 20 r•^ MAIL (This section need not be,completed if the work involved by the Total No Additional ADDRESS-_ Q O Q ca Q_ permi=t is for one hundred dollars($100)or less.) ' I certify that In the performance of the work for which this permit CITY ')e_M C/ Tel No is issued, I shall not employ any person in any'manner-so as to PLAN become su ject o the Workers'Compensation Laws Lighting Fixtures First 20 APPLICANT K 1 Total No Additional ADDRESS Date , Applica� 1 15 OR 20A,120V BRANCH CIRCUITS NOTICE O APPLICANT: If, aft aking this Certificate of CITY Tel No Exemption,you should become subject to the Workers'Compensation 1 TO 10 INCLUSIVE EACH provisions of the Labor Code, you must forthwith comply with such 11 TO 40 INCLUSIVE EACH PERMIT Sr_L f C C provisions or-this permit shall be deemed revoked. APPLICANT f P p 41 OR MORE BRANCH CIRCUITS EACH LICENSED CONTRACTORS DECLARATION - - ADDRESS l j I hereby affirm that I am licensed under provisions of Chapter 9 15 OR 20A,208V TO 277V,LIGHTING EACH (commencing with Section 7000) of Division 3 of the Business and _ _ CITY IV G,c' Tel No Professions Code,and my license is in full force and effect RESIDENTIAL APPLIANCES UP TO 3HP LICENSE B Class f:!1_/1_) Q s Power Apparatus-&Large Appliances REG NUMBER �� _ License Number �I L c.Class I t? Size&Type HP,KW,KVA,or KVAR DISTRICT NO PR CESSED BY O �-��( '` We '� Up to 3 Incl. —5-;gO� �� jolt �- Over 3 to 10 Incl. FINAL a Contractor ate - - - - - - DATEOver,10 to 50 Incl • - U) (/� ,�y/ Z ❑ I am exempt under Sec Over 50 to 100 Ihcl ` `� VALIDATION _ - - -- Over 100 FINAL - B&P.C.for this reason BY / Services,(g��CC&Panelboards + U 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 I hereby affirm that I am exempt from'the Contractor's License Law Sign with One Branch Circuit for the following reason (Section 7031.5, Business and Professions Additional Sign,Branch.Circuits' Code): ❑ I, as owner of the property,will do the work and the structure Misc Conduits-&Conductors— is onductors's not Intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) ;1 31 and Professions Code). CONSTRUCTION LENDING AGENCY ' i+r_,t}3r .. 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.) PLAN CHECKING FEE _ ')Jt.: `_.U:J C:1 Lender's Name PERMIT ISSUING FEE Lender's Address ` S I certify that I have read this application and state that the above TOTAL FEE 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 inspect16ri'purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE OF APPLICANT OR AGENT DATE l '