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Home My Public Portal About8814 GARIBALDI AVE_Electrical__ 76A6153-CE806 10/72 APPLICA ION FO EEC4TICAL RMIT COUNTY OF LOS AN�ELES DEPARTMENT OF COUNTY ENGINEER JOB .a- BUILDING AND SAFETY DIVISION 1?=IIR OCALI EAREST FOR APPLICANT TO FILL IN ROSS ST, OUTLETS ° A S S ME RECEPT.� MAI L FIRSY20 A ADDRESS LIGHTTO L V CITY TEL. NO.z '— SWITCH OVER 20 .10 PLAN CHECK' LIGHTINGTOTAL �`O FIRST 20 APPLICANT FIXTURES VER 20 ADDRESS 10 RESIDENTIAL APPLIANCES CIn TEL. NO. PERMIT RANGE DRYER WTR. HTR. APPLICANT STA. COOK DISP. F.A.U. ADDRESS SPACE HTR. AIR COND. CITY N0. CLOTHES WASH. DISHWASH. EMggR CLASS FAN OTHER 1 1.00 I HEREBY ACKNOWLQDSETHAT I HAVE READ THIS APPLICATION AND STAT[ THAT THE ABOVE IS CORRECT AND ASR[[ TO COMPLY MOTORS, TRANSFORMERS RATINS WITH ALL COUNTY ORDINANCES AND STAT[ LAWS REGULATING IND. HEATERS, ETC. HP. KW. KVA. [L[CTRICAL WIRING. SII[ k TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AMD/OR 0 — 1 ipp LICENSED AN REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAI I AM THE LEGAL OWNER OF THE ABOVE 1 — 10 Spp DESCRIpED RESIDENTIAL PR RT . PERMITEE 10 EQ 0.00 SIGNATURE 50 — 100 10.00 DISTRICT NO. OC SED BY 100 — 5w 15.00 a °v3 z SIGN, GAS SIGH AND ONE CIRCUIT 0.00 APPRQvALS DATE oer[c S$RGLITU! TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE SfAVICENOTOVER 600VOLTS OR200AMP 5.00 Q UNDERSLAB WORK SERVICEOVER600VOLTS OR200AMP 10 ROUGH CONDUIT TE24PSERVICE,ROLE, &APPURTENANCES 0.00 WIRING " TEMP LIGHT OR RECEPT. SYSTEM 5.00 FIXTURES � POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL PERMIT FEE (SUB TOTAL) PLAN CHECK FEE PERMIT ISSUING FEE SAO d �! TOTAL FEE PLAN CHECK VALIDATION CK. M.O. CASH PER VALIDATION CK. M.O CASH ss-Es-E��,1t1N 4 7.5 0 ,&"8 SE[ BACK OF APPLICATION FOR COMPLETE SCHEDULE SE T WORKERS'COMPENSATION DECLARATION CE-w6 10,81 APPLICATION FOR ELECTRICAL PERMIT •IKiorRfflrm that I have a certificate of consent to self ��' Insur ora certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY ora erYffled copy thereof (Sec. 3800, Lab. C,) IF X�e -Policy No. Company FOR APFUCANT TO FLL IN IADDRESS r..I Certified copy Is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE❑ _ _ LOCAL G t Certffted copy is filed with the county building inapec- 1 8 2-Family, Sq. Ft. $ E1741�0 PA tion department. Multi-family Sq. Ft. AREST Residential mming Pools OWNER _MST. Date Applicant R pp FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' 0 u t I Ight�Sw 4AAIL COMPENSATION INSURANCE First ADDIS J (Thts section need not be completed if the work Involved by ti l C Tel. N the permtt h for one hundred dollars (;100)or loss.)) Total No Additional ple I certify that In the performance of the work for which this APPUC NT t permit Is Issued, I shall not employ any Person In any manner so as to become subject to the Workers Com tion Laws. Lighting Fixtures First 20 ADDRESS Q Total No. CfTY Tel. No. Date r Ilcnn Additional Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making Is Certificate of APPLICANT Exemption, you should become subject to the Workers' Range_ Heater_D.W. — Compensatlon provisions of the Labor Code, you must forth- Oven _ Dryer —W.M.— ADDRESS with comply with such provisions or this permit shall be Top — FAU —W.H. — deemed revoked. CITY Tel. No. ED LICENSCONTRACTORS DECLARATION Hood Fan _Other— O UaNM OR I hereby arrn that I am licensed under provisions of Chapter 9 Dlap. Room Air Cond. REG NUMBER Class fN (commencing with Section 7000) of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NO. P BY } and Professions Code,and my license Is In full force and effect. d Size b Type HP, KW, KVA, or KVARiG O License Number I Ic. Class Up to 1 Incl. FINAL V Over 1 to 10 Incl. DATIEt\�3 VAUDATION 0 Contractor Date Over Ind.10 to 50 InFINAL Cj ❑ I am exempt under Sec. Over 50 to 100 Inc. BY a B.BP.C. for this reason Over 100 Date: Z Services, Swbd., MCC 8 Ponelboards , — 0 -200 Amp. Under 600 V Signature 201 -1000 Amp. Under 600 V ❑ Over 1000 Amp. or Over 600 V Exemption for Reg. Moint. Elect. SINGLE FAMILY Temp. Power Pole 8 Appurtenances HOME OWNER-BUILDER DECLARATION Sign wLth One Branch Circuit I hereby affirm that I am exempt from the Contractor's License - 1 0 3 0 A Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits Profealons Code): o 0 o 0 0 Mlsc. Conduits 8 Conductors I, as owner of the property, will do the work and the Other See Com lete Fee Schedule)- 70.", chedule _ ' 0 0 3 a 7 5 structure Is not Intended or offered for saie (Section ( p ) 704", Business and Professions Code). tr .0 0 3 ti i F _. CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for L the performance of the work for which this permit Is Issued PERMIT FEE (Sub-Total) (Sec. 3097, Clv. C.). PLAN Ci-IECKANG FES Lenders Name PERMIT ISSUING FEE Q Lender's Address 1 certify that 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 Electrlcal wiring, and hereby authorize representatives of this County to enter upon the above-mentioned property for Irnpectlon purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Ignatur erml a to ll 'WOR IC1TtS'COMPENSATION DECLARATION 7APPLICATION FOR ELECTRICAL. PERMIT • CE-BMG (2-80)�08 I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY insure, or a certificate of Workers',Compensation Insurance,or a certified copy thereof(Sec. 3800,Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN SOB New Residential Bldgs.&Pools EACH NO. FEE ADDRESS ❑ Certified copy V hereby furnished. 1 &2-Famlly,Sq. Ft. f — = LOCALITY, F ❑ Multi-famlly Sq. Ft. dpartcertified copy 6 filad with the county building inspection Residential Swlmmin Pools CR089 ST department. g c OWNER OR '/ / FIRM NAME Date Applicant Outlets: RecIght�Sw,C� �Vd pMAIL �+ F 2200// 2' ADDRE �f Inst CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional COMPENSATION INSURANCE CITY Tal No. } PLAN CHECK CL 8 (Thneed i section not be completed if the work bivohred APPLICANT Lighting Fixtures First 20 by the peffiit Is for one bundred doRm ($100) or las.) Additional ADDRESS Total No. O I certify that In the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No. 0 permlt is Issued, I shall not employ any person in any manner PERMIT so as to become subject to the Worker' Compensation Laws. Range_ Heater_D.W. APPLICq A ``��``��,, Oven Dryer_W.M. ADDRESS S - Z �Date�Applican�ecome Top FAU _W.H._ CITY ` Tal N '�F�,� // ,, Hood Fen _Other_ NOTICE TO APPLICANT: after making this Certificate of Dlsp. Room Air Condom_ Exemption, you should subject to the Workers' REQ.NUMBER leas Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appllances DISTRICT NO. PROCES ED BY with comply with such provisions or this permit shall be Size&Type HP,KW,KVA,or KVA deemed revoked. Up to 1 Incl. FI AL Over 1 to 10 Incl. DATE 3� VALIDATION LICENSED CONTRACTORS DECLARATION - Over 10 to 60 Incl. I hereby ■form that I am licensed under FINAL provisions of Chapter Over 60 to 100 Inc. BY / 9 (commencing with Section 7000) of DtvWon 3 of the Bust- QVef 100 Q—t� nae and Prbfesslom.Code, and my license Is in full force and effect. Services License Number�}' .Ic.Clara v 0-200 Amp. Under 600 V ¢ 201-1000 Amp. Under 800 V ContrafR o/T� Fate ^��f Over 1000 Amp.or Over 600 V HOME OWNER-BUILDER DECLARATION Temp.Power Pole&Appurtenances_, I 'hereb3N affirm that I ■m exempt from the Contractor's Sign with One Branch Circuit License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits nese and Professions Code): 5 3 a 8 A Misc.Conduits& Conductor ❑ 1, as owner of the property, wnl do the work and the Other(See Complete Fee Schedule)— #(o 0 0 0 0 2 structure is not intended or offered for sale (Section 7044, Business and Professions Code). ;s o /� 3 1 Q CONSTRUCTION LENDING AGENCY I hereby ■fflrm that there is ■ construction lending agency for the performance of the work for which this permit D .o e'o 4 a 1 0•5 PERMIT FEE (Sub Total) Issued (Sec. 3097,civ.C.). ` 0 a 2 1 -8 1 Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) Lender's Address PERMIT ISSUING FEE 8 `� I certify that I have read thls application and 'state that the TOTAL FEE above information L 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 ��► r_f/ lure ttee Date