The URL can be used to link to this page

Home My Public Portal About9835 GARIBALDI AVE_Electrical__ 78A863-Ci308 10-89 APPLICATION FOR ELECTRIC PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER T -�1 rte' — WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY //''/E', �I 7 PEBMT FEES FOR APPLICANT TO FILL IN NEAREST CROSS ST. CPL GLS OWNER E� ITEM NUMBER EACH FEE MAIL OUTLETS: S S ADDRESS LIGHTS RECEPT. SW. .IO (,' LIGHTING FIXTURES 10 CITY TEL.NO. ELEC.RANGES CLO.DRYERS ELECTRICIAN WATER HEATERS .50 ADDRESS ELEC.SPACE HTRS. DISHWASHERS CITY GARBAGE DISPOSERS AUTO.- STATE r WASHERS STA.COOKING UNITS .25 V LICENSE NO. / 31 7 MOTORS: OVER INC. H.P. DIS�RI T NO. GROUP 1, ZQNE PROCESSED B O— 1/2 .25 q 1/2- 2 .50 INSPECTION RECOR 2— 5 1.00 5— 15 1.50 15— 50 2.50 50-200 5.00 ?/ NO.TRANS. ;T SIGNS: NO.LAMPS SERVICE 0-600V 1.00 O �- SERVICE OVER 600V 5.00 MISC. WIRING PERMIT 1.00 D FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .50 TOTAL FEE S 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 WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT ELECTRICAL WIRING. �-- 1✓ I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR WIRING LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERPOWER SIGNATURE UTILITY CO. TIFIEO OF PERMITTEE FINAL ®FSUPERVISING ELECTRICAL ENGINEER ,)MLIDATION ARTHUR C.VEIT. c mo CASH L�I� 0 u 9 DEC 3 CI 2 9.5 5 79 EYiPL C91""if 9 F-36- 16A663-CE606 4-60 APPLICATION FOR ELECTRICAL PERMIT 'I COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS A, JOHN A.LAMBIE, COUNTY ENGINEER WILLIAM A. JENSEN. SUP'TOF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. PERMIT FEES OWNER 1 TE M NUMBER EACH FEE MAIL OUTLETS: $ $ ADDRESS LIGHTT ECEPT. SW. LIGHTING FIXTURES y� CITY TEL.NO. ELEC. RANGES CLO. DRYERS ELECTRICIAN P6 WATER H EATERS .50 ADDRESS Y - ELEC.SPACE HTRS. DISHWASHERS CITY TEL.NO. 2 c LYS GARBAGE DISPOSERS AUTO.- STATE LICENSE NO. WASHERS STA. COOKING UNITS .25 MOTORS: OVER INC. H.P. DISTR T N?- I GUP Z�].�IE P ECSSED �£ 0 — '/z .25 j f) �� z 50 INSPECTION RECORD >- 2 5 1.00 /L67 0 O 5 — 15 1.50s U w 15 — 50 2.50 0 L) 50 U 200 5,00 i W SIGNS: NO TRANS. d N NO. LAMPS Z SERVICE 0.600V 1.00 SERVICE OVER 600V 5.00 MISC. WIRING PERMIT 1.00 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT ,50 TOTAL FEE $ `� 1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPRO ALS 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 1 I A LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES 7 0 CALIFORNIA ORTHAT 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PR /Q�'1� POWER SIGNATURE UTILITY CO. NOTIFIED OF PERMIT- FINAL f VALIDATION ARTHUR C.VETT. SUPERVISING ELECTRICAL ENGINEER CK MO CASH OCT 1- 6 2 u WORKERS'COMPENSATION DECLARATION 76A663 10/81 , APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self CES' Insure, or a certificate of Workers' Compensbtlbn Insurance, 'COUNTY OF LOS ANGELES BUILDING AND SAFETY cr a certified copy thereof (Sec. 3800, Lab. C.) Policy No. Company PGIt APMJCANT TO Rtl IN JOB NSS Ce t[fled copy Is hereby furnished. New Residential Bldgs. 8 Pools E 0 FEE ADD� ❑ ; = f LOCALIIIT Y�� Certified copy Is flied with the county building Inspec- 1 8 2-Family, Sq. Ft. tion department. Multi-family Sq. Ft. NEAREST CROSS ST. Residential Swimming Pools 4W Date App I I ca n T I�I�NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: R10—Light�SWA MA L COMPENSATION INSURANCE ADDS First 20 (This section need not be completed If the work Invotred by the permit Is for bne hundred dollars (;100)or lees.) Total No Addltlonal r' CITY Tel. No. PLAN C1iEOC 1 certffy That In the performance of the work for which this ICANT permit IF Issued, I shall not employ any person In any manner so as to become subject to the Workers'Compensation L¢ws. Lighting Fixtures First 20 ADDRESS Total No. ti Additional CITY Tel. No. Date Zppllcant Fixed Appliances Not Over 1 HP pp�7 NOTICE TO APPLICANT: If, after making thl Iflcate of APPLICANT 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.— ADDRESS with comply wRh such provisiorls or this permit shall be Top — FAU —W.H. — CITY Tel. No. deemed revoked. LICENSED CONTRACTORS DECLARATION Hood — Fan —Other— LIONM OR 1 hereby arm tftat I am licensed under provisions of Chapter Q Dlsp. — Room Air Cond. REG NUMBER Class. ffi (commencing with Section 7000) of Division 3 of The Business DISTRICT NO. BY and Professlons Code,and my license Is In full force and effect. Power Apparatus 8 Large Appliances DISTRICT tZ Size 8 Type HP, KW, KVA, or KVAR S-1 O License Number Llc. Class Up to 1 Incl. FINAL u DATEVX Over I to 10 Incl. "23 VALFDAT10N O Contractor Data Over 10 to 50 Incl. la FINAL ❑ I am exempt under Sec. Over 50 To 100 Inc. BY _ �� W B.BP.C. for this reason Over 100 Date: Services, Swbd., MCC 8 Panelboards ► 0 -200 Amp. Under 600 V Slgnature 201 - 1000 Amp. Under 600 V ❑ Over 1000 Amp. ar Over 600 V Exemption for Reg. Malnt. Elect. SINGLE FAMILY Temp. Power Pole 8 Appurtenances HOME OWNER-BUILDER DECLARATION 7 (.R Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractors Llcerue t' o 0 0 o o 2 Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits of Ions Code): 7 0 0 34. 25 as owner of The property, will do the work and the Mlsc. Conduits 8 Conductor structure Is not Intended or offered for sale (Section.4Other (See Complete Foe Schedule)— poll, v v j 70 , Business and Professions Code). ? L CONSTRUCTION LENDING AGENCY I _ 4 I hereby affirm that there Is a construction lending agency for 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 ! PERMIT ISSUING FES /O Lender's Address I 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 Electrical wiring, and hereby authorize representatives of This County to enter upon thea vo-mentlo py or Inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of ml ee Date WO11If�ERS'COMPENSAfIONDECLARATION CES 0 (2-80) APPLICATION FOR ELECTRICAL PERMIT ' I hereby affirm that I have a-cer"cate orobment-to self COUNTY OF LOS ANGELES BUILDING AND SAFETY insure, or acertificate of Workers'Compensation Insuruce,or a certified copy thereof(Sec. 3Abl),Lab.C.) FOR APPLICANTTO FILL IN JOB Policy No. Company- EACH NO. FEE' ADD-RESS New Realdentlel Bldgs.&Pools 0 CertlAed copy is hereby furnished,. 1 &2-Famlly,Sq. Ft. S — LOCALITY Certified copy Is filed with the county building inspection Multi-iemlly Sq. Ft.T_ CROSS ST department. Residential Swimming Pools OWNER OR FIRM NAME Date Applicant Outlets: Rec.—Light Sw. MAIL —first 20 ADDRESS CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY Yal No. COMPENSATION INSURANCE PLAN CHECK (TMs welt n need not 1M completed if the work' hrohred APPLICANT ^ by the permit is for one hundred dollars ($100) or lass.) Lighting Fixtures Fl rat 20 r ADDRESS �XJ Total No.�_ Not Over 1 HP Additional . Y certify that'in the performanca of the Work for which this Fixed CITY Tel No. O permit h Issued, I shall not employ any'pemn in any manner Appliances PERMIT so as to become subject to the Worken' Compensation Laws. Lange_ Hooter D.W. _ APPLIQANT W Oven _ Dryer_W.M._ ADDRESSCn Date1-�D Applicant Top FAU _W.H._ Z Hood � Fen _Other_ CITY" Tel No. NOTICE TO APPLICANT: If, after making thincm ate of Dlsp. _ RooAir Condom C R Exemption, you should become aubloct to thAe Workers' REQ.NUMBER Class Compensation provisions of the,Labor Code, you mast faith- Power Apparatus& Large Appliances DISTRICT NO. PROLE D with comply with such, provisions or this permit shall be W deemed revoked Size&Type HP,K ,KVA,or KVA Up to 1 Incl. Over 1 to 10 Incl. FINAL LICENSIrD CONTRACTORS DECLARATION Over 10 to 60 Incl. / �!(;/ VA l DATION I hereby affirm that I am license¢under provisions of Chapter Over 60 to 100 Inc. FINAL 9 (commencing with Sectiod 7000) of Dfvialott 3,of the Busi- Over 1DO BY C..S ness and Profaslom.Codd, and my license is,in full force and effect. License Number Lic.Clans 0-208 Amp. Under Under 600 V Contractor Dote Over 1000 Amp.or Over 800 V ' 09.6 a L ' 0',0' a 0 o 2. HOME OWNER-BUILDER DECLARATION Temp.Power Pole&AppurtenenceaI ' I hereby afArm�that I am exempt from the Contract OT's Sign with One Brooch Circuit ? 0i0La50 License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits "00,0 0 Z 5 E 0 peas and Professions Code): , _ I ' ' ' I, u owner of the property, Misc.Condults&Conductors ,O 0-814 p party, wild do the work and the Other (See Complete Fee Schedule)— structure is not intended or offered for sale (Section 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that them is a construction lending agency for the performance of the work for which this pgrmit V IssaM(Sec. 3097,Civ.C.). PERMIT FEE (Sub-Total) Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) Lender's Address PERMIT ISSUING FEE 0 I certify that I have read this application and state that the TOTAL FEE 7— above above Information L correct.I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorise representatives of this County to enter upon ttie above-mentlod roparty for inspection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE I L tureofl'ermlttee Data -