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Home My Public Portal About5216 GLICKMAN AVE_Electrical__ -Tt-1,1PLE C-1 y 76A663-CE806 5-62 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEEWf—\' BUILDINGBUILDING AND SAFETY DIVISIONADDRESS JOHN A. LAMBIE. COUNTY ENGINEER WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS Sr. RECEPT. TOTAL NO. EACH FEE OUTLETS FIRST 20 $20 $ OWNER LIGHT MAIL ADD'L f0 ADDRESS SWITCH. OVER 20 CITY TEL. NO. LIGHTING TOTAL i F1RST2O .20 FIXTURES 1( ADD'L 10 ELECTRICIAN OV R 20 RANGES CLO.DRYERS WTR.HTRB. 1.00 ADDRESS GARB.D18P. 11 STA.COOK CITY TEL. NO. DISHWASH. AUTO.-WASH. STA E SPACE HTRB, BTA.APP.(:/i H.P.MAX.) .50 / LICENSE NO. MOTORS: OVER NOT OVER H.P. DISTRICT NO. GROUP ZONE PROCESSED BY O 1 1.00 S+ a IL'1 CoWf C�c( 1 3 1.50 INSPECTIONRECORD 3 8 2.00 I S ['ti1 1�i t7 0 6 8 15 2.50 } n. 15 50 3.00 0 50 100 5.00 O' O SIGNS: NO.TRANS V NO.LAMPS W OL SERVICE0-600V-NOT OVER 200A 1.00 V) Z 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 8 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOWSSIGNATURE AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY CONDUIT WITH ALLCOUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING r 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR ' LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT 1 TH LEGA OWNER OF THE ABOVE DESCRIBED RESIDENTIAL O POWER SIGNATURE UTILITY CO.NOTIFIED OF PERMITTEE FINAL 0LIDATION ARTHUR C. VEIT CK MO CASH SUPERVISING ELECTRICAL ENGINEER 16A663-CES06 5-62 APPLICATION FOR ELECTRICAL PERMIT .' COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER TNEAREST. DING BUILDING AND SAFETY DIVISION ESS JOHN A. LAMBIE, COUNTY ENGINEER - WILLIAM A.JENSEN, SUPT OF BUILDING LITY FOR APPLICANT TO FILL IN S ST ` RECEPT. e TOTAL NO. EACH FEE OUTLETS FIRST 20 , $20 $ OWNER LIGHT .i� MAIL ADD'L f0 ADDRESS SWITCH. v OVER 20 LIGHTING �A�L^ FIRST 20 20 TOTCITY EL. NO. FIXTURES } lLl _ DR 20 tp ELECTRICIAN RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS GARB.DISP. STA.COOK CITY,r')I:zTEL.NO. DISHWASH. / AUTO.-WASH. STATE SPACE HTRS.! BTA.APP.('/$H.P.MAX. .50 Q LICENSE NO. MOTORS: OVER NOT OVER H.P. DISTRICTNO. GROUP ZONE I PROCESSED BY O 1 1.00 I 3 1.50 , i INSPECTION RECORD 3 8 2.00 6/5 3 8 15 2.50 L o_ 15 50 ,3.00 0 50 100 5.00 D' O NO.TRANS ~ SIGNS: NO.LAMPS Lu O_ SERVICE 0-60OV-NOT OVER 200A 1.00 /' z Z 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 $ I HEREBY ACKNOWLEDGE THAT i HAVE READ THIS APPLICIATION 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 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BLOS ANGELE COUN AND STATE OF FIXTURES .r- f � \ "`:�%�/�-- e4�• CALIFORNIA OR THAT I LEGA OWN OF ABOVE �" DESCRIBED RESIDENTIAL O Y. DPOWER i SIGNATURE UTILITY CO.NOTIFIED OF PERMITTEE FINAL - j LIDATION ARTHUR C. VETT ru CK MO CASH SUPERVISING ELECTRICAL ENGINEER �OR off,4KEt2hatIhave ATIONDECLARATION CE-806 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby affwm that I have a certificate of consent to self CE-806G '`.� 14asure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec. 3800, Lab. C.) Policy No. WC64 i 173C3ompany Homeland Ins.CO_. FOR APPLICANT TO FILL IN JOB ❑ ADDRESS 5216 Glickman Certified copy is hereby furnished. EACH NO. FEE New Residential Bldgs. & Paols �/ LOCALITY Tem le Cit ' "17�Certified copy is filed with the unty building inspec- 1 &2-Family, Sq. Ft. $ _ $ p y `fes tion department. Multi-family Sq. Ft. NEAREST CROSS ST. Date 04/01/87 Applicant Residential Swimming Pools OWNER OR FIRM NAME Mr. Behmier CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec 13 Light 1Q—Sw.15 MAIL as Ob COMPENSATION INSURANCE 20 s-og ADDRESS (This section need not be completed if the work involved by 4th 38 First 20 the permit is for one hundred dollars ($100)or less.) Total No. Additional CITY Tel. No. I certify that in the performance of the work for which this PLAN CHECKAPPLICANT 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 20 101 ADDRESS Date Applicant Total No. 10 Additional CITY Tel. No. Fixed Appliances Not Over 1 HP NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT Cobine electric CO, Inc. PERMIT 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 1607 Chestnut St. with comply with such provisions or this permit shall be Top _ FAU W.H. — deemed revoked. Hood _ Fan 1 Other_ CITY Alhambra Tel. No. 282-0315 LICENSED CONTRACTORS DECLARATION 2 LICENSE OR Disp. _ Room Air Cond. a Class. I. hereby affirm that I am licensed under provisions of Chapter 9 REG. NUMBER 22.847 G 10 (commencing with Section 7000) of Division 3 of the Business power Apparatus & Large Appliances DISTRICT NO. PROCESSED 1 LL and Professions Code,and my license is in full force and effect. ®' 229847 C10 Size &Type HP, KW, KVA, or KVAR License Nu er - Lic. Class Up to 1 Incl. FINAL Over 1 to 10 Incl. DATE � � VALIDA lON Contractor. Te Over 10 to 50 Incl. ❑ FINAL I am exempt under Sec. Over 50 to 100 Inc. BY a B.&P.C. for this reason Over 100 Z Services, Swbd., MCC& Panelboards Date: 0 -200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V ❑ Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V 6 5 i,9 A SINGLE FAMILY Temp. Power Pole&Appurtenances e o o e o 2 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 4 9. I hereby affirm that I am exempt from the Contractor's License o Additional Sign Branch Circuits 00 Law for the following reason (Section 7031.5, Business and Professions Code): 0 0 - 49. 006 ❑ I, as owner of the property, will do the work and the Misc. Conduits&Conductors structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ , 0 220-87 7044, Business 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 PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE 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 th mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE 02/19/87 Signature of Permittee Date