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Home My Public Portal About5127 GOLDEN WEST AVE_Electrical__ .,APPLICATION FOR ELECTRICAL PE IT COUNTY OR LOS ANGELES DEPARTMENT OF'-COUNTY ENGINEER ADDRESS DIN A SAFETY DIVISION vp LOCALITY New Residential Bldgs& Pools EACH Nb. FEE NEAREST 1 A 2-Ferhlly,Sq. Ft� .025 — CROSS ST. MultFfanlly Sq. Ft_ 02 OWNER OR FIRM NAME Residential Swimming Pooh 20.0/I0 MAIL ADDRESS SW Ltd@ sf— Outieb: Light, Switch &Receptacle 4 � CITY Ie– T.1.No. F l rst 20 -ACO Additional 30 j APPL(CANT AO D R ESS Ughting Flkturas FIrot 20 -50 CITY TN.No. AddlUoi,el PERMIT APPLICANT Fixed Appllance. Not Over 1 HP ADDRESS ' Rengo_Haatar�XD.W.— CITY Tai.N6. Ovens Drygr_W-M.�_ Top _ FAU _W.H. it � LICENSE EO..NUMBER OL.. Hood_ Fen ___ I HERF,EY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION D Dlsp—A.C. 2` ARD /TAT[ THAT THE ABOVI< Ia CORRECT AND ARSE TO COMPLY WITH ALL COUNTY ORDINANCES ARO STATE LAY. RA ESUTTINS ELECTR ICAL W IR INS-, Power Apparatus& Large Appllencer 1 HEREBY CERTIFY THAT t AM PROPERLY RE442TERKD AND/OR Size&Type HP, KW, KVA, or KVAR LICENSED Aa RKOUIRED MY LOS AX"LFS COUNTY A STATE OF �— Up to 1 Incl. 2.00 CALIFORNIA OR TH I AM THE LEGAL OWNER HE ABOVE �— Over 1 t0 10 Ind. 5.00 DEOCRIRED hEEID AL PROPERTY �— Over 10 to 60 Ind. 10.00 PEWITE� "r 60 to 100 Ind. 20.00 SIQIATl,IR� Over 100 30.00 DISTRICT NO. O BY C s.,viDe. 0C9 b 0- 200 Amp. Under 600 V 12.50 INSPECTORS 1�- 201,1000 Amp. Under 600 V 25.00 APPROVALS SIGNATUREZ Over 1000 Amp. or Over WO V 50.00 TEMP,POWER POLE Tamp. Power Pole& Appurtenar,ceE •� UNDERSLABWORK Sign with One Branch Circuit 19,00 ROUGH CONDUIT Addltlonel-Sign I3rgnch Circuits i.w WIRING (Other) FIXTURES POWER AUTHORIZED UTILITY COT NOTIFIED FINAL PERMIT FEE (Sub-:Total) NOTES 1 rrV. PLAN CHECKING FEE (One-Fourth Permit Fee) r' PERMIT ISSUING FEE $6.00 r1� TOTAL FEE PLAN(:HECK VALIDATION CK 'M.O.` CrASH PERMIT VA ID T70N CK CASH 93 6 MC Sts BACK OF APPI.IL-ATION FOR COMPt-JETS SCH[Dt4L[ , l ,I 'GASSY``"G IO'" APPLICATION FOR ELECTRICAL PERMIT c COUNTY OF LOB ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION v=71dsw Wes LOCALITY 77!M C)JtO 74NEAREST 5 FOR APPLICANT TO FILL IN CROSS eT. OUTLETS OWNER OR FIRM NAME RECEPT. MAIL LIGHT TOTAL FIRST 20 ADDREU CITY u TEL. NO. SWITCH_ OVER 20 .10 PLAN CHECK FIRST 20 APPLICANT LIGHTING TOTAL OVER 20 ADDRESS F I)<T U RED .10 RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT RANGE DRYER_WTR. HTR. APPLICANT STA. COOK DISP. F,A.U. ADDRESS SPACE HTR, AIR COND. CITY TEL, NO. CLOTHES WASH. DISHWADH, CLADS. FAM OTHER 1.00 I HEREBY ACKNOWL[DS[ THAT I HAV[ READ THIS APPLICATION AND STATE THAT THE ABOVE 1/ CORRECT AND AGREE TO COMPLY MOTORS TRAMSFORM[Rl RA TIN/ WITH ALL COUNTY ORDINANCE■ AND /.TAT[ -LAWS RE/ULATIN/ IND. HI[A.TE 15 ETC. Ii P. KW. KVA. ELECTRICAL WIR IMS. SIZE S TYPE OVER TO I H[REDY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 — 1 1A0 LICENSED AS REQUIRED By LOS ANGELES CO Y AND STAT[ OF CALIFORNIA Oil T T I AM THE LESAL OW 11OF,TH[ ASOV[ ' — 10 3.00D[/CRIE[D R[ D TIAL PROF 600 O 10 — 60 PERMITEE SIGNATURE 50 — 100 1040 DISTRICT NO. P EBBED BY 100 — 600 15.00 Q c — SIGN, OAS SIGN AND ONE CIRCUIT &OD APPROVAL/ DAn Dtt ECTO"S NWMTURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.001 TEMP. POWER POLE SERVICENOTOVER 600 VOLTS OR 200 AMP 9.00 UNDERSLAB WORK SERVICE OVER 600 VOLTSOR200AMP 10 ROUGH CONDUIT TEMPSERVICE,POLE,&APPURTENANCES 0.00 WIRING TEMP LIGHT OR RECEPT. SYSTEM JAO FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL PERMIT FEE (SUB TOTAL) NOTES: PLAN CHECK FEE PERMIT ISSUING FEE TOTAL FEE PLAN CHECK VALIDATION CK. M.O. CASHPERMIT VALIDATION CK. M.0 CASH 0a4tin�r, 2 0 1 0.2G � SE[ SACK OF APPLICATION FOR COMPLETE SCHEDULE "'°-R" "' ''`° T'°" DECLARATION lf C r7&&.643 '°�' APPLICATION FOR ELECTRICAL PERMIT I hereby c¢firm t�iat L have a certificate of consent to se >;�06G Insure, or a certh9date of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec- 3800, Policy No.w4-r'1—&--3-Q-r2-- 1ih1T Company APII-U TO RL i+ JOB 760 40� f f ❑ Certified copy Is hereby furnished. New Residential Bldgs, 8 Pools EACHNO. FEE OV ❑ Certified copy.lsfiled with the county bullding Inspec- 1 8 2-Famlly,'Sq. Ft.- s — i LOCALITY — tion department. Multi-famlly Sq. Ft. OZOSSLST Date '� ApResidential SwIMming Poolsplicant OWKER OR PM NA-FIME C`} r CERTIFICATE OF EXEMPTION F WORKERS' Outlets: Rec_Llght Sw._ L COMPENSATION INSURANCE 46 Is section mmd not be coca eted If the work involved First 20 th Total No Addltlohaf CITY E ' Tel. No. the p*rmM b for one hundred dollars(;100)or less. 1 cbrtlfy that In the perfort»ante of the Work for which this � permlt is Issued, I shrill not employ any Person In any manner was to become sub(ect to the Workers Compienscrtlon laws. Ughting �lxtures First 20 ADDRESS Total No. Additional' Date CITY Tel. No. A'—Ilcant Fined`Appllances Not Over 1 HP PERMIT NOTICE 70 APPLICANT: If, after making this Certificate of Range— Hooter—D.W. T Exemption, you should become sublect to the Worken g Compensation provisions of the Labor Code,you must forth- Oven T Dryer — W.M.— ADDRESS wltb comply with such provisions or this permit shall be Top — FAU —W.H. — deemed revoked. I ' Hood _ Fan Other_ CITY �� Tel. No. - - ' LICENSED CONTRACTOR$ DECLARATION` LKI SE OR I hereby affirm that I am licensed under provisions of Chapfer 9' - Dlsp. _ Room Air GondREG NUMBER Q Chis. (commencing with Section 7000) of Dlvl}lon 3 of the Business ppDISTRICT NO. `; BY Power Apparatus.8 La[ge Appliances � ! anb affect.d Professions Code,qnd my license In full force and eect. Q Size d Type HP,KW, KVA, or KVAR License Nyimber Ic. CI Up to 1 Incl. INAL /} �_8 K- �� Over 1 to 10 Intl. DATE �'/ 7� VALIDATION Contract Dino- Over 10 to 50 Ind. FINAL 10 ❑ I.qm a enlpt under Sec. Over 50.to 100 Int. By _ ,�� d B.BP.C. for this reason_ - Over 100 H Date: bd Services, SW ., MCC 8 Pahelboards , 0 -200 Amp. Under 600 V Signature 201 - Tp00 Amp. Under 600 V ❑ Over 1000 Amp. or Over 600 V Exemption for Reg. Malnt. Elect. SINCAE FAMILY Temp. Power Pole 8 Appurtenances 0 6 9,.9'A HOME OWNER$UILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contraetors License } 0 0,0 0 0 2 Law for the following reasonss(Section 7031.5, Buslneand Addltlohal Sin Branch Circuits I . Professions code): `erty2Q50 ❑ Misc. Conduits$ Cor doctors .o a 0'2 a 5�0 2s I, as Owner of the prop , will do the work and the structure Is not Intendbd or offered for sale (Sectiori Other (See Complete Fee Schedule)_ , 7Q.", Buslness and Professlons Code). 0423-84 CONSTRUCTION LENDING AGENCY. I hereby affirm that there Is a construction lending agency for the performance of the w6rk for which this permit Is Issued PERMIT FEE jSub-Total) /O (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Namo- PERMIT ISSUING FtE Lenderrs Address I certify that I have read this appllcatlon.and state that the TQTAL FEE above Information Is correct, I agree to comply with all County ordinances and Sts aws regulating Electrical wiring, and heesentatives of this ty to enter upon property for I n purposes.. SEE REVERSE FOR EXPLANATORY LANGUAGE mities Do fe