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Home My Public Portal About6019 GOLDEN WEST AVE_Electrical__ 76A663-G806_11.70 APPLICATION FOR ELECTRIC A�PERMIV • COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING / 1 / BUILDING AND SAFETY DIVISION ADDRESS COLEMAN W. JENKINS SUPERINTENDENT OF BUILDING LOCALITY NEAREST n�1 FOR APPLICANT TO FILLIIN CROSS ST /L OU ETS NO EACH FEE OWNER RECEPT $ $ MAIL FIRST 20 25 ADDRESS W LIGHT 3 TO L CITY TEL N0. SWITCH OVER 20 10 PLAN CHECK LIGHTING TOTAL FIRST 20 25 APPLICANT FIXTURES OVER 20 10 ADDRESS APPLIANCES clry TEL. NOPERMTD RANGE DRYER WTR HTR. APPLIICANT e STA COOK DISP. F A U ADDRESS SPACE HTR. AIR COND. CITY TEL. NO CLOTHES/WASH. DISHWASH. LICENSENO �fo� CLASS / FAN • OTHER - 100 / �7� I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION V _ AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING I WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND HEATERS, ETC HP KW KVA ELECTRICAL WIRING SIZE & TYPE OVER TO I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR 'O - I 100 LICENSED AS REQUIRED BY,LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER•OF, AND INTEND TO >- 1 - 10 300 RESIDE IN, THE ABOVE DESCRIBED RESIIDENTIIAL PROPERTY O SIGNATURE ,[/ /I�� V 10 - 50 500 OF PERMITTEE 50 - 100 1000 DISTRICT NO CLASS - / OCE SED BY O 100 - 500 '1500 6Q UJ a to SIGN, GASSIGN AND ONE CIRCUIT 500 NOTES: Z TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 SERVICE NOTOVER 600 VOLTS OR 200 AMP 300 APPROVALS DATE INSPECTOR'S SIGNATURE SERVICEOVER600 VOLTS OR 200AMP 1000 TEMP POWER POLE TEMP SERVICE,POLE, &APPURTENANCES 5 D UNDERSLAB WORK _ TEMP LIGHT OR RECEPT. SYSTEM 3 D ROUGH CONDIUT WIRING / 97. FIXTURtS 1 POWER AUTHORI7ED PERMIT FEE (SUB TOTAL) 6 3 I,I , UTILITY CO NOTIFIED PLAN CHECK FEE /y FINAL PERMIT ISSUING'FEE 300 ero JOSEPHIC. ROOHAN TOTAL FEE3L SUPERVISING ELECTRICAL ENGINEER, 'PLAN-CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION cK M 0 CASH '-'I 1 4--' juL 2 3 2 D 0-1.3!,D— c' SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 16A663-CE80610-61 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 NEAREST FOR APPLICANT TO FILL IN CROSS ST I T E M NO EACH FEE OUTLETS (FIRST 20) $20 $ OWNER LIGHTS RECEPT. SW. MAIL OUTLETS. (ADD'L UNITS) 1O ADDRESS LIGHTS RECEPT. SW. LIGHTING FIXTURES: (FIRST 20) .20 CI TEL. N LIGHTING FIXTURES. (ADDITIONAL) .10 ELECTRICIA RANGES CLO DRYERS WTR HTRS. 1.00 ADDRESS GARB DISP STA COOK CITY TEL N DISHWASH AUTO-WASH. STATE SPACE HTRS BTA.APP.(%s H.P.MAX) .50 LICENSE NO. Q MOTORS OVER Nor OVER H. . DISTRICT NO. G UfyE P D BY O 1 1.00 1 1 3 tso INSPECTION RECORD ' o_ - 3 8 2.00 U 8 15 2.30 d 15 50 300 - O 50 100 S 00 d SIGNS NO.TRANS. NO.LAMPS L SERVICE 0.60OV-Nor OVER 200A 1.00 SERVICE 0.60OV-OVER 200 A. 1200 SERVICE OVER 600V 5.00 ' MISC. PERMIT ISSUING FEE 200 SUPPLEMENTARY PERMIT ISSUING FEE 100 TOTAL FEE $ 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE •INSPECTbR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRI NG 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS REq IRED BOH S ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR A IE L O R OF THE AB DESCRIBED RE81 ALSRTY. 1 OWER SIGNATUR s UTILITY"CO.NOTIFIED OF PERM[ FINAL ✓�% / '-TyO CAS ART SUPERVISING VETT C MO CASH SUPERVISING ELECTRICAL ENGINEER 3.0 Ofv l r /� 7A663 DES-SA 9•SS 9 A LICA` ION FOR ELECTRIC ■ ERMIT 1 S• DIVISION OF BUILDING AND SAFETY Depm'tment of County Engineer // ,+ was County of Los Angeles BUILDADDREING SS 6f / fwd Was WM.J. FOX, COUNTY ENGINEER CASSATT D. GRIFFIN.SUPT OF BUILDING LOCALITY �... G FOR APPLICANT TO FILL IN NEAREST PERMIT FEES CROSS ST NUMBER EACH FEE LIGHT OUTLETS OWNER d%i�[ �'" J� J• k MM - RECEPTACLES ADDRESS 04 J4/✓ WALL SWITCHES Q� TOTALOUTLETS 5¢ $ CITY • TEL NO Yom" 7'1279/& ELEC RANGES 25 ELECTRICIAN y� _ELEC. HEATERS 25 ADDRESS /��/J IJ V KW EA CITY TEL NO. FIXTURES 5 LICENSE NO. NUMBER OF LIGHT CIRCUITS y DISTRIC I GR I �Qt�E READY FOR INSPECTION NUMBER OF RECEPTACLE CIRCUITS MOTORS NUMBER HORSEPOWER FEE INSPECTION Wr0RD NEW MVD HP OVER INC EACH 1/2&LESS S- .25 1/2- 2 50 2 - 5 1 00 �y -�,�� tl/� 5 15 1 50 2 ---2- /M14 `/'Qn"5- 6111 �j- I5 50 2 50 50 200 '500 MISC. NO SIGNS NO TRANS. NO SIGNS NO LAMPS FOR EACH PERMIT' WIRING 51.00 FIXTURES $1.00 CDD SUPPLEMENTARY 50 APPROVALS TOTAL FEE g DATE INSPECTORS SIGNATURE 1 HEREBY'ACKNOWLEDGE THAT 1• HAVE READ THIS APPLICATION CONDUIT - AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING r ELECTRICAL WIRING. - 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES 22-S12 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE POWER DESCRIBED RESIDENTIA6 PROPERTY. �. UTILITY CO NOTIFIED ...� SIGNATURE OF PERMITTEE Pwf�'Ac"C.� � '' 94 FINAL WILLIAM J. FOX, COUNTY ENGINEER VALIDATION A. C.VEIT.CHIEF ELECT. INSPECTOR -5w, FEB 17 2 2.8 5 '7" TEMPLE CITY 1 7CA063-CESOG 10-59 APPLICATION FOR ELECTRIC PERMIT COUNTY OF LOS ANGELES J� DEPARTMENT OF COUNTY ENGINEERFADRE BUILDING AND SAFETY DIVISION ko 19 CJ JOHN A. LAMBIE. COUNTY ENGINEER WILLIAM A JENSEN,SUPT OF BUILDING FOR.APPLICANT TO FILL IN PERNIIT ,FEESNUMBER EACH FEEOUTLETS; $ $ LIGHTS RECEPT. SW. to LIGHTING FIXTURES 10 CITY rl.lr9EL NO ELEC.RANGES CLO.DRYERS ELECTRICIA WATER HEATERS .50 ADDRESS ELEC SPACE HTRS DISHWASHERS CITY TEL. NO GARBAGE DISPOSERS AUTO.- STATE WASHERS STA COOKING UNITS .25 LICENSE NO. MOTORS OVER INC H P 'DISTRICT-NO . GRUP ZON P ESSED BY IL O— 1/2 25L v.— 2 .50 INSPECTION RECORD 2— 5 100 S— 15 150 15— 50 250 50-200 Soo — SIGNS- NO TRANS 'w- NO LAMPS .L-7-4 ��! Z Q�/I7ZL !' SERVICED-600V 100 _ �XlvJeC [.G/J SERVICE OVER 600V 500 MISC WIRING PERMIT - too FIXTURE PERMIT 100 y" SUPPLEMENTARY PERMIT - 50 TOTAL FEE Is I HEREBY ACKNOWLEDGE THAT 1 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 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR WIRING LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES ' CALIFORNIA OR THAT IAM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. POWER SIGNATURE UTILITY CO.NOTIFIED OF PERM ITTE JA) �1 - FINAL J 2-2 MO ( cPQI� / ARTHUR C.VETT, CK Mo - CK nsH / SUPERVISING ELECTRICAL ENGINEER- ' LiY OCT 27 2 .4- 0 WORKERS'COMPENSATION DECLARATION 10ie1 CE-806c APPLICATION FOR ELECTRICAL PERMIT I,-hereby 'ffirm thcr4I have a certificate of consent to self CE-806 ` insure, ori"certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a'certified copy thereof (Sec 3800, Lab C ) Policy No Company FOR APPLICANT TO FILL IN JOB ��_/ Certified copy is hereby furnished New Residential Bldgs & Pools EACH NO FEE ADDRESS Ot 0LJP 41iiJrZ ❑ "Certified copy is filed with the county building inspec- 1 & 2-Family, Sq Ft $ — $ LOCALITY NE tion department - Multi-family Sq Ft CROSS AREST ST Date Applicant Residential Swimming Pools' AW OWNER OR FIRM NAMEtlEf IT CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec—l—Light7_Sw 3 MAIL COMPENSATION INSURANCE ADDRESS section need not be completed if the work involved b First 20 (This sep y Total No�� Additional CITY � Tel No 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 1 '� permit is issued, I•sholl not employ any person in any manner I so as to become subject to the Workers'Compensation Laws Lighting Fixtures First 20 ADDRESS s. fy Total No� 2 Additional CITY � el No Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT If, after making this Certificate 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 0 with comply with such provisions or this permit shall be Top _ FAU —WH — deemed revoked Hood Fan _Other_ CITY Tel Na LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp _ Room Air Cond REG NUMBER 3 Class (commencing with Section 7000) of Division 3 of the Business DISTRICT NO PROC SED BY and Professions Code,and my license is in full force and effect Power Apparatus & Large Appliances Size &Type HP, KW, KVA, or KVAR License Number Lic Class Up to 1 Incl FINAL Over 1 to 10 Incl DATE Contractor Date —jam W LIDATION 0 Over 10 to 50 Incl ❑ 1 am exempt under Sec Over 50 to 100 Inc 0. B&P C for this reason Over 100 N Date Services, Swbd , MCC & Ponelboards ► 0 - 200 Amp Under 600 V Signature 201 - 1000 Amp Under 600 V ❑ Exemption for Reg Mcint Elect Over 1000 Amp or Over 600 V SINGLE FAMILY Temp Power Pole & Appurtenances 27921 N HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit # o o 0 0 10 2 I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits Law for the following reason (Section 7031 5, Business and .0 0 27.50 Professions Code) ❑ I, as owner of the property, will do the work and the Misc-Conduits& Conductors o 0 0 2 7,5 0? structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ 7044, Business and Professions Code) Q 9, 1-5 t 8 7 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 O 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 the above-mentioned property for inspection purposes .SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date l