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Home My Public Portal About10619 HALLWOOD DR_Electrical__ 716A6 63. APPLICATION FOR ELECTRIC. PERMIT PBS-5A 12-:C4 ' DIVISION OF BUILDING AND SAFETY ." Department of County Engineer County of.Los Angeles BUILDING �J�pay ✓�� r, j� ��'n pp WM. J: FOX, COUNTY ENGINEER ADDRESS CASSATT D. GRIFFIN, SUPT OF BUILDINGr�- FOR APPLICANT TO FILL IN LOCALITY PERMIT FEES NEAREST CROSS ST. FEE NUMBER EACH � OWNER � V 7 LIGHT OUTLETS - - MAIL RECEPTACLES ,T ADDRESS „'p��pp WALL SWITCHES { _�Jrr� g - TEL. NO.�� {,p 74L�'a TOTAL OUTLETS ai 5� $ 4Y CITY r.� ?`��. e -Y ELEC. RANGES 25 'ELECTRICIAN Q.a.Q.Oo%L �a F ELEC. HEATERS 25 ADDRESS A KW EA _ YY CITY ::�f�'.-'='”✓�'�// _ TEL. NO.. FIXTURES 5 V`S LICENSE NO. NUMBER OF LIGHT CIRCUITS NUMBER OF RECEPTACLE CIRCUITS JG'DISTRICT�h10: �GROIJP ZONE READY FOR INSPECTION MOTORS . _ _NUMBER HORSEPOWER FEE INSPECTION RECORD .NEW MVD. HP OVER INC. EACH _ I/2 IN LESS $ .25 - �/2. 2' .50 . 2 5 1.00 5 15 1.50 15- 50 2.50 50 200 5.00 MISC. NO. SIGNS NO. TRANS. NO. SIGNS NO:LAMPS FOR EACH PERMIT: a WIRING $1:00 bo FIXTURES $1.00 A _ - SUPPLEMENTARY .50 - - . . APPROVALS TOTAL FEE $ 3 DATE INSPECTORIS SIGNATURE I HEREBY ACKNOWLEDGE THAT ['HAVE READ THIS APPLICATION CONDUIT AND STATE THAT THE ABOVE'IS CORRECT AND AGREE TO COMPLYI iJA WITH ALL COUNTY ORDINANCES AND STATE LAWS ,REGULATING WIRING 7 , ELECTRICAL WIRING. - IHEREBY CERTIFY THAT, I AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED B LOS ANGELES COUNTY-AND STATE OF • POWER ' CALIFORNIA OR THAT AA1 THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENT( ROPERTY. ' UTILITY CO.NOTIFIED SIGNATURE OF PERMITTEE FINAL WILLIAM J. FOX,COUNTY E(VGINEER_ VALj �f+PI .8 I n MAR 1 0 2 3.60 m .11U"V DY - - ...._. .. DEPUTY COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY ELM,� <. WILLIAM J. FOX, County Engineer T FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. FOW%f#.N ELECTRICIA 11 A—J %3O RECEIVED BY READY FOR DATE ISSUED ADDRES Y}r'C�J•L•Js� FIRST INSPECTION CITY TEL NO. 4 /— COUNTY LICENSE NO. EXPIRES BUILDING PERMIT FEES NUMBER FEE��EACH LOCALITY LIGHT OUTLETS NEAREST RECEPTACLES 77 CROSS 9T. , WALL SWITCHES OWNER TOTAL 13UTLETS 5c $ MAIL ELEC. RANGES 25 4,1 ADDRESS /✓ _ ELEC. HEATERS 25 -YF' CITY TEL NO. FIXTURES 5 '` 1 HEREBY ACKNOWLE - THAT I HAVE READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER KNEw Ill HP OVER INC. EACH OF THE REBIDENTIAL ROPERTY PrESCRIEKD. ,e VE. i _ I/2 6 LESS_ $ .25 SIGNATURE OF I/2 2 .50 - PERMITTEE ----- 2 5 1.00 INSPECTION RECORD _ 5 15 1.50 - 7 S 50 2.50 60 200 5.00 200 Sao 10.00 500 1 OOO 15.00 Z Z OVER 1000 20.00 M.G. SET/FREq. CHANGER-HP WELDERS:AC-KVA GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF CIRIG.) MOVED MOTORS (75% OF 011i MISC. SIGNS NO. NO.TRANS. APPROVALSNO. NO. LAMPS FOR EACH PERMIT: - DATE INSPECTOR'S NAME WIRING $1.00 j �" CONDUIT /' A FIXTURES $1.00 / WIRING ,�, SUPPLEMENTARY .50 —T' FIXTURES -i/�--,��-y,A�/ y✓ ,� POWER �j.."711 / I TOTAL FEE 5 UTILITY CO. NOTIFIED 1 1 'Dv 11�b�� , FINAL U V 76A663 DBS#SA 2-53 I ,� a KERS' COMPENSATION DECLARATION 10/81 CE-806 APPMC�AT N FOR ELEC�TUCAL pLQ6Uv U I i ebyFaffir that I have Oa certificate of consent to self CE-806G risure qr a certificatb of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thQreof (Sec. 3800, Lob. C.) , �r Policy No' Company FOR APPLICANT TO FILL IN, JOB /� Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS 'J Certified copy is filed with the county building inspec- 1 & 2-Family, Sq. Ft. $ — $ LOCALITY. w Pr tion department. Multi=family Sq. Ft. — 'NEAREST CROSS ST. Date Applicant Residential Swimming Pools OWNER OR FIRM.NAME CERTIFICATE OF EXEMPTION FROM WORKERS' . MAIL Outlets:'Rec Light Sw. /c COMPENSATION INSURANCE l✓ ADDRESS (This'section need not be completed if the work involved b First v ( p Y Totdl No. Additional, CITY Tel. No." '7 the permit is forone hundred dollars($100)or less.) IcertifY that in the performance of the work for which this PLAN CHECK' P APPLICANT permit is issued, I shall not employ any person 'r any manner \ e so as to,become subject to the Workers'Co nsation Laws. Lighting FixturesFirst 20 ADDRESS, -Total No. Additional 'CITY Tel. No. Date — Applicant �" Fixed Appliances Not Over 1 HP PERMIT NOTICE TO, APPLICANT: If, after ak' g this Certificate of APPLICANT Exemption, you should become s ject to the Workers' Range_ Heater_D.W. Compensdtion provisions of the Labor Code, you must forth- Oven_ Dryer'— W.M.— ADDRESS ' �•, 1 with comply with such provisions or this permit shall be Top FAU' —W.H. — deemed revoked. ` CITY Tel. No. . . LICENSED CONTRACTORSDECLARATION Hood Fan _Other— DispRoom Air Cond. LICENSE O (AWfINa I hereby affirm that I am licensed under provisions of Chapter 9 REG. NUMBER = Y�y ' Class: (commencing with Section 7000) of Division 3 of the Business DISTRICT NO. _ PROCESSED B and Professions Code, and my license.is in full force and effect. Power Apparatus & Large Appliances /' > Size & Type HP, KW, KVA, or KVAR' ( V 0 License Number Lic. Class Up to 1*Incl. FINAL Contractor Dare 1 Over 1 to 10 Incl. DATE ' VALIDATION 101Over 10 to 50 Incl FIN CCC111 V I am exempt under Sec. Over 50 to 100 Inc. BY A BAP'.C. for this reason Over 100 H Date: Services, Swbd.., MCC& Panelboards 0 -200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V ❑ Over 1000 Amp. or Over 600 V Exemption for Reg. Maint. Elect. SINGLE FAMILY Temp. Power Pole & Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits- 2:7 6 9.9 A. Law for the following reason (Section 7031.5, Business and Professions Code):, #;o o a o e 2 ❑. I, as owner of the property, will do the work and the Misc. Conduits&Conductors structureis not intended or offered for sale (Section Other (See Complete Fee Schedule)— D 4 8.5 0 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY ;o;o o 4 8,5 Ob I hereby affirm that there is a construction lending agency for d the performance of the work for which this permit is issued PERMIT FEE• (Sub-Total) 0 8A $ $7 (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 thea ve-me �nedpro�ertyforinspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Sig atu,16 of Permit ee - Date