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Home My Public Portal About8723 HERMOSA DR_Electrical__ 76A663.CE-806 f11 /78) ..— __ .. '_• .--•--� APPLICATION FOR ELECT_ R_ICAL PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN New'Residenrial Bldgs.&Pools '- EACH NO. FEE, ADDRESS _ 72 �. F/ �°• Ct _,5... 1 &2.Family,S4 Ft. $ .025 — $ LOCALITY Multi-family Sq.F. .02 1 — CROSSTINEARSEST . /,x,, ResidentialSwimming Pools 25.00_ FIRMNAME Outlets: Rec_Light_Sw._ MAIL. - _ First 20 ,50 ADDRESS 7:2,3 )_ Total No. Additional- _30 CITY li �+-6 y.; 1 Tel,Na-.:Z86'-%?25 PLAN CHECK APPLICANT_ Lighting Fixtures First 20 .50 ADDRESS 'Additional .30.. _ Tolcl No. CITY Tel. No. Fixed Applionces.Not Over I HP .PERMIT - - - - - -- - - Range—Heater— D.W. _ APPLICANT Li�F� ' r 12'fZ OJen—Dryer= W.M.— - ADDRESS Top _FAU W.H._ CITY ) Tel.No, r Hood—Fane —Other— S4•-r �i!-- 2.50 LICENSE OR Class. -Disp.—Room Air Cond. — _ REG.NUMBER - I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA. Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO Size 8 type HP, KW, KVA,or KVAR COMPLY*WITH ALL'COUNTY-ORDINANCES -AND' STATE 'L1' AWS- '7 2.50 REGULATING ELECTRICAL WIRING. 0. Up to 1 Incl. t HEREBY CERTIFY THAT I•AM'PROPERtY REGISTERED ANDIOR' --O Over 1 to IO Incl. 5.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF Over 10 to'SO Incl- 12.50 _ CALIFORNIA OR:THAT I AM THE LEGAL OWNER OF ?HE ABOVE, �p 25.00 DESCRIBED RESIDENTIAL PROPERTY, Over 50 to 100 Inc. 40:00 PERMITEE /L , -��/ YT Over 100- - SIGNATURE U-(/V N Services �� DISTRICT N 0-200 Amp.Under 600 V � 12.50 201-1000 Amp. Under 600 V 25.00 - - --- Over 1000 Amp.or Over 600 V 50.00 = O Temp. Power Pole&Appurtenances' 10.00 - Q Sign with One Branch Circuit 10.00 G Additional Sign Branch Circuits 2'00 _ INSPECTION. > INFORMATION u F 9 2 Mise Conduits&Conductors 10.00 ON REVERSE Other(See Complete Fee Schedulel_ _,SIDE •t -Z 1: (1 f: 0 C 12 5 PERMIT FEE (Sub-Totall a S ,• - ` " •' D "• PLAN CHECKING FEE (One-Fourth Permit Feel O (' 2, 11 —d(I F PERMIT ISSUING FEE :'$7.00 - o TOTAL FEE > INSPECTION FINALED rc W date: BY Gs peDAPPLICATION FOR PERMIT EPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES ELECTRICWM. J. FOX CHIEF ENGINEER NAME LRECEIVED'By NO. GROUP ZONE PERMIT NO. U ADDRESS lz �READY FOR DAMISSUED U CITY TEL.NO. FIRST INSPECTION / aJ J COUNTY �•`��'�/ �l,1 M CERT.NO. EXPIRES APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY JOB DESCRIPTION OF WORK ADDRESS f/'l NUMBER OF OUTLETS ON CIRCUITS LOCALITY LOCATION BY ROOMS NEAREST LIGHT OUTLETS JSW. PLUGS lFIkT CROSS ST. 6 ,1,✓`� CIRCUIT A B C D E F G H W NAME ! //\ � rn �• 3 ADDRESS a O CITY TEL.NO. 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION.. ELECTRICIAN. I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE -119�a CORRECTIONS�+ OWNER: 9 ORRECTIONS , J Q _Z L7 R D TOTAL / 'y 3 NO. OF OUTLETS a 3t7 APPROVALS I 4NO. OFTURES $ DATE INSPECTOR'S NAME TORS H.P. S CONDUIT GNS TRANS. a WIRING NGES OR HEATERS $ FIXTURESNEOUS a POWEREUTILITYCO.NOTIFIED S FINAL y-zY- Y7 �Gl/r -- DDS-5A 11-59 APPLICATION FOR ELECTRIC PERMIT 1 DIVISION OF BUILDING AND SAFETY Department of County Engineer BUILDING County Of Los Angeles ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST PERMIT FEES C OSS ST. nuMeea OWNER I LIGHT OUTLETS MAIL �-L RECEPTACLES ADDRES I WALL SWITCHES FEE CITY T.L. NO --- TOTAL OUTLETS @ 5¢ $ ELECTRICIAN 4:S _ ELEC. RANGES 25 ELEC. HEATERS 25 ADDRESS KW EA CITY TEL. NO. STATE FIXTURES 5 Q LICENSE NO. MOTORS DISTRICT NO. I GROUP 17�f� �READY FOR INSPECTION NUM9ER HORSEPOWER FEE J( �( NEW MVD. HP OVER INC. EACH —� f e LESS $ .25 e9 INSPECTION RECORD f2 2 .50 2 5 1.00 5 f5 1.50 15 50 2.50 50 200 5.00 MISC. rS'I�S � /iLT AI7 FQ/c -(014,1'AfAfll/r nPaaG —^bra NO. SIGNS NO.TRANS. NO. SIGNS NO. LAMPS FOR EACH PERMIT: WIRING $1.00 If FIXTURES $1.00 SUPPLEMENTARY .50 APPROVALS TOTAL FEE $ DATE INSPECTOR'S SIGNATURE 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION 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 PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY ANGELES C NTY AND STATE OF CALIFORNIA OR THAT i HE LEGA HER OF THE ABOVE POWER DESCRIBED RESIDENTIA ERTY SIGNATURE UTILITY CO.NOTIFIED J `/ OF PERMITTEE FINAL JOHN A.LAMBIE. COUNTY E GI EER VALIDATION ARTHUR C.VEIT.CHIEF ELECT. INSPECTOR CK NO CASH !11004 1 5 3 MAR 15 2 2.6 0 i ION WORKERS ave a certificate of conseri o 15-863 10,91 APPLICATION FOR ELECTRICAL PERMIT {� I Hereby affirm that I have a certificate'of consent to self insure, cPaosG LJ or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY ' copy thereof(Sec.3800,Lab.C.) Policy No.—'Company FOR APPLICANT TO FILL IN - JOB- �+//��••�� ''77 ❑ - ADDRESS Certified copy is hereby furnished. New Residential Bldgs.& Poo EACH NO. FEE Certified copy is filed with the county building inspection40 1 & 2-Family, Sq. Ft. 00 $ — $ LOCALITY t c� depastmeM. - Multi-family Sq.Ft. NEAREST �� –As 1"(–, '(_ Date Applicant Residential Swimming Pools CROSS ST.OWNER OR q —g CERTIFICATE�OF EXEMPTION FROM WORKERS' �fj �Z �} PRM NAME �.(/ J I( �� f„Q>/- Outlets:Rec— Light t 2 1_ MAIL COMPENSATION INSURANCE � � O ADDRESS 7�3 � _ -Q./'.o-(j';$ '• , (This section need not be completed if the work involved by the First 20 _ Total No. 7S Additional CITY •„� � �.� Tel.No. 6- permit is for one hundred dollars ($100) or less.) l I.certify that in the performance of the work for which this permit APPLAPLICANT CHECK is issued, I shall not employ any person in any manner so as to 4 becomesubject to the Workers'Compensation Laws. Lighting Fixtures' ' First 20 / u ADDRESS / ''II Total No.� Additional CITY Tel. Date � Applicant 4))//!�`" Vlf NOTICE TO APPLICANT: If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT Exemption,you should become subject to the Workers'Compensation Range_ Heater D.W. _ APPLICANT provisions.of the Labor Code,you must forthwith comply with such Oven _ Dryer _ W.M. _ ADDRESSY'2 Q provisions or this permit shall.be deemed.revoked. Top _ FAU W.H. TT LICENSED CONTRACTORS DECLARATION Hood _ Fan OtherZsp _ CITY Tel.No. ' I hereby affirm that I am licensed under provisions of Chapter 9 CENSE R (commencing with Section 7000) of Division 3 of the Business and Disp. — Roam Air Cond. "'� REG.NUMBER Class. Professions Code,and my license is in full force and effect. Power Apparatus& Large Appliances DISTRICT 0. PROCESSED BY Size& Type HP,KW,KVA,or KVARD License Number Lic.Class Up to iIncl. FINAL U Over 1 to 10 Incl. DATE Contractor Date VALIDATION C F-1 - Over 10 to 50 Incl. FINAL U am exempt under Sec. Over 50 to 100 Inc. BY W BAP.C. for this reason Over 100 /.1 f d Services, Swbd.,MCC& Panelboards ► co Date: 0 - 200 Amp.Under 60C V I Signature 201 - 1000 Amp..Under 600 V =_ 0 0S,1 A Exemption for Reg- Mainf.Elect. - Over 1000 Amp.or,Over 600 V s . SINGLE FAMILY _. Temp.Power Pole& Appurtenances s^ 1 Il 57 Jr HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law 616.1 rl S.7 Si for the following reason (Section 7031.5,Business and Professions Additional Sign Branch Circuits - Code): O0-88 b3 LXl I,as owner of the property,will do the work aripthe structure Misc.Conduits & Conductors is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) , 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(Sec.3097, PERMIT FEE (Sub-Total) - .. 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 above TOTAL FEE ` 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 z ti� ignature of Permittee - Date ' DEC TION s WORKERS'that t I have a certificate cafe of corse CE-806 10/81 APPLICATION FOR ELECTRICAL PERMIT I_herT.by affirm that I have a certificate of consent to self CE-806G ins,,,, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec. 3800, Lob. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB ADDRESS .ZIsYK Certified copy is hereby furnished. New Residential Bldgs. 8 Po Is EACH NO. FEE Lis, Certified copy is filed with the county building inspec- 18 2-Family, Sq. Ft. OD' 8 — $ LOCALITY - _y 6.�f '—;�>-,.q L-^Lc<t.•; tion department. Multi-family Sq. Ft. — NEAREST CROSS ST. Residential Swimming Pools Date Applicant OWNER OR ) FIRM NAME (r✓/ �!(.� (- -�- CERTIFICATE OF EXEMPTION FROM WORKERS' � MAIL Outlets: Re Light Sw. COMPENSATION INSURANCE First 20 .7, � ADDRESS �23 �, .L/'y-�O$(�- (This section need not be completed if the work involved by Total No.l CITY :7CEN G Tel. No.�� the permit is for one hundred dollars ($100)or less.) Additional P- f7 I certify that in the performance of the work for which this - PLAN CHECK gppLICANT 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 , ADDRESS Total No. Additional , „ • AN/044 y CITY el. No. Date Applicant t Qver i HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of Fixed Appliances NoL APPLICANT Exemption, you should become subject to the Workers' Range_ Heater D.W. — ry Compensation provisions of the Labor Code, you must forth- Oven _ Dryer — W.M.— ADDRESS with comply with such provisions or this permit shall be Top _ FAU W.H. deemed revoked. Hood _ Fan CITY Tel. No. LICENSED CONTRACTORS DECLARATION OtherS� Disp: _ Room Air Condr D LICENSE M Class. I hereby offirm tha+I am licensed under provisions of Chapter REG. NUMBER (commencing with Section 7000) of Division 3 of the Business power Apparatus 8 Large Appliances DISTRICT NO. PROCEYE.R BY 6 and Professions Code,and m license is in full force and effect. C (/� Size 8 Type HP, KW, KVA, or KVAR' O License Number Lic. Class Up to 1 Incl. FINAL V DATE Over 1 to 10 Incl. VALI TIO 0 Contractor Date Over 10 to 50 Incl. H FINAL am exempt under Sec. Over 50 to 100 Inc. BY B.BP.C. for this reason Over 100 Z Date: Services, Swbd., MCC 8 Panelboords Q� ► - - K ) U 0 - 200 Amp. Under 600 V V 39, q Signature 201 - 1000 Amp. Under 600 V ## e e e e 'Z ❑ Over 1000 Amp. or Over 600 V t Exemption for Reg. Maint. Elect. I ° 57 rJ SINGLE FAMILY Temp. Power Pole &Appurtenances ° ) ) �'�Jr HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch ircuitCircuds 7,05-85 Low for the following reason (Sectiom7D31.5, Business and Professions F' Code): lis I, as owner of the property, will do the work and the Misc. Conduits 8 Conductors ( P Fee Schedule)—Com lete See her , r structure is not intended or offered for sale (Section Other 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY I.hereby affirm that there is o 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 CrV PERMIT ISSUING FEE Lender's Address / S r 7 I certify that I have read this application and state that the TOTAL FEE ' above information is correct. 1 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 Permi r Dote