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Home My Public Portal About8755 HERMOSA DR_Electrical__ 75^663-CE806 10"2 APPLICATION R ELECT ICAL PE IT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER FFIRMNAME_:;50 F BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN . OUTLETS NO. EACH FEE 1��,,RECEPT. JL S S FIRST 20 25 - A T .�� LIGHT TOTAL CIT /'LG� TEL. NO. �7= SWITCH � OVER 20 .10 PLAN CHECK FIRST 20 'S FIXTURES /✓ �10 ,25 APPLICANTT,C�)/�[._ LIGHTING TO'[&y OVER 20 ADDRESS RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT RANGEDRYER_WTR. HTR._ APPLICAN STA. COOK DISP.�F.A.U. r ADDRESS SPACE HTR. AIR GOND. CITY TEL. N0. E Z.S l CLOTHES WASH. DISN WAS H. RG. MBEROR ' CLASS.0 �Q FAN_OTHER 100 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS. TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. SIZE 9 TYPE OVER TO HEREBY CERT IFT THAT AM Pfl OPERL REGISTERED AND/OR O - 1 1.00 LICENSED AS REOU IN EO BY L05 ANGELES C UNTY AND STATE OF CAL I FON NIA OR THAT I AM THE LEGAL W ER OF THE ABOVE > 1 - 1D 300 OESCRI BEO RESIDE TIgL Pq OPEPT CL O 10 - 50 5.00 PERMITEE �,,2 � ✓ SIGNATU O H 50 - 100 1000 DISTRICT N0. SED BY w LL 100 - 500 15.00 _ �{�D OO 2 v 1 _ SIGN, GAS SIGN AND ONE CIRCUIT &00 APPROVALS DATE INSPE 'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 TEMP. POWER POLE SERVICENOTOVER600VOLTSOR200AMP 3.00 6(J UNDERSLAB WORK SERVICEOVER60OVOLTS08200AMP 10.00 ROUGH CONDUIT TEMPSERVICE, POLE, &APPURTENANCES 5.00 WIRING TEMP LIGHT OR RECEPT. SYSTEM 3.00 1 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL PERMIT FEE (SUB TOTAL) NOTES: F PLAN CHECK FEE PERMIT ISSUING FEE 3.00 -3 ('fa TOTAL FEE Z� PLAN CHECK VALIDATION CK. M.G. CASH PERM%VALIDATION 7CK. J M.G. cesH 7'2 O FEB `6� 2 U 2 2,8 55 A SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE , � '°A°°' `E°°° '°"° APPLICATION FOR LECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER Joe '+ BUILDING AND SAFETY DIVISION GRESs •�-G .� LOCALITY ' NEAREST �J FOR APPLICANT TO FILL IN CROSS ST. _�/�4. �✓CL OUTLETS N0. EACH IEE OWNER OR S $ FIRM NAME / p f RECEPT. MAIL �y ADDRESS T FIRST 20 ( O fA LIGHT TOTAL J SWITCH OVER 20 l0 CITY TEL. N0. S - . PLAN CHECK LIGHTING FIRST 20 25 G APPLICANT TOTAL p FIXTURES OVER 20 10 ADDRESS 3 RESIDENTIAL APPLIANCES CITY EL. NO,�,QS�,Z PERMIT RANGE_ORYER_WTR. HTR._ APPLICANT STA. COOK__OISP,_F.A.U._ ADDRESS SPACE HTR, AIR CONIC. CITY TEL, NO. CLOTHES WASH._OISHWASH._ LICENSE OR G REG. NUMBER �OS�Q CLASS FAN_OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THISAPPLICATION AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY - MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. SIZE B TYPE OVER TO HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR - 0 - 1 1.00 LICENSED A9 RETHAI I BY L09 AN G EL EB COUNTY AND STATE OF CALIF ORNIA OR THAI I AM THE LEO AL OWNER OF TXE 4BOVE d 1 - 10 3,00 OESGRIP.ED RESIDE TI L PROP RTX U PERMITEE / 10 - 50 9.00 SIGNATURE H-D SO - 100 10.00 DISTRICT N0. PR SED BY w w Y d 100 - SDO 15.00 SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPEC R'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE SERVICE NOTOVER 600 VOLTS OR 200 AMP 3.00 UNOERSLAB WORK SERVI CEOVER 600 VOLTS OR 200AMP 10.00 ROUGH CONDUIT TEMPSERVICE, POLE, &APPURTENANCES 5.00 WIRING TEMP LIGHT OR RECEPT, SYSTEM 3.00 FIXTURES POWER AUTHORIZED gal UTILITY CO. NOTIFIED FINAL PERMIT FEE (SUB TOTAL) NOTES: PLAN CHECK FEE --T` PERMIT ISSUING FEE TOTAL FEE PLAN CHECK VALIDATION CK. M.D. CASH PERMIT VALIDATION cK.% M.D. CASH 0 4 1-�R "16 2 1 1.0.0 A5 SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE /� WORKF,QS'.COMPENSATIQN DECLARATION ]6A663 iD,B, APPLICATION FOR ELECTRICAL PERMIT I here�oy affirm Mat.I hove a certificate of consent to self CE806G insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY V'or a certified copy thereof (Sec. 3800, Lob. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB ADDRESS 77S r r'c,. Certified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE ❑ LOCALITY Certified copy is filed with the county building inspec- 1 8 2-Family, Sq. Ft. °' — S NEAREST ` lion port enc. Multi-family $q. Ft. CROSS ST. d � 7e.Z i�,vwy"� Residential Swimming Pools Date Applicant "� OWN= FIR CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL n Outlets: Rec_LightSw._ COMPENSATION INSURANCE First 20 ADDRESS (This section need not be completed If the work involved by Total No. CITY r[,(& Tel. No.d��`17 the permit is for one hundred dollars ($700)or less.) Additional certify that in the performance of the work for which this PIAN CHECKAPPLICANT permit is issued, I shall nal employ any person in any manner so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS Total No. Additional CITY Date Applicant Fixed Appliances Not Over I HP PERMIT NOTICE APPLICANT: If, after making this Certificate of APPLICANT Exemption,n, 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 with comply with such provisions or this permit shall be Top _ FAU —W.H. deemed revoked. CITY Tel. No. LICENSED CONTRACTORS DECLARATION Hood _ Fan _Other— Disp. Room Air Con LICENSE M Class. I hereby affirm that I am licensed under provisions o4 Chapter 9 REG. NUMBER (commencing with Section 7000) of Division 3 of the Business power Apparatus 8 Large Appliances DISTRICT NO. PR ES D BY Dry' and Professions Code,and my license is in full force and effect. /1 C1 Size 8 Type HP, KW, KVA, or KVAR' License Number Lic. Class- - Up to 1 Incl. FINAL `� n Over I to 10 Incl. DATE C'/J yq IDATION 0 Contractor Date Over 10 to 50 Incl. FINAL W ❑ I am exempt under Sec. Over 50 to LOO Inc. BY d' 100 N 6.8P.C. for this reason Over Z Date: Services, Swbd., MCC 8 Ponelboords ' 0 - 200 Amp. Under 600 V ;2451.2A Signature 201 - 1000 Amp, Under 600 V❑ • • ^ • • 2 Over 1000 Amp, or Over 600 V Exemption for Reg. Maint. Elect. ( e e 1 4.00 SINGLE FAMILY Temp. Power Pole 8 Appurtenances = HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit • • • 1 4 0 0 cs I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits Low fort following reason (Section 7031.5, Business and 4,22 86 profe ons Code): 0 I, as owner of the property, will do the work and the Misc. Conduits 8 Conductors structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ , 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 /40 1 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 ve-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE EeA, -/4.- t, Signature of Permittee Date - WORKERS' COMPENSATION DECLARATION 76AM3 10/81 APPLICATION FOR ELECTRICAL PERMIT I he i*y)5 affirm that I have a certificate of consent to ;elf CE806G Insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec. 3800,/Lob. C.) Policy B� tsIany 0, � `w / FOR APPLICANT TO FILL IN JOB ('� J Certified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE ADDRESS €r 6SA Certified copy is filed with the county Widding inspec- 18 2-Family, Sq. FL — $ LOCALITY r' G tion department. Y Multi-familyNEAREST Sq. Ft. CROSS ST. ��( pplica nt Residential Swimming Pools - Dote OWNER OR NAME ��/-C•-!• CERTIFICATE OF EXEMPT IO FROM WORKERS' d Z MAIL COMPENSATION INzSURANCE Outlets: Rec�_Light Sw._ ADDRESS /9)'1'f� (This section need not be completed if the work Involved by r� First 20 �' the permit is for one hundred dollars ($100)or less.) Total No.L� Additional CITY �L,t p �I Tel. No.2-1,E PLAN CHIC I certify that in the performance of the work-for which this APPLICANT K/'`9- 6U/L 41 permit is issued, I shall not employ any person in any manner �/� �.C/� �r.� � so as to become subject to the Workers'Compensation Lows. Lighting Fixtures First 20 ADDRESSCi r�rV �� Total No. Additional CITY Date Applicant Tel. No. PERMIT E NOTICE TO APPLICANT: If, offer making this Certificate of Fixed Appliances Not Over 1 HP PAPPLICANT Exemption, you should become subject to the Workers' Range_ Heater_D.W. Compensationprovisions 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. CITY Tel. No. LICENSED CONTRACTORS DECLARATION Hood _ Fan _Other' Dis _ Room Air Cond. LICENSE OR hereby affirm that am licensed under provisions of Chapter 9 p' REG. NUMBER Class. r (commencing with Section 7000) of Division 3 of the Business DISTRICT NO. _ PROCES D BY a. Power A aratus 8 E r e A lionoes and Professions Code,and my license is in full force and effect. Rp g PP O �q�� Size 8 Type HP, KW, KVA, or KVAR' `� c JV ,License Number "l ( Lic Class Up to 1 Incl FINAL V V11. t I L� �,(I 1 '�" ��/s'�G[ Over 1 to 10 Incl. DATE ✓� 8� VALID ION U Contractor^ ISILV�i ate ! 0o Over 10 to 50 Incl. v ❑ I am exempt under Sec. Over 50 to 100 Inc. B N N B.BP.C. for this reason Over 100 Z Services, Swbd., MCC 8 Ponelboords 4 4 Q 5 A Dale: 0 -200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V ( ° - 21.75 ❑ Exemption for Reg. Maine. Elect. Over 1000 Amp. or Over 600 V • ° ° 2 1.7 5 V SINGLE FAMILY Temp. Power Pole 8 Appurtenances o QO 5786 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 Low for the fallowing reason (Section 7031.5, Business and Professions Code): ❑ I, as owner of the property, will do the work and the Misc. Conduits 8 Conductors structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction tending agency for the performance of the work for which this permit is issued PERMITTEE (Sub-Total) (Sec. 3097, Civ. C.), 1 PLAN CHECKING FEE Lender's Name— ,L Lender's Address PERMIT ISSUING FEE Q /I certify that I have read this application and state that the TOTAL FEE s above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and her by authorize representatives of this County to enter upon the bove-menti ned proper for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE k Signat re of Permittee Date