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Home My Public Portal About9067 HERMOSA DR_Electrical__ 16A663-CE806 9-67 APPLICATION FOR ELECTRICA�IT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADOR ESS JOHN A. LAMBIE. COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY / NEAREST FOR APPLICANT TO FILL IN CROSS ST. NO. EACH FEE RECEPT. S .,S OWNER MAIL //�G LIGHT TOTAL FIRST 20 .20 ADDRESS (ice SWITCH_ OVER 20 .10 OITY61" TEL. NO. LIGHTING iTOTAL FIRST 20 .20 CONTRACTOR FIXTURES 1( OVER 20 .10 ADDRESS RANGE +'TR�WTR.HTR.— CITY TEL. NO.,elZJ f/ STA.COOK_DISP. F.A.U._ LICENSE NO. SPACE HTR.—AIR COND. I HEREBY ACKNOWLEDGE THAT I H VE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CLOTHES WASH._DISHWAS H._ WITN ALL COUNTY ORDINANCES AND STATE LAWS REGULATING - ELECTRICAL WIRING. FAN OTHER 1.00 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF MOTORS.TRANSFORMERS RATING CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO IND. HEATERS, ETC. HP. KW. KVA. RESIDE IN, THE ABOVE ESC BED RESIDENTIAL PROPERTY. SIZE & TYPE OVER TO SIGNATURE 0 - I 1.00 OF PERMITTEE d - '0 3.00 tDRICT NO. GR�.SJP ONE PROCESSED BY 8 � v ,O _ SD 5.00 0 50 - 100 10.00 ES: F W Ioo - sao 15.00 a N SIGN,GAS SIGN AND ONE CIRCUIT 3.00 TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 SERVICE NOT OVER 600 VOLTS OR 200 AMP DQ�- 2.00 1.00 SERVICE OVER 600 VOLTS OR 200 AMP 5.00 TEMP SERVICE, POLE, & APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE . POWER POLE RSLAB WORK H CONDUIT ISSUING FEE 2.00 GURES SUPPLEMENTARY ISSUINGFEE 1.00R AUTHORIZED PERMIT FEE TYCO.NOTIFIED /. PPLAN CHECK FEE (50% PERMIT FEE) L TOTAL FEE �J JOSEPH C. ROOHAN SUPERVISING EL CAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.D. CASH iEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE -I;'� 76AS63 " 806R 10"' APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER JOB BUILDING AND SAFETY DIVISION ADDRESS FOR APPLICANT TO FILL IN LOCALITY TP-! f , I G New Residential Bldgs.&Pools EACH NO FEE NEAREST 1 &2-Family,Sq. Ft $ .025 — $ CROSS ST.. Ca-�tQ�✓'+ EEL., OWNEROR E ' Sap Multifamily Sq. Fr. .02 — FIRM NAME IJ Residential Swimming Pools 25.00 MA ADRESS e, ri, o -AD Outlets: Rec_L—hghr Sw. CITYT ` el.Na _gaLp First 20 .50 PLAN CHECK Total No. Additional .30 APPLICANT ADDRESS Lighting Fixtures First 20 .50 1 1 1 CITY Tel,No. Additional .30 PERMIT _ Total No. APPLICANT 1^ l Fixed Appliances Not Over 1 HP ADDRESS 31,5 5 . 5 Z Range—Heater—D.W.✓ CITY SANGA6gletN.. _ 0 4fn Oven —Dryer—W.M,L LICENSE OR Top — FAU —A ' REG.NUMBER Class` Q Hood—Fan _O ^ 1 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE Disp. _ Room Air LOnd —6J4 2'50 1 O THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDIN- ANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. Power Apparatus&Large Appliances Size&Type HP;KW, KVA,Or KVAR HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED As REOWRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I.AM Y Up to I Inc[. 2'50 THE LEGAL OWNEROF THEABOVE DESCRIBED RESIDENTIAL PROPERTY. Over 1 to 10 Incl. 5.00 c.a Over 10 to 50 In . 1 2.50 PERMITTEE clC SIGNATURE O Over 50 to 100 Inc. 25.00 d~J Over 100 40.00 DISTRICT NO. pp PR SSE Y N Services J 06 ? 0-200 Amp. Under 600 V 12.50INSPECTOR'S 201-1000 Amp.Under 600 V 25.00 APPROVALS DATE SIGNATURE Over 1000 Amp.or Over 600 V 50.00 TEMP. POWER POLE UNDERSLAB WORK Temp. Power Pole&Appurtenances 10.00. - Sign with One Brooch Circuit 10.00 ROUGH CONDUIT Additional Additional Sign Branch Cl o, WIRING Misc.Conduits&Conductors 10.00 FIXTURES Other(See Complete Fee Schedules POWER AUTHORI ZED UTILITY CO. NOTIFIED FI NAL PERMIT FEE (SubTotal) NOTES PLAN.CHECKING FEE (One.Fourth Permit Feel PERMIT ISSUING FEE $7.00 TOTAL FEE Ind yPLAN CHECK VALIDATIONL CK. WO, CASH PERMIT VALIDA ,/ CK. 1 M.O. CASH z-796, 700��,WG26 200 30.00A SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 'ti 76Ai63 DOS SA 3-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF'LOS' ANGELES WILLIAM J. FOX, CHIEF ENGINEER. FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRICIAN WrC`v J , r /f—/ 21 70Y RECEIVED- BY . READY FOR DATE ISSUED ADDRESS ZM4.r ' /] /YJ FIRST INSPECTION CITY 7• TEL NO S(��7ryJ COUNTY LICENSE NO. EXPIRES(//-�0 -SJ GUILDINOADDRESS Q 417 B PERMIT FEES NUMBER EACH FEE LOCALITY LIGHT OUTLETS NEAREST CROSS ST. RECEPTACLES / - WALL SWITCHES ` OWNER TOTAL OUTLETS — $ 0 MAIL ELEC. RANGES 25 ADDRESS ELEC. .HEATERS 25 CITY TEL NO. FIXTURES 5 I HEREBY ACKNOWLEDGE THAT 1 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 NUHBEa #EPDWERR FEE ANGELES COUNTY LICENSE, OR I AMI THE LEGAL OWNER New Mvo. HP . EACH OF THE RESIDENTIAL-PROyE DESCRIBED OV E. ess S .25SIGNATURE OF2 .50s 1.00 INSPECTION RECORD 5 1.50 V D 2.500 5.00 0 10.000 15.00Z 20.00 0 M.G. BET/FRED. CHANOER-HP WELDERS: AC-KVA O GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (95% DF ORIO.) MOVED MOTORS (75% or DRIO.) MISC. SIGNS NO. NO.TRANS. APPROVALS NO, N0. LAMPS FOR EACH PERMIT: DATE INSPECTOR'S NAME WIRING $1.00 40 CONDUIT 1- FIXTURES $1.00 / O O WIRING SUPPLEMENTARY .50 FIXTURES POWER TOTAL FEE $ UTILITY CO. NOTIFIED FINAL 11. �� I3R16T l.C.IY Wm that I have a certificate Nof consent 76-663 'Ore, APPLICATION FOR ELECTRICAL PERMIT {� I hereby affirm that I have.a certificate of consent to self insure, CE-606G �J or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy tqe��( C.k'800yab.C.) �- r/�� - Policy No. 'may Campsn `� �� FOR APPLICANT TO.FILL IN JOB M c ,!r ❑ Certified copy is hereby furnished. New Residential Bldgs.8 Pools EACH NO. FEE ADDRESS �OlP / 4��/iA� 0J✓� $� $ — LOCALITY, 1 & 2-Family,Sq.Ft. G} ' Certified copy is filed with the county building inspection — �•�• departm intL-, Multi-family Sq. Ft. NEAREST p�' CROSS ST I Date Applicant Residential Swimming Pools OWNER OR FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec� Light L Sw. L MAIL COMPENSATION INSURANCE ADDRESS (This section need not be completed if the work involved by the First 20 Total No. additional CITY Tel.No. permit is for one hundred dollars ($100) or Jess.) I certify that in the performance Ofthe work for which this permit PLAN CHECK. is issued, I shall not employ any person in any manner so as to APPLICANT become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 -xiADDRESS Additional Date Applicant Total Na / CITY Tel.No. NOTICE TO APPLICANT: If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMITC p Exemption,you should become subject to the''Workers'Compensation. Range_ Heater_ D.W. APPLICANT / provisions of the Labor Code, ybu must forthwith comply with such Oven _ Dryer _ W.M._ Q ADDRESS X 7 provisions or this permit shall be deemed revoked. Top _ FAU W.H. _ �- - CITY Tel.NI LICENSED CONTRACTORS DECLARATION Hood — Fan Other_ & i�e 1 hereby affirm that I am licensed under provisions of Chapter 9 LICENSE OR (commencing with Section 7000) of Division 3 of the Business and Disp. ROOM Air.Card. REG.NUMBER �7 ,� p` Class. Professions Code,and my license is in full force and effect. Power Apparatus.& Large Appliances DISTRICT NO. PROCESSED BY �/ /( Size 8 Type HP,KW,KVA,or KVAR a License Number-2=• //! s T L.Class / Up to 11ncl. FIN U Over 1 to 10 Incl / O� D E VALIDATION Contractor K J7 Date O ❑ Over 10 to 50 Incl. 17- am exempt under Sec. Over 50 to 100 Inc. BY FINAL A f _ W B.BP.C. for this reason Over 100 // a Services,Swine,MCC&Panelboards ® N Date: 0 - 200 Amp.Under 600 V Signature _ 201 - 1000 Amp.Under 600 V ❑ Exemption for Reg.Maint.Elect. Over 1000 Amp.or Over 600 V SINGLE FAMILY Temp.Power Pole 8 Appurtenances HOME OWNER-BUILDER DECLARATION ' Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law for the following reason(Section 7031.5, Business and Professions Additional Sign Branch Circuitsy{_��•e Code): Zo ❑ 'jj'1-1f • 1,as Owner of the property,will do the work and the structure Misc.Conduits& Conductors 4. 6C is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) 1 HEMS Eh1S and Professions Code). - TOTAL 483 - 60 CONSTRUCTION LENDING AGENCY CHECK 48.611hereby 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-Tota) CCHAphaE •Ill I Civ. C.), PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE 0000-0001, 911-21i1:1 Lender's Addre s / certify thaiave reatl this application and state that the above TOTAL FEE �. (p 23,4 1 AN111:'c informatio s orrect. agree to comply with all County ordinances and Sta ws regulating EI 'cal wi g, and hereby authorize , ' represe fives of t un me pon the above-ment' ned - - prope f r inspe ion ose /(j ^-� SEE REVERSE FOR EXPLANATORY LANGUAGE ignature o�r / Date � / v'1 „ • _