HomeMy Public PortalAbout9802 HOWLAND DR_Electrical__ 74A663-CfiB06 1/70
'JAPD �,
- , GOUN L ANGELES
APPLICATION FOR ELECTRICAL P RMIT
DtPARTMENT OF COUNTY ENGINEER BUILDING 1
BUILDING-AND SAFETY DIVISION ADDRESS QOC =, U
JOHN A. LAMBIE, COUNTY ENGINEER LOCALITY /-
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING
NEAREST
FOR APPLICANT TO FILL IN CROSS ST. /
OUTLETS NO. EACH FEE /
(5-
t OWNER ' � R bG ��
RECEPT. IJ - $ S _
LIGHT TOTAL FIRST 20 Zp
ADDRESS S S 6 o v E
CITY TEL. No. — 766
SWITCH -712 OVER 20 .10 PLAN CHECK
GHTING TOTAL LFIRST 20 20 APPLICANT
FI%TURES 10 I
OVER 20 ADDRESS
.
APPLIANCES CITY TEL. NO.
PERMIT ' ^
RANGE_ORYER WTR. HTR._ APPLICANT A'-lam
STA. COOKDISP. F.A.U._ ADDRESS
SPACE HTR, AIR COND. CITY TEL. NO.
CLOTHES WASH. DISHWASH._ LICENSE NO. CLASS.
FAN_OTHER 1,00 1 HEREBY ACKNOWLEDGE THAT I NAVE READ THIS APPLICATION
ANO STATE THAT THE ABOVE 15 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 & TYPE OVER TO
HEREBY CERTIFYIR THAT AM PROPERLY REGISTERED ANO/OR
0 - 1 100 LICENSED A5 REQUIRED BY l05 ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
I - 10 3.00 RESIDE IN, THE ABOVE DESCRICED RESIDENTIAL PROPERTY.
6
fRE
ATURE 0
10 - 50 5.00ERMITTEE U
50 - 100 1000 y.
ICTNO. CVA55 GROUP 20N PROCESSED BY
100 - 500 15.00 (� � -SIGN, GAS SIGN AND ONE CIRCUIT 3.00S: Z L 7 TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1003 7'SERVICENOT OVER 600 VOLTS OR 200AMP 200 APPROVALS DATE INSPECTOR'S SIGNATURE
SERVICEOVER 600 VOLTS OR 200AMP SOO
.POWER POLETEMPSERVICE,POLE, &APPURTENANCES 300RSLAB WORKTEMP LIGHT OR RECEPT. SYSTEM 3.00H CON DI UTGPERMIT FEE (SUB TOTAL) RES AF
R AUTHORIZED �PLAN CHECK FEE (50% PERMIT FEE) ITY CO. NOTIFIEDPERMIT ISSUING fEE 2.00 L SUPPLEMENTARY PERMIT ISSUING FEE 1.00
JOTOTAL FEE - SUPERVISING ELECTRICAL ENGINEER.
PLAN CHECK VALIDATION CK. M.D. CASH PERMIT VALIDATIO cK. M.O. CASH
nr,.. 8 .3 r sJAN 18 2(/x/^4^+.00- Q _
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
WORKERS'COMPENSATION DECLARATION 76.663 ,D,B, APPLICATION FOR ELECTRICAL PERMIT {�
I hereby affirmm That
at I have a certificate oPconseM.to Self ivsure, •
or a cNficate of Workers' Compbnsation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY
copy tiler (Sec..n600, ab. C.) �i n ,VI
P❑oIICy NO�gvo2 Compahy ^�„� /» �r�� FOR APPLICANT TO FILL IN JOB'
EE ADDRESS
EACH NO. F
Certified Copy is hereby furnished. New Residential Bldgs.& Pools EALOCALITY I LC_
(� 117
I�Q/ Certified copy is filed,with the ounty building coon 1 & 2-Family,Sq.Ft. $ — $
T`-department. Multi-family Sq.FL. — NEAREST
CROSS ST.
Date
TyCj+- Appl. •1�� Residential Swimming Pools OWNER OR
FIRM NAME
CERTIFICATE OF E ION FROM WORKERS' Outlets:ReeLight Z-Sw. v .MAIL gyp )
COMPENSATION INSURANCE — ® ADDRESS WL/,rft/
(This.section need not be completed if the work involved b the /// First 20 .,
y .�/ CITY Tel.No:
permit is far one hundred dollars ($100)or less.) Total No. /t Additional'. -
I certify that•in the performance of the work for which this permit PLAN CHECK.
APPLICANT
is issued, I shall not employ any persod in any manner so as to
become subject to the Workers'.Compensation Laws, Lighting Fixtures - First 20 ADDRESS
Total No. Additional CITY Tel.No.
Date Applicant
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._ ADDRESS
provisions or this permit shall be deemed revoked. Top _ FAU _ W.H. CITY L �/T Tel.NO.
LICENSED CONTRACTORS DECLARATION Hood _ Fan Other_
I hereby"affirm that 1 am licensed under provisions 01 Chapter 9 LICENSE OR
(commencing with Section 7000) of Division 3 of the Business and Disp. Room Air Contl: REG.NUMBER Z� Class.
Professions Code,and my license is in full force and effect. DISTRICT PR N SSE;BY
Power Apparatus &Large Appliances
-2
License Nurnlder.?A2 / Lia Class Size &Type HP,KW,KVA,or KVAR Q
License Number /� Up to 1 Incl. FINAL C••)
Over 1 to 10 Ind. DATE _ VALIDATION
Contractor Date - Over 10 to 50 Incl. •� - U
E3FINAL
I am exempt under Sec. Over 50 to 100 Inc. BY W
d
e.&P.C. for this reason Over 100 N
Services,Swbd,MCC&-Panelboards Uri
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& Appurtenances 2 '
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit
I hereby affirm that I am exempt from the Contractor's License Law r.
for the following reason(Section 7031.5, Business and Professions Additional Sign Branch CircuitsCI •T
Code): 3307 22.90
❑ I,as owner of the property,will do the work and the structure Misc. Conduits & Conductors 1 ITEMS,
is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) — -
and Professions Code). ' ,' TOTAL 22. 90
CONSTRUCTION LENDING AGENCY - CHECYi 22.90
1 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) - - CHANGE .00
Civ.C.).
Lender's Name PLAN CHECKING FEE 0l)—DWI 4/26/90
PERMIT ISSUING FEE
1 0346. 1 AM 9:24
Lender's Address F ,3�(
I certify that ! have read this application and state that the above TOTAL FEE� `707U
information is correct. I agree to comply with all County ordinances
and State laws regulating Electrical wiring, and hereby authorize
rept fives of this County to enter upon the above-mentioned - - -
,p perry or inspe�pu, SEE REVERSE FOR EXPLANATORY LANGUAGE Sgnature of P r� Date _