HomeMy Public PortalAbout9903 HOWLAND DR_Electrical__ TBABBB.CEBOB IQ.BI APPLICATION FOR'.ELECTRICAL/ PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING ® �J
BUILDING AND SAFETY DIVISION ADDRESS J
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A. JENSEN, SUPT of BUILDING LOCALITY _
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
I T E M NO. EACH FEE A
OUTLETS: (FIRST 20) S.20 $ OWNER '-aP1H
LIGHTS RECEPT. SW. MAIL
OUTLETS: (AOD'L UNITS) 10 ADDRESS' 9 c
LIGHTS RECEPT. SW. /
LIGHTING FIXTURES: (FIRST 20) 20 CITY L! l G• TEL. NO.
LIGHTING FIXTURES: (ADDITIONAL) .10 ELECTRICIAN
RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS
GARB.OISP. STA.COOK
clry TEL. NO.
OISHWASH. AUTO.-WASH. STATE
SPACE HTRS. STA.APP.(yy H.P.MAX.) / ,50 S LICENSE NO.
MOTORS: OVER NOT OVER H.P. DISTRJ NCS/ GROUP ZONE P ESSED By
o 1 1.00 -
I — s 1.50 I PECTION�tECORD
3 e
2.00
�7tL71
O
B is 2.50 / 1 -56 U
K
15 50 3.00 rQr
50 100 5.00 U
W
a
SIGNS: NO.
LAMPS
NO.LAMPS z
z,
SERVICE 0.600V.NoT OVER 200A 1.00
SERVICE O-000V-OVER 200 A. 2.00
SERVICE OVER 600V 5.00.
MISC.
PERMIT ISSUING FEE 2.00 1
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 1
TOTAL FEE $ jQ
�} A
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS IV DATE I SPECTOR'S SIGNAT RE
ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING p A ihf v
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR �J '� �✓ L:
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES A/
CALIFORNIA OR THAT AM THE LEG#L OWNER OF THE ABOVE
DESCRIBED REBID T PROPERTY. POWER if�CY
SIGNATOR UTILITY CO.NOTI ED
OF PERMI
FINAL
VALIDAT� ARTHUR C. VEIT
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
L.:i02 9 0 4 !'.AY 2 D 1 .5
WORKER'S COMPENSATION DECLARATION 76A663 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT lJ
I hereby affirm Jhat.I.have a certificate of consent to self insure,
or a certificate of worker-s Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV.
copy thereof(Sec. 3800 Lab. C.) qq m
Policy No. \ Company FOR APPLICANT TO FILL IN gOBRESS qy 3 V Vf
❑ Certified copy is hereby furnished.❑ New Residential Bldgs.&Pools NO. EACH FEE. l$ $ LOCALITY r
Certified copy is(ileo with the county building inspection 1 &2-Family,Sq.Ft. NEAREST
department. - Multi-family Sq..Ft. CROSS ST.
Date Applicant Residential Swimming Pools ASSESSOR.,, _ /1 GG
MAP BOOK •� PAGE 00--5 PARCEL 0/0
CERTIFICCOMPENSAATE OF TIONIMSUROANCEORKERS' Outlets:ROC._�Light Sw. b FIRMOWNER OR ' t IL 1,•
O Q MAIL NAME L
First io �l MAIL
(This section need not d completed 0 the work Involved by the Total No, Additional ADDRESS 6„/ ✓/1/ HU
permit is for one hundred dollars($100)or less.).
I certify that in the performance of the work for which this permit � Gt T.I.No. Z r—?3/a
is issued, I shall not employ any person in any manner so as to OCAPPLICANT
become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 To I No. AdditionalDate Applicant REID NTIALAPPL S R3HP. /NOTICE TO APPLICANT: If, after making this Certificate of TeI.NoExemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HPprovisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR
I hereby affirm that I am licensed under. provisions of Chapter 9 Over 3 to t0 Incl.
(commencing with Section 7000) of Division 3 of the Business and CITY Tel.No.
Professions Code,and my license is in full force and effect. Over 10 to 50 Ind }
Over 50 to 100 Incl. LICENSE B Class.
REG.NUMBER d
Over,100 DISTRICT NO. PROCESSED BY O
License Number Lic.Class p 0
Services,Swbd.,MCC&Panelboards
Contractor Date0-399 Amp.Under 600 V DATE 0
F-1
400-1000 Amp.Under 600 V ~
I am exempt under Sec. i ��- ( / VALIDATION V
Over 1000 Amp.or Over 600 V FINAL d
B.&P.C.for this reason _ BRANCH CIRCUIT FEES BY
Date: 15A,or 20A 120V,Lighting or Recept. - Z
.. 1 To 10 Branch Circuits
Signature -
51 To 40 Branch Circuits
❑ 41 Or More Branch Circuits
Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting.Br.Circuits
SINGLE FAMILY Temp.Power Pole&Appurtenances y
HOME OWNER-BUILDER DECLARATION {-;-?- E
I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit f`C I �F
for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits ,[,i 75
IIIC���o//de): _ -�. !-v., J
L7 I I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors - T71_(IS
Is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) , i_E=i IL 66 - 75
and Professions Code). CH E('; >L.; 7
CONSTRUCTION LENDING AGENCY _
�
c I-.:
I hereby affirm that there is a construction lending agency for the CHANGE .� V
performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total) O
Civ.C.)
PLAN CHECKING FEE 130)01j_;}riri'I 1::Y.,+;-,
Lender's Name n/
PERMIT ISSUING FEE Art Ly',',-_,
Lender's Address
I certify that I have read this application and under penalty of purjury state TOTAL FEE (fes 6• 5
that the above information is correct. I agree to comply with all County
ordinances and State laws regulating Electrical wiring,and hereby authorize -
715shveb of this C unty to enter upon the above-mentioned property
forn purp as. SEE REVERSE FOR EXPLANATORY LANGUAGE
jZ -135 - i3
SIGNAZIEO PERMITTEE DATE
T6AB6B-DEE°812-58 APPLICATION FOR ELECTRIC PERMIT �.
COUNTY OF LOS ANGEL
DEPARTMENT OF COUNTY ENGIEB
NEER BUILDING yyD3 �,yow la n d hr
BUILDING AND SAFETY DIVISION ADDRESS .(J
JOHN A.LAMBIE.COUNTY ENGINEER
//�T I
CASSATT O.GRIFFIN,SUPT OF BUILDING LOCALITY h`P �+ I•tY
,FOR APPLICANT TO FILL IN NEA •REST 1-y..T
CROSS ST. 27C Licm
PERMIT FEES /O o
OWNER
ITEM NUMBER EACH FEEL,
OUTLE i)/1 $ $ MAIL
ADDRESS 9O X/61 9) rr r'
LIGHTS-49 RECEP W SW, .10
LIGHTING FIXTURES .10 CITY B Cl,+ TEL.NO. /
ELEC.RANGES H CLO.DRYER$ ELECTRI IAN S P
WATER HEATERS .50 ADDRESS
ELEC.SPACE HTRS. DISHWASHERS
GARBAGE.]..POSERS I— AUTO.- / CITY TEL.NO.
STATE
WASHERS STA.COOKING UNITS .2$ � LICENSE NO.
MOTORS: OVER INC, H.P. DIST R C NO. G OUP ONE P ESSED BY
0— Vz .25 «GA�i�J
.50 INSPECTION RfCORD
5— 15 1.50 0o7 /
Alo
15— 50 2.50
50-200 - 5.00
SIGN$:. NO.TRANS, ,
NO.LAMPS
SERVICEO-600V -A— 1.00 1
SERVICE OVER 600V 5.00
MISC.
WIRINGPERMIT LOO
FIXTURE PERMIT 1.00 �J
SUPPLEMENTARY PERMIT .50
TOTAL FEE S APPROVALS
1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS A LIGATION DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING �q n^
ELECTRICAL WIRING. WIRING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED A5 REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I A THE LEGAL WNER OF THE BOVE
DESCRIBED RESIDE IA PERTY. POWER ..
SIGNATURE ' UTILITYCO.NOTIFIED 7-16 9r�11/-
OF PERM I
FINAL
®' /VAI>IDATION ARTHUR C. VEIT,
`Q_!//MO CASH SUPERVISING ELECTRICAL ENGINEER
CK
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