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HomeMy Public PortalAbout9917 HOWLAND DR_Electrical__ j . a6L.i` 76A663-CE806 8-62 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS )l /7 JOHN A. E. COUNTY ENGINEER A.JEN WILLIAM A.JENSEN, SUPT OF BUILDING LOCALITY !r NEAREST FOR APPLICANT TO FILL IN cRoss ST. RECEPT. TOTAL NO. EACH FEE FIRST 20 $.20 $ OWNER/, t. l R4C//�-� P-S- OUTLETS LIGHT MAIL ��j• /�'Y� �— ADD'L 10 ADDRESS SWITCH. OVER 20 TOTAL CITY G�iy%P�E C TEL. NO.';-/& LIGHTING FIRST 20I .20 FIXTURES ADD'L ELECTRICIAN 1-1 OVFR 20 10 RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS/./�J//"K✓//�7�i J, A!Z GARB.DISP. STA.COOK CITY � ��lE Chir TEL. NO;X4-"y-16 DISHWASH. AUTO.-WASH. STATE SPACE HTRS. STA.APP.(yp H.P.MAX.) •50 LICENSE NO. MOTORS: OVER NOTOVER H.P. DISTRICT NO. GROUP ZONE I PROCESSED PY, O 1 1.00 1 3 1.5o INSPECTION RECORD s S 2.00 8 15 2.50 15 50 3.00 } a 50 100 5.00 0 SIGNS: NO.TRANS- NO.LAMPS O 1"- SERVICE 0.60OV-NOT OVER 200A 1.00 - u W SERVICE 0.60OV-OvER 200 A. 2.00 D_ N SERVICE OVER 600V 5.00 ? MISC. i PERMIT ISSUING FEE 2.00 " - SUPPLEMENTAgY PERMIT ISSUING FEE 1.00 TOTAL FEE $ 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PRO/PWY. POWER SIGNATURE /,�/�v UTILITY CO.NOTIFIED ' OF PERM ITTE ,/ FINAL AArLIDATION ARTHUR C. VEIT MO CASH SUPERVISING ELECTRICAL ENGINEER 1 2 5 4;z JUL 13 2 D 3.0 0" i i 76A663 GE-806(6/78) /r0P11 UV'/r011M V FOR ELECIrMCALS PERN7 .... -. COUNTY OF LOS ANGELES BUILDING AND SAFETY < FOR APPLICANT TO FILL IN; JOB EACH NO New Residential Bldgs.&Pools FEE ADDRESS 17 Howland 1 &2-Family,Sq. Ft. $ - .025 — $ LOCALITYTemple UIZ Multifamily Sq. Ft. .02 — NEAREST Residential Swimming Pools 25.00 CROSS ST. Baldwin OWNER OR FIRM NAME Wittyneir Outlets:Rec Light ADDRESS Howland 2 . MAIL Firstst 20 50 ' Total No. Additional .30 CITY Tel. No. 286-43121 , PLAN CHECK' APPLICANT Lighting Fixtures First 20 .50 ADDRESS . Additional .30 ' . Total No. CITY Tel.No. Fixed Appliances Not Over 1 HP PERMIT Range_Heater_ D.W. APPLICANT Morales Electxic Oven_Dryer_W.M._ ADDRESS _ - •SSiOn Drive Top —FAU — W.H._ CITY goSem d• Tel.No. 280-426o Hood_Fan _Other_ LICENSE OR Disp.—Room Air Cond. 2'50 REG.NUMBER Class.C-10 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&Type HP,' KW, KVA,or KVAR COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. 250 Up to 1 Ind. . HEREBY,CERT IFY THAT•I AM,PROPERLY REGISTERED AND/OR Over 1 to 10 Incl. 5.00 1 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF Over 10 to 50 Incl. 12.50 CALIFORNIA OR THAT I A THE LE OWNER OF THE ABOVE Over 50 to 100 Inc. 25.00 DESCRIBED RESIDE TIAL P PERTY: Over 100 40.00 PERMITEE SIGNATURF-:5 `Services DISTRICT NO. PROCED Y 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 Z ' O Temp. Power Pole&Appurtenances 1 0.00 Q i Sign with One Branch Circuit 10.00 G Additional Sign Branch Circuits 2'00 INSPECTION > 9059,5A , INFORMATION U" # o o o o'o 2 Misc.Conduits&Conductors 10.00 ON REVERSE ui Other(See Complete Fee Schedule) SIDE Z : 2P01: 200 00012005 rPERMITFEE (Sub-Totall1140'u 7 8 FEE (One-Fourth Permit Feel O FEE $7.00 7° > INSPECTION FINALED W date: '" d_ By d es WORKERS' COMPENSATION DECLARATION 20-0019 DPW 3/87 APPMCA7,MH FOR ELECTMAL PERNT I•A.reby affirm that I have a certificate of consent-to self CE-806G iniv,re, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certified copy thereof (Sec. 3800, Lab. C.)' Policy No. Company FOR APPLICANT TO FILL IN JOB ❑Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO, FEE ADDRESS ❑Certified copy is filed with the county building inspec- 1 & 2-Family, Sq. Ft. $ — $ LOCALITY tion department. Multi-family Sq. Ft. -- NEAREST q CROSS ST. FA (L Residential Swimming Pools OWNER OR Date Applicant FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light SwMAIL A COMPENSATION INSURANCE ._ ADDRES /l First 20 (This section need not be completed if the work involved by + Total No. Additional CITY Tel. No. the permit is for one hundred dollars•($100)or less.) I certify that in the performance of.the work.for PLAN CHECK which this APPLICANT permit is issued, I shall not employ any person in any manner Lighting,Fixtures First 20 ADDRESS so as to become subject to the Workers'Compensation laws. �j ✓ Q Total No. Additional CITY Tel. No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If_after making is Certificate f Exemption, you should become subject to the Workers' Range— Heater—D.W. APPLICATION Compensation provisions of the Labor Code, you must forth- Oven — Dryer —W.M.— ADDRESS with comply with such provisions or this permit shall be I Top FAU —W.H. — deemed revoked. Hood Fan —Other— CITY el. No. LICENSED CONTRACTORS DECLARATION Disp. LICENSE OROF — Room Air Cond. — REG. NUMBER Class.. I hereby affirm that I am licensed under provisions of Chapter 9 Ae (commencing with Section 7000)of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO. PROCESSED BY >_ and Professions Code,and my licens is in full force and effect. p n- O Size &Type HP, KW, KVA, or KVAR � �Gy�L�C O License Number Lica ClasL 91 Up to 1 Incl. FINAL U ' Over 1 to 10 Incl. DATE S VALIDATION t2 Contractor Date Over 10 to 50 Incl. ❑ I am exempt under Sec. Over 50 to 100 Inc. By FINAL B.&P.C: for this reason `Over 100 n_ Services, S`b LdA'C P elboards / /� D Z Date: 0-200 It.4 Un e� V _ Signatur — 201 - 1000 Amp. Under 600 V El Over 1000 Amp.'or Over 600 V Exemption for Reg. aint. Elect.• S GLE FAMILY Temp. Power Pole&,Appurtenances ' HOME OWN;R-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit 'i° ' i =•s Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits Professions Code): i_.rte:- ❑ I, as owner of the property, will do the work and the Misc. Conduits&Conductors !t'_I D structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ D ;l g`¢rg Business and Professions Code). :_I! •n:��n1{�1 CONSTRUCTION LENDING AGENCY ! / " ANI3E ,310I hereby affirm that there is d construction.lencling agency for the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) n (Sec. 3097, Civ.,C.). PLAN CHECKING FEE J Lender's Name t f't' zl3f i i ;•C'1 � �_!„!�,� L::.,.;s .ter•��: :t. PERMIT ISSUING FEE /3 Q Lender's Address I certify that*1 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 the above-mentioned property for inspection purposes.' SEE REVERSE FOR EXPLANATORY LANGUAGE Q Signature of Permittee Date ©s/ i v 11