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Home My Public Portal About9941 HOWLAND DR_Electrical__ .APPLICATION A�� ®R ® . r Ry�� ELECTRIC PERMIT DBS-5A !/"CPI! LICATION POo 11 ftrmll ECTRIC tl ERMIT DBS-5A 3.55 DIVISION OF BUILDING AND SAFETY Deportment of County Engineer BUILDG County of Los Angeles ADDRESS WM.J. FOX, COUNTY ENGINEER ADDRESSS CASSATT D. GRIFFIN. SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN < NEAREST PERMIT FEES CROSS ST. L. NUMBER EACH FEE OWNER LIGHT OUTLETSIV RECEPTACLES MAIL - - ADDRESS WALL SWITCHES TOTAL OUTLETS _ 5¢ S CITY TE NO. ELEC.RANGES 25 ELECTRICIfAN/ n ELEC. HEATERS 25 ADDRESS KW EA CITY TEL.NO. FIXTURES 5 LICENSE NO.- NUMBER OF LIGHT CIRCUITS ' DISTRICT NO, I GROUP I ZONE I READY FOR INSPECTION S NUMBER OF RECEPTACLE CIRCUIT /'' ..7�✓ � MOTORS ' NUMBER HORSEPOWER FEE INSPECTION RECORD MVD. HP OVER ER I INC. �I EACH _ 1/Z&LESS 1/z 2 5 0 2 . 5 1.00 5 15. 1.50 - 1550 2.50 50 200 5.00 C MISC. NO.SIGNS NO..TRANS. _ NO.SIGNS NO.LAMPS FOR EACH PERMIT: I' ' WIRING $1.00 Qb FIXTURES $1.00 SUPPLEMENTARY :50 APPROVALS TOTAL FEE $ I DATE INSPECTOR'S SIGNATURE 1 HEREBY ACKNOWLEDGE'THAT 1 HAVE READ THIS APPLICATION CONDUIT AND STATE THAT THE ABOVE IS CORRECT AND AGREE'TO COMPLY WITH ALL COUNTY ORDINANCES AND 'STATE LAWS REGULATING WIRING ELECTRICAL WIRING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF _ I CALIFORNIA OR THAT AM' TH LEG OWNER OF THE ABOVE POWER I b DESCRIBED RESIDE R / I SIGNATURE UTILITY CO.NOTIFIED OF PER MITTE / �{ FINAL A t WILLIAM J.FOX, COUNTY ENGINEER VALIDATION A. C.VEIT.CHIEF ELECT. INSPECTOR .1:.3 7LZAR JAM 2 3 2 1 .25 WORKERS'COMPENSATION DECLARATION 76 66G (2-80) 1i� P LbICL�1MN FOR ELECTPUCAL . 1�1511SUG11� U I hereby affirm that I hdye a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY insure, or a certificate of Workers'Compensation Insurance,or �b a certified copy thereof(Sec. 3800,Lab.C.) FOR APPLICANT TO FILL IN JOB Policy No. Company ADDRESS Q New Residential Bldgs.&Pools EACH NO. FEE Certified copy is hereby furnished: 1 &2-Family,Sq. Ft. $ — $ LOCALITY Multi-family Sq. Ft. — NEAREST Certified copy is filed with the county building inspection CROSS ST department. Residential Swimming Pools OWNER OR ^ FIRM NAME e— . O Date Applicant Outlets: Rec.—Light—Sw. MAIL First 20 ADDRESS CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY el No. COMPENSATION INSURANCE. p PLAN CHECK 4} (This section need not be completed if the work involved APPLICANT p Fixtures First 20 ADDRESS Uhting by the permit is for one hundred dollars ($100) or less.) LigAdditional ' Total No. � I certify that in the performance of the•work for which this Fixed Appliances Not Over 1 HP CITY Tel No. -0 permit is issued, I shall not employ any person in any manner PERMIT V so as to become subject to the Workers' Compensation Laws. Range_Heater_D.W. APPLICANT IUICG W 0. Oven Dryer_W.M._ ADDRESS Date�jL'$�Applicant ` Top _ FAU _W.H.. z Hood — Fan _Other— CITY Tel No. / NOTICE TO APPLICANT: If, after making this Certificate of Disp.'_ Room Air Cond-_ LICENSE OR Exemption, you should become subject to the Workers' REG. NUMBER Class Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO. PR OCE ED BY with comply with such provisions or this permit shall be Size&•Type HP,KW;KVA,or KVAR �i deemed revoked. Up t6'1 Incl. _ FINAL —ate Over,1 to,10 Incl. DATE LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl: VALIDATIONr Z I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL 9 (commBYencing with Section 7000) of Division 3 of the Busi- Over 100 `—"�- ness and Professions.Code, and my license is in full force and effect. Services 0-200 Amp. Under 600 V T License Number322 Lic.Class ` (� 201-1000 Amp. Under 600 V ' Coniracto Date jQ II " O Over 1000 Amp.or Over 600 V --3 5L — HOME OWNER-BUILDER DECLARATION Temp. Power Pole&Appurtenances I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit Additional Sign Branch Circuits - o License Law for the following reason (Section 7031.5, Busi- z 3 3 q,4 A ness and Professions Code): Misc.Conduits&Conductors # o o 0 0 o 2 I, as owner of the property, will do the work and the Other-(See Complete Fee Schedule)— structure is not intended or offered for sale (Section 2 0'0 1 200 7044, Business and Professions Code). CONST RUCTION.LEN DING'AGENCY 1 hereby.affirm that there is a construction lending agency o,o.0 1 2,0-Q czi for. the performance of the work for which this permit is PERMIT FEE (Sub-Total) 21 1 —80 issued(Sec. 3097,Civ.C.). Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) Lender's Address -PERMIT ISSUING FEE I 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 the above-mentioned property for inspection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date W�'��'HERS'COMPENSATION DECLARATION 76A663 _ � SP CnTCFOR ELECTMICAL PERMIT CE-806G (2-80) I hereby affirm 'that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800,Lab.C.) FOR APPLICANT TO FILL IN ,JOB n Policy No. Company EACH NO. FEE ADDRESS d" New Residential Bldgs.&Pools Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ — $ LOCALITY ❑ cMulti-family Sq. Ft. — NEAREST. Certified copy is filed with the county building inspection CROSS ST department. Residential Swimming Pools 1 OWNER OR FIRM NAME Date Applicant Outlets: Red.^Light_Sw. MAIL First 20 ADDRESS / CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY Tel No. COMPENSATION"INSURANCE } PLAN CHECK. D. (This section need not be completed if the work involved APPLICANT 0 by the permit is for one hundred dollars ($100) or less.) Lighting Fixtures First 20 ADDRESS 0 . Additional cc ' Total No. I certify that in the performance of the work for which thisCITY Tel No. 0 1'H Fixed Appliances Not Over P permit is issued, I shall not employ any person in any manner PERMIT (� so as to become subject to the Workers' Compensation Laws. Range_ Heater_D.W. APPLICANT JT e e W �7 Oven Dryers_W.M. ADDRESS Date//-1)C'Applicant ESC C�� !/��g9[.XJ'� Top FAU _W.H. FY Hood Fan _Other_ CITY. l Tel No.NOTICE TO APPLICANT: If, after making this Certificate of Disp. Room Air Cond-_ LICE SE RExemption, you should become subject to the Workers' REG. NUMBER Class Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO. PROCE SED with comply with such provisions or this permit shall be Size&Type HP,KW, KVA,or KVAR deemed revoked. i 1,0 p Up to 1 Incl. FINAL Over 1 to 10 Incl. DATE z / -7 LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl. VALIDATION I hereby effirm that I am licensed under provisions of Chapter. Over 50 to 100 Inc. FINAL [/ 9 (commencing with Section 7000) of Division 3 of the Busi- Over 100 BY ness and Professions.Code, and my license is in full force.and effect. n Services License NumbeAC 33 'Lic.Class(`- J O 0 200 Amp. Under 600 V 201-1000 Amp. Under 600 V Contract o de,16®YC— Date j�.��+ 6>� Over 1000 Amp,or Over 600 V A HOME OWNER-BUILDER DECLARATION Temp. Power Pole&Appurtenances I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit License.Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits 1 ness and Professions Code): -3.1 2 7 A Misc.Conduits&Conductors I, as owner of the property, will do the work and the Other (See Complete Fee Schedule)— structure is not intended or offered for sale (Section #..o. 0 o o o 2 7044, Business and Professions Code). CONSTRU.CTION.LENDING AGENCY 2 0 0 1 9,5 0 1. hereby affirm that there is a construction lending agency for the performance of the work for which this permit is PERMIT FEE (Sub-Total) o 0 0 1 9, 5070- issued (Sec. 3097,Civ.C.). Lender's Name PLAN CHECKING FEE . (One-Fourth Permit Fee) ' 1. 1 9-80 Lender's Address - PERMIT ISSUING FEE I certify that I have read this application and state that.the TOTAL FEE f� 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 prop ty,for inspection purposes. SEE'REVERSE FOREXPLANATORYLANGUAGE r � i Signature of PermitNe Date , S � nn � �p FOR pp 22 n �� pp PERM WORKERS'COMPENSATION DECLARATION . " CE 80,6G',- •• J•, APPR �C IMDOH FOR ELL CTUCAL� IT LSII�M57 I hereby affirm that I have a c`?rtificate'of zronsent 1'a seLf insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec. 3800, Lab, C.) i ' Policy No. Company FOR APPLICANT TO FILL IN ADDRESS q( ) � r Certified copy is hereby furnished. New Residential Bldgs. &.Pools EACH NO. FEE ❑ 1 & 2-Family, S Ft. $ — $ LOCALITY „ hr - Certified copy is filed with the county building inspec- Y• q� tion department. Multi-family Sq. Ft. — 'NEAREST ,rr1�I �i/�� t' Residential Swimming Pools CROSS ST. vcy(/"e> 1�co Date Applicant � OWNER OMR /I. i (1— i I FIRM NAE ,I V CERTIFICATE OF EXEMPTION FROM WORKERS' - Outlets: Rec�LightSw./ MAIL COMPENSATION INSURANCE ADDRESS This section need not be completedFirst 20 ( if the work involved b Y Total No. Additional CITY {�` Tel. No��, the permit is for one hundred dollars ($100)or less.) i. I certify that in the performance of the work for which this PLAN CHECK n � APPLICANT permit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. Lighting Fixtures +� First 20 ADDRESS .,iAdditional Total No. CITY Tel. No'. Date Applicant Fixed Appliances Not Over 1 HP. PERMIT NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT Exemption, you should become subject. to the Workers' Range_ Heater_D.W. — Compensation provisions of the Labor Code, you must forth- Oven Dryer _W.M. ADDRESS with comply with such provisions or this permit shall be Top FAU —W.H. — deemed revoked. Hood Fan _Other_ CITY Tel. No.- _ LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. _ Room Air Cond. REG. NUMBER Class. (commencing with Section 7000) of Division 3 of the BusinessDISTRICT NO. PROCESS BY and Professions Code, and my license is in full force and effect. Power Apparatus&.Large Appliances Size &Type HP, KW, KVA, or KVARUO License Num er Lic. Class Up to.1 Incl FINAL U Over 1 to 10 Incl. DATE Q ZO VALIDATION 0 Contracf Over 10 to 50 Incl. CJ u ❑ FINA I am exempt under Sec. Over 50 to 100 Inc. BY ue B.&P.C. for this reason Over 100 H Date: Services, Swbd., MCC & Ponelboards D 0 -200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V Over 1000 Amp. or Over 600 V ❑ Exemption for Reg. Maint. Elect. SINGLE FAMILY Temp. Power Pole & Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits Law for the following reason (Section 7031.5, Business and Professions Code): 4 6 A ❑ I, as owner of the property, will do the work and the Misc. Conduits&Conductors J o structure is not intended or offered for sale (Section Other (See Complete.Fee Schedule)_ D •o o'0 0 o 2 7044, Business and Professions Code). 2 0 0 11$•,Q a CONSTRUCTION LENDING AGENCY _ I hereby affirm that there is a construction lending agency for o.c oT the performance of the work for which this permit is issued PERMIT FEE (Sub-Total). 1 (}c� (Sec. 3097, Civ. C.). PLAN CHECKING FEE 03, 15-83 Lender's Name ' PERMIT ISSUING FEE D Lender's Address I certify that I have read this application and state that the TOTAL FEE d above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize gfpresentatives of this County to enter upon the a ove-m nti ed prop for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE nature of'Permittee, Date