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Home My Public Portal About5239 KAUFFMAN AVE_Electrical__ I s 76A663C1 CE806131 1 /76 APPLICATION FOR ELECTRICAL PERMIT BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN JOB Q FRential Bldgs. & Pools EACH NO. FEE ADDRESS aily Sq. Ft. $ — $ LOCALITY ily Sq. Ft. CROSS ST. / L/�i��:ial Swimming Pools OWNER OR �"FIRM NAME 'e/ht, Switch & Receptacle MAIL -:3 �- -..! ADDRESS al CITY Tel No. PLAN CHECK APPLICANT Lighting Fixtures First 20 ADDRESS Additional CITY Tel No. .PERMIT Fixed Appliances Not Over 1 HP APPLICANT A_101_0 L=,�'S �A Range_ Heater_ D.W. ADDRESS io /�/Q1_0� Oven Dryer W.M. Top FAU W.H. CITY e�4_1c'"164 Tel. NO. d�'3 _U Hood Fan LICENSE OR >" REG. NUMBER vZZ— 90V 7 Class. C-10 �p Disp. A.C. v I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY 0 Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING U Size&Type HP, KW, KVA,or KVAR ELECTRICAL WIRING. W Up to 1 Incl. I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR C/7 �� Over 1 to 10 InCI. LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE Over 10 to 50 Incl. DESCRISED.RESIDENTIAL ERTY. Over 50 to 100 Incl. PERMITEE Over 100 SIGNATURE DISTRICT NO. P �CESBY Services y// 0-200 Amp. Under 600 V 0 201 - 1000 Amp. Under 600 V APPROVALS DATE ISIGNATUURREE Over 1000 Amp. or Over 600 V. SIGNA TEMP POWER POLE Temp. Power Pole&Appurtenances U'NDERSLAB WORK Sign with One Branch Circuit Additional Sign Branch Circuits ROUGH CONDUIT (Other) WIRING FIXTURES POWER AUTHORIZED PERMIT FEE• (Sub-Total) - UTILITY CO.NOTIFIED PLAN CHECKING FEE (One-Fourth Permit Fee) FINAL —2,5—7e PERMIT ISSUING FEE NOTES - TOTAL FEE PLAN CHECK VALIDATION CK. M.O CASH PERMIT VALIDATION CK. M CASH . 8.2 "A-APR, 20 2 .�, 2 9.3 0 L3� TEMPLE CITY 76A66C -CE#806 5-61 APPLICATION FOR ELECTRICAL PERMIT LLJJ COUNTY OF LOS ANGELES DEPARMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE. COUNTY ENGINEER WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. PERMIT FEES ' OWNER I T E M- NUMBER EACH FEE MAIL OUTLETS: . ADDRESS LIGHTS RECEPT. SW. .10 CITY TEL. NO. LIGHTING FIXTURES ,10 ELEC. RANGES CLO. DRYERS ELECTRICIAN WATER HEATERS .SO ADDRESS ELEC.SPACE HTRS. DISHWASHERS CITY TEL NO. GARBAGE DISPOSERS AUTO.- STATE WASHERS STA.COOKING UNITS ,25 1 - LICENSE NO., _ MOTORS: OVER INC. H.P. DISTRICT O. 1 G P Z N P ESSED BY O— 1/2 .25 `. /t- 1/2— 2 SO INSPECTION RECORD 's a 2— s 1.00 O 5— IS 1.50 V oe i S— 50 2.50 O H SO— 200 5.00 W NO TRANS. O. SIGNS: N • NO.LAMPS Z SERVICE 0-600V 1.00 SERVICE OVER 600V- 500 M ISC. WIRING PERMIT 1.00 FIXTURE PERMIT 100 'SUPPLEMENTARY PERMIT 50 TOTAL FEE S I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT,THE ABOVE IS CORRECT AND AGREE TO COMPLY / WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT / /j ��.✓y�A ,� J ELECTRICAL WIRING. ` WIRING ///A, IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES y CALIFORNIA OR THAT I AM THE LEGAL OWNFt OF THE ABOVE DESCRIBED RESID NTIAL PROPERTY. / POWER 14 SIGNATURE UTILITY CO.NOTIFIED OF PERMITTEE FINAL VALIDATI ARTHUR C. VEIT CK Mo CASH SUPERVISING ELECTRICAL ENGINEER LA,-``J 0 8 6 9 APR 10 D 1 .J 0 M WORKER S'COMPENSATIONDECLARATION CE-806G (2-80) APPLICATION FOR ELECTRICAL PERMIT � CE-806 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 4 - a certified copy'thereof(Sec 3800,Lab.C.) FOR APPLICANT TO FILL IN SOB Policy No. Company EACH NO. FEE ADDRESS New Residential Bldgs.&-Pools El Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ $ LOCALITY Multrfamily,Sq. Ft. I — NEAREST EJ Certified copy is filed with the county building inspection CROSS ST department. Residential Swimming Pools OWN NAME L C FI.RMr� Date Applicant Outlets Rec �(7 MAIL ADDRESS J �Sf} �Light� Sw. — . F i rst•20 CERTIFICATE OF EXEMPTION FROM WORKERS'' Total No Additional CITY Jt/eJ� v jsA Tel No. 6 adg COMPENSATION INSURANCE , } PLAN CHECK' t1 APPLICANT Q (This section need not be-completed if the'work involved �d !� U by the permit'is for one 'hundred dollars ($100) or,less.) Lighting Fixtures First Additional ADDRESS Additional � Total No._� I certify that to the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No. permit is issued, I shall not employ any person in any manner PERMIT /1 V so as to become subject-to the Workers' Compensation Laws. Range_ Heater_D.W. / APPLICANT VA LL W Oven Dryer_W.M._ ADDRESS /g N Date ��J�'r Applicant Top FAU _W.H. Z CITY ��sr Cwl��el No. _ Hood — Fan _Other_ 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 �y3' Class 'Compensation provisions of.the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRIC NO: PROCE SED BY with comply with such provisions or this permit shall be .0 deemed revoked. Size&Type HP, KW, KVA,or'KVAR :`✓✓J Up to 1 Incl FINALC/ Over 1 to 10 Incl. DATE L LICENSED'CONTRACTORS DECLARATION Over 10 to 50 Incl. VALIDATIE�IV I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL BY 9 (commencing with Section 7000) of Division 3 of the Busi- Over 100 ness and-Professions Code, and my license is in full force and gt� effect. Services License Number •9y3'//7 Lic.Class 0-200 Amp. Under 600 V el 4::ry- 201-1000 Amp. Under 600 V ContractorV "?y c-atk5e Date 9-15�� Over 1000 Amp.or Over 600'V' 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 ness and Professions Code): Misc.Conduits& Conductors F11, as owner of the property, will do the work and the Other(See Complete Fee Schedule)— 22 1 4.7 A structure, is not intended or offered for sale (Section 7044, Business and Professions.Code). CONSTRUCTION LENDING'AGENCY :# 6 0.01-0-.0 2 I hereby affirm- that there is a construction lending.agency 2 0 0 0 8 5 0 for the performance of the work for which this permit is PERMIT FEE (Sub-Total) ' Q issued (Sec. 3097,Civ.C.). 0 0.0'6 Q 5 0 U Lender's Name PLAN CHECKING FEE, ,(One-Fourth Permit Fee) 0.9, 1 5-80 Lender's Address" PERMIT ISSUING FEE 4 - ' 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 represe tatives of this County to enter upon the above-mentio 'ed'pr erty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date /\