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Home My Public Portal About10206 LA ROSA DR_Electrical__ 76ABSS-CE80S T=SB APPLICATION FOR 'ELECTRIC PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER euaowc ,� 2-0 BUILDING AND SAFETY DIVISION ADDREss 6 : 77 JOHN A. LAMBIE, COUNTY ENGINEER' CASSATT D. GRIFFIN, SUPT OF BUILDING .LOCALITY FOR APPLICANT TO FILL INNEAREST PERMT FEES "CROSS $ / I T E M NUMBER EACH 'FEE OWNER 4LG ' OUTLETS: $ $ MAIL LIGHTS RECEPi. W. .10 ADDRESS LIGHTING FIXTURES ,10 CITY TEL. NO, ELECT RANGES CLO. DRYERS ELECTRICIAN WATER -H EATERS .50 ADORES$ J ELEC.SPACE HTRS. DISHWASHERS 22ll CITY / TEL. NO. , U GARBAGE DISPOSERS AUTO.- WASHERS STA. COOKING UNITS .25 STATE CENSE NO. MOTORS: OVER INC. H.P. DISTR T NO. G O P Z NE ESSED BY 0— 4z .25 vz— 2 .50 INSPECTION RECORD 2— 5 1.00 s— Is - 1.50 I5— 50 2.50 50-200 1 5.00 ' SIGNS: NO. TRANS. 1 NO. LAMPS 4-1 SERVICE 0-600V 1.00 S�1_tiG - A SERVICE OVER SOON 5.00 ,+ MISC. WIRING PERMIT 1.00 - ��"� " QQ � � � ,� rL �^( FIXTURE PERMIT- 1.00 1- SUPPLEMENTARY PERMIT .50 TOTAL FEE $ APPROVALS I HEREBY.ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS. REGULATING p ELECTRICAL WIRING. WIRING -�-�- I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LO5 ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. _ POWER.. SIGNATURE- UTILITY CO.NOTIFIED 3 (1 OF- PERMITTEE �• _ FINAL v A ARTHUR. C. VEIT. - CK ee0 CASH SUPERVISING ELECTRICAL ENGINEER -S a3.4 5 3,� i alp 13 z. n 2.2 0 e _. . I WORKERS'II COMPENSATION DECLARATION 75-886 ,ore,` .APPLICATION FOR .ELECTRICAL PERMIT hereby:affirm that have a certificate of.consent to self insure, CE-806G •or a certificate of Workers'.Compensation Insurance, or a certified. ' COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec.3800,Lab. C.) Policy NO - L Company .• FOR APPLICANT TO FILLIN _ _ JOB �n - ,❑ - ADDRESS I% LG a[; �S41- v- CerhfleI copy Is hereby„fu.n I-tl 1, New Residential Bldgs.8 Pools EACH NO. - FEE ❑ Certified •copy Is filed witk'tlie county building inspection :1 & 2-Family,�Sq.Ft.' $ — $ LOCALITY r 1 :Y'..: ,. - NEAREST.,'Certified ; •�t\ Multi-family Sq. ^L� Residential Swimming Pools OWNER R Date Applicant - OWNER OR - 'CERTIFICATE OF EXEMPTION YFROM WORKERS .:+ - f r y. FIRM NAM �Jpi�J' •- ' ` `COMPENSATION INSURANCE•,:'-. - Outlets.Rec_ Light._ Sw 1 i * - } ADDRESS' . .First 20'. . - (This'section need not be completedAf.the work Involved by the 'CITY. Tel.No. ,permit,is'forlone hundred dollars ($100)or,less.)., _ - Total No.• � Additional_• - : . of r I. .PLAN CHECK• I•certifyrlhat in the performance of the Fwork for which thispermit - APPLICANT:t,istissued I shall not employ any-person•in any,manner so as to . + - t - - - - become subject IS the Workers'Compensation Laws. .Lighting Futures,' First 20 -- 'ADDRESS AdditionalTotal No1. . CITY - 'Tel.No.. Date ” Applicant Fixed Appliances Not Over 1 HP PERMIT - - NOTICE -TO APPLICANT. If, after. making. tms.:Certificate of ' .r ' 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 - visions oo-this permit shall.be deemed.revoked. • ' .-....Top FAU L W.H.•—.- . r ai `� a - .. r LICENSED CONTRACTORS DECLARATION••h CITY "' pro Tel No" ° • t • Hood Other_ �n - ♦(commhereby affirm that am licens7600)o under:provisions B Chapter _9. " _ I. - .S,/�/ REG.LICENU B - (commencing,with Section 7000)of Division 3-of the Business antl Dispf—Room Air Cont' --F � - ' REG.NUMBER -Glass Professions Code,and my license is In full force and effect Power�Apparatus& Large'Appliances _ _ DISTRICT NO. r PROCESS BY • - - Size& Type HP, KW,KVA,or KVAR - ^a - 0 License Number Lie.Class ' Up to tinct., FINAL - V' Over 1 to tO Incl. - DATE VALIDATION 0, Contractor Date Over iO to SO IncL ( (� U FINAL 12 ..❑' I am exempt:under.Sec. •t> - Over 50 to 100 Inc. By. .- W 'B.&P.C.for this reason - Over 100 ' Panelb0oardsV ?w� - Z Date {/6rU ntler 60 .3 3b - •Signature _ '• 1 - 1000 Amp.Under 600 V • - • -` " • r Over 1000 Amp.or Over'600 V ' Exemption for Reg.Maint:Elect• r-. w SINGLOFAMILY '' Temp.Power Pole &.Appurtenances. . . _ . HOME OWNER-BUILDER DECLARATION Sign with'One Branch Circuit y I hereby affirm that I,am exempt.from the Contractor's License law - for the following reason(Section 7031.5, Business and Professions Additionah Sign Branch Circuits -• - •, - - - - 'CodeF 3303 91.50 I as owner of theproperty,will do the work and the structure 'Mist.Conduits& Conductors 1 IT'cMS 'is'not intended or offered for sale (Section 7044, Business Other (See Complete Fee Schedule) , - and ProfessionsCode). ,' •_ `TOTAL -9 r'-- 50 .CONSTRUCTION LENDING AGENCY .. .: t 'CASH - 91..F0 I hereby affirm that there-is a construction lending agency for the - CI'IANGE-_ - ., I]Q performance oLthe work for which this permit is issued(Sec.3097, PERMIT FEE* - (Sub-Total) - C.1. PL^AN'CHECKING FEE Lender's Name W09 0001,.. /lzg . .• - r PERMIT-ISSUING FEE; , - !Z 3O Lender's'Address �Q ' I certify that I have-read'this-application'and state that the above - TOTAL FEE, '. .- -. xS' - �. _ 'information is correct.Iagreeto comply with all County ordinances .• - - '` •and State laws'regulating Electrical wiring, and hereby authorize - - ' representatives. f this County to enter upon the above-mentioned - - "Pro for in option purposes. - - •• SEE REVERSE FOR EXPLANATORY•LANGUAGE Sig ur of Permittee " • , WORKER'S COMPENSATION DECLARATION 20.0019 DPW(1291) APPLICATION FOR ELECTRICAL PERMIT 6A663 I Hereby,aff:m that I have Ave a certificate of consent to self insure, , or a cehificate of Worker's.Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. , lcopythereof(Sed.;3800Lab..LC.)..,r Policy No _ Company FOR APPLICANT TO FILL IN - JOB O ,r _ / Zj[ Q NO.hereby ADDRESS d(/!/ .Cerh(Ietl copy is furnished New Residential Bld s.&Pools NO. EACH FEE g _ $. $ LOCALITY ❑, rCertified copy is filed'with the county o uildi ng'inspection -1 &-2-Family,Sq.ft. NEAREST departmepl:: '\ .r ; Multi-family Sq.FL GROSS ST. Date Applicant'r - Residential Swimming Pools y ASSESSOR MAP,BOOK - PAGE PARTE CERTIFICATE OF EXEMPTION FROM WORKERS' _ ER OR d. 'r Outlets:Rea Light�Siv. K,k `COMPENSATIONINSURANCE - First 20 IRM NAME �-�O /2 MAIL (Thissectmn need not be completed it U-4 work Involved by the Total No. Additional ADDRESS Permit is for one tiundred dollars(5100).of iess.) - I certify that In the performance of the xwork for which this permit CITY _ L ' Tel.No. is issued„I shall not employ any`�person in any manner so as to , become.:subject 4o the.Workers'Compensation Laws: LightingFixtures First 20 PLANCHET, bt7 PLAIN APPLICANT, Total No. Additional /� V ADDRESS . Dater <* -T SII-Applicant RESIDENTIAL L N S'.N OVER3 HR / - NOTICE.TO.APPLICANafter making this Certificate of CITY. ” Tel:No. ' Exemption you should become subject to the`.Workers Compensation OTHER APPLIANCES NOT OVER 3 HP. _ provisions of the Labor Code,.you,mu at to comply with such PERMIT r provisions or this permit shalfbe'deemed revoked: ' Power Apparatus&Large Appliances APPLICANT "' LICENSED,CONTRACTORSrDECLARATION-' -Size&Type HP,KW,KVA,or KVAR _ _ ADDRESS I-hereby affirm that I am licensed under provisions of'Chapter 9 Over 3to 10 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. Over10 to 50 Ind. - ' Over 50 t0 100 Ind. BEG. NUM ER'CENSE OR Class d OVe!100DISTRICT NO. O ESSED BY 0 License Number Lie.Class '- Services',Swbd.,MCC&Panelboards - 0 Contractor Date 0-3 99 Amp Under 600 V FINAL / ^ .. 0 ❑ I am exempt under Sec. - 400-1000 Amp Under 600 V 8(L VALIDATION 0 U - Over 1000 Amp or Over 600 V FINAL - LU B:&P.C-for this reason -' BRANCH CIRCUIT FEES BY In Date: 15A,or20A. 120V,Lighting or.Recept. - - - Z - - - - - - 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits - - - ❑ - - 41 Or More.Branch Circuits Exeinpti0n for Reg.Maint.Elect. `SA,20A,.208V To 277V Lighting Br.Circuits SINGLE FAMILY Temp.Power Pole,&Appurtenances HOMEOWNER-BUILDER-DECLARATION Sign with One Branch Circuit } hereby affirm that I'am exempt fro the Contractor.'s License Law 'li ;'1�) for the.followmg reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits - Code): I,as owner of the.property, will do the work and, he structure Misc.Conduits&Conductors ITEMS iES is not intended or offered for sale (Section 7044, Business' Other(See Complete Fee Schedule) 1 #'� .p and Professions.Code). ®__ ` ( 5:2 mFPsjd CONSTRUCTION LENDING AGENCY CHANGE .I-It' I hereby affirm that there-is a construction lending agency for'the - ;ij�LL}-1 00, 6 ,09 performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE' (SubTotal) Civ. c.) J.1s J . PLAN.CHECKING FEE Lender's Name ' - ' PERMIT ISSUING FEE O Lender's Address I certify that I have read this application and under penalty of purjury state TOTAL FEE that the above information is correct. I agree to comply with all County - :ordinances and State laws regulating Electrical wiring,and hereby authorize - oferesentetive of this County to enter upon the above-mentioned property - OP-M beat n urposes. / SEE REVERSE FOR EXPLANATORY LANGUAGE J�ARNATUREOF PERMITTEE DATE DEC TION • WORKERS't I hove a certificate cafe of corse CEA106 I0,81 APPLICATION FOR ELECTRICAL PERMIT 'I hereby affirm that 'I have a certificate of consent to self CE.806G ' insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LCIS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec,3800, Lab. C.) e Policy No. Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE ADDRESS y , - Certified copy is filed with the county building inspec- 18 2-Famil y, Sq. $ — $ LOCALITY IfQir /1? C_I lion department Multi-family $q. Ft. — NEAREST Residential Swimming Pools CROSS ST. ��-s�r`i . Date Applicant OWNER OR .. FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec_Light_Sw._ AIL COMPENSATION INSURANCE ADDRESS This section need notbe com leted if the work Involved b First 20 _ ( R 9 Total No. CITY G1 1)4 Tel. No./ Z_ '7 the permit is for one hundred dollars ($100)or lass.) Additional- I certifythat in the performance of the viork for which this MAN CHECK - P APPLICANT permit is eco I shall not employ any person in any manner so as to become subject to the Workers''Compensafion'Laws. Lighting Fixtures First 20 ADDRESS _ '. 1 1 Total No. Additional Date�' Z-g+3 Applicant w•52 ,UAN fibh CIN Tel. No. Fixed Appliances Not Over 1 HP PERMIT - NOTICE APPLICANT: If, making this Certificate of APPLICANT (- Exemption,n, you should become subject Io' the Workers' Range— Heater_D.W.' Compensation provisions of the Labor Code, you must forth- Oven — Dryer — W.M._ - ADDRESSZ It (2ta •L with comply with such provisions or. this permit shall be Top FAU —W.H. — deemed revoked. CITY 0 - -hl o. 8.2260 LICENSED CONTRACTORS DECLARATION Hood _ Fon _ Other_ - Disp. _ Room Air Cond. 'LICENSE M Class.�,- I hereby affirm that licensed under provisions of Chapter REG. NUMBER, 1 (commencing with Section 7000) of Division 3 of the Business DISTRICT NO. PROCES D BY .and Professions Code, and my license is in full force and effect. Power Apparatus 8 large Appliances _ 6 Size.B:Type HP, KW, KVA, or KVAR' Q� - O License Num(berc39924 9 Lic. Class C_.3G .Up to I Incl. FINAL /�7 t9� - V ad ConrroctoSls'tn�G✓114 Date �'z g 3 _ Over 1 to 101nc1. DATE / VALIDATION O ❑ Over 10 to 50 Incl. FINAL {~j 1 am exempt under Sec.- Over 50 to 100 Inc. BY, `I. �s.f_J _ _ d B.BP.C. for this reason Over 100 W eServices, Swbd., MCC 8 Ponelboards ' /U �i�: � 0 -200 Amp. Under 600V ► v( d Signature -CSC 7Y 201 -.1000 Amp.Under 600 V _ -Over 1000 1000 Amp. or Over 600 V Exemption for Reg. Mai Elect. SINGLE FAMILY Temp. Power Pole 8 Appurtenances _ HOME OWNER-BUILDER DECLARATION - Sign with One Branch Circuit 1 hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits 2 461A Law for the following reason (Section 7031.5, Business and Professions Code): • Misc. Conduits 8 Conductors �., a °:° 2 I, as owner of the property, will do the work and the • structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ polo 1 45 O 7044, Business and Professions Code). °•° ° � [J,S CONSTRUCTION LENDING AGENCY _ . . I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued PERMITTEE _ (Sub-Total) _ (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name , PERMIT ISSUING FEE Q Lender's Address ' 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-m nNoned pro ty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE - Signature of Per i fee Date -