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Home My Public Portal About10212 LA ROSA DR_Electrical__ -76ABBS-CEB0612.58 APPLICATION FOR ELECTRIC PERMIT 1 COUNTY OF LOS ANGELES _ DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS ./O2/,.� - �� DSf! ,e• JOHN A.LAMBIE,COUNTY ENGINEER CASSATT D.GRIFFIN,SUPT OF BUILCING LOCALITY "c J f FOR APPLICANT TO FILL IN CROSSST. CT.��eKMAq✓ PERMIT FEES OWNER % lJa.e G'• ITEM NUMBER EACH FEE /_ q 4 OUTLE $ S MAIL :' OSA b� LIGHTS REOEPT. SW. k -A 70 ADDRESS YJ /Dl •may LIGHTING FIXTURES .10 O CITY �M/-CE CrTEL.NO.G/ ELEC.RANGES CLO.DRYERS \ ELECTRICIAN Q' WATER HEAT E R5 .50 I ADDRESS ELEC.SPACE HTRS. D15HWASHERS / CITY TEL.NO. GARBAGE DISPOSERS AUTO-. STATE WASHERS STA.COOKING UNITS 25 LICENSE NO. MOTORS: OVER INC. WP. DISTRIC O. GROUP ONF!il:kBY O— '/ 25 v:— 2 .50 Q INSPECTION RECORD 2— 5 1.00 5— 15 1.50 15— 50 2.50 50-200 5.00 SIGNS: NO.TRANS. NO.LAMPS SERVICE 0-600V _ _1.00- SERVICEOVER 600V 5.00 MISC. WIRING PERMIT 1.00 ': QV FIXTURE PERMIT 1.00 Q SUPPLEMENTARY PERMIT .50 TOTAL FEE s APPROVALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION DATE INSP ATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY - WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT ELECTRICAL WIRING. HEREBY CERTIFY THAT 1 PROPERLY REGISTERED ANO/OR WIRING LICENSED AS REQUIRED BY LOSS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIA. PROPS POWER POWER SIGONATUR NATURE TTEE UTILITY CO.NOTIFIED //CC// . uffamum FINAL ®' XJVMATION ARTHUR C..VETT. NO ' CASH SUPERVISING ELECTRICAL ENGINEER LACO 8 1,12 JUr4 17 2 A 3.2 0 '6g683 «BD8I2 APPLICATION FOR ELECTRIC PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING ,,OO BUILDING AND SAFETY DIVISION ADDRESS / �- �� "-01'� J' JOHN A.LAMBIE,COUNTY ENGINEER CASBATT D.GRIFFIN,SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL` IN NEAREST PERMIT FEES CROSS ST. OWNER �...! cx. C- �Y I T E M NUMBER EACH FEE _ c_ OUTLETS: g - g MAIL v LIGHTS RECEPT. SW. ,10 ADDRESS /LIGHTING FIXTURES .10 - CITY TEL.NO ELEC.RANGES CLO,DRYERS ELECTRICIAN I ad I WATER HEATERS .50 ADDRESS D J ,� ELEC.SPACE HTRS. DISHWASHERS _ CITY TEL.NO. !A O GARBAGE DISPOSERS AUTO.- [/ STATE C - WASHERS STA,COOKING UNITS .25 LICENSE NO. MOTORS: o0 wc. H.P. DISTR�CS.7J0. OUP Z N%go PROCESSED BY O— 1/z .25J vB— 2 .50 INSPECTION RECORD 2— 5 1.00 5— 15 1.50 15— 50 2.50 50—200 5.00 SIGNS: NO,TRANS, NO.LAMPS SERVICE 0-600V 1.00 QQ SERVICE OVER 600V 5.00 MISO. WIRINGPERMIT / 1.00 FIXTURE PERM IT 1.00 �,O,!� SUPPLEMENTARY PERMIT .50 f Q SLJ POP � ��L Z/1 � TOTAL FEE S / p APPROVALS 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY OR°INANCES AND STATE LAWS REGULATING CONDUIT ELECTRICAL WIRING. WIRING HEREBY CERTIFY THAT AM PROPERLY CRE OUNTY ERE° ANC/OR LICENSED AS REQUIRED BY LO ALEGAL COUNTY F STATE OF FIXTURES CALIFORNIA OR THAT AM E LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAC�P ERTY. / POWER SIGNATURE ✓ UTI LITY CO.NOT[FI ED OF PERMITTEE FINA17 L ®" AL DATION ARTHUR C. VETT, cK O CASH SUPERVISING ELECTRICAL ENGINEER - in 9 1. 0 3 °; JUL 8 2 A_ 1.5 0 •' WORKERS'COMPENSATION DECLARATION 764663 10191 6G APPLICATION FOR ELECTRICAL PERMIT {� hereby affirm that I'have a certificate of consent to self insure, CE-80 �Jdr,a certbtc6e of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof (Sec:3800,Lab.C.) P011by':YO; ' Company -- FOR APPLICANT TO FILL IN JOB Q Certified copy is hereby furnished, New Residential Bldgs.8 Pools •.EACH NO. FEE. ADORES$ 7. A ' Certified'co g 1 & 2-Family, $ — $ LOCALITY copy is filed with the county building inspection y,Sq.Ft. ' NEAREST' departmertr, a . Mu{ti-fami{y 5q.Ft _ CROSS ST •�- - Date_ 'Applicant r Residential Swimming Pools 'OWNER OR FIRM NAME CERTIFICATE OF EXEMPTION FROM:WORKERS' 1 Q Sw . - MAIL COMPENSATION INSURANCE. Outlets: Rech. light -D /• DD ADDRESS '— (This section need not be completed lfthe-work involved.by the /� First 20 .permit is for one hundred dollars.j$WO) or less.) Total No.-d!L Adtltlional QD CITV Tel:No. '^G --22- I certify that in the performance of the work for which.this permit PLAN C ECK - is issued, I shall not employ any person in any manner s0_as to '- L APPLICANT become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 - ADDRESS - ' Additional r Total No. ' CITY - - Tel.No: .Date Applicant Fixed Appliances Not Over 1 HE - NOTICE TO APPLICANT: If, after, making this Certificate of - PERMIT -- Exemption,youshould become subject to the Workers'Compensation Range_ Heater_ D.W. APPLICANT provisionslof the.Labor Code, you must forthwith'comply'with'such Oven _ Dryer _ VIM ODADDRESS provisions'ar this permitshall be deemed revoked. Top FAU .(L W.H. CITY �l �• Tel:No.�✓,� dL2 LICENSED'CONTRACTORS DECLARATION 'Hood _ Fan Other_ hereby affirm that amilicensed under provisions of--0hapter 9 ' - LICENSE OR / Disp. ._ Room Air Cond. _ Glass. (commencing with Section.7000) of Division 3 of the Business.and - REG.NUMBER - Professions Code,and my"liben6e is In full forceand effect. ' DISTRICT NO. - - PRO BY Power Apparatus 8 Large.Appliances _ Size& Type HP,KW,KVA,or KVAR °� �1ff-L:G.✓ 0 .License Number - ,Lic:Class - 'Up to 1-Incl - FINAL - U .Over 1.to 10 Ind. - DATE 'VALIDATION Contractor " Date n - ❑ - G Over 10 to 50 Incl cp_FINAL " am exempt under Sec. Over 50 to 100 Inc. BY /p�(y/t/()N.'�'.,,—✓ _ 8&P.C. for this reason - Over 100 13- Services, Services, Swbd.,MCC& Panelboards' - fA - Date: - f/0 -. ®.200 Amp.Under 600 V O .-, Z Signature 201 - 1000 Amp.Under 600:V - ,I Over 1000 Amplrap ..or Over.600 V. y;,t;Ta ' Exemption for Reg.Maint.Elect. -. - SINGLE FAMILY - Temp.Power Pole & Appurtenances b SC;� �`_�° l'1 HOME OWNER-BUILDER DECLARATIONiSign with One Branch Circuit dTEMS I hereby affirm that I arn-exempt from the Contractor's LicenseLaw for the following reason (Section 7031.5„Busness and Professions Additional Sign Branch Circuits TOTAL f .®.- ' Misc.•Conduits & Conductors - CHECK I,as owner of the property,will do the work and the structure is not intended of offered for sale (Section 7044, Business Other(See Complete Fee Schetlule) and Professa^ Professions Code). ' ' CONSTRUCTION LENDING AGENCY ' - ., •pl�C+l1'11f1i)1. - fIP?V/9i; I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued(Sec.3097, PERMIT FEE - - (Sub-Total) .. 4 LJ_ iy �,[I: Civ.C.). PLAN.CHECKING FEE Lender's NamePE - ' RMIT IUING.FE SSE Lender's Address - I certify that I have read this application and..state that'the-above TOTAL FEE - 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' i property for inspection purposes, ,/ g 'SEE REVERSE FOR EXPLANATORY.LANGUAGE __ �S-ignature of.Permj D ' s �