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HomeMy Public PortalAbout9143 LA ROSA DR_Electrical__ 76A663-CE806 9-66 APPLICATION FOR ELECTRIM PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER FMA ING / D BUILDING AND SAFETY DIVISION ESS .L JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY EST FOR APPLICANT TO FILL IN S ST. R EC EPT, TOTAL NO. EACH FEE OUTLETS FIRST 2 $.20 $LIGHT SWITCH __3 ADD'L 10 ADDRESS / OVER 20 TOTAL FIRST 20 .20 CITY TEL. NO. LIGHTING 1 FITXTURES FIXTURES J( ADD'L OVER 20 10 CONTRACTOR r� RANGES DRYERS WTR.HTRS. 1.00 ADDRESS'/,Q,/ GARB.DISP. STA.COOK CITYA11TEL. NO. �J DISHWASH. AUTO.-WASH. STATE ' SPACE HTRS. BTA. APP L. .SO LICENSE NO. MOTORS: OVER NOT OVER H.P. DISTRICT GRQrQP NE IPI ol O 1 1.00 1 3 1.50 INSP C ON RE ORD s a 2.00 8 15 2.50 15 50 3.00 a 50 100 5.00 O SIGNS: NO.TRANS NO.LAMPS O G SERVICE 0.60OV-Nor OVER 200A 1.00 U.1 EL SERVICE 0-60OV-OVER 200 A. 2.00 N Z SERVICE OVER 600V 5.00 OTHER (SEE COMPLETE FEE SCHEDULE) PERMIT ISSUING FEE 2.00 SUPPLEMENTARY PERMIT ISSUING FEE 1.00 APPROVALS DATE INSPECTOR'S BIGNATURK TOTAL FEE IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION UNDERSLAB WORK AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ROUGH CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF. AND INTEND TO POWER RESIDE IN,THE ABOV SCRIBED RESI IAL PROPERTY. SIGNATURE UTILITY CO.NOTIFIED OF PERMITTE FINAL / (DATION JOSEPH C. ROOHAN CK MO CASH SUPERVISING ELECTRICAL ENGINEER UkCo 8.2 '3 8-0 APR 2 7 -2 D 3.6 0 N �L t 76A663-CE80611-71 APPLICATION FOR ELECTRICAL PERMIT LI COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS LOCALITYJ styFOR APPLICANT TO FILL IN CROSSSST. /Y OUTLETS NO EACH I FEE OWN ER`° RECEPT._ s Is MAIL LIGHT TOTAL FIRST 20 26 ADDRESS / CITY TEL. NO. SWITCH OVER 20 10 I PLAN CHECK FIRST 20 1 APPLICANT LIGHTING TOTAL FIXTURES 26 OVER 20 10 ADDRESS RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT RANGE DRYER_WTR. HTR. i APPLICA L STA. COOK DISP. F.A.U. ADDRESS SPACE HTR. AIR COND. CITY 1,(1 TEL. NO.3 3 L; CLOTHES WASH. DISHWASH. LICENSE N0. xf ? CLASS. C, Q FAN OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP KW. KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO _ I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AHD/OR O - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF d / CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO 0 / �J •Til 1 - 10 300 a l RESIDE IN, THE ABOVE DESC IBED RESIDENTIAL PROPERTY. V 7 -((%% V SIGNATURE �, i, 10 - 50 500 OF PERMITTEE O 50 - 100 1000 C DISTRICT NO. CLASSZONE PROLES ED BY Ll.l 1 00 - 500 1500 SIGN, GAS=AND ONE CIRCUIT 5.00 NOTES: 1 ? TUBE, OR S /7 MARQUEE ADDITIONAL CIRCUITS 100 SERVI CENOT OVER 600 VOLTS OR 200 AMP 300 Q APPROVALS DATE INSPECTOR'S SIGNATURE SERVI CEOVER 600 VOLTS OR 200 AMP 10.00 TEMP.POWER POLE TEMP SERVICE,POLE, &APPURTENANCES 600 UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM 300 ROUGH CONDIUT WIRING FIXTURES POWER AUTHORIZED PERMIT FEE (SUB TOTAL) UTILITY CO. NOTIFIED PLAN CHECK FEE FINAL PERMIT ISSUING FEE 300 3 O d TOTAL FEE © -6 _ PLAN CHECK VALIDATION CK. M 0 CASH PERMIT VALIDA CK. M.O. CASH ,9,0 `�N SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE u""� �•} r) C 76A663-cE80612-68 APPLICATIOW FOR ELE6RICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS 9143 4a fe.-r � JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY I �r R t� ! {- NEAREST FOR APPLICANT TO FILL IN CROSS ST. ('-1 a- I IL FRAN .3J TOTAL No. EACH FEE t OUTLETS �� $20 $ O Q OWNER Q �fFIRST 20 MAIL /3 ---I OVER 2011'7 •10 _7LJA.DRESSG F XOTURES FIRST 20 '4O -.20 Q0CITY : TEL. NO.ES ( nven zo / •1OCONTRAC7TOR �ff.R1USH E7�ECTRIC DRYERS wTR.HTRB. 1.00 ADDRESS 1 OTZG"t E. RUSH STREET P. STA.COOK SO:_ EL MONTE 448-8911 CITY TEL. NO.. AUTO.•WASH. STATELICENSE NO. 3 O Cd ` O RS. STA. APPL. .50 - - MOTORS. OVER NOT OVER H.P. DISTRICT—NO. GZONE CESSED BY O 1 1.00 A 1 3 1.50 INSPECTION RECORD O s s 2.00 J U 8 15 2.50 0 O 15 50 3.00 ti— Lu 50 100 5.00 N Z SIGNS: NO.TRANS NO.LAMPS SERVICE 0.60OV-NOT OVER 200A z 1.00 Z d d SERVICE 0.600V•OVER 200 A. 2.00 SERVICE OVER 600V 5.00 OTHER (SEE COMPLETE FEE SCHEDULE) PERMIT ISSUING FEE 2.00 �, �J ���,6 7 SUPPLEMENTARY PERMIT 18 SUING FEE 1.00 APPROVALS F DATE INSPECTOR'S SIGNATURE TOTAL FEE '6 IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION UNDERSLAB WORK AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ROUGH CONDUIT / WITH ALL COUNTY ORDINANCES AND-STATE LAWS REGULATING ELECTRICAL WIRING. A Al WIRING "1 CHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES LIENSED AS RE RED BY LOS ANGELES COUNTY AND STATE OF f CALIFORNIA OR HAT AM THE LEGAL OWNER OF,AND INTEND TO POWER Illy y RESIDE IN,THE BOV DESCRIBED RESIDE PROPERTY. _ Jul/ SIGNATURE UTILITY CO.NOTIFIED OF PERMITTEE _ FINAL DATION JOSEPH C. O CK O CAB. SUPERVISING ELEC ELECTRICAL ENGINEER .8' 8.3 s 10 JUN 2 2' D 2 1.7 0 $wORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent.to self insure, ora certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY_DIV. copy thereof(Se 3800 Lab. Grr Policy No. ompany FOR APPLICANT TO FILL IN JOB - ADDRESS ❑ Certified copy is hereby furnished New Residential Bldgs.&Pools NO. EACH FEE LOCALITY $ $ e — �Certd1 &ied copy is filed with the county ullding ction _ NEARES I S T department Multi-family Sq Ft. CROSS ST Date Applicant Residential Swimming Pools ASSESSIf MAP OR PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec. Light• Sw. ,Q OWNIRM NAME ' LL COMPENSATION INSURANCE- rst 20 �+ MAIL (This section need not be completed If the work involved by the ADDRESS q permit is for one hundred dollars($1'00)or less.) Total No. Additional `— r I certify that in the performance of the work fof which this permit CITY Tel.No. is issued, I shall not employ any person in any manner so as to PLAN CHECK become sublect,to,the Workers' Compensation Laws Lighting FixtuFirst 20 APPLICANT• res Total No Additional ADDRESS Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP NOTICE TO APPLICANT.-If, after making this Certificate of . CITY Tel No Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. rovisions of the Labor Code, ou must forthwith com I with such PERMIT provisions-or this permit shall be deemed revoked p y p y Power Apparatus&Large Appliances APPLICANT h AM' "LICENSED`CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS I hereby affirm thatr'I am licensed under provisions of Chapter 9 Over 3 to 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. Over 10 to 50 Incl: LICENSEOR B NUMBER ass ClV Over 50 to 100 Ind REG Z a LOver 100 DISTRICT NO ESSED BY 0 cense Number Llc.Class Services,Swbd.,MCC&Panelboards —5, D FINAL qwey0-399 Amp. Under 600 V /O J„ /J Contractor ate DATE 7 , ❑ I am exempt under Sec 400-?000 Amp Under 600 V. Over 1000 Amp.or Over 600 V, FINAL VALIDATION W B.&P.0 for this reasonBRANCH CIRCUIT FEES. BY f1 Date 15A,or 20A,120V,Lighting or Recept. Z _ 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits - ❑ 41 Or More Branch Clrcuds Exemption for Reg. Maint Elect. - 15A,20A,208V To 277V Lighting Br Clrcuds r• 7 a SINGLE FAMILY Temp. Power Pole&Appurtenancesc r HOME OWNER-BUILDER DECLARATION - 01•?"tcZ I hereby affirm that I am exempt from the Contractor's License Law Sign wlth'One Branch Circuit q "T for the following reason (Section 7031 5, Business and Professions Additional Sign Branch Circuits j 4` I"r Code)- TUTAj IML 154 20 ❑ I,as owner of the property,will do the work and the structure Misc Conduits&Conductors _ t1c is not intended or offered-for sale (Section 7044, Business Other(See Complete Fee Schedule) `•E�'' -��s- and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the i _ rt" ILO/ {L performance of the work for which this permit Is issued (Sec. 3097, PERMIT FEE (Sub-Total) 111/j f ` Civ C) PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address I certify that I have read this application and under penalty of purlury 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 representatives of this County to ent)upon the above-mentioned property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATU OF E DATE _ WQRiCERS'COMPENS ATIONDECLARATION CE-806 APPLICATION FOR ELECTRICAL PERMIT I here(y'affirm that I have-a certificate of consent to self COUNTY OF LO NGE LES ^'�� BUILDING AND SAFETY insure, or a certificate of Workers'Compensation Insurance,or a'certified copy thereof(Sec. 3800,Lab.C.) FOR APPLICANT TO F IN B Policy No. Company ACH NO. F ADDRESS d New Residential Bldgs.&Pools , ED Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ — $ LOCALIT.f Multi-family Sq. Ft. — NEAREST Certified copy is filed with the county,building inspection CROSS ST department. Residential Swimming Pools OWNER OR FIRM NAME •AP .L0 Date Applicant, Outlets Rec-_Light Sw. MAIL ,L First 20 ADDRESS. CERTIFICATE OF EXEMPTION FROM WORKERS' Total No Additional CITY: �j Tel No } COMPENSATION INSURANCE a • � PLAN CHEC O • (This section need not be completed if the work.involved APPLICANT U by the permit is for one hundred dollars'($100) Lighting Fixtures First 20 ADDRESSor less.) ' aC Total No. Additional O Fixed Appliances Not Over 1 HP CITY I certify that in the performance of the work for which this \ Tel No. U permit is issued, I shall.not employ any person in any manner PERMITLLI so as to become subject to the Wor ers' C nsation L ws. Range_ Heater D.W. APPLICANT l`y2 d to y Oven _ Dryer._W.M. ADDRESS d Z Date—+'rZ)Applicant 'Top FAU _W.H. — Hood Fan _Other_ CITY ,y, el No. NOTICE TO APPLICANT-,If, after making this Certificate of Disp. Room Air'Cond-_ LICENSE OR ,,��fi�`r' ` tom' Class Compensation provisions of the"Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO. PROSEED BY with comply with such, provisions or this permit shall be deemed revoked. Size&Type HP, KW, KVA,or KVAR ��•vC � Up to 1 Incl. Over 1 to 10 Incl. FINAL DATE- �. .LICENSED CONTRACTORS DECLARATION VAL(DATI Over 10 to 50 Incl. 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, - effect. f Services 0-200 Amp. Under 600 V License Number ` Lic.Class y i ^ .�. 201-1000 Amp. Under 600 V Contractor '� (Date 2`G�— 9� 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 ❑ 1, 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 7044, Business and Professions'Code). CONSTRUCTION LENDING-AGENCY �:g 14 9,8 A I 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.o,ojo o 2 issued(Sec. 3097,Civ.C.). ' • Lender's Name PLAN CHECKING FEE• (One-Fourth Permit Fee) 2'-•0 2 LI,5 0 Lender's Address PERMIT-ISSUING FEE 0 CIO 2 4,50c-) I certify that I have read this application and state that the TOTAL FEE ' 0 a 0 1,80 above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby author'ze representatives of this County,to enter upon the ov e i ed prop y for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE . Signature of Permittee Date