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Home My Public Portal About9509 LA ROSA DR_Electrical__ D6 5-A 12:44 % MPLICATION FOR PEUffr DEPARTMENT OF 'BUILDING AND SAFETY t COUNff OF,LOS ANGELES �i��i...,ECTRIC WM. J. FOX CHIEF ENGINEER Q NAM . DISTRICT NO. GROUP pIZONE PERMIT J NO. U ADDRESS S1 ^I� "�' w/ rl 33 `� �^ LL CITY ' TEL.N RECEIVED BY READY FOR FIRST INSPECTION DATE ISSUED UI COUNTY W CERT.NO. D EXPIR S _ . APPLICANT FILL IN IIEAVII.Y OUTLINED PORT19N ONLY DESCRIPTION OF WORK ooREs D NUMBER OF OUTLETS ON CIRCUITS LOCALITY LOCATION BY ROOMS NEAREST F LIGHT OUTLETS lsw. PLUGS FIZT CROSS ST. CIRCUIT A B C D I E F G IH w NAME Z MAIL 3 ADDRESS O CITY TEL.NO. 1 AME LEGAL PO SE O THE AB VE LOS ANG COUNTY C F4 IO Q ALIFIC ION.. ELECTRICIAN. i AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE OWNER. CORD.EC7.`IONS Z cl I TOTAL NO. OF OUTLETS 34 $ APPROVALS r 9 NO. OF FIXTURES d $ DATE, INSPECTOR'S NAME NO. OF MOTORS H.P. $ I CONDUIT NO. OF SIGNS TRANS. $ WIRING NO. OF RANGES OR HEATERS $ i FIXTURES MISCELLANEOUS $ i POWER y�� n A PERMIT FEE $ UTILITY CO.NOTIFIED TOTAL FEE i FINAL I S 768663-CE806 10/72 APPLICATI N R EL'tt_ ICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER JOB (� BUILDING AND SAFETY DIVISION ADDRESS f fl G, 1 f LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. OUTLETS NO EACH I FEE OWNER OR $ Is FIRM NAME (� RECEPT._ MAIL LIGHT TOTAL FIRST 20 25 ADDRESS f � f CITY 7 SWITCH OVER 20 IO PLAN CHECK LIGHTING 1 ��O IRST 20 25 APPLICANT J} TOTALADDRESS FIXTURES VER 20 •10 RESIDENTIAL APPLIANCES CITY TEL. N0. PERMIT RANGE DRYER_WTR. HTR. APPLICANT Edd, 7,PG P •- STA. COOK DISP. F.A.U. ADDRESS SPACE HTR. AIR COND. CITY ;4• ft EL. N0. CLOTHES WASH. DISHWASH. LICENS OR ij' CLASS. C REG. NUMBER 2 2 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 AND/OR 0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA ORTHAI I AM THE LEGAL OWNER OF THE ABOVE 1 - 10 300 OESCRIP.ED RESIDENTIAL PROPERTY. /J O PERMITEE 10 - 50 500 SIGNATURE O I- 50 - 100 1000 DISTRICT NO. ROCESS D BY W a. 100 - 500 1500 SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALSL/ DATE INSPEC R'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 �/ TEMP. POWER POLE SERVICENOTOVER600VOLTS OR200AMP 3.00 Q(/ UNDERSLAB WORK SERVICEOVER600VOLTS OR200AMP 10.00 ROUGH CONDUIT TEMPSERVICE,POLE, &APPURTENANCES 500 WIRING TEMP LIGHT OR RECEPT. SYSTEM 300 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL / PERMIT FEE (SUB TOTAL) NOTES: PLAN CHECK FEE PERMIT ISSUING FEE 300 G TOTAL FEE Cj 0 PLAN CHECK VALIDATION CK M.O. CASH PERMIT VALIDATION CK. M.O. CASH f f', 2 5 9 073 AUG 3 2 D 6.G 0 d SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE DBS-SA 12•x$4 13NISIAPPLICATION FOR ,ELECTRIC PERMIT ON OF BUILDING AND SAFETY y Department of County.Engineer 1 County of Los Angeles - 'BUILDING WM. J. FOX. COUNTY ENGINEER ADDRESS' / C��- �1 CASSATT D. GRIFFIN, SUPT OF BUILDING FOR APPLICANT TO FILL IN . LOCALITY � �� (l PERMIT FEES NEAREST e Fj•L . ' CROSS ST. I` FEE - NU� EACH ` OWNER LIGHT OUTLETS- RECEPTACLES MAIL ADDRESS � WALL SWITCHES 5! $ CITY-^{t )Qi T- TEL. NO. TOTAL OUTLETS � -j ELEC. RANGES 25 ELECTRICI N- ' ELEC. HEATERS 25 ADDRESS KW EA - CITY - - TEL. NO. FIXTURES 5 - - r LICENSE NO. NUMBER OF LIGHT CIRCUITS J DISTRICT NO GR.00UP ZONE READY FOR INSPECTION NUMBER OF RECEPTACLE CIRCUITS - � �/ MOTORS- NUMBER HORSEPOWER- FEE INSPECTION RECORD NEW - MVD 'HP. OVER INC. EACH "I/2 8 LESS $- .25 I/Z 2 .50 2 5 1.00 �.- 5 '15 1 50 15 50 2 50 50 200 5.00 - MISC. NO SIGNS. NO TRANS. NO. SIGNS NO. LAMPS FOR EACH PERMIT: WIRING - $1.00 FIXTURES - - S1 00 SUPPLEMENTARY .50 sv -APPROVALS - TOTAL FEE $ DATE INSPECTOR'S SIGNATURE I HEREBY ACKNOWLEDGE -THAT I HAVE READ THIS APPLICATI.ON CONDUIT AND STATE THAT THE ABOVE-IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING �� LC14)J(J.., ELECTRICAL WIRING 1 HEREBY CERTIFY THAT I AM .PROPERLY REGISTERED AND/OR FIXTURES - LICENSED AS REQUIRED BY LOS ANGELES.COUNTY AND STATE OF POWER CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE _ DESCRIBED RESIDENTIAL PROPERTY. _ UTILITY CO. NOTIFIED SIGNATURE n - OF PERMITTEE 1 r I / FINAL l o �c -' WILLIAM X. FOX,COUNTY ENGINEER' ALIDA O , 2 2.2' 5 m By DEPUTY WORKERS'COMPENSATION DECLARATION 76A663 ' . CE-806G (2-80) APPLICATION FOR ELECTRICAL PERMIT , {� I hereby affirrrl that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY IJ insure, or a certificate of Workers Compensation Insurance,-or a certified copy thereof(Sec. 3800,Lab. C.) FOR APPLICANT TO FILL IN SOB iPolicy No. Company EACH NO FEE ADDRESS & r aNew Residential Bldgs.&Pools Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ — $ LOCALITY Multi-family Sq. Ft. — NEAREST_ r copy is filed with the county-building inspection Residential Swimming Pools CROSS ST Certified department. OWNER OR ,hy h FIRM NAME c Date Applicant Outlets- Rec, LightA Sw /V G ADDRESS S� ��jj First 20 CERTIFICATE OF EXEMPTION FROM WORKERS' Total No.�L Additional 1 v CITY z Tel No. /, r 6 } COMPENSATION INSURANCE PLAN CHECK tl (This section need not be completed if the work involved' Lighting Fixtures/-. Ft 20 , �� APPLICANT O by the permit is for one hundred 'dollars ($100) or less.) irsADDRESS Total No. Additional O I certify that in the performance of the work for which this CITY Tel No. Fixed Appliances Not Over,1�HP F" permit is issued, l shall not employ any person in any manner PERMIT W so as to become subject to the Workers' Compens on Laws. Range_ Heater_D.W. APPLICANT a Oven 4 Dryer_W.M. 'ADDRESS y Date /Applicant ( Top _ FAU'. W.H. 3 r Z Hood _ Fan _Other_ CITY Tel No. 7J/ 'NOTICE TO APPLICANT: If, after making this Certificate of Disp. — Room Air Cond.— LICEINSE OR Exemption, you should become subject to `the' Workers' REG.NUMBER Class G, d Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT N,9.,- PROCESSED BY with comply with such provisions or this permit shall be Size&Type HP,KW, KVA,or KVAR bJ , deemed revoked. ✓ ��--�- Up to 1 Incl. FINAL Over 1 to 10 Incl. DATE //... VALIDATION LICENSED CONTRACTORS'DECLARATION Over 10 to 50 Incl. I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL -e 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. Servic s' N r _ 20 mp. Under 600 License Number Lic.Class 2 Amp..Under 600 V / Contractor Date �'!r� Over 1000 Amp.or Over 600 V HOME OWNER-BUILDER-DECLARATION Temp.,Power Pole& Appurtenances p� IC /✓IGG� , I hereby affirm, that •I am exempt from the Contractor's Sign with One Branch-Circuit /� 1 License Law for,the following reason (Section 7031.5, Busi- ness and Professions Code):_ .2,1' 2 0,,0 A Misc.Conduits& Conductors I, as owner of'the property, will do the work and the Other (See Complete Fee Schedule)— #'o,0}0,0 o 2 structure is not intended or offered for sale)(Section 7044, Business and Professions Code). 2 0 o 5'1,9 Q CONSTRUCTION LENDING AGENCY I hereby affirm that there is.a construction lending agency 'o-o'o = for the performance of the work for which this permit is 5 1. 9 v issued (Sec. 3097,Civ.C.). PERMIT FEE (Sub-Total) 1 D Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) 9 1 ib::8 1 Lender's Address PERMIT ISSUING FEE �n I certify that I have read this application and state that the TOTAL FEE i b 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 -mmentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Si ture of Perm.ttee Date