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HomeMy Public PortalAbout9571 LA ROSA DR_Electrical__ 1 �r COUNTY OF LOS ANGELES '� � j' APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY WILLIAM J. FOX, County Engineer FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRICIAN .fyPa ECEIVED BY READY FOR DATE ISSUED ADDRESS FIRST INSPECTION l CITY TEL. NO. O-9 7QT �'p COUNTY LICEN E NO. JJ4-1 EXPIRES U— L/ BUILDIN PERMIT FEES ADDRESS D`'�►�! FEE � NUMBER EACH LOCALITY LIGHT OUTLETS NEAREST RECEPTACLES CROSS ST. WALL SWITCHES 17 OWNER , TOTAL OUTLETS 7 50 !g MAIL ELEC. RANGES 25 ADDRESS ELEC. HEATERS 25 CITY TEL. NO. _ FIXTURES 5 70 ' 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS M16C APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOB NUMBER HORSEPOWERFEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER NEW MVD HP OVER INC EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. t !/2 6 LESS $ .25 SIGNATURE OF _�/2 2 50 PERMITTEE - s/ 2 5 1100 INSPECTION RECORD 5 15 1.50 __ ----- '•-- -- Jls so 2.50 O2.s0 �- --'-` --- -- - - � � - - - -^- -- - -^ - � a --- - - P - 50 200 Soo 200 500 10.00 �! 5130 1000 15130 Q Z OVER 1000 20.00 M G. SET/FREQ. CHANGER-HP WELDERS:AC-KVA O GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF ORIG) MOVED MOTORS (75% OF ORIG.) MISC. SIGNS NO. NO.TRANS. N0. NO. LAMPS APPROVALS DATE INSPECTOR'S NAME FOR EACH PERMIT: WIRING $1.00 CONDUIT FIXTURES $1.00 00 WIRING 41.LZ SUPPLEMENTARY .50 FIXTURES POWER TOTAL FEE $ a0 UTILITY CO.NOTIFIED FINAL (l/ 75A663 DBS#SA 2-53 76A663-CES06 B-62 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING ) BUILDING AND SAFETY DIVISION ADDRESS C"JF - L't kCS 4 JOHN A. LAMBIE. COUNTY ENGINEER /� I WILLIAM A JENSEN, SUP T OF BUILDING LOCALITY -0- t ` L NEAREST FOR APPLICANT TO FILL IN cRoss sT RECEPT TOTAL NO TEACH FEE OUTLETS FIRST 20 $.20 $ OWNER E f Ic a Q LIGHT MAIL ADD'L 10 ADDRESS SWITCH OVER 20 TOTAL CITY 1OpA TEL NO ! + LIGHTING I F7RST2020 FIXTURES OADD'L 10 ELECTRICIAN VR 2 0 RANGE CLO DRYERS R HTRS / 100 ADDRESS GARB DISP STA COOK CITY TEL NO DISHWASH AUTO-WASH STATE SPACE HTRS STA APP (%i H P MAX ) .50 LICENSE NO MOTORS OVER NOT OVER HP D PTRICT FIR Z NE P O D B O 1 100 __::5 1 3 150 INSPECTION RECORD 3 B 200 - S 1s 250 15 s0 380 } a 50 100 500 O V SIGNS NO TRANS NO LAMPS O SERVICE 0.600V-NOT OVER 200A 1100 G - W SERVICE 0.60OV-OVER 200 A 200 d N SERVICE OVER 600V 500 MISC PERMIT ISSUING FEE 2 00 SUPPLEMENTARY PERMIT ISSUING FEE 1 00 TOTAL FEE 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING WIRING I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOB ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENT(JA/} P OPE RTY POWER SIGNATURE �j ' UTILITY CO NOTIFIED OF PERMITTEE ` MM FINAL VALIDATIO ARTHUR C. VEIT CK MO CASH SUPERVISING ELECTRICAL ENGINEER LAW'" 1 2 ,6 4'12" FEB 2 1 2 D ,Q CIT Y o j:= ��MPL-E C ,-T 76A663-CE806 9-64 APPLICATION FOR ELECTRICAL 4"ERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING BUILDING AND SAFETY DIVISION ADDRESS Cl JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W JENKINS, SUPT OF BUILDING LOCALITY ILA NEAREST' , Y ` FOR APPLICANT TO FILL IN CROSS ST RECEPT TOTAL FIRST 20 NO $EA2C00 $ FEE OUTLETS OWNER Q LIGHT MAIL SWITCH ADD'L 1O ADDRESS _ Lr'� c) OVER 20 ] TOTAL I CITY TEL NO ,b" LIGHTING FIRST 20 20 FIXTURES r , 1;;:'L 10 ELECTRICIAN 20 RANGES CLO DRYERS WTR HTRS 1 00 ADDRESS GARB DISP STA COOK CITY TEL NO DISHWASH AUTO-WASH STATE C£1 LI NsJ SPACE HTRS BTA APP P (%y H P MAX ) 50 LICENSE NO MOTORS OVER NOT OVER HP DISTRICT NO. GROUP I ZONE I PROCESSED BY O 1 100 5.og _t R 1 3 is INSPECTION RECORD 3 6 200 a' O 8 15 250 V 15 50 300 Of O SO 100 500 ~ U w SIGNS NO TRANS h NO LAMPS z SERVICE 0.60OV-Nor OVER 200A 100 ' SERVICE 0.600V-OVER 200 A 200 SERVICE OVER 600V 500 MISC PERMIT ISSUING FEE 200 Z _ SUPPLEMENTARY PERMIT ISSUING FEE 100 TOTAL FEE $ 3 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY 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' O NER OF, AND INTEND TO RESIDE IN, THE ABO DE_ CRIBED REST TIAL PROPERTY POWER SIGNATURE UTILITY CO NOTIFIED OF PERMITTEE FINAL `VALIDATION JOSEPH C ROOHAN F SUPERVISING ELECTRICAL ENGINEER CK MO CASH LI IVO 2 2 5 Q-'-- MAY 2 3 2 D 3.5 0- WORKERS'CO1 1';1. TION DECLARATION CE-80676A663APPLICATION, FORE ECTRICAL PERMIT I hereby affirm that-I"have a certificate of consent to self COUNTY OF LOS ANGELES e BUILDING AND SAFETY insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec 3800, La C) ]} / L d j - �� /I FOR APPLICANT TO FILL IN JOBADDRESS, ���/j Yolicy o Company /T New Residential Bldgs &Pools EACH NO 'FEE /.&,, Certified copy is hereby furmshedl j 1 &2-Family,Sq Ft $ — $ LOCALITY Multi-family Sq Ft — NEAREST Certified copy is filed with t county building inspection CROSS STr7-• 6L X49 department OWNER Residential Swimming Pools 7� / _ FRM NAME !`�� ��A l0�P c,,_ry /J Datje $� Applicant �- Outlets Rec Light ' First 20 / ADDRESS J CERTIFICATE OF EXEMPTION FROM WORKERS' Total No AdditionalCITY}� 1_/, F?, ' (y�? Tel No COMPENSATION INSURANCE PLAN CHECK (This -section need not be completed if the work involved APPLICANT ,Q , by the permit ts for one hundred dollars ($100) or less.) Lighting Fixtures First ADDRESS U Total No Additional I certify that in the performance of the work for which thisCITY Tel No 0 Fixed Appliances Not Over 1 HP permit is issued, I shall not employ any person in any manner PERMIT n so as to become subject to the Workers'�Compensation Laws Range_ Heater_D W APPLICANT W en Dryer_•W M ADDRESS S- / r �N [rr} N Dat �f ApplicanC,t` - T Ov T _. _ _ Top_-_FAU--_W H -- - z- - Hood Fan _Other_ l CITY gra ;E,4C . Tel No r` e NOTICE TO APPLICANT If, after making this Certificate of Disp Room Air Cond.— LICE SE OR �/ Exemption, you should become'subject to the Workers' REG NUMBER->i�( Class Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO P D BY with comply with such provisions or this permit shall be deemed revoked _ - Size&Type HP, KW, KVA,or KVAR �© Up to 1 Incl ' ,Over 1 to 10 Incl FINAL LICENSED CONTRACTORS DECLARATION DATE / / C VALIDATION Over 10 to 50 Incl I hereby affirm that I am licensed under provisions of Chapter -Over 50 to 100 Inc FINAL 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 Services n License Number,�� Lic Class �� 0-200 Amp Under 600 V �p //��� •-�i�CC// 201-1000 Amp Under 600 V Contractor�gJS:CR��7 Date 11=Z 7J7J 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 91 39 9 A License Law for the-following reason'(Section 7031 5, Busi Additional Sign Branch Circuits _ _ - ness and Professions Code) IWe 0 0 0 0 2 Misc Conduits& Conductors I, as owner of the property, will do the work and the Other (See Complete Fee Schedule). i 2 0,0"0 7.5 0 structure is not intended or offered for sale (Section - 7044, Business and Professions Code) - o o o o CONSTRUCTION LENDING AGENCY 7,5 5 v I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is g 3��-$ 1 PERMIT FEE (Sub-Total) issued (Sec 3097,Civ C) ' Lender's Name PLAN CHECKING FEE (One-Fourth Permit•Fee) Lender's Address y 'PERMIT ISSUING FEE 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 he.�ylauthorize representatives of this County to enter'upon T e above-mentioneV'roperty for inspection purposes ( SEE REVERSE FOR EXPLANATORY LANGUAGEAj S 'U ignature of Permittee Date --- - -- - WORKER'S COMPENSATION DECLARATION 200019 DPW(t2-9t) APPLICATION FOR ELECTRICAL PERMIT 76A663 I hereby affirm that I have a certificate of consent to self Insure, or a certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV copy thereof(Sec 3800 Lab C) I - Poli � �'�cy No Company — FOR APPLICANT TO FILL IN JOB ADDRESS C Certified copy Is hereby furnished New Residential Bldgs &Pools NO EACH FEE — $ $ LOCALITY ' 27 Certified copy iscfiled with the county b doling i p Ion 1 &2-Family,Sq Ft departm�e7ntq Multi-family Sq Ft CROSSSST (J Date /— / y Applicant • Residential Swimming Pools ASS BOOK ' PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Z OWNER OR Outlets Rec Light J—Sw ' S COMPENSATION INSURANCE' � /�/Q FIRM NAME ���N ��N!le, ,�(�/ First 20 / MAIL (This section need not be completed it the work involved by the Total No JAG— Additional Z O b0 ADDRESS permit`is for one hundred dollars($100)or less') I certify that in t,a performance of the work for which this permit CITY t Tel No CITY Is Issued, I shall not employ any person In any manner so as to become subject to the Workers' Compensation Laws Lighting Fixtures First 20 PLAN APPLICANTK Total No Additional OA4 I l dE ! tf ADDRESS 10 Le T- /✓ SJ Date � Applicant - � NOTICE TO APPLICANT If, after making this Certificate of RESIDENTIAL APPLIANCES NOT OVER 3 HP CITY Tel No S� — -Exemption,youu.sheuldybecome subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP provisions of the Labor Code, you must forthwith comply with suchPERMIT provisions or this permit shall be deemed revoked Power Apparatus&Large Appliances --- ----_ APPLICANT S LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR p ADDRESSS<— I hereby affirm that 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 C Tel No Professions Code,and my license Is In full force and effect Over 10 to 50 Incl LICEY1 /) Over 50 t0 100 Incl REG NNUM ER SI 7 d Class License Number �• �/ LIC CI85S 01- Over 100 DISTRICT NO n P SSED BY O 1 r Services,Swbd,M C&Panelb � Cc Contractor 4 �P /p},{sr 0 V �� Date ���`` �'Y' DATE �7 O EJ400-1000 Amp Under 600 V -Lf 9� VALIDATION V I am exempt under Sec Over 1000 Amp or Over 600 V FINAL a B&P C for this reason BRANCH CIRCUIT FEES BY ftn Date 15A,or 20A, 120V,Lighting or Recept Z 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits F-141 Or More Branch Circuits Exemption for Reg Maint Elect 15A,20A,208V To 277V Lighting Br Circuits - Y SINGLE FAMILY Temp Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031 5, Business and Professions Additional Sign Branch Circuits �1iJ� 1� Code) ❑ I, as owner of the property,will do the work and the structure Mlsc Conduits&Conductors i EI= Is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) and Professions Code) TfITA! -169 80 L�,�j CONSTRUCTION LENDING AGENCY 1--HEi'f, —,.71: 1 hereby affirm that there is a construction lending agency for the CHIN a_,:f performance of the work for which this permit is issued (Sec 3097, PERMIT FEE (Sub-Total) 3 Civ C) A1Mel PLAN CHECKING FEE Lender's Name _ PERMIT ISSUING FEE Lender's Address I certify tha I have read this application and under penalty of perjury state TOTAL FEE that the at, ve Information is correct I agree to comply with all County ordinances nd State laws regulating Electrical wiring,and hereby authorize represent Ives of this Count to enter upon the above-mentioned property for inspe ion purposes SEE REVERSE FOR EXPLANATORY LANGUAGE ATURE OF PERMI E DAIFE