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Home My Public Portal About9813 LA ROSA DR_Electrical__ >RABBG.CE#BOE=-sI APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARMENT OF COUNTY ENGINEERBUILDING BUILDING AND SAFETY DIVISION ADDREss JOHN A. LAMBIE. COUNTY ENGINEER A WILLIAM A. JENSEN.SUPT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. LZJ PERMIT FEES OWNER 1 T E M NUMBER EACH III FEE MAIL OUTLET %1 $ ADDRESS LIGHTS I/RECEPT SW. ,IG O CITY TEL. NO. LIGHTING FIXTURES zLn .Ip (2 ELEC. RANGES CLO. ORYERS ELECTRICIAt CHARDSON ELECTRIC CO.. 1n6- W ATER HEATERS .50 ADDRESS 8923 E. Broadway EL PACE HTRS. DISHWASHER San a r B y \� CITY I EL NO. ualli- *T.7-0539 GARBAGE OIBPOSERS� AU'j / (� LICE I ENSE NO. W ERS STP.COOKING UNITS .25 MOTORS: ER INC. H.P. DISTRICT NO. GROUP ZONE PROCESSED SO INSPECTION RECORD z— s LDo 3�a��G2 ��y.7NeSO ovl� LY. foLrLPtr• 5— Is 1.50 1S— 50 2.50 / Q 50— 2005.00 U W NO TRANS, a SIGNS: 401, NO.LAMPS Z SERVICE 0-000V 1.00 SERVICE OVER 600) 5100 MISC. WIRINGPERMIT 1.00 / FIXTURE PERMIT i,pp SUPPLEMENTARY PERMIT ,5O TOTAL FEE 5 (� 1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATF LAWS REGULATING CONDUIT 31,P F? ///, ,r/�y�// ELECTRICAL WIRING, ^I WIRING 3/T-'//VK. .V�/'NL1 I HEREBY CERTIFY TH 1 OS PROPERLY EGIST EO /OR LICENSED AS REOVIRE BY LOS ANG. b O NTY AND Al1E OF FIXTURES CALIFORNIA OR HAT M THE L A O NE OF T BOVE DESCRIBED RE51 E TIA OPFvY. POWER ^� P• Y q �� SIGNATURE UTILITY CO.NOTIFIED. J - Ac .r...y+� •:d OF PERINH FINAL VALIDATION RR C. VETT SUPERVISING cK mD cnsH SUPERVISING ELECTRICAL ENGINEER 11;�9964 2j 2 D �p9.30 WORKER'S haveCOMPENSATIONcertificate DECLARATION 7W63 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT u o2o7�t 6A663 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'(SSec.c.-3600 Lab. C.) . P❑Olicy NO.& —1 1�� rP9111pPnA f�! E� �� FOR APPLICANT TO FILL IN JOB (' ADDRESS' 05A 1 , Certified copy is hereby furniNew Residential Slogs.&Pools NO. EACH FEE g _ S S LOCALITY L� Certified py is tiled with thng in cli 7&2-Family,Sq.FL _ NEAREST /�ep Multi-family Sq. Ft. CROSS ST. /1Date, ApplicanResidential Swimming Pools ASSESSORMAP BOOK PAGE PARCELCERTI KATE OF EXEMPWORKERS' Outlets:Rec.—Light Sw. OWN NAME COMPENSATIOE NFirst 20 MAILS/1 n(This section neetl not be domplork Involvetl by iha Total No. Additional ADDRESS T _J Q `permit Is for one hunt dollarsss.) I certify that in the performance of the work for which this permit CITY _ /,,16frE `f- Tel.N.. 75y 3&9¢ is issued. I shall not employ any person in any manner so as t0 PLAN CHECK J... ` became subject to the Workers' Compensation Laws. Lighting Fixtures First 20 APPLICANT A All ,.I( EIC[.. (i Total No. Additional ADDRESS r7� 7d-2-L-, / p, Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of T.I.No.b11O Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP.RESIDENTIAL APPLIANCES NOT OVER 3 HP. CITY JE<5_ provisions of the Labor Code, you must forthwith comply with such PERMIT ^ `( l nI 1E L , provisions or this permit shall be deemed revoked. Power Apparatus 8 Large Appliances APPLICANT [T n LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS b 7 ZQ I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Ind. 800 (commencing with Section 7000) of Division 3 of the Business and CITY ( J C E Tal.No. Professions Code, and my li ense is in full force and effect. Over 10 to 50 Ind. 4�SY LICENSE OR Class. L '1 Over 5010 100 IDCI. REG.NUMBER V Il c> Over 100 DISTRICT NO. PROCESSED BY O License Numbe L' .Class��/ Services,Swbd.,MCC&Panelboards CL 0-399 Amp.Under 600 V FINAL 0 Contract DaterrT7DATE ❑ I o x I untler Sec. 400 1000 Amp.Under 600 V W VALIDATION Over 1000 Amp.or Over 600 V FINAL d B.&P.C.for this reason BRANCH CIRCUIT FEES BY U) Date: iSA.or 20A, 120V,Lighting or Recept. Z I To 10 Branch Circuits Signature 11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits SINGLE FAMILY Temp. Power Pole&Appurtenances HOMEOWNER-BUILDER DECLARATIONt- I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit - "- - - --- •p..,3j1 for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits -- - '-'- -L I_ri° - - Code): r ❑ I, as owner of the property, will do the work and the structure Misc.Conduits&Conductors is not intended or offered for sale (Section 7044, Business Cher fee Complete Fee Schedule) hill and Professions Code). Q Ar"� A-1frit _K K. CONSTRUCTION LENDING AGENCY 2Rae,nab b c I hereby affirm that there is a construction lending agency for the '`� performance of the work for which this permit is issued (Sec. 3097, PE T FEE M!E'f'6_f _'�{ ub-Total) O Civ.C.) PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE 2� Lender's Address n I certify that I have read this application and under penalty of purjury state TOTAL FEE that the above rmation is correct. I a e to comply with all County ordinancesa tate laws gui 'ng Elec al wiring,and hereby authorize represent a of this unt o rater n the above-mentio ed property for ns ctio purpos /y SEE REVERSE FOR EXPLANATORY LANGUAGE $I NATUR OF PE ITfEE DATE (/I') ' WORKERS'COMPENSATION DECLARATION ' 63 CE 806G (2801 APPLICATION FOR ELECTRICAL PERMIT {� CE806G U I hdiebv affirm that I have, a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY insure, or a certificateofWorkers'Compensation Insurance,or a certified copy thereof�ec. 3800,Lab. C.) WA$�}.�.'Soo7Me�r FOR APPLICANT TO FILL IN JOB ' Policy No. 4 Loompany ADDRESS ' - EACH NO. FEE / ' - New Residential Bldgs.&Pools - t _Certified copy is,hereby furnished. 1 & 2-Family,Sq. Ft. $ — $ LOCALITY -.QMulti-family Sq. Ft. — NEAREST Certified copy.is filed with the o my buildin in ec[ion CROSS ST department. Residential Swimming Pools OWNER OR ' 11 i FIRM NAME __ ' Date/0 !0 Applicant_ Outlets: Rec�Light__6_ Sw.� ?S ADDRESS rY+'6 CERTIFICATE OF EXEMPTION FROM WORKERS' t �j First 2 Total No. �_ Additional COMPENSATION INSURANCES CITY Tel No. z Z - PLAN CHECK IL ll (This section'need not be completed if ik involved _ 0 . by the permit is .for, one hundred dollarss (SIO APPLICANT 0 (SIOLighting Fixtures first 20 or less.) Additional - ADDaESS - Ir Total No.le 0 1 certify that in the performance of the work for which this - CITY Tel No. F Fixed Appliances Not Over 1 HP permit is issued, I shall not employ.any person in any manner PERMIT W so as to become subject'to the Workers' Compensation Laws. Range_ Heater_D.W. APPLICANT -tl Oven _ Dryer_W.M. ADDRESS Z Date .Applicant � Top _ FAU _W.H.. Hood _ Fan _Other CITY LobAmcfTel No. 2, 55.5'6 .:NOTICE TO APPLICANT: If, after making this Certificate of Disp. _ Room Air Cond. LICENSE OR , Exemption, you should become subject to the Workers' REG. NUMBER Class Compensation provisions of the Labor Code;you must forth- Power Apparatus& Large Appliances DISTRICT NO. PROCESSEQJBY with comply with such provisions or this permit shall be- Size&Type HP,KW, KVA,or KVAR �f deemed revoked. ' 0 IV � Up to 1 Incl. FINAL ' Over 1 to 10 Ind. DATE/- .� LICENSED CONTRACTORS DECLARATION Over'10 to 50 Incl. � VALID TION I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc.. FIN Ae 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. Services License Number 355S?L I,ic Class_ 0-200 Amp. Under 600 V 1� 201-1000 Amp. Under 600 V Contractor 1—0- WQBD Date/0/�A 6 Over 1000 Amp.or Over 600.V 1 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 foi the followingreason (Section 7031.5, Busi- Additional Sign Branch Circuits ness and Professions Code): 23 1 1.3 A Misc. Conduits&Conductors # _� • • 2 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 (nR� 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY Q 10 z JJ 11 hereby affirm that there is d construction lending agency - - for the performanceof the work for which this' permit is issued (See. 3097,Civ.C.). PERMIT FEE (Sub-Total) g Lender's Name PLAN CHECKING FEE _(One-Fourth Permit Fee) Lender's Address PERMIT ISSUING FEE U J I certify that 1 have read this application and state,that the TOTAL FEE - above.information is correct.1 agree to comply with all County , ordinances nd State laws regulating Electrical wiring, and - hereby auth ize representative o his County to enter upon the ab a=m tinned property pectwo purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE 0 1 45 ature of Permittee D to - WORKERS• Chave SATION DECLARATION 763 10/01 APPLICATION FOR ELECTRICAL PERMIT •,I„here'by affirm that I have b certificate of consent to self CE E-88066 insurer or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY �,,or"r�la�ertif led copy thereof (Sec. 3800, Lab. C.) / - "F'❑olbicy Na O ompany • ie/tWMT �i FOR APPLICANT TO FILL IN Certi708 T fied co is hereby furnished. EACH NO. FEE ADDRESS PY Y New Residential Bldgs. 8 Pools rn — C� Certified copy is filed with the county building ins pec- 1 8 2-Family, Sq. Ft. $ — $ LOCALITY (��^�/��/ 'NEAREST tion dep/artment •7 Multi-family Sal Ft./��s // Residential Swimming Pools CROSS ST. Date Applicant OWNER OR -�; 'y FIRM NAME �P/•r1..r CERTIFICATE OF EXEMPTION FROM WORKERS' -MAIL Outlets: Rec_Light_Sw._. !r COMPENSATION INSURANCE First 20 ADDRESS - J (This section need not be completed if the work involved by Total No. Additional CITY Tel. No. the permit is for one hundred dollars ($100)or less.) PLAN CHECK I certify that in the performance of the work for which this - ermit is issued, I shall not employ APPLICANT... p y an p y person in any manner so as to become subject to the Workers"Compensation Laws. Lighting Fixtures First 20 ADDRESS Total No. Additional CITY Tel. No. Date Applicant Fixed Appliances Not Over I HPPERMIT NOTICE TO APPLICANT: If, after making -this Certificate of APPLICANT O Exemption, you should become subject to the Workers' Range_ Heater—D.W. — Q Compensation provisions of the Labor Code, you must forth- Oven _ Dryer _ W.M.— ADDRESS with comply with such provisions or this permit shall be Top FAU _W.H. — deemed revoked. CITY cpm �P �c Tel. No.ginf_ .? LICENSED CONTRACTORS DECLARATION Hood Fan _Other_ _ Dis _ Room Air Cond. REG. (79 LICEM qO S - Class. ii I hereby affirm.that I am licensed under provisions of Chapter 9 P� REG. NUMBER (commencing with Section 7000) of Division 3 of the Business DISTRICT NO PROCE Y and Professions Code, and my license is in full farce and effect. Power Apparatus 8 Large Appliances Ss U� Yo 3736 if Size &Type HP, KW, KVA, or KVAR a O License Number Liz. Class U to 1 Incl. FINAL - V `/� ,7 '/02 - Over 1 to 10 Incl DATE /_"_ ��O VALI ATION Q Contractor_IG'ol"/" Date " /1 `O � Over 10 to 50 Ind. FINA`J W ❑ I am exempt under Sec. Over 50 to 100 Inc. 8Y W Q. B.BP.C- for this reason Over 100 �.3 8 4.5 A Services, Swbd., MCC 8 Panelboards Z Date: 0 - 200 Amp. Under 600 V # s • • e e 2 Signature - 201 - 1000 Amp. Under 600 V -' ❑ ( • • 17.50 0%1 1000 Exemption for Reg. Mainz. Elect. Amp. or Over 600 V • • 0 7.5(]cam+. SINGLE FAMILY Tem Power Pole& Appurtenances Circuit rices 01,'1 5=86 HOME OWNER-BUILDER DECLARATION Sign with,One Branch Circuit ' I hereby affirm that Ham exempt from the Contractor's License l Sign gn additioBranch Circuits Law for the following reason (Section 7031.5, Business and ' Professions Code): ❑ I, as owner of the property, will do the work and the Misc. Conduits 8 Conductors ' structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)— ' 7044,.Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there is a consVUUion lending agency for the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). - - PLAN CHECKING FEE Lender's Name o - PERMIT ISSUING FEE 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 bove-mennoned erty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date '