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Home My Public Portal About9817 LA ROSA DR_Electrical__ 6�lr 2e -' V.e"� 'BA689-CESOG 10-60 •rV/APPLICATIONFORvELECTRICAL PERMIT � COUNTY OF LOS ANGELES DEPARMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY.DIVISION ADDRESS 7 JOHN A. LAMBIE. COUNTY ENGINEER WILLIAM A.JENSEN, SUPT OF BUILDING LOCALITY -T NEAREST FOR'APPLICANT TO FILL IN CROSS ST. PERMIT FEES OWNER I T E M NUMBERI EACH FEE MAIL OUTLETS $ 'S ADDRESS LIGHTS ECEPT. sw. L .d0 4 CITY TEL. NO. LIGHTING FIXTURES „J .10 O{! ELECTRICIAN Richardson. Elect.Go. ELEC. RANGES CLO. DRYERS WATER HEATERS .50 ADDRESS . ELEC.SPACE HTRS. DISHWASHER �Y y CITXJan Gabriel TEL NO. At �� ARBAGE 61B SERS STATE 11 07�� ' WASHERS 'STA.COOKING VNITS .25 ` LICENSE N0. 1 CCJJJ MOTORS: OVER INC. H.P. DISLLLRICT O. GROUP ZONE ( PROCESSED BY / .25 J 0 " — 2 .50 INSPECTION RECORD 5— 15 - 1.50. 0 15— 50 2.50-1 w 50— 200 5.00 O, SIGNS: NO TRANS. 1(76JJ NO.LAMPS N z ' SERVICE 0.600V 1.00 SERVICE OVER 600V 5,00 MISC. WIRING PERMIT 1.00 FIXTURE PERMIT 1.00' SUPPLEMENTARY PERMIT .:50 TOTAL FEE $ IH 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 STATE LAWS REGULATING CONDUIT JI I! ELECTRICAL WIRING. WIRING 1 HEREBY CERTIFY THAT M PROPERL ST 0 AND R LICENSED AS REOUIRB LAOS ANGELE C N TSTA F FIXTURES CALIFORNIA Ofl T 1 THE LEGA �O N F THE VE DEBCRISEO RESI NT L ERTV POWER (- SIGNATURE UTILITYCO.NOTIFIED OF PERMITTE _ FINAL /.V-ALIDATION ARTHUR C. VEIT cK MO CASH SUPERVISING ELECTRICAL ENGINEER Lit c9 92 U1; ?3 2D GjD WORKERS' COMPENSATION DECLARATION - EA6010/81 CE-80 6G APPLICATIONS FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self insure, or'a cer�ficatx;.,_PGNore kers' Compensation Insuranc , ora certified 'COUNTY OF LOS ANGELES BUILDING AND SAFETY, copy thereof(Sec.3600.Lab.C.) - - • r - MO y No • 1 Company FOR APPLICANT TO FILL IN / - !'- r /l o (`� ` - - - . EACH NO. ,. FEE. , ADDRESS - J Csullied copy Is hereby furnished �. New Residential Bldgs &Pools ` Certified copy iswhledl witn the county buildmgins pechgnNEARET 1 &'2'-Family,Sq Ft. .• $ — $ LOCALITY, el _ department. - Multi-family Sq Ft. - 'CROSS55?- - I 3Ac'D, ( �La . ^}Date ApphcanY ` " r Residential Swimming Pools., t. ry i OWNER OR /7 p r - r \ , \ .\ ... FIRM.NAME W yL•,'t.NN -�•47�C 1 CERTIFICATE OF EXEMPTION FROM WORKERS. Outlets:'Rea— Light Sw. ADDR- 'T� M1 \ MAIL - F i .. _ COMPENSATION'INSURANCE,. ' ESS First 20 - (This section need not be completedtf the work involved by the ,, . , ., • CITY, Tel.'No. . .permit Is,for one hundred dollars($100)or less.) ., Total No. Addihona. _ I certify thati in the performance of the work;for which.this permit '` ., ?7V r a'• t r T zit 'P.LAN CHECK /�� t: - - Y P APPLICANT, (`t /A: is issued.subject not employ, any person in any manner so as to • - S - become suhject to the Workers'Comp n anon Laws Lighting Fixtures First 20 • - ADDRESS _ Additional I ' - '..,�Ipp TotAppli + - CITY - Tel No... Date APPlidant" �iJft S �CnT/C/��: .` - , -Fixed Appliances.Not Over 1HP PERMITp NOT( TO APPLICANT If, afte making this Certificate of APPLICANT r T~ c Exemption,you should become subject tc the Workers Compensation Range_ Heater_ D.W. ' .r / e provisions of,mWt,abor Coded you must forh1with comply with'such Oven-.— Dryer _ W.M.— ADDRESS/,��J •r o o,('O provisions. TRACTOR oy+'r''fi is..permit siall,be deemed•revoked Top' — 'FAU _"W.H. _ - - - 'CITY NS DECLARATION Hood Fan Other_ -fR.�Fs'etJ'T*_^` Tel No Q y1 , LICENSED CO ', — I hereby affirm that I am'licensed under_,provisions of Chapter 9 LICENSE OR � O -a C��.0. v .. Disp..�—.Room Air Cond. y - Class '(commencing with"Secbon.7000) of Division 3 of the Business and - REG:NUMBER _ ' Professions Code and m license is in full force and effect." 9 e A , DISTRICT NO ',PROCESS B y Power Apparatus 8 Largppliances -_ Size & Type-HP,KW,.KVA,or KVAR �. Cj Q License Nu Lic:Class �'I O ' -• - Up to 1 Incl FINAL n - — V. Old-" - Over 1 to 10 Incl DATE VALIDATION-` �. Contract. Date' - "' ' -'' G� "_. _ _ _ - Over 10 to 50 Ind. -- " U ❑ - FINAL am`exempt untler Sec. Over.50 to 100 Inc. 'gy -. for � Over 100 B&P.C.for this reason •_ - � ', N Services' MCC& Panelboards. O Date: . . l , .- ., y - 200 mp.,Under 600 V - Signature 201 0 Amp.Under600 V •^ - .. - - •❑ Over 1000 Amp.or Over 600 V _ 'Exemption for Reg.Maint.Elect. ' SINGLE FAMILY'' . Temp,Power Pole_& Appurtenances - HOMEOWNER-BUILDER DECLARATION - LY Sign with-One.Branch Circuit •" -^a - I I hereby affirm that I am exempt from the Contractor's License'Law '•Additional Sign Branch Circuits, - ..> _ - e following reason (Section 7031.5,Business and Professions - M�pp .I Code): ` c7•� �e , - ' Misc.•Conduits& Conductors - ,� �.3 I,as owner of the,property,will do the work and the structure Other(See Complete FeeSchedule) • I1EIiS . is not intended.or„offered for sale (Section 7044, Business - r - `and Professions Code). _ ® z- _`1 _,MAL CONSTRUCTION LENDING AGENCY - - - - 25m all 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 - -• ISub-Total).' rr �7MT1G _-r A. - ' BLAN.CHECKING.EEE - .<....- rr •.' 7/21/8 Lenders Name i PERMIT ISSUING-FEE _may Lenders Address.- -- • - 4611 '1. AN11 ._ 1 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 .3 •� "1 , representatives of. thypuaff enter u n the above-mentioned _ pr ty for inspeg /y, _ .;,,SEE REVERSE FOR,EXPLANATORY LANGUAGE -SiOnalfure of Peifiriffiter,_ Date ` WORKER'S COMPENSATION DECLARATION 76-A06G139DPW 9/89 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(Sec.3800 Lab.,C.);,..;1� Policy No. Company FOR APPLICANTTO FILL IN JOB )) ❑ .-e _ �,s. ADDRESS a Certified copy is hereby furnished. r' New Residential Bldgs.8 Pools � EACH NO. -.FEE -�' � .• •.. •� $ _ LOCALITY , ❑' Certified copy is filed with the county building'inspection ".. 1&2-Family,Sq.Ft. $ department. i , , Multi-family Sq.Ft. _ CaoSSSs. 11A4 B .. , - .. - .. �,. ,s Residential Swimming Pools - ASSESSOR Date AppfiCeot MAPBOOK PAGE PARCEL e , CERTIFICATE OF EXEMPTION.FROM WOAKERS'I (/v Outlets:Red.�..�Light Sw.T! OWNER OR -/ I Vi1 COMPENSATION INSURANCE / 'First 20 �/�i L �.p FIRM NAME O• (This section need not be Completed If the,work Involved by the ��^ /-1 MAIL permit is for one hundred dollars($100)'or less.) Total No.� �/ Additional r- ADDRESS- MAIL that in the performance of the work for which this permit CITY- .. . CITY �^ ✓ TO.No. is/issued, I shall not employ any person in any manner so'as to PIAN CHECK }/ecome subject to the Workers'Compensation Laws. 1 Lighting Fixtures First 20 0 APPLICANT dr / 42W 0! .. Total No.7 Additional ADDRESS V � ' Date 7 ./7 9�gpplicant - - 150R 20A,120V BRANCH CIRCUITS--- ' NOTICE TO.APPLICANT: H,.after making his^Certificate of - •' • CITU - TJNo: Exemption,you should become subject.to the Workers',Compensation 1 T010 INCLUSIVE EACH -provisions of the Labor Code, you.must forthwith comply,with such 11 TO 40 INCLUSIVE EACH _ PERMIT P - - - APPLICANT provisions or this permit shall be,deemed revoked. 41 OR MORE BRANCH CIRCUITS EACH -. } LICENSED CONTRACTORS DECLARATION - -- - - - - - ADDRESS _ __� I hereby affirm that I am licensed under provisions of Chapter 9 150R20A,208VT0277V LIGHTINGEAd- O (commencing with Section 7000) of'Division 3 of the Business and _ _ -_ CITY TO,No. _ U Professions Code, and my license is in full force and effect. RESIDENTIAL APPLIANCES UP70 3HP LICENSE OR IT I Power Apparatus 8-Large Appliances. _ _ REG.NUMBER Class. 0 License Number L ic.Class Size 8 Type HP,KW KVA or,K DISTRICT NO. P SED BY F— J ' � J/ J Up to 3lnci - - _ �� S (�z/LL -a Over 3 to 10 Incl. FINAL - DOnVaC10! Date .- _ _ _ DATE _ ❑ - - - Over 10 to 50 Incl: 2_�2 /z_' Z I am exempt under Sec. Over 50 to 100 Incl, l VALIDATION _.- _ - FINAL -' -BAP.C.for this reason --- Over 100 - BY Services,Swbd.,MCC&Panelboards _ _ C . _ �/•_�"�� Date: _ 0-200 Amp.Under 600 V Signature .._201 -1000 Amp.Under 600 V - ❑ Over 1000 Amp.or Over 600 V - Exemption for Reg.Maint.Elect. o SINGLE FAMILY Temp.Power Pole&Appurtenances �- d HOME OWNER-BUILDER DECLARATION - - - --- - - -� - I hereby affirm that 1 am exempt from the Contractor's License Taw Sign with One Branch Circuit Z for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits Cade: l I,as owner of the property, will do the work and the structure Misc.Conduits&Conductors - - - - - - - __4 is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) , and Professions Code). - - - - - CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction Mending agency for the performance of the work for which this permit is issued (Sec. 3097, PERMIT.FEE_ _- _. .__ ..(Sub-Total) _ Civ.C.) ` Lender's Name v`��e N �// PLAN CHECKING FEE ✓ �1 � Gr4 ��r^'� - J7 r / PERMIT ISSUING FEE A• Lender's Address 'LLL—LIA I-G. 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 property for inspection purpo s. SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE OF APPLICxINT OFFAGENT DATE