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Home My Public Portal About10101 LANDSEER ST_Electrical__ 76A66C-CE#806 5.61 APPLICATION FOR ELECTRICAL ERMIT COUNTY OF LOS /ANGELES DEPARMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION 7 ADDRESS JOHN A.'LAMBIE, COUNTY ENGINEER WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. PERMIT FEES OWNER I T E M NUMBER EACH FEE MAIL OUTLE ! S $ ADDRE LIGHTS RECEPT. SW./ .10 D CITY TEL. LIGHTING FIXTURES .10 O ELEC.,RANGES CLO. DRYERS ELECTR IAN WATER HEATERS .5O ADDRESS ELEC.SP CE HTRS. DISHWASHERS / CITY TEL GARBAG DISPOSERS / AUT..- Ire, 2 STATE WASHERS STA.COOKING UNITS ,25 LICENSE NO. (� - MOTORS: OVER INC. H.P. DIST,Fj'=T NW GRO P Z E P D Y O— 1/2 .25 O 1/2- 2 .50 INSPECTION RECORD >- 2- 5 1.00 O 5— 15 1.50 u is— 50 2.50 ®L 50— 200 5.00 U W NO TRANS. d SIGNS: Vf NO.LAMPS z SERVICE 0-600V 1.00 SERVICE OVER 600V 5.00 misc. WIRING PERMIT 1.00 S' FIXTURE PERMIT 1.00 r SUPPLEMENTARY PERMIT 1 50 , TOTAL FEE f 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 �ii" Q 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTE ED AND/O., ? LICENSED AS REQUIRED BY LOS ANGELEYCINT D .TATE OF FIXTURESCALIFORNIA OR THA AM THE LE LE THE ABOVE 6 , DESCRIBED RESIDENT P RTY. POWER SIGNATURE A w UTILITY CO.NOTIFIED OF PERMITTEE FINAL ,l s �5 e- DATION A ITHUR C. VEIT MO GASH SUPERVISING ELECTRICAL ENGINEER CK Lf,r�a X 7 7 �-CcV i 3 2 D 12 .2 r 76A663-CE006.10,74 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES li DEPARTMENT OF COUNTY ENGINEER JOB BUILDING AND SAFETY DIVISION ADDRESS L SCZF,', ""' LOCALITY —7 ��C Cil 1py NEAREST } , I FOR APPLICANT TO FILL IN CROSS ST. Qom/ OUTLETS NO EACH I FEE OWNER OR TiL $ $ FIRM NAME RECEP . I MAI L G FI RST 20wF V ADDRESS �— LIGHT -( ^ 0 CITY TEL. N0. �V SWITCH Z OVER 20 `,jp PLAN CHECK ' LIGHTING FIRST 20 APPLICANT l TOTAL�_O 'u � . )( VER 20 ADDRESS FIXTURES 10 RESIDENTIAL APPLIANCES CITY TEL. N0. PERMIT RANGE ORYER_WTR, HTR. APPLICANT NC- STA. COOK DISP. F.A.U. ADDRESS �_ 0A/ SPACE HTR. AIR COND. CITY TEL. NO. ��.-�(� CLOTHES WASH. DISHWASH. LICENSE REG. NUMBER i CLASS. 1 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 d-0 LICENSED AS REQUIRED LOS GELES COUNTY AND STATE OF CALIFORNIA OR THAI A EG AL OWNER OF THE ABO E p 1 - 10 300 DESCRIBED RESIDENT P OPER Y. U PERMITEE C) 10 — 50 500 SIGNATURE U 50 — 100 1000 DISTRICT NO. OCE ED BY 1 Lu 00 — 500 1500 X08 SIGN, GAS SIGN AND ONE CIRCUIT 500 APPROVALS DI-TE INSPECTOR'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 TEMP. POWER POLE ' SERVI CENOTOVER 600 VOLTS OR 200 AMP 3.00 UNDERSLAS WORK SERVI CEOVER 600 VOLTS OR 200 AMP 10.00 ROUGH CONDUIT ' TEMP SERVICE,POLE, &APPURTENANCES 5.00 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 f U TOTAL FEE 91 PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATI N CK M 0 cAsn 3 7 9'APR 16 2 D. .. 8.0 0 Aja SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE WORKER S'COMPENSATION DECLARATION 6 0E--806806G (2-BO) APPLICATION FOR ELECTRICAL PERMIT -' P C that 'I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING'AND SAFETY insure, or a certificate'of Workers'Compensation Insurance,or I hereby affirm a certified copy thereof(Sec. 3800,Lab.C.) L� Als 0�� ,/ _ Ty e�ur� FOR APPLICANT TO FILL IN 3pg Policy No. / ompany R�E�I Yrs PACNO FEE ADDRESS j �- New Residential Bldgs.&Pool§ . Certified copy is hereby furnished. . 1 &2-Family,Sq. Ft. — $ LOCALITYMulti-family Sq; Ft. 1 NEAREST Certified copy'is filed with the county building inspection CROSSST department. Residential Swimming PoolsOWNERORFIRM NAME�Date Applicant Outlets Rec L Light Sw. /� MAIL First 20 ' ADDRESS 10 U1 CERTIFICATE OF EXEMPTION FROM WORKERS' Total No Additional CITY �� T. Tel No. LIP-7 Vo } COMPENSATION INSURANCE t • _. - PLAN CHECK t '• a (This section need not be completed if the work involved APPLICANT O by the permit is for.one hundred dollars-($100) or less.) Lighting Fixtures First ADDRESS cc � Additional o Total No. I certify that in the performance of the wFixed Appliances Not Over HP II— permit for which this CITY Tel No. O 1 permit is issued, I shall-not employ any person in any manner PERMIT -r-' V so 'as to become subject to the Workers' Compensation'Laws. Range_ Heater_D.W% = APPLI6AN4f - e rep, a Oven Dryer_W.M. ADDRESS Z Date Applicant - Top FAU _W.H. . i Hood _ Fan, . —Other CITY Tel No.' 7 j,q*,0 NOTICE TO APPLICANT. If, after making this Certificate of 'Disp. Room Air Cond— LICENSE.OR �y; Exemption, you should become subject to the Workers' REG. NUMBER+Ng fO 4 Class C 3C Sc y Compensation,provigions of the Labor Code, you must forth-' Power Apparatus& Large Appliances DISTRICT NO. PROCE BY with comply with such provisions or this permit shall be Size&Type HP, KW, KVA,or KVAR, �+D deemed revoked. Cr4Af'g.�hO � Up to.1 Incl. 3 4 1 - FINAL � , Over 1 to 10 Incl. DATE Z �' '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 9 commencin with Section 7000 of.Division 3 of the Busi- BY ( g ) Over 100 - ness and Professions.Code, and my license is in full force and effect. Services ' License'Number Lic.Class 3 SC 0-200 Amp. Under 600 V e� I 201-1000 Amp. Under 600 V /' 7 Contractor4l Gtn�►Ttkf� i,Date fl Over 1000 Anip.or Over 600 V HOME OWNER-BUILDER DECLARATION Temp. Power Pole&Appurtenance s 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 Ell, as owner of the property, will do the work and the Other.(See Complete Fee Schedule)— 2.2'8 1,7 A .structure is not intended or offered for sale (Section I 7044, Business and Professions Code). # o m o 0 0 2 CONSTRUCTION LENDING AGENCY ' I hereby'affirm 'that there is a construction lending agency 2 o,o 121 0 for the performance of the work for which' this permit is 1 PERMIT FEE (Sub-Total) issued'•(Sec. 3097;Civ C.). ` ( CJ 60 ;oro ko 12 0 c=i Lender's Name PLAN CHG ECKINFEE (One-Fourth Permit Fee) e" ' . 0 �0'�1 '-82 . Lender's Address 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 i ordinances and State laws regulating Electrical wiring, and , hereby authorize representatives of this County.to enter upon the abo zentioned propert for iris pection'purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE � yam, I , - ' • Signature of Permittee D e - WORKER'S COMPENSATION DECLARATION DPW(12-91) 76A663 APPLICATION FOR ELECTRICAL PERMIT 76A663 I hereby affirm that I have a certificate of consent to self Insure, c or a. ertiflcate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy,thereo Se . 3800 Lab.• ) Policy No. Company FOR APPLICANT TO FILL IN JOB, ❑ -If ADDRESS Certified copy is:hereby furnished New Residential Bldgs &Pools NO EACH FEE LOCALITY Certified copy-is filed with the•count building ins ection 1 &2-Family,Sq Ft — $ $ Y 9 — NEAREST dep t nt. Multi-family Sq Ft CROSS ST r Residential Swimming Pools - ASSESSOR Date Applicant MAP BOOK PAGEPARCEL ER IFICATE OF EXEMPTION FR WORKERS' OWNER OR COMPENSATION INSURANCE Outlets Rec _Light Sw. FIRM NAME First 20 MAIL S (This section need not be completed if the work Involved by the Total No. Additional ADDRESS pernriIs for one hundred dollars($100)or less.)' I certify that in the performance of the'work for which this permit CITY Tel No is issued,,I shall not employ•any person in ariy manner so as 10 PLAN CHECK become subject to the Workers'Compensation Laws. Lighting,Fixtures First 20 APPLICANT Total No. Additional ADDRESS DateApplicant "' RESIDENTIAL APPLIANCES,NOT OVER 3 HP NOTICE,TO APPLICANT: If, after making.this Certificate of CITYTel No Exemption,.you should become subject to the Workers,Com_pensation OTHER APPLIANCES NOT OVER 3 HP. rovIsioris of the LaborlCode, you must forthwith Com I with Such PERMIT p Y_ P Y Power Apparatus&Large Appliances APPLICANT provisions or this permit shall be deemed revoked LICENSED CONTRACTORS'DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS I hereby affirm that I am'licehsed under provisions of Chapter 9 Over 3 to 10 Incl CITY �� Tel No. ' r -(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is In full force an Over 10 to 50 Incl.e fect , LICENSE OR Class. aO Over 50 t0.100 Ind REG NUMBER Over 100 DISTRICT NO P ED BY � U License Number Lic.Class y� / o Services,Swbd,MCC&Panelboards f/ FINAL 0-399 Amp Under 600 V Contractor e - DATE _❑ U 400-1000 Amp Under 600 V I am exempt under Sec. VALIDATION W Over 1000 Amp or Over 600 V FINAL B.&P.C.for this reason- BRANCH CIRCUIT FEES BY Z Date. 15A,or 20A, 120V,Lighting or Recept • 1 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 HOME OWNER-BUILDER DECLARATION Sigh with One Branch Circuit El�•�.T°g 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 330 44.15 Code): aITEM t Ei Misc.Conduits&Conductors 1 1 t Ef i` I, as owner of the property,will do the work and the structure h �- Is not Intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) TI I�A 4-4 m 1- F and Professions Code). CHECK - 44.15 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the I CHANG '-if) performance of the work for which this permit is Issued (Sec. 3097, PERMIT FEE (Sub-Total) Civ C.) { !t3; PLAN CHECKING FEE '`90—I� O ]�: 1: r Lender's Name PERMIT ISSUING FEE Lender's Address I certify that I have read this application and under penalty of purjurystate TOTAL FEE that the above information is correct I agree to comply with all County - ordinances and St to laws regulating Electrical wiring,and hereby authorize represent I e this County to enter upon the above-me tioned property for insp i ses. SEE REVERSE FOR EXPLANATORY LANGUAGE A/0 A,4z��_ SIGNA F P '-6AIE