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HomeMy Public PortalAbout10125 LANDSEER ST_Electrical__ s I I•If 78A66C-CE }`808,5-61 APPLICATION FOR MECTRICCAL ;:EMT COUNTY OF LOS /ANGELES Y DEPARMENT OF COUNTY ENGINEER BUILDING"'' BUILDING AND SAFETY DIVISION 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 NUM ER EACH I • FEE MAIL OUTLE $ $ ADDRES LIGHTS RECEP SW. •1O CITY TEL. LIGHTING FIXTURES •10 ELEC. RANGES - - CLO:DRYERS ELEC-1 AN AV Yz' L+/ W'A T E R HEATERS .SO ADDRESS ELEC.SP CE HTRS. DISHWASHERS. CITY EL O. GARBAG�SPOSERS ALIT STATE WASHkRS STA.COOKING UNITS rJ •2$ LICENSE NO. !� MOTORS: OVER INC. H P. DIST T N G OUP ZONE, POC S D Ry O 1/2- .25 r 2so INSPECTION RECORD 2— 9 1.00 J � d / / l3 �.l !cd " ,Ilos��.,C�� 0 S 15 i.$O '.is- 50 2.50 O 0 200 5.00 W NO TRANS. 4. SIGNS: N NO.LAMPS Z. SERVICE;O-600V :" 1:00 7 I t SERVICE OVER 600V 5.00 MISC. - WIRING PERMIT 1.00 r� o FIXTURE PERMIT 100 - SUPPLEMENTARY PERMIT .50 ` TOTAL FEE $ 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE ANO�STATE THAT THE ABOVE•IS CORRECT AND AGREE TO COMPLY , CONDUIT - WITH ALL COUNTY' ORDINANCES AND STATE LAWS REGULATING ELECTRICAL'WIPING. e WIRING •- I HEREBY.-CERTIFY THAT I AM PROPERLY, REGISTERED AND�OR �1 q '•'LICENSED AS REQUIR BY,LOS /NGFUN D STATE OF - FIXTURES ,4c.. ) ni- ) CALIFORNIA OR THAT, AM THENF THE ABOVE , DESCRIBED RESIDENTI P RTY. POWER SIGNATURE UTILITY CO NOTIFIED / B OF PERMITTEE FINAL •�� r /" 0-0 LIDATION ARTHUR C. VEIT •i'• 'I CASH SUPERVISING ELECTRICAL ENGINEER 76AG63-CE806 3-69 e APPLI .W .- FOR ELECTR CAL PERMIT 1 COUNTY OF LOS ANGELES ,DEPARTMENT OF COUNTY ENGINEER NG BUILDING AND SAFETY DIVISION FADDRESS �A95— tios�JOHN A. LAMBIE, COUNTY ENGINEERCOLEMAN W. JENKINS, SUPERINTENDENT OF BUILDINGTYST , FOR APPLICANT TO FILL IN CROSS ST. NO. EACH FEE /J $ $ OWNER L9 e.fK.-rl RECEIP MAIL _ - LIGHT TOTAL FIRST 20 Al ,20 O v ADDRESS OJ IAVEL/C SWITCH! OVER 20 ,10 CITY � TEL.NO. PLAN CHECK LIGHTING TOTAL FIRST 20 ,20 �0 APPLICANT FIXTURES } -7 OVER 20 .10 ADDRESS RANGE_DRYER_WTR. HTR. CITY TEL.NO. STA. COOKDISP. F.A.U. •CONTRACTOR -Q ewAlc e or.0/-,� SPACE HTR_ AIR COND. lll� ADDRESS 1132-1 CLOTHES WASH._DISHWASH. CITY ��, ,� �1 TEL.NO. FAN_OTHER 1.00 © LICENSE NO. 13 qfr7-3,jCLASS. MOTORS,TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION IND. HEATERS, ETC. HP. KW. KVA. AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. 0 — 1 1.00 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR CL LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATEOF O 1 — 10 3.00 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO U RESIDE IN, THE A�DESCRI, ESIDENTIAL PROPERTY. 1O — 50 5.00SIGNATURE50 - 100 10100 OF PERMITTEE () W 100 — 500 15,00 DISTRIC NNo. �`/ GRO ZO PR CE55ED Y SIGN,GAS SIGN AND ONE CIRCUIT 3.00 oy TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES: SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 Qp SERVICE OVER 600 VOLTS OR 200 AMP 5.00 TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATUREIr TEMP. POWER POLE UNDERSLAB WORK ROUGH CONDUIT WIRING 7- 9-7c, PERMIT FEE (SUB TOTAL) FIXTURES POWER AUTHORIZED PLAN CHECK FEE (50% PERMIT FEE) PERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED 7-/P/'70 SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL .'8. TOTAL FEE JOS PH C. ROOHAN SUPERVISING ELECTRICAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. SH _ SEF. BACK OF APPI If,ArInN cnR f:DMPI.F_TF FEE SCHEDULE i WORKERS' COMPENSATION DECLARATION 76A663 -10/8) APPLICATION FOR ELECTRICAL PERMIT I'iiCaeby'SCE-806G that I have a certificate of consent to self CE-8066 7� ynsure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES' BUILDING AND SAFETY 'ul ^ora certified copy thereof (Sec 3800, Lab C.) Policy N� raID Compa4p'rs— LIC s FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished New Residential Bldgs & Pools EACH NO FEE ADDRESS 1 & 2-Family, S Ft $ — $ LOCALITY Certified copy is filed with the county building inspec- Y. q tion department Multi-family Sq. Ft — NEAREST CROSS ST. Dat�� �► —Apprn• _�IFh�,� r. Residential Swimming Pools OWNER OR ~' "FIRM NAM CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets- Rec�Light Sw._ _ T MAIL COMPENSATION INSURANCE ADDRESS (This section need not be completed if the work involved by First 20 CI Tel. N Total No. the permit is for one hundred dollars($100)or less.) Additional 1 certifythat in the performance of the work for which this PLAN CHECK P - APPLICANT permit 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 ADDRESS -Total No Additional CITY Tel. No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT- If, after making this Certificate of APPLICANT ' Exemption, you should become subject to the'Workers' Range_ Heater—D.W. — Compensation provisions of the Labor Code, you must forth- Oven _ Dryer —W.M.— ADDRESSZZe, with comply with such provisions or this'permit shall be Top FAU —W.H. CITel. N deemed revoked Hood Fan _Other_ L-150i r> 46- LICENSED CONTRACTORS DECLARATION LICENSE R I hereby affirm that I am licensed under provisions of Chapter 9' Disp. — Room Air Cond. REG. NUMBER 4 Z, Class. (commencing with Section 7000) of Division 3 of the Business DISTRICT NO. PROCES Y Q0„' Power Apparatus& Large Appliances �) and Professions Code, and my license'is in full force and effect. �� tC/ Q � `' Size &Type HP, KW, KVA, or KVAR 0 License Number_�2 Z,' Lic Class 7-In Up to 1 Incl. FINAL cc-_--• , 5��2 -+�� �— Over 1 to 10 Incl DATE VALI ATION V Contrac�r� 9WICA• Date Over 10 to 50 Incl. • C FINAL I am exempt'under Sec. Over 50 to 100 Inc. BY LL N` B 8P C. for this reason Over 100, =•Z Date: Services, Swbd., MCC &'Panelboards ► 0 -200 Amp. Under 600 V Signature 201 - 1000 Amp Under 600 V Over 1000 Amp or Over 600 V Exemption for Reg Mamt. Eject \ f SINGLE FAMILY Temp Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit #�' ;� ii I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Crcuits • Law for the following reason (Section 7031.5, Business and I. ;� 2'S Professions Code)- o o. Misc Conduits&Conductors ' o:o o' 1, as owner-of the property, will do the work and the 2 5 5 structure is not intended or offered for sale (Section Other (See.Complete Fee Schedule)_ 'S 1 . 7044, Business and Professions Code). O =$6 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued PERMIT FEE- (Sub-Total) 7 7 (Sec 3097, Civ C.) PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lend'er's Address I certify that I have read this application and state that the TOTAL FEE b above information is correct I agree to comply with all County ordinances and State jaws regulating Electrical wiring, and , hereby authorize representatives of this County to enter upon the above-mentioned pr erty for i spection purposes. • SEE REVERSE FOR EXPLANATORY LANGUAGE ' A �• Signature of PermitTee Date