HomeMy Public PortalAbout9953 LAS TUNAS DR_Electrical__ 76A663 CE- ""'e' A_PPLICATI O LECTRIC
Y COUNTY OF LOS ANGELES W.T w BUILDING AND SAFETY
FOR APPLICANT TO FILL IN JOB'
New Resideritidl'BIBgs &Pools' "' EACH •-; NO• -• FEE --• ADDRESS,
1 &2-Family,Sq Ft $ 025 — $ LOCALITY
Multi family Sq Ft '02- — _. NEAREST
25 00 CROSS ST'
Residential Swimming Pools _ OWNER OR �v FIRM NAME
NAME C.
'Outlets-Rec L19ht,;L MAIL
First 20 S0 ADDRESS'
Tot.I_No Additional• 30 CITY
' PLAN CHECK
' y APPLICANT
Lighting Fixi"ures-- First 20 50 ADDRESS y M
Total No _ Additional 30
CITY Tel No
Fixed Appliances Not Over-L.Hl?. _ -PERMIT
C�
Range_ APPLICANT �.'Heater_D W " •
-OGen_Dryer'_W M— _ " ADDRESS- -� —
.Top _FAU — W H _F CITY L _ -Tel'Nd
` Hood_�Fan _Other=
25
L`ICEN_ SE O Closs
Disp RoomAir_Con_d _— r ,r REG.NUMBER
T IHEREBY ACKNOWLEDGE THAT)HAVE READ THIS A PLICA
Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS-CORRECT.AND'AGREE TO
Size&Type HR}V COMPLY WITH-ALL-COUNTY'-ORDINANCES'AND STATE-LAWS
, KW, KVA,or KVAR
2 50 REGULATING ELECTRICAL WIRING: , O
Up to 1 Incl_ IHEREBY•CERTIFY`THAT{tA•M PROPERLY-REGISTERED-AN DIOR (,y
Over 1 to 10 Incl 500 LICENSED AS REQUIRED BY LOS-ANGELES COUNTY ANVSTATE OF _
Over,10 to 50-Incl 1250 CALIFORNIA OR THAT I AM THE•LEGAL;OWNER OF THE:ABOVE a_® -
25'00 DESCRIBED RESIDENTIAL PROPERTY
Over`50 to 1'00 Inc' - t -
4000 _ PERMITEE _
-Over,10 SIGNATURE
Services,- - •` _ -
' • 'DISTRICT NO ""' "pR �Bl'�' "`,•
0' 200 Amp Under 600 V '12 50
'1201-1000 Amp Under 600-V'- 25 00-.-
.Over'l000 Amp or Over 600 V 50 00
Temp Power+Pole&Appurtenarices`
Sign with One Branch Circuit 1000
Additional Sign Branch Circuits " ' 2 00 4INSPECTION ,>' ',
INFORMATION
Misc Conduits&Conducfors 10 00 y+ �.0 9 Q, A?,•
ON REVERSE' x.
Other:(See Complete Fee Schedule)' u - '
p _ . SIDE _ _ Z ° "A0,10 'o o;b
2,.0'0: ''3}" .`.
PERMIT FEE '' "(Sub Total) r- _� ,�• y t "o o » o"$r
PLAN CHECKING FEE (One Fourth'Permit Fee) _ 'O Q
PERMIT ISSUING FEE $7 00 �'.
TOTAL,FEE ZVI
INSPECTION FINALED /� o�c c
date, �' �E � By /� iL' OS
76A663 CE 806(11 /78) APPL CATI FOR EL RI AL •PLel
E IT
r
CO TY S AN isBSPJNG ANDiAFETY
FOR APPLICANT TO FILL IN JOB ' r t~• '
_
ADDRESS.
NWw Residential Bldgs&Pools EACH NO' FEE
1 &2 Family;Sq Ft' $ 025. — $ LOCALITY
Multi-family Sq'Ft NEA R EST
25 00 : CROSS ST &I
•
Residential SwLmming.Pools OWNER OR, - -
FIRM NAME'
Outlets Rec Light Sw: MAIL
First 20 50ADDRESS`
Total No Add tional `30 CITY. W-0-
PLAN CHECK
APPLICANT
Lighting Fixtures First 20 50 ADDRESS ,
Total Nom 'Addriiorial 30
CITY Tel No
Fixed-Appliances Not OSer..l HP ' ' PERMIT
Range_Heater_ D W APPLICA S4
Oven"_Dry"er_.W M— ADDRES
CITY
Hood_Fari Other_
LICENSE OR
Disp__Room Air Cond2 50 REG NUMBER
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA-, b
Power Apparatus&Lorge•Appliances TION AND STATE THAT THE ABOVE IS CORRECT'AND AGREE TO
Size&Type COMPLY WITH ALL COUNTY'ORDINANCES AND`STATE 'L'AWS' "� r
ype HP, KW, KVA,or KVAR 2 50 REGULATING ELECTRICAL WIRING ' Q
Up,to 1 Incl I HEREBY CERTIFY'THA_T'I"AM PROPERLY REGISTERED"AND/OR V
Over 1 to'l0 Incl 5 00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
Over 1 0 to SO,Incl 1 2 50 CALIFORNIA OR-TH THE LEGAL,OANER F E' B VE' ;, o .1
Over 50 to 100"Inc
25 00 DESCRIBED RESIDE I P,ERTY ;"F�'
LU
'Over^100' 4000 PERMIT EE_ _ _L
SIGNATURE
-
Services- " " DISTRICT NO r PROSE Y -
0 200 Amp Under 600V 12 50"
'201 1'000 Amp Under 600 V •25 00 C''•- -+, -
Over 1000 Amp or Over 600 V 5000 Z f
p ,
Temp Power Pole&Appurterionces 70 00 ^r Q
Sign with One'Bronch Circuit 10 00'' I
.9974 .7A-
Additional Sign Branch Circuits 1 2 00 INSPECTION. . > # o. o 0 0' o
10 00 wt INFORMATION, v
Misc Conduits&Conductors X
Other(See Complete Fee Schedule)' ON REVERSE'•' u ' 2 0 0'0 7 -
SIDE _ Z 7 S
__. 04;07-8G
PERMIT FEE' (Sub-Total)
PLAN CHECKING FEE r (One�Fourth'Permit Feel O
0
PERMIT ISSUING FEE _$7.00 - G _
TOTAL FEE >
INSPECTION FINALED.`.-
W
date By
76A663`E-806(6/79). APPLICATION FOR ELECTRICAL PERMIT ,
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN` JOB _
New Residential Bldgs &Pools EACH NO FEE ADDRESS
1 &2-Family,Sq Ft $ 025 — $ LOCALITY
Multi-family Sq Ft 02 NEAREST
ST
Resident ial,Swimmmg Pools 25 00 CROSS OWNER OR _
FIRM NAME
Outlets Rec Light Sw _ MAIL
First 20 50 ADDRESS S r
Total No Additional_ 30 CITY Tel No
PLAN CHECK
APPLICANT
Lighting Fixtures First 20 50 ADDRESS
Additional 30 _
Total No CITY - Tel No
Fixed Appliances Not Over I,HP _ PERMIT ��
Range—Heater_D W APPLICANT yADDRESS
Oven—Dryer_W M_ /
Top _FAU -/— W H _ CITY Tel N
Hood_Fan _Other_ LICENSE OR fJ
Disp —Room Air Cond 2 50 REG NUMBER
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA
Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE'TO
Size&Type HP, KW, KVA,or KVARCOMPLY WITH ALL COUNTY ORDINANCES AND.STATE LAWS
pro REGULATING ELECTRICAL WIRING
Up to 1 Incl 2 50 ♦ V_ I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
Over 1 to 10 Incl 500 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
Over 10 to 50 Incl
12 50 CALIFORNIA
BED R T RO THE LEGAL OWNE F THE VEDESQV
Over 50 to 100 Inc 2500
Over 100 4000 PERMITEE
SIGNATU i
Services - DISTRICT NO - P ESSE Y
0-200 Amp Under 600 V 1 2 50 0
201-1000 Amp Under 600 V 25 00 _
Over 1000 Amp or Over 600 V 50 00 Z
Temp Power Pole&Appurtenances 10 00 Q
Sign with One Branch Circuit 10 00
Additional Sign'Branch Circuits 2 00 INSPECTION >
INFORMATION '
Misc Conduits&Conductors 1000 d
ON REVERSE
Other)See Complete Fee Schedule) SIDE u
Z
Q r
J -
d i.
PERMIT FEE (Sub-Total
r
Z
PLAN CHECKING FEE (One-Fourth Permit Feel O
PERMIT ISSUING FEE $7 00 0
P3441A
TOTAL FEE ,� S >
# 000002
INSPECTION FINALEDm G� S�
I '� ' W /
date By �
_ ��- 7
77'cEsoe
B ./75 APPLICATION FOR ELECTRICAL PERMIT �.
-
12
O
BUILDINGD SAFETY DI ION
FOR APPLICANT TO FILL IN JOB
ADDRESS
New Residential Bldgs.& Pools EACH NO FEE � 1
1 &2 Finaily Sq Ft $ — $ LOCALITY G
Multi-family Sq Ft — NEAREST
Residential Swimming Pools CROSSST
OR
FIRM NAME
Outlets Light, Switch & Receptacle MAI L
First 20
ADDRESS
"
Additional CITY Tel No
PLAN CHECK
Lighting Fixtures APPLICANT
First 20 ADDRESS
Additional
CITY Tel No -
PERMIT
Fixed Appliances Not Over 1 HP , APPLICANT
Range Heater_ D W ADDRE C.
Oven Dryer W M.
Top FAU W H. CITY ! Tel No
Hood Fan REG LICI�NSE OR
NUMBER Class O
Disp. AC C>
' ' /`�/�y/1/I 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
�( AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY O
Power Apparatus Large Applian QS WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING f-
SIZe& ype HP, KW, KVA,or KVAR ELECTRICAL WIRING W
el-
Up to
.Upto 1 Incl O I HEREBY CERTIFY THA I AM PROPERLY REGISTERED AND/OR Z
Over 1 to 10 Incl LICENSED AS REQUIRE Y LOS ANGELES COU NTy AND STATE OF
CALIFORNIA OR TNA THE LEGAL OW E /OF HE'ABOVE
Over 10 to 50 Incl. DESCRIBED RESIDE RO PERTY� r/
Over 50 to 100 Incl. PERMITEE
�� VeO �j SIGNATURE
Cv, - DISTRICT NO PROCE ED B
Services
0-200 Amp Under 600 V f C/
201 - 1000 Amp. Under 600 V APPROVALS DATE IN ECTOR'S
Over 1000 Amp or Over 600 V
GNATURE
TEMP POWER POLE
Temp Power Pole&Appurtenances UNDERSLAB WORK
Sign with One Branch Circuit ROUGH CONDUIT
Additional Sign Branch Circuits
(Other) WIRING
FIXTURES
POWER AUTHORIZED
PERMIT FEE (Sub-Total) UTILITY CO NOTIFIED
PLAN CHECKING FEE (One-Fourth Permit Fee) FINAL, 77 �/ (
PERMIT ISSUING FEE
TOTAL FEE NOTES
PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION K 'M O CASH
'9 0 1 r-MAR 3 2 9 1 2.0 0 e
76A663-CE806 ++-71
APPLICATION R ELECTRICAL PERMIT LI
COUNTY OF LOS ANGELES
'DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS 53 G/�S 7'!//Y s
LOCALITY
NEAREST 0
FOR APPLICANT TO FILL IN CROSS ST.
OUTLETS NO EACH FEE -Ar
OWNERz/,[� �G G�eC
MAIL
RECEPT._ ADDRESS J� V` V• �S
LIGHT I TOTAL FIRST 20 25
TEL NO
CITY �_ .
SWITCH_ OVER 20 10 _
PLAN CHECK
LIGHTING TOTAL FIRST 20 25 APPLICANT
OVER 20 ADDRESS
FIXTURES +0
RESIDENTIAL APPLIANCES CITY T TEL. NO.
RANGE DRYER_WTR HTR. APPMICANTI�cT�+' uJ„ 1Q'
STA COOK DISP F A.U. ADDRESS 4-n 'g.
SPACE HTR, AIR COND. CITY 2C TEL. NO.41V lG
CLOTHES WASH. DISHWASH. LICENSE NO. 7. CLASS.CM—/
FAN OTHER 100 1 HEREBY ACKNOWLEDGE THAT 1 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 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
1 - 10 300 RESIDE IN, THE A OV DESCR BED BESIDE NTIAL PROPERTY L)
10 - 50 500 SIGNATURE /�
OF PERMITTEE
50 — 100 1000
DISTRICT NO. ICLASS ZONE =CESBY Lu
100 — 500 +soo p h
SIGN, GASSIGN AND ONE CIRCUIT 500 NOTES: ?
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 100
SERVICENOTOVER 600 VOLTS OR 200 AMP 300
APPROVALS DATE INSPECTOR'S SIGNATURE
SERVICEOVER 600 VOLTS OR 200AMP +000
TEMP.POWER POLE
TEMP SERVICE,POLE, &APPURTENANCES 5
UNDERSLAB WORK
TEMP LIGHT OR RECEPT. SYSTEM V17300 (�
ROUGH CONDIUT
WIRING
FIXTURES ,
POWER AUTHORIZED
PERMIT FEE (SUB TOTAL)
UTILITY CO. NOTIFIED
PLAN CHECK FEE
FINAL �'�/i��� all.✓Q'/%j$,CS�
PERMIT ISSUING FEE 300 O4?
TOTAL FEE
PLAN CHECK VALIDATION CK M G CASH PERMIT VALIDA ION CK M Q CASH
9 4,3-N JUN 2 3• 2 ® 6..0 0 ♦tFv
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
76A663-CEB06 10,74 APPLICATION FO ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER JOB
BUILDING AND SAFETY DIVISION ADDRESS —
LOCALITY N
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
OUTLETS NO EACH FEE OWNER OR
FIRM NAME
RECEPT._ $ $ oe
MAIL
LIGHT TOTAL
FIRST 20 25 ADDRESS
CITY TEL. NO.
SWITCH_ OVER 20 10 PLAN CHECK
LIGHTING TOTAL FIRST 20 25 APPLICANT
OVER 20 ADDRESS
FIXTURES 10
RESIDENTIAL APPLIANCES CITY TEL. No.
PERMIT
RANGE DRYER_WTR HTR. APPLICANTjtrA
STA. COOK DISP F.A.U. ADORES
SPACE HTR. AIR COND. CITY TEL. NO
CLOTHES WASH. DISHWASH, r LICENSE OR '�A� CLASS.
REG. NUMBER
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 CE TIFY THAT I AM PROPERLY REGISTERED AND/OR
0 — 1 100 LICENSED AS RE IRE_D BY LOS ANGELES COUNTY AND STATE OF },
CALIFORNIA ORT l 1 AM THE LEGAL OWNER OF THE ABOVE �•^
1 — 10 300 DESCRIPED RESID TIAL PROPERT
V
PERMITEE
10 — 50 500SIGNATURE O
F—
G.�
50 — 100 1000 LIj
DISTRICT N0. PROCES ED BY N
1 00 — 500 16 00
_/ ` D v z
SIGN, GAS [SIGN ONE CIRCUIT 500 APPROVALS DATE INSPEC R'S SIGNATURE
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 100 TEMP POWER POLE
SERVI CENOT OVER 600 VOLTS OR 200 AMP 300 UNDERSLAB WORK
SERVI CEOVER 600 VOLTS OR 200 AMP 1000 ROUGH CONDUIT
TEMPSERVICE,POLE, &APPURTENANCES 500 WIRING
TEMP LIGHT OR RECEPT SYSTEM 300 a FIXTURES '
1
POWER AUTHORIZED
UTILITY CO. NOTIFIED
FINAL
PERMIT FEE (SUB TOTAL) NOTES
PLAN CHECK FEEd--v
PERMIT ISSUING FEE 300 _
TOTAL FEE
PLAN CHECK VALIDATION CK M o CASH PERMIT VALIDATION cK M 0 CASH
5 7 ,9,N'.rt> 9.0 0 A
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE jr�
76A663C_ C1390EB 1_ /75 APPLICATION FOR ELECTRICAL PERMIT
BUILDING AND SAFETY DIVISION `
FOR APPLICANT TO FILL IN JOB P➢. /\.
EACH NO FEE ADDRESS /VU
New Resfidential Bldgs.'& Pools ,
1 &,2 Finaily,Sq Ft $ — $ LOCALITY
Multifamily Sq Ft — NEAREST t•.
CROSS ST ,
Residentlal Swimming Pools OWNER OR
FIRM NAME
Outlets Light, Switch & Receptacle MAI L
First 20 ADDRESS
A tional 9 CITY �f Tel No -7
PLAN CHECK
r/ APPLICANTi ht ng fixtures
First 20 <I� 1 ADDRESS s
Additional CITY Tel No
n
PERMIT
Fixed Appliances.Not Over 1 HP APPLICANT
Range Heater_ D.W Z
ADDRESS J
Oven Dryer W M
,Top FAU W H CITY
Hood Fan'' LICENSE OR
REG NUMBERClass exp
Disp. AC c'i
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE'TO COMPLY
Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING O
Size&Type HP, KW, KVA,or KVAR ELECTRICAL WIRING W
o_
Up to 1 InCI'• I HEREBY CERTIFY TH 'I AM PROPERLY REGHSTE D A D/OR
Over 1 to 10 Incl . LICENSED AS REOUI LOS ANGELES OU TE OF
CALIFORNIA OR T AT M THE LEGA O ABOVE
Over 10 to 50 Incl tUNDER
RES ID N PROPERTY
Over 50 to 1010 Incl. E
Over 100 RE
{
'NO P O E D BY
Services0-200 Amp 'Under 600-V201 , 1000 Amp Under 600 V ROVALS INSPECTOR'SOver 1000Amp or Over 600 V
SIGNATURE
ER POLE
Temp•Power Pole&Appurtenances AB WORK
Sign with One Branch Circuit
AdditionalSign Branch Circuits
NDUIT
(Other)' WIRING
FIXTURES
POWER AUTHORIZED
PERMIT FEE (Sub-Total) UTILI TYCO NOTIFIED c �)
PLAN CHECKING FEE (One-Fourth Permit Feel FINAL -Z�S-��
PERMIT ISSUING FEE
NOTES-
TOTAL,FEE
9. od. I
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VL DATION CK M 0 CASH
76A663C- CE806812/75 APPLICATION FOR ELECTRICAL PERMIT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN JOB
Fedmetial Bldgs & Pools
EACH NO FEE ADDRESS IV itsqr -Tu
ly Sq Ft $ — $ LOCALITYy Sq Ft CROSS ST /Swimming Pools OWNERORFIRM NAMEt,Switch & Receptacle MAILL�ADDRESS
Additional CITY :F— C.1T el NO 1
PLAN CHECK
Lighting Fixtures APPLICANT
First 20 ADDRESS
Additional
CITY Tel No
PERMIT
Fixed Appliances Not Over 1 HP APPLICANT p
Range Heater D W ADDRESS
Oven Dryer W M
Top FAU W H. CITY f. Tel No%y r
Hood Fan LICENSE OR ^ ,�/ O
REG NUMBER Class < v
Disp A.C.
• I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION Q
' AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY V
Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING LU
Size&Type HP, KW, KVA,Or KVAR ELECTRICAL WIRING O.
cr7
Up to 1 Incl Z
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
Over 1 to 10 Incl LICENSED AS REQUIRE B LOS ANGELES COUN Y AND STATE OF
CALIFORNIA OR THA 1 THE LEGAL OWN F T ABOVE
Over 10 to 50 InCI. DESCRIBED RESIDE PROPER
Over 50 to 100 Incl. PERMITEE
Over 100 SIGNATURE
Services DISTRICT`O P C BY
0-200 Amp Under 600 V �
201 - 1000 Amp Under 600 V APPROVALS DATE INSPECTOR'S
Over 1000 Amp.or Over 600 V
SIGNATURE
TEMP POWER POLE
Temp. Power Pole&Appurtenances UNDERSLAB WORK
Sign with One Branch Circuit
[Additional Sign Branch Circuits ROUGH CONDUIT
tWIRING
FIXTURES
POWER AUTHORIZED
ERMIT FEE (Sub-Total) UTILITY CO NOTIFIED
PLAN CHECKING FEE (One-Fourth Permit Fee) FINAL y��--
PERMIT ISSUING FEE
TOTALFEE 16 NOTES
PLAN CHECK VALIDATION CK MID CASH PERMIT VALIDATION 0
1 7 6 tiJUN 26 2 _U
r
VA
76A663-CE806 3-69
APPLICATION FOR ELECTRICA PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN (CROSS ST.
NO. EACH FEE
$ $ OWNER
RECEIPT. MAIL
ADDRESS
LIGHT TOTAL FIRST 20 .20
SWITCH OVER 20 10 iCITy TEL.NO.
PLAN CHECK
LIGHTING TOTAL FIRST 20 .20 APPLICANT
ADDRESS
FIXTURES OVER 20 10
RANGE_DRYER_WTR. HTR.
CITY TEL.N0.
STA COOKDISP. _F.A.U. CONTRACTOR
SPACE HTR_ AIR COND. ADDRESS o
CLOTHES WASH._DISHWASH. CITYZ:ez TEL.N0. aLUJ
FAN OTHER 1 00 LICENSE NO. o1/a / CLASS.
MOTORS,TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
IND. HEATERS, ETC. HP. KW. KVA. AND STATE THAT THE ABOVE IS 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/ORCL
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATEOF
1 - 10 3.00 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO O 0
RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERT .
10 - 50 5 00
SIGNATURE
50 - 100 10.00 OF PERMITTEE I
W
CL
100 - 500 15.00 DIST GROUP ZO PR
(v) N
/ Z
SIGN,GAS SIGN AND ONE CIRCUIT 3.00
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES.
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00
SERVICE OVER 600 VOLTS OR 200 AMP 5 00
TEMP SERVICE, POLE, &APPURTENANCES 3 00 APPROVALS DATE INSPECTOR'S SIGNATURE
* TEMP. POWER POLE
UNDERSLAB WORK
' ROUGH CONDUIT
WIRING 1.
PERMIT FEE (SUB TOTAL) FIXTURES
POWER AUTHORIZED
PLAN CHECK FEE (50% PERMIT FEE)
PERMIT ISSUING FEE 2.00
UTILITY CO.NOTIFIED r 0 I
SUPPLEMENTARY PERMIT ISSUING FEE 1 00 FINAL �
TOTAL FEE JOSEPH C. ROOHAN
SUPERVISING ELECTR AL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M O. CASH
I-Afl 5 b 5 3.r JIL 5 2 D 3.0 0-
SFE BACK OF APPLICATION FOA COMPI.F_TE FEE SCHEDULE
6
76A663'-CE806 3- 9
.: Tim PF— c-/Tr
- APPLICATION FOR - ELtCTRItAl PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING /gyp
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NO. EACH FEE
$ $ OWNER '
RECEIPT. MAIL
LIGHT TOTAL FIRST 20 .20 O ADDRESS
_ CITY TEL NO.
SWITCH-12- OVER 20 .10 PLAN CHECK
LIGHTING TOTAL FIRST 20 .20 v APPLICANT
FIXTURES le/
} C/ OVER 20 ,10 ADDRESS
RANGE_DRYER_WTR. HTR. CITY TEL.NO.
STA COOK_DISP F.A.0 CONTRACTOR
SPACE HTR AIR COND. ADDRESS / QG
CLOTHE r7WLH61 Hco , DISFyWASH. CITY TEL.N0.
FAN f 1.00 iy,� LICENSE NO. CLASS
MOTORS,TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
IND. HEATERS, ETC. HP. KW. KVA. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING
O - 1 1 DD 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSEDAS REQUIRED BV LOS ANGELES COUNTY AND STATEOF
1 - 10 3 00 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO d
RESIDE IN, THE ABOVE DESCRIBED ESIDE�TI)PIRO PERTY. O
10 - 50 5 00 VI
SIGNATURE
50 = 100 10.00 OF PERMITTEE O,;
100 - 500 15.00 DISTRICT NO
GROUP IZONE I PROCESSED BY W
CL
SIGN,GAS SIGN AND ONE CIRCUIT 3 00 `-' u —;L,n �� v7
MARTUBEQUEE OR ADDITIONAL CIRCUITS 1.00 NOTES G� /7
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 y �a �"��w
SERVICE OVER 600 VOLTS OR 200 AMP 5 00
TEMP SERVICE, POLE, &APPURTENANCES 3 00 APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
WIRING
PERMIT FEE (SUB TOTAL) FIXTURES
PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED
PERMIT ISSUING FEE 2.00 UTILITY CO NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1 00 / �d FINAL
TOTAL FEE �Gl JOSEPH C. ROOHAN
SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK:' M.O. CASH PERMIT VALIDATION 0 M.O CASH
n 6 3 -- DEC2 9 2 n 4.8 U
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE y
7 /J
76A 663-CEBF6 3-89
APPLICATION FOR ELECTRICOL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY _
NEARE-i
T -
FOR APPLICANT TO FILL IN CROSS ST.
NO. EACH FEE
$ $ OWNER
RECEIPT. MAIL
/
LIGHT 42. TOTAL FIRST 20 20 ADDRESS Iz
CITY TEL.N0.
SWITCH OVER 20 10 PLAN CH K
q �I
LIGHTING 1 TOTAL FIRST 20 201 APPLICANT
11
FIXTURES 1� OVER 20 .10 ADDRESS
RANGE_DRYER_WTR. HTR. CITY TEL NO
STA. COOK_DISP. j—F.A.U. CONTRACTOR
SPACE HTR AIR COND.
ADDRESS 0Q
CLOTHES WASH _DISHWASH.� CITY
FAN_OTHER 1.00 �, LICENSE NO. CLASS. Q
MOTORS,TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
IND. HEATERS, ETC. HP. KW. KVA. A'ND STATE THAT THE ABOVE IS 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
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
I — 10 3 00 CALIFORNIA OR THAT I AM E LEGAL OWNER OF, AND INTEND TO
RESIDE IN, THE ABOVE SCR BED RESIDENTIAL PROPERTY. O
10 - 50 5 00 (J
SIGNATURE
50 - 100 10.00 OF PERMITTE O
100 — 500 15.00 DISTRICT NO. GROUP ZO PR C SE
f� W
SIGN,GAS SIGN AND ONE CIRCUIT 3 00 ` (J
TUBE, OR Z
MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES G
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00
SERVICE OVER 600 VOLTS OR 200 AMP 5 00
TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
WIRING
PERMIT FEE (SUB TOTAL) FIXTURES
Q
POWER AUTHORIZED
PLAN CHECK FEE (50% PERMIT FEE)
PERMIT ISSUING FEE 2 00 U' UTILITY CO.NOTIFIED oz
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL d
JOSEPH C. ROOHAN
TOTAL FEE SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION CK. M.O. CASH.
I -
('�2 9 1 GOT 23 2 0 1 1.1,0
SEE BACK OF APPLICATION FOR rOMPLFTE FFE GCHFDULF_ ,
M176A663-CE8064 ,;70
APPLICATION FOR -ELECTRICAL._PERMIT. .,
r " COUNTY OF LOS ANGELES . • , I
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING-AND SAFETY DIVISION ADDRESS, ,.
COLEMAN W. JENKINS SUPERINTENDENT OF BUILDING• LOCALIT
NEAREST, • �
FOR APPLICANT TO FILL IN"-- CROSS.ST' '
OUTLETS NO,. EACH FEE '
OWNER `
RECEPT_ $ $ _MAIL'" S�
FIRST 20 ADDRESS J
LIGHT TOTAL 25 -
SWITCH OVER'20- 10 CI TY - TEL N0.
PLAN CHECK
LIGHTING FIRST 20' 25 APPLICANT - -
_ TOTAL
OVER 20 -ADDRESS••
FIXTURES 10 ..
APPLIANCES CITY', . TEL
• 'k PERMIT• / �-
RANGE -DRYER WTR HTR. APPLICANT - -
STA COOK - DISP 'F.A.0 ADDRESS,
SPACE HTR AIR COND.
^
CLOTHES WASH. DISHWASH CITY TEL NO
LICENSE NO CLASS. — Q
FAN OTHER - 100 1p,HEREBY ACKNOWLEDGE'THAT I HAVE READ THIS APPLICATION
AND STATE-THAT.TH_E ABOVE IS CORRECT AND AGREE'-TO COMPLY
MOTORS, TRANSFORMERS RATING - - WITH ALL COUNTY ORDINANCES AND STATE LAWS- REGULATING
INDHEATERS, ETC HP KW KVA i ELECTRICAL WIRING ,
SIZE'& TYPE OVER TO'
1-HEREBY' CERTIFY 'THAT_ I AM'PROPERLY REGISTERED--AND/OR
0 - 1 100 __ LICENSED' AS REOUIRED'BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM E LEGAL OWNER'OF,' D-INTEND TO }
` 1 - 1O '300 RESIDE IN, THE ABOVE ESCRIBED ,REST ENT PROPERTY- a
10 —.50 500 SIGNATURE VO'
• OF PERMITTEE'
' GC
50 — 100 1000 •_ O',
D I'S
STT^RI CT NO• CLASS- ,ZONE' } SED BY
100 —, 500 i 5 0o J, �_ ���_o w'
CL
SIGN, GAS. SIGN AND ONE CIRCUIT '500 .NOTES: :IV v ' Z
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 100 "
SERVICE NOT OVER600VOLTS OR200AMP 300 —
SERVICEOVER'600VOLTS OR200AMP 1000 APPR ALS DATE IN ECTOR'SSI TORE,
TEMP POWER POLE
TEMPSERVICE, POLE; &APPURTENANCES, x500
_ UNDERSL+AB WORK -
TEMP LIGHT OR RECEPT••SYSTEM - - '300 • •< - I ,.
ROUGH CONDIUT -
• WIRING
a FIXTURE'S
POWER AUTHORIZED
PERMIT FEE tet' (SUB TOTAL) - -" .. -
UTILITY CO NOTIFIED • '
PLAN CHECK FEE -
FINAL --
PERMIT ISSUING FEE - . 300 - '
JOSEPH C.-'ROOHAN'
TOTAL FEE SUPERVISING ELECTRICAL ENGINEER,
PLAN''CHECK VALIDATION - CK ' M o CASH PERMIT VALIDATION OCK O CASH'
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE,
+76A663-CE806 11/70 APPLICATION FOR ELECTRICAL PERM T
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING r
BUILDING AND SAFETY DIVISION ADDRESS
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST,
OUTLETS NO EACH 11 FEE
OWNER `
RECEPT._ $ $ 'MAIL '
FIRST 20ADDRESS
LIGHT TOTAL 25� '
OVER 20 ,CITY TEL NO
SWITCH_ IO PLAN CHECK
LIGHTING FIRST 20 25 APPLICANT
FIXTURES
TOTAL
10
OVER 20 ADDRESS
—r— ,
APPLIANCES 'CITY TEL. NO.
PERMIT L
RANGE DRYER WTR. HTR APPLICANT
STA COOK DISP F.A U. ADDRESS
SPACE HTR. AIR COND CITY TEL NO3
CLOTHES WASH. DISHWASH. LICENSE NO CLASS
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 W,IR ING _
SIZE & TYPE OVER TO '
I HEREBY CERTIFY THAT I AM, PR OPERLY REGISTERED AND/OR
O - 1 100 LICENSED AS RED IRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM T E LEGAL OWNER OF, AN INTEND TO >_1 - lO 300 RESIDE IN, THE A00 E ESCRIDED RESIDENTIA PROPERTY a
O
10 - 50 500 SIGNATURE V
OF PERMITTEE
50 - 100 1000 DISTRICTNO CLASS IZ02_ PROLES E Y O100 - 500 1500UD_
SIGN, GAS SIGN AND ONE CIRCUIT 500 NOTES: N
`TUBE, OR ?
MARQUEE ADDITIONAL CIRCUITS 100 '
SERVICENOTOVER 600VOLTS OR200AMP 300
SERVICE OVER 600 VOLTS OR 200 AMP 1000
APPROVALS DATE INSPECTOR'S SIGNATURE
� ,
TEMP POWER POLE
TEMPSERVICE,POLE, &APPURTENANCES 500 ,
UNDERSLAB WORK
TEMP LIGHT OR R ERT, SYSTEM 300 ,
ROUGH CONDIUT
WIRING
FIXTURES
- - '
PERMIT FEE (SUB TOTAL) POWER,AUTHORIZED ,
UTILITY CO NOTIFIED ,
PLAN CHECK FEE
FINAL
PERMIT ISSUING FEE 300
JO PH C. ROOHAN
TOTAL FEE SUPERVISING ELEC IVOGINEER
N
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION cK cASH
LAC,o 2 -9, 19►: T 2 0 2 a 8.0 0-
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE - ,
78AO63-CES081/70 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING Jr
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE. COUNTY ENGINEER LOCALITY
COLEMAN W. JENKINS SUPERINTENDENT OR BUILDING
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
OUTLETS 0. EACH FEE
OWNER AIA
Z i �1- V 12 tr7
RECEPT._ $ $ MAIL
LIGHT TOTAL
FIRST 20 20 ADDRESS
CITY TEL. NO.
SWITCH_ OVER 20 10 PLAN CHECK
LIGHTINGTOTAL FIRST 20 20 APPLICANT
FIXTURES OVER 20 ADDRESS
.10
APPLIANCES CITY TEL. NO.
PERMIT
RANGE DRYER_WTR. HTR. APPLICANT .tf oef-fI j
STA. COOK DISP. F.A.U. ADDRESS Ji CA E•{/y/
SPACE HTR. AIR COND. CITY TEL. NO.
CLOTHES WASH. DISHWASH. LICENSE NO. �j CLASS. Y-iO
FAN OTHER 100 1HEREBY 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
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
1 - 10 300 RESIDE IN, THE ABOVE D SCRIBED RESIDENTIAL PROPERTY
SIGNATURE
10 - 50 500 OF PERMITT 0
50 - 100 1000 DISTRICT NO CLASS ZONE SED 0
100 — 500 1500 C
SIGN, GASryO / t/j yJ W
SIGN AND ONE CIRCUIT 300 NOTES:
TUBE, OR 1 1Z
MARQUEE ADDITIONAL CIRCUITS 100
SERVI CE NOT OVER 600 VOLTS OR 200 AMP 200
APPROVALS DATE INSPECTOR'S SIGNATURE
SERVI CE OVER 600 VOLTS OR 200 AM P 500
TEMP POWER POLE
TEMP SERVICE,POLE:&APPURTENANCES 300
TEMP LIGHT OR UNDERSLAB WORK RECEPT. SYSTEM 300 ��
ROUGH CONDIUT
WIRING
PERMIT FEE (SUB TOTAL) FIXTURES
PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED
UTILITY CO NOTIFIED
PERMIT ISSUING FEE 200
FINAL
SUPPLEMENTARY PERMIT ISSUING FEE 100
JOS PH A00HAN
TOTAL FEE dinl � SUPERVISING ELECTRICAL ENGINEER.
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION cK M 0 CASH
1 4 2 JUN 2 9 2 D 5.'o 0~
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
. .� e
76A663-CE806 8-62 APPLICATION FOR • ELECTRICAL P RMIT
COUNTY OF LOS ANGELES
DEPARTMENT 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.
RECEPT �., TOTAL NO. EACH FEE
OUTLETS FIRST 20 $20 $ OWNS
LIGHT Z4 MAIL ,
'k ADD'L •1O ,� ADDRESS
SWITCH
3' OVER 20 •
TOTAL .CITY TEL. NO.
LIGHTING FIRST 20 .20 �d
FIXTURESL_4� ADD'L
oV R 20 .10 ELECTRICIAN
RANGES CLO.DRYERS WTR HTRS 1.00 ADDRESS A
GARB DISP. STA.COOK
CITY TEL NO. (A '
DISHWASH AUTO.-WASH STATE
SPACE HTRS STA.APP.(ya H P.MAX ) ,SO
LICENSE NO.
MOTORS. OVER - NOT OVER H P. DISTRICT NO. GROUP ZONE PR ZSSED B
O 1 1.00
1 3 150 5 `.a INSPECTIONN�✓�RyyEC.00RRD 1
3 s 2.00 �e� G
8 15 2.50 - �,�� ` .�6Gd.♦I�,R✓'� �'c -k'4Z, ^''"/J'1•%�
15 50 300ry
q �'
50100 500 Il.fir�7��d $w>v.✓i e�P'��'!'.✓'�� yO%� �f��� V
NO,TRANS
SIGNS: NO.LAMPS 1i'J'd .G&/C41Ay Cf .� 1 yt�'B - Q
SERVICE 0-600V-NOT OVER 200A 1.00
J D.
SERVICE 0-60OV-OVER 200 A. 2.00 h 3 ✓i J, .�, � � „ y e _Z
SERVICE OVER 600V 5.00 ,. ?� P� f' 'j Pt 9 -'
MISC.
PERMIT ISSUING FEE 200
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE $ �
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVAL
`�S 'j DATE/ INSPECTOR'S 61GNATURE
AND STATE THAT THE'ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING !`r /i�f(f6+� sT",,f'� kt'�-'vim '
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED A6 REQUIREDBY L06 AN COUNTY AND STATE OF FIXTURES 2(�
CALIFORNIA OR THAT I AM T EG OW R OF THE ABOVE - y�
DESCRIBED RESIDEN Y POWER
SIGNATURE UTILITY CO.NOTIFIED
OF PERMITTEE '
FINAL
LIDATION. ARTHUR C. VEIT
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
irll,os-9 3 o- EEa25 ?,,p, 15 0.70�
i
76A663 CE-806 NF 6/78 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN JOB
New Residential Bldgs. EACH NO FEE ADDRESS&Pools LOCALITY
1 &2-Family,Sq. Ft. — $
Multi-family Sq. Ft. — NEAREST
CROSS ST.
Residential Swimming Pools OWNER OR
FIRM NAME
Outlets: Rec Light Sw. MAIL
First 20 ADDRESS.
Total No. Additional CITY Tel. No.
PLAN CHECK
APPLICANT
Lighting Fixtures First 20 ADDRESS
Total No. Additional
CITY Tel. No
Fixed Appliances Not Over 1 HP PERMIT
Range_Heater_D.W.
APPLICANT
Oven_Dryer_W.M. ADDRESS
Top _FAU _W.H._ CITY Tel. No.
Hood_Fan _Other_ LICENSE OR
Disp.—Room Air Cond. REG.NUMBER Class
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA
Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO
Size&Type HP, KW, KVA,or KVAR COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS O
REGULATING ELECTRICAL WIRING. U
Up to 1 Incl. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR W
Over 1 to 10 Incl. LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
Over 1 0 to 50 Incl. DESCRIBED RESIDENTIAL PROPERTY. ''
Over 50 to 100 Inc.
EE
Over 100 SIGNATURE
U
SIGNURE O
Services DISTRICT NO. PROCESSED BY CLCL
0-200 Amp. Under 600 V LU
201-1000 Amp. Under 600 V
Over 1000 Amp.or Over 600 V Z
O
Temp. Power Pole&Appurtenances Q
Sign with One Branch Circuit
Additional Sign Branch Circuits INSPECTION >
INFORMATION v
Misc.Conduits&Conductors L+
Other(See Complete Fee Schedule) ON REVERSE
SIDE Z
9L
a
PERMIT FEE (Sub-Total)
PLAN CHECKING FEE (One-Fourth Permit Fee) O
PERMIT ISSUING FEE o
a
TOTAL FEE >
INSPECTION FINALED X
W
date: By
"p)5
76A663-.-806(6/78) APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN
New Residential Bldgs. &Pools EACH NO. FEE ADDRESS
1 &2.Family,Sq. Ft. $ .025 — $ LOCALITY
Multi-family Sq. Ft. .02 — NEAREST
CROSS ST.
Residential Swimming Pools 25.00 OWNER OR
FIRM NAME
Outlets: Rec Light Sw. MAIL
First 20 .50 ADDRESS
Total No. Additionalr.5
CITY Tel. No,
PLAN CHECK
APPLICANT
Lighting Fixtures First 20 ADDRESS
Additional
Total No. CITY Tel No.
Fixed Appliances Not Over 1 HP PERMIT
Range_Heater_D.W. _
APPLICANT
Oven_Dryer_W.M, ADDRESS
Top _FAU _ W.H._ CITY Tel. No.
Hood_Fan _Other_ LICENSE OR
Disp._Room Air Cond. 2.50 REG.NUMBER Class.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA
Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO ®1„
Size&Type HP, KW, KVA,or KVAR COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS O
REGULATING ELECTRICAL WIRING. U
'
Up to 1 Incl. 2.50 S.OG I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR a
Over 1 to 70 Incl. LICENSED AS REQUIRED BY LOS ANGELES COUNTY.AND STATE OF 11616Over 10 to 50 Incl, 12.50 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE -
Over 50 to 1 00 Inc.
25.00 DESCRIBED RESIDENTIAL PROPERTY, >_
4000 PERMITEE
.
Over 100 SIGNATURE
O
d
Services DISTRICT NO. PROCESSED BY c
0- 200 Amp, Under 600 V 12.50 LU
201-1000 Amp. Under 600 V 25.00
Over 1000 Amp.or Over 600 V 50.00 Z
O
Temp. Power Pole&Appurtenances 10.00 Q
Sign with One Branch Circuit 10.00 D
Additional Sign Branch Circuits 2.00 INSPECTION >
INFORMATION
Misc.Conduits&Conductors 10.00 ON REVERSE i
Other(See Complete Fee Schedule) SIDE v
Z
Q
d
PERMIT FEE (Sub-Total;
PLAN CHECKING FEE (One-Fourth Permit Feel O
PERMIT ISSUING FEE $7.00 0
J
TOTAL FEE >
INSPECTION FINALED 4Z
W
date:
By �
Pis
76A663GE•80616/78) APPLICATION FOR ELECTRICAL- PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN r JOB
New Residential Bldgs &Pools EACH NO FEE- ADDRESS
TO fy
1 &2-Family,Sq Ft $ 025 — $ LOCALITY
Multi-family Sq Ft 02" — NEAREST
CROSS ST
Residential Swimmmg'Po�Js 25 00 OWNER OR
FIRM NAME CJ.
Outlets RecLight(_Sw / " ADDRESS
First 20 "'50 1
Total No Additional 30 ' CIT Tel No
PLAN CHECK
APPLICANT
Lighting Fixtures
First=20 50 ADDRESS
Total No ( ) itsonal - 30
Add
CITY ' Tei No
Fixed Appliances,NotOve'r 1 HP .. PERMIT,
APPLICANT f
Range_Heater_D W —
Z �
Oven—Dryer_ W M— ^'� ✓' ADDRESS
*
Top —FAU — W H _ .� a , L 'CIT, Tel N
Hood_F6n —'Other LICENSE OR �/
D_is_p —_Room Air Cond 2 50 'REG,',NUMBER S / 2_a Class
-'I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA
Power Apparatus&Large Appliances -A TION.AND,STATE THAT THE ABOVE IS CORRECT AND-AGREE TO
„� COMPCI�`'WITH,ALL C6UNTY ORDINANCES AND STATE LAWS
Size,&Type HP, KW, KVA,or KVAR REGULATING,ELECTRICAL WIRING
'2 5'0
Up to 1 Incl y I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR C
Over 1 to 1 0 Incl 5 OQ LICENSED AS,REQUt BY LOS ANGELES COU TY AND' TATE OF U
Over 10 to 50 Incl 12 50 CALIFORNIA ORT AM TH LEGAL R E ABOVE
Over 50 to 100 Inc-
25 00 DESCRIBED RESIDPROPE
Over 100 -40 00 PERMITEE
SIGNATUR
Services DISTRICT NO - - P OCESS -BY
0 200 Amp Under 600V 12
50
00 y C/
201-1000 Amp Under 600'V '
Over 1000 Amp or Over 600 V 5000 Z
- `` O
Temp Power Pole&•Appurtenances 10`00` _ 1• -;r z' :\Q
Sign with One Branch Circuit,rcuit, , ,
Additional Sign Branch Circuits 200 INSPECTION >
INFORMATION v
Misc Conduits&Conductors 1000 ON REVERSE x �Jr 1 :7,0 A
Othe e Clete Fee Schedule) ^ _ SIDE "
Z
- g # 000002 •
2. 01 Q 0 0�
PERMIT FEE (Sub-Totbl) 0 0 0,1 Q 0 0 v
PLAN CHECKING FEE Ione-Fourth Perm it,Feel' O
PERMIT ISSUING FEE $7 00 r c 0627-79
'TOTAL FEE >
INSPECTION FINALED W
date ��o��ve(f BY
76A683CE-806NF6/78 APPLICATION OR ELECTR AL PERMIT' - - -
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN JOB
New Residential Bldgs &Pools EACH NO FEE, ADDRESS V
1 &2-Family,Sq Ft $ — $ LOCALITY �fG
Multi-family Scl Ft — NEAREST /, G✓!�
CROSS ST �J
Residential Swimming Pools OWNER OR
��, FIRM NAME C (/I�
Outlets. Rec�Light' 0 Sw MAIL 0/__11ff
First 20 U ADDRES
Total No Additional CITY Tel No
PLAN CHECK
APPLICANT
Lighting Fixtures First
First 20 ADDRESS
A 6
Total No- Additional CITY Tel No }
Fixed Appliances Not Over 1 HP PERMIT
Range_Heater_D W APPLICANT e - t
Oven—Dryer_W M— ADDRESS v
Top _FAU — W H CITY -Tel No Ly3
Hood—Fan —Other LICENSE OR
Disp —Room Air Cond REG NUMBER �� /� Clas%e—% -/6
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA
Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND'AGREE TO
COMLYALL COUNTY
Size&Type HP, KW, KVA,or KVAR REEGULATI GITELECTRICAL WIRINGORDINANCES AND STATE LAWS
Up to 1 Incl I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR V
Over 1 to 10 Incl LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
Over 10 to 50 Incl -D CALIFORNIA OR THAT•I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDE TIAL PROPERTY
Over 50 to 100 Inc
PERMITEE
Over 100 SIGNATURE N
Services DISTRICT NOVROCESS D BY
,0-200 Amp Under 600 V ` •} �1 Q
201-1000 Amp Under 600'V ` U
Over 1000 Amp or Over 600 V Z
Temp Power Pale&Appurtenances Q
Sign with One Branch Circuit
Additional Sign Branch Circuits INSPECTION >
INFORMATION
Misc Conduits&Conductors ON REVERSE z
Other(See Complete Fee Schedule)' SIDE u
;?509,6A
PERMIT FEE (Sub-Total)
Z 2 - 1 84.90'
PLAN CHECKING FEE (One-Fourth Permit Fee) O
PERMIT ISSUING FEE — c 1 8 4,9 0
J
TOTAL FEE > 0622779
r
INSPECTION FINALED ]�� LU
date �j Z�N By �{ Ot
�J •�l
` COUNTY OF LOS ANOELES APPLICATION FOR PERMIT
Department of County Engineer ELECTRIC
� ��
DIVISION OF BUILDING & SAFETY '`
WILLIAM J. FOX, County Enolneer
FOR APPLICAN TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO.
ELECTRICIAN s .R
ECEIVED BY READY FOR DATE ISSUED
ADDRESS 1 I FIRST INSPECTION /
CITY TEL NO.
EXPIRES ... _ 'BUILDING
PERMIT FEES ADDRESS
NUMBER EACH FEE LOCALITY
LIGHT OUTLETS f 6 NEAREST
CROSS ST.
RECEPTACLES 1
WALL SWITCHES OWNER
TOTAL OUTLETS SC S MAIL '
ELEC. RANGES 25 ADDRESS
ELEC. HEATERS 25 CITY TEL. NO.
FIXTURES 6
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
MIBq. APPLICATION AND STATE THAT THE ABOVE 10 CORRECT
NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING.
MOTORS 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOB
NUMBER HORSEPOWERFEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
NEW MVD. HP OXER INC. EACH OF THE RESIDENTIAL PROPERTY BCRIBED BOVE.
I/p s Leae $ .25 SIGNATURE OF Olt
2 .50 7 PERMITTEES
2 s 1.00 INSPECTION RECORD
5 1s 1.50
Ts so 2.50
s0 200 5.00
2130, SOD 10.00 .C"-' J
500 1000 1 s.013 Z
OVER 1000 20.00 IU
—MOVED MOTORS (75% OF CRIS.)
M.G. SET/FRED. CHANGER-HP `�� r'? 1'
WELDERS:AC-KVA t
I<1-- -140 Al P
GENERATORS - KW
TRANSFORMERS - KVA
MISC.
SIGNS
NO. NO.TRANS.
APPROVALS
NO. NO. LAMPS
DATE INSPECTOR'S NAME
FOR EACH PERMIT:
WIRING $1.00 CONDUIT
(FIXTURES $1.00 ` WIRING (�
)SUPPLEMENTARY ,g0 FIXTURES �.I S , �t g,9,f ,-
POWER ft re,
TOTAL FEE >B -Y UTILITY CO. NOTIFIED
FINAL f�ri1
76A663 DBS#SA
_1 Cdb 12-53
DB S-A 14-43 SSM MM C•TION FOR n
DEPAR'T'MENT OF BUII.DnvG AND SAFETY, ELECTRIC,
COUNTY OF LOS ANGELES
WM. J. FOX. CHIEF ENGINEER
ZIDISTRICT NO. GROUP ZONE PERMIT NO.
_< NAME "01-14D-4jAR�A S
U ADDRESS
1� tt RECEIVED BY READY FOR DATE ISSUED
B1 CITY 11 TEL.NO /� Yl FIRST INSPECTIONCOUNTY
W CERT.NO. 9 EXPIRES . • iP
APPLICANT Ful K HEAVILY OUTLINED PORTION ONLY
DESCRIPTION OF WORK n nnREBB
NUMBER OF OUTLETS ON CIRCUITS LOCALITY 46l
LOCATION BY ROOMS NEAREST
LIGHT OUTLETS SW.I PLUGS FACT CROSS ST
CIRCUIT A B C I D I E F G H 1% NAME
Z MAIL
ADDRESS
O. !
CITY TEL.NO.
1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERT AIC_ATE OF,QUALIFICATION
LXCTRICIAN.d
I AM THE LMAL OWNER OF THE PROPORTY DE�RIBED
ABOVE
OWNER.
' CORRECTIONS
J
Q
_Z
O
(Y
O
TOTAL
NO. OF OUTLETS $ APPROVALS
NO. OF FIXTURES $ DATE N-I,\NSPECTOR'S NAME
NO. OF MOTORS H.P. $ CONDUIT
NO. OF SIGNS TRANS. $ WIRING
NO. OF RANGES OR HEATERS $ FIXTURES
L
LLANEOUS E POWERT FEE $ UTILITYCo.NOTIFIED FEE
P
DBS SA 25M SETS 2-47 B7�HB7THA�•m'rnY4j tem Foia P m�
DEPARTMENT' OF BUILDING Alm'+ SAFETY iia�l/��tEII CTRIC
COUNTY OF LOS ANGELES
�f WM. J. FOIL CHIEF ENGINEER
e NAME DISTRICT NO. GROgP ZONE PERMIT NO..
.14
/
U ADDRESS G �yr4
2 -
RECEIVED BY READY FOR DATE ISSUED
W
CITY E FIRST INSPECTION
j COUNTY
W CERT.NO-3,1,YPHONE 118011.28
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
JOB
(DESCRIPTION OF WORK ADDRESS �
NUMBER OF OUTLETS ON CIRCUITS LOCALITY
LOCATION BY ROOMS : NEAREST
LIGHT OUTLETS JSW. PLUGS r1 r CROSS ST.
CIRCUIT A B C D E F G H !r NAME
Z MAIL
ADDRESS
O
CITY TEL.NO.
1 AM THE LEGAL POSSESSO OF THE ABOVE LOS
ANGELES COUNTY CERTI AT OF QUALIFICATION..ICIAN.
ELECTR
I AM THE LEGAL ER OF THE PROPERTY DESCRIBED
ABOVE
OWNER.
v CORRECTIONS
J
— a
z
o
TOTAL
No. OF OUTLETS APPROVALS
I NO. OF FIXTURES $ DATE INSPECTOR'S NAME
NO. OF MOTORS H.P. $ CONDUIT
NO. OF SIGNS 2 TRANS. — $ D c! WIRING /
NO. OF RANGES OR HEATERS $ FIXTURES
MISCELLANEOUS 9+ POWER
PERMIT FEE $ 00 UTILITY CO.NOTIFIED
7GA663 DSS SA 3-50 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL
IIN
DISTRICT NO. GROUP ZONE PERMIT Na.
ELECTRICIAN
RECEIVED BY READY FOR DATE ISSUED
ADDRESS FIRST INSPECTION
CITY TEL NO. c J 3
COUNTY LICENSE N EXPIRES ; BUILDING
ADDRESS- u
PERMIT FEES
FEE
NUMBER EACH LOCALITY
LIGHT OUTLETS NEAREST -
CROSS ST.
RECEPTACLES
n
WALL SWITCHES OWNER. c,c
TOTAL OUTLETS ,r 5C $ Q MAIL
ELEC. RANGES 25 ADDRESS
ELEC. HEATERS 25 CITY TEL. NO.
FIXTURES 5
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
MISC., i APPLICATION AND STATE THAT THE ABOVE IS CORRECT '
NUMBER OF L113HT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING.
MOTORS 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS
NUMBER HORSEPOWERFEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
NEW MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY D SCRIBED ABOVE.
%z s Less S 25 SIGNATURE OF
Vg 2 .50 PERMITTEE
2 5 1.00 INSPECTION RECORD
5 15 1.50
"-+ 15 50 2.50
60 200 5.00
200 500 10.00 J
500 1000 15.00 Z
OVER 1000 20.00
M.G. BET/FREQ. CHANGER-HP a
WELDERS:AC-KYA v O
GENERATORS - KW
TRANSFORMERS - KVA -
TEMP. MOTORS (75% OF ORIG.)
MOVED MOTORS (750/a OF ORIG.) -
MISC.
SIGNS
�- NO. NO.TRANS. -
NO. NO. LAMPS APPROVALS
FOR EACH PERMIT: DATE INSPECTOR'S NAME
WIRING $1.00 CONDUIT -ZJ-a
FIXTURES $1.00 WIRING 62 r#!Yr1F1j)S J'1-3 '-Q/ l i1V
SUPPLEMENTARY .50 FIXTURES
t/1 ? POWER
TOTAL FEE `o J UTILITY CO.NOTIFIED �+
FINAL
WORKER'S COMPENSATION DECLARATION 20-0019 DPW 9189
1 hereby affirm that I have a certificate of consent to self Insure, 76A663 APPLICATION FOR ELECTRICAL PERMIT 11
or a certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV.
copy therev'0ec 3800 L-ab C) �� C - - - -
— �/
Policy NO Company _ FOR APPLICANT TO FILL IN JOB Q
ADDRESS � 7.�� - fr %�fh✓/yS '�l��
Certified copy is hereby furnished. EACH NO FEE
New Residential Bldgs &Pools _ LOLOCALITYll Lr�
❑ Certified copy Is filed with the county building Inspection 1 &2-Family,Sq Ft $ $
department Multi-family Sq Ft CROSS ST
Date Applicant Residential Swimming Pools ASSESSOR
• MAP BOOK PAGE PARCEL
CERTIFICATE OF EXEMPTION FROM WORKERS' �Sw OWNER OR
Jtft�?
Outlets Rec Light `I_l
COMPENSATION INSURANCE L�- FIRM NAME �T 4Kc�C T�J�
First 20
(This section need not be completed if the work Involved by the MAIL Total No �' Additional ADDRESS T
3 L/f]s J C ..
permit Is for one hundred dollars,($100)or less.)
I certify that In the performance of the work for which this permit CITY , Tel No �PpmiW
is Issued, I shall not employ arty person In any manner so as to
become subject to the Workers' Com ens Ion Laws Lighting Fixtures First 20 PLAN CHECK
1 P 9 9 APPLICANT
Total No Additional
ADDRESS
Date 3 Applicant15 OR 20A,120V BRANCH CIRCUITS '
NOTIC TO APPLICANT If, after making Is Cerfrticate of CITY Tel No
Exemption,you should become subject to the Workers' Compensation 1 TO 10 INCLUSIVE EACH
provisions of the Labor Code, you must forthwith comply with such 11 T040 INCLUSIVE EACH PERMIT
APPLICANT G So,v L'fLu�"T�
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 15 OR 20A,208V TO 277V LIGHTING EACH r�2 4wzI AO d
(commencing with Section 7000) of Division 3 of the Business and _ _ CITYC7,,OW ;�B�Z� Tel No
Professions Code,and my license Is in full force and effect RESIDENTIAL APPLIANCES UP TO 3HP 0
LICENSE OR ``�*_ Class�'-J�
�f Power Apparatus&Large Appliances REG NUMBER 7 Gf' O
License Number !7���V LIc•Class C /0 Size&Type HP,KW,KVA,or KVAR DISTRICT NO P Oc SED BY
Up to 3 Incl �� � LLU
Contractor Date ' Over 3 to 10 Incl FINAL _ d
--c Over 10 to 50 Incl DATE rq U)
❑ I am exempt under Sec Over 50 to 100 Incl " 2_!_11> VALIDATION
B&P C for this reason Over 100 BY AL
Services,Swbd,MCC&Panelboards O 'g—,
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
SINGLE FAMILY Temp Power Pole&Appurtenances
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit — 1 i1•t• ,v
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
Code) .r0145.77
i ateS
❑ • I 1 I,as owner of the property,will do the work and the structure Mlsc Conduits&Conductors ~, TEM
Is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) _ -- TOTAL 45 - 75
and Professions Code) • - -
CONSTRUCTION LENDING AGENCY _ ftttH��hEi��•rr� 45.75
1 hereby affirm that there is a construction-lending agency for the CHANGE .00,
performance of the work for which this permit is Issued (Sec 3097, _PERMIT FEE (Sub-Total) j
Civ C)
PLAN CHECKING FEE ul (�—Iiy/i5/!�3
Lender's Name
PERMIT ISSUING FEE 7 0475 1 AM11.11
Lender's Address
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 Stat laws regulating Electrical wiring, and hereby authorize
rep
resen atives of this County to enter upon the above-mentioned
proper for Inspection purp ses SEE REVERSE FOR EXPLANATORY LANGUAGE
SIG-NATU7 AP CANT OR AGENT PATE
WORKER'S COMPENSATION DECLARATION 9 DPW'9/89 APPLICATION FOR ELECTRICAL PERMIT
76A66 '
I hereby affirm that I have a certificate of consent to self Insure, 76A663
or a certlflcateof Wo er's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV.
copy thereof(Sec 38 ab C)
Policy No Company FOR APPLICANT TO FILL IN - JOB �� / e
❑• ADDRESS 4,65 r � ,
Cetv
d copy eby furnished, New Residential Bldgs &Pools EACH NO FEE1 &2-Family,Sci'Ft LOCALITY
ct $ — $❑-' Cecop Is fled with the county budding mspectiori" - _ - _
r department Multi-family Sci Ft CROSS ST
Date Applicant Residential Swimming Pools ASSESSOR
_ . MAP BOOK PAGE PARCEL
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec `L ht Sw i� OWNER OR�-�
COMPENSATION INSURANCE First 20 �j/� FIRM NAME i4Z1�IlF�E
'(This section need not be completed ifithe work involved by the MAIL �^
Total No Additl0 f/ ADDRESS
permit,is for one hundred dollars($100)or less) f.1� ,
' I certify that In the performance of the work for which this permit - - - CITY �j K Tel Noa+,rj �a' o
is Issued, I shall not employ any pers In any manner so as to
become subject the Workers'Com a -tion Laws Lighting Fixture First 20 PLAN CHECK-
I e g g �� - D / O APPLICANT
To �o Additional ADDRESS
Date`s �' Applican 15 20A,1 0 BRANCH CIRCUITS
NOTI E TO APPLICANT If, a ter ma/Ig/his Cer Ificate of CITY Tel No
Exemption,you should become subject to tfieWorkers'Compensation 1 TO 10 INCLUSIVE EACH
provisions of the Labor Code, you must forthwith comply with such 11 TO 40 INCLUSIVE EACH ' PERMIT
SO_ 1
APPLICANT
provisions or this permit shall be deemed revoked41 OR MORE BRANCH CIRCUITS EACH
LICENSED CONTRACTORS DECLARATION ADDRESS?0-) L�
15 OR 20AO O
I hereby affirm that I am licensed under provisions of Chapter 9 ,208V TO 277V LIGHTING EACH
(commencing with Section 7000) of Division 3 of the Business and _ CITY 91. Tel No Z77 I V
Professions Code,and my license is In full force and effect RESIDENTIAL APPLIANCES UP TO 3HP LICENSE OR
Power Apparatus&Large Appliances REG NUMBER �L cias%1_ O O
License Number G` `� Lic Class�r Size&Type HP,KW,KVA,or KVAR DISTRICT NO Q PRoc SSED BY U
Up to 3 Incl
// Q iL
W
Contractor to 2 7 Z Over 3 to 10 Incl DATE U)
Over 10 to 50 Incl Q Z
❑ 1 am exe pt der Sec Over 50 to 100 Incl ` VALIDATION
-" - FINAL
B&P C for this reason Over 100 BY
Services,•Swbd,MCC&Panelboards',
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
SINGLE FAMILY Temp Power Pole&Appurtenances -
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit
1 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 - r
Code)
❑- I,as owne f he will do the work and the structure Mlsc Conduits&Conductors-
is not Int d dor red for sale (Section`7044, Business Other(See mplete Fee Schedule)
and Prof s ns )
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 (Sec 3097, PERMIT FEE (Sub-Total) __ ^� ! -i•s s
Civ C)
PLAN CHECKING FEE
Lender's Name
PERMIT ISSUING FEE p�
Lender's Address
I certify that I have read this application and state that the above TOTAL FEE ��i
Information correct I agree to comply with all County ordinances
and State ws regulating Electrical wiring, and hereby authorize
represent ves of this County t enter upon the above-m nuoned
propert r Inspection rpos SEE REVERSE FOR EXPLANATORY LANGUAGE
TA LIC T RAGE DAT
WORKERS'COMPENSATION DECLARATION 76-663 i- APPLICATION FOR'ELECTRICAL-PEMIT•,
I fiereby1affirm that I have a'certificate of consent-to self insure,
CE-806G_
or a certificate of Workers' Compensation Insurance, or a certified COUNTY'OF LOS ANGELES BUILDING AND SAFETY
,copy thereof(Sec 3800,Lab C)
Policy No, - Company " - FOR APPLICANT•TO FILL IN JOB
❑ Certified copy is hereby furnished New Residential Bldgs & Pools EACH NO EEE ADDRESS �Gf
i.
❑ Certified 'copy is filed with'the county budding inspection .1 & 2-Family,Sq Ft $ _ $ LOCALITY
department Multi-family Sq Ft r NEAREST O /
CROSS ST
Residential Swimming Pools
Date Applicant• OWNER OR
.�`.�: - FIRM NAME
CERTIFICATE OF EXEMPTION FROM WORKERS: ' " �' MAIL
COMPENSATION INSURANCE •, Outlets Rec— Light Sw
ADDRESS
First 20 •�'_ '
(This,,-section need not be completed d the work Involved by he
,permit is for one hundred dollars($100)-or less') Total No Additional. CITY ,r ; Tel No
I certify-that in the performance of the work'for which thi ,permit PLAN CHECK,
..aS issued, I shall not employ any person in any mariner O_ s.t0 - " • APPLICANT ,
y
'become subject to the Workers' mpensation Laws, Lighting Fixtures First 20i' ' ADDRESS
Total No
Additional CITY Tel No
DatesS—_~- Applicant Fixed,Apphances Not Over 1,HP PERMIT
NOTICE-,TO:APPLICANT If, after `makin this"Certificate f
Exemption,you should become subject to the Workers'Compens tion Range_ Heater_ DW APPLICANT 1
provisions of the,Labor_Code, you must forthwith comply with such Oven Dryer._ WM•_ ADDRESS �
provisions or this•perrW,shall be deemed revoked Top FAU , _ W H _ CITY Tel No {
• LICENSED CONTRACTORS DECLARATION Hood Fan Other_ 114,
I,hereby,affirm• that'I am licensed under provisions of Chapter 9 , LICENSE O G
' Disp — Room Air Cond ass ,
(commencing,with Section 7000) of Division 3 of the,Business and w „ REG'NUMBER
Professions Code,and my license is in full force and effect DISTRICT NO PR E ED BY
Power Apparatus&Large Appliances ,
Size & Type HP,KW,KVA,or_KVAR
' License,Numbe� Lic Class �t. l"n
FINAL' O U,
DATE` Zip 0
Contractor Date r ci CJ VALIDATION
.❑ , FI L 77 ,- - - M" = W
I am exempt under Sec Over 5Q to 100 Inc W
B&PC for this reason Over 100 (n
"v Services,Swbd,MCC &Panelboards , r Z
Date 0 - 200,Amp Under 600.V
Signature 201 - 1000 Amp Under 600'V
❑ ° Over 1000 Amp,or,Overn600,V
Exemption for Reg Maint Elect x
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 e i 01.
Code)
`
I,'as owner of the property,will do the work and the structure Misc Condwts'& Conductors
is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule),
and Professions Code) °• � �Y adi.�E
'CONSTRUCTION LENDING AGENCY _ F ��✓
I hereby affirm that there is a construction lending agency for She
Performance of the work for'which this permit is issued(Sec 3097, PERMIT FEE ; -, ,' (sub-total), ,
Civ C) r
PLAN CHECKING FEET" ;' _•
�,er cler.'s Name,
PERMIT ISSUING FEE r
Lender's Address
F I certify,ihat I have read this application and state that,the above _ TOTAL FEE
-information is correct I agre to comply with all Courity ordinances
and State laws regulating lectrical wiring, and hereby authorize
representatives of this Co
my to enter upon the above-mentioned '
pr erty for inspec on os
i _SEE REVERSE FOR.EXPLANATORY LANGUAGE _
Signature Permd a Date
I
WORKERS'COMPENSATIONDECLARATION CE-806G (2-80) APPLICATION FORLECTRICAL PERMIT',
I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES T1 ,� BUILDING AND SAFETY
insure Workersp or or a certificate of W 'Compensation Insurance - _ "fl
a certified copy thereof(Sec 3800,Lab C)
llJJ ��J �r����� � FOR APPLICANT TO FILL IN 30'g _
Policy No%S^ SCom�any J—f--- � EACH NO FEE ADDRESS 3 1
New Residential Bldgs &Pools
F1Certified copy is hereby furnished , 1 &2-Family,Sq Ft $ — $ LOCALITY L+�
'
Multi-family Sq NEAREST Ft CROSS ST
09,department Swimming Pools OWNER OR
Certified copy is Bled with the county tiu,ldmg inspection ,,
de artment
p FIRM NAME
Dai/4—& pplicant�/���•/D,V EL:W Outlets Rec'_Light_Sw MAIL pi, •
First 20 ADDRESS
CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY TekNo }
COMPENSATION INSURANCE `
_ PLAN CHECK CL
APPLICANTO
(This section need not be'Completed if the work involved
Lighting Fixtures First ADDRESS U
by the permit is for one hundred dollars ($100) or less.) Additional �
Total 0
I certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No '
permit is issued, I shall not employ any person ,n any manner PERMIT ^ UJ
so as'to become subject to the Workers"Compensation Laws Range_ Heater_D W APPLICANT /V i d
'.Oven _ Dryer'
_A W M • ADDRESS N
Date Applicant Top _'FAU o_W.H. `/� Tel 4 /k'U '
Hood '_ Fan _Other_ 04� 01111 CITY TTel No
NOTICE TO APPLICANT If, after making this Certificate of 'Disp _ Room Air Cond.— LI CEN OR
Exemption, you should become subject to' the Workers,' REG NUMBER b� Class
Compensation provisions of the Labor Code, you must forth- Power Apparatus&Large Appliances DISTRICT NO PROCE SED e�
with comply with such provisions or this permit shall be /1
deemed revoked Size&Type HP, KW, KVA,or K•VAR / d
/ - Up to 1 Incl.
FINAL �� i
Over 1 to 10 Incl DATE
LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl .VALIDATION
I.hereby affirm that I am licensed under provisions of'Chapter Over 50 to 100 Inc FINAL
BY
9 (commencing with Section 7000) o'f Division 3 of the Busi- Over 100
ness and Professions Code, and my license is to full force and
effect Services
License Number Lic.Class 0-200 Amp Under 600 V P�190
201-1000 Amp. Under 600 V
Contractor Date eo Over 1000 Amp.or Over 600 V
HOME OWNER-BUILDER DECLARATION Temp.Power Pole&•Appurtenances '
I hereby affirm that I amt exempt from th"e Contractor's Sign with One Branch Circuit 3.6 1.9 A
License Law for the following reason (Section 7031 5, Busi- Additional Sign Branch Circuits r
•
ness and Professions Code) + #10,°-°,° °-2, 0,;
M,sc Conduits&Conductors
❑ I" as owner of the property, will do the work and the Other (See Complete Fee Schedule)— ,tri° -.5.14,50
structure is not intended or offered for sale (Section o 0 0 5 4,5 Q L
7044, Business and Professions Code)
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending,agency Q 7. 1,3.—8.3'
for the performance of the work fog which this permit is PERMIT FEE (Sub-Total)
issued (Sec 3097,Civ C)
Lender's Name PLAN CHECKING FEE (One-Fourth Permii Fee),
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,wdh all County i
ordinances and State' laws regulating Electrical wiring, and
hereby authorize representatives of this County to enter upon
the above-me ritioned property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE
6
Signature of Permt tee Date
WORKERS' COMPENSATION DECLARATION CE-806 10181 APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I have a certificate of consent to self CE-8066 [�
insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY IILJ''
or a certified copy thereof (Sec•3800, Lab C )
Policy No Company FOR APPLICANT TO FILL IN' JOB
❑ . Certified copy is hereby furnished New Residential Bldgs & Pools EACH NO FEE ' ADDRESS
❑ 1 & 2-Famil S Ft $ — $ LOCALITY
Certified copy is filed with the county building inspec- Y- 4
tion department Multi-family Sq Ft NEAREST
Residential Swimming Pools CROSS STOWNER OR
Date Applicant FIRM NAME
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec Light Sw_ MAIL
COMPENSATION INSURANCE First 20 ADDRESS 1
(This section need not be completed if the work involved by Total No Additional CITYTel No 87–
the permit is for one hundred dollars($100)or less.) PLAN CHE
I certify that in then performance of the work for which this APPLICANT
permit is issued, I shall not employ any person in any manner
so as to become subject to the Wo r s'Compens n Laws Lighting Fixtures First 20 ADDRESS
` Additional
�q Total No CITY Tel No
Date / Applicant Fixed Appliances Not Over 1 HP PERMIT
NOTICE TO APPLICANT If,.after making this Certificate of APPLICANT i y/
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 — ADDRESS
with comply with such provisions or this permit shall be Top FAU —W H —
deemed revoked Hood _ Fan _Other_ CITY Tel No C4 k4 7
LICENSED CONTRACTORS DECLARATION LICENSE OR
I hereby affirm that I am licensed under provisions of Chapter 9 Disp _ Room Air Cond REG NUMBER Class
(commencing with Section 7000) of Division 3 of the Business Power Apparatus& Large Appliances'' DISTRICT NO PR 55 BY a
and Professions Code,and my license is in full force and effect }
Size &Type HP, KW, KVA, or KVAR V V
License Number Lic Class U to 1 Incl FINAL
Contractor Date Over 1 to 10 Incl DAT ?� /_ VALI ATION 0
❑ Over 10 to 50 Incl FIN Cr(Q !✓
I am exempt under Sec Over 50 to 100 Inc BY LtJ
B&P 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 Maint Elect
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 Additional Sign Branch 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& Conductors 4 8'a 8 A
structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_
7044, Business and Professions Code) Pool # •'o o'• o 2
CONSTRUCTION LENDING AGENCY IJA 1 o.-,l 550
1 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) • o'o;1 5505
(Sec 3097, Civ C )
PLAN CHECKING FEE' '06 2 5-8 6
Lender's Name /
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 orid State jaws regulating Electrical wiring, and
hereby authorize representatives of this County to enter upon
the ove-mento property for inspection purposes -- - -
{ SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature o ermi tee
WORKERS'COMPENSATION DECLARATION .7,6A663+�'� 0181' "fi�PL�Cf�iT��N',,FDII E�E�TI-I�CQL PERMIT
' f�i Il \! Il f1 ��YY�� Y
I hereby affirm'that I havef a certificate of consent to�self,Insure,;' CE-806G
or a certificate of Workers' Compensation,Insurance, or a certified, • ' COUNTY' EL
OF LOS ANGLES,.- BUILDING AND SAFETY
copy thereof(Sec,'38601ab,,C) F' P ° „ , 6•
} yPolicy NO - Company 1 F - ',FOR APPLICANT TO FILL IN + JOB- 77 //q�
a .ADDRESS ie - !� i
❑.• Cert ied copy is Hereby furnished t New Resdential Bidgs'8-Pools`" EACH, NO' FEE, ,
- - Certified copy is'filed wAh 4he„ccurity building inspection %1 &� -'Famiy,'Sq Ft $ a — $
7 department '' p Multi-family'Sq Ft, NEAREST' i +
y•, CROSS ST'. ��
Date' Applicant" ' � r r Residential Swim}nmg Pools? _� �� OWNER OR
'X, i` '•r, , - ..• "',• •fi��!_- •''�• 'r' - -Sk FIRM NAME
'CERTIFICATE SOF,EXEMPTION FROM;WORKERSk ' I " SN -1 �� � - MAIL
Outlets Reo Liglit '
"
.,,COMPENSATION INSURANCE.' •ADDRESS;-
. �,-s� = Fdst-20
(This-section need not be'cornpleted°if,the'Work•inpohmd,by,the °CITY Tel No`
Total No - Additional
permit,Is for:one hundred,dollars,($,100),or,less j �, " r
I.certif that m the performance of the,work,for which this permit'. 1 '.PLAN CHECK,
Y P P r -` R„ �� APPLICANT, °
isaissued„I shall not,employ any perso 'i any manne to t -
become subject to'the,Work p t n L Lwghting Fixtures_ 4 First 20- j ADDRESS
` Additional
• CITY " "�.• • Tel-No
Date Plicant
;NOTICE�'TO=,;APPLICANT If; after, making: t is Certificate .of' "Fixed Appli$nces Not Over. HP-,
PERMIT." ` q
xemption„you should become,subject to the Workers'Compensation ' Range_-Heater•_ DW * ti.
IV
APPLICANT ASO N'^
' + provisions of.the Labor'Code,•you must forthwith, 'omply with such 'Oven}'-•Dryer W M e - �, ' ADDRESS _
pro3isions or this peimit shall be deemed•re,'voked, ;'. Top —'FAU W H?' _ f `
g' ' LICENSED CONTRACTORS DECLARATION. ' GITY� Tel N
,.7 '� ' Hood —' Fan Other= '
hereby affirm that)-am licensed urider,provisions of'Chapter 9`1, ” ` LICENSE P ,' ' :t;�;-- o•,
f�(c`o r mencing with Section'7000)°of Division 3r of the Business and Dksp — Room,Air CoridF REG NUMBER 6^ 2�� -• ,Class�- �• N
}Professions Code,and`My license is in full force•and effect DISTRICT NO P C SED eY. ,
Power -pparatu_s,9-Large'Appliances r
^ Size & Type HP, KW,'KVA,or KVARG 0
License'Numbe' �f/ Li"Class CL`s �{ Up to'1'Incl FINAL' U'y
�d� "� , Over 1 to'101nc1 DATE �� rC/ Q VALIDATION '
Contractor r p
Over 10 to.50 Incl FINA T
I am exempt under Sec Over 50,to 1,00 Inc
BY',. W"
y'B&P C for this'reason `. Over 100
Services,Swbd,MCC& Panelboards
,S'' 0 200 Amp Under 600 V ;: � ;, s r•s
r J Sigure'• ' ' 1201 1000 Amp Under 600'V 4'
nat2 0 A'
- _< ,Over,j000_Am' 'Or Over 600 V.'-,"' �' . 3
Exemption for Reg-,Main Elect ,- „• ;� :� i -� , ;}
a x # e o'o o o
SINGLE FAMILY .' lljemp,Power Pole&Appurtenances
9, ~' 'HOME OWNER-BUILDEN DECLARATION v ^ " ' c 3 - -1 o o_ 1',6`5 0
Sign,with One Branch Circuit f
I'hereby affirm that }'ani exempt,'from:the Contractor's License Law, % +�- � i. P ,� ",° � t o,o`o' z'
"for,the following-reason (Section 7031 5„Business and”Professions r Adddional Sign,Branch CfrcuIts. 5.�tv,
Code) "
—Misc,Conduits& Conductors ''� P e�•
' '+0 I,as owner of•the:prope�fy,611 do the work and the structure
�. is�`not intended•or otfe"(ed for sale (Section 7044, Business
Other(See,Co nplete'Fee Schedule)_ 1 k
r, �I
and'Professions°'Code)� •. -. �a, - �A ��. ", - �- .� ° .t. .-,.,
CONSTRUCTION LENDING AGENCY ,�. •�_ -- - z "} :.
Rhereby affirm'that there,is'a construction'IendingAagency,for the ,
performa'nce'of the work for whicKthis per'md is issued(Sec'3097; PERMIT FEE- a-k z• dSub-Tdtap
y' CIV.C'), sr, y .i: ti ,1 .1 a ' h•—,"�, , 'i
PLAN CHECKING
FEE
L'ender's'-Name.
t. PERMIT ISSUING FEE „�
• ' `,''Lender's Address; '' ”•„ . s, _�,
I certify that 1`6ave read'this,,appl(catidn and,state fthae,the above TOTAL FEE o { r•t}a
information is correct I,'agree` to,comply with all County ordinances' tt:� K,r
and' Stafe'laws regulating Electrical wiring, and hereby authorize �/✓ , � ' ,'�,"
represe ti s of this;Cou 0 e r upon the,above-mentioned
proper in ur s' -
,SEE.REVERSE FOR,EXPLANATORY-LANGUAGE
gnature,of'Perm ee ate
WORKERS'COMPENSATION DECLARATION 76A66310/81 APPLICATION FOR ELECTRICAL PERMIT
' I hereby a'fi,m� CE-806G have a certificate of consent to self CE-8066
insLtre, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY
or a certified copy thereof (Sec 3800, Lab C )
Policy No Company Ea I M^Y)t FOR APPLICANT TO FILL IN JOB
❑•' Certified copy is hereby furnishedNew Residential Bldgs & Pools EACH NO FEE ADDRESS
=Certified copy is filed with the county m1 & 2-Family,building spec- , Sq Ft $ $ LOCALITY
tion department Multi-family Sq Ft NEAREST
CROSS ST
Residential Swimming Pools
Date Applicant j OWNER OR
�• 1 FIRM NAME fN It
- CERTIFICATE'OF EXEMPTION FROM WORKERS' 3 MAIL
COMPENSATION INSURANCE Outlets Rec Light Sw_ L 20 ADDRESS C ')
This section need not be completed if the work involved b First ti
( p Y Total No Additional, CITY Tel No i
the permit is for one hundred dollars ($100)or less.)
I certifythat in the performance of the work for which this PLAN CHECK
P r. 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 V Applicant < Fixed Appliances Not Over I 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 — ADDRESS �� pej 0�
with comply with such provisions.or this'permit shall be Top _ FAU —W H
deemed revoked
Hood Fan _Other— CITY Te No C�
LICENSED CONTRACTORS DECLARATION r LICENSE OR
I hereby affirm that I am(licensed under provisions of Chapter 9 Disp — Room Air Cond REG NUMBER p Class �1
(commencing with Section 7000) of Division 3 of the Business DISTRICT NO PRO
CE E BY
and Professions Code,and m license is in full force and effect Power Apparatus&Large Appliances 0
• y y Size 8 Type HP, KW, KVA, or KVAR Q
License Number d Lic Class ���� Up to 1 Incl FINAL V
-i��h �-/- i Over 1 to 10 Incl DATE -Z — VALID ION Q
Contractor7l:4 tFIx
/. �Q-Date r Over 10 to 50 Incl FINAL' (~j
�'❑ I am exempt under Sec Over 50 to 100 Inc BY IL
B &P C for this reason Over 100 / Z
Date Services, Swbd , MCC& Ponelboa�ds f L ys
0 -200 Amp Under 600 V
Signature 201 - 1000 Amp Under 600 V
❑ Exemption Over 1000 Amp or Over 600 V
for Reg Maint Eject 2 1 7.5 A
SINGLE FAMILY Temp Power Pole & Appurtenances
2-'IHOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit #"o o o o o2--
I
hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits
Law for the following reason (Section 7031 5, Business and g1 a o 0
Professions'Code) JMisc Conduits&Conductors o o'o
I, as owner of the property, will do the work and the r •
structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ ► p 5 31 =S 5 !ti
7044, Business and Professions Code)
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for
the performance of the wo�k'for which this permit is issued PERMIT FEE (Sub-Total)
(Sec 3097, Civ C )
PLAN CHECKING FEE )
Lender's Name
PERMIT ISSUING FEE Q
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 lows regulating Electrical wiring, and
hereby authorize representatives of this County to enter upon -
the above-mentioned property for inspection purposes
� SEE REVERSE FOR EXPLANATORY LANGUAGE
J35
Signature of Permittee Date ,