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Home My Public Portal About6436 LOMA AVE_Electrical__ 76A663C- CE606B 12;75 APPLICATION FOR ELECTRICAL PERMIT tr t BUILDING ND SAFETY DIV ON FOR APPLICANT TO FILL IN JOB . �� ^ EACH NO. FEE ADDRESS /� FResidentialntial Bldgs.& Pools jlJ LF C�r< aily Sq. Ft. $ — $ LOCALITYily Sq. Ft. — NEAREST CROSSST.al Swimming Pools FORM NAMEht, Switch&Receptacle l . MAILADESS al CITY Tel. No. PLAN CHECK Lighting Fixtures APPLICANT First 20 / ADDRESS Additional CITY y� Tel. No. Fixed Appliances Not Over 1 HP PERMIT Range Heater_ D.W. ADDRESS O /'�OG�' Oven Dryer W.M. Y— . /� Top FAU W.H. CITY d LVr�/� Tel. No. MY—f- Hood Fan LICENSE >' REG. NUMBER ALF Class. 23 Disp. A.C. o U I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY Q Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING Size&Type HP, KW, KVA,or KVAR ELECTRICAL WIRING, V w a Up to 1 Incl. I HEREBY CERTIFY THAT AM P RL REGISTERED AND/OR Over 1 to 10 Incl. LICENSED AS REQUIRED B LOS ES COUNTY AND STATE OF CALIFORNIA OR THAT T A OWNER OF THE ABOVE Over 1O to 50 Incl. DESCRIBED RESIDEN PR RTY. Over 50 to 100 Incl. PERMITEE Over 100 SIGNATURE DISTRI NO. RO SS i B Services �' 0-200 Amp. Under 600 V v INS CTOR'S 201 - 1000 Amp. Under 600 V APPROVALS DATE SIGNATURE Over 1000 Amp.or Over 600 V 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) UTI LITY CO.NOTIFIED 8✓ PLAN CHECKING FEE (One-Fourth Permit Fee) FINAL PERMIT ISSUING FEE NOTES TOTAL FEE PLAN CHECK VALIDATION CK. M.O. ASH PERMIT VALIDATION CK. M.O._' CASH �-� 76A663-CE606 12/75 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER JOB BUILDING AND SAFETY DIVISION ADDRESS 5vw FOR APPLICANT TO FILL IN LOCALITY Pi ,C New Residential Bldgs& Pools EACH NO. FEE NEAREST /' 1 & 2-Family, Sq. Ft. $ .025 — $ CROSS ST. Multi-family Sq. Ft. •02 — OWNER ORFIRM NAME Residential Swimming Pools 20.00 MAIL ADDRESS �. - On Outlets: Light, Switch & Receptacle CITY �G�p7 L_C 6 Tel No.2 c ��oZ First 20 •50 PLAN CHECK Additional .30 APPLICANT ADDRESS Lighting Fixtures CITY Tel.No. First 20 .50 Additional 30 PERMIAPPLICANT APPLICANT x Fixed Appliances Not Over 1 HP ADDRESS'/ /` �� 5�<�C_ P� Range_Heater_D.W._ CITYSF Ic ,'//� Tel.No. �� Oven -Dryer W.M. ��w(�� LNS 7 Top FAU W.H. REGEG.NUMBB ER drp tr Class. Hood_ Fan __ - I HERES 1' ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION Disp._,A.C. 2.00___ C7 AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING Power Apparatus& Large Appliances ELECTRICAL WIRING; Size & Type HP,KW, KVA, or KVAR I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS A G LES COUNTY AND STATE OF Up t0 1 Incl. 2.00 CALIFORNIA OR THAI AM GAL OWNER OF THE ABOVE Over 1 t0 lU Incl. 5.00 q DESCRIPED QS rDE Y. Over 10 to 50 Incl. 10.00 PERMITEE Over 50 to 100 Incl. 20.00 SIGNATURE Over 100 30.00 DISTFkI'CT !]5_ ELDB PY U Services V O 0- 200 Amp. Under 600 V 12.50 INSPE CIKO R'S 201.1000 Amp. Under 600 V 25.00 APPROVALS DATE SIGNATURE Over 1000 Amp. or Over 600 V 50.00 TEMP.POWER POLE UNDERSLAB WORK Temp. Power Pole& Appurtenances 10.00 Sign with One Branch Circuit 10.00 ROUGH CONDUIT Additional Sign Branch Circuits 2.00 WIRING (Other) FIXTURES POWER AUTHORIZED UTILITY CO.NOTIFIED FINAL PERMIT FEE (Sub-Total) NOTES �� x• PLAN CHECKING FEE (One-Fourth Permit Fee) PERMIT ISSUING FEE $6.00 < TOTAL FEE / f PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. MO; CASH TO 841- .,JUL 20 2 D 1-0.5 SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 76A668-CE8067-68 APPLICATION FOR ELECTRIC PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER FBUILDINGBUILDING AND SAFETY DIVISION JOHN A. LAMBIE, COUNTY ENGINEER CASSATT D. GRIFFIN, Sul'T OF BUILDING FOR APPLICANT TO FILL IN NEAREST PERMIT I•EES CROSS ST. 1 T E M NUMBERI EACH FEE OWNER /�• OUTLET15:, �•� $ $ /.�® MAIL �/ to LIGHTS RECEPT. SW. .,10 ADDRESS / LIGHTING FIXTURES .10 CITY TEL. NO. ELEC. RANGES CLO. DRYERS ELECTRIC(A S WATER H EATERS .50 ADDRESS Q ELEC.SPACE HTRS. DISHWASHERS �A pp C CITY Mil ��1 N TEL. N0. ® 0'- Ll GARBAGE DISPOSERS AUTO. - - - �7 STATE WASHERS STA. COOKING UNITS .25 B'C LICENSE NO. s9 MOTORS: OVER INC. H.P. DISTRICT NO. GROUP ZONE PROCESSED BY O— 1/2 .25 g. �� zt 7/2— 2 .50 INSPECTION RECORD 2— 5 1.00 5— 15 1.50 15— 50 2.50 50-200 5.00 /IAA .ca r SIGNS: NO. TRANS. NO. LAMPS SERVICE 0-600V 1.00 / C6 !' SERVICE OVER 600V 5.00 MI SC. i WIRING PERMIT 1.00 Y D jf FIXTURE PERMIT 1.00 �® SUPPLEMENTARY PERMIT .50 TOTAL FEE $ APPROVALS 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY y„ CONDUIT r WITH ALL. COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR Ij �r♦ ,,/I�.,. �.,Q LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES '' �-1(�♦ I`�''x ,,� j %r�f CALIFORNIA OR THAT I AM THEq LEGAL OWNER OF THE AB VE DESCRIBED RESIDENTI ^•PR ERTV.Y I - POWER SIGNATURE r � i UTILITY CO.NOTIFIED OF PERM=Eeoz FINAL -E.�'A QAi1'iTd.I - `,' LIDATION ARTHUR C.`V EIT, MO CASH SUPERVISING ELECTRICAL ENGINEER ...Aro 6 9 2 5 NOT 2 4 2 A 5.15 I WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT LJ I hereby affirm that I have a certificate of consent to self insure, 76A663 or a certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec. 3800 Lab.C.) Policy No. Company FOR APPLICANT TO FILL IN JOB A ADDRESS Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE $ $ LOCALITY ❑. Certified copy is filed with the county building inspection 1 &2-Family,Sq.Ft. department. Multi-family Sq.Ft. CROSS ST. �r/f �64,04 Date, Applicant Residential Swimming Pools ASSESSOR MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec. �_Sw. OWNER OR COMPENSATION INSURANCE Light FIRM NAME First 20 A '/ - MAIL / q (This section need not be completed if the work involved by the Total No. Additional ADDRESS d _' p perSnit is for one hundred dollars($100)or less.) _ 1 certify that in the performance of the work for which this per CITY � 7e1.No, is issued, I shall not employ any person in any manner so a PLAN CHECK become subject to the Workers'Compen tion L Vis. Lighting Fixtures/� First 20 APPLICANT Total No. + Additional 12 1' 719 ADDRESS Date � � Applic � � NOTICE TO APPLICANT: If, er making Certificate of RESIDENTIAL APPLIANCES NOT OVER 3 HP. CITY Tel.No. Exemption, you should become subject to the W rl rs' Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code, you must forthwith comply with such PERMIT GTS provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances. APPLICANT C7/Y LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS �l 1 hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. p (commencing with Section 7000) of Division 3•of the Business and CITY Tel.No. - Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. >_ Over 50 to 100 Incl. LICENSE B REG.NUMBER Class. d Over 100 DISTRICT NO. PR CESSED BY Q License Number ( Lic.Class G V Y/' Services,Swbd.,MCQ_&Panelhoards d X Contractop /C 'Date Vr/ Z 0-399 mp.fn 600 V / FINAL 0 ❑ I am exempt under Sec. 400-1000 Amp,Under 600 V ? ~ Over 1000 Amp.or Over 600 V FINAL 7 ) VALIDATION W B.&P.C.for this reason BRANCH CIRCUIT FEES BY 15A,or 20A, 120V,Lighting or Recept. Z Date: _ 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits 3307 2.1.Jy Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits — - �L SINGLE FAMILY i�EI Sys Temp.Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION 7 i I hereby affirm that I am exempt from the Contractor's License,Law Sign with One Branch Circuit ""' TOTAL r O i AL 1 5. 59 for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits . qq C Code): � 1,{ ❑ I, as owner of the property,will do the work and the structure Misc.Conduits&Conductors 'HANG—� o Ll is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) and Professions Code). CONSTRUCTION LENDING AGENCY t tt 1/22/93 i 4 I hereby affirm that there is a construction lending agency for the 7765 1 AM 9:07 performance of the work for which this permit is issued(Sec. 3097, PERMIT FEE (Sub-Total) �f Civ. C.) PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address I certify that I have read this application and under penalty of purjury state TOTAL FEE that the above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring,and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE . SIGNATURE.OF PERMITTEE DATE '