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Home My Public Portal About9038 LONGDEN AVE_Electrical__ f76A669-CE806-7-56 APPLIC-ATION FOR ELECTRIC PERMIT } BUILDING AND SAFETY DIVISION Department of County Engineer S U I LD I N G County of Los Angeles _ ADDRESS JOHN-A, LAMBIE, COUNTY ENGINEER +�> CASSATT'1D. GRIFFIN, SUP T OF BUILDING LOCALITY p` OV FOR APPLICANT TO FILL IN NEAREST I CROSS ST {I PERMIT FEES �NUPBERJ OWNER r� '1`_'` LIGHT OUTLETS 1 , MAIL ADDRESS v, RECEPTACLES 'i WALL SWITCHES FEE CITY /Q TEL NO +� TOTAL OUTLETS @ 5Q $ ELECTRICIAN /J I ELEC RANGES 25 ADDRESS ," ELEC HEATERS 25 CIT — TEL NO t KW EA i •STATE ., LICENSE NO (...i FIXTURES 5 MOTORS = DISTRICT NO. I GROU ZONE oREADY FOR INSPECTION NUMBER HORSEPOWER FEEJ, NEW MVD HP OVER INC EACH 1/2&LESS $ .25 - INSPECTION RECORD t/Z 2 .50 2 5 1.00 - 5 15 1.50 15 50 2 50 50 200 5 00 M ISC NO SIGNS NO TRANS NO SIGNS NO LAMPS- , jF.OR EACH PERMIT e WIRING PERMIT v'`• $1 00 FIXTURE PERMIT SI 00 SUPPLEMENTARY .50 APPROVALS TOTAL FEE $ ' DATE INSPECTOR'S SIGNATURE t I FjEREBY AC LEDGE THAT.I HAVE READ THIS APPLICATION CONDUIT - - AND STATE T THE ABOVE IS CORRECT AND AGREE TO COMPLY r WITH ALL COUNTY 'ORDINANCES AND STATE LAWS REGULATING WIRING — ELECTRICA WIRING.. • I HEREBY CERTIFY THAT 1 AM ,PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF POWER CALIFORNIA OR THAT, I: AM THE, LEGAL OWNER OF THF..-,ABOVE DESCRIBED RESIDEN A . ER �.� f UTILITY CO NOTIFIED SIGNATURE Lr - OF PERMITTEE FINAL `JOHN A. LAMBIE. r VALIDAUDA, ARTHUR C. VEIT. �Q CK MO CASH COUNTY ENGINEER �H SUPERVISING ELECTRICAL ENGINEER - COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY WILLIAM J. FOX, County Engineer FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ONE PERMIT NO. ELECTRICIAN Y _- - ®wn ADDRESS D 3 ,,,1 �� RECEIVED BY READY FOR DAT {9$UED FIRST INSPECTION CITY - �cM frC� t / TEL. NO. J COUNTY LICENSE NO. EXPIRES BUILDING }� PERMIT FEES ADDRESS /1_ C) _ 7� NUMBER EACH FEE LOCALITY e_! LIGHT OUTLETS NEAREST q✓' �T v RECEPTACLES 6/ Z- f/L /_ �A CR OBB ST. •� �� ^, _ WALL SWITCHES OWNER f f� • � /V TOTAL OUTLETS MAIL ELEC. RANGES 25 ADDRESS 9c� 3 % • �'(J �+� ELEC. HEATERS 26 CITY , /' �� 4 �� EL. NO. � �.3..5 7 FIXTURES - 5 1 HEREBY ACKNOWLEDGE HAT 1 HAVE READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE IS 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 HORSEPOWER FEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER NEW MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRI E ABOVE. a LESS $ .25 SIGNATURE OF77 y 2 .50 PERMITTEES - 2 B 1'00INSPECTION RECORD 5 1s 1 1.50 is 50 2.50 60 200 5.00 200 BOO 10.00 J SOO 1000 15.00 Q Z OVER 1000 20.00 M.O. SET/FREQ. CHANGER-HP WELDERS:AC-KVA �� (�,�� O GENERATORS - KW TRANSFORMERS - KVA L•T' rr ra. ''IIy TEMP. MOTORS (75% OF ORIBJ MOVED MOTORS (75% OF ORIG.) MISC. 6-c SIGNS NO. NO.TRANS. APPROVALS NO, NO. LAMPS FOR EACH PERMIT: DATE _INSPECTOR'S NAME WIRING $1.00 CONDUIT FIXTURED $1.00 old WIRING Z 1/- I UPPLEMENTARY .SO I FIXTURES POWER _ TOTAL FEE r8 4FINAL UTILITY CO.NOTIFIED 76A663 DBS#SA 1-53 WORKERS'COMPENSATION DECLARATION 76-806 to/St Afl'AP C 6�MON FOR E E�STMC p p p�ERNT I hereby-affirm that I have a certificate of consent to self insure, CE-Bose 1� I Iy LW II�1 16. L'�ll� Ir tl"9tlH0 or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy !Hereof(Sec 3800,Lab'C) Policy No Company FOR APPLICANT TO FILL IN JOB ❑ ,i ADDRESS Certified copy Is hereby furnished -New Residential Bldgs & Pools EACH NO FEE, 1 &'2Family,Sq Ft $ — $ LOCALITY ❑: Certified copy is filed with the county bud - ding inspection _ NEAREST department ' ; Multi-family Sq Ft CROSS ST •, Date Applicant nW ntlal Swimming Pools wNER oRl INAMECERTIFICATE OF,EXEMPTION FROM WORKERS' ec�_ Light 1 Sw'L E) MAIL �j/i� _� �/" COMPENSATION INSURANCE i Q S v (This section need not be completed If the work involved by the First 20 CITY permit Is for,one hundred dollars($100)or less) Total No Additional ^fl vG. d certifythat,in the-performance of the work for which this permit PLAN.0 NT ; P ,P _ APPLICANT ?; Is,issued,,I shall„not employ any-person,in any manner so as to ,become subject. to#7,Workers'Compensation Laws Lighting Fixtures . ;First 20 ADDRESS'• Additional Total No CITY Tel No Date r 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'Compensation Range_ HeaterA�WH DW M1 provisions of the-Labor Code, you'must forthwith comply with such Oven _ Dryer ADDRESS' ,1provlslons,or this permif shall be deemed revoked 'Top � — FAU CITY Tel No LICENSED CONTRACTORS DECLARATION Hood — Fan Other ' I hereby affirm that I am licensed under provisions of Chapter 9 Dis Room•Air Cond LICENSE OR nClass (commencing with Section 7000) of Division 3 of the'Business and• p REG NUMBER Professions Code,and my license is in full force and effect' Power,Apparatus& Large Appliances DISTRICT'No i PR ED BY ai Size& Type HP,KW,KVA,or'KVAR Q dQ License NumberLic Class Up to 1 Incl' �� U FINAL V Over 1 to 10 Incl DATE VALIDATION Q Contractor Date Over-10,to,50 Incl C/ U ❑ FINAL I am exempt under Sec � Over 50 to 100 Inc BYW "B&PC for this reason Over 100 ). C _ Services;S & Panelboards ? Z: - Date o- 00 Am I In nr R00 V, Signature ^201 - 1000 Amp Under 600 V - 1�. .I °a Over 1000 Amp or Over 600 V —= -- ❑ Exemption for Reg Malnt Elect SINGLE FAMILY Temp'Power Pole& Appurtenances i .I TON F HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit _ --° ` 1 hereby affirm that I am exempt from the Contractor's License Law TCIT,;' 164._ -La L 1 for the following reason(Section 7031 5, Business and Professions Additional Sign Branch Circuits r j �Code) �•rl_�'f .i.�-t°_. Mlsc Conduits& Conductors er ofthe property,will do the work and the structure is not Intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) and Professions Code) D CONSTRUCTION LENDING AGENCY 1 hereby affirm that there I'S a construction lending agency'for the 1 ., }7 performance of the work for which this permit is Issued,(Sec 3097, PERMITTEE (Sub Total) - y+ Clv C), ” _.PLAN CHECKING FEE. Lender's Name PERMIT'ISSUING FEE Lender's Address I certify that I have read this application and state that the above _ TOTAL FEE ,� Y 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 1. property for Inspection purposes SEE REVERSE,FOR,EXPLANATORY LANGUAGE Signature of Permittee '," ��ate '_