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HomeMy Public PortalAbout9180 LONGDEN AVE_Electrical__ 7GA66C-CE#806 5-6I APPLICATION FOR ELECTRICAL PERMIT RMIT COUNTY OF LOS ANGELES DEPARMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS. ,G JOHN A. LAMBIE. COUNTY ENGINEER Az WILLIAM A.JENSEN.SUPT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. C PERMIT FEES OWNER 2 G 1 T E M NUmj3zRj EACH FEE MAIL OUTLETS: 1 S $ ADDRESS LIGHTS RECEPT. SW. .10 CITY TEL.NO. LIGHTING FIXTURES ELEC.RANGES .CLO.DRYERS .10 ELECTRICIAN 111S�J� C WATER HEATERSI� .50 © ADDRESS /] ELEC.SPACE HTRS. DISHWASHERS CITY –4rEL NO GARBAGE DISPOSERS AUTO.- STATE / WASHERS STA.COOKING UNITS ,25 LICENSE NO. MOTORS: OVER INC. H.P. DIS IC NO. I G OUP ZONE P CESSED BY 0. 1/s ,25 a 1/2— 2 soNSPECTIO ORD/ 2— 5 1.00 5— 15 / -0- 1.50 / : -•rV7 Is— So2.80 1 OG O DO— 200 5.00 SIGNS: NO TRANS. f H NO.LAMPS % i Z z SERVICE 0-600V 1.00 a SERVICE OVER 600V 5.00 MISC. WIRING PERMIT 1.00 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT 50 TOTAL FEE S I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS : DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY Y WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT - ELECTRICAL WIRING. WIRING /j* I��/J�} 'I.1,} '• ,�;r� IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT 1 AM LE O ER OF THE ABOVE 1 DESCRIBED RESIDENTIAL PRO RTY. POWER SIGNATURE UTILITY CO.NOTIFIED % :~ / •r OF PERMITTER FINAL 1 i' /•� �,: s ' a / �LIDATION ARTikUR C.VEIT ^� MO CASH SUPERVISING ELECTRICAL ENGINEER \`cy/`/LAPs o s HB 3 2 0 1650 TION 76A66 WORKERS't I have a certificate DECLARATION CE-806 10i81 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, l COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof(Sec. 3600, Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB r.'10 ne�.` Certified copy is herebyfurnished. EACH NO. FEE ADDRESS 4 t New Residential Bldgs..6'Pools ❑ Certified copy is filed with the county building inspec- ) 1 8 2-Family, Sq. Ft. — $ LOCALITY .tion,department: Multi-family Sq. Ft. — NEAREST r Residential Swimming.Pools CROSS ST, OWNER OR Date Applicant FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' I Outlets: Rec Light Sw._ MAIL COMPENSATION INSURANCE ' First 20 ADDRESS (This section need not be completed if the work involved by Total No. Additional CITY Tel. No. �b the permit is for one hundred dollars($100)or less.) PLAN CHECK I certify that in the 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 Workers'Compensation.Laws. Lighting Fixtures First 20 ADDRESS Total No. Additional Date pplicant SAN ` i CITY Tel. No. ' NOTICE TO APPLICANT: If, after m king his Certificate of FixedAppliances Not Over 1 HP j PERMIT Exemption, you should become subject to the Workers' Range_ Heater_D.W: APPLICANT e Compensation provisions of the Labor Code, you must forth- Oven _Dryer —W.M. ADDRESS with comply with 'such provisions or this permitshall be Top. _ FAU —.W.H. deemed revoked. j Hood _ Fan _Other_ CITY II, tt J,jl[D Tel. No. LICENSED CONTRACTORS DECLARATION ^ �`I� ! Dis Room Air Cond. j LICENSE OR d. 1 hereby affirm that I am licensed under provisions of Chapter 9 p' REG.NUMBER Clcss. (commencing with Section 7000),of Division 3 of the Business I power Apparatus li Large Appliances DISTRICT NO. PROCE BY and Professions Code,and my license is in full force and effect. 0 j Size&Type HP, KW, KVA, or KVAR` L 0 License Number Lic. ClassUp to 1 Incl. FINAL . l o + 1: - I ' Contractor Date ��-16 Over 1'to 10 Incl: Q j DATEVAL ATION f.: ❑ Over 10 to 50 Incl. FINAL lam exempt under Sec. Over 50 to 100 Inc. BY p' B.BP.C.for this reason i Over 100 Z ' Services, Swbd.,MCC&Panelboards j ► Date: 0=200 Amp. Under 600 V Signature 201 -1000 Amp. Under 600 V i ❑ Over 1000 Amp. or Over 600 V, ) Exemption for Reg. Maint. Elect. j' I ;1511-7 A SINGLE FAMILY, Temp. Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign. with One Branch Circuit i # o 0 0 o b '2 I hereby affirm that I am exempt from the Contractor's License l Aditional Sign Branch Circuits Law for the following reason (Sect!on 7031.5, Business and Professions Code): _� I ) 0 0 2 5 Q j ❑ 1, as owner of the property, will do the work and the Misc. Conduits 6 Conductors 0 0 0 2 5 cj Q 535 structure is not intended'or offered for sale (Section Other(See Complete Fee Schedule)_ 7044, Business,and Professions Code). j , 0 T2 4' 8 6 - CONSTRUCTION LENDING AGENCY i 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) U, (Sec. 3097, Civ. C:.): i PLAN CHECKING FEE Lender's Name I PERMIT ISSUING FEE 10 Lender's Address I:certify that I have read this application and.state that.the I TOTAL FEE. 49 above information is correct. I agree to comply with all County I ordinances and State laws regulating Electrical wiring, and I' hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. { SEE REVERSE FOR EXPLANATORY LANGUAGE i • I ! Signature of Permittee Date