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Home My Public Portal About9537 LONGDEN AVE_Electrical__ 76AAS-E aO@ 8-62 APPLICATION FOR -ELECTRICAL PERMITNTY OF LOS ANGELES ; rDEPAROTMENT-OF COUNTY ENGINEER FNEAREST BUILDING AND SAFETY DIVISION S� 4 JOHN A. LAM'BIE, COUNTY ENGINEER 1 i WILLIAM A.JENSEN,'SUP'T OF BUILDING ?moll C// T. FOR APPLICANT.TO FILL IN /MAO S,9 . RECEPT. TOTAL NO. I EACH FEE .�• � LIGHT OUTLETS FIRST 20 4.20111 2-0OWNERMAIL d ADD'L .10 ADDRESS OVER SWITCH. ' LIGHTINGU-2--lOvIiR OTAL FIRST 20 .20, CITY (r�-e Qr TEL.NO. FIXTURES, D 20 t.o ELECTRICIAN x 4cc—'e.., / RANGER CLO.DRYERS WTR.HTRS. ` 1.00 ADDRESS GARB..DISP. .STA.COOK CITY 7HA a—Ce—Ily TEL.NO. �5''i-to®I DISHWASH. AUTO.-WASH. STATE a� SPACE HTRS. STA.APP.('/s H.P.MAX.) .50 ,��Q LICENSE NO. MOTORS: OVER NOT OVER H.P. .DISTRCT GROMP ONE ESSED B � O t 1.00 t 3 1.5o INSPECTION RECORD- 3 B 2.00 s is 2.50 t S so 3.00 a J SO too 5.00 VO SIGNS: NO.TRANS- NO.LAMPS OO, SERVICE 0.60OV-NOT OVER 200A 1.00 W SERVICE 0.600V-OVER 200 A. 2.00 _ Z SERVICE OVER 600V r 5_.00 Misc. 1 PERMIT ISSUING FEE 2.00 SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE S 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE/ INSPECTOR'S SIGNATURE AND.STATE THAT THE ABOVE IS CORRECT'AND AGREE TO COMPLY CONDUIT WITH ALL•COUNTY ORDINANCES'AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING 113/( !� I HEREBY CERTIFY THAT 'I AM PROPERLY REGISTERED AND/OR r ,/ LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES 7 '1 l— I .F' a CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE i DEBCRIBED RESIDENTIAL PROPERTY. /POWER ` SIGNATURE I UTILITY CO.NOTIFIED ) ' OF PERMITTEE FINAL zz -6 �1 (DATION ARTHUR c. vEl C OG CASH SUPERVISING ELECTRICAL ENGINEER J_ U .9 G JUI4 12 2 D 5.J 0~ .K' I 11VORKECOMPENSATION DECLARATION 76A66310 81 APPLICATION FOR ELECTRICAL PERMIT tthhereby affirm that I have a certificate of consent to self ' CE-806G insure, or a certificate'of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified c py ereof(Sec. 3800, Lab. CJ i Policy No. Company FOR APPLICANT TO FILL IN JOB gDDRESS ❑ Certified copy is hereby furnished. EACH NO. FEE New Residential Bldgs. &Pools • em — S Certified copy is filed with the county. building1 A 2-Fomil $ LOCALITY inspec- y, Sq. Ft. tion department. ®/�/{ Multi-family Sq. Ft. NEAREST CROSS ST. Date R I�"�-4 aFP Residential.Swimming Pools OWNER OR �//�� Applicant- FIRM NAME N CERTIFICATE OF EXEMPTION FROM WORKERS' I Outlets: Rec�LightSw.� MAIL p COMPENSATION INSURANCE ' ADDRESS � N-e� (This section need not be completed if the work involved by First 20 the permit is for one hundred dollars($100)or less:) Total No. Additional CITY �, a Tel. No. W��3r I certify that in the performance of the work for which this PLAN CHECK 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 I' Total No. Additional �, CITY Tel. No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers.' Range_ Heater._D.W. APPLICANT Compensation provisions of the Labor.Code, you must forth- Oven _Dryer W.M.._._ ADDRESS '-g with comply with such provisions or this permit shall be Top _ FAL; W.H. — ` deemed revoked.. CITY '' Tel.No. LICENSED CONTRACTORS DECLARATION Hood _ Fan —.Other— 7. Disp. Room Air Cond. LICENSE OR Class. /! j hereby q#irm that I am licensed under provisions of Chapter 9 REG.NUMBER 2-70 1 —ZO (commencing with Section 7000)of Division 3 of the Business power Apparatus 8 Large Appliances DISTRICT NO. PROCE BY O f"t�3 and Professions Code,and my license is in full force and effect. �//'��r/• _�.� Size&Type HP, KW, KVA, or KVAR' Sr ® U License Number ` �iZ[9 Lic. Class vr� p to 1 Incl. FINAL LQ Contractor. Date — ver 1 to 10 Incl. ] DATE ' _ � VALI ION Over 10 to 50 Incl. FINAL 2 Ellam exempt under Sec. Over 50 to 100 Inc: BY N B.BP.C. for this reason i Over 100 Z Date.: Services,Swbd., MCC.&Ponelboards 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 FAMILYA 3 4 2 2 A Temp. Power Pole&Appurtenances HOME OWNER-BUILDER QECLARATION Sign with One Branch Circuit # 0 0 0 0 0 2 I hereby affirm that I am exempt from the Contractor's License Additional SiBh Circuits Low for the following gnrancrcus reason (Section 7031.5, Business and I o 0 2 0 0 Professions Code): ❑ I, as owner of the property, will do the work and the Misc. Conduits&Conductors o 0 0 ,2 4 0 0 6 structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)_ 7044, Business and Professions Code). I ® ( 1, 07-85 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) 3 (Sec. 3097, Civ. C.). I PLAN CHECKING FEE Lender's Name 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 with all County ordinances and State laws regulating Electrical wiring, and ereby authorize representatives of this County to enter upon t e above-m ti n d pro pection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE • � r Signature 0 f Permittee Date WORT EyA'•�OMPENSATION DECLARATION CE-806 ;o,a, APPLICATION FOR ELECTRICAL PERMIT i• y" oo GE-808G I hereby•affirm,:that I}have a certificate of consent to self insure, or a ceYtificate of Workers' Compensation Insurance,or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sea 3800,Lab.C.) Policy..No. Company. FOR APPLICANT TO FILL IN JOB ADDRESS /q 6/-3 / L O –7 h'e/i. Certified copy.is hereby furnished. New Residential Bldgs.&Pools EACH NO. FEE ❑ 1 &2'-Famlly,Sq.Ft. $ — $ LOCALITY Certified copy is'filed with the county building inspection department. Multi-family Sq.Ft. NEAREST CROSS ST k i m p–B 5 , " U e,.. 'Date Applicant Residential Sw.imming.Pools, OWNER OR. CERTIFICATE OF EXEMPTION FROM WORKERS' 7 A �= "FIRM NAME Do.�i;Tt} Nb C1 Outlets:RecA_Light Sw.— � MAIL COMPENSATION INSURANCE S Z' ADDRESS SI-537 (This section need.hot be completed if the work Involved by the First 20 • • P Total No.; Additiohal CITY q 4_ . Lt_6I Tel.No.a.3,[63 r l permit is for one hundred dollars($100)or less.) a PLAN CHECK I certify that.in the performance of the'work for which this permit f APPLICANT 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 t 75 Z ADDRESS �� yy^ Additional d r��,Gl�. Total.No. , CITY Tel'.No. Date � Applicant ) Fixed Appliances Not Over 1 HPPERMIT - - NOTICE TO APPLICANT: If, after making this Certificate of Exemption,you should become subject to the Workers'Compensation Range! Heater_ D.W. APPLICANT. _ . provisions of the Labor Code,you must forthwith comply with such Oven _ Dryer_ W.M._ ADDRESS provisions or this permit shall be deemed revoked. Top — FAU _ W.H. LICENSED CONTRACTORS DECLARATION Hood — Fan _ OtherCITY Tel.No. . _ I hereby affirm that I am licensed under provisions of Chapter 8 ,• LICENSE OR (commencing with Section 7000)•of Division 3 of the Business and Disp. — Room Air Cond. REG.NUMBER Claw. Professions Code,and my license is in full force and effect. Power Apparatus&Large Appliances DISTRICT NO. PROCESSED BY Size&Type HP,KW,KVA;.or KVAR �./ 6Y License Number Lic.Class T Up to 1 Inc]. FINAL `h� V Over 1 to 10 Incl. DATE � Contractor ,Date ' VALIDATION 0 Over 10 to 50 Incl. FI ❑ I am exempt under Sec. Over 50 to 100 Inc. BY W BAP.C.'for this reason. Over 100 p, I Services,Swbd.,MCC&Panelboards Cl) Date: 0:200 Amp.Under 600 V es Signature 201 - 1000 Amp.Under 600 V .288915 ❑ Exemption for Reg.Maint.ElecOver 1000 Amp.or Over 600 V " J Elect. Over o a o SINGLE FAMILY Temp:Power Pole&Appurtenances 0 0 HOME OWNER-BUILDER DECLARATION Sign with.One Branch Circuit O I hereby affirm that I am exempt from the Contractor's License Law o o ,!4,0 0 C5 for the following reason(Section 7031.5,Business and Professions Additional Sign Branch Circuits Code): 0 2.0 2-8 8 Misc.Conduits&-Conductors I,as owner of the property,will do the work and the structure is not intended or offered for sale (Section 7044, Business i Other(See Complete Fee Schedule) _ pool o° and Professions Code). CONSTRUCTION LENDING AGENCY 021 9—.88 1 hereby affirm that there is a construction-lending agency for the 1:,. performance of the work for which this,permit is issued(Sec.3097„• PERMIT FEE (Sub-Total), Civ.C.). Lender's Name f �es'1 7�/b ' 1 000 qg'tt I PLAN CHECKING FEE L) PERMIT ISSUING FEE Lender's Address 7 . GO 1VL�.D eJL) I certify that I have read this application and state that the above i TOTAL FEE GRJ 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. 6u SEE REVERSE FOR EXPLANATORY LANGUAGE k1G�-c,y-Z�, /.lv0U� o 1�J'1� Signature of Perithittee Date