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Home My Public Portal About9632 1/2 LONGDEN AVE_Electrical__ 76A60 CEAM(11 /78) APPLICATION ® ��EC7R CAL PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN ;OB New Residential Bldgs.&Pools EACH NO FEE ADDRESS 7 ems../c�• LC �G�'Ek &2-Family,Sq. Ft. 02 �' $ 025 — $ LOCALITY �GCdI/�IOCtG C/7- Multi-family /TMulti-family Sq.Ft. 02 CROSS ST NEAREST 2/T )UV.L> Residential Swimming Pools 25 00 OWNER OR FIRM NAME /N Outlets.Rec Light Sw. MA-L First 20 50 ADDRESS 1 7 f? -40LL b e- Total No. Additional 30 CITY �(�t) Te, No f1/7ls PLAN CHECK APPLICANT ' Lighting Fixtures First 20 .50 ADDRESS Additionai 30 Total No. CITY Te; No Fixed Appliances Not Over 1 HP PERMIT Range—Heater—D.W APPLICANT GGA Oven—Dryer_W.M— ADDRESS Top _FAU —W.H._ CITY Tel N Hood—Fan —Other LICENSE OR j v g Disp._Room Air Cond. 2.50 REG NLMBER / IJ , U 3 2— Class I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APP ICA 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 LAIAS YP REGULA'ING ELECTRICAL WIRING Up to 1 Incl 2.50 I HEREBY CERTIFY THAT I A PROPERLY REGIST ERED AND.OR V Over 1 to 10 Incl. 5 CO LICENSED AS REQ_IRED BY LOS ANGELES COUNTY AND STATE OF ; C+ Over 10 to 50 Incl 1250 CALIFORN A OR THAT I AM THE LEGAL OWNER OFABOVE 25.00 DESCRIBED RESIDENTIAL tRTr (- Over 50 to 100 Inc 4000 N %A TE E '�i P Over 100 S_NAT,,kF UZ 'Services � 12 50 DISTRICT NO F .E ED BY 0-200 Amp Under 600 V ( •> 201.1000 Amp Under 600 V 2500 e U � ��'e' Over 1000 Amp or Over 600 V 5000 Z O Temp.Power Pole&Appurtenances 10 OC c Sign with One Branch Circuit 10.0C Additional Sign Branch Circuits 200 INSPECTION � Misc Conduits&Conductors 1000 INFORMATION ORI REVERSE x Other-See Complete Fee Schedule. SIDE u Q d PERMIT FEE Sub Total PLAN CHECKING FEE One-Fourth Permit Fee A PERMIT ISSUING FEE $700 % G TOTAL FEE ?� > INSPECTION FINALED a W 0. date: r ^ r� )-c By `, j n J vs IeAeesC- CFeGeB*IZ,75 - APPLICATIO FOR ELECTRICAL PERMIT BUILDI AND SAFETY DIV N FOR APPLICANT TO FILL IN ,JOB New Residential Bldgs.&Pools EACH NO. FEE ADDRESS &3 1 &2 Finaily Sq. Ft. $ — $ LOCALITY �47LOf.0 Multi-family Sq. Ft. — NEAREST 8LJ,D CROSS ST. Residential Swimming Pools OWNER OR FIRM NAME Outlets: Light,Switch&Receptacle MAI L ADDRESS [.) 6oGL r /gPfC. First 20 Q ai n� /, Additibnal - CITY 12C;412 A Tel. No. 7 7 5 PLAN CHECK Lighting Fixtures APPLICANT First 20ADDRESS Additional CITY Tel.No. PERMIT Fixed Appliances Not Ovet 1 HP APPLICANT Range__�_ Heater D.W. ADDRESS Oven X Dryer W.M. Top X FAU W.H. CITY Tel. No. Hood Fan LICENSE OR / V o REG. NUMBER r 9 0 J Z' Class. Disp. A.C. - v 1 HERDOY ACKNOWLCOGE THAT 1 HAVE ROAD THIS APPLICATION Q ANO STATE THAT TND ADOVE IS CORRECT AND AGREE TO COMPLY I__ Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING tV ELECTRICAL IY IRING. 0- Size&Type HP, KW,KVA,or KVAR GO Up to 1 Incl. I HOROBY CERTIFY THAT I AM PROPERLY RCGIGTCRCO AND/OR 2-1 Over 1 to 10 Incl. LIC13NSCD AS RCOUIRED BY LOS ANGELES CO=VC OF CALIFORNIA OR THAT 1 AM M LEGAL OW Over 10 to 50 Incl. DESCRIBED REGIDENTIA R •TY, Over 50 to 100 Incl. PERMITEE Over 100 SIGNATURE DISTRICT NOj, ROC SED BY Services 41 0-200 Amp. Under 600 V 201 -1000 Amp. Under 600 V APPROVALS DATE INSP OR'S Over 1000 Amp.or Over 600 V SI ATURE TEMP.POWER POLE Temp.Power Pole&Appurtenances UNDERSLAB WORK Sign with One Branch Circuit Additional Sign Branch Circuits ROUGH CONDUIT (Other) IRING XTURES WER AUTHORIZED PERMIT FEE (Sub-Total) UINAL TILITY CO.NOTIFIED PLAN CHECKING FEE (One-Fourth Permit Fee) PERMIT ISSUING FEE OTES TOTALFEE PLAN CHECK VALIDATION CK. M.O. I CASH PERMIT VALIDATION CK. M.O. CASH �=( Z- 7,/2- g-WORKERS'hive a car Moats DECLARATION 76-863 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I hive a cerfSicate of consent to self insure, CE-608G or a certificate of WorkgL; Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec.3800,Lab.C.) � cy No. Company FOR APPLICANT TO FILL IN JOB ADDRESS L Certified copy is hereby furnished. New Residential Bldgs.&Pools EACH NO. FEE +_ $ LOCALITY_ Certified copy is filed with the county building inspection 1 &2-Family,Sq.Ft. $ _ NEAREST department. Multi-family Sq.Ft. CROSS ST. Date Applicant Residential Swimming Pools OWNER OR FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL COMPENSATION INSURANCE Outlets:Rao—Light— Sw.— ADDRESS (This section need not be completed if the work involved by the First 20 CITY Tel.No. permit is for one hundred dollars($100)or less.) Total No. Additional I certify that in the performance of the work for which this permit PLANCHECKis 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 Appli nt Fixed Appliances Not Over 1 HPPERMIT NOTICE TO APPLICANT: If, after m r i I this Cec e f APPLICANT Exemption,you should become subject to the Workers'Compens wn Range— Heater— D.W. — 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 Other— CITY Tel.No. I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. LICENSE OR REG.NUMBER 10..l Class. C (� (commencing with Section 7000) of Division 3 of the Business and Professions Code,and my license is in full force and effect. DISTRICT NO. PROCESSED Power Apparatus&Large Appliances License Number ��y Lic.Class I(� Size&Type HP,KW,KVA,or KVAR V 8 Up to 1 Incl. FINAL Over 1 to 10 Incl. DATE VALI -TION0 Contra Date FINAL l/ 0 ❑ Over 10 to 50 Incl. I am exempt under Sec. Over 50 to 100 Inc. BY B.&P.C.for this reason Over 100 Date: Services,Swbd.,MCC&Panelboards ® N 0-200 Amp.Under 600 V r` Signature 201 - 1000 Amp.Under 600 V Over 1000 Amp.or Over 600 V Exemption for Reg.Maint.Elect. --894 /A SINGLE FAMILY Temp.Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATIONr o 0 0 0 0 2 Sign with One Branch Circuit 1 hereby affirm that I am exempt from the Contractor's License Law Additional Sign Branch Circuits 0 o i./�� for the following reason(Section 7031.5,Business and Professions G 5,..V Code): Misc.Conduits&Conductors o c u "15 : El I,as owner of the property,will do the work and the structure See Complete Fee Schedule is not intended or offered for sale (Section 7044, Business Other( ) — u G 1 o-38 and Professions Code).. 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) Civ.C.). PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE 10 Lender's Address I certify that I have read this application and state that the above TOTAL FEE elle— I 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 inspectipR purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE 2 �. QIft6re of Permittee Date