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HomeMy Public PortalAbout9638-9640 LONGDEN AVE_Electrical__ 7SA663-CES06 468 APPLICATION FOR EL-ECTR�AL RM COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER FLOC7ALI �. BUILDING AND SAFETY DIVISION JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDINGFOR APPLICANT TO FILL IN . AREST NO. EACH FEE CROSS ST. $ $ RECEPT._ OWNERMAIL LIGHT TOTAL FIRST-20 .20 ADDRESS 'SWITCH_ OVER 20 .10 CITY TEL. N22&- PLAN CHECK LIGHTING �TOTAL. FIRST 20 .20 APPLICANT FIXTURES OVER 20 1 .10 ADDRESS RANGE_DRYER—WTR.HTR._ CITY TEL. NO. STA.COOK_DISP._F.A.U._ CONTRA&TOR Ll oze:c T- SPACE HTR. AIR COND._Z__ ADDREqer _�44 15 '� r�S CLOTHES WASH.—DISHWASH._ CIT TEL. .. FAN—OTHER t.00 LICENSE 1J0. CLAS MOTORS.TRANSFORMERS RATING IND. HEATERS, ETC. HP. KW. KVA. 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION SIZE & TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY. ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING- 0 - 1 1.00 1 HEREBY CERTIFY THAT I AM. PROPERLY REGISTERED AND/OR 1 - 10 3.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF _ CALIFORNIA OR THAT 1 AM 10 - 50 5.00 TH EG OW ER OF, AND INTEND TO r RESIDE IN, THE ABOVE ES D ESIDENTIAL PROPERTY. 50 -.100 10.00 SIGNATURE. a OF PERMITTEE CD 100 - Soo 15.00 DIST N GR P ZO E P SIGN,GAS CD TUBE, OR SIGN AND ONE CIRCUIT 3.00 C~.7 MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES a/Q.i y SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 Q Z SERVICE OVER 600 VOLTS OR 206 AMP 5.00 TEMP SERVICE, POLE. IN APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP. POWER POLE UNDERSLAB WORK ROUGH CONDUIT PERMIT FEE (SUB TOTAL) WIRING FIXTURES / PLAN CHECK FEE (50% PERMIT FEE) POWER.AUTHORIZED PERMIT ISSUING FEE 2.00 V, UTILITY CO.NOTIFIED I F64) SUPPLEMENTARY PERMIT ISSUING FEE 1.00 .FINAL v TOTAL FEE JOSEPH C. ROOHAN SUPERVISING ELECTRICAL ENGINEER PLAN CHECK VALIDATION. CK. M.0. CASH PERMIT VALIDATION CK. M.0. Q0 [)r,,o146SP Q918 2 u 5.00~ V -E.BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE `_- WORKERS'COIyPENSATiQN DECLARATION CE-806 to/Bl APPLICATION. FOR ELECTRICAL PERMIT af,i irm that I have a certificate of consent to self CE-806G a ccvtificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY rtified kjAy thereof(Sec.'8800, Lab. C.) No..—Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished. New Residential Bldgs. &Pools EACH rNO FEE ADDRESS LOCALITY tz C Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. $ $ c�tion departmenQt Multi-family Sq. Ft.� NEAREST I C Residential Swimming Pools OWNER OR � Date .r CROSS ST. fFpplicant�(drt&c� ` / "�— .FIRM NAME pact CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec ELight Sw._ MAIL COMPENSATION INSURANCE ADDRESS / First 20 .(This section need not be completed if the work Involved by CITY Tel. No. the permit Is for one hundred dollars(;100)or less.) Total No. Additional I certify that in the performance of the work for which this A PPLALCHECK ICANT 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 Additional Tel. No. ' Total No. CITY Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT a, Inc- Exemption, you should become subject to the Workers' Range_ Heater—D.W. — Compensation provisions of the Labor.Code, you must forth= Oven —Dryer —W.M.— ADDRESS ,[01 Id1 G> r with comply with such provisions or this permit shall be 'Top _ FAU —W.H. —_ ._ CITY Tel. IVo3 deemed revoked. Hood Fan _Other 'LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air,Cond. REG.-NUMBER' If Class. C,%.1a (commencing with Section 7000)of Division 3 of the Business DISTRICT NO. PROC SSED BY and Professions Code,and m license is in full force and effect. Power Apparatus&Large Appliances my &Type HP, KW; KVA, or KVAR. iJ.l U License Number26z?%__ Lie.Class 4-10. Up to 1 Incl. FINAL � Over 1 to 10 Incl. DATE A DATION 8 Contractor �{,,r(/�Q� Date Over 10 to 50 Incl: t" FINAL I am exempt under Sec. Over 50 to 100 Inc. BY LU E] B.&P.C. for this reason Over 100 #A Services, Swbd.., MCC&Ponelboards Date: 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 FAMILY Temp. Power Pole&Appurtenances ;9 7 6 7.5 A HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit # 0 0 0 0 0 2 1 hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits Law for the following reason (Section.7031.5, Business and Professions Code): 31.2 5 ❑ 1, as owner of the property, will.do the work and the Othe Conduits&Conductors ' structure is not. intended or offered for sale (Section , Other(See Complete Fee Schedule)_ ® 0 0 1 31.2 5 7044,Business and Professions Code). CONSTRUCTION LENDING AGENCY 08,14-87 1 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) (Sec. 3097,'Civ. C.). PLAN CHECKING FEE Lend'er's Name PERMIT ISSUING FEE Lender's Address I certify that I have read this application and state that the TOTAL FEE 3 .2 above information is correct. I agree.to comply with all County ordinances and pws regulating Electrical wiring, and hereby au horiz epr entatives of this County to enter upon *6.abov. ment' ne roperty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE g-iJ:!j ature of tt Date WORKERS'COMPENSATION DECLARATION ' 76A663 10/61 CE-8066 APPLICATION FOR ELECTRICAL PERMIT 4.herebypaffirm that I have a certificate of consent to self insure, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof(Sec. 3800, Lab. C..) i Policy No. Company FOR APPLICANT TO FILL IN JOB / 2Xoq Certified copy is hereby furnished. EACH NO. FEE ADDRESS �t7 New Residential Bldgs. &Pools ❑ 9 LOCALITY Certified cbpy is filed with the cou building nsp'e - 1 &2-Family, S Ft. $ $ �+ tion department. Multi-family Sq, Ft. — NEAREST CROSS ST: Re ' ential Swimming Pools OWNER OR Date Applicant , FIRM NAME �' /� • - CERTIFICATE OF EXEMPTIO ROM WORKERS' MAIL O f�kv COMPENSATION I SURANCE i Outlets: Rec Light Sw._ ADDRESS-?,, v (This section need not be completed if the work Involved by First 20 Total No. Additional CITY j)�y©W kyo Tel. No �JJrG3 the permit is for one hundred dollars(;100)or less.) j PLAN CHECK I certify that in the performance of the work for which this i 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 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,Wbrkers' Range_ Fleater_D.W. APPLICA T ej(�-7� �� Compensation provisions of the Labor Code, you must'forth- Oven —Dryer _W.M.— ADDRESS with comply with•such provisions or this permit shall be Top _ FAU —.W.H. — deemed revoked. I Hood _ Fan _Other— CITY Tel, No. LICENSED CONTRACTORS DECLARATION Room Air Cond. LICENSE OR / I hereby affirm that I am licensed under provisions of Chapter 9 Disp. _ REG.NUMBER Class. (commencing with Section 7000)of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NO. PROCESSED BY and Professions Code,and my license is in full force and effect. Size&Type HP, KW, KVA, or KVAR' I L O License Number Lic: Class Up to 1 Incl. FINAL Over 1 to 10 Incl. DATE (JJJ VALIDA N 09 Contractor Date I ❑ Over 10!a 50 Incl. A t under Sec. i FINAL I am exempt Over 50 to.100 Inc. BY B.&P.C. for this reason I Over 100 / y Date: I Services, Swbd., MCC&Panelboards 0 -200 Amp. Under 600 V Signature 201 -1000 Amp. Under 600 V Over 1000 Amp. or Over 600 V❑, 7 4 7 A Exemption for Reg..Maint. Elect. SINGLE FAMILY Temp. Power Pole&Appurtenances # 0 0 0 0 0 2 HOMEOWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Additional SiBranch Circuits Law for the following reason (Section 7031:5, Business aonaSign rcus o 0 and ( 2 a 5 O Professions Code): o 0 0 2 Jr O c=i ❑ I, as owner of the property, will do the work and the Misc. Conduits&Conductors structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)_ ® 0 TO 9 g 7 7044, Business 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 PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name / PERMIT ISSUING FEE [� , Lender's Address t-y� 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 an Stat laws regulating.Electrical wiring, and. hereby author! r esentatives of this County to enter upon th bove-me Io property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE ig.nature f Permittee Date WORKERS:rCO/VfPENSATIQN DECLARATION 10/81 CE-806G APPLICATION FOR ELECTRICAL PERMIT Affirm that. I 'ave a certificate of consent to self CE-806 a car(ificate f workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof(Secr'3800,,Lab. C.) . :.� Policy No. Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished. EACH NO. FEE ADDRESS New Residential Bldgs. &Pool LOCALITY t .Certified copy is filed with the county building inspec- 19 2-Family, Sq. Ft. 7,� $ _ $ tion department. fA��! Multi-family Sq. Ft. NEARESTCROSS ST. c � Date L` Applicant Residential Swimming Pools OWNER OR o 1 FIRM NAME L CERTIFICATE OF EXEMPTION'FROM WORKERS' OutMAIL Outlets: Rec Light Sw._ COMPENSATION INSURANCE First 20 ADDRESS (This section need not be completed if the work Involved by Total No. Additional CITY Tel. No. the permit is for one hundred dollars($100)or less.) I certifythat in the performance of the work for which this PLAN CHECK p 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 CITY Tel. No. Date 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' Range— Heater_D.W. _ �e— Compensation provisions of the Labor Code, you must forth- Oven —Dryer _W.M.— ADDRESS 110 with comply with such provisions or this. permit shall be Top — FAU —W.H. — CITYTel. No:deemed revoked. Hood —.Fan _Other— LICENSED'CONTRACTORS DECLARATION LICENSE. R I hereby affirm that I am licensed under provisions of Chapter Disp. _ Room Air Cond. REG. NUMBER (commencing with Section 7000)of Division 3 of the Business DISTRICT NO. PR OC BY and Professions Code,and my license is in full force and effect. Power Apparatus&Large Appliances } Size&Type HP., KW, KVA, or KVAR' License Number � Lic. ClassC 16 Up O to I. Incl. FINAL � Over 1 to 10 Incl. DATE ad f�el� Date V IDATION O Contracto �.. �. Over 1'0 to 50 Incl. FIN V ❑ I am exempt under Sec. Over 50 to 100 Inc. BY. CL B.&P.C. for this reason Over 100 Services, Swbd., MCC&Panelboards a 7 6 7.4 A Date: 0--200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V •°0 Exemption1 ¢J ❑ Over 1000 Amp. or Over 600 V` for Re Maint. Elect. SINGLE FAMILY' o o 1 02506 Temp. Power Pole 8 Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 0.91 4'-87 I hereby affirm that I am exerrmpt from the Contractor's LicenseAdditional Sign Branch Circuits Law for the following reason (Section 703.1.5, Business and Professions Code): ❑ I, as owner of the property, will do the wokk and the Misc. Conduits&Conductors structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)_ 7044, Business 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 PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name f PERMIT. ISSUING FEE J Lender's Address 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 hereby auth izX.-Sentatives of-this County to enter upon th' bove- ntproperty for inspectin purposes. SEE REVERSE FOR.EXPLANATORY LANGUAGE Ir ` 7 Sig Lure of P rmi ee Date j"* WORKERS'COMPENSATION DECLARATION 76A863 10/81 - I hereby affirm that'I have a certificate of:consent to self insure, CE-806G APPLICATION FOR ELECTRICAL PERMIT or a certificate of Workers'Compensation In copy thereof(Sec.3800,Lab.C.) surance,or a certified , COUNTY OF LOS ANGELES BUILDING AND SAFETY ; Policy No. Company FOR APPLICANT TO FILL IN JOB / / q El Certified copy is hereby furnished. Residential Bldgs.&Pools EACH NO. FEE ADDRESS 9C•�c �. �C.O.A �A1 . ❑ Certified copy is filed with the county building Inspection 1 &2-Family,Sq:Ft: $ — $ LOCALITY ` department. Multi=family Sq.Ft. — NEAREST DateResidential Swimming Pools CROSS ST.' Applicant OWNER OR FIRM NAME D O. a AlqL� CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Ree Light Sw. - MAIL �� COMPENSATION INSURANCE _ _ .— ADDRESS (This section need not be completed If the work Involved by the First 20 permit is for one hundred dollars($100)or less.) Total No. Additional CITY 7T Tel.No. I certify that in the-performance of the work-for which this permit PLAN CHECK is issued, I shall not employ any person in any manner so as to APPLICANT become subject to the Workers"Compensation Laws. Lighting Fixtures First 20 ADDRESS �L Additional (/ W Total No. CITY Tel.No. /Date 7` �— Applicant Fixed Appliances Not Over 1 HP NOTICE TO APPLICANT: PERMIT if, after making this Certificate of;' PERMITNT Exemption,you should become.subject to the Workers'Compensation' Range_. Heater .W. _ provisions of the Labor Code,.you must.forthwith comply with such Oven _ Dryer W.M._ ADDRESS v provisions.or this permit shall be deemed revoked. TO FAU W.H. _ . CITY , Tel.No. LICENSED CONTRACTORS DECLARATION Hood — Fan Other_ I hereby affirm that I am licensed under provisions of Chapter 9 LICENSE OR (commencing with Section 7000)of Division 3 of the Business and' Disp. — Room Air Cond: REG.NUMBER. Class. Professions Code,and my license is in'full force and effect. PR.DISTRICT NOSS BY Power Apparatus&Large Appliances SizeType HP,KW,KVA,or KVAR License Number Lic.Class Up to 1 Incl. FINAL Over 1.to 10 Incl. DATE VALIDATION Contractor Date Over 10 to 50 Incl. FINAL 15 ❑ I am exempt under Sec. Over 60 to 100 Inc. gY W Over 100 B.&P.C.for this reason !� + Services,Swbd.,MCC&Panelboards poll.Date: 0-200 Amp.Under 600 V Signature 201 - 1000 Amp.Under 600 V ❑ Exemption for Reg.Maint.Elect. Over 1000 Amp.or Over 600 V SINGLE FAMILY Temp.Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATIONSign:with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law ` a for the following'reason(Section 7031.5,Business and Professions Additional Sign Branch Circuits cv Code): 11 3M7 14.00. 'I Misc.Conduits&Conductors 1,as ownerof the property,will do the work and the structure 1 ITEMS is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) and Professions Code). ► MAL 14.00 CONSTRUCTION LENDING AGENCY CHECK 146M Thereby 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) Q Civ.C..). PLAN CHECKING FEE. Lender's Name. GOM1 7/19/89 PERMIT ISSUING FEE /Q 0 1 049 Lender's Address r 1 certify that I have read,this application and state that the above TOTAL FEE 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 inspection purposes. r SEE REVERSE FOR EXPLANATORY LANGUAGE fYI Signature of Permittee Date