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Home My Public Portal About9845 LONGDEN AVE_Electrical__ Flo i i" ..6'� I 1 i i.•� ! �1�� epi! ?i �f,fl`i, ;'� ?h �+ — � x ��y � �y ,CIMS w' DESC... E_. h/ ROOMSNUMBER LOCATION BY - ' ,�,.? �.; MOV■IN MMMFA r RAN FAM IN sp Van 7,PEA Ww re.C..r�.rr�� O....r,IA. IN ■ ....rAM�P—� f INE NINON �....... ... ■ �...... e..IN MOTORS C(ATE INSPECTOR'S NAME NO. OF H.P. 'MIM. NO. OF SIGNS TRANm� NO. OFF RANGEIMOR�HEATERS Ell WORKER'S I COMPENSATION DECLARATION 20.0019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT 11 I hereby affirm that have a certificate of consent to self insur=e,' 78A683, or a certificate of Worker's Compensation Insurance, or a certified' COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec,3800 Lab.C.)w, Policy No. Sb Company•�'�— r FOR APPLICANT TO FILL IN JOB ADDRESS Certified copy is'hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE $ $ LOCALITY C rtified copy is filed with the county b 'Iding Inspection 1A 2-Family,Sq.'Ft. NEAREST �Jd part t. ti Multi-family Sq.Ft. — CROSS ST. Date I b Applicant Residential Swimming Pools MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' / OWNER OR ^, _ COMPENSATION INSURANCE Outlets:Rec. Light L Sw. ,�� y p FIRM NAME First 20 MAIL. (This section need not be completed if the work Involved by the Total No. Additional ADDRESS W '1 permit Is for one hundred dollars(8700)or less.) fiJ lid I certify that in the performance of the work for which this permit CI —aY is issued, I shall not employ any person in any manner so as to PLAN CHECK become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANT Total No., Additional ADDRESS Date Applicant i NOTICE TO APPLICANT: If, after making this Certificate of RESIDENTIAL APPLIANCES NOT OVER 3•HP, CITY Tel.No. Exemption,you should become subject to the Workers!Compensation OTHER APPLIANCES NOT.OVER 3 HP. A _ provisions of the.Labor Code,you must forthwith comply with such PERMIT provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances. APPLICANT L LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,ar KVc R DDRESS _,a (h,( O I hereby affirm that I am licensed under provisions of Chapter 9 3/�t�T16 J ? /� qq/ (commencing with Section 7000)of Division 3 of the Business and CITY v�dKs� .3/D_C 64. Professions Code,and my license is in full force and effect. Over 10 to 50 Incl: LICENSE OR ` iJ q / Class�� a J' ^l Over 50 t0 100 Incl. REG.NUMBER [ !/�Iv License Number �O��Z� Lib.Class'( '� `� Over 100 DISTRICT NO. I ESSED BY 0 Services,Swbd.,MCC&Panelboards Contracto . ® l i 0-399 Amp.Under 600 V FINAL O r ate DATE ❑ I am exempt under Sec, r 400-1000 Amp.Under 600 V VALIDATION U Over 1000 Amp.or Over 600 V FINAL B.&P.C.for this reason. BRANCH CIRCUIT FEESBY IL Date: 15A,or 20A,120V,LI ecept. / Z 1 ch Circuits. Signature 11 To 40 Branch Circuits ACCT.AT ❑ uits Exemption for Reg.Malnt.Elect. 15A;20A,208V To 277V�ighting Bra.Ci cults 3303 68.80 SINGLE FAMILY Temp.Power Pole&Appurtenances 1 ITEMS HOME OWNER-BUILDER DECLARATION I hereby affirm that I am exempt,from the Contractor's License Law Sign with One Branch Circuit TOTAL 613=80 for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits Code): CHECK 680$0 ❑ I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors CHANGE .00 Is not intended or offered for sale(Section 7044,Business Other(See Complete Fee Schedule) Opp. Professions Code). CONSTRUCTION LENDING AGENCY 0000-0001 7/18/96 1 hereby affirm that there is a construction lending agency for the ' 7561 1 PM 5:46 performance of the work for which:this permit is issued(Sec. 3097, PERMIT FEE (Sub-Total) 5 Civ.C.) ' PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address I certify that I have read this application and under penalty of purjury state. TOTAL FEE that the above information is correct. I agree to comply with all County , ordinances and State laws regulating Electrical wiring,and hereby authorize representatives of this Coun to enter upon the above-mentioned property n esti . p . ses SEE REVERSE FOR EXPLANATORY LANGUAGE 71 r-7 9� SIGNATURE" PERMITTEE- DATE WORKER'Sfve a certificate of consent to 7BA663 72-97) APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self insure; •.. or a certificate of Worker's Compensation Insurance,or a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec.380 ) "_�2 Policy No. �T1(L 20 Am7pany ^, � ` v �/ FOR APPLICANT TO FILL IN JOB ADDRESS F-1 Q Y (J Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE $ $ LOCALITY � ❑ Certified copy is filed with the county buildin inspectio 1&2-Family,.Sq.Ft. _ NEAREST department: Multi-family sq.Ft. CROSS ST. t Residential Swimming Pools ASSESSOR Date Applican MAP BOOK PAGE PARCEL CERTIFICATE OF EXEfAPTION FROM.-WORKERS' Outlets:Roe..—Light Sw.. OWAM N NE (TV COMPENSATION INSURANCE Tit (This section need not be completed If the work Involved by the First 20 MAIL .— &VV y permit Is for one hundred dollars($100)or less.) Total No. Additional ADDRESS I certify,that in the performance of the work for which this permit CITY Tel.No�--O is issued, I shall not employ any person irr any manner so as to become subject to the.Workers'Com ensation Laws. Lighting Fixtures First 20 PLAN CHECK j p APPLICANT Total No. Additional ADDRESS Date. Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: If, after making this Certificate of CITY ' Tel.No. Exemption,you should.become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code,you must forthwith comply with suchPERMIT r provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances %A V LICENSEWCONTRACTORS DECLARATIONSize&Type HP,KW,KVA,or KVA.R ADDRESS , Rv I glA/ AWL I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. q�. (commencing with Section 7000)of Division 3 of the Business and CITY S' 6v Tel.No eZ Professions Code,and my-license is in full.force and effect. Over 10 to 50 Incl. } LICENSE OR ' 'a- Class. Over 50 to.100 Incl. REG.NUMBER 0 C_—r0 d v' C, ® Over 100 DISTRICT NO. P SED BY 0 License Number Lic..Class U 9 Services.,Syv MC &P cards � D cz�• �4 d�6 � Contracto '� ate Ga 0- n r 80 V DATE O I am exempt under Sec. 40 - mp. n r. 00 ?`�O —VALIDATION w Over 1000 Amp.or Over 800 V FINAL d B.&P.C.for this reason BRANCH CIRCUIT FEES BY Z Date: . . 15{1,or 20A,120V,Lighting or Recept. _ 1 To 10 Branch Circuits. ��•�� - Signature 11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits 2 Exemption for Reg.Maint.Elect. 15A,20A,2D8V To 277V Lighting Br.Circuits ACCT e JL HOME OWNER-BUILDER DECLARATION SINGLE FAMILYTemp.Power Pole&Appurtenances 3303 100.25 I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit for the'following reason(Section 7031.5, Business and Professions Additional Sign Branch Circuits 1 ITEMS Code): TOTAL :wllo 25 ❑. I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors 100.25 Is not Intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule) CHECK and Professions Code). , CHANGE .00 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of th9 work for which this permit:is issued (Sec. 30.97, PERMIT FEE (Sub-Total) 7/22/96 Civ.C.) ' PLAN CHECKING_FEE 7575 1 AM 91-112 Lender's Name PERMIT ISSUING FEE Lender's Address. I certify.that I have read this application and under penalty of purjury state TOTAL FEE eq that the above 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 ant upon the above-mentioned property for i.nspectio urposes.. SEE REVERSE.FOR EXPLANATORY LANGUAGE TURE OF PERMI E DATE