HomeMy Public PortalAbout10501 LYNROSE ST_Electrical__ 76A663-CE806 9-64 APPUCAMN FOR En ('�u
MUCAn P �jM07 'I
COUNTY OF LOS ANGELES tiv 1� 1� ILJI
DEPARTMENT OF COUNTY ENGINEER BUILDING SD ' Q
BUILDING AND SAFETY DIVISION ADDRES
JOHN A. LAMBIE, COUNTY ENGINEER J
COLEMAN W JENKINS, SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
RECEPT. TOTAL NO EACHI FEE
OUTLETS FIRST 20 $20 $ OWNER �/ V� -
LIGHT ` MAIL _
` AOD'L ESS
SWITCH 10 ADDRQ Q
OVER 20 f�
LIGHTING I TOTAL
t F1Rsr20l .20 CITY EL.NO.
FIXTURES ADD'L 10 ELECTRICIAN
OVER 20
RANGES CLO DRYERS WTR HTRS 1.00 ADDRESS
GARB DISP. STA COOK
CITY TEL. NO.
• DISHWASH AUTO.-WASH STATE
SPACE HTRS STA.APP.(M.H.P.MAX ) .50 LICENSE NO
F MOTORS: OVER NOT OVER H.P. DISTRICT NO. GROUP E P64kCESSED B
O 1 100
1 3 1.So ' INSPECTION RECORD
s a 200
v
a 15 250 ! 7AI" ;IA�l,o
73 SO 300 /' n ,�Q ! m y}
50 100 500
[�V ,e.�C.
�. � Tb aIJT�aT L5 a
SIGNS- NO TRANS �p }� I Q H
t NO.LAMPS i w/'� ST Vd IAQ�t_7. 5 O G'Qd�,PS _Z
` SERVICE 0.600V-Nor OVER 200A 100
„1
I SERVICEO.60OV-OVER 200 A. 2001
!
SERVICE OVER 600V 5.00 I �f
MISC
U
PERMIT ISSUING FEE 2 00
SUPPLEMENTASY PERMIT ISSUING FEE 100
TOTAL FEE $
1 HEREBY ACKNOWLEDGE THAT I 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 _r
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF _
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY POWER
J
SIGNATURE
OF PERMITTE OF
CO.NOTIFIED dl `
FINAL
VALID N JOSEPH C. ROOHAN
CK M CASH SUPERVISING ELECTRICAL ENGINEER
� fl 2 9 4 2 juu 2 2 2 D
2.8 0, Q
76A663-CE80610-62y APPLICATI®N FOR ELECTRICAL PERMIT •"�
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING �D r-•
_ BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A JENSEN, SUP'T OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
RECEPT TOTAL NO. EACH FEE
OUTLETS FIRST 20 �ffi 20 $ OWN
LIGHT MAIL
SWITCH I OVER 20 .10 - ADDRESS LL
LIGHTING l4 TOTAL FIRST 20 .20 CITY TEL NO 5�6'oo
FIXTURES 1 ' ADD'L 'O ELECTRICIAN
111 OVER 20 raj
RANGES CLO DRYERS WTR•HTRS 1.00 .ADDRESS
GARB.DISP. STA COOK
CITY TEL NO.7" •' ;b
DISHWASH AUTO.-WASH STATE -^� _
SPACE HTRS STA.APP.('A H.P.MAX ) .50 LICENSE NO !.�
MOTORS: OVER NOT OVER H.P DISTRICT NO. GROUP I ZONE PRO SSED BY
O 1 1.00
3 •1.50 INSPECTION RECORD
s a 2.00 _ [,GClrZICAL 6f fd.' -S a
a Is 250
1 7 /A-) od,_,"- 1 S TO O .
15 50 3.00
e-- - -�u o o 12 p
' S0 100 5 00
OP Av
SIGNS NO.TRANS.
NO LAMPS
SERVICE O-GOOV-NOT OVER 200A 1.00
SERVICE 0-60OV-OVER 200 A. 200 -
SERVICE OVER 600V 5.00
MISC.
PERMIT ISSUING FEE 200 „
SUPPLEMENTARY PERMIT ISSUING FEE 100
TOTAL FEE $ ol3
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S 81 NATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE-TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING WIRING -
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 M THE LEGAL OWNER OF THE ABOVE -
DESCRIBED RESIDENT IA ROPERTY. POWER
OF PERM 11 OF
CO.NOTIFIED
FINAL /'-- -71 Z y; •,�'�
IIALIDATfPN URIC. VETT
SU
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
L& 1.370 7�1 Ja 1 4 2 0 3.60—
75AS69_CESOO 10.60 APPLICATION FOR ELECTRICAL PERMIT 1
COUNTY OF LOS ANGELES
DEPARMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS 10501 T{ynrose St.
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY TP.mlple City
FOR APPLICANT TO FILL IN
CROSS ST. Tract 26551 Lot 11
PERMIT FEES OWNER Thi3nderbjxd Estates
ITEM NUMBER EACH I FEE MAIL
OUTLET $ S ADDRESS
LIGHTS RECEPT. SW. .10 CITY TEL. NO.
LIGHTIN FIXTURES I 10
ELEC. RANGES CLO. DRYERS ELECTRICIAN
_ WATER HEATERS .50 ADDRESS ,2610 So• Peck Road
ELEC.SPACE HTRS. DISHWASHERSCITY PZOI'12'OVlc'�EL NO. Hi -2131
GARBAGE DISPOSERS AUTO.- / STATE
WASHERS STA.COOKING UNITS ,25 LICENSE NO. 15116
MOTORS: OVER INC. H.P. DISTRICT GROUP Z NE I PR SSED By
.25
0— 1/2 �v kb
1/2— 2 .50 INSPECTION RECORD
o_
z— 5 1.00 O
5— 15 1.50 U
15— 50 2.50 O
SO— 200 5.00
NO TRANS.
SIGNS: H
NO.LAMPS -�
SERVICE 0-600V 1.00 G
SERVICE OVER 600V 5.00
MISC.
WIRING PERMIT 1.00
FIXTURE PERMIT 1.00 Cl
SUPPLEMENTARY PERMIT .50
TOTAL FEE S
1 HEREBY ACKNOWLEDGE THAT I 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
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ,
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AMT L AL OWNER OF THE ABO
DESCRIBED RESIDE IAL P Y. POWER
SIGNATURE /I UTILITY CO.NOTIFIED
OF PERMITTE - 1
FINAL -
IDATION ARTHUR C. VEIT
SUPERVISING ELECTRICAL ENGINEER
CK MO CASH
G 1 1 .65
WORKERS' COMPENSATION DECLARATION '76A663 DPW 3/87 APPUCAMON FOR ELECTMC AL PERNT
I hereby affirm that I have a certificate of consent to self -�eA�
insure%or a certificate of Workers' Compensation InsuLance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS
Woc
hfied copy the f (Sec 3800 ab Co '�Company FOR APPLICANT TO FILL IN JOB
Certified
rtified copy is hereby furnished New Residential Bldgs & Pools EACH NO FEE ADDRESS
copy is filed with the county building inspec- 1 &2-Family, Sq Ft $ — $ LOCALITY
n a rimentMulti-family Sq Ft NEAREST
y Residential Swimming Pools CROSS ST
Date Applicant _ OWNER OR
FIRM NAME
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec_LLi ht MAIL
COMPENSATION INSURANCE g �Sw— ADDRESS
First,20 r
(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
PLAN CHECK
I certify that m 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
Additional
'Total No CITY Tel No
Date Applicant Fixed Appliances Not Over 1 HP
NOTICE TO APPLICANT If, after making this Certificate of PERMITUA
Exemption, you should become subject to the Workers' Range— Heater—D W — APPLICATION
Compensation provisions of the Labor Code, you must forth- Oven — Dryer —W M — ADDRESS 7
with comply with such provisions or this permit shall be Top FAU —W H
deemed revoked Hood Z)Fan —Other— CITY Tel No A6 77
LICENSED CONTRACTORS DECLARATION Q LICENSE OR
I hereby affirm that I am licensed under provisions of Chapter 9 Disp _ Room Air Cond REG NUMBER Class
(commencing with Section 7000)of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO PR SED BY
and Professions Code,and my Iicen is in full force and effect ` t1
Size &Type HP, KW, KVA, or KVAIR �f Q
License Number O Lic Class Up To 1 Incl FINAL - U
Contractor✓`� t Over 1 to 10 Incl DATE / VALIDATION CE
ElOver 10 to 50 Incl FINAL I—
I am exempt under Sec Over 50 to 100 IncgY U
LL
Over 100
B 8P C for this reason t1
Date Services, Swbd , MCC& Panelboords Z
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 'c
HOME OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit HIL C.E r a
\ Law for the following reason (Section 7031 5, Business and Additional Sign Branch Circuits
Professions Code)
❑ I, as owner of the property, will do the work and the Misc Conduits & Conductors
structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ D ; I' }riL 90
Business and Professions Code)
CONSTRUCTION LENDING AGENCY i:;�Ei. ', i a.•'`_}
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 }_}j}i3«_} }:_�
PERMIT ISSUING FEE
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
h�qnjioned
tatives of this County to enter upon
perty for inspects n purpos s SEE REVERSE FOR EXPLANATORY LANGUAGE
I °1
Signature'ST Permittee Date Os