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HomeMy Public PortalAbout10769 LYNROSE ST_Electrical__ 78A888-CE808 12-58 APPLICATIONS FOR .ELECTRIC �I� ��.� I� COUNTY OF LOS ANGELES. ` " MEW kildd� DEPARTMENT OF COUNTY ENGINEERJADDRESS- JOHN ILDING BUILDING AND SAFETY DIVISION A.L:AMBIE,COUNTY ENGINEERCASSATT D.GRIFFIN.SUPT OF BUILDING CALITY /! .... a FOR APPLICANT TO FILL IN NEAREST PERMT FEES cRoss sr.. OWNER ITEM INUMiFRI EACH FEE - OUTLEC $ $ MAIL17 LIGHTS A RECE SW. ,10' ADDRESS LIGHTING FIXTURES .10 CITY E .N ELEC.RANGES CLO.DRYERS ELECTRICIA ~ -WATER HEATERS :50 ADDRESS' _ ELEC.SPACE HTRS. DISHWASHERS - CITY TEL.NO 1 GA AQEDISPOSERS -pUTO.- gv - n STATE WASHERS STA.COOKING UNITS .25 LICENSE NO. MOTORS: OVER INC. H.P. -DISTRICT NO. GROJJP ZONE OCESS BY 0— 1/2 .25 1/2— 2 :50 INSPECTION RECORD 2— 5 - 1.00 .5— i5 1.50 Is— 50 2.50 50-200 5.00 1= 4 NO.TRANS. .SIGNS: NO.LAMPS SERVICE 0-600V 1.00 I SERVICE OVER 600V 5.00 MISC.. IWIRINGPERMIT 1.00 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .50 TOTAL FEE $ ' APPROVALS 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ.THIS APPLICATION DATE INSPECTOR'S SIGNA RE •AND STATE THAT THE ABOVE IS CORRECT AND'AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES- AND STATE LAWS REGULATING ° ELECTRICAL WIRING. I HEREBY CERTIFY THAT 1 AM PROPERLY GISTERED AND/OR WIRING LICENSED ASREO ED BY LOS ANGE ES C TY AND' STATE OF FIXTURES 1 �lr CALIFORNIA OR H I THE LEG L O E OF THE ABOVE DESCRIBED RES EN IAL PERT POWER' �[S SIGNATURE UTILITY.CO.NOTIFIED OF PERMITTE Fi NAL bF ATION - - ARTHUR C. VEIT. ell CK Mo; CASH SUPERVISING ELECTRICAL ENGINEER LACo 8 3 8 5 �;ua 2 3 A 9 e9 5 .. x°C' WORKERS,-COMPENSATION DECLARATION I 20A019DPW 3/87 APPLICATION FOR ELECTRICAL PERMIT ,..,.hereby affirm that I have a certificate of consent to.self! CE O iIT�re,or a certificate of Workers'Compensation Insurance., COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS o;%'1,�e!ified copy thereof(Sec. 3800, Lab. C.). Policy No. Company FOR APPLICANT TO FILL IN JOB a 1 Certified copy.is hereby furnished. New Residential Bldgs: &Pools EACH. NO. FEE ADDRESS Y© V ❑Certified copy is filed with the county'building inspec- 1 &2-Family,Sq. Ft. $ — $ LOCALITY ggq � fG� LrT tion department. ! Multi-family Sq. Ft. NEAROSS ST.I/F� r•r SII©G/V °I Residential Swimming Pools Date Applicant OWNER OR /� ` A FIRM NAME L� /'� CERTIFICATE OF EXEMPTION FROM WORKERS' , Outlets: Rec Light Sw._ MAIL "'RA-0 A-0 COMPENSATION INSURANCE ADDRESS �P'1 First 20 (This section need not be completed if the work involved by` ; CIN Tei. No.+/g. the permit is for one hundred dollars($100)or'less.) I -Tota! No. Additional a � PLAN CHECK I certify that in the performance of the,work for which thisAePLICANT permit is issued, I shall not employ any person in any anner w so as,to become.subject to the Wor C mp a n,Laws. ,� Lighting Fixtures first 20 ADDRESS Additional Date Appl!c of t Total No: CITY Tel. No. Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, afte makinZd., Certificate -of APPLICATION �S�Y A–sio 5 t6#1 0C&—_ Exemption.; you should become subjethe Workers' -Range— Heater—D,W. Compensation-provisions of the Labor Cou'rnustforth- Oven — Dryer —W.M.— ADDRESS $r('L1 L�-- ,q/}g ey a with comply with such provisions or this permit shall be Top — FAU —W.H. deemed revoked. Hood — Fan —Other QO CIT*-[L _ f7f Tel. No.�$S� LICENSED CONTRACTORS DECLARATION ,. LICENSE OR `f /o7 �en _ :/ / 1 I hereby affirm that I am licensed unDisp. _ Room Air Cond. REG. NUMBER Classt� �der,provisions of Chapter$ � (commencing with Section 7000)of Division 3 of the Business Power Apparatus&Large Appliances t. DISTRICT NO. P O SED BY a and Professions Code.,and my license is in full force and effect. � d1 Size&Type-HP, KW'„.KVA, or KVAR O License Number-47p p7 Lie. Class r Up to 1 Incl. FINAL V Over 1 to 10 Incl. DATE VALIDATION. 0 ContractorT UAW: Da C Z I. Over 1.0 to 50 Incl. H req FINAL j�C J I.am exempt under Sec. j Over 50 to 100 Inc. BY W B.&P.C. for this reason �U Over 100 ® �` -Drop. f� �� Services, Swbd., MCC&Ponelboards l Z P 0-20 0 Amp..Under 600 V Sig re 201 - 1000 Amp. Under 600 V Over 1000 Amp. or Over 600 V ❑' xem on for Reg: M� . Elect. i ` SINGLE FAMILY HOME OWNER-BUILDER DECLARATION f Temp. Power Pole 8 Appurtenances I Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License i g Law for the following reason (Section 7031.5, :Business and ' Additional Sign Branch Circuits .,., , Professions Code): ,y307 I� I, as'owner of the property,.will do the work and the ' Misc. Conduits&Conductors i i°_M structure is not intended or offered for sale(Section 7044, Other(See Complete Fee Scheduled .. , TOTALTOTAL 'sr--+ � Business and Professions Code). , m CONSTRUCTION LENDING AGENCY , CHECK I hereby affirm that there is a construction lending-agency for I' CtL1'A('3GE nil-' the performance of the work for which this permit is issued I PERMIT FEE (Sub-Tota!) Q t4,0 (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name 13000-131010 s�–€ €€0 s � � PERMIT ISSUING FEE _i i € Lender's Address � v_ Ah 3,:1-_- I C=-=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 I j hereby authorizer opresen fives of this County to enter upon i ZrnWu men' edp er or inspectionp rpos s. SEE REVERSE FOR EXPLANATORY LANGUAGE R g/f Perrp ee Date ®s