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Home My Public Portal About4954 MCCLINTOCK AVE_Electrical__ ,aga07.ceaae e.aa APPLICATION F'O R �E LE CT R I C PE R M �L I . 1 COUNTY OF'LOS ANGELES -• REBUILDING AND SAFETY DIVISION RTMENT OF COUNTY ENGINEER ADDRESS 4.954 McClintock - COUNTY JOHN A. LAMBIE, COUNTY ENGINEER CASSATT D. GRIFFIN,SUPT OF BUILDING LOCALITY Temple City FOR APPLICANT TO FILL IN NEAREST PEMWT FEES CROSS ST. ' ITEM NUMBER I EACH FEE OWNER $Omer F+'Or@ AIL OUTLETS: 7 ADDRESS 4954 McClintock LIGHTS RECEPT. SW .10 LIGHTING FIXTURES .10 CITY, Temple Cit TEL.NO. ELEC.RANGES - CLO.DRYERSELECTRICIAN Certified vacuum Prod t9 IWASHERS sTATE WATER HEATERS .130ADDRESS1-755 e e tlYle ELEC.SPACE HTRS. DISHWASHERS GARBAGEDISPOSERS AUTO.- CITY TEL.NO. ..n STA.COOKING UNITS -:25 "LICENSE NO. - --18 12 - - - - '• MOTORS: OVER INC. H.P. 1 25 * DIS 1 T- I GRO I Z NE 0— I/s :25 I — a .50 2— 5 1.00 INSPECTION BECOBD 2 � � .- ! � �ysf.J•. hl G�1..F.,, 1.50 IS-- 50 2.50 50-200 5.00 SIGNS: NO.TRANS. HO.LAMPS SERVICE 0-600V 1.00 SERVICE OVER 600V 5.00 MISC. Ruil t-in Gleanin S stem _ WIRING PERMIT 1.00 1 00 FIXTURE PERMIT 1.00 SUPPLEMENTARY.PERMIT - .50 TOTAL FEE 1-81-125. _s 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO 'COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT ELECTRICAL WIRING. WRING 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR s LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES / ` v ' CALIFORNIA OR THAT I AM THE LEGAL .OWNER OF THE ABOVE • DESCRIBED RESIDENTIAL PROPERTY. POWER A SIGNATURE UTILITY CO.NOTIFIED r. 1 .1 � � �r OF PERMITTE f t - FINAL _- �a• ..C%O�W• ATION SU ERVISINTHUR G ELECTRICAL.ENGINEER CIS 'MQ CASH 76AGOSCCFSGG-i1.s7APPLICATI.ON FOR ELEC"T"RIC PERMIT 1 COUNTY OF LOS ANGELES - = DEPARTMENT OF COUNTY ENGENM BUILDING «� BUILDING AND SAFETY DMSION ADDRESS C,]rO�H�N A.LAMSffi.fc t, e� � !7' �:AaA�ATT D.GRIFFIIII,Sup t of Suildiag LOCALITY FOR APPLICANT TO FILL IN NEAREST ROSS ST. `pie09-/YU PERMIT FEES � /� ql /�• ��y� ITEM NUMBER EACH FEE OWNER vZ e/'pfjg Cil /"I OUTLET $ $ MAIL LIGHTS EczPT SW. ..f0 Q ADDRESS LIGHTING FIXTURES .10 CITY TEL.NO. ELEC.RANGES CLO.DRYERS ELECTRICIAN ' WATER HEATERS .50 ADDRESS e�-g /e-M. .d ELEC.SPACE HTRS. DISHWASHERS ARB GE DISPOSERS AUTO.- CITY TEL.NO STATE WASHERS STA.COOKING UNITS .2S LIC#NSE NO. MOTORS: OVER INC. H.P. 0— +/a 25 -DISTRIC O. I GROUP NE READY FOR INHPEOTION + — 2 .50 2— 5 t.00 I INSPECTION RECORD 2 s —, is 1.50 g Is — s0 2.50 (-57N �S[r' >wr. a�, c'_1 k-W/T A"—'t SO'— 200 5.00 f+ d 2 FO a1 .('co q SIGNS: NO.TRANS. ,r k I C�t �^a D i It • •�C+ I-c- 3) NO.LAMPS d5c SERVICE O-600V 1.00 SERVICE 01(ER 600V 5.00 / /i MISC. I WIRING PERMIT 1.00 a FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .50 TOTAL FEE g APPROVALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP11LICATION 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 1 HEREBY CERTIFY THAT I AM PROPERLY GISTERED. AND/OR <• i" LICENSED AS IRED BY LOS ANGE ES TY AND STATE OF FIXTURES �J• �e __ CALIFORNIA OR TAT 1 AM THE LEG L E OF THE ABOVE '. POWER DESCRIBED RESI E TIAL P OPERTY. SIGNATURE UTILITY CO.NOTIFIED + %�La�►� OF PERMITTE FINAL t3 ;TION ARTHUR C.VETT. CK Mo CASH 8UPERVISINC3 ELECTRICAL ENGINEER ( AC6311 'u'R NOV 3 2 A 9.30 1 WOR1<ER'S COMPENSATION DECLARATION 706.0663 DPW(.12-91) 'APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to elf,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.3800 Lab'.C'.) , Policy No. Company FOR APPLICANT TO FILL IN JOB -ADDRESS.' ❑ Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE LOCALITY 1&2❑ -Family,Sq.Ft. — $ $ f�Certified copy is filed with the county building Inspection _ NEAREST department. Multi-family Sq.Ft. CROSS ST, Residential Swimming Pools �- `. A Date Applicant SSESSOR MAP BOOK PA10,03 PARCEL O CERTIFICATE OF EXEMPTION FROM WORKERS' '�„ OWNER OR COMPENSATION INSURANCE Outlets:Rec. Sw. �p M NAME (This section need not be completed if the work Involved by the First 20Total No. Additional ADDRESS � 1, !} permit Is for one hundred dollars($160)or.less.) r-. I certify that.in the performance of the work for which this permit CITY . T.I.No ii?' 2 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 ��-N!�} Total No. � Additional - ADDRESS Date t Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: If, after making this Certificate of CITY 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 such PERMIT provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances. _APPLICANT- +�V LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS W f hereby affirm that I-am licensed under provisions of Chapter 9 Over 3 to.10 Incl. f (commencing with,Section 7000)of Division 3 of the Business and CITY Tel.No. � ( Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. LICENSE OR Over 50 to 100 Incl. REG.NUMBER �I ' a �!7 Over 100 DISTRICT NO. P SED BY V License Number 6216-6 `� Lic.Class .6 I �1 Services,Swbd.,MCC&Panelboards Contractor 6-As'caNg Date 0-399 Amp.Under 600 V DATE 0 400-1000 Amp.Under 600 V .� ❑' I am exempt under Sec. - VALIDATION W Over 1000 Amp.or Over B00 V FINAL' B.&P.C.for this reason BRANCH CIRCUIT FEES BY W Date: 15A,or 20A,12OV,Lighting or Recept. Z 1 To 10 Branch Circuits Signature 1:1 To 40 Branch Circuits 41 Or More Branch Circuits ❑ Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V,Ughting Br.Circuits SINGLE FAMILY Temp.Power Pole&Appurtenances 2/+('. HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit A44Te8 I hereby affirm that I am exempt from the•Contractor's License Law for the following reason(Section 7031. ,.Business and Professions Additional Sign Branch Circuits M03 ' 39.30 Code): 5' 1 ITEMS El1,as owner of'the property,will do the work and the structure Misc.Conduits&Conductors is not intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule) TOTAL 39.3101 and Professions Code). CASH 30030 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the FfAhIGE o00 performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total) �� ! Civ.C.) PLAN CHECKING FEE 0000—MDI 11/14/95 Lender's Name 3291 1. AM IM P-0? PERMIT ISSUING FEE' 7 Lender's.Address I certify that I have read this application and under penalty of puriury state TOTAL FEE y . 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 enter upon the above-mentioned'property for in ion purpo SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE OF PEjPMITTEE DATE