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Home My Public Portal About5019 MCCLINTOCK AVE_Electrical__ Ao L �BABBB+CEBOS-B-g, APPLICATION FOR ELECTRIC PERMIT, 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER ,BUILDING �d19Al c CL//I1TG� BUILDING AND SAFETY DIVISION ADDRESS JOHN A.LAMBIE,COUNTY ENGINEER CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL 1N CROSS ST. �C. O1�Te_�' Sc CEi� PEFWT FEES OWNER Irl LCE r�oAe LIGHTS RECEPTACLES C> SWITCHES p�J - NUMBER ITEM EACH FEE MAIL r� ADDRESS -5'0I TOTAL OUTLETS $ ,10 $ R U ELEC. RANGES, WATER-HEATERS, - CITY TEL.NO. " 3113 cLorxfiS DRYERS '50 ELECTRICIAN C. SPACE LExEATE STAT'Y. COOK GE DISPOSERS- , — AUTO WASHERS, DISHWASHER .25' ADDRESS S OK e_1 LIGHTING FIXTURES .10 V CITY TEL.NO. MOTORS STATE LICENSE NO. HORSEPOWER H.Pr DIST OVER INC. r .– RICT NO. GRO ON • READY FOR INSPECTION %B LEBO .25 + , 2 .so INSPECTION RECORD z — s I.00 S — IS 1.sd �v- I G. Lov I i% 15 — 2:5o o a GL 1�� p et P. sa 200 0 5:oa - �ne_em I ee— c 'w=:& Misc. y 1 SIGNSI NO.TRANS ' p Sr,4��j NO.LAMPS r U ..(!_. a SERVICE O-SOON 1.00 ivmeiCa r SERVICE OVER GOOV 5.00 �I WIRING PERMIT 1.00 > FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .50 APPROVALS TOTAL FEE Sx DATE INSPECTOR'S SIGNATURE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING 1-7,ELECTRICAL WIRING. WIRING fr f t!'y I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES �/rj. , ,p„)A ��,4s'i LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA 'OR THAT I AN THE LEGAL OWNER OF THE ABOVE POWER DESCRIBED RESIDENTIAL PROPERTY. SIGNATURE �.Q,_„ �/yI UTILITY CO.NOTIFIEDOF PERMiTT �^'w i • FINAL IOHN A.LAMBIE. ATION ARTHUR C.VEIT. , .OUNTY ENGINEER CK MO ' CASH SUPERVISING ELECTRICAL ENGINEER L-. 2 X41:1 .3 9; W18 2 5.15 -9 ` WORKERS'COMPENSATION DECLARATION ' 6A669 10/81 APPLICATION FOR ELECTRICAL PERMIT I Fker2ley affirm that I have a certificate of consent to self CE-8066 iMreorrtificate of Workers'Compensation Insuran COUNTY OF LOS ANGELES , BUILDING AND SAFETY o f(Sec. 38 b.ompany FOR'APPLICANT TO FILL IN JOB Certified copy is hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE ADD "en Iff r- led with the ty u Idin inspec- 1 &2-Family, Sq. Ft. $ — S LOCA Multi-family Sq. Ft. — SResidential Swimming Pools CROSSST. pplicant �. OWNER OR FIRM NAM CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light. MAIL –I COMPENSATION'INSURANCE ADDR I (This section need not be completed if the work involved by First the permit is for one hundred dollars($100)or less.) Tot61 No. Additional I. No. I certify that in the performance of the work for which this APPLICANTPLAN'CHECK permit is issued, I shall not employ any person in any manner so as to b. a subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS Total No. Additional CITY Tel. No. Date licant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: fter making this Certificate of APPLI T Exemption, you should bee subject to the Workers' f Range_ Heater_D.W. _ Compensation provisions of the Labor Code, you must forth- Oven —Dryer —W.M.— [ADDRE!% with comply with such provisions or this permit shall be Top — FAU —W.H. — deemed revoked. Hood _ Fan. _Other_ CI 0I. IV LICENSED CONTRACTORS DECLARATION LICEN R I hereby affirm that I am licensed under provisions of Chapter 9 Disp. _ Room Air Cond. REG. NUMBER Clas (commencing with Section 7000)ofivision 3 of the.Business DISTRICT NO. PROCES D BY and Professions C d aid li ns is in full fore n Power-Apparatus&Large Appliances {� >- (^/f` 5 Size&Type HP,.KW, KVA, or KVAR' ✓ �U� License ber i Class I Up to 1 Incl. FINAL V ► Over 1 to 10 Incl. DATE VALIDATION 090 Conti, to Da Over 10 to 50 Incl. FINAL: O ❑ l.am exempt under Sec. Over.50 to 100 Inc. BY IL B.& for this reason Over 100 Date.: Services, Swbd.,.MCC&Panelboards ► 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. [zip ` C SINGLE FAMILY Temp. Power Pole.&Appurtenances. ' ° ° HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I 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): •` " -' ❑ 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)_ 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY I.hereby affirm that.there is a.construction lending agency for the performance oft work for which this permit is issued PERMIT FEE (Sub-Total). (Sec. 30 , Civ. C.). f PLAN CHECKING FEE Lender's Nam PERMIT ISSUING FEE �O Lender's Address I certify that I .have read this application:and state that the TOTAL FEE above' ation is c rrect..I agree to comply with all County ordi. Hees d State laws regulating Electrical wiring, and her y auth ize repr sentatives of this County a er upon the Bove- nti e. for in ection r e . property p %y SEE REVERSE FOR EXPLANATORY LANGUAGE 'If O 1 Signature o Permittee Date ii J�'IORKFRS'COMPENSATION DECLARATION1' z6A663 DPW 3/87 APPLICATION TION FOR r F,rreby affirK','fit I have a certificate of consent to self: CE_806G I`ll® ELEMICAL PERMIT Q insure, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certified copy thereof (Sec. 3800, Lab. C.) oli y No. Company FOR APPLICANT TO FILL IN JOB ADDRESS C29- ertified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ^� / J ❑Certified copy is filed with e c unty bui 1 spec- 1 &2-Family, Sq. Ft. $ _ $ LOCALITY �/t4 L6 Cj t '�ert�m�f Multi-family Sq. Ft. NEAREST f!6�/J fid& Residential Swimming Pools CROSS ST. !� �[+ d� Date A a t OWNER OR 'P FIRM NAME /u� CERTIFICATE OF EX MPTI FROM WORKERS' Outlets: Rec Light—/ MAIL d /'g �/(X!s/D COMPENSA NSURANCE First 20 (This section need not be completed if the work involved by Total No. Additional CITY �tJ /� Tel. the permit is for one hundred dollars($100)or less.) PLA CK I certify that in the performance of the work for which thin PPLICANT permit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. I Lighting Fixtures First 20 ADDRESS Additional Total No.� CITY Jel. No. Date Applicant Fixed Appliances Not Over 1 HP NOTICE TO APPLICANT: If, after making this Certificate of PERMIT / Exemption, you should become subject to the Workers' Range— Heater—D.W. — APPLICATION V Compensation provisions of the Labor Code, you must forth- Oven — Dryer —W.M.— ADDRESSE" wt I with comply with such provisions or this permit shall be Top — FAU W.H. — itW deemed revoked. Hood — Fan Other— o.CITY g ! j Tel. N LICENSED CONTRACTORS DECLARATION LICENSE M Disp. — Room Air Cond. — Class. I hereby affirm that I am licensed under provisions of Chapter 9 REG. NUMBER (commencing with Section 7000)of Division 3 of the Business Power Apparatus&Large Appliances DISTRICT N f , PROCESSED B a and Professions Code a m ice se is in full force and effect. �f Size 8 Type HP, KW, KVA, or KVAR v O License Numb Lir. Class Up to 1 Incl. FINAL G Over 1 to 10 Incl. DATE v VALI 10 cc Contractor G� /�� 401�ate O ❑ Over 10 to 50 Incl. FINAL_ U I am exempt under Sec. Over 50 to 100 Inc. BY LU B.&P.C. for this reason Over 100 t1 Services, Swbd., MCC&Panelboards Z Date: Z 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 DECLARATION aO Q 4 2 7 A I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits # 0 0 0 0 0 2 Professions Code): ❑ Misc. Conduits&Conductors 0 - 2 (100 I, as owner of the property, will do the work and the structure is not intended or offered for sale(Section 7044, Other(See Complete Fee Schedule)— ,.„, 0 0 0 2 Q,Q Q c=i Business and Professions Code). CONSTRUCTION LENDING AGENCY p 8,1 5”8 8 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 /013 A Lender's Address TOTAL FEE I certify that I have read this application and state that the t above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical Wiring, and the eby authorize represe es of this County to enter upon the authorize inspection purposes. i SEE REVERSE FOR EXPLANATORY LANGUAGE nature of Permittft Date Y WORKERS'COMPENSATION DECLARATION'"-�`� 76Ab69 ,ole` +. APPLICATION FOR ELECTRICAL PERMIT � liereby affirm that I have a certificate of consent to self CE-8066 insure, or a certificate A;Worke Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or -%t�f'�e�jcggy,h7#( ec , Lab. C.) I a PolicyoNo. 1 omponJJJy FOR APPLICANT TO FILL IN JOB ❑ Certified copy is hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE ADDRESS 1 Certified copy is filed with the unty ui ing inspec- 1 &2-Family, Sq. Ff. $ — .$ LOCALITY 9tion department. Multi-family Sq. Ft. — NEAREST CROSS ST. QaApplicant Residential Swimming Pools . OWNER OR �' t FIRM NAME 7) k4Ed1(r9P1< CERTIFICATE OF EXEMPTION FROM WORKERS' + MAIL Outlets: Rec Light Sw._ , /,11 COMPENSATION INSURANCE First 20 ADDRES 0. (This section need not be completed if the work involved by Total No. Additional CI Tel. No. the permit is f9.r one hundred dollars($100)or less.) f certify that in the performance of the work for which this PPLAN CHECK permit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. i Lighting Fixtures First 20 ADDRESS Total No. Additional CITY -v Tel. No. Date Applicant Fixed Appliances Not Over 1 HP T NOTICE TO APPLICANT: If, after making this Certificate of PERMIT t- 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 /(0 C)7 �-� �� ' , with comply with such provisions or this permit shall be li Top — FAU —W.H. — deemed revoked. Hood _ Fan _Other_ CITY Tel. No. LICENSED CONTRACTORS DECLARATION 400 LICENSE 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 DISTRICT NO. PRO ED BY and Professions d my I' a is in full.force and effe t. Power Apparatus&Large Appliances (l ., Size 8 Type HP, KW, KVA, or KVAR'• �'�� O License Number Li Class v FINAL V �I�"� Up to 1 incl. Contracto�"�K>>� 6 e v Over 1 to 10 Incl. DATE VALIDATION 0 ❑ Over 10 to 50 Incl. FINAL F I am exempt under Sec. Over 50 to 100 Inc. BY d B.&P.C. for this reason Over 100 Services, Swbd., MCC:•&Panelboards• 1 ► Date, 0 -200 Amp. Under 600 V I Signature .. 201 - 1.000 Amp. Under 600 V ❑ Exemption for Reg. Over 1000 Amp. or Over 600 V 11Aaint. Elect. SINGLE FAMILY Temp. Power Pole&Appurtenances, HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractors License Additional Sign Branch Circuits Law for,the following reason (Section 7031.5, Business and �� Professions Code): 1 '6 3.0 A ❑ 1, as owner of the property, will do the work and the Mise. Conduits&Conductors "o,0 0 0 0 Schedule)— structure is not intended. or offered for sale (Section Other(See Complete Fee Schedule)_ , 2 7044, Business and Professions Code). 2 5 0 CONSTRUCTION.LENDING AGENCY I hereby off irm that there.is a construction lending agency for ° ° °,2 ter' F 0.5 the performance of the work for which this permit is issued PERMIT-FEE (Sub-Total) (Sec..3097, Civ..C.). L' 5.02-83 J�w�� PLAN CHECKING FEE Lender's Namet PERMIT ISSUING FEE Lender's Address 1 I certify that I ho . ad this application and state that the TOTAL.FEE above information is c.rrect. I agree to comply with all County a dina and State laws regulating Electrical wiring, and here y out rize re esentatives of this County to enter upon the ov m ntio d property for inspection purposes. r SEE REVERSE FOR EXPLANATORY LANGUAGE Signature o Permittee Date