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Home My Public Portal About5104 MCCLINTOCK AVE_Electrical__ 76A663-CEB'08 4-88 M' APPLICATION FOR ELECTRIC PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEERBUILDING' i BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE,.COUNTY ENGINEER • COLEMAN•W. JENKINS. SUPT. OF BUILDING LOCALITY NEAREST FOR APPLICANT TO'. ILL IN CROSS;ST. RECEPTACLE, TOTAL No, EACH FEE I I OUT FIRST 2'0 -4✓S.20 $ OWNER c LIGHT T W7-- D. MAIL AD'L ADDRESS SWITCH OVER 20 iC TOTAL FIRST 20 / .20 CITY TEL.NO; o �'/ LIGHTING FIXTURES FIXTURES] - ADD•L .10 CONTRACTOR OVER 20 - . ct� RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS GARB.DISP. BTA.COOK �(� &ISTRlrT � TEL.NO.A DIBrIwaBH. wuro.-waBH. a� SPACE HTRS. BTA.APP.(ys'H.P..MAX.) ;s0 MOTORS: OVER NOT OVER H.P. G UP Z E PR DO' 1 1.00 Ir I1 3 1.50SPECTION RECORD 3 S 2.00 S: is 2.50 1s 50 3.00 O s0 100 .5.00 u - ve SIGNS: NO.TRANS. O NO.LAMPS SERVICE 0.600V-Nor OVER 200A 1.00 � rA SERVICE-0.60OV-0VER 200 A. 2.00. Z SERVICE OVER 600V 5.00 OTHER (SEE COMPLETE FEE SCHEDULE) - 1 PERMIT ISSUING FEE 2.00 r .SUPPLEMENTARY PERMIT ISSUING FEE 1.00 -' TOTAL FEES O APPROVALS DATE INSPECTOR'S SIGNATURE 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION UNDERSLAS WORK AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY ROUGH CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ,(+ _ ELECTRICAL WIRING. WIRING 1 HEREBY CERTIFY THAT L AM PROPERLY REGISTERED AND/ORFIXTURES' LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO. POWER RESIDE IN,THE SCRIEMD RESIDENTIAL PROPERTY. SIGNATURE UTILITY Co.NOTIFIED OF PERMITTEE FINAL (DATION JOSEPH C.ROOHAN CK MO CASH SUPERVISING ELECTRICAL ENGINEER LA o:1 5 9, 8ZOR APR 2 8 2 'D 3.6 0 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS JOHN A.LAMBIE,COUNTY ENGINEER , WILLIAM A.JENSEN. SUP-T OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS 8T PERMIT FEES OWNER ITEM INUMBER EACH FEE MAIL OUTLETS r $ S ADDR S LIGHTS RECEPT—f SW. _� .10 len LIGHTING FIXTURES .20 45 CITY ELEC.RANGES CLO.DRYERS ELECTRI AN WATER HEATERS .SO ADDRESS A _ ELEC.SPACE HTRS. DISHWASHERS CITY TEl NO. GARBAGE DISPOSERS AUTO.. STATE WASHERS STA.COOKING UNITS .28 LICENSE NO. 90 V1 I MOTORS: OVER INC. H.P. DISTRI T NO. G / UP ZONE 1213MOCESSED BY 0 . I/z .29 V2 -- 2 ,SO INSPECTION RECORD Q 2 — B 1.00 a I r�� o -r '—r u S — f8 1.80 s per`. c=�¢-^r,�; Ip, ,•� 1s — so 2.90 L !_. �1_� '�-%� < t ! t=�?:: 9 •%l Ax �0 SO — 200 8.00 �� a `sem_ -•: fl W. 1"?AA. r� NO TRANS. SIGNS: NO.LAMPS 10 '� yi '�°r'�u'�n 'r Z SERVICE 0-SOON 1.00 ��qq 1 �- •"� `'�_�' SERVICE OVER SOOV 3.00 MISC. / VxcL WIRING PERMIT 1,p0 6� FIXTURE PERMIT 1.00 � y �'�'FF�• SUPPLEMENTARY PERMIT 8O ' TOTAL FEE S I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ,CONDUIT A Ir WITH ALL COUNTY ORDINANCES AND• STATE LAWS REGULATING . ELECTRICAL WIRING. WIRING 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ,FIXTURES t /' I•/..9/1 y.77 CALIFORNIA OR THAT I AM THE LEGA OWNER OF THE ABOVE �►"l"y C i f fav^ �'rt/w DESCRIBED R631 6NT1 L PROPERA POWER I l.•• I��' SIGNATURE OF PERMIT T UTILITY CO. NOTIFIED FINAL (DATION ARTHUR C.VEIT, CK MO CASH SUPERVISING ELECTRICAL ENGINEER cs' 4 3 11 - .i .?3 2 D 4.30 3A663-CES0610.CO APPLICATION FOR ELECTR CAL PERMIT 1 COUNTY OF LOS ANGELES DEPARMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRES JOHN A. A.JEN E. COUNTY ENGINEER WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY p_ NEAREST FOR APPLICANT TO FILL IN CROSS ST. J PERMIT FEES OWNER I T E M NUMBERJ EACH FEE MAIL -• OUTLET s s �� ADDRESS LIGHTS RECEPT. W. .10 CITY TEL NO. LIGHTING FIXTURES ,10 ELEC. RANGES CLO. DRYERS ELECTRICIA I WATER HEATERS .50 ADDRESS IFIV ELEC.SPACE HTRS. 1SHWASHER a CITY TEL NO. GARBAGE DISPOSERS AUTO.- _ STATE WASHERS TA.COOKING U .25 t J LICENSE NO. MOTORS: OVER INC. H.P. D15TRIC NO. GCBY ROUP ZONE P ESSED 0— 1/2 .25 Ci -6-111- 1/2- 2 .50 INSPECTION RECORD } 2— 5 1.00 O_ O V 5— 15 1.50 cd 15— 50 2,50 O i-- 50— 200 5.00 a SIGNS: NO TRANS. H NO.LAMPS Z SERVICE 0-600V / 1.00 SERVICE OVER 600V 5.00 misc. WIRINGPERMIT 1.00JA JFIXTURE PERMIT i 00 SUPPLEMENTARY PERMIT .50 TOTAL FEEiHEREBY ACKNOWLEDGE THAT 1 HAVE READ THISN APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGRELY CONDUITWITH ALL COUNTY ORDINANCES AND STATE LAWSGELECTRICAL WIRING. WIRINGI HEREBY CERTIFY THAT I AM PROPERLY REGISTORLICENSED AS REQUIRED BY LOS ANGELES CO TY OF FIXTURESCALIFORNIA OR THAT I AM THE LEGAL O ER OVE DESCRIBED R - L PROPERTY. POWER SIGNATURE UTILITY CO.NOTIFIED OF PERMITT FINAL VALIDAT� ARTHUR C. VETT cKMo CASH SUPERVISING ELECTRICAL ENGINEER 1` ORKER'S COMPENSATION DECLARATION 20.0019 DPW(12-91) OftrebrIft-4 thlit I have a certificate of consent to self insure, 76A663 APPLICATION FOR ELECTRICAL PERMIT �J 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.)--• " Pbltcy No. Company FOR APPLICANT TO FILL IN JOB ❑ I•'�/O� /�/f Certified copy is,hereby furnished. New Residential Bldgs.&Pools NO. $EACH $• FEE ADDRESS G., L LOCALITY' LC"0 T- Certified'copy is filed with1&2-Family,Sq.Ft.the county building inspection NEAREST department. ;•' Multi-family Sq.Ft. CROSS ST. Date Applicant Residential Swimming Pools ASSESSOR MAP BOOK PAGE D PARCELd /t�� 7 CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec. 1_Light Sw. �/ p OWNER oR.� ` � /X COMPENSATION INSURANCE d / FIRM NAME C7' First 20 (This section need not be completed if the work Involved by the Total No. Additional MAIL cZo 7_e{- permit is for one hundred dollars($100)or less.) I certify that in the performance of the work for which this permit CITY e, 0 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 q•._ First 20 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 provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances APPLICANT *LICENSED CONTRACTORS DECLARATION Size&Type HP;KW,KVA,or KVAR , ADDRESS I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. (commencthg 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. } Over LICENSE B Class. ver 50 to 100 Inc REG.NUMBER d Over 100 DISTRICT NO. PROCES D BY V License Number Lie.Class. "0 Services,Swbd.,MCC&Panelboards 0 Contractor Date 0-399 Amp.Under 600 V DAA O 400-1000 Amp.Under 600 V -3— I am exempt under Sec. VALIDATION V Over 1000 Amp,or Over 600 V FINAL LLI B.&P.C.for this reasonBRANCH CIRCUIT FEES BY 11 Date: 15A,or 20A,,120V,Lighting or Recept. Z_ 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits 41 Or More Branch Circuits El Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits SINGLE FAMILY Temp.Power Pole&Appurtenances _ gtr HOME OWNER-BUILDER DECLARATION ACCT. I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit 44.40 for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits 333035 Code):. El I I I Ei j Conductors I,as owner of the property,will do the work and the structure Misc.Conduits& r ,,r is not Intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule) TOTAL •',,• 4. 40 and Professions Code). �' ECK 44-40 CONSTRUCTION.LENDING AGENCY rti � ij I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total) Civ.C.) PLAN CHECKING FEE i;(4'( — (� , IF. Lender's Name p PERMIT ISSUING FEE V 685% 1 1of 2s.05 - 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 Counfy to enter upon the above-mentioned property for s to urposes. g SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE R DATE