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Home My Public Portal About5226 MCCLINTOCK AVE_Electrical__ /6A6G3-CE80G-6-S7 APPLICATION FOR ELECTRIC PERMIT `1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING ct^Z Cq-C .`h• 6 BUILDING AND SAFETY DIVISION ADDRESS V G� JOHN A.LAMBIE,COUNTY ENGINEER CASSATT D.GRIFFIN,SUPT OF HUILDIN6 LOCALITY ��+ Q' NEAREST rG NJ FOR APPP LE IC�AT TSS ILL IN .cRoss sr. V OWNER LIGHTS RECEPTACLES SWITCHESI NUMBER I ITEM EACH 6 MAIL J ADDRESS S ll� TOTAL OUTLETS $ ..f0 ELEC: RANGES, (NATER HEATERS, CITY .�V TEL.NO.V�`•e s '�b CLOTHES DRYERS 'SO ELEC'TRICiA ELEC.SPACE HEATERS,STAT'Y. 000K- ING UNITS, GARBAGE.DISPOSERS, .ADDRESS AUTO WASHERS, DISHWASHER .25• LIGHTING FIXTURES .10 CITY TEL.NO. MOTORS STATE LICENSE NO. HORSEPOWER ME H.PJ I OVER INC. DISTRICT NO. G O P READY FOR INSPECTION - - V.aLESS .2s V$ — 2 .50 /` INSPECTION RECORD ',; ��, 4,/ I — 6 1.00 s is 1.50 IS — so 2.50 go' — 20.0 5.00 0�6• SIGNS NO.TRANS -•�� sd''9n'.w Dai ..' Ae.)14 NO.LAMPS ,�.,la•%.:La .f ._ �/S//t �ALy`>• •!I uP��'' . ./-77� SERVICE O-eoOV 2 1.00 ! SERVICE OVER 600V 6.00 WIRING PERMIT 1.00 FIXTURE PERMIT 1.00 -� SUPPLEMENTARY PERMIT .50 , TOTAL FEE g APPROVALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUITWITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING / r �� ELECTRICAL WIRING, WIRING n m/../l/. '2'-w`c0` �jli��it. .P�t!�•1;�+/' I HEREBY' C.ERTIFY THAT I AM PROPERLY.REGISTERED AND/OR F LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR. THAT 1 AM THE LEGAL OWNE F THE ABOVE POWER DESCRIBED R961DENTIA ROP SIGNATURE UTILITY CO.NOTIFIED Lf .p,,�,.sl„ „.49 OF PERMITTE FINAL - [OHN A.LAMBIE, ATION ARTHUR C.VEIT. rOUNTY ENGINEER MO coati SUPERVISING LECTRICAL]ENGINEER ' f Coo 3.2 9M APR 28 5AO � , WORKERS'COMPENSATION DECLARATION c 3 +l0/81 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I htave a certificate. of ci:66t to 'self insure, or a certificate of Workers'Compensation 'anc __ �" COUNTY'OF LOS ANGELES BUILDING AND SAFETY' r a certifi c. (Sec'. 3800, LC. �"�1 icy No. Compan FOR APPLICANT TO FILL IN JOB ❑ Certified copy is hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE ADDRESS 1 8 2-Family, S Ft. $ — S LOCALITY C. Certified copy is filed with the county building inspec- Y q' _ 'NEAREST �t4ionde Multi-family Sq. Ft. �Residential Swimming Pools CROSS ST. DateApplicant �414 OWNER OR /� FIRM NAME EXEMPTION FROM WORKERS' � r �J ` MAIL Outlets: Rec Light Sw. r ADDRESS COMPENSATION INSURANCE First 2 -r � 2-O �� (This section need not be completed if the work Involved by Total No.� Additional 1 CITY Tel. No the permit Is for one hundred dollars($100)or less.) I certifythat in the performance of the work for which this PLAN CHECK P .APPLICANT permit is issued, I shall not employ any person in any mariner so as to become subject to the Workers'Compensation Laws: Lighting Fixtures First 20 ADDRESS Total No. I Additional CITY Tel. No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT A, r / Exemption, you should become subject to the Workers' Range_ Heater D.W. Compensation provisions of the Labor Code, you. must forth- Oven. _Dryerl��W.M.— ADDRESS with comply with such provisions or this permit shall be Top _ FAU —W.H. — deemed revoked. Hood _Fan _Other_ CITY LICENSED CONTRACTORS DECLARATION 3�� 3 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 DISTRICT NO. PROCESSED BY Power Apparatus 8 Large Appliances d Y and Professions Code,and my license is i full force and effect.. �� O d Size&Type HP, KW, KVA, or KVAR• aJ e v Or 0 License Number Lic. Class Up to 1 Incl. FINAL Over 1 to 10 Incl. DATE f,Z_ . -3 VALIDATION Contractor 4e 4 Date - Over 10 to 50 Incl. a" FINAL U ❑' 1 am exempt under Sec. Over 50 to 100 Inc. BY LUB.&P.C. for this reason Over 100 Z Date: Services, Swbd.,MCC&'Panelboards + _ mp. . n er Signature 201 -.1000 Amp. Under 600 V ❑ Over 1000 Amp. or Over 600 V Exemption for Re Maint. Elect. ' 63 SINGLE FAMILY • f�3 Q"4 A HOME OWNER-BUILDER DECLARATION l Temp. Power Pole&Appurtenances s`. u o e a o 2 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 g C O Professions.Code): r ❑ I; as owner of the property, will do the work and the Misc. Conduits&Conductors s" G z structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)_ ► R S_P y 7044, Business and'Professions Code). CONSTRUCTION LENDING AGENCY 4 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 7/=0 / Lender's Address Icertify th I have read this application and state that the TOTAL FEE above in ation is correct. I ree to comply with all County ordina s and State laws r ulating Electrical wiring, and hereb uthori epre t es this County to enter upon the ove-m ne ty r 1 spection purposes. ( .SEE REVERSE FOR EXPLANATORY LANGUAGE _ Signature of Pe e Dpvre .r WORKERS'COMPENSATION DECLARATION 7,&A60 10/81- APPLICATION FOR E ECTRICA.L. PERMIT E- '' _ I hereby affirm that. I have a certificate of eons"ent.j*� �� insure, ora,certificate of Workers'Compensation Insurance, .f COUNTY OF LOS ANGELES �r r BUILDING AND SAFETY or a certified copy thereof(Sec.•3800, Lab:C.i) ! policy No. Company FORAPPLICANT TO FILL IN JOB L Certified co is hereb furnished, f EACH NO. FEE ADDRESS ' 02 LI'M 7-6 C.7� copy y New Residential Bldgs. &Pools , ❑ Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. $ — $ LOCALITY ern L` Tion department.* Multi-family Sq. Ft. — NEAREST Reside tial Swimming Pools CROSS ST. A-e- 'Date Applicant +. n g OWNEROR //�� FIRM NAME /.70 4C.S J'rri, CERTIFICATE,OF EXEMPTION FROM WORKERS' Outlets: Rec Light. Sw._ COMPENSATION INSURANCE MAIL st (This,section need not be completed if the work Involved'by Additional _ the permit'is for one hundred dollars(;1.00)or less.) Total No. Additional CITY Tel. No .d I'certify that in.the. performance of the work for which this PLAN CHEC CIQ- permitiis issued,I shall'not employ any person"ih any manner APPLICANT /J (.tJ 4-.6_6 iV so.as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20' ADDRESS, j A D. P Total No. Additional Date ��'� d�pplkant ' �� w �� °`� CITYd.g-�.�' Tel. No. O NOTICE TO APPLICANT: if, after making this Certificate of Fixed Appliances Not Over 1' HP PERMIT Exemption, you should become subject to the Workers' Range_ Heater_-D.W..— APPLICANT Compensation provision's of the Labor Code,..you'must forth-, Oven _Dryer _W.M.— ADDRESS ,✓` , with. comply with such provisions or this•permit shall be Top _ FAU _W.H. — deemed revoked. .V Hood _Fan _Other_ CITY• Tel.-No. + LICENSED CONTRACTORS DECLARATION LICENSE OR: D'isp. _ Room Air Cond..._ Class. Cv-Z a I hereby affirm that I am licensed under provisions.of Chapter 9- REG. NUMBE e-I �l (co'mm Tessio with Section y license of Division 3 of,the Business Power.Apparatus&Large Appliances DISTRICT NO. PROCESSED BY �„ and Professions Code,and my license is. n full.force and effect. IL Size&Type HP, KW, KVA, or KVAR- 4XM� O .License Number,24:5691 4 ? L•ic. Class�` "Zm. V Up to 1 Incl:' FINAL —A Over 1 to 10.Incl. DATE ✓ _' Contractor7aVa-i' FN�Date e "�� )Z-2(CC 3. VALIDATION O �� Over 10 to"•50 Incl. FINAL - I- 1 I am exempt under Sec.. Over 5.0 to 100 Inc. BY I e� 4 CL BAP.C. for this reason ' Over 100 . in Date: Services, Swbd.,, MCC&Panelboards �jQ�j 0.-200'Amp. Under 600 V ► `/114L [ "G 7 Signature 20'1 -}000 Amp. Under 600 V Over 1000,Amp. or Over 600 V ti ❑ Exemption for Reg. Mairit.,Elect. SINGLE FAMILY Temp. Power Pole&Appurtenances. HOME OWNER-BUILDER DECLARATION Sign with.One Branch-Circuit �. ry� I hereby e 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): U o •,j 0.0 G ❑ 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). s ,�- U 37 CONSTRUCTION LENDING AGENCY I'hereby affirm that there is a construction lending agency for11, -F the performance of the work for which this permit is issued i PERMIT FEE (Sub-Total) (Sec. 3097,.Civ. C..). i PLAN CHECKING FEE r D Lender's Name PERMIT ISSUING FEE Lender's Address' I certify that I have.read this application and state'that the f TOTAL FEE 19 above information is coriech 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 inspection purposes. SEE REVERSE.FOR EXPLANATORY LANGUAGE Signature of Permitt . Date