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Home My Public Portal About9843 MILOANN ST_Electrical__ 76.0663-C�E80611-71 APPLICATION FOR ELECTRICAL PERMIT .CO'UNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST OUTLETS NO. EACH FEE $ $ OWNER RECEPT._ MAIL LIGHT TOTAL FIRST 20 25 / ADDRESS CITY TEL. NO. SWITCH,'4— 7 OVER 20 •10 PLAN CHECK LIGHTING TOTAL FIRST 20 25 APPLICANT OVER 20 ADDRESS FIXTURES .f0 RESIDENTI APPLIANCES CITY TEL. No, L PERMIT RANGE DRYER_WTR. HTR. APPLICANT STA. COOK DISP. F.A.U. ADDRESS, SPACE HTR. AIR COND. CITYTEL. N CLOTHES WASH. DISHWASH. LICENSE NO./F, r CLASS FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATINiL IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR 0 - 1 1.00 LICENSED S REQUIRED BY LOS ANGELES COUNTY AND STATE OF d CALIFORNI HAT 1 E LEGAL OWNER OF, AND INTEND TO s 1 - 10 3.00 0 C� RESIDE IN, SCRIBED RESIDENTIAL PROPERTY. O SIUNATUR ad 10 — 50 5.00 OF PER TEE O 50 — 100 10.00 V j DISTRICT NO. CLASS PROC SEED Y Lu 100 — 500 15.00 A N SIGN, GAS SIGN AND ONE CIRCUIT 5.00 NOTES: ? TUBE, OR MARQUEE ADDITIONAL CIRCUITS IAO lei SERVICE NOT OVER 600 VOLTS OR 200 AMP 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE SERVICEOVER 600 VOLTS OR 200AMP 10.00 TEMP.POWER POLE TEMP SERVICE,POLE,&APPURTENANCES 5.00 rPERMIT OR RECEPT. SYSTEM 3.00 UNDERSLAB WORK ROUGH CONDIUT WIRING ` Zj FIXTURES POWER AUTHORIZED (SUB TOTAL) UTILITY CO. NOTIFIED FEE ' FINAL ING FEE 3.00 00 E 911-17-6- PLAN CHECK VALIDATION CK. M.G. CASH PERMIT VA I N CK. M.O. CASH {ACO 0 8 6 7 ij fa 1 2 D (13.75- SEE .75NcoSEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 76A869-eE806 9-64 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF. LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING S BUILDING AND SAFETY DIVISION ADDRESS' JOHN A. LAMBIE. COUNTY ENGINEER 1 COLEMAN W. JENKINS, SUPT. OF BUILDING LOCALITY �Q Awa NEAREST FOR APPLICANT TO FILL IN CROSS ST. •{w .¢, ' RECEPT. TOTAL NO. I EACH FEE oUT� FIRST 20;?o $ D .20 $ db OWNER LIGHT MAIL ADD'L �'j ADDRESS SWITCH. OVER 20 J •70D TOTALCITY TEL.NO. LIGHTING 1 � FIRST 20 70, .20 Q(� / � ./... /� FIX T S 1 p( J— OVER 20 1, .10 � 0 ELECTRICIAN WG. / `L d o RA CLO.DRYERS WTR.HTRS. 1.00 ` R ®0 ADDRESS /'1 ESTA.COOK CITY R TEL.NO. b d )�� A A STATE fi -Ow F41 D LICENSE NO. d TiiB. � ST .APP.(I H.P.MA .50 S: OVER oven H.P. DI.SICT N G P E D 0 1 1.00 0 also 1 s 1.50 INSPECTION RECORD s s 2.00 .Z 1 - Q 13 — le 2.50 - r1-c'J9-(�•n 'G. V 15 so 3.00 50 100 5.00 OR bd SIGNS: NO.TRAMS. a. NO.LAMPS U) z SERVICE 0-500V-Nor OVER 200A 1.00 0 SERVICE 0-SOOV-OVER 200 A. 2.00 SERVICE OVER SOOV 5.00 MISC. PERMIT ISSUING FEE 2.00 0 0 SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP LI _TI N APPROVALS TE INSP 'S SIGNATURE AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TOC MPLY CONDUIT WITH ALL•COUNTY ORDINANCES.AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING ,p 1 HEREBY:CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES ' LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT AM THE.LEGAL OWNS F,,AND IN TO RESIDE IN,THE ABOVE ESCRI B ED RESIDENTIA APR Y. POWER SIGNATURE UTILITY CO.NOTIFIED OF PERMITTEE FINAL (DATION JOS PH t. ROOHAN CK MO CASH SUPERVISING ELECTRICAL ENGINEER 3 0 7 0- JUN 2 4 2 D 17.90- '20-001 WORKERS'COMPENSATION DECLARATION n1 r. .76AM9DPW3/ft7 APPLICATION FOR ELECTRICAL PERMIT' O I. hereby af�tirm thc�!I have a,certificate of consentNio self •cep 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.) Policy No. Company FOR APPLICANT TO FILL IN JOB ❑Certified copy is hereby furnished. New Residential Bldgs: &Pools EACH NO. FEE ADDRESS / K ❑Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. $ — $ LOCALITY tion department. Multi-family Sq. Ft. NEAREST �. CROSS ST. Date Applicant Residential Swimming Pools OWNER OR FIRM NAME UgZ& fl CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL COMPENSATION INSURANCE Outlets: Rec Light Sw._First 20 ADDRESS lltir+.� (This section need not be completed If the work involved by Total No. Additional.' N. CITY Tel. No• fl-74,71 the permit is for one hundred dollars($100)or less.) PLAN CHECK I certify that in the performance of the work for which this APPLICANT permit is issued, I shall not employ any person in any manner Lighting.Fixtures' First 20 ADDRESS so as to become subject to the Workers'Compensation Laws. Additional Date r ApplicantAm. Total No. CITY Tel. No. NOTICE TO APPLICANT: If, aften this Certificate of Fixed Appliances Not Over 1 HP PERMIT g Range— Heater—D.W. APPLICATION f • Exemption, you should become subject to the Workers' Compensation provisions 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. — CITY I: No. deemed revoked. Hood: — Fan —Other— "a-.IZ77 LICENSED CONTRACTORS DECLARATION LICENSE OR Disp. _ Room Air Cond. — 3 Z�'�3 Class.C-1 b I hereby affirm-that I am licensed under provisions of*Chapter 9 �I REG. NUMBER (commencing with Section 7000)of Division 3 of the Business Power Apparatus&Large Appliances ' DISTRICT NO. PROCESSED BY d and Professions Code,and my license is in full force and effect. p� 3C�Z t��/ G/d Size&Type HP, KW, KVA, or KVAR ��d U License Number - 'Lic. Class Up to 1 Incl. FINA 7_ ..�/ Over 1 to 10 Incl. DAT 1 VALIDATION cc Contractor Date Over 10.to 50 Incl. FIN U ❑. I am exempt under Sec. Over 50 to 100 Inc. BY W B.&P.C. for this reason Over 100 d CO Services, Swbd.,MCC.&Panelboards ! Z Date: 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. , SINGLE FAMILY Temp. Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit l r r I hereby affirm that I am exempt from the Contractor's Licenser,; Law for the following reason (Section 7031:5, Business and. Additional Sign Branch Circuits Professions Code): '73137 " IDI, as owner of the.property, will do the work and theMisc. Conduits&.Conductors �. T . LTEniiw= structure is not intended or offered for sale(Section 7044, Other(See Complete Fee Schedule)_ Business and Professions Code). , j 1 I E AL 3 1 0�f CONSTRUCTION LENDING AGENCY il, ('HC'C r CHECK•t 5.�.l.O!-+LI 1 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) 'CHANGE. (Sec. 3097,3097, Civ. C.). PLAN CHECKING FEE Lender's NameC� i L/ 101-01101 7/26/3'7 PERMIT ISSUING FEE Lender's Address � -8 2 48 1.certify that I have read this application and statd.that the TOTAL FEE above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and h eby authorize representatives of this County to enter upon t above-mentioned property for inspection purposes. ; SEE REVERSE FOR EXPLANATORY LANGUAGE ' r U , Si§ ure o Permittee Date 5 WORKERS'COMPENSATION DECLARATION 20.0019 DPW 3/87 APPLICATION FOR ELECTRICAL PERMIT O I,herec) by ffirrn kW I have a certificate of consent to self CE-80 G 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.) Policy No. Company FOR APPLICANT TO FILL IN JOB ❑Certified copy is hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE 1 ADDRESS ✓ ❑Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. $ _ $ LOCALITY tion department. Multi-family Sq. Ft. NEAREST JIV Residential Swimming Pools CROSSST. Date Applicant— OWNER OR FIRM NAME Ad., / CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL COMPENSATION INSURANCE Outlets: Rec Light Sw._ ADDRESS (This section need not be completed if the work Involved by First CITY . Tel. No:,ff 7a,3/ the permit is for one hundred dollars(;100)or less.) Total No. Additional PLAN CHECK I certify that in the performance of the work for which this APPLICANT permit is issued, I shall not employ any person in any manner Lighting Fixtures First 20 ADDRESS so as to become subject to the Workers'Compensation Laws. Additional Total No. CITY Tel. No. Dote Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of APPLICATION (. 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 with comply with such provisions or this permit shall be Top — FAU —W.H. — deemed revoked. Hood — Fan —Other— CITY t2 Tel. No LICENSED CONTRACTORS DECLARATION LICENSE OR y /�� I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. REG. NUMBER Class.G)_V (commencing with Section 7000)of Division 3 of the Business Power Apparatus&Large Appliances DISTRICT NO. P SASSED BY d and Professions Code,andmy license is in full force and effect. Size&Type HP, KW, KVA, or KVAR ,�� y U License Number�? Lic. Class G �-6 Z_ Up to 1 Incl. FINAL jfr `i' ,o,..,/ (t /_12 �. Over 1-to.10 Incl. DATE VALIDATION Contracto LL�� Over 10 t0 50 Incl. U ❑ FINAL I am exempt under Sec. Over 50 to 100 Inc. BY W Over 100 a B.&P.C. for this reason I Services, Swbd., MCC&Panelboards , U) Date: Z 0-200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V DExemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY Temp. Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit S•;- I hereby affirm that I am exempt from the Contractor's License Additianal Sign Branch Circuits i'r Law for the following reason (Section 7031.5, Business and g �___ r;—s Professions Code): .J30i Misc. Conduits&Conductors 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)— Business and Professions Code). _CITAL 20 00i CONSTRUCTION LENDING AGENCY 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) Q j HNUL •=11 (Sec. 3097, Civ. C.). 1 PLAN CHECKING FEE _ Lender's Name + IJI.:t:l.s�l.il.,Isf ,l.ti7 t PERMIT ISSUING FEE C� Lender's Address iL` p" I certify that I have read this application and state that the I TOTAL FEE ll'� above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and h reby authorize representatives of this County to enter upon t above-mentioned property for inspection purposes. } SEE REVERSE FOR EXPLANATORY LANGUAGE LZ�9, ig ture of Permittee Date j ®' i