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Home My Public Portal About5832 MUSCATEL AVE_Electrical__ i 76A669-CEBOS B-62 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER VI LDING BUILDING AND SAFETY DIVISION RESS JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A.JENSEN,SUPT OF BUILDING CALITY ARESTFOR APPLICANT TO FILL 1N OSS ST. RECEPT. TOTAL NO. EACH FEE OUTLETS FIRST 20 $2O $ od OWNER '. LIGHT fes+✓ MAIL p SWITCH. =,gL 0 10 �O ADDRESS -• , JL OVER 2a7 � V TOTAL CITY LIGHTING l� FADD'L .20 TEL.40. FIXTURES 1 OVER 20 .10 ELECTRICIAN RANGES CLO.DRYERS WTR.HTRS. 1.00 1. 001 ADDRESS GARB.DISP. 8TA.COOK CITY0713 DISHWAGH. AUTO.-WASH. STATE y �y/� SPACE HTRS. •STA:APP.(Va H.P.MAX.) .50 Sol'LICENSE 1 NO. Q T3 MOTORS3 OVER NOT OVER H.P. DISTRICT NO. I G E OSOV0 B O 1 1.00 1 s 1.50 INSPECTION gEeORD a 8 2.00 s 12.50 15 so 3.00 } a so 100 5.00 O SIGNSt NO.TRANS, OC NO.LAMPS O ti SERVICE 0m600V-NoT OVER 200A LOO ly 0. SERVICE 0-600V-'OVER 200 A. 2.00 h SERVICE OVER 600V 5.00 ? MISC. PERMIT ISSUING FEE 2.00 ca SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE $ 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI TION APPROVALS DATE INGPECTOR'G 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 1 AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF E ABOVE DESCRIBED RESIDENTIAL PROPERTY. POWER SIGNATURE UTILITY CO.NOTIFIED OF PERMITTEE FINAL LIDATION ARTHUR C. VEI CK MO CASFI SUPERVISING ELECTRICAL ENGINEER �a- L.`x,01 3 2 Q OCT 7 2 A 9.4 0 r M DECLARATION 76A663 10,8, APPLICATION FOR ELECTRICAL PERMIT a certificate of consent to self CE-8066NPMMM116SA-TION 1 ''r Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or L. reof(Sec.. 3800, Lab. C.) I r Policy No. Company FOR APPLICANT TO FILL IN JOB f� is j- Certified copy is hereby furnished. i New Residential Bldgs. &Pools EACH NO. FEE ADDRESS . Tom` ❑ 1 &2-Family, Ft. $ — $ LOCALITY eVh, C Certified copy is filed with.the county building inspec- Y• S9• tion department. i Multi-family Sq. Ft. NEAREST i Residential Swimming Pools CROSS ST. �_a5 Date Applicant OWNER OR �V FIRM NAME vpew CERTIFICATE OF EXEMPTION FROM WORKERS' MAR Outlets:utlets: Rec Light Sw._ S `��. COMPENSATION INSURANCE ADDRESS completed if the work involved b First 20 (This section need not be com p Y Total No. Additional CITY �� Tel. No. the permit is for one hundred dollars($100)or less.) I certifythat in the performance of the work.for which this I ' PLAN CHECK permit issued, I shall not employ any person in any manner APPLICANT so as to com subject to the Wo kers'Corrop nsat' n Laws. Lighting Fixtures First 20 ADDRESS Total No. Additional N_4�� CITY Tel. No. Date pplicant "Fixed Appliances Not Over 1 HP PERMIT NOTICE O AP ICANT: If, after making this Certificate of APPLICANT v`C r Exemptio yo should become .subject to the Workers' Range_ Heater—D.W. — Compensation provisions of the Labor Code, you must forth- Oven —Dryer _W.M.— ADDRESS V � 3 with. comply. with such provisions or this permit. shall be' Jop — FAU —W.H. — deemed revoked. CITY Tel.-No. LICENSED CONTRACTORS DECLARATION Hood _ Fan _Other V� O�OV Disp. — Room Air Cond. LICENSE OR \� { Class. I hereby affirm that I am licensed under provisions of Chapter 9 REG.NUMBER l (commencing with Section 7000)of Division 3 of the-Business. DISTRICT NO. PRO SSED BY and Professions Code,and.my licehse is in full force and ffect. Power Apparatus&Large Appliances - } e Size&Type HP, KW, KVA, or KVAR' 0 License Number Lic.Class `� W C � Up To.. 1 Incl. FINAL d�\\0.� I s`" DATE /� VALIDATION 0 �J 'f�'�-� . ver 1 to 10 Incl. Contractory �'Date FINAL Over 10 to 50 Incl. V ❑ I am exempt under Sec. Over 50 to 100 Inc.. BY �+ B.&P.C. for this reason Over 1:00, V Services, Swbd.., MCC&Panelboards' ► Date: 0 -200 Amp. Under 600 V Signature 201 :1000 Amp. Under 600 V ❑ Over 1'000'Amp. or Over 600 V ,�O r_ Exemption for Reg. Maint. Elect. S. A SINGLE.FAMILY Temp..Power Pole&Appurtenances •P, a HOME OWNER-BUILDER DECLARATION "•2 Q' Sign with One Branch Circuit ' I,hereby affirm that I am exempt from.the Contractor's License Additional Sign Branch Circuits 4 R y. Law for the following reason (Section 7031.5,. Business and [ r• ' Professions Code): , ❑ 1, 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 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) (Sec. 3097, Civ. C.). PLAN CHECKING FEE I Lender's Name ;PERMIT ISSUING FEE Lender's Address i r I certify that I have read this application and state that the TOTAL FEE 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 t e above-menti ed p. pe y or inspection purposes.. SEE REVERSE FOR EXPLANATORY LANGUAGE 'i Signature of Permittee ate q WORKERS'COMPENSATION DECLARATION 1081 I APPLICATION FOR ELECTRICAL PERMIT i I hereby affirm that I have a certificate of consenf•to self E-806 E-BO6G .. insure, or a.certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof(Sec. 3800, Lob. C.) 1 46195 ZZ Policy No. Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE ADDRESS A S — Certified copy is filed with the county building inspec- 1 &2-Family, q• Ft. $ $ LOCALITY_ ' tion department. Multi-family Sq. Ft. CROSS ST. pLr ' Residential Swimming Pools Date Applicant OWNER OR FIRM NAME E �— CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw._ MAIL I� COMPENSATION INSURANCE ADDRESS First 20 (This section need not be completed If the work involved by Total No. Additional 'CITY aez 0— Tel. the permit is for one hundred dollars($100)or less.) that in the performance of the work for which this PLAN CHECK. I certify P APPLICANT permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's'Compensation Laws. Lighting Fixtures First 20 ADDRESS Total No. Additional CITY Tel. No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If; after making this Certificate of APPLICANT 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 Tel. No. LICENSED CONTRACTORS DECLARATION 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 " Power Apparatus&Large Appliances DISTRICT NO. �l PROCESSED BY >_ and Professions Code,and my license is in full force and effect. ✓/� p, i Size&Type HP, KW, KVA, or KVAR O License Number Lic. ClassUp To 1 Incl. FINAL V Contractor Date Over 1 to 10 Incl. DATE' r VALIDATION OW l 50 I 10 Over to Incl.❑ FINAL N I am exempt under See: Over 50 to 100 Inc. BY ��j W B.&P.C. for this reason Over 100 I Z i Date: Services, Swbd., MCC&Ponelboards ► 0 -200 Amp. Under 600 V Signature 201 -1000 Amp: Under 600 V ❑ Over 1000 Amp. or Over 600 V Exemption for Reg. Main.t. Elect. i SINGLE FAMILY Temp. Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION I Sign with One Branch Circuit O! 6 A I hereby affirm that I am exempt from the Contractor's License ' Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits a 0'0 0 0 C Professions Code): J I, as owner'of the property, will do the work and the + Misc. Conduits&Conductors 0 0 C 5 Or D structure is not intended or offered for sale (Section I Other(See Complete Fee Schedule)_ 7044, Business and Professions Code). ► " a " - r' 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) (Sec. 3097, Civ. C.). PLAN CHECKING FEE (a Lender's Name PERMIT ISSUING FEE Lender's Address I certify that I have read this application and state that the TOTAL FEE 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 inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE 42*ignature of Permittee Date