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Home My Public Portal About10143 NADINE ST_Electrical__ 760663 CRGOG IO 156 APPLICATION FOR ELECTRIC PERMIT 1 BIIWING AND SAFETY DMSION Dep�mt� {Y ew BUILDING Commity ADDRESS JOHN A LAMBIE Couuw ENGINEER CASSATT D GRIFFIN Sup T OF Summme LOCALITY FOR APPLICANT TO FILL IN CROSS ST. PER= FEESor • OWNER LIGHTS RECEPTACLES SWITCHES NUMBERI 1 T E M EACH FEE MAIL TOTAL OUTLETS ; 10 d ADDRESS ELEC RANGES WATER HEATERS ITY TEL N CLOTHES DRYERS s0 IST ELEC SPACE HEATERS STAT Y COOK ELECTRICIAN IS UNITS GARBAGE DISPOSERS Q� ADDRESS 44- AUNTO WASHERS DISHWASHER as i6I LIGHTING FIXTURES10 t a CITY TEL NO MOTORS STATE LICENSE NO a HORSEPOWER H P OVER INC DISTRICT NO GROUP ZONE READY FOR INSPECTION Vit Be LESS 25 Yz — 2 2 0 DiS=TION EMMIW 2 — s 100 8 1s Igo IS so 250 50 200 s 00 MISC SIGNSI NO TRANS NO LAMPS SERVICE O GOOV too O SERVICE OVER GOOV Boo WIRING PERMIT 1 00 FIXTURE PERMIT I 1 00 ASA SUPPLEMENTARY PERMIT s0 APPROVALS TOTAL FEE EZLI DATE INSPECTOR S SIGNATURE 1 HEREBY ACKNOWLEDGE THAT I HAVE READ TH19 A 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 FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 M TINI LEG OW]WR OF THE ABOVE POWER DESCRIBED RESIDENTIA OPFXY SIGNATURE UTILITY CO NOTIFIED OF PERMITTEE FINAL JOHN A LAMBIE VAMATON.. ARTHUR-C-VETT COUNTY ENGINEER CK MO CASH ) SUPERVISNG ELECTRICAL ENGINEER ,a3 � 9� s�16 a 1210 76S663_Q 0/72 APPLICATION FOR ELECTRICAL PERMIT U A, -1 l COUNTY OF LOS ANGELES CtPARTMENT OF COUNTY ENGINEER 7NEAREST • BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN CROSS ST /IV� OUTL.ZTS NO EACHI FEE OWNER OR FIRM NAME RECEPT 1 $ $ MAIL FIRST 20 25 ADDRESS LIGHT TOTZZAL CITYAeup TEL NO � SWITCH -7-3OVER 20 10 �0 PLAN CHECK LIGHTINGL 10 FIRST 20 25 APPLICANT FIXTURES TO OVER 20 ADDRESS RESIDENTIAL APPLIANCES CITY TEL NO PERMIT RANGE DRYER WTR HTR APPLICANT N STA COOK DISP F A U ADDRESS /17ft i SPACE HTR AIR COND CITY TEL NO CLOTHES WASH DISHWASH LICENSE OR REG NUMBER CLASS FAN OTHER 100 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS TRANSFORM ERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND HEATERS ETC HP KW KVA ELECTRICAL WIRING SIZE & TYPE OVER TO I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR 0 - I 100 LICENSED A9 REQUIRED BY LOS ANGELES COUNTY AND STATE OF' CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE I - 10 300 DESCRIPED REST PROPERTY C� PERMITEE C7 10 - 50 500 SIGNATURE C F- 50 - 100 1000 DISTRICT NO ROC ED BY yV� 100 - 500 1500 Q 8 o Z SIGN GAS SIGN AND ONE CIRCUIT 500 APPROVALS DATE INSPEC 8810NATURE TUBE OR MARQUEE ADDITIONAL CIRCUITS 100 TEMP POWER POLE SERVI CENOT OVER 600 VOLTS OR 200 AMP 300 UNDERSLA13 WORK SERVICEOVER 600 VOLTS OR 200AMP 1000 ROUGH CONDUIT TEMPSERVICE POLE &APPURTENANCES 500 WIRING 3 TEMP LIGHT OR RECEPT SYSTEM 300 FIXTURES POWER AUTHORIZED / UTILITY CO NOTIFIED FINAL PERMIT FEE (SUB TOTAL) NOTES PLAN CHECK FEE PERMIT ISSUING FEE 300 D TOTAL FEE PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALI ION cK M 0 CASH � a 0669773 APR 20 D 12801 SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE As WORKERS COMPENSATION DECLARATION 7&AW 10/81 APPLICATION FOR ELECTRICAL PERMIT I�arelaVroffirm that I have a certificate of consent to self a� �ii1sure or a certificate of Workers Compensation Insurance COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof(Sec 3800 Lab C ) Policy No Company FOR APPLICANT TO FILL IN JOB 3 ❑ Certified copy is hereby furnished New Residential Bldgs &Pools EACH NO FEE ADDRESS Certified copy is filed with the county building in e 1 8 2 Family Sq Ft $ — g LOCALITY do dep rtment .. Multifamily Sq Ft — NEAREST Residential Swimming Pools CROSS CT OWNER OR Date Applic FIRM NAME CERTIFICATE OF EXEMPTION FROM W RKERS �Sw MAIL COMPENSATION INSURANCE Outlets RecLight ADDRESS First 20 J321 (This section need not be completed If the work involved by Total No Additional CITY Tel No 6�SZ8' 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 so as to become subject to the Workers Compensation Lows 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 Ilk 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 _WH _ r 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 DISTRICT N PROCE Y and Professions Code and m license is in full force an c(effect Power At8 Large Appliances >. r / Size&Type HP KW KVA or KVAR f 0 License Numb v Lic Class Up to 1 Incl FINAL V Over 1 to 10 Incl DATE Contractor L C Date VALI TION ❑ Over 10 to 50 Incl t— FINAL I am exempt under Sec Ove-F 50 to 100 Inc BY B&P C for this reason Over 100 Z Date Services Swbd MCC&Panelboards ► 0 200 Amp Under 600 V *27(15A Signature 201 1000 Amp Under 600V ❑ Exemption for Reg Maint Elect Over 1000 Amp or Over 600 V # • e • • • 2 SINGLE FAMILY Temp Power Pole&Appurtenances 1 - - 1575 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 • • • 5755 Law for the following reason (Section 7031 5 Business and Professions Code) I ) Q Q 14—8 5 ❑ I as owner of the property will do the work and the Misc Conduits 8 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 of the work for which this permit is issued PERMIT FEE (Sub Total) (Sec 3097 Cw C ) PLAN CHECKING FEE Lender s Name PERMIT ISSUING FEE Lender s Address I certify that I have read this application and state that the TOTAL FEE A,6 above information is correct I agree to comply with all County ordinances and State laws regulating Electrical wiring and hereby authorize represe trves of this County to enter upon the ab mentioned erty for inspecti (purpos 11, ; SEE REVERSE FOR EXPLANATORY LANGUAGE .\-�Signature 1 Permittee I Date