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Home My Public Portal About10240 NADINE ST_Electrical__ 7SAGS8 C&E19OS 756 APPLICATION FOR ELECTRIC PERMIT 1 • BU=lr4G AND SAFETY DIVISION DP Covatyt of o!LCOosmAagdes ear UILDING ZB S �JOHN A LAMBIE COUNTY ENGINEERCASSATT D GRIFFIN SUP T OF BUILDINGTY T ct FOUR APPLICANT TO FILL IN /�d C m 6 NUMBER OWNER G� LIGHT OUTLETS MAIL ADDRESS RECEPTACLES r WALL SWITCHES FEE CITY TEL NO TOTAL OUTLETS 0 s! $ ELECTRICIAN X0 / mr ELEC RANGES 25 ADDRESS 4, ELEC HEATERS 25 CITY TEL NO KW EA ATE 7FIXTURES S LI / CENSE NO 20 MOTORS DISTRICT] GR Z E READY FOR INSPECTION NUMBER HORSEPOWER FEE NEW MVD HP OVER INC EACH >�&LESS $ 25 IIPJMTION RECORD 14 2 so 2 s 100 s is Iso 1s 50 2150 50 1 200 500 MISC NO SIGNS NO TRANS NO SIGNS NO LAMPS FOR EACH PERMIT WIRING PERMIT $1 00 FIXTURE PERMIT $100 SUPPLEMENTARY s0 APPROVALS TOTAL FEE DATE INSPECTOR S SIGNATURE 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION CONDUIT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY i WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING ELECTRICAL WIRING FIXTURES I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELE COUNTY AND STATE OF POWER CALIFORNIA OR THAT I AM THE LE OWNER OF THE ABOVE DESCRIBED RES IDENTI L ROPE .T UTILITY CO NOTIFIED SIGNATURE OF PERMITTEE FINAL JOHN A LAMBIE ATION ARTHU VETT COUNTY ENGINEER CIC Mo CASH SUP�tYISING ELBCTRICAL ENGINEER LACO 9 3 9 7 L JUAN 1 s3 2 245 4 S 78p888 CE808 8 84 APPLICATION FOR ELECTRIC L PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS 0240 JOHN A LAMBIE COUNTY ENGINEER WILLIAM A JENSEN SUP T OF BUILDING LOCALITY eTem le Cit NEAREST F APPLICANTO FILL IN CROSS ST RECEPT TOTAL NO EACH MR OUTLETS FIRST 20 $2041 OWNER George E. Hearne MAIL LIGHT ADD L 10 ADDRESS Same SWITCH �— OVER 20 =TOTALLIGHTINGFIRST 20 20CITY TBL NO FIXTURESADD L OVER 20 10 ELECTRICIAN RANGER CLO DRYERS WYE MTRS 1 col I I ADDRESS 40 3 E. Broadway GARB DISP STA COOK CITY San Gabriel TEL No 446-0040 DISHWASH AUTO WASH STATE SPACE HTRS STA APP (Irl,H P MAX) s0 LICENSE NO 201816 MOTORSs OVER NOT OVER N P D=JZIC}eT ZONE P D O 1 100 U rA Al 1 s ISO INSPECTION RECORD } d s a 200 — Ey 0 V 8 IS laso Pw O 16 s0 Soo �'r so too s oo ; t U A� �� 3 N NO TRANS /� Z SIGNBt NO LAMPS sem+ �C• Q o pm SERVICE O GOOV NOT OVER 200A too r Pb ojiw SERVICE O GOOV OYBII 200 A 200 SERVICE OVER GOOV s 00 MISC DibL Pnnl- bnnijinq nqlu 141 rqrl, - PERMIT ISSUING FEB 200 SUPPLEMENTARY PERMIT ISSUING FEB too TOTAL FEE 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AP`PlItCAfALfi 0ATx INSPECTION S SI AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT L WITH ALL COUNTY ORDINANCES AND STATE LAW REGULATING LSIGNATURIC WIRING ��(( WIRING Z CEWrIFY THAT 1 M PROPERLY O III AND/OR Al REQUIRED BY S ANGELES COU ANbb STATE OF FIXTURES OR THAT 1 TME LEGAL WN OF THE ABOVE RESIDENTIA RTY POWER E UTILITY CO NOTIFIEDTTE FINAL i / ILIA R VER � MOO CAS CASH SUPERVISING ELECT CAL ENGINEER ut,01 0 6 o3 APR30 2 D 5.50- \ � T` , CITY OF 76A669-CE806 8.62 APPLICATION FOR ELECTRICAL PE MIT COUNTY OF LOS ANGELES 2 DEPARTMENT OF COUNTY ENGINEER ME) BUILDING AND SAFETY DIVISION JOHN A LAMBIE COUNTY ENGINEER �J`WILLIAM A JENSEN SUP T OF BUILDING C/ FOR APPLICANT TO FILL IN CROSS ST De'Al RECEPT TOTAL NO I EACH FEE OUTLETS FIRst 20 $20 $ OWNER ge, 2G6- LIGHT MAIL ADD L 10 ADDRESS OL G AI SWITCH OVER 20 n. 9 CITY E�-/ TEL NO G Z LIGHTING TOTAL l� F1Rst 20 20 FIXTURES 1 ADD L 10 ELECTRICIAN OV R 2O RANGES CLO DRYERS WT HTRB 100 ADDRESS W VC/7— CAM DISP STA COOK � CITY TEL NO DISHWASH AUTO WASH STATE SPACE HTRS STA APP (%H P MAX) 50 LICENSE NO MOTORS OVER NOT OVER HP_ DIST ICTU Z NE P D B O 1 fool ix I— s" 15o INSPECTION RECORD s a 200 s'.� Poop or— S/-av M!1 / a 15 2 50 15 50 Soo , so 100 5001 Ov SIGNS= NO TRANS NO LAMPS , O SERVICE O 600V NOT OVER 200A 100 1j SERVICE O SOOV OVER 200 A 200 f N SERVICE OVER 600V 500 ? J MISC PERMIT ISSUING FEE 2 00 SUPPLEMENTARY PERMIT ISSUING FEE 1100, TOTAL FEE $ S. 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS OA IN OR S SIGNATIUM AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY CONDUIT Z WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING WIRING 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AB REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES milt CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL ERTY POWER SIGNATURE P UTILITY CO NOTIFIED OF PERMITTE FINAL c MC, TI� A U C ELc CK MO CASN QSUPERVISING ELE RICAL ENGINEER 3 1 1 7 0 JUN2g 2 U 340 - 14 RKER S ON 20 0019 I hereby affirm Otthat I have Ma certificate of consen Oto self Insure 76AG63 Dom"(t2 91) APPLICATION FOR ELECTRICAL PERMIT or a gertificate 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) r Policy No Company FOR APPLICANT TO FILL IN JOB O 0 ADDRESS Certified copyishereby furnished New Residential Bldgs &Pools NO EACH FEE ❑ _ $ $ LOCALITY Certified copy is filed with the county building Inspection 1&2 Family Sq Ft NEAREST department Multifamily Sq Ft NAWST Date Applicant Residential Swimming Pools ASSESSOR MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERSOWNER OR I COMPENSATION INSURANCE Outlets Rec _Light Sw First 20 FIRM NAME (This"section need not be completed If the work Involved by the Total No Additional ADADRESS Q i permit Is for one hundred dollars($100)or less) I certify that in the performance of the work for which this permit CITY -C.0 Tel No r 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 First 20 APPLICANT Total No Additional ADDRESS Date Applicant NOTICE TO APPLICANT If after making this Certificate of RESIDENTIAL APPLIANCES NOT OVER 3 HP 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 such PERMIT gamic provisions or this permit shall be deemed revoked Power Apparatus&Large Appliances APPLICANT LICENSED CONTRACTORS DECLARATION' Size&Type HP KW KVA or KVAR ADDRESS N I hereby affirm that I am licensed under provisions of Chapter 9 ' Over 3 to 10 Incl (commencing 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 �, LICENSE Over 50 to 100 Incl REG NUMBER Clens O Over 100 DISTRICT NO P SS ED BY License Number Lic Class y V Servic wbd/, CC Panelb rds i PO Contractor If Date 0 go A p er 0 V DArTE ❑ 41 I am exempt under Sec 400 1000 Amp Under 600V V�� VALIDATION LU Over 1000 Amp or Over 600 V FINAL O_ B&P C for this reason — BRANCH CIRCUIT FEES 8Y (n Date 15A or 20A 120V Lighting or Recept ? 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits41 Or - its ❑ Exemption for Reg Mamt"Elect 15A 20A 208V To 277V Lighting Branch Ci�litsu SINGLE FAMILY Temp Power Pole&Appurtenances JL HOME HOME OWNER BUILDER DECLARATION JL 1 hereby affirm that I am exempt from the Contractors License Law Sign with One Branch Circuit for the following reason(Section 7031 5 Business and Professions Additional Sign Branch Circuits : 05 Code) 1 ITEMS I as owner of the property will do the work and the structure Misc Conduits&Conductors is not intended or offered for sale(Section 7044 Business Other(See Complete Fee Schedule) TI ITAL 37 .05 and Professions Code) , IHErK L7 0` CONSTRUCTION LENDING AGENCY y � AIv7E OIL!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 OCOO-0001 °/ 1/0-- Lenders /0-- Lenders Name PERMIT ISSUING FEE f�4 i 1 Ah10-10 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 Cou ty to enter upon the above mentioned property for m I SEE REVERSE FOR EXPLANATORY LANGUAGE Au I f DATE WORKER S COMPENSATION DECLARATION 2BA�9 DPW c12 91, 7APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self Insure 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(Sea 3800 Lab C) Policy No Company FOR APPLICANT TO FILL IN JOB foayo NA (a ADDRESS ')Certified copy Is hereby furnished New Residential Bldgs &Pools NO EACH FEE Ft Sq — $ $ LOCALITY ❑ Certified copy is filed with the county building Inspection 1 &2 Family — NEAREST department Multifamily Sq Ft CROSS ST PW Whir Date Applicant Residential Swimming Pools ASSESSOR rMAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec !L Light Sw J� rp OWNER OR p f►f�� a�� COMPENSATION INSURANCE First 20 O o �()� FrRAFf1AMe 1Y f< (This section need not be completed If the work Involved by the MAIL permit to for one hundred dollars(1100)or Isar) Total No Additional ADDRESS i I certify that in the performance of the work for which this permit CITY TTSC, Tel No L(qf fVq( 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 ' First 20 APPLICANT Total No — Additional ADDRESS Date Applicant (D�o IVIAf�t:AJR NOTICE TO APPLICANT If after making this Certificate of RESIDENTIAL APPLIANCES NOT OVER 3 HP CRY C Tel No Exemption you should become subject to the Workers Compensation OTHER APPLIANCES NOT OVER 3 HP 0�( provisions of the Labor Code you must forthwith comply with such PERMIT provisions or this permit shall be deemed revoked Power Apparatus&Large Appliances APPLICANT I 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 (commencing with Section 7000)of Division 3 of the Business and CITY "l. Tel No Professions Code and my license Is In full force and effect Over 10 to 50 Incl y, LICENSE Over 50 t0 100 Incl REG NUMBER Class 0. O Over 100 DISTRICT NO R ED BY License Number Lic Class V Services Swbd MCC&Panelboards C, Q Contractor Date 0 399 Amp Under 600V DATE AL O ❑ 400 1000 Amp Under 600 V Z� W I am exempt under Sec Over 1000 Amp or Over 600 V FINAL VALIDATION CL B&P C for this reason BRANCH CIRCUIT FEES BY Z Date 15A or 20A 120V Lighting or Recept _ 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits Exemption for Reg Maint Elect 15A 20A 208V To 277V Lighting Br Circuits + SINGLE FAMILY Temp Power Pole&Appurtenances 7 HOME OWNER BUILDER DECLARATION Sign with One Branch Circuit AtCT a I hereby affirm that I am exempt from the Contractor s License Law r forithe following reason(Section 7031 5 Business and Professions Additional Sign Branch Circuits Code) °V 1 as owner of the property will do the work and the structure Misc Conduits&Conductors 1 ITEMS Is not Intended or offered for sale(Section 7044 Business Other(See Complete Fee Schedule) , TOTAL ®�� and Professions Code) CHECK 1J9 �� CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the CHAkGE °OZI performance of the work for which this permit Is Issued(Sec 3097 PERMIT FEE (Sub Total) Civ C) PLAN CHECKING FEE n�tnnn ��1tn Lender s Name 00M—OW 1 7/2-17,f/ . PERMIT ISSUING FEE0959 1 AM 3:1,- Lender s Address TOTAL FEE Aim I certify that 1 have read this application and under penalty of purjury state that the above Information Is correct I agree to comply with all County ordinances and State laws regulating Electrical winng and hereby authorize representatives of this County to enter upon the above-mentioned property for nsa tlo &e, ` A SEE REVERSE FOR EXPLANATORY LANGUAGE eNATURE OF PERMITTEE YBATE