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Home My Public Portal About5503 PAL MAL AVE_Electrical__ 76AG53-CESOG 1,70 APPLICATION FOR ELECTR(CAC PEa LJ COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER Bu1LOING BUILDING AND SAFETY DIVISION ADDRESS SO JOHN A LAMBIE COUNTY ENGINEER LOCALITY COLEMAN W JENKINSSUPERINTENDENTof BUILDING FOR APPLICANT TO FILL IN NEAREST CROSS ST OUTLETS NO GAZA F! OWNER RECEPT 1 MAIL LIGHT� O L FIRST 20 20 ADDRESS OVER 20 Cl TV TEL NO SWITCH ID PLAN C ECK LIGHTING FIRST 20 20 APPLICANT TOTAL = OVER 20 ADDRESS FI XTURlS 10 APPLIANCES CITY — TEL NO PERMIT RANGE_DRYER_WTR HTR_ APPLICANT STA COOK_DISP_F A U _ ADDRESS �60� SPACE HTR AIR GOND CITY TEL NO 3 CLOTHES WASH DISHWASH_ LICENSE NO 07WCLASS FAN OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STAT[ THAT THE ABOVE IS CORRECT AND AYR[E TO COMPLY MOTORSTRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STAT[ UWD REGULATING IND HEATERS ETC HP KW RVA ELECTRICAL WIRING SIZE A TYPE OVER TO 1 HEREBY A CERTIFY THAT I AM ANGELES CI REGISTERED ATE OF Q - 1 100 LICENSED AS REQUIRED I BY LOS ANGELES COUNTY ADD STATE 01 CA LIIORNIA OR THAT I V THE L[SAL OWNER OF AND INTEND TO 1 - 10 300 R[tIDC IX THE ABO V! 0lDCRI [D RESIDENTIAL PROPERTY SIGNATURE 0_ 10 - SO SOD OF PERMITTEE 0 V SO — 100 10A0 mtTRmrXo cost GRouP zoxe PR a r o< 100 — Soo lana ,�0 0 91GN, GAS SIGN AND ONE CIRCUIT 300 NOTES OL Tun, oR n MARQUEE ADDITIONAL CIRCUITS 100 Z SERVICE NOTOVER SOO VOLTS OR 200 AMP 200 SERVICEOVER600 VOLTS OR 200 AMP 500 APPROVALS PDATElOOPlCTONS tNI4TUR! TEMP POWER POLE TEMP SERVICE POLE,d APPURTENANCES 300 UNDERSLAD WORK TEMP LIGHT OR R!ClPT SYSTEM D00 ROUGH CONDIUT WIRING FIXTURES PERMIT FEE (SUB TO POWER AUT14ORIZED PLAN CHlCX FEE (EO% PERMIT FEE) UTILITY CO NOTIFIED PERMIT ISSUING. FEE 200 FINAL SUPPLEM ENTARV PERMIT ISSUING FEE IAO JOSEPH C ROOHAN TOTAL FEE G SUPERVISING ELECT)IL ENGINEER PLAN CHECK VALIDATION CR M 0 CASH PERMIT VALIDATION CRM 0 CASH I An_ 0rAY21 2 D 2.00 - 519 NAM Of APPLICATION FOR COMPLETE SCNIDVLE 7SA663-0005 Ino J \ APPLICATION FOR ELECTRIC L PERM U COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING SSO (I BUILDING AND SAFETY DIVISION AOOR ESS o-C JOHN A LAMBIE COUNTY ENGINEER LOCALITY , COLEMAN W JENKINS, SUIPIRRINT11INDISMIT OI 13UILDING FOR APPLICANT TO FILL IN CROSS ST , OUTLETS H FEE / s OWNER /p MKs MAIL11Av ie [ECEPT FIRST 202D ADDRESS SSD'3A` L HT TOT OVER 20 TY ,P An i� l�T TEL NO TCH 10PLAN CHECK HTING l FIRST 20 m APPLICANT -= )j TOTAL OVER 20 ADDRESS FI%TURES 10 APPLIANCES CITY TEL NO PERIT RANGE_DRYER—WTR HTR_ APPLICANTO �c ,t Cuicv STA COOK_DISP _F A U _ ADDRESS 6O / • , SPACE HTR AIR CONO CITY ^ TEL NO CLOTHES WASH _DISHWASH_ LICENSE NO b P CLASS C'-10 Ad._T.. FAN—OTHER QTR 100 I HEREBY THAT THE ABO THAT I HAVE READ THIS APPLICATION AND STATE ALL THAT TN[ ABOVE E CORRECT TE ADR![ TO COMPLY MIND H TRANSFORMERS RKW K EWIT HLEC ALL CWNTY ORDINANCES AND STATE LAWS REGULATING ILD REATCRt [TC NI EW KVA ELECTRICAL WIq IMO li! S TYPE OVER TO I NEREDY CERTIFY THAT 1 AM PROPERLY REGISTERED ANOMR O — 1 100 i5uLICCHDCD AI REOUIRED IY LOS ANGELES COUNTY AND STATE OF CALIFORNIORA THAT 1 AM THE LEGAL OWNER OF AND INTEND TO I — 10 300 RESIDE IN THE ASOVC OESCRIrEA RE31DENTIAL IR ERTY rIXTURES TURE 10 — SO 500 RMITTEE 50 - 100 IOAO DT NO ClAbf GROUP 20X! PRO 100 - Soo 1500 DSIGN GAS SIGN AND ONE CIRCUIT 300 S �J�TUBE ORMAROUEE ADDITIONAL CIRCUITS 100 SERVICENOTOVER 600 VOLTS OR 200AMP 200 PPROVALS DATE IH9[CTOR'D DIONATUR!SERVI CE OVER 600 VOLTS OR 200 AMP 500POWER POLETEMP SERVICE,POLE 6APPURTENANCES 300SLAB WOR%TEMP LIGHT OR RECEPT SYSTEM 300 CONDIUTGPERMIT FEE (SUB TOTAL) RESPLAN CHECK FEE (SDR PERMIT FEE) AUTIq RIZEDY CO NOTIFIEDPERMIT ISSUING FEE 200A�If 1 GSUPPLEMENTARY PERMIT ISSUING FEE 100JOS H C ROOHAN TOTAL FEE FSUPERVISING ELECTRICAL ENGINEER PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATIO � M It CASH I A" 0 3 6 0�- N120 2 D 5.40- SCC DAM OF APPLICATION FOR COMPLETE SCHEDULE "O"nRS °°""°E"S""°"DECLARATION 7E BO °'a' APPLICATION FOR ELECTRICAL PERMIT c J heraty Itis that I Have a Certificate d Consent to sett i mise. eoeO 1 • « e lca e of V.orken Compensation insurance. or a cebfied COUNTY OF LOS ANGELES BUILDING AND SAFETYcopy theIUI (Sec 3800 Lab C I Policy No7 a 3a Compena Lgtl-eLJ 111 •-� FOR APPLI(-d11T 70 F61 IN J°8 ❑ CertifiedCertifiedCopyie he Copy reby turnmlod New Residential Bldgs,A EACH NO FEE ADDRESS LOCALJTY . Certified copy s filed with the county 1 d 2-Family So Ft. S — S AA Mulb-family,So Ft NEAREST Date 4 t APPllrarlt Reelderllsl SWImmmO FbdeCROSS ST IOU 111,.0-It OWNER OR 4044 L4. FNA NAMEget CERTIFICATE OF EXEM FROM NORKERS r IAAe- COMPENSA Sl1RANICE Outlets Flee I.P9M SW A00RESS (Thio section need not be completed ifthework Involved by theFirst 20 Told No Additional Permit Is f«we hundred dollen(5100)« eu l ) I certify that in the performance of the work for which the permit PLAN CK Is Issued 1 snail not empty, afy person in any manner s° ss to became nrblect to the Vio"m Compensation Lewy Lghhng Fixtures First 20 ADDRESS Additional Total No CITU Tel No DateApplicantAppliances Nd Ovor 1 HP p bM Tr NOTICE TO APPLICANT H after making this Certificate d Exemption you should become subfeet to the Vrbfkers Compensation Range— Heater_ Ow _ APPLICANT proviaona of the Labor Code you trust lorthrnth Comply wrath such Olen _ Dryer _ W M _ ADDRESS provisions or this permit Mall be deemed revoked Top _ FAU _ WH LICENSED CONTRACTORS DECLARATION Flood — Fan _ OtherCITU Tel No _ I hereby me affirm that 1 em licensed under n 3 of provisions d Chapter 0 D Boon Mr Cord LICENSE B Cw. (commencing with Section 7000) of Division 3 d the Business and REO NUMBER Professions Code and my license is In kill f and effectDISTRICT NO PROCE By FUwer Apparatus 6 Large Apdancea S License Number 47(0 6-13 Sae A Type HP KW KW or KVAR (, � Up to 1 Uri FINAL CambeCt« � (�_Data 4AA n�-�¢p_ —over Ito 10 DATE Over 10 o fil SO fiid I am exempt under Sec Over 50 to 100 In- SAP C nnSAPC I«this reason Over 100 Dere Services,Swbd MCC 8 Panelboards ► N 0-200 Arte Under 600 V Signature 201 - 1000 Amp Under 600 V ❑ Over 1000 Amp «Over 600 V Exemption lion Reg Marco Elect SINGLE FAMILY Tamp Furter Pole It Appurtenances HOME OWNER-BUILDER DECLARATION Sign win One Branch Circuit I hereby affirm that I am exempt from the Contractors License Lew Additional Sign Branch Granth f« the following match(Section 7031 5 Bialress and Professions Code) f 9 4 9 0 A ❑ I as owner of the property wig do the work and the structure Misc.ConduM 6 Corduct«E # . . . . . 2 Is not mrerided or offered for sale (Section 7044 Business COW(See Compere Fee Schedule) ► i 1 • • 3 e 7 5 and Professions code) . . -3a756 CONSTRUCTION LENDWG AGENCY 1 hereby affirm that thea is a comb cton lending agency for the perl«marce d the work for Which thin perrmt is band(Seo.3097 PERMIT FEE (Sub-Told) 04.29-88 PLAN CHECKING FEE Lender Nano Leaders Atib' did PERMIT ISSUING FEE at I hive re �, I ceve ad This application and state that above TOTAL FEE ntormaton is correct I agree to oor py with all County ordinances and State lawns regulating Electrical wiring and hereby auttorae representatives Of County to emu upon the above-memonad I« purposes SEE REVERSE FOR EXPLANATORY LANGUAGE u I rrnmee Da WOPo`atu have I COMPENSATION DECLARATION to CE 8040 bra, APPLICATION FOR ELECTRICAL PERMIT {1 �4lteraby r.7f�rril,that 1 haw a cerMlmte d torment to sail usury �B0a0 �J or a certificate of Workers Canpereate Insurance or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy Tnefeol(Set.38DO Lab C) Policy N1430Z0 Company jKt J ,96t FOR APPLIGNT TO FILL W JOB ADDRESS .1C/ I ❑ Certded copy s hereby h nW*d New ReResidentialBldpe a Poole EACH NO FEE ❑ Cerafed cops is filed with the county GaldFq Inspects 1 a 2-Family So FL $ = S LOCALITY de Multi-famdy So Ft NEAREST CROSS ST Date Applicant 4� Residential Swimm ng Rwb FFM R OR y OWFER OR 1 CERTIFICATE OF EXEMPTION FROM WORKERSMAL COMPENSATION INSURANCE Outlets Ret—LqM _Sw ADORE (This section need not be completed If the work bwohed by the Fust 2i) Permit Is for one hundred dollars(S 100)or CITU leas) Total No Additional e. L(K 1 Tel NO I certdy that in the performance d the work far which this permit ��7 K is issued I shall not empty any person in any marner so as to become subject to the Workers Canpereaton laws Lighting Fixtures First 20 ADDRESS Total No Additional CITY Tal No Data �'(AV APplcmll�� Fled Appliances Not Over 1 HP NOTICE TO APPLICANT If stow meklnp us Cendcate d APPLX:AFfT Li ec N� Exemption you should become subject to the Work" Canpensaton Range_ Heater_ OW provisions of the Labor Coda you must furthwnh comply with such Own _ Dryer W M _ ADDRESS duaS' promrone or the permit sha11 be deemed revoked Top — FAU y,L W H UCENSED CONTRACTORS DECLARATION Flood _ Fan Other_ CITY T m I hereby affirm that I am licensed under powsiors of Chapter g prep _ Roan Air Cond — ? REO�Nln.ON Cu. (cotnmerlcing with Section 7000)d od Dn sn 3 the Business and iv Professions Code and my license is in full force and effect DISTRICT NO PROLE D BY Povver Apparetrs a Large ApplsnCea License Number V r�[f I� W �s Sae d Type HP KW KVA or KVAR `� �(-��1 xic, lip to 1 bid FINAL Convector�•� /--G Date- � Over 10 to 50 Ind ��—Over I to 10 Ind VAUDAnoN ❑ I am exempt under Soc Over 50 to 100 no y� WW BAPC for the reason Over 100 a Servicea Swbd MCC a Parefboards , N Date 0-200 Amp Under 600 V Z Signature 201 - 1000 Amp Under 600 V 3 9 5 Q 4 A w Over 1000 Amp or Over 600 V # e • . • • 2 ❑ Exemption for Rep A1sint Elect SINGLE FAMILY Temp Power Pole 6 Appi rtersnces e 92 1. 0Q HOME OWNER-BUILDER DECLARATION Sign with One Branch Crmud I hereby affirm that 1 am exempt from the Contractor s License Law l SBranch Cl for the fdk w M reason(Section 7031 5 Business and ProlmmAdditionaqnrancrgAh e . e ons 2 t o Q b C(xe) Mea Conduits Conduct= 05 Q2 —8 8 ❑ I as owns of the 70 mPY will do the work and the structure s not eoffered on 70 intended or offered for sale (Swo44 structure Other(See Complete Fee Schedule) and Professes 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(Sec 3007, PERMIT FEE (Sub-Total) CTI C) PLAN CHECKING FEE Lendara Nana 0 PERMIT ISSUING FEE Larder's Address I cartiy that I haw read the aPdcaton and state that the above TOTAL FEE r 0 information is correct I agree to comply, with an County, ordnance i and State Jews regulattrq Elednal wring and hereby authorize representatives of the County to enter upon the abc a menbwed for s SEE REVERSE FOR EXPLANATORY LANGUAGE of Penn Date