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Home My Public Portal About4839 PERSIMMON AVE_Electrical__ 7GA663-CES0610/72 APPLICATION%i_aii�CTRIC'Al. ERMIT COUNTY OF'LOS ANGELES DEPARTMENT OF COUNTY ENGINEER JOB ,3g NI7E �7'1rno�l BUILDING AND SAFETY DIVISION ADDRESS LOCALITY 1� NEAREST FOR APPLICANT TO FILL IN CROSS ST. OUTLETS NO. EACH I FEE FIRNAME $ $ RECEPT._ MAIL FIRST 20 25 ADDRESS LIGHT TOTAL OVER 0 CITY TEL. N0. 2 SWITCH_ .10 PLAN CHECK LIGHTINGTOTAL FIRST 20 .25 APPLICANT FIXTURES OVER 20 .10 ADDRESS RESIDENTIAL APPLIANCES CITY TEL. N0, PERMIT RANGE DRYER_WTR. HTR. APPLICANT I IZS STA. COOK DISP. F.A.U. ADDRESS SPACE HTR. AIR COND.� CITY 7g5,,d /r- TEL. N0. • d CLOTHES WASH. D15HWASH. LICENSE ORREG. NUMBER / CLASS. FAN OTHER 1.00I HER ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION 00ANDSTATE THAT.THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND S,TATE LAWS REGULATING IND. HkATERS, ETC. HP. KW.KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO • I HERESY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR 0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE v 1 - 10 3.00 O: DESCRIBED RESIDE IAL PROPERTY. O PERMITEEj 10 - 50 5.00 o SIGNATURE v` P. F 50 - 100 1MOO DISTRICT N0. R CE ED BY41 W Ci. 100 — 500 15.001 :5 D ti Z SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTOR'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS IAO TEMP. POWER POLE SERVI CENOT OVER 600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK SERVICE OVER 600 VOLTS OR 200 AMP 10.00 ROUGH CONDUIT TEMPSERVICE,POLE,&APPURTENANCES 5.00 WIRING -4 `7J TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES , POWER-AUTHORIZED UTILITY CO. NOTIFIED FINAL PERMIT FEE (SUB TOTAL) j) NOTES: PLAN CHECK FEE PERMIT ISSUING FEE 3.00 TOTAL FEE PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION CK. M.0. CASH O b 6 ci!i�Y 1.7 2 D 7.00 Aid SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 16A663C-CH6068 12/73 APPLICATION FOR ELECTRICAL PERMIT BUILDING AND SAFETY DIVISION FOR APPLICANT TO PILL IN JOB V' New Residential.Bldgs.&Pools EACH NO. FEE ADDRESS 3'. 1•&2 Finaily Sq. Ft. $ — $ LOCAL.ITY �tT (LC C T� Multi-family Sq. Ft. 64 CROSS ST.i+OWf- j?AM,?#4 d p6QS1 Residential Swimming Pools OWNER O.R FIRM NAME' Outlets: Light;Switch&Receptacle MAI L .0 !, First 20 RES (L J 50 b C Additibnal u CITY Tel. No. rC�!3 5 J . / PLAN CHEW Lighting Fixtures APPL:ICAN First 20 9oQ ADDRESS _ Additional CITY Tel.No. PERMIT Fixed Appliences.Not Over 1 HP APPLICAN Range— Heater_ D.W. ADDRESS ' U. - Oven Dryer _ W.M. Tel.No. Top FAU _ W.H. _ CITY �. S >_ Hood Fan LICENSE OR o REG. NUMBER Class. Disp. A.C. v 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION Q Power Apparatus& Large Appliances AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY V WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING W Size&Type HP, KW,KVA,or KVAR ELECTRICAL WIRING. y U to 1 Incl. Upto CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR Over 1 to 10 Incl: "L=> LICENSED A GUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER P THE ABOVE OveW10to 50 Incl. DESCRIBED ESID NTIA.L P Ovee 50 to 100 Incl. PERMITEE Over 100 SIGNATURE DISTRICT NO. Services PR ESS �`O ry 0-200 Amp. Under 600 V 2S 201 -1000 Amp. Under 600 V JR PPROVALS DATE I SPECTOR'S. Over 1000 Amp,or Over 600 V SIGNATURE ` OWER POLE Temp. Power Pole&Appurtenances LAB WORK Sign with One Branch Circuit Additional Sign Branch Circuits CONDUIT (Other) . ES _ AUTHORIZED PERMIT FEE (Sub-Total) CO.NOTIFIED CHECKING FEE (One-Fourth Permit Fee)PERMIT ISSUING FEETOTAL FEE. PLAN CHECK VALIDATION CK. M.O. CASH, PERMIT VALIDATION CK.: M.O. CASH 912,AUS =16 2 -0 13.0.0 t�G�2 73A683•CESOS 4.85 APPLICATION 'FOR 11EC ICAL PE IT- COUN.TY-OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING Q BUILDING AND SAFETY DIVISION ADDRESS /h7 M d�. JOHN A. LAMBIE,.COUNTY ENGINEER P �p COLEMAN.W. JENKINS. SUPT. OF BUILDING LOCALITY (l�H1 v �'e Com! NEAREST y� FOR APPLICANT TO FILL IN CROSS ST. 6�/Qi+v RECEPTACL TOTAL NO. EACH FEE I _j OUTLETS FIRST 2 III=4.3 0b OWER MG (/ rLIGHT , MAIL SWITCH OADD'L 10ADDRESS WER TOTALFIRST 20 .20 �� CITY TEL.NO.LIGHTING FIXTURES .FIXTURES ( ADD'L 1OCONTRACTOR I� mc;f G% OVER 20 RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS / L,/ ,`./yy�. d ��T / (� GARB.DISP BTA.COOK CITY �' /_v I Zd TEL.NO: DISHWASH• AUTO.-WASH. h STATE / O �S�) SPACE HTRS. STA.APP-(va N.P.MAX.) 850 �i LICENSE.NO. < O MOTORS: OVER NOT oven' H.P. DiS T GR U4RCORD NE P=ESSED O 1 1.00 1 s 1.50 INSPECTION a S 2.00 ZbZ � e t S is 2.50 �,� y .� . r1 ar a is so 3.00 p V so too 1 5.00 SIGNS: NO.TRANS. NO.LAMPS V ' W SERVICE O•SOOV-Nor OVER 200A 1.00' Op d - rA SERVICE O-SOOV-OVER 200 A. 2.00 SERVICE OVER SOOV 5.00 OTHER (SEE COMPLETE FEE SCHEDULE) PERMIT ISSUING FEE 2.00 :O SUPPLEMENTARY PERMIT ISSUING FEE 11.00 TOTAL FEE5 ® APPROVALS DATE INBPecTOR'S SIGNATURE I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION �UNDERSLAB WORK AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ROUGH CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING \�� 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES 1 FS�f�f:1) ��i' ='rl:� G(S . LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF i s N CALIFORNIA OR THAT I AM .LEGAL OWNE OF AND INTEND TO POWER RESIDE IN,THE ABOVE B ESIDEN PERTY. SIGNATURE UTILITY CO.NOTIFIED OF PERMITTEE FINAL ALIDATION .lo EPH C. ROOHAN MO CASH SUPERVISING ELECTRICAL ENGINEER otic5804 SEP22 2 D 13.50- ( 1. WORKERS'COMPENSATION DECLARATION 7A,01119DPW 3/8776463 APPLICATION FOR ELECTRICAL PERMIT O I hereby affirm that I hove a certificate of consent to self insure, or a certificate of'Workers'Compensation [insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certif' +thereof(Sec. 3800, b. C Policy No5.L-0 Company FOR APPLICANT TO FILL IN JOB P/ Certified copy is hereby furnished. New Residential Bldgs. &Pools EACH NO.I FEE ADDRESS C rtified co is filed with the count building 1 &2-Family, S Ft. $ _ $ LOCALITY copy y g inspec- I y, q• tion depar' nt. t ,Multi-family Sq. Ft. NEAREST T. Date / Applica Residential Swimming Pools OWNERCROSS SOR FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light._.�_Sw.1 IL COMPENSATION INSURANCE V ADDRESS (This section need not be completed if the work involved by First 20 ' CITY Tel. No*Z the permit Is for one hundred dollars($100)or less.) iTotal No. Additional dCAN CHECK I certify that in the performance of the work for which this I 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. i I. Additional iTotal No. CITY Tel.�No. Date Applicant Fixed Appliances Not Over 1 HP NOTICE TO APPLICANT: If, after making this Certificate of PERMIT n Exemption, you should become subject to the Workers' Range— Heater—D.W. _ APPLICATION 60 % Compensation provisions of the Labor Code, you must forth- Oven .— Dryer W.M.— ADDRESS a?VM _ria wi - with comply with such provisions or this permit shall be Top — FAU (M W.H. — deemed revoked. Hood — Fan —Other— LICENSED Other— CITY Tel. No LICENSED CONTRACTORS DECLARATION LICENSE OR Disp. _ Room Air Cond. — REG. NUMBER CIO I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business Power Apparatus&Large Appliances DISTRICT NO. PRWSSED BY d and Professions Co e,and my license is in full for a ect. Size&Type HP, KW, KVA, or KVAR �.�� _� O License Numbe A/27Lic. Clas"s Up to 1 incl. FINAL .. V Over 1 to 10 Incl. DATE 5 --/f��{ VALIDATION 0 Contractol Over 10 to 50 Incl. 6 _I ❑ I FINAL U I am exempt under Sec. Over 50 to 100 Inc. BY W B.&P.C. for this reason I Over 100 d Services, Swbd., MCC&Panelboards Date: I Z 0-200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V ❑ Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V r SINGLE FAMILY Tem Power Pole 8 A _ s HOME OWNER-BUILDER DECLARATION p' Appurtenances eft!` i : °v Sig with One Branch CircuitCn 1 hereby affirm that I am exempt from the Contractor's License �tl{ Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits Professions Code): � Lj`mi ❑ I, as owner of the property, will do the work and the Mi�c. Conduits&Conductors I Tl 1 Fil 5 a 25 structure is not intended or offered for sale Section 7044, Other(See Complete Fee Schedule)— ITCIZ Business and Professions Code). 55 CONSTRUCTION LENDING AGENCY I tvH ((jE 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 Lender's Name j-5[4 1 lirl ?:54 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 a h e representatives of this County to enter upon the abo _ i property for inspection p po s. I' SEE REVERSE FOR EXPLANATORY LANGUAGE Signature 0 Permittee to ®'