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Home My Public Portal About4929 PERSIMMON AVE_Electrical__ (2) 76ASSS-CESOS 12-BB APPLICATION FOR ELECTRIC P BE 1 T �: COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDR144 JOHN A.LAMBIE.COUNTY ENGINEER CASSATl'D.GRIFFIN,SUPT OF BUILDING LOCALITY FOR APPLICANT TO FICC IN NEAREST CROSS ST. PERNIIT FEES - ITEM NUMBER EACH FEE OWNS AIL OUTLETS• $ S ADDRESS LIGHTS RECE SW. .10 * LIGHTING FIXTURES / .10 CITY TEL.NO. ELEC.RANGES CLO.DRYERS ELECTRICIAN n-4.1 WATER HEATERS .50 ADDREIPPAwft� ELEC.SPACE HTRS. DISHWASHERS n CITYTEL.NOOV GARBAGE DISPOSERS AUTO.. STATE t. WASHERS STA.COOKING UNITS .25 LICENSE NO. MOTORS: OVER INC H.P. DISTRICT NO. GROUP I 2gONE I PRPCESSED BY 0— 1/2 .25 1/:— 2 .50 INSPECTION RECO 2— 5 1.00 5— 15 1.50 is— 50 2.50 50--200 5.00 SIGNS: NO.TRANS. NO.LAMPS SERVICE 0-600V 1.00 SERVICE OVER 600V 5.00 MISC. 1' WIRING PERMIT 1.00 FIXTURE PERMIT 1.00 �D �.SUPPLEMENTARY PERMIT .50 TOTAL FEE s o APPROVALS IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ' COND l— - ELECTRICAL WIRING. WIRIN 1 HEREBY CERTIFY THA 1 AM PROPERLY REGI RED AND/OR - LICENSED AS REQUIRED LOS ANGELES C I ND ATE OF FIXTURES /• C91 ~` CALIFORNIA OR THAT I THE LEG OF ABOVE DESCRIBED RESIDENTIAL OPER,'Y. POWER SIGNATURE UTILITY CO.NOTIFIED ✓4""��. .A OF PERMITTE FINAL. /�� 4�- c— D' ATION ARSrHUix C. VEIT. " CKMo CASH SUPERVISING ELECTRICAL E IG R �!''�6 0 6 5 1 MAY 4 2 A 2.6 Q 7GA663-CE80612-58 APPLICATION FOR ELECTRIC PEWIT 1 COUNTY OF LOS ANGELES FA DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS It va JOHN A.LAMBIE,COUNTY ENGINEER �� CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY7-� L OVA FOR APPLICANT TO FILL IN NEAREST CROSS ST. PERNIIT FEES ZY ITEM NUMBER EACH FEE OWNER OUTLETS S MAIL LIGHTS Si/ RECEPT3 SW.� •10 � ADDRESS LIGHTING FIXTURES /* .10 CITY TEL.NO. ELEC.RANGES CLO.DRYERS ELECTRICIAN 4Z �0.5Ly 1 R W A T E R H E A T E R S .50 ADDRE ELEC.SPACE HTRS. DISHWASHERS CITY TEL.NO GARBAGE DISPOSERS AUTO.- STATE WASHERS STA.COOKING UNITS .25 LICENSE NO. MOTORS: OVER INC. H.P. DISTRICT NO. I GROUP ZONE I PR ESSED BY O— 1/2 .25 1/2— 2 .50 INSPECTION RECOR 2— 5 1.00 5— 15 1.50 15— 50 2.50 50-200 5.00 SIGNS: NO.TRANS. NO.LAMPS SERVICE 0-600V 1.00 SERVICE OVER 600V 5.00 MISC. WIRING PERMIT 1.00 V FIXTURE PERMIT 1.00 00 SUPPLEMENTARY PERMIT .50 TOTAL FEE S APPROVALS c� 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY _ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDU,I-T -/ ELECTRICAL WIRING. WIRING I HEREBY CERTIFY THAT-[ AM PROPERLY REGI TERED AND/OR ._ LICENSED AS REQUIRED LOS ANGELES C NT AND TATE OF FIXTURES CALIFORNIA OR THAT 1 THE LEG E OF ABOVE DESCRIBED RESIDENTIAL OPERTY. POWER r. SIGNATURE UTILITY CO.NOTIFIED OF PERMITTEE r , FINAL b' DATION ARTHu C. VEIT. MO CASH SUPERVISING ELECTRICAL E G CK ��', 065 - A 2..60 s WORKER'S COMPENSATION DECLARATION 20.0019 DPW(12.91)76A663, APPLICATION FOR ELECTRICAL PERMIT I hefeby affirm that I have a certificate of consent to self insure, or a ce4tificaTe of Worker's Compepsation Insurance, or a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. coA tAereCl-(Sec.3800 Lab.C.) 4 JOB Q �� Policy No. Company FOR APPLICANT TO FILL IN ADDRESS `�? / � 1/Jlj! o4f** Certified co Is hereby furnished. NO. EACH FEE213 LOCALITY PY� Y New Residential Bldgs.&Pools _ $ $ �E� �. � oc 9/7�- �vS ❑ Certified co is filed with the count buildin ms action 1 &2-Family,Sq.Ft. PY Y g P NEAREST department. Multi-family Sq.Ft. CROSS ST. 1-0&Vr0 Sq Date Applicant Residential Swimming Pools ASSESSOR p� ASSESSOR fiJ�/ ppGE da� PARCEL 02/ CERTIFICATE OF EXEMPTION FROM WORKERS' �, / PO FMM NAnDnE C eE ��,�e'f COMPENSATION INSURANCE Outlets:Rec Lightq; f,,.3,w0 G MAIL (This section need not be completed If the work Involved by the Total No. Additional a'� ADDRESS oR.. �(�7P.5��/tf6p✓ permit Is for one hundred dollars($700)or less.) I certify that in the performance of thework for which this permit CITYTkARZAE 104 ' Tel.N is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANTR,f� CHECK c 119-�,I�,�,�• Total No. Additional ADDRESS / Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of RESIDENTIAL APPLIANCES NOT OVER 3 HP. CITY �- L.� � Tel.No f g �W,&f Exemption,you should become subject to the Workers'Compensation OTHER,APPLIANCES NOT OVER 3 HP. PERMIT provisions of the Labor Code,you must forthwith comply with such APPLICANT 4JeVa r_ provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances LICENSED COWRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS fg,,q /;FA*At K I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. u_ (commencing with Section 7000)of Division 3 of the Business and CITY Tel.N 4)YV7r Over 10 to 50 Incl. Professions Code,.and my license.is In full force and effect. LICENSE OR d Over 50 to 100 Incl. REG.NUMBER Class. License Number Lic.Class Over 100' DISTRICT NO. P SED BY V Services,Swbd CC&P/�n�IbrQ�a Contractor Date 0�399 Am llfiJP tp dfF tf00 DATE QQ H 0 I am exempt under Sec. 40 1000 Amp.Under 600 V •-r %'3 VALIDATION W Over 1000 Amp.or Over 600 V FINAL O. B.&P.C.for this reasonBRANCH CIRCUIT FEES BY CO 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 i HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ^" I hereby affirm that I am exempt from the Contractor's License Law ACCT.T for the following reason(Section 7031.5, Business and Professions Additional Sign Branch Circuits Code): +`30 199.015 I,as owner of the property,will do the work and the structure Misc.Conduits&.Conductors 1 ;EMS is not intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule) and Professions Code). TOTAL CONSTRUCTION LENDING AGENCY CHECK 199.05 I hereby affirm that there is a construction lending agency for the CHANGE1lyl Performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total) 3 CHANGE . 110, C.) PLAN CHECKING FEE Lender's Name 130010-006 PERMIT ISSUING FEE 85635 1;'111��r Lender's Address TOTAL FEE 1 certify that I have read this.appiication and under penalty of purjury state ��f.,o that the above information is correct. 1'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 SIGAIWAAE TURE OF PERMITTEE DATE