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Home My Public Portal About5126 PERSIMMON AVE_Electrical__ 76A863 GE-606R 9/76 APPLICATION FOELEWICAL PERMIT COUNTY OF LOS ANGELES y J DEPARTMENT OF COUNTY ENGINEER FADDRESS !� '��/Y1�d�S' BUILDING AND SAFETY DIVISION FOR APPLICANTTO FILL IN 7YNew Residentiol Bldgs.&Pools EACH NO. FEE CRST. 1 &2-Family,Sq.Ft. $ •025 — $ OWNER OR Multi-family Sq.Ft. .02 — FI.RM'NAME 4,57.L Residential Swimming Pools 20.00 MAIL ADDRESS C' Outlets:Rec, Light_Sw. CITY Tel.No. First 20 .50 PLAN CHECK Total No. Additional .30 APPLICANT ADDRESS Lighting Fixtures' First 20 .50 CITY Tel.No. Al Total No. Additional 30 APPLICANT Fixed Appliances Not Over 1 HP ADDRESS Range_Heater_D.W._ CITY Tel.No—<STJZ Oven_Dryer_W.M. LICENSE OR �7 Top —FAU —W.H._ REG.NUMBER /2✓ Class. x%00 Hood_Fa'n _Other— I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE Disp. — Room Air Cond. 2.00 THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDIN• ANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. Power Apparatus&Large Appliances Size&Type HP,KW,KVA,or KVAR I HEREBY CERTIFY AT M PROPERLY ISTERE D/ LIC SE AS •1.00 REQUIRED BY LOS AN LES UNTY AND ST E OF RN OR A AM Up to 1 Incl. THE LEGAL OWNER TH OVE DESCRIBED ESIDENTI PR RTY. Over 1 to 101ncl. 5.00 Over 10 to 50 Incl. 6 10.00 PERMITTEE 20.00 SIGNATURE Over 50 to 100 Inc. �g Over 10030.00 DISTRICT NO. PRO CES ED BY Services 0-200 Amp.Under 600 V 12.50 INSPECTOR'S us 201.1000 Amp.Under 600 V 25.00 APPROVALS DATE SIGNATURE Z Over 1000 Amp.or Over 600 V 50.00 TEMP.POWER POLE Temp.Power Pole&Appurtenances 10.00 UNDERSLAB WORK 10.00 ROUGH CONDUIT p 9 4 S 5 A Sign with One Branch Circuit 2,00 Additional Sign Branch Circuits WIRING 0 0 0 0 0 2 Misc.Conduits&Conductors 15.00 FIXTURES Other(See Complete Fee Schedule) POWER AUTHORIZED u UTILITY CO.NOTIFIED FINAL PERMIT FEE (Sub-Total) NOTES PLAN CHECKING FEE (One-Fourth Permit Feel PERMIT ISSUING FEE $6.00 TOTAL FEE r� PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE ®s 76A663A-CE606A 4/72 APPLICAT16N FOR ELECTRICAL PERMIT 41 COUNTY OF LOS ANGELES _ DEPARTMENT OF COUNTY ENGINEER BUILDING ^ •? BUILDING AND SAFETY DIVISION ADDRESS s �a+� Q LOCALITY 1y j T NEARESTr FOR APPLICANT TO FILL IN CROSS ST. olc OUTLETS NO. EACH I FEE $ $ OWNER S` RECEPT. MAIL LIGHT_ TOTAL / FIRST 20 0 �G�. ADDRESS OVER 20 �� CITY TEL. NO. SWITCH PLAN CHECK LIGHTING TOTAL FIRST 20 APPLICANT FIXTURES OVER 20 ADDRESS RESIDENTIAL APPLIANCES CITY TEL. N0. PERMIT RANGE DRYER_WTR. HTR. APPLICANT Vj, s G� STA. COOK DISP. F.A.U. ADDRESS SPACE HTR. AIR COND. CITY t (:2 TEL. N0. CLOTHES WASH. I DISHWASH. LICENSE NO. _ CLASS,oC- D FAN OTHER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY C MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING C� IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. S1ZE & TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR �... 0 - 1 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF W CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO LL 1 - 10 RESIDE IN, THE A VE D IBED RESIDENTIAL PR RTY. y Z SIGNATURE 10 - 50 OF PERMITTEE 50 - 100 DISTRICT NO. CL S Z RO SB@D-B 100 - 500 D o SIGN, GAS SIGN AND ONE CIRCUIT NOTES: TUBE, OR MARQUEE ADDITIONAL CIRCUITS ` SERVICENOT OVER 600 VOLTS OR 200 AMP SERVI CE OVER 600 VOLTS OR 200 AMP APPROVALS DATE INSPECTOR'S SIGNATURE TEMP.POWER POLE TEMP SERVICE,POLE,&APPURTENANCES UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM ROUGH CONDI UT WIRING FIXTURES POWER AUTHORIZED PERMIT FEE (SUB TOTAL) UTILITY CO. NOTIFIED, PLAN CHECK FEE PERMIT ISSUING FEE , FINAL /�6 / 7 TOTAL FEE 1 PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION <CK.� M.0. CASH 5 4 4 (TCT ?r COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY WILLIAM I FOX, County Engineer ELECTRIC I FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMIT NO. ELECTRICIAN 4937 I r r RECEIVED BY READY FOR DATE ISSUED ADDRESS I6 MONTE •` FIRST INSPECTION CITY TEL NO. q VIA COUNTY LICENSE NO. EXPIRES ADDBUILDIREB ..fNOi_ .1 PERMIT FEES FEE NUMBER EACH LOCALITY f LIGHT OUTLETS NEAREST RECEPTACLES CROSS BT. WALL SWITCHES OWNER TOTAL OUTLETS Bc 8 MAIL ELEC. RANGER 23 ADDRESS ELEC. HEATERS 28 CITY TEL NO. FIXTURES 5 • 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS HUNGER HORSEPOWER FEE ANGELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER NEW MvD. HP OVER I INC- EACH OF THE RESIDENTIAL PROPERTY DESpIklBED ABOVE. I/2 A LESS >a .25 SIGNATURE or I/2 2 .50 PERMITTEE_'Z0;' 2 B 1.00 INSPECTION RECORD 5 18 1.50 is 50 2.50 50 200 5.00 200 BOO 10.00 J 500 1000 15.00 Z OVER IOOO 20.00 5 M.G. SET/FREQ. CHANGER-HP 0: WELDERS:AC-KVA O BENERATDRS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF DRIG-) MOVED MOTORS (75% DF ORIG.) MISC. SIGNS NO. NO.TRANS. APPRO ALS NO. NO.LAMPS FOR EAOH PERMITI D TE INSPECTORPS NAME WIRING 417,00 ®Q CONDUIT FIXTURES 101.00 WIRING rl/ .*(�r4 •-•' �j� � SUPPLEMENTARY ,50 FIXTURES J POWER TOTAL FEE 111 UTILITY co.NOTIFIED /�/, ; , •f - /! FINAL TGASSS DBS#5A 4-52 WORKER S'COMPENSATIONDECi'kRATION 76A663 APPLICATION FOR ELECTRICAL .PERMIT CE-806G (2480) I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES '7`^ �y BUILDING AND SAFETY insure,or a certificate of Workers Compensation Insurance,or a:certified copy thereof(Sec.3800,Lab.•C.) �� 5naa��, MT FOR APPLICANT TO FILL IN JOB Policy NW - panY TOM EACH ;NO. FEE ADDRESS 5126 14'. PERS-IMMON New Residential Bldgs.&Pools Certified copy;.is hereby furnished. 1 &2-Family,Sq.Ft. $• Is LOCALITYTEMPLE' CITY Multi-family Sq. Ft. — NEAREST Certified copy is filed with:the county building® inspection CROSS ST department.' Residential Swimming Pools FRN l�AOnaEDIAI�TE DAVIS 413= ]Applicant]Applicant PATTY KERRY Outlets: Rec._Light Sw.. MAIL First 20 ADDRESS 5126 N2 CERTIFICATE OF EXEMPTION FROM WORKERS' Total N6. Additional : .CITY TEMPLE CITY Tel hko 443-5488 a COMPENSATION INSURANCEI PLAN CHECK IL is section need not be completed if the work involved APPLICANT V (Th Lighting Fixtures First 20 by the permit is for one hundred dollars ($100) or less.) g g ADDRESS Total No. Additional I certify that in the. performance of the work for which this ,Fixed Appliances Not Over 1 HP CITY Tel No. permit is issued, I shall not employ any person in any manner V PERMIT III 0 so as to become.subject to the Workers'Compensation.Laws. Range_Heater D.W.._ APPLICANT SWAN POOLS. a Oven _ Dryer_W.M._ ADDRESS 961 N. AZUSA 'AVE. ' Z Date.Applicant Top _ FAU _W.H'. Hood — Fen _Other_ CITY COVINA Tel No966-8631 NOTICE TO APPLICANT: If, after making this Certificate of D.isp. _Room Air Cond_ LICENSE OR 254846 C-53 Exemption, you should become subject to the. Workers' REG.NUMBER Class Compensation provisions,of the Labor Code,you must forth- Power Apparatus&Large Appliances DISTRI.CT.NO. PROCESSEDBY_ with comply with such provisions or this permit shall be Size&Type HP,KW,KVA,or KVAR Up deemed revoked. l/ to 1 I'ncl.• FINAL Over 1 to 10 Incl. • DATEVALIDATION. LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl. I hereby affirm that I.am licensed under provisions of Chapter' Over 50 to 100 Inc. FINAL 9 (commencing with Section 7000)of Division 3 of the Busi- Over 100 BY '— ness and Professions.Code,and my license is in full force and effect. Services I License Number 254846 Lic.Class. C-53 0=200 Amp.Under 600 V 4 sat 201-1000 Amp.Under 600 V ; Contractor_SWAN P00T.S Date 4.1 in'/R 1 Over 1000 Amp..or Over 600 V ' HOME OWNER-BUILDER DECLARATIN Temp.Power Pole&Appurtenances 1 I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits 0 5 0 7.9 A ness and Professions Code): 0 I, as owner of the 'Misc.Conduits&Conductors � 0 0 0 0 0 property, will do the work and the Other(See Complete Fee Schedule)— structure is not -intended or offered for sale (Section 2 - 3200 7044,Business and Professions Code). ' CONSTRUCTION LENDING AGENCY -'o o 3 2.0 0 5 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued(Sec.3097,Civ.C.). PERMIT FEE (Sub-Total) + 0504-81 Lender's Name!CA-Sli PLAN CHECKING FEE (One-Fourth Permit Fee) Lender's Address CASH 'PERMIT ISSUING FEE 7H I certify that'I have read this application and state that the TOTAL FEE 3eZ 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 ab mg oned property for inspection purposes. SEE"REVERSE FOR EXPLANATORY LANGUAGE Signature of Permit Date