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Home My Public Portal About5319 PERSIMMON AVE_Electrical__ -AA6¢3-CE60%1/70 ,APPLICATION FOR ELECTRICAL PERMIT C/ •;COUNTY OF LOS ANGELES DEE RTMgN'G OF COUNTY ENGINEER BUILDI77/,, BOILDING AND SAFETY DIVISION ADDREJOHN A. CAMBIE. COUNTY ENGINEER LOCALICOLEMAN W. JENKINS, SUPERINTENDENT OF BUILDINGNEARESTFOR APPLICANT TO FILL IN CROSS ST JOUETS NO. EACH FEE �~ n 4/�,�OWNER 2 .S�mjet6iRECEP $ $ ADDRESSLIGHTTOTAL FIRST 20 O 20 OPCIT �� TEL. NOSWITCH 20 •10 PLAN-CHEC LIGHTINGFIRST 20 .20 APPLICANT TOTA 20 OVER FIXTURES � .10 ADDRESS APPLIANCES CITY (TEL. �NO. . PERIT RANGE DRYER_WTR. HTR. APPLICANT SG/4 USC STA, COOK DISP. F.A.U. ADDRESS eder1/No"t?1j SPACE HTR. AIR COND. CITY-ro-'l j TEL. NO. yS�3a� CLOTHES WASH. DISHWASH. LICENSE NO. CLASS. FAN OTHER 1.00 1•HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION •AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND, HEATERS, ETC. HP. KW.KVA. - ELECTRICAL WIRING. SIZE & TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 - 1 100 LICENSED AS RE BY LOS ANGELES CO TY AND STATE OF CALIFORNIA OR. HAT I M THE LEGAL OWNE OF•, AND INTEND TO I - 10 3.00 RESIDE ,•I N, THE B E DESCR RED A DE NTIAL PROPERTY. 10 - 50 5.00 SIGNATUR .� t a OF PERMI 0 50 - 100 1DA0 DISTRICT NO. CLASS 1GROU ZO PR CE S 100 _ 500 15.00 r V SIGN, GAS TUBE, OR SIGN AND ONE CIRCUIT 3.001 NOTES: W a � � N MARQUEE ADDITIONAL CIRCUITS 1.00 Z SERVI CENOT OVER 600 VOLTS OR 200 AMP 2.00 SERVICE OVER 600 VOLTS OR 200 AMP 5.00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP.PbWER POLE TEMPSERVICE,POLE,&APPURTENANCES 3.00 UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM 3.00 ROUGH CONDIUT WIRING I -� FIXTURES PERMIT FEE (SUB TOTAL) _ POWER f0 Zf ro PLAN CHECK FEE (50% PERMIT FEE) " � UTILITY CO. NOTIFIED PERMIT ISSUING FEE 2.001 4 �•" • SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL JOSEP C. ROOHAN TOTAL FEE SUPERVISING ELECTRiCAL ENGINEER J PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH a1928 2 D 9.60—, q SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE (%/'D A , aF I6A663 CE-806 t6/78) ` APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN JOB 4� ADDRESS New Residential Bldgs.&Pools EACH N0. FEE r^ 1 &2-Family,Sq.Ft. $ .025 — $ LOCALITY . -- C, Multi-family Sq.Ft. — Residential Swimming Pools 25.00 CROSS OWNER . —� r FIRM NAME Outlets:Rec A Lightx2*2_Sw. 2. MAIL —i First 20 .50 ADDRESS Total No. Additional .30 CITY /� 2G Tel:No. z2 b PLAN.CHEC APPLICANT Lighting Fixtures First 20 .50 ADDRESS Additional .30 Total No. CITY Tel.No. Fixed Appliances Not Over 1 HP PERMIT Range—Heater—D.W.— APPLICANT Oven—Dryer_W.M. ADDRESS Top _FAU —W.H._ CITY Hood_Fan .—Other LICENSE OR Disp._Room Air Cond. 2.50 REG.NUMBER Class. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA. Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS.CORRECT AND AGREE TO Size&Type HP,KW,KVA,or KVAR COMPLY WITH ALL COUNTY.ORDINANCES AND STATE LAWS y YP REGULATING ELECTRIC WIRING. P 2.50 U to 1 Incl. I HEREBY CE FY HAT I AM PROPE.. Y REGISTERED ANb/OR Over 1 to 10 Incl. 5.00 LICENSED S R IRED Y LOS ANGEL OUNTY ND STATE OF Over 10 to 50 Incl: 12.50 CALIFOR IA 0 A I AM LEGA WNE THE ABOVE O Over 50 to 100 Inc. 25.00 DESCRIBE_ RTY., v Over 100 40.00 PERMITEE SIGNATU Services r 'DISTRICT NO OCE FID BY 0-200 Amp.Under 600 V 12.50' f _ 201.1000 Amp. Under 600 V 25.00 (/ Over 1000 Amp.or Over 6.00 V 50.00 Z � O Temp.Power Pole&Appurtenances 10.00 Sign with One Branch Circuit 10.00' O Additional Sign Branch Circuits 2.00 INSPECTION > Misc.Conduits&Conductors 10.00 INFORMATION 'ug ON REVERSE s ;Lr4 5 9,3 A Other(See Complete Fed Schedule SIDE u 5 � � 00002 d 2 o 11.CC PERMIT FEE (Sub-Total). 0 0 0 Z PLAN CHECKING FEE (One-:Fourth Permit Fee) O 0529-79 PERMIT ISSUING FEE $7.00 0 TOTAL FEE > INSPECTION FINALED W date: By r'� `'�_ es J a( RKEf25:+C1JMPENSATION DECLARATION CE BWG 10/e1 APPLICATION FOR ELECTRICAL ;PERMIT 1;1ro h� in that I have a certificate of consent to self 7� 7vr 1' '.or c rtificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY 1uI or a certified copy thereof(Sec..8800, Lab. C.) a Policy No. Company i FOR APPLICANT TO FILL IN JOB ADDRESS 3/ GJPSlo"42da) Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE i Certified copy is filed with the county building,inspec- 1 &2-Family, Sq. Ft. $ — S LOCALITY tion department. Multi-family Sq. Ft. — NEAR ESSTT. CROSS CL Residential Swimming Pools OWNER OR Date Applicant CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec++��''�L � ightSw.S MAIL COMPENSATION INSURANCE FIRM NAME 5 ADDRESS5 / P,---AJ 7y/hOA� (This section.need not be completed If the work involved by First 20 the permit.is for one hundred dollars(:100)or less.) Total No.� Additional CITY 7 � '�' Tel. N k/� djVf I certify that in the performance of the work for which this PLAN CHECK APPLICANT permit is issued, I shall not employ y person in any manner /) so os to become subject to �Vvk 'C peati Laws.• Lighting Fixtures First 20 V ADDRES Total No. Additional •g Date —Ir A lica CITY , Tel. No. P.P Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, offer makin this Certificate of Exemption, you should become subject to the Workers' Range_ Heater_D.W. — 'APPLICANT 0WAie_4_ Compensation provisions of the Labor Code, you must forth- I Oven —Dryer _W.M.— ADDRESS 57 with comply with such provisions or this permit shall be Top _ FAU —W.H. — deemed revoked. CITY ? �� Tel. No. Hood _ Fan _,Other_ ' ' LICENSED CONTRACTORS DECLARATION J� LICENSE OR Dis _ Room Air Cond. � I hereby affirm that I'am licensed under provisions of Chapter 9 p' .REG.NUMBER Class. (commencing with.Section 7000)of Division 3 of the Business Power Apparatus&Large,Appliances DISTRICT N -/ PRO D BY a' and Professions Code,and my license is in full force and effect. (o/ 0 Size 8 Type HP, KW, KVA, or KVAR �.O V License Number Lic. Class . O n Up to 1 Incl. FINAL 9 Over 1 to 10-Incl. ,v v DATE Contractor Date V DATION ❑ Over 10 to 50.lncl. W FINAL I am exempt under Sec. Over 50 to 100 Inc. BY p; B.&P.C. for this reason Over 100 Z Date: Services, Swbd., MCC&Panelboords ► 0 -200 Amp'. Under 600 V Signature 201 - 1000-Amp. Under 600 V 'Over 1000 Amp. or Over 600 V Exemption for Reg. Maint. Elect. SINGLE FAMILY Temp. Power Pole&Appurtenances -2 6 3.9 6 A HOME.OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby'off irm that I am exempt from the Contractor's License # 0 0 0 0 0 2 Law for the following reason (Section 7031.5, Business and IAdditional Sign Branch Circuits ergfessions Code): .1 o o51,50 V1 I, as owner of the property, will do the work and the Misc. Conduits&Conducto}so 0 0 5.1.5 0 v x Aj structure is not intended -or .offered for sale { Other( )— P See Complete ete Fee Schedule Section 7044, Business and Professions Code). ► 0 1i 2 6-8 7 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 PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name0 PERMIT ISSUING FEE Lender's Address I certify that I have read this application and state that the TOTAL FEE S above information is correct. I agree to comply with all County a d'n nces and State laws regulating Electrical wiring, and % he authorize presentatives of this County to enter upon 44v e- enti ed. operty#or inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE SignaturePermittee Date