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Home My Public Portal About6022 PRIMROSE AVE_Electrical__ 76AG63-CES0611-71 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER ADDRESS �vQ�Z r BUILDING AND SAFETY DIVISION /� A LOCALITY 7-,E V Z (,"f TP C4.1 NEARE FOR APPLICANT TO FILL IN CROSS ST. &616,9gU154 OUTLETS N0. EACH FEE / OWNERGoS��y RECEPT._ $ $ ADDRESS Zfi// LIGHT TOTAL FIRST 20 ,25 SWITCH OVER 20 10 24 CITY � Zb r TEL. NO. PLAN CHECK LIGHTINGTOTAL FIRST 20 .25 APPLICANT FIXTURES OVER 20 .10 ADDRESS RESIDENTIAL APPLIANCES CITY /J TEL. NO. PERM T7 RANGE DRYER_WTR. HTR. APPLICANT r .Ad�LS C ) STA. COOK DISP. F.A.U. ADDRESS SPACE HTR. AIR CONDj2MR0 CITY ��/ TEL. NO.Z',T f,-3 CLOTHES WASH. DISHWASH. LICENSE NO. / CLASS FAN OTHER 1.00 ail 1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CJ _ AND STATE THAT THE ABOVE 15 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 D - 1 1.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO 5 ` 1 - 10 9.00 RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. O 10 - SO 5.00 SIGNATURE Ix OF PERMITTEELLL.�� O SO- 100 10.00 b DISTRICTI CLASS Z P CESSED NW 100 - S00 15.00 P- a SIGN, GASSIGN AND ONE CIRCUIT 5.00 NOTES: ? TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 SERVICENOTOVER 600 VOLTS OR 200 AMP 3.00 :od SERVICEOVER 600 VOLTS OR 200AMP 10.00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP.POWER POLE TEMP SERVICE,POLE,&APPURTENANCES 5.00 TEMP LIGHT OR RECEPT. SYSTEM 3.00 UNDERSLAB WORK ROUGH CONDIUT WIRING FIXTURES PERMIT FEE (SUB TOTAL) POWER AUTHORIZED - UTILITY CO. NOTIFIED �0 PLAN CHECK FEE C - FINAL � 1 - PERMIT ISSUING FEE 3.00 TOTAL FEE O9 PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VAL �ATION cK. ) M.O. CASH LAW 7-1-31 HE 2T 1 Oluo- SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 70ASBS-CR000 11-OAPPLICATION FO'R. ELECTRIC PERMIT 1 COIINTY OF LOS MEM r DEPARTNNI M OF-COUNTY ENGINEER BUILDING ,,"� BURDING AND SAFETY DMSION ADDRESS. V-0, �1 : P✓' )OFII11 A.LANBIEr Co_ is BnQtn.� c 7T a.GSIFFaL s>sr't 0!9 LOCALITY . . s NEAREST FOR APPLICANT TO FILL IN � PEMffr FcRoss sr. EES ITEM HUM139RI EACH FEE . 7.. OWNER / . OUTLETS• S S MAIL LIGHTS RECEPT. SW. .10 04;& ' ADDRESS' - '. LIGHTING FIX_TURES' .10 CITY TEL.NO. `. ELEC.RANGES `CLO.DRYERS - ELECTRICIAN J,, j rle g, fG WATER HEATERS .50 ELEC.SPACE HTRS. DISHWASHERS ADDRESS. 3a /��y ecz dg 1te y. GARBAGE DISPOSERS AUTO.- CITY y TEL.NO. WASHERS STA.COOKING UNITS .25 STATE �r+ /ems�6 MOTORS: OVER INC. H.P. LICENSE NO. O— +/2 .25 DISTRIC NO. R P READY FOR INSPECTION i I/a — 2 .50 - 2 — s 1.00 _ MSPECTION RECORD 15 — 50 2.50 SO— 200 5.00 SIGNS: NO.TRANS. , NO.LAMPS SERVICE 0-000V 1.00 1 SERVICE OVER SOOV 5.00 MISC. y WIRING PERMIT 1.00 00 FIXTURE PERMIT 1.00 (a SUPPLEMENTARY PERMIT .SO' TOTAL FEE $ APPROVALS. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION 1 DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT'AND AGREE TO COMPLY CONDUIT WITH ALL. COUNTY ORDINANCES AND STATE LAWS REGULATING J ELECTRICAL WIRING. WIRING =',�7',/j() / /1 ,f/ , •i'r - 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS-ANGELES COUNTY AND STATE OF < < r �• CALIFORNIA OR THAT I T LEGAL OWNE OF THE ABOVE POWER r DESCRIBED RESIDENTIA P ry SIGNATURE UTILITY CO.NOTIFIED �_ e OF PERMITTE :FINAL �� T�r35 1 -./G� ATION I ARTHUR C.VETT, cK. Mo CASH SUPERVISING ELECTRICAL EN3lNE6R �_.. _._� .. Ml-94'2.M - tom17. 2 A 2.70 ON 19 I hereby affirmlth R'haveMa cast elate o}Consent RAlOo sail insure, 6AA63 DPW(,2.9,) APPLICATION FOR ELECTRICAL PERMIT or0a certificate of Worker's Compensation Insurance,or a,certified I COUNTY OF LOS ANGEWS , y DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thergof(Sea:8800 Lab.C.) Policy No. Company FOR APPLICANT TO FILL IN JOB ADDRESS ❑ Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE ❑ _ $ $ LOCALITY Certified.co is filed with the count building inspection 1 &2-Family,Sq.Ft. PY Y 9I department. II Multi-family.Sq.Ft. NEAREST ST. Date. Applicaht t Resltlential Swimming Pools! ASSESSOR MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' ��[[,//' OWNER OR COMPENSATION INSURANCE Outlets:Rec( LightFir$2U , �6FIRM C�2 �/s (This section need not.be completed if the work Involved by the MAI No. L t� r. Total N � Additional ADDRESS 62� / 1 ,eJSJr r permit is for one hundred dollars.(S100)or leas.) , A I certify that in the performance of the work for which this permit I. CITY"f ,j G Tel.N '� is Issued, I shall not employ any personin any manner so as to i become subject to the Workers'Compensation Laws. 'Lighting Fixtures/ First 20' APPLIC APPLICANT Total No._,,e,- Additional ADDRESS Date Applicant^)°� RESIDENTIAL APPLIANCES.NOT OVER 3 HP. NOTICE TO APPLICANT: If, after making this Certificate Of CITY Tel.No. Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions.of the Labor Code,you must forthwith comply with such PERMIT P Y P y :Power Apparatus&Large.Appliances APPLICANT provisions or this permit shall.be deemed revoked. LICENSED CONTRACTORS.DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl (commencing with Section 7000)of Division•3 of the Business and . CITY; Tel.No. Professions Code,and my license.is in full force and effect. I Over 10 to 50 Incl. Over 50 to 100 Incl. LICENSE OR Class. } REG.NUMBER fl Over 100 DISTRICT NO. P SED BY O License Number L'ic.Class• U 'S ervices,Swbd. C anel � / •�� Contractor Date eI 0- 9 mp. nd 6 DATE �. O ❑ I 400:1000 Amp.Under 500 V VALIDATION V I am exempt under Sec. Over 1000 Amp.or Over 600 V FINAL d B.&P.C.for this reason BRANCH CIRCUIT FEES BY co Z Date: �J; 15A,or 120V,Lighting or Recept. _ 1 TO 10 Branch Circuits Signature 11 To 40•Branch Circuits ❑ Exemption for Reg.Maint.Elect, 15A,20A,208V To 277V Lighting Branch .Circuitsults I� SINGLE FAMILY ACCT,# :Temp.Power Pole&Appurtenances HOMEOWNER-BUILDER DECLARATION +� � 3303 16900 Sign with One Branch Circuit , I hereby affirm that I am'exempf from the Contractor's License Law I •S for the following reason(Section 7031.5, Business.and Professions Additional Sign Branch Circuits 1 ITEMS lS Code): �I ❑ Misc:Conduits&Conductors TOTAL 169.20 I,as owner of the property,will do the work and the structure CHECK 1690 is not'intended or offered for sale(Section 7044., Business Other(See Complete Fee Schedule) , and Professions Code). CHANGE o00 CONSTRUCTION LENDING AGENCY i I hereby affirm that there is a construction lending agency for the 1 performance of the work for which this permit is issued(Sec. 3097, PERMIT FEE (Sub-Total) 0000-0001 1/10/96 Civ.C.) IiPLAN CHECKING FEE 4201 1 AM1.1-051 Lender's Name e I - PERMIT ISSUING FEE 006 Lender's Address I certify that I have read this application and under penalty of purjury state TOTAL FEE ' that the above information is correct. I agree to comply with all County ordinances and State laws regulatin Electrical wiring,and hereby authorize I representatives 9t this,C n er upo above-mentioned property t for Insp p poses SEE REVERSE FOR EXPLANATORY LANGUAGE ,SIGNA F' DATE , t , WORKERS'COMPENSATIONDECLARATIQ.N- 76-663 ', APPLICATION FOR. ELECTRICAL PER-MIT , I hereby affirm that I have a certificate. of consent, to self i COUNTY OF LOS ANGELES BUILDING AND SAFETY insure,or a certificate of Workers"C.ompensation Insurance,or I /� a certified copy thereof(Sec.38.00,Lab.C. t Policy No. CompanFOR APPLICANT TO FILL IN JOB• ADDRESS /,OZZ r� Al- � , lm2�s•g . y New Residential Bldgs.&Pools EACH NO. FEE Certified copy is.hereby furnished. 1 &2-Family,Sq. Ft. $ — $ LO'CALI'TY T/� Multi-family Sq. Ft... — NEAREST L Certified copy is filedwith the county building inspection.. CROSS STR"�/ f^ ° department. Residential Swimming Pools OWNER OR FIRM NAME- Date— Applicant Outlets'. Rec.f Light Sw. ADDRESS 670..? A First 20 CERTIFICATE OF EXEMPTION FROM WORKERS', Total No.� Additional CITY .7--,,C. - Tel No.,ZF- 6 fF71 } :COMPEN'SATI.ON INSURANCE PLAN CHECK d PPLIC'ANT �Iq-Y-+'t O (This section- need.not be completed if'the wor)'C involved �`�C/ Fi i htng xtures First 20 - by the permit is for one hundred dolhtts ($100.) or less.) LigAdditional -ADDR;ESs. 0 Total No. I certify that in the ,performance!of the work for,which thisCITY Tel No. O permit'is issued, I shall not employ any person in any manner Fixed Appliances Not Over 1 HP PERMIT so as to become subject.to the Workers'Compensation Laws. Range_. Heater_D.W._ APPLICANT W Oven _.Dryer._W.M._ ADDRESS N Date - Applicant Top: FAU W.H. z Hood — Fan _Other'_. CITY T.el No. NOTICE TO,APPLICANT: If, after making this Certificate of Disp. _Room Air Condom 'LICENSE OR Exemption, you should become subject to the Workers' 'REG.NUMBER Class Compensation provisions,of the Labor Code,.you must forth Power Apparatus&Large Appliances. DISTRICT NO, �rED BY with comply with such provisions or this permit shall be ype HP',KIN, ,or deemed revoked. Size&TKVAKVAR Up to 1 Incl. FINAL !/ Over'Ito 10 Incl:. DATE LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl. rY' VALI:D'ATI I hereby affirm that I am:licensed under provisions of Chapter Over 50 to 100 Inc. FINAL 9 (commencing with Section 7600)of.Division 3 of the Busi- Over 100 BY — °— ness-and Professions.Code,and my license is in:full force and effect. Services 0-200 Amp.Under 600,V License Number Lic.Class 201-1000 Amp.Under 600 V Contractor Date Over 1000 Amp.or Over 600 V HOME OWNER-BUILDER DECLARATION Temp.Power Pole&/appurtenances I' hereby affirm that I am, exempt from the C'ontractor's Sign with One Branch Circuit License Law for the following reason (Section 703.1.5, Busi- Additional Sigh,Bunch Circuits ness and ofessions Code): ''Mise.Conduits&Conductors' �5 G 6.'9 A owner of the property, will do the work and the Other(See Complete Fee Schedule)—` # 0 0 0 0 0.2 structure is not .intended or offered for-sale (Section, 7044,Business and Professions Code,). 2 c a O O CONSTRUCTION LENDING AGENCX I .hereby affirm that there is a:construction lending agency • o. o o.J G(�_ ifor the performance of the work for which this permit is v issued(Sec.3097,Civ:C.). _ PERMIT FEE (Sub-Total) Lender's Name '19PLAN CHECKING.FEE (One-Fourth Permit Fee). `�� 01 $ Lender's Address i PERMIT ISSUING FEE I certify that I have.read thisapplication and state that the: TOTAL FEE above.information is correct.'I'.agree to comply With all County ordinances and State 1 s' regulating•Electrical wiring, and 'hereby.authori re tatives of this County to enter upon ,the -m ti d roperty for inspection purposes. SEE*REVERSE FOR EXPLANATORY LANGUAGE ur 00 ermittee Date�/ i