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Home My Public Portal About6039 PRIMROSE AVE_Electrical__ APPLICATION FOR ELECT-RICA PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS JOHN A.LAMBIE,COUNTY ENGINEER WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN CROSS PERMIT FEES OWNER ITEM NUMBER EACH FEE MAIL OUT �^ S ADDRESS LIGHTS RECEPT. SVI[. /-,<1 -2P 0.0 LIGHTING FIXTURES O CIT TEL NO ELEC.RANGES CLO.DRYERS ELECTRI 1•AN 0. --Ake W XT E R HEATERS .50 ADDRESS ga?a?I /;d / ELEC.SPACE HTRB. DISHWASHERS CITY—'<v 1 WO/!Ad TEL.NO. �fG GARBAGE DISPOSERS / AUTO.- STATE ' wasHeRB sra.COOKING UNITS Q LICENSE NO. C 16'�o�Qa f MOTORS: OVER INC. H.P. D.ISTRI G E P 0 — %a .25 yz — 2 .50 INSPECTION CORD 2 — S 1.00 B — to 1.50 O U Is — BO 2.50 O SO — 200 5.00 W SIGNS: NO TRANS. NO.LAMPS Z f: SERVICE O-SOOV 90 / 1.00 SERVICE OVER SOOV 5.00 MISC. WIRING PERMIT 0 D FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT ,Sp TOTAL FEE 1 HEREBY ACKNOWLEDGE THAT,I HAVE READ THIS APPLICATION APPROVALS DATE INSBECLOR'SsSIG14ATURIC AND STATE THAT THE ABOVE IS CORRECT A D AGREE TO COMPLY CONDUIT .P rJi WITH ALL COUNTY O INANCES AND ST E LAWS REGULATING ELECTRICAL WIRING. WIRING "% % IKAW� 1 HEREBY CERTIFY H T 1 AM PROP L REGISTERED AND/OR LICENSED AS REQUI D Y LOS ANGE S OUNTY AND STATE OF FIXTURES CALIFORNIA OR 1 M THE HER OF THE ABOVE: f DESCRIBED REST I ROP RTY. POWER / SIGNATURE UTILITY CO.NOTIFIED a ! OF PERMITTE FINALdam I E'I`J/IO l 1'z� VALIDAT ARTHUR C.VEIT. cK Mo CASH SUPERVISING ELECTRICAL ENGINEER L&0.5 1- 3-Q SEP23' 2 D 7.10,- 9 WORKERS'COMPENSATION DECLARATION CE-B06 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self E"806G �j insure, or a certificate,pf Worke?l'Compensation Insurance, ( COUNTY OF LOS ANGELES BUILDING AND SAFETY II JI or a certified copy reof�(SS'e-c-..13800, Labs. C.) / f Policy No: AP0V Company / -�/�� /� FOR APPLICANT TO FILL IN JOB _ S �❑ Certified co is hereb furnished. EACH. NO. FEE ADDRESSt �^JjPJ pY y �New.Resid'ential Bldgs. &Pools ❑ 1 &2-Family, S Ft. $ — $ LOCALITY Certified copy is filed with the county building.irispec- Y q• tion department. Multi-family Sq. Ft. — CROSS ST. Y NEAREST �� s V7�jLL Residential SwimmingPools OWNER OR Date Applicant /'�� FIRM NAME �. t.. ti( CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL COMPENSATION INSURANCE Outlets: Rec Light . Sw._ ADDRESS (This section need not be completed if the work involved by First 20Total No. Additional T No. the permit is for one hundred dollars($100)or less.) CITY 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 so as to become subject•to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS Total No. Additional CITY%, Tel, No. Date- Applicant Fixed Appliances Not Over 1,HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT APPL Exemption, you should become subject to the Workers' ff Range Heater—D.W. — /. Compensation provisions of the Labor Code, you must forth- I Oven _Dryer _W.M.— ADDRESS with comply with such provisions or this permit shall be Top — FAU —W.H. deemed revoked. Hood — Fan —Other— CITY -� Tel. IVo�d 3 LICENSED CONTRACTORS DECLARATION LICENSE OR — I hereby affirm that I dm licensed under provisions of Chapter 9 Dis p' Room Air Cond. Class,REG.NUMBER �D (commencing with Section 7000)of Division 3 of the Business Power Apparatus&Large Appliances DISTRICT NO. PRO S BY. Qom, and Professions Code,and my license.is in full force and effect. -dr Size&Type-HP, KW, KVA,or KVAR' V License NumberLic..Class > pp Up to 1 Incl. FINAL Contractor n Date� / ill Over 1 to 10 Incl. DATE _� VALID ION Over 10 to 50 Incl. r F-1FINA W I am exempt under Sec. Over 50 to 100 Inc: j BY W 8.8P.C. for this reason Over 100 ° U) Services, Swbd., MCC'&Panelboards ► ;2'6 4 4.8 A 0. Date: -200 Amp. Under 600V Signature 201 - 1000 Amp. Under 600 V # 0.0 0 0,0 2 ❑ ,Over 1000 Amp. or Over 600 V Exemption for Reg. Maint. Elect. ( 0.0 2 5 5 O SINGLE FAMILY Temp. Power Pole&Appurtenances o 0.0 2 5 5 0,53 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits Law for the following reason (Section 7031.5,. Business and ' Professions Code): ❑ I, as owner of the property, will do the work and the Misc. Conduits&Conductors ,. . structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)_ , 1,3 O 8 7 7044, Business and Professions Code). 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.). PLAWCHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address n•� I certify that I have read this application and state that the TOTAL FEE DCv t� above information is'correct. I agree to comply with all County - ordinances and State laws regulating Electrical wiring, and hereby authori representatives of this County to enter upon the above-m Toned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date TION reb' WCirnloh' I hSlYe S cerci DECLARATION � 10/81 APPLICATION FOR ELECTRICAL PERMIT •- I'he�ebY offirni.,thaff I ka�'e a certificate of consent To self , • ,insure, of a certificate,of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy'thereof(Sec. 3800,"Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB _ Certified copy is hereby furnished. EACH NO. FEE ADDRESS New Residential Bldgs. &Pools . ❑ Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. 1� $ — $ LOCALITY , tion department. Multi-family Sq. Ft. — NEAREST Residential Swimming Pools CROSS ST. Date Applicant OWNER OR FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw._ COMPENSATION INSURANCE ADDRESS (This section need not be completed if the.work involved by First 20 Total the permit is for one hundred dollars($100)or less.) No.. .Additional CITY Tel. No I certify that in the performance of the work for which this PLAN CHECK APPLICANT permit 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 ADDRESS ` % % Additional CITY Tel. No. Total No. Dateib- pplicant�' & Fixed Appliances Not Over l HP PERMIT NOTICE O APPLICANT: If, after making this Cert(Acate of Exemption, you should become subject to the Workers' Range_ Hedter_ PPLICANT D.W..W. _ J14 Compensation provisions of the Labor Code, you,must forth- Oven —Dryer _W.M.— ADDRESS with comply with such provisions or this permit shall be Top _ FAU —W.H. —' deemed revoked., Hood _,Fan _Other_ CITY 1 i Tel. No,I _2221 LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. Room Air Cond. REG. NUMBER 1V i Classy of-CP (commencing with Section 7000)of Division 3 of the Business DISTRICT N� PRO ED and Professions Code,and my license is in full force and effect. Power Apparatus&.Large Appliances _ L1, f� Size&Type HP, KW, KVA, or KVAR' v V License Number ar Lic. Class C-1 Up to 1 Incl. FINAL Over 1 to 10 Incl. DATE '� p Contractor. V LIDATION �–L- 92J,& Date Over 10 to 50 Incl. FIN W ❑ 1 am exempt under Sec. Over 50 to 100 Inc. BY a B.&P.C. for this reason Over 100' Date: Services, Swbd.,MCC&Panelboards Nov 0 -200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V E] Over 1000 Amp. or Over 600 V ;2.6 b 7 9 Exemption for Reg. Maint. Elect. #,0 0 0•o:o.� SINGLE FAMILY Temp. Power Pole&Appurtenances 1 0.0 1 4 5 545 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit •o 0 0 I hereby affirm that I am exempt from the Contractor's License � i Law for the following reason .(Section 7031.5, Business and Additional Sign Branch Circuits -63, 1 7_8 7 Professions Code): J ❑ 1, as owner of the property, will do the work-and the Misc. Conduits&Conductors structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)_ 7044,.Business and Professions Code). , 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 Name ! " PERMIT ISSUING FEE Lender's Address I certify that I have read this application and state that the TOTAL FEE 31 above information is correct. I 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 • Signature of Permittee Date Is