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HomeMy Public PortalAbout10052 RANDWICK DR_Electrical__ . . 1 'GAS63-CESOO 10-62 APPLICATION FOR E ECTRICAL 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 NEAREST ' FOR APPLICANT TO FILL IN CROSS ST. - RECEPT. TOTAL NO. EACH FEE OUTLETS FIRST 20 $.20 $ �� OWNER LIGHT MAIL SWITCH. ADD'L ADDRESS 5 S OVER 20 .10 D TOTAL CITY TEL.NO. LIGHTING FIRST ZO 3 .20 6a FIXTURES ADD'L .10 ELECTRICIAN OVER 20 RANGES CLO.DRYERS WTR.HTRS: 1.00 ADDRESS AARDAI-^ISI,=, STA.COOK 9Y B/ h CITY TEL.NO. ET Q (y !� DISHW AUTO.-WASH. STATE �j ¢J Sj r� SPACE HTRB. ) 3 .SO LICENSE NO. Tom' Q (9 0�L3 MOTORS: OVER NOT OVER H.P. DISTRICT NO. GROUP NE P ESSED BY O 1 1.00 1 s 1.50 INSPECTION RECORD s s 2.00 TVA „ , .R. auhNq s ss 2.50 n O 15 50 3.00 O r� A,,LL Am so 100 5.00 i7 �, -S l©6 -Ar-(j F SIGNS: NO.TRANS. illJ7 NO.LAMPS d SERVICE 0.600V.NoT OVER 200A 1.00 SERVICE O-SOOV-OVER 200 A. 2.00 SERVICE OVER SOOV 5.00 MISC. PERMIT ISSUING FEE 2.00 SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE $ 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATI ]POWER APPROVALS DATE INSPECTOR'S SIGNATURE. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPCONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATIN !, ELECTRICAL WIRING. WIRING 4 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/O - d LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OFIXTURES CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOV - DESCRIBED RESIDENTIAL PROPERTY. SIGNATURE UTILITY CO.NOTIFIED OF PERMITTEE FINAL �LIDATION ARTHUR C. VEIT l/ MO CASH SUPERVISING ELECTRICAL ENGINEER LACO.1 7 9 5Q IMAY19 2 D 14.70- 9 7F6A688-CE808 9-68 APPLICATION FOR ELEC`t'RICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDINGLOCALITY NEAREST FOR APPLICANT TO FILL IN I CROSS ST. RECEPT. TOTAL NO. EACH FEE I / / OUTLETS FIRST 20 S20 $ 70 OWNER LIGHT AIL 041 SWITCHADD'L 10 ADDRESS OVER 20 LIGHTING TOTALFIXTURES FIRST 20 ,20 CITY TEL.NO. FIXTURES ADD'L 10 CONT OVER 20 _ RANGES -DRYERS WTR.HTR8. 1.00 ADDRESS GARB.DI8P. STA.COOK CITY 'FEL.NO. DISHWASH. AUTO.-WASH. STATE SPACE HTR8. BTA. APPL. ,50 LICENSE NO. -„Z �p MOTORS: OVER NOT OVER H.P. DISTR�IryCT O. G U ZONE J=ED ED BY O 1 1.00 �^V 1 8 1 11.50 INSPECTION RECORD 8 S 2.00 S 15 2.50 1s so 8.00 t so 100 5.00 V SIGNSI NO.TRANS- NO.LAMPS GO SERVICE 0.600V-NOT OVER 200A 1.00 W Lu SERVICE 0-600V+OVER 200 A. 2.00 Z i SERVICE OVER 600V 5.00 OTHER (SEE COMPLETE FEE SCHEDULE) PERMIT ISSUING FEE SUPPLEMENTARY PERMIT ISSUING FEE 1.00 APPROVALS DATE INSPECrOR'S SIGNATURE TOTAL FEE i 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION UNDERSLAB WORK AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ROUGH CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO POWER �J RESIDE IN,THE ABOVE DESCRIBED RESIDE TIAL PROPERTY. t SIGNATURE 1 UTILITY CO.NOTIFIED / OF PERMITTEE FINAL ! l LI JOS . CK MOO CASH SUPERVISINGG ELECTRICAL ENGINEER LACO8 7 0 6:- My23 2 D 4-.00~ CQ WORKERS'COMPENSATION DECLARATION 7BA683 10/81 >• 1 hereby affirm that I have a certificate of consent to self insure, CE-8066 APPUCA ION FOR ELECTRICAL PERMIT tior a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec.3800,Lab.C.) . ��p 5 S.�t e fv,.� 1 Policy Noi2Zy 7Jo Company // � // FOR APPLICANT TO FILL IN ADDRESS OO Ale 1 Q Ld ❑ Certified copy is hereby furnished. (461-1—f6 New Residential Bldgs.&Pools EACH NO. FEE ❑ 1 &2-Family,Sq.Ft. $ _ $ LOCALITY � 1 e- C-! , (� Certified copy is filed with the county building inspection NEAREST d part ent. Multi-family Sq.Ft. `Z zsTas CROSS ST. Applicant I.-u/Lb-74C E:Je j-eLL Residential Swimming Pools OWNER R Date FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL " �� COMPENSATION INSURANCE Outlets:Rec—Light_Sw.— ADDRESS L OD 4'8- wn�WEC-I (This section need not be completed if the work Involved by the First 20 permit is for one hundred dollars($100)or less.) Total No. Additional PLAN CITY --E' (C �, Tel.No. I certify that in the performance of the work for which this permit APPLICANT is.issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. I 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 L-LL)C L—)LrC- V G Exemption,you should become subject to the Workers'Compensation Range_ Heater_ D.W. provisions of the Labor Code,you must forthwith comply with such Oven _ Dryer_ W.M._ ADDRESS Fes-[ k ZO 6 L I/.a provisions•or this permit shall be deemed revoked. Top _ FAU W.H. _ CITY Tel.No.gts-,baZ 1 LICENSED CONTRACTORS DECLARATION Hood — Fan Other_ ym I hereby affirm that I am,licensed under provisions of Chapter9 Disp. — Room Air Cond. LICENSE OR S 7 7 R3 Class.C-t p (commencing with Section 7000)of Division 3 of the Business and REG.NUMBER Professions Code,and my license is in full force and effect. Power Apparatus&Large Appliances DISTRICT NO. E2 BY a Size&Type HP,KW,KVA,or KVAR' 0 O LicC-'0 FINAL 0 License Number-S-7-)q3 .Class Up to 1 Incl. Z� �S Over 1 to 10 Incl. DATE 9 � VALIDATION 0 Contractor�`y�-�`« �� ��L- Date Over 10 to 50 Incl. FINAL ❑, I am exempt under Sec. Over'50 to 100 Inc. BY OW. Over 100 B.&P.C.for this reason � N Z LS FS 6c:esW, b CC& nelboards Date: p, n er I V' Signature H 201 - 1000 Amp.Under 600 V ❑ Over 1000 Amp.or Over 600 V Exemption for Reg.Maint.Elect. SINGLE FAMILY Temp.Power Pole&Appurtenances ACCTo4 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law Additional Sign Branch Circuits 3303 65.60 for the following reason(Section 7031.5,Business and Professions Code): 1 ITEMSElMisc.Conduits&Conductors I,as owner of the property,will do the work and the structure Other(See Complete Fee Schedule) _ TOTAL 65 o 60 is not intended or offered for sale (Section 7044, Business , Ln and Professions Code). 6500 �1G n 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(Sec.3097, PERMIT FEE (Sub Total) 'gr D Civ.C.). PLAN CHECKING FEE , 0000-0001 7/25/95 ' Lender's Name �/J 1544 1 Ate 8028 PERMIT ISSUING FEE Lender's Address I certify that I have read this application and state that the above TOTAL FEE ' information is correct:1 agree to comply with all County ordinances and State laws regulati g Electrical wiring, and hereby authorize representative f this ounty to enter upon the above-mentioned prop r 1 p ctio urposes. SEE REVERSE FOR EXPLANATORY LANGUAGE o 7/7-5/f5Sign re of . rmittee 7/7-5/f5Date