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Home My Public Portal About10253 RANDWICK DR_Electrical__ .76A663-C€8061-68 APPLICATION FOR ELECT XLyPrlERMIT a COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING , BUILDING AIy D SAFETY DIVISION ADDRESS JOHN A. LAMBIE. COUNTY ENGINEER /+y COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY CfT FOR APPLICANT TO FILL IN FOR CROSS ST. 7l/ NO, EACH FEE � $ $ OWNER r RECEPT._ MAIL LIGHT TOTAL FIRST 20 .20 6e, ADDRESS t SWITCH A_ 12 OVER 20 .10 CITY T TEL. NO. .� PLAN CHECK LIGHTING ITOTAL, FIRST 20 .20 APPLICANT FIXTURES OVER 20 .10 ADDRESS RANGE—DRYER—W'TR.HTR.— CITY TEL. NO. STA.COOK_DISP.—F.A.U._ CONTRACTOR SPACE HTR. AIR COND. ADDRESS CLOTHES WASH.—DISHWASH.— CITY TEL. NO. FAN—OTHER 1.00 LICENSE IJO. CLASS. MOTORS,TRANSFORMERS RATING IND. HEATERS, ETC. HP. KW. KVA. 1 HEREBY ACKNOWLEDGE THAT I. HAVE READ THIS APPLICATION SIZE & TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. 0 — 1 1.00 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 1 — 10 3.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ' CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO 10 — 50 5.00 RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. O 50 100 10.00 SIGNATURE U Y FFREE ad 100 — Soo ts.00 O. GF�QWP ZONE PtaiO SED BY ririSIGN,GAS SIGN AND ONE CIRCULT 3.00 TUBE, OR we Ci. LLI MARQUEE ADDITIONAL CIRCUITS 1.00 jor h e�SERVICE NOTOVER 600 VOLTS OR 200 AFAP 2.00 [`''SERVICE OVER 600 VOLTS OR 200 AMP 5.00TEMP SERVICE, POLE, &APPURTENANCES 3.00 VALS DATE INSPECTOR'S SIGNATURE POWER/POLE POLE UNDERSL WORK ROUGH ONDUIT PERMIT FEE , (SUB TOTAL) J WIRI C! Z G FI URES PLAN CHECK FEE (50% PERMIT FEE) OWER AUTHORIZED PERMIT ISSUING FEE �� .00 UTILITY CO.NOTIFIED SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL TOTAL FEE JOSEPH C. ROOHAN SUPERVISING ELEC AL ENGINEER PLAN CHECK tV,ALIDATI ON CK. M.0. CASH PERMIT VALIDATION CK. M.O. CASH 6 s 8 4- OCT 23 2 0 420- -'E .2 N:E BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE ^A D 76A663-CE806 g=68 APPLICATION FOR ELECTRICAL PERMIT �. es� � COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING o, -`'Bt91LDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE. COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY Cj FOR APPLICANT TO FILL IN NEAREST CROSS ST. NO. EACH FEE $ $ OWNER T.3L MAIL LIGHT TOTAL FIRST 20 .20 g�140 ADDRESS /J SWITCH OVER 20 10 .10 CITYEL. NO. 7'377 PLAN HECK LIGHTING JTOTAL FIRST 20 .20 401APPLICANT FIXTURES OVER 20 .10 ADDRESS' RANGE_DRYER—WTR.HTR._ CITY TEL. NO. STA.COOK_DISP..t--F.A.U.— CONTRACTORcal-gym SPACE HTR.-AIR COND.—ADDRESS Q , CLOTHES WASH._DISHWASH._ aa CITY TEL. NO. FAN—OTHER d 1.001001LICENSE IJO. CLASS. MOTORS,TRANSFORMERS RATING IND. HEATERS, ETC. HP. KW. KVA., IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION SIZE & TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY W.ITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. 0 — 1 1.00 ' I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 1 — 10 3.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO 10 50 5.00 RESIDE N, THAT ABOVE DESCRIBED RESIDENTIAL PROPERTY. O — ` SIGNATURE U 5'0 — 100 10.00 OFPERMITTEE OC 100 - soo 15.00 1DIS RICT NO. GW _e ZONE P OCESSED B SIGN,GAS SIGN AND ONE CIRCUIT 3.00 �� LLI TUBE, OR h MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES: 9 �• C. Z SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 SERVICE OVER 600 VOLTS OR 200 AMP 5.00 TEMP SERVICE, POLE, &APPURTENANCES 3...00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP. POWER POLE UNDERSLAB WORK G ROUGH CONDUIT PERMIT FEE (SUB TOTAL) WIRING FIXTURES PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED PERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED SUPPLEMENTARY PERMIT ISSUING FEE 1.Do FINAL TOTAL FEE JOSEPH C. ROOHAN SUPERVISING E'L�E AL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION M.D. CASH L&6 7 .99� WTI , CK.0 2 0 11201- BACK 1.201BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE IA668-CEB06 3-62 APPLICATION FOR ELECTRIC PERMIT % COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER j� BUILDING BUILDING AND SAFETY DIVISION vii/ 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 t7l OUTLETS 61 FIRST 20 �d ffi.2O ffi s OWNER LIGHT MAIL A DO'L ADDRESS SWITCH. OVER 20 ..10 TOTAL - CITY EL.NO.zz LIGHTING 66ryry FIRST 20 .20 FIXTURES ADD'L 10 ELECTRIC AN QVIER 20 RANGES CLO.DRYERS *TR.HTRB. 1.Oo _FADDRESS J11VOp GARB.DISP. STA.COOK CITYTEL.NO. DISHWA8H. AUTO..WASH. I STATE ` /J SPACE HTRB. 14 vt& BTA.APP.1'A H.P.MAX. ,s0 LICENSE NO. (� (/ MOTORSf OVER NOT OVER H.P. DIST ICT G Fj P O D19- .3 O 1 1.00 J 1 3 t.SO INSPECTION RECORD s 2:Oo s to 2.50 a 1s so 3.00 0 so 100 5.00 m O SIGNSf NO.TRANS. F NO.LAMPS W d SERVICE 0.600V-NOT OVER 200A 1.00 N Z 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 ffi - Ni IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INBPWfOR'881GNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT /. WITH ALL-COUNTY ORDINANCES AND STATE LAWS REGULATING / ELECTRICAL WIRING. WIRING a A-3 I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED A8 REQUIRED BY LOB ANGELES COUNTY AND STATE OF FIXTURES ':j'�i�X3 CALIFORNIA OR THATI M THE LEGA OWNER OF TH ABOVE DESCRIBED RESIDENTIA R Y. POWER •p/ �., .J., SIGNATUREq s / TTEE UTILITY CO.NOTIFIED OF PERMI �7r - �:G✓'y & FINAL. 7y�`.�le ��S ►li�f ./-VALIDATION ARTHUR C. VEIT s "� CK MO CASH SUPERVISING ELECTRICAL ENGINEER L11t,o 9 2 9 2 Ga, JAN 9 2 o 1 8.0 0- v WORKERS'COMPENSATION DECLARATION CE-806 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent•to self �' JAUNTY OF LOS ANGELES BUILDING ANDS FETY insurd,or a certificate of Workers'Compensati Insurance,or ifi o y 4hereof 3800 b. r y L FOR APPLICANT TO FILL IN JOB om any ADDRESS ew Residential Bldgs.&Pools EACH NO. FEE ertified copy is hereby furnishe 1 &2-Family,Sq. Ft. $ —' $ LOCALITY Multi-family Sq. Ft. — NEAREST Certified copy is filed with the county buil inspection �S CROSS ST rtment Residential Swimming Pools OWNER OR FIRM NAM Date �plicant ` Outlets: Rec.—Light Sw. MAIL -t -j!��a First 20 ADDRESS CE TIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITel 1 01 . } COMPENSATION INSURANCE I PLAN CHECK p_ (This section need not be completed if the work involved APPLICANT by the permit is for one hundred dollars ($100) or less.) Lighting Fixtures, First 20 ADDRESS C1 Total No. Additional I certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No. permit is issued, I shall not employ any person in any manner: PERMIT CC so as to become subject.to the Workers'Com sat(on Laws. Range_Heater D.W. _ APPLICANT Oven _ Dryer_W.M._ ADDRE$ ` fa Da. 4 �pplicant. Top _ FAU _W.H. Hood_Fan _Other_ CI•T Tel N NOTIC TO APPLICANT: If,,after making this Certificate.of Disp. _Room Air Cond._ LICENSE OR Exemption, you should become subject to the Workers' REG.NUMBER lass Compensation provisions of the Labor Code,.you must forth- Power Apparatus&Large Appliances DISTRICT NO. IPROCES ED BY with comply with such provisions or this permit shall be Size&•Type HP,KW,KVA;or KVAR deemed revoked. j i() Up to Incl. FINAL Over 1 to 10 Incl. DATEa, r, VALIDATION L ® 'LICENSED CONTRACTORS DECLARATION � Over 10 to 50 Incl. o - I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL 9 (commencing with Sectiorl.7000)of Division 3 of the Busi- Over 100 BY r -- ness and Professions.Code,:and my license is in full force and effect. Services License Nu b r ic.Class 0-200 Amp.Under 600 V 67 G 2014 000 Amp.Under 600 V Contract Over 1000 Amp.or Over 600 V HOME OWNER-BUILDER DECLARA ION Temp.Power Pole&Appurtenances 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 , ness and.Professions Code): I Misc.Conduits&Conductors ' Ell, as owner of the property, will do the work qnd 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). CONSTRUCTI.ON LENDING AGENCY C o o32.00 I hereby affirm -that there is a construction lending agency for the performance of the work for which this permit is0 0 0 520010 issued(Sec.3097,Civ.C.). PERMIT FEE (Sub-Total) Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) 03 110—M Lender's Address PERMIT ISSUING FEE I certify that I have read this application and state that the TOTAL FEE 3 Qd 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 above-mentioned pro erty for inspection purposes., SEE•REVERSE FOR EXPLANATORY LANGUAGE' Signature of Permittee Date T WhERS'COMPENSATION DECLARATION I 40.0019 DPW 3/87 APPLICATION FOR ELECTRICAL PERMIT O I hereEYj,affirm that I have a certificate of consent to self Ceeoe3G Q insure,6r a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS h or o certified copy thereof(Sec. 3800, Lab. C.) /J Policy No.��9Bil Company /fie LOHPt;11w664 :25S• FOR APPLICANT TO FILL IN JOB ❑Certified copy is hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE ADDRESS 10.253 AMAIDWMA� Dei. Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. $ — $ LOCALITY 7kA1,4 0- C/ tion department. Multi-family Sq. Ft. NEAREST Residential Swimming CROSS ST. Date Applicant Pools I OWNER OR FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec�Light�Sw.J IL flrJpdt!lC,� d1Q. COMPENSATION INSURANCE I ADDRESS lOzS-3 First 20 y8–O/'s (This section need not be completed If the work Involved by Total No. � Additional CITY 7E�ypLE �j Tel. No. the permit is for one hundred dollars($100)or less.) I certify that in the performance of the work for which this PLAN PIANTK 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 Date Applicant Total No.—L_ CITY Tel. No. Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers' Range— Heater—D.W. _ APPLICATION /18 4104167-,elle7MAJ 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 hee.4O1A Tel. No.57V-7307- LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. — REG. NUMBER✓Z/G3 3 Class. $ (commencing with Section 7000)of Division 3 of the Business Power Apparatus&Large Appliances DISTRICT NO. PROCESSED BY and Professions Code,and my license is in full.force and effect. /r Size&Type HP, KW, KVA, or KVAR V 0 License Number 32/1033 Lic. Class '8 Up to 1 Incl. FINAL 0 cr Contractor�'� Lrg�1ST�4e�aJ pate a/' Over 1 to 10 Incl. DATE , ATION 0 ❑ Over 10 to 50 Incl. O�U FINAL I am exempt under Sec. Over 50 to 100 Inc. BY LU B.&P.C. for this reason Over 100 d Services, Swbd., MCC&Panelboards Z Date: 0-200 Amp. Under 600 V — Signature 201 1000 Amp. Under 600 V 9 9 LL 2 A ❑ Exemption for Reg. Mainf. Elect. Over 1000 Amp. or Over 600 V # 0 0 a 0 0 2p' I a 0 1 �5 0, Circuit SINGLE FAMILY Tem Power Pole&Appurtenances x HOME OWNER-BUILDER DECLARATION C 0 0 ail 3.5 0 U I hereby affirm that I am exempt from the Contractor's License Sign with One Branch C L'aw for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits 0 621 -88 Professions Code): ❑ I, as owner of the property, will do the work andhe Misc. Conduits&Conductors structure is not intended or offered for sale(Section 70`4, Other(See Complete Fee Schedule)— , 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 issded PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE (f Lender's Address TOTAL FEE I certify that I have read this application and state that the above informatio is correct. I agree to comply with all County ordinances a ate laws regulating Electrical wiring, and hereby out riz representative f this County to enter upon the abov a io r per specfion purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of rrIttee Date I ®°