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Home My Public Portal About5000 ROSEMEAD BLVD_Electrical__ ,36A863-CE606 1/70 APPLICATION -FO�ELECRl. L, PERMIT COUNTY OF'LOS ANGELES DEPARTMENT OF COUNTY-ENGINEER BUILDING BUIL,61NG AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE,-COUNTY ENGINEER LOCALITY COLEMAN W. JENKINS SUPERINTENDENT OF BUILDING NEAREST FOR APPLICANT TO FILL IN CROSS-ST.: OUTLETS NO. EACH FEE -. OWNER • � $: $ RECEPT, MAIL LIGHT TOTAL FIRST 20 ADDRESS CITY TEL. N0, SWITCH' - OVER 20 .10 PLAN CHECK ) LIGHTINGFIRST 20 APPLICANT. TOT L OVER 20 ADDRESS FIXTURES 10 APPLIANCES CITY TEL: NO PERMIT - RANGE DRYER_WTR. HTR• :APPLICANT STA. COOK. DISP. F.A.U. ADDRESS. : SPACE HTR. AIR COND. CITY CLOTHES'WASH. DISHWASH, LICENSE'NO. CLASS. FAN OTHER 1.00 - 1 HEREBY ACKNOWLEDGE. THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE .ISCORRECT AND AGREE TO COMPLY ' MOTORS, TRANSFORMERS RATING '• WITH ALL COUNTY: ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW. KVA. - ELECTR-ICAL WIRING. -• SIZE & TYPE OVER TO - - - - I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR O — 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 1 •—,1O 3.00 RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. JSIGNATURE s 0 10 — 50. 5.00 OF PERMITTEE ✓.: 0 V 50 — 100 10.00 Iw DISTRICT NO. CLASS GROUP ZONE -PROCESSED 10.0 — 500 15.00 . -3 1 V SIGN, GAS SIGN AND ONE CIRCUIT 3.00 NOTES:k./4 ®eN�, N Lu TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 1 . r SERVICENOTOVER60OVOLTSOR200AMP 2.00 " A ROVALS-' DATE INSPECTOR'S SIGNATURE SERVI CE OVER.600 VOLTS OR 200 AM P 5.00 TEMP.POWER POLE TEMP SERVICE,POLE, &-APPURTENANCES 3.00 UNDERSLAS WORK' . . i, TEMP LIGHT ORRECEPT. SYSTEM 3.00 ROUGH CONDIUT Iry .•f a, •, -7- WIRING ^ PERMIT FEE - - (SUFIXTURES- POWER TO POWER AUTHORIZED PLAN CHECK FEE (50%PERMIT FEE) UTILITY.CO. NOTIFIED PERMIT ISSUING FEE' 2.00 FINAL SUPPLEMENTARY.PERMIT ISSUING FEE • i".00 ' JO PH'C. ROOHA TOTAL FEE - .SUPERVISING ELECTRICALR, ENGINEEPLAN..CHECK VALIDATION. CK. M.O. CASH PERMIT VALIDATION (K. M.O. CASH -`.8"54` .AUG' 2 D : 5.0'0- SEE BALK OF APPLICATION FOR COMPLETE SCHEDULE - . 76^663-CE8051/70 .APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER FDD Nc� BUILDING AND SAFETY DIVISION JOHN A: LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING T ST'FOR APPLICANT TO FILL IN ST•OUTLETS• NO. EACH - FEE • OWNER 7 RECEPT.� - $ $ MAIL FIRST.20. / ,20 ADDRES LIGHT TOTAL - - CITY TEL. N0. f SWITCH_ OVER 20 .10 PL•X N CHECK ' ' - LIGHTINGTOTAL FIRST 20 - '20 APPLICANT ' OVER 20. ADDRESS FIXTURES .10 APPLIANCES CITY TEL. No. PERMIT RANGE DRYERWTR. HTR. APPLICANT STA. COOK DISP. - F.A.U. 'ADDRESS SPACE HTR. AIR COND. CITY TEL. NO. - 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 CORRECTANDAGREE TO COMPLY MOTORS,'TRANSFORMERS RATING .WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING' IND. HEATERS,-ETC. HP. KW. KVA. ELECTRICAL W.IR ING. - SIZE'& TYPE OVER -TO - 'I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 —'1 1.00 LICENSED AS REOU IRED"BY LOS'ANGELES COUNTY AND=STATE'OF CALIFORNIA OR THAT IA THE LEGAL OWNER_ OF'AND INTEND TO 1 — 10 3.00 I RESIDE IN, THE AB E DESCRI ED RES D IAL PROPERTY. 10 - 50' . 5.00 SIGNATURE d OF PERMITTEE i V 50 — 100 10.00 DISTRICT NO -,CLASS GROU, ZONE, PR CESS ED•BY GC 100 - 500 15.00 J ! _ -a- SIGN, GAS - LV SIGN AND ONE CIRCUIT 3.00 N T TUBE, OR H • MARQUEE. ADDI.TI'ONAL CIRCUITS 1.00 % . 61,176 ? I SERVICENOTOVERGOOVOLTSOR200AMP 2.00 SERVICEOVER GOO VOLTS OR 200AMP - 5.00 APPROVALS. DATE INSPECTOR'S SIGNATURE TEMP.POWER POLE - TEMPSERVICE,POLE, &APPURTENANCES 3.00 UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM• 3.00 ROUGH•CONDIUT . I WIRING - FIXTURES - - PERMIT FEE (SUB TOTAL) POWER AUTHORIZED ' PLAN CHECK FEE (50%PERMIT FEE) ) . UTILITY CO-NOTIFIED PERMITISSUING FEE 2.60 - - FINAL SUPPLEMENTARY PERMIT ISSUING FEE 1.00 :{ JOSEPH' C. ROOHAN " TOTAL. FEE V SUPERVISING ELECTRICAL ENGINEER PLAN CHECK VALIDATION CK.' M'.o. cnsH PERMIT VALIDATION CK., M.O. CASH .7°3 2,9ti`OCT 26 2` D 2.�0^' a .SEE BACK OF APPLICATION-FOR COMPLETE SCHEDULE - WORKERS'COMPENSATION.DECLARATION 76A663, ioiBi • I hereby offir,,((nn'that I,have c certificate of consent to self' CE-806G APPLICATION FOR _ELECTRICAL PEROVIIT . insure Tor a cAriificote of Workers' Com ensation Insurance, p -. . ,. �� COUNTY.OF LOS'.AN,GELES , ` BUILDING'ANDSAFETY or a,cjprtified copy"thereof(Sec. 3800, Lab.-C). s ' t Policy No Company t FOR APPLICANT TO FILL IN JOB ` Certified„copy is hereby furnished New Residential'Bld s & Pools ADDRES a ;. Bldgs' $ EACH O.'1$ LOCAL! S CH N FEE Certifiedco' is filed wrth'the courit'Vbuilding inspec a & 2 Family .Sq.-Ft• — tion_department. Multi-family Sq, Fi. NEAREST e m CROSS ST:' Date Applicant x Residential Swimming Pools FIRM Q CERTIFICATE OF EXEMPTION'FROM'WORKERS'.` r MAIL NA _ N+r Outlets; Rec Light Sw_ DDRE '`! C COMPENSATION'INSURANCE < ..- A S.ME Q JF Q J_ om leted if the'work involved 6 . Flrst ti - P Y-, CII :Tel. N This section need not be c Total No: the Pei mit is For one'hund'red;dollars (5;100)or'less.) ddrtional 'PLAN HEC M c, .A 7 I certify that it'the per,formance,;of,the'work for which,this APPLICANT permit is;issued l`shall'rot'empl'oy any person'cinan manner :,so as'to!tiecome subject to the Workers'Co "en's n Laws:”' Lighting Fixtures. First 20� AC DRESS Q dditional '. D. APPlica p Total o •A. No. P Tel Fined Appliances Over l HP _ -v� ,..i NO ICE TO'APPLICANT If;. ter'making Certificate.of` 'PERMIT, - Y Exemphon, yor ,should become subject 'to'the Workers' Range_,Heater_,.D.._W.- APPLICANT `Compensation provisions'of the L"abor Code, you.musi forth- Oven — Dryer W.M. •ADDRESS, , with comply," with such provisions' or,this''permii'shall,be, Top FAU —W.H.'.—• ; deemed,revoked. - Hood Fan _ Other—, CITY Tel No.' LICENSED CONTRACTORS•'DECLARATION " LICENSE OR I hereby affirm that I am licensed'under:'provisions of Chapter 0isp. Rbom'Air Condi. AEG. NUMBER Class. (commencing with,Section;7000) of Divisio'n'3 of-the-Business" P DISTRICT NO: P CESS BY ower Apparatus,& Large Appliances �� `and Professions Code; and my license'is in full'force and effect: : r VO' Size.&Type HP, KW"KVA; or KVAR ' License Number; Lic. Class Up t0'1 Incl. FINAL 0= �C6ntracfor• Date,:' 10 t Over 1 to 10 Incl.. DATE �i^ VALIDATION Over o 50 Incl. , • ,am.exem t under'•Sec ;,. Over 50 to.100 Inc. BY O.. 4 I , B_&P C for this reason; v Z . O er 100' Services, Swbd ; _MCC& Panelboar'ds Dateiii�7/15 0 -'200 AmUnder 600 V x Signature „E 201 - 1000 Amp: Under,600 V �• Exemption for Reg. Maine: Elect. v V ,. O er 9000 Amp.'or Over.600 SINGLE FAMILY. HOME.OWNER-BUILDER DECLARATION.' Temp. Power Pole &.Appurtenances.. . Sign with One Branch Circuit, 1 herebyaffirrYi that. am exempt from the Contractor's'License : 'A'dditionol Sigh Branch Circuits' Law'for-the following-reason'(Section 70315; Business and 9 Professions Code):, 59 M Conduits & Conductors, f, as owner of the property, will do the work and the isc' 1 ! :strudure•is noY,intended .or offered_for.:'sale (Seedi'on• Other (See.C6mplete FeeSchedule)� o °2 7044 `Business,and Professions Code). CONSTRUCTION LENDING AGENCY.:_ o e 25,5r0 I hereby affirm that there.is,o�construction lending agency for.:• -,,r o e o 55 2 5,0,6 the performance of the work'for which this,permit is issued PERMIT'FEE. (SubTotal) 386 (Sec. 3097, Civ. C.) 111 FEE- PLAN,CHECKING s e r F Lepcler's Nome .: 1 : • PERMIT ISSUING FEE k" nder's Address ' I certify,that I have read this application and state that the; ' TOTAL FEE,:• 9 above information js correct;I agree to comply with all County ordinances-and State laws•regulating-Electrical'wiring, and• - hereby authorize representoti es,of this County toenter:.upon . thea v ;mentioned prope for inspection purposes.' SEE REVERSE FOR EXPLANATORY LANGUAGE ��,,, gnature of Perm Date