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Home My Public Portal About6310 ROSEMEAD BLVD_Electrical__ 76A663_CES06-6-57 APPLICATION FOR ELECTRIC PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS �(J JOHN A.LAMBIE,COUNTY ENGINEER I CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSSST PERMIT FEES OWNER LIGHTS RECEPTACLES SWITCHES NUMBER I T E M EACH FEE MAIL ADDRESS TOTAL OUTLETS � 10 � � ELEC RANGES, WATER HEATERS, CITY TEL NO CLOTHES DRYERS .50 ELEC SPACE HEATERS, STAT'Y COOK• ELECTRICIAN (y ING UNITS, GARBAGE DISPOSERS, ADDRESS d AUTO WASHERS, DISHWASHER .25 Lzi LIGHTING FIXTURES .10 CITY TEL NOC. l OD MOTORS STATE—LICENSE TATE i/ LICENSE NO �"Q J HORSEPOWER DISTRICT NO. GROUP ON READY FOR INSPECTION H P: OVER INC C✓ V.B:LESS 25 J �• 1/2 2 Bo INSPECTION RECORD 2 — 5 100 5 — 15 1 50 ° 15 50 250 50 — 200 Soo ✓"7' t'13�,0.6,' ! MISC. ,I 'NO.TRANS Lt✓/4I1d'/Id SIGNS; Ar– SERVICE j NO LAMPS SERVICE O-600V 00 C SERVICE OVER 600V 500 WIRING PERMIT 100 ? o ;J-)- UT l>/— /-/47— FIXTURE PERMIT 100 �'� ,�•� ,S IRF_S- �('d /✓� �O� SUPPLEMENTARY PERMIT 50 _.-APPRO_V.ALr , TOTAL FEE t (� TU /'P- Gr✓H/e-HMI/f�•,I Pe I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT 0 LC GNjy T T WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING I 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 THE ABOVE POWER DESCRIBED RESIDENTIAL p,�OP�RTY, SIGNATURE -�-(/��J /_�j UTILITY CO NOTIFIED OF PERMITTEE I a OLS O)VI, 2- J� w _ FINAL JOHN A.LAMBIE. VALIDATION ARTHUR C.VEIT, COUNTY ENGINEER CK Mo ,%+sH SUPERVISING ELECTRICAL ENGINEER t 4684.E NOV 2g 2 2.20 0 I ®� 76AG63-CESOG-6-57 APPLICATION FOR ELECTRIC PERMIT 1, COUNTY OF LOS ALDrMION DEPARTMENT OF COUNEER BUILDING cn BUILDING AND SAFETADDRESSG_/7JOHN A.LAMBIE,COUNER CASSATT D GRIFFIN,SUPNG LOCALITY NEAREST / FOR APPLICANT TO FILL IN cRoss ST' L /✓ /V PEPMT FEES OWNER C/�SLr/,EGL LIGHTS RECEPTACLES SWITCHES NUMBER ITEM EACH FEE MAIL ADDRESS TOTAL OUTLETS $ .10 $ ELEC. RANGES, WATER HEATERS, CITY TE NO CLOTHES DRYERS 50 ELECTRICIAN L.a�?'►. �G..O ( - ~ +_� ELEC SPACE HEATERS, STAT'Y COOK- ING UNITS, GARBAGE DISPOSERS, ADDRESS z1 7 AUTO WASHERS, DISHWASHER .25 '� LIGHTING FIXTURES .10 CITY TEL NO I �ut MOTORS_ STATE r— LICENSE NO f �� HORSEPOWER H P: OVER INC (STRICT NO. I GROUP I ZONE ;READY FOR INSPECTION - ys IN LE59 25 V2 - 2 50 INSPECTION RECORD 2 — 5 100 5 — 15 1.50 15 — 50 250 - 50 200 Boo MISC. S lZE/E P SIGNS I NO TRANS NO.LAMPS - SERVICE O-600V 100 SERVICE OVER 600V Soo WIRING PERMIT 100 Vv FIXTURE PERMIT too SUPPLEMENTARY PERMIT 50 TOTAL FEE $ APPROVALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APP ICATION DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING d 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF , CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE POWER DESCRIBED RESIDENTIAL. PROPERTY. I �1 SIGNATURE .....0� UTILITYCO NOTIFIED •�/ OF PERMITTE GUJ "I FINAL Lf JOHN A.LAMBIE. VALIDATN� ARTHUR C. EIT, COUNTY ENGINEER (�Al SUPERVISING ELECTRICA CK MOL ENGINEF� y14 9-4 8t DEC 9 2 2.00 M 1 - =s• WORKERS'COMPENSATION DECLARATION 7E-806 10/81 - APP CATION FOR ELECT(7� A [�ERM67 I hereby affirm that I have a certificate of consent to self CE-806G [f{� €1 U'CI Ili C� If" 5l`9N IJ insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUIL DIN _AND SAFETY or a certified copy thereof (Sec 3800, Lab C ), /0 a Policy No Company FOR APPLICANT TO FILL IN JOB k il P '/ Certified copy is hereby furnished New Residential Bldgs & Pools EACH NO FEE ADDRESS 6f e�E C� GM Certified copy is filed with the county building inspec- 1 & 2-Family, Sq Ft $ — $ LOCALITY L� tion department Multi-family Sq Ft — 'NEARESCROSS ST IT ! Residential Swimming Pools OWNER OR Date Applicant FIRM NAMETe ,. O CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec O Li ht MAIL COMPENSATION INSURANCE. g First 20 ' ADDRESS Sq18 V (This section need not be completed if the work involved by Total No Additional CITY YE� �' 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 CHECK APPLICANT permit is issued, I shall not employ any person in an anner so as to become subject to the Wo ers' am 'sat 'L Lighting Fixtures�j First 20 ADDRESS E Total No L•-� Additional f CITY Tel Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT If, after ma g this Ce i cafe of Range— Heater APPLICANT Exemption, you should become subject to th orkers' 9 -�6 W — Compensation provisions of the Labor Code, yo m st forth- Ovenp D W M — ADDRESS� f�" with comply with such provisions or this permit shall be To F —W H deemed revoked CITY r Cl--,t /Tel No .2 LICENSED CONTRACTORS DECLARATION Hood — an —Other_ , Disp _ Room Air Cana LICENSE OR Class I hereby affirm that I am licensed under provisions of Chapter 9 REG NUMBER (commencing with Section 7000) of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO PROCE SED BY and Professions Code,and my license is in full force and effect Size &Type HP, KW, KVA, or KVAR O License Number Lic Class Up to JktclFINAL VALIDATION O Z; 10 Incl DATE /^ 7�� Contractor Date Over 10 to 50 Incl FINAL I— ❑ I am exempt under SecOver 50 to 100 Inc BY 0. B &P C for this reason Over,100 N Date Services, Swbd , MCC r& Panelboards D Z —'-'0 - 200 Amp Under 600 V Signature 201 - 1000 Amp Under 600 V ❑ Over 1000 Amp or Over 600 V Exemption for Reg Maint Eject SINGLE FAMILY Temp Power Pole&Appurtenances -2,2.2 7,8 A HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit # 0 0 0 0 0 2 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 2 0)0 5 0 Professions Code) ❑ j, as owner of the property, will do the work and the Misc Conduits&Conductors o 0 0 •�`5 D.H om structure is not intended or offered for saleOther Complete Fee Schedule)—(Section ( p )— 0626-8-4 7044, Business and Professions Code) CONSTRUCTION LENDING AGENCY 71A Z 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 ) �r PLAN CHECKING FEE 4 Lender's Name- d�-'l e PERMIT ISSUING FEE- Lender's Address I certify that I have read this application and state that the TOTAL FEE above information is correct I agree to comply with all County ordinances and State jaws regulating Electrical wiring, and hereby authorize re sent Ives of this County to enter upon ab e-l/,. pro t ny for inspection purposes I -SEE REVERSE FOR EXPLANATORY LANGUAGE �o -26-84= ti gn ture ofrerlte Date