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Home My Public Portal About5715 ROWLAND AVE_Electrical__ 785 DBS-SA 8-SB. I�PPLOCA TION FOR ELECTRIC PERMIT SA� DMSION OF BUILDING AND SAFETY Deportment of County Engineer NG County of LOB. Angeles ADDRESS U WM.J.FO, COUNTY ENGINEER CASSATT D.GRIFFIN.SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL.IN NEAREST PERMIT FEES CROSS sr. NUMBER EACH FEE OWNER 49.I= / C /�'j� 7- LIGHT LIGHT OUTLETS MAIL L RECEPTACLES ADDRESS 't WALL SW ITCHES ? TOTAL OUTLETS 5¢ $ CITY EL.NO. ELEC.RANGES 2'5 ELECTRICIAN O /Q F ELEC.HEATERS . 25 ADDRESS �S/ KW EA CITY S/� I�I+TEL.N �! FIXTURES 5 LICENSE NO: c� NUMBER OF LIGHT CIRCUITS ��DISTRICTN I GROUP I ZOI�I� I READY FOR INSPECTION NUMBER OF RECEPTACLE CIRCUITS MOTORS NUMBER HORSEPOWER FEE INSPECTION RECORD NEW MVD. HP OVER INC. EACH 1A&LESS $ .25 1h 2 .50 .2 5 1.00 P 5 15 1.50 15 50 2.50 .50. .. 200 5.00 1 y MISC. x. NO.SIGNS NO.TRANS. NO.SIGNS NO'.LAMPS FOR EACH PERMIT: WIRING $1.00 0 " FIXTURES •$1.00 n SUPPLEMENTARY ..50. APPROVALS s. TOTAL FEE $ DATE INSPECTOR'S SIGNATURE 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP.PLICATION CONDUIT �I AND STATE THAT THE ABOVE. IS CORRECT AND AGREE TO COMPLY' p F WITH ALL COUNTY' ORDINANCES AND STATE. LAWS REGULATING WIRING to S tf1 fI.L.Ln•-4._- ELECTRICAL WIRING. 1. HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ^ FIXTURES LICENSED AS REQUIRED BY ANGLES UNTY AND STATE OF CALIFORNIA OR THAT 1 T E AL HER OF THE ABOVEPOWER DESCRIBED RE£IDENTIA R E Y .UTILITY CO:NOTIFIED SIGNATURE OF PERMITTEE FINAL w WILLIAM J.FOX.COUNTY ENGINEER VALIDATION A.C..VEIT.CHIEF ELECT.INSPECTOR UVA o � i5c 9 2 1.25 APPLICATION R ELECTRICAL PE IT 75A663-CE606 10/72 COUNTY OF LOS ANGELES _ DEPARTMENT OF COUNTY ENGINEER Joe .r7/S aw i-�No 19�U G. BUILDING AND SAFETY DIVISION ADDRESS LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. 4-&-O 7 ;4, OUTLETS N0. EACH FEE OWNER ORJd^ $ $ FIRM NAME 49WXL MkC �' • A.US'i JrZ RECEPT._ MAIL ADDRESS r 7 cc.�s..1-mo LIGHT TOTAL FIRST 20 25 CITY T .2f 7/4�/ OVER 20 �� C f T TEL. NO SWITCH .10 PLAN CHECK LIGHTING TOTAL- FIRST 20 .25 APPLICANT FIXTURES OVER 20 •10 1 ADDRESS RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT RANGE DRYER_WTR. HTR. APPLICANT STA. COOK DISP. F.A.U. ADDRESS 94 SPACE HTR. AIR COND. CITY 944t= TEL. NO. CLOTHES WASH. DISHWASH. LICENSE OR CLASS. REG. NUMBER FAN OTHER _ 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR 0 — 1 1.00 LICENSED AS REOUIRED BY LOS ANGELES COUNTY AND STATE OF } CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE 1 — 10 3.00 DESCRIBED RESID IAL PROPERTY. p CJ PERMITEE 10 - 50 5.00 SIGNATOR "' ' "` CD F- 50 - 100 10.00 v DISTRICT NO. PROCESS D BY Lu 12- 100 - 500 15.00 O� y e SIGN, GASSIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTOR' SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE SERVI CENOTOVER 600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK S ERVI CE OVER 600 VOLTS 0 R 200 AM P 10.00 ROUGH CONDUIT on TEM P S ERVI CE,POL E,&APPU RTENANCES 5.00 WIRING TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL PERMIT FEE (SUB TOTAL) NOTES: PLAN CHECK FEE PERMIT ISSUING FEE 3.00 Q(} TOTAL FEE PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION CK. M.O. CAS 7 0 3AAPR 25 2 D 6.0 0 ,&98 SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE WORKER;3O ENSATION DECLARATION CEA-806G (2-80) APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that� 't hy'have a`certificate of consent to self COUNTY OF LOS.ANGELES BUILDING AND SAFETY insure,or a certificate of Workers'.Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) FOR APPLICANT TO FILL IN JOB Policy No. Company EACH NO. FEE ADDRESS • New Residential Bldgs.&Pools Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ '— $ LOCALITY E Certified copy is filed with the count. Multi-family Sq. Ft. — NEAREST y building v� g inspection CROSS ST , department. Residential Swimming Pools OWNER OR tti�nn '" Date Applicant 'A FIRM NAME r�-S� �� Outlets: Re Light Sw._/� MAIL First 2 ADDRESS CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. � Additional COMPENSATION INSURANCE PLAN CHECK Tel No. O}. APPLICANT �'�/ 0 (This section need not be .completed if the work involvedt 20 First Fixtures xtures rs _ U by, the permit.'is for one hundred dollars ($100) or less.) LigADDRESS Additional 1Z �1lv I certify that in the performance Total No. p of the work for which this CITY 'Tel No. permit is issued, I shall not employ any person in any manner Fixed Appliances Not Over 1 HP U PERMIT IL so as to become subject to the Workers'Compensation Laws. Range_Heater D.W. _.. APPLICANT Oven —. Dryer_W.M. p ADDRESS o 2? Date Applicant Top _ FAU _W.H. Hood Fan _Other_. CITY Tel No. NOTICE TO APPLICANT: If, after making.this Certificate of Disp. _ Room Air Condom LICENSE OR Exemption, you shopid become subject to the Workers' REG.NUMBER Class Compensation provisions of the Labor Code,you must forth- Power Apparatus&Large Appliances DISTRICT NO, PROCESSED BY with' comply with such provisions or this permit shall be deemed revoked. Size.&Type HP,KW,KVA,or KVAR Up to 1 Incl. FINAL LICENSED CONTRACTORS DECLARATION Over 1 to 10 Incl. DATE S [� VALIDATION Over 10 to 50.Incl'. r 0 I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL 9 (commencing with Section 7000)of Division 3 of the Busi- Over 100 BY ness and Professions,Code, and my license is in full force and effect. Services 0-200 Amp.Under 600 V License.Number Lid.Class 201-1000 Amp.Under 600 V -5 Jr a 9 A Contractor Date l Over 1000 Amp.or Over 600 V # 0,0 010 0 HOME OWNERZUILDER DECLARATION Temp.Power Pole&Appurtenances I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit 2 °.- 47.30 License Law for the followingAdditional Sign Branch Circuits o 0 0'[). ] �.� reason (Section 7031.5, Busi- x ness and Professions Code): . Misc.Conduits&Conductors 0 � 121-82 I; as ownet of the property; will do the work and the Other(See Complete Fee Schedule)— structure is not intended or offered for sale (Section 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(Sec.3097,Civ.C.). PERMIT FEE (Sub-Total) Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) Lender's Address PERMIT ISSUING FEE 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. laws regulating Electrical wiring, and hereby authorize.re esentatfves of this-County to enter upon the ab entio roperty for inspection purposes. SEE"REVERSE FOR EXPLANATORY LANGUAGE \ Signature oPermittee Date