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Home My Public Portal About4937 SERENO DR_Electrical__ TGA":CZ CMwa APPLICATION FOR ELECTR C�L PERMIT BUILDING SA1 Irl DIVISION OR APPLICANT TO PILL INID" New Residential Bldgs &Pools EACH NO FEE ADDRESS 41 F,4 1 &2 Finaily Sq Ft $ — $ LOCALITY l( Multi family Sq Ft NROS6T ST Residential Swimming Pools OWNER FIRM NAME Outlets Light Switch& Receptacle MAIL First 20 0 IT ADDRESS Additional O CITY Tel No 7 PLAN CHECK Lighting Fixtures APPLICANT First 20 ADDRESS Additional CITY Tel No PERMIT Fixed Appliances Not Over 1 HP APPLICANT / Range— Heater_ DIN ADDRESS (s Oven Dryer _ W M Top _ FAU _ W H CITY Tel No .2 Hood Fan LICENSE ORCom,O Drip AC REG NUMBER cis..Clep wRe. ACKNOWLEDGE THAT Nu APPLICATIONC Power Apparatus& Large Appliances THAT Ae AAND IS STAND ATE LAWS RaGVTO LATSliG Size&Type HP, KW, KVA or KVAR `ECT"`A"""'"' ORDINANCES ET LAR. w 0 Up to 1 Incl . EwTiwT THAT i A DPEw REGISTERED AND/.. LICE = Over 1 to 10 Incl we NEGUIREG Los w ANGELES c TNTATE oP PC.Niw ow TN.T i wY LEGAL oRNEw ePTNE AEDVE Over 10 to 601nc1 DocwiecG"Selo ENTUL.wo.E/y Over 5010100 InCI PERMIT EE Over IDD 61GTU RE Services DISTRICT NO PRO ESSE BV 0-20 _ 1 0 Amp Under 600 V O v 201 1000 Amp Under 600V APPROVALS DATE INSPECTOR S SIGNATURE Over 1 ODO Amp or Over 600 V TEMP POWER POLE Temp Power Pale& Appurtenances UNDERSLAB WORK Sign with One Branch Circuit Additional Sign Branch Circuits ROUGH CONDUIT (Other) WIRING FIXTURES POWER AUTHORIZED PERMIT FEE (Sub Total) UTILITYCO NOTIFIED PLAN CHECKING FEE (One-Fourth Permit Fee) FINAL PERMIT ISSUING FEE TOTAL FEE NOTES PLAN CHECK VALIDATION CK MO - CAS H• , ERMIT VALIDATION CK M D CASH ` X83' 7[ZSEP 14 2 D 1 5.30 • 78Aee9 CEeOS , SS APPLICATION FOR ELECTRICAL AL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADORESB K3 O Ax JOHN A LAMBIE COUNTY ENGINEER y // J-7 COLEMAN W JENKINS-SUPT OF BUILDING LOCALITY / 10 7,NEAREST O "Oee ST G/RECEPTACLE TOTAL No EACH FEEOUTLETS FIRST zo It zo [ OWNER �11�i 11/AM LIGHT MAI ,/SWITCH ADD L 10 ADDRESS ..YdMlOVER 20TOTAL FIRST 20 20 CITU E TEL NOIGHTING FIXTURESFIXTURES ADDLCONTRACTOR / OVER,20 10 RANGES CLO MYER. WTR HTRS 100 '� ADDRESS"M DIW STA COOKCln. TEL NO DISHWAS AUTO WAS STATE WACE HYRS STA APP IW H R MA% 1 60 LICENSE NO MOTORS, OVER NOT OVER Hr DISTR NOG U ZONE Po — 1 too 1 — s 150 INSPECTION R CORD 9 S 200 , C� p IS Seo 74 16 50 300 Eo — 100 500 p10Np� NO TRANS 1 NO LA"S SERVICED SOOV NOT over 200A 100 SERVICE O 600V OVER 200 A 200 1 SERVICE OVER 600V 600 1 OTHER IS" COMPLETE FEE SCHEDULE) � I PERMIT ISSUING FEE 200 SUPPLEMENTARY PERMIT ISSUING FEE 100 TOTAL FEE [ O' APPROVALS DAn 1 I HERESY ACKNOWLEDGE THAT I HAVE READ THIS ArPLI TION UNDERSLA6 WORK AND STATE THAT THE ABOVE IE CORRECT AND AGREE TO COMPLY ROUGH CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WINING WIRING / /t^ 1 HERESY CLRTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALWORN IA OR THAT 1 AM THE LEGAL OWNER Or AND INTEND TO POWER RESIDE IN THE ABOVE O ISED NES10E L PROrE SIGNATURE UTILITY CO NOTIFIED O PURE OF ER je FINAL /! ! VALIDATI� JOSEPH C ROOLECT CX MO GpN SUPERVISING ELECTRICAL ENGINEER LhLo 6 1 0 9 CCT 4 2 D 4.0 Q/— "- WORKERS COMPENSATION DECLAR T 7� ,et e.r,APPLICA,TION FOR ELECTRICAL PERMIT I hereby off Firm that I have a certificate o e� 806r, V insure ore copyt a of Workers 0, Tob Compensation Insurance COUNTY OF LOS ANGELES BUILDING AND SAFETY mor a certified copy thereof (Sec 3800, Lab C ) Policy No Compony FOR APPLICANT TO FILL LL IN PolNew Residential Bldgs 8 Pools Certified copy is hereby furnished I EACH NO FEE ADDRESS q93 "7 J�'2 .a J Q7L � ❑ Certified copy is filed with the county building inspec- 18 2 Family Sq Ft $ — f LOCALITY hon department Multi-family Sq Ft — NEAREST CROSSST GSnac N -� Residential Swimming Pooh Dale Applmant OWNER OR - CERTIFICATE OF EXEMPTION FROM WORKERS - - MAMA NAME L-y}rL e .•+ COMPENSATION INSURANCE Outlets Rec�Light��Sw z ADDRESS L43'5 Fust 2o` k\ 1 a —• 7 3 ,tC'auo (art_ (This section no"not be completed If the work Involvwd by Cn. , - v the permit Is for ono hundred dollars ($I00)or loss ) Total No 7{� Additional ' - CITY —w C u Tel No AAS-SS VY PLAN CHECK I permit that m the performance of the work for which this APPLICANT permit a issued, I shell not employ any Workers' to any manner so as to become subject to the Workers'Compensahoa Laws Lighting Fxtuies Fust 20 ADDRESS Total No L Additional Dote -2L-VN Applicant CITY - Tel No Fixed Appliances Not Over I HP PERMITNOTICE TO APPLICANT If, come making t s the of APPLICANT Exemption you should become subject to the Workers ,__ Range_ Heater_D W _ Compensation provisions of the Labor Code you must forth Oven _ Dryer _ W M — ADDRESS with comply with such provisions or this permit shoil 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 9 Dup _ Roam Air Cond REG NUMBER Claes (commencing with Section 7000) of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NO PRO(-F D BY and Professions Code and my license is in full force and effect Q Size 8 Type HP, KW KVA, or KVAR License Number L,c Class - Up to 1 Incl FINAL V Contractor Date Over 1 to 10 Incl ' DATE - VALIDATION ❑ Over TO to 50 Incl FINA FO- I am exempt under Sec Over 50 to IDO Inc BY C B 8P C for this reason Over 100 C N Services Swbd , MCC 8 Ponelboords Z Dote 0 - 200 Amp Under 600 V Signature 201 - 1ODD Amp Under 600 V - ❑ Over 1000 Amp or Over 600 V Exemption for Reg Maint Elect f SINGLE FAMILY Temp Power Pole 8 Appurtenances _ HOME OWNER BUILDER DECLARATION Sign with One Branch Grant �j -107541- Low 7 Jr.�4 _ I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuit s C j8 tB 1 R 41 L Law for the following reason (Section 7031 5 Business and car' 1 9 0 0 Professions Code) ❑ I as owner of the property will do the work and the Mac Conduits 8 Conductors 02¢'z b_ 8 4 structure is not intended or offered for sale (Section _ Other (See Complete Fee Schedule)_ Poo Business and Professions Code) CONSTRUCTION LENDING AGENCY 1 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, Cry C J - PLAN CHECKING FEE Lenders Name PERMIT ISSUING FEE Lender s Address " I certify that I have read this application and stole 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 representatives of this County to enter upon ' the above mentioned property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE LO Al-j,(,-k,4 ' $�gnaNre of armntae Date WORKERS COMPENSATION DECLARATION CE 86.3 tD,BIi;eAPPLICATION FOR ELECTRICAL PERMIT ori �nsulg axo}Hf cotte of Workers Comtpensaton Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec 3800 Lab C ) Policy No Company FOR APMICANT TO FAL IN JOB Certified copy is hereby furnished New Residential Bldgs & Pools EACH NO FEE ADDRESS s Certified copy is filed with the county budding inspec- 1 8 2 Family, Sq Ft $ — f LOCALITY tion department Multi family Sq Ft — NEARESTCZ Dote F A 6cant - Residential Swimming Pools CROSS S7 i pp OWNER M r11 elirl)e CERTIFICATE OF EXEMPTION FROM WORKERS _ FIRM NAME 9'" Dirties Rec Light Z Sw MAIL COMPENSATION INSURANCE First 20 t /(This secllon need not be completed if III work in•olvad by Total No _ CIN el No f/ 111e permit Is for one hundred dollars($100)or less ) Addlianal 7 ECK I certify that in the performance of the work for which this PRjCPLAN At , permit is issued I shall not employ any person in any manner - so as to become subject to the Workers Compensation Laws LightingTotal Fixtures Fust 20 - ADDRESS ' (0�2�7 Total No 2— Additional CITU Tel Date Applicant Fixed Appliances Not Over 1 HP _ PE~ NOTICE TO APPLICANT If after making his Cerhhwte of -FX- APPLICANT Exemption you should become subject to the Workers Range_ Heater_D W 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 — CIN Tel No deemed revoked Hood _ Fan _Other— LICENSED CONTRACTORS DECLARATIONt LICENSE OR I hereby affirm that I om licensed under provisions of Chapter 9 Dnp Room Au Cond REG NUMBER Class (commencing with Season 7000) of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NO�Cr PROCE BY and Professions Code and my license n in full force and effect � y _ Size 8 Type HP KW KVA or KVAR ) a O License Number L,c Class— %P Up to 1 Incl FINAL V _ Over 1 to IO Incl r) DAA - V ATION 0 Contractor Date Over 10 to 50 IncO ❑ l FINA I am exempt under Sec Over 50 to 100 Inc BY 916. Over 100 B 8P C for this reason Z Dote Services Swbd , MCC 8 Ponelboards O , - '- �+0 200 Amp Under 600 V Signature 201 1000 Amp Under 600V ❑ Exemption for Reg Moms Elect Over 1000 Amp cr Over 6DD V - 275 1.9 A SINGLE FAMILY Temp Power Pole 8 Appurtenances #,a its is is,2 HOME OWNER BUILDER DECLARATION Sign with One Branch Circuit ( • • 3 9.2 5 1 hereby affirm that I am exempt from the Contractor s License Additional Sign Branch Circuits Low for the following reason (Section 7031 5 Business and - • • --39,255 Professions Code) / I Mord Conduits 8 Conductors 0723 -87 as owner of the property, will do the work and the structure is not intended or offered f« sale (Season Other (See Complete Fee Schedule)— , 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 PERMIT FEE (Sub-Total) (Sec 3097 Civ C ) t PLAN CHECKING FEE _ Lender s Name PERMIT ISSUING FEE Lenders Address I certify that I have read this application and state that the TOTAL FEE 5 above information is correct I agree to comply with all County orduonces and State laws regulating Electrical wiring and hereby authorize representatives of this County to enter upon the ob mentioned property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE y L�ctC6 � 7 Sig ture o Permittee Date