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HomeMy Public PortalAbout5031 SERENO DR_Electrical__ �I TSASBS-CEBOS-11417APPLICATION FOR-ELECTRIC PERMIT 1 COUNTY OF LOS ANGELES DEPARTMEM OF COUNTY ENGINEER TB SU DR No BUII.DING AND SAFETY DIVISIONDRHSBCALITY ARESTFORAPERM FEESLLIN Oss ST ze�p �1401,1TEM NUMBER [AG F[[ NEROUTL fILLIO% R[cePr ew 10 DRESS LIGHTING FIXTURES 3r 10CITYT! O KIM RANGES CLD DRYERS ELECTRICIAN WATER HEATER[ 50 ADDRESS [LEC BPAC[HTRS DISHWASHERS ARBASE DISPOSERS AUTO- CITY TEL NO 7 GB WAEHERETA COOKING UNITS ^ 25STATE C MOTORS ovu Inc Hp LICE8NO B[ADT reE InEP[GTIOM O— VE 26 I/. — 2 50 2 — a 100 DNSPE(.R!!ON SEGO a — 1a 150 to — so 2 So ao— 200 a o0 1 SIGNS NO TRAMS _ NO LAMPS a. ZVI SERVICED 600V 100 +. SERVICE OVER 600V a00 MISC. WIRING PERMIT 100 FIXTURE PERMIT 1 00 ' SUPPLEMENTARY PERM IT a0 TOTAL FEE , sgOVALg I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION DATE - INSPECTOR 3SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING WIRING N I.-z, 1 HEREBY CERTIFY THAT 1 AN PROPERLY REGISTERED AMD/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND ATE OF CALIFORNIA OR THAT M THE LEGAL WNE F E AEOYE DESCRIBED RESIDENTI P PERI POWER SIGNATURE UTILITY CO NOTIFIED OF PERMITTE FI DATION ARTHURC SIT._ Mo CASH SDPBlVIDINa QAI c LACC 7.0 94 gS DEC 1 2 A 6.6 0 :9 , l - ._�i APPLICANT FUL IN BEAVELY OUTUNM PORTIOPI ONLY DLOCATION BY ROOMS ESCREMON OF WORK off �,. �000MU.00©. �.■ ■.....■ _ �.■■....... �m rl9plppjm t e WORKERS CO�]sPENSATION DECLARATION 7eA� tD,BI APPLICATION FOR ELECTRICAL PERMIT [I I'hutb R,ffum that I trove o certificate of cement to self ' insureoof coph cthe of Workers Compensation Insurance BOUNTY OF l05 ANGELES BUILDING AND SAFETY or o certified copd y (hereof (Sec 3800 Lob C ) Policy No Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished New Residential Bldgs 8 Pools EACH NO FEE ADDRESS ❑ Certified copy is filed with the county budding mspec 1 8 2-Family, Sq Ft $ — $ LOCALITY hon deportment Multi family Sq Ft — NEAREST QQ Residential Swimming Pools OWNER pR Date (A FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS Outlets RecLtght�Sw v IL COMPENSATION INSURANCE ADDRESS (This sectlon need not be completed If the work'irrvolved byr Fust 20 , ClTel No the Permit Is for one hundred dollars($100)or less) Total No Additional PLANCHECK T m I certify that the performance of the work for which this APPLICANT permit is issued I shall not employ any person to any manner so as to became subject to the Work ompens ttton laws Uphnng Fixtures First 20 ADDRESS Totol No Additional Dote pphcon CITY Tel No NOT( T APPLICANT li of making this C rbhcote o Fixed Appliances Not Over 1 HP PERMIT Exemption you should become subject to the Worker Range_ Heater_D W — APPLICANT 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 --WH — 'deemed revoked CITY Tel No LICENSED CONTRACTORS DECLARATION Hood — Fan _Other_ I here affirm that I am licensed under Dap — Room Au Cond LICENSE Class by provisions of Chapter 9 REG NUMBER >„ (commencing with Section 7000) of Division 3 of the'Bminess Power Apparatus 8 Large Appliances DISTRICT NO ED BI O. an' d Professions Code and my license is in full force and effect U O Q Sae 8 Type HP KW KVA or KVAR r O V License Number L¢ Class Up to I Incl FINAL K Over I to 10 Incl DATE VALIDATION O Contractor Date Over 10 to 50 Incl FINAL W ❑ I am exempt under Sec - Over 50 to 100 Inc BY M N 100 /) Z B 8P C for this reason Over i(/�/y Services SwLd MGC 8 Ponellwards Dote 0 -200 Amp Under 600 V /Y�^ � Signature 201 - 1000 Amp Under 600 V ❑ Exemption for Reg Motnt Eject Over 1000 Amp or Over 600 V SINGLE FAMILY Temp Power Pole 8 Appunenonces HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits ' Low for the following reason (Section 7031 5 Busmess and Prof ns Code) Mac Conduits 8 Conductors I as owner of the property will do the work and the Other (See Complete Fee Schedule)_ ► structure in not intended or offered for sale (Section 7044 Business and Professions Cade) A 5 9 61 A CONSTRUCTION LENDING AGENCY # • • ! • • 2 I hereby affirm that there is a construction lending agency for if the performance of the work for which this permit is issued • PERMIT FEE (Sub-Total) r 1-!' e 2 n 2 5 (Sec 3097 Ci C PLAN CHECKING FEE e e @20259' Lender s Nam D �t( PERMIT ISSUING FEE 18 e 8 6 lenders Address I certify that I have rood this application and state that the TOTAL FEE rGV �Cr+ above information is correct I agree to comply with all County wcliwnces and State jaws regulating Electrical wiring and , hereby authorize representatives of this County to enter upon this,plov entioned property for spechon purposes - SEE REVERSE FOR EXPLANATORY LANGUAGE zx tgnature of Per u Dote