HomeMy Public PortalAbout5112 1/2 SERENO DR_Electrical__ Thaw-CROOIYe[ APPLICATION FOR ELECTRIC PERMIT l
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER �o L IN JY S6/iL O v
BUILDING AND SAFETY DIVISION ESS
JOHN A LAMBIE CouNTY ENoINEER
CAGSATT D GRIFFIN SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
PERM FEES
I T R M NUMBERI EACH I rce OWNER
OUTLF- lMAIL
LIGHTS REC[!f IV 1. AI t 10 t ADDRESS
LIGHTING FIXTURES 7.4 10 Q CITY
ELEC RANGES CLO DRYERS ELECTRICIANSA"Aff
Lb�
WATER HEATERS 00 ADDRESS /(/ SC
[LAC SPACEHTKS DISHWASHERS
CITY TEL NO •/- f0
GARBAGE DISPOS[R6 AUTO
STATE
WAEHERD STA COOKING UNITE 2E uceNse No
MOTORS OV[R INC H P
DIST No I GP ZONE I PR C SED
O— y[ 23 _
VA— 2 30 II['SP=ON EW=BD
2— 3 too
3— 15 too
ID— SO 230
30-200 300
SIGNS NO TRANS
No LAMPS
SERVICE O DOOV too 00
SERVICE OVER EOOV goo
MISC
WIRING PERMIT 100
FIXTURE PERMIT 100 n
SUPPLEMENTARY PERMIT 30 /i•�\ '�� t
TOTAL FEE t p /APMOVA=
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APILICATION -2� DATE INSPECTORS SIGNATURE
AND STAT[ THAT THE ABOVE IN CORRECT AND AGREE TO COMPLY WITH
WITH ALL COUNTY ORDINANCES AND STAT[ LAWS REGULATING _
ELECTRICAL WIRING WIRING\ V W pS L. _
1 HEEO REQUIRED
THAT 1 AM VROPKAANGELES
COUNTY
AND/OR ! t
CALIFORNIA AS R THAIID A LOS AN!VL COUNTY STATE OF FIXTURES\
CALPOEDOR THAT I A [ L!VL WN E ABOVE \ J,
DESCRIBED REBIDRITIAL P P POWERAV� �.it •• b \.� \ n
SIGNATURE UTILITY CO NOTIFIED pl'\ '911-14-1-11
FINAL \
\/ iloNA \rVaRTHURrC VETT,
X
ONO OASN tUP6RV181NG ELECTRICAL ENGINEER
LQ 8 603MAR 31 2 A 820
Wm that I have
a certificate
of consent
. 7er,eea ,pyo, APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I have a cartllaate o/ consent to self insure �eoeG
or a certificate of VArkers' CoTnpensatan Insurance or a certifiedCOUNTY OF LOS ANGELES BUILDING AND SAFETY
I
copy thereof(Sec 3800 tab C)
Policy NO Company I FOR APPLICANT TO FILL.IN A106
DORESSJI I Z p 1�I✓��l�I
IJ Certified copy 4s hereby furnished New Residential Bldgs d Pools EACH NO FEE
❑ — S
Certified cops Is bwith ih the county buildinginspectionpectlon 1 8 2-Family Sq Ft $ LOCALITY
department Mulb-family Sq Ft — NEAREST cC
CR035 ST +f.
Date Applicant Residential Swimming Pools OWNER OR
�j C FIRM NAME K.JLn G
CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec�Lght Z Sw �L. MAL
COMPENSATION INSURANCE First 20 ADIXiESS V
(This section need not be completed if the work Involved by the
Permit is for orre hundred dollars IE 100)m lase) I Total No Additional / CITY Tel No 7_17,
PLAN G CK
i t ceridy that h the t performance n of the work for which this permit APPLICANT
Is issued I shall not ernpby, any person In any manner so as to
become subject to the Workers Coapensatan Laws (Light''Flxtur First 20 ADDRESS
_ Additional
Total No CITY Tel No
Gate Applicant ,Fixed Appliances Not Over 1 HP PERMR
NOTI TO PPUCANT If after ebr10 this Cereflcate
Exemption you should become subject to the Wbrkere Com..t Range— Heater— DW APPLICANT
provsions of the Labor Code you must forthwith comply with such Oven _ Dryar _ WM — ADDRESS
Prov sans or this permit shall be deemed revoked Top — FAU — WH
LICENSED CONTRACTORS DECLARATION HCRY - Tel No
—
hereby affirm that em licensed under pro the
Chapter 9 Dtsp sp _ Fan�� Air��Other—
I
NN MEER Cl—
/`i with Secrvi
Section 7000) of Osan 3 of of the Buness and
Professions Code and my license Is In full force and effect JPower Apparatus 8 Large Appliances DISTRICT 0 DB
II Size 8 Type HP KW KVA or KVAR t
License Number La Class Up to 1 Inc! FINAL
Over 1 to 10 Incl DATE a.
Conhaclor Date - I VALIDATION
Over 10 to 50 Ind FINAL
❑ I am exempt under Said + Over 60 to 100 Inc RY
88PC for this reason Over 100
Services Swbd MCC 8 Panelboards N
Date 0-200 Amp Under 600 V 2
Signature 201 - 1000 Amp Under 600 V ACCT..
❑ Exception for Over 1000 Amp or Over 600 V
Reg Mamt Elect
HOME OWNER-BUILDER DECLARATION SINGLE FAMILY Temp Power Pole 8 Appurtenances 1 ITEMS
Sign with One Branch Circuit
I hereby affirmMown that am exempt from703 the Contractors sinesan Profen Lew
for the following reason(Section 7031 5 Business and Protessons Pdtllhonal Sign Branch Circuits TOTAL 32. 80
Code) CHECK 32.80
I as owner of the property, will do the work and the structure ' Mlsc Conduit 8 Conductors
Is not Intended or offered for sale (Section 7044 Business Other(See Complete Fee Schedule) — , 41"v9ll� .00
and Professions Code)
i
CONSTRUCTION LENDING AGENCY - OOW'OQO1 9/14/90
I hereby affirm that there is a construction lending agency for the
performance of the work for which this permR Is Issued(Sec 3097 ',PERMIT FEE (Sub-Total) Q 2WO 1 AM 9:08
Cm C)
PLAN CHECKING FEE
Lenders Name
I PERMIT ISSUING FEE
Lenders Address i
1 certify that I have mad this applaatan and state that the above TOTAL FEE
Information Is correct I agree to comply with all County ordinances
and State Laws regulating Electrical wiring and hereby authorize
representatives
ss oa�f this County to enter upon the a�bo� m�ennttxmad
property SEE REVERSE FOR EXPLANATORY LANGUAGE
C
Sign re T Parm T Datel _
r