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Home My Public Portal About5271 SERENO DR_Electrical__ TeAGGrca[os 1D/74 APPLICATION FOR ELECT(C2'kAAAt PERMIT COUNTY OF LOS ANGELES DHP.�KRTMENT OF COUNTY ENGINEER -A DRESS S Se,9,eW G BUILDING AND SAFETY DIVISION LOCALITY �,,, err NEARET FOR APPLICANT TO FILL IN CROSS 5T "ie.Q..) OUTLETS [ ONN ER OR !` S S FIRM NAME AC RECEPT�fJ-Z,6112_94_4j E71 MAIL LIGHT-111 TOTAL FIRST 20 O O O ADDRESS 945- OVER 20 7& CITY TEL NO SWITCH PLAN CHECK LIGHTING l TOTAL FIRST 20 �Q �O APPLICANT TFIXTURES OVER 20 /7ADDRESS RESIDENTIAL APPLIANCES CITY JTEL NO PERMIT RANGE_DRYER_WTR HTR_ APPLICANT 17 crl Nor lWrJ Cl DTA COOK_OISP_F A U ADDRESS 2 SPACE HTR AIR COND CITY TEL N0I/ , IOp IZT CLOTHES WASH 01SHWASH RE N MB e2 CLASS C:D/0 �,q0 FANScOTHER 100 QQ 1 H[REBT ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND CTAT[ THAT THE ABOVEORDINANCES E CORRECT AND ACRS E COMPLY MOTOR" TTN""ETC RATING WIT ALL COUNTY OROINAMC[I ANO ITAT[ LAW[ REGULATING IND X[ATLRS [TC XP KW RVA ELECTRICAL WIRING SIS[ i TYPE OVER TO 1N[IESY CERTIFY THAT 1 A4 PROPERLY REGISTERED AND/OR O - 1 100 CALIFORNIA AS 1 THAI BY LO" AN/[L[[ COUNTY AND "TAT[ OF VE GSCRIBED OR IDE I AM HE LEGAL OWNER 01 IN ABOVE 1 - 10 300 DESCRIBED R[IIOI L PERTY O ¢ 10 - 80 500 PERMITEE SIGNATURE O U 60 - 100 POLO DISTRICT NO � PROLE 0 BY y 100 _ BOD 1500 SIGN, GAS SIGN AND ONE CIRCUIT 500 APPROVALS DAT[ UISP[GTOWS IISNATUR[ TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 TEMP POWER POLE SERVI CENOTOVER BOO VOLTS OR 200AMP !GO UNDERSLAB WORK SERVICEOVER600 VOLTS OR200AMP 1D jo0 ROUGH CONDUIT TEMPSERVICE,POLE, &APPURTENANCES 500 WIRING TEMP LIGHT OR RECEPT SYSTEM 300 FIXTURES POWER AUTHORIZED UTILITY CO NOTIFIED FINAL PERMIT FEE (SUB TOTAL) NOTES I'l W 15-A.6jrVc y/I.pb• PLAN CHECK FEE 7 VIGr' 4-1C. 4957" _� 11 PERMIT ISSUING FEE !DO Ig I.1 LN GOJ TOTAL FEE PLAN CHECK VALIDATION CK M D CASH PERMIT VALIDATION CK M 0 CASH ( I u.1 2 D 68.7 () A!Jo 519 BACK OF APPLICATION FOR COMPLETE SCHEDULE I ML APPLICATION R ELECTRICAL PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN DRESS New Residential Bldgs 8 Pools � EACH NO FEE ADo LOCALITY � 1 &2 Family,Sq Ft E 025 — E Multi family Sq Ft 02 - - NAR ROSS ST - - Residential Swimming Pools 2500 WN - s- - �yy F NA Outlets RecLl-Lght4-5w � MAIL First 20 50 d V ADDRESS Total No Additional 30 CITY _ _ _Tel No _ PLAN CHECK APPLICANT Lighting Fixtures First 20 50 ADDRESS ddeionol 30 _ _ _ I Total No A CITY Tel No I Fixed Appliances Not Over 1 HP PERMIT w Range_Heater_D W _ APPLICANT i Oven.Dryer_W M_ ` / - ADDRESS/-Z /PG Top —FAU — WH — CITY y.. Tel Nq(�,((� Q` Hood—Fon -L-Other— LICENSE OR Drsp —Room Au Cond 250 REG NUMBER [� Class p I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO SI e&Ty HP KW KVA or KVAR COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS - Z W 0/G 2 50 V REGULATING ELECTRICAL WIRING Up to I Incl 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR Over 1 to 10 Incl 5 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF Over 10 to 50 Ind 1250 CALIFORNIA OR THAT I AM THE LEGAL OWNER gKTHE ABOVE 25 00 DESCRIBED RESIDENTIAL PROP TV Over 50 to 100 Inc 40 PERMOEE Over 100 - SIGNATURE Services DISTRICT NO - IS P E BV 0 200 Amp Under 600V 1250 201 1000 Amp Under 600 V 2500 _ _ Over 1000 Amp or Over 600 V 5000 o r Temp Power Pole d Appurtenances 10 00 0 00 �d Sign with One Branch Circuit 7 Additional Sign Branch Circuits 200 INSPECTION > 1-000 INFORMATION g 8 3 4 8 8 A id OtherCSee Co 8 ConductorsON REVERSE x Other ISee Complete Fee Schedule)_ SIDE 3u # • • IS • • 2 "12 2 • • 44.00 PERMIT FEE (Sub Total) ' ' • 4 4 O O E PLAN CHECKING FEE Ione Fourth Permit Feel C o402-79 F PERMIT ISSUING FEE $700 0 TOTAL FEE j INSPECTION FINALED ' dote '/ Z* -7 Q By CBs ' CA 11 Taneea-ceeoa a•eoAPPLICAT)IOOWFOR ECTRICAL PERMIT COUNTY OF LOS ANGELES -DEBUILDIING AND SAFETY EER BU DIV SENT OF COUNTY IIOIN 7ADIR SS ✓� h JOHN A LAMBIE, COUNTY ENGINEER COLEMAN IN JENKINS, SUPERINTENDENT OF BUILDING ITY ST FOR APPLICANT TO FILL IN ST[ACM PE[ S 3 RECEIPT LIGHT_ TOTAL FIRST 20SS /J TEL NO -O 2 SWITCH_ OVER 20 10 PLAN CHECK LI G XT ING l TOTAL FIRST 20 20 APPLICANT FIXTURES J} OVER 20 10 ADDRESS / RANGE_DRYER_WTR HTR CITY -4 / TEL NO 4z _ STA COOK_DISP _F A U _ CONTRACTOR SPACE HTR —AIR COND ADDRESS / 2 rl PC,g 1, ^J CLOTHES WASH _DISHWASH CITY Sd /I/ TEL NO - FAN_OTHER 1100 LICENSE NO IP7,72 7 CLASS Q MOTORS TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION IND HEATERS ETC HP KW KVA AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY SIZE Q TYPE OVER TO WITH ALL COUNTY OROINANCES AND STAY LAWS REGULATING ELECTRICAL WIPING 0 1 1 00 1 HEREBY CERTIFY THAT 1 AM PROPERLY PEOIf TER[O ./OR LICENSED AS REQUIRED By LOS ANGELES COUNTY AND STATE OF 1 - 10 3 OO CALIFORNIA OR THAT I AM THE LCGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY O 10 - SD 5 00 U SIGNATURE pC 50 - 100 1ODO OF PERMITTEE Q 100 - 500 15001 DISTRICT NO GROUP ZONE R [SeEo r tj PROUGHCONOUIT CL SIGN,GAS SIGN AND ONE CIRCUIT 3 00 - �Y - L Vii MARQUEE ADDITIONAL CIRCUITS 1 00 Q /Al fV-'>✓ INA ? SERVICE NOT OVER 600 VOLTS OR 200 ANP 2 DOOti 1'y SERVICE OVER 600 VOLTS OR 200 AMP 5 00 TEMP SERVICE, POLE, &APPURTENANCES 3 00LS (DATE INSPECTORS SnIATQRS POLE ORK IT PERMIT FEE (SUB TOTAL) FIXTURES PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED PERMIT ISSUING FEE 200 -b UTILITY CO NOTIFIED FINAL SUPPLEMENTARY PERMIT ISSUING FEE 100 TOTAL FEE JOSEPH C ROOHAN SUPERVISING ELECTRICAL ENGINEER PLAN CHECK VALIDATION CK M D CASH /' PERMIT VALIDATION CK' M o Cee , BEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE 8 7 8�N'MEEN 18 2 D 1 2.0 0 0� 3/ 9 r O WORKERS COMPENSATION DE �aaa CLARATION tr�wJ,� APPLICATION FOR ELECTRICAL PERMIT ;'X'17erb�y Aif40ai Thai I have a certificate of convent to self �a s106c;insure or a certificate of Workers Compensation Insurance, COUNTY OF LOS ANGELES ` DEPT, OF PUBLIC WORKS or a certified copy thereof (Sec 3800 Lab C ) -2w-ry ZY.P �s Polity No Company FOR APPLICANT TO FILL IN JOB �f Certified copy is hereby furnished New Residential Bldgs 8 Pools EACH NO FEE ADDRESS Spr.7/ Al, Seee/rd, bw [KCerhfied copy is filed with the county building inspec- I & 2 Family Scl Ft $ = $ LOCALITY tion deportment Mull,-family Scl Ft ` ST41 APP CROSS ST _ p G Dote /� -a S Residential Swimming Pools OWNER Applicant I FIRM NNrf CERTIFICATE OF EXEMPTION FROM WORKERSOutleA Rec L� ht� g _71e, S. MAR COMPENSATION INSURANCE First 20 ADDRESS (Tela permit I tread not be red completed if the work Involved 6T Total No Additional CITY Tel No 1M pr.rmit b for o.to hundred dollars($100)or Ins) PLAN CHECK I certify that in he performance of the work for which this APPLICANT permit is issued I shall not employ any person in any manner so as to become subject to the Workers Compensation Laws Lighting Futures First 20 ADDRESS _3� Additional CITY Tel No Date Applicant � Fixed aApplionces Not Over 1 HP PERMIT NOTICE TO APPLICANT If after making this Certificate of Exemption, you should become subject to the Workers' Range Heater—D W APPLICATION Compensation provisions of the Labor Code you must forth- Over Dryer —W M ADDRESS,/,q,, with comply with such provisions or this permit shall be Top — FAU —WH JL- deemed revoked Hood — Fan Other— CITY Tel No LICENSED CONTRACTORS DECLARATION Div — Room Air Cond — DRECGN UMBER IG177AL9 Clain/p I hereby offirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NO D BY > and Professions Code and my license is in full force and effect U C/ d �,L, Size 8 Type HP KW KVA w KVAR d O License Number 777-201 Lic Class 112 S6/�L%fo I Incl (] FINAL U Contractor.CL7S� 166-e-1 Dote 9=17 —Py 'T� Over 1 to 101nc1 DAT g V ATION 0 OOver 10 to 50 Incl FIN f- I am exempt under Sec Over 50 to 100 Inc U W B&P C for this reason Over 100 � Dote Services, Swbd , MCC 8 Ponelboords , Z 0-200 Amp Under 600 V - Signature 201 - 1000 Amp Under 600 V �9 0 8 8 2 A Exemption for Reg Maint Eject Over 1000 Amp w Over 600 V # • • •Is s 2 SINGLE FAMILY Tamp Power Pole 8 Appurtenances ,( • 1 2 3 5 0 HOME OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor s License Sign with One Branch Circuit ss pp Law for the following reason (Section 7031 5, Business and Additional Sign Branch Circuits T 4 Professions Code) ❑ I as owner of the property, Misr Conduits&Conductors p pe o will f o the work and the Other See Complete , T structure n not intended or offered for sole(Section 7044 ( Fee Schedule)_ Business and Professions Code) CONSTRUCTION LENDING AGENCY , I hereby affirm that there is a construction lending agency far the performance of the work far which this permit is issued PERMIT FEE (Sub Total) (Sec 3097 Civ C ) i PLAN CHECKING FEE Lender s Name PERMIT ISSUING FEE Lender s Address TOTAL FEE I certify that 1 have read this application and state fiat the J 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 alio enhoned�x rty for inspection purposes / SEE REVERSE FOR EXPLANATORY LANGUAGE / -Z SCL}A ignature c,fKrfhiltea Date ms