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Home My Public Portal About9665 SPARKLETT ST_Electrical__ r TBABBS-CESGB-¢-BT APPLICATION FOR ELECTRIC PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS JOHN A LAMBIE CouNTY ENGINEER CABBATT D GRIFFIN,BUR T OR BUILDING LOCALITY NEAREST / FOR APPLICANT TO FILL IN c ST ITEM I N�R EACH FEE OWNER LIOHTD� R¢CP7 BW , f 10 fJ10 4 - ADDRESS LIGHTING FIXTURES 10 I TEL NO ELEc RANam CLO DRYERS ELECTRIC N WATER NEATENS BO 1.1 SLED SPA=XTNS, DIBHWASH¢Ra ADDRESS GARBAGE DISTOICAS AUTO_ CITY TEL NO WASHERS, BTA COOKING UNITS 25 STATE L CENSE 0 MOTORS ovER INC H P RBwor row IxsREanox 0 — 1/2 25 NL) OUPIXNE V. — E 1 1 EO E — B 100 DWECTION RECORD B — 15 Too GD 15 — B° EBD 50— 200 500 SIGNS NO TRANS NO LAMPS SERVICE O BOOV 100 SERVICE OVER BOOV 500 M18C, WIRING PERMIT Too FIXTURE PERMIT 100 SUPPLEMENTARY PERMIT 50 TOTAL FEE f A"ROVAIS 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APP TION AT IMS TURF AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT I WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING WIRING I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ND SPATE OF FIXTURES i CALIFORNIA OR THAT 1 AM THE LEGAL OWNER F iXE ABOYE POWER DESCRIBED RESIDERTIAL ROPTT q HIONATV RE 6 UTIL CO ROTI PIED OF PERNIME AL ,,, IDATION ARTRUFfC ITTA aK/fro CASH su►0ev1BIMa GAL EMaNMsr [ AP-2060S JUN 19 2 A 2.7 O 7i n 1�l , I r -i 3800Lcertificate of consent to self J-. WORKERS COMPENSATION DECLARATION I hereby affum that I have a 76IDrBI APPLICATION FOR ELECTRICAL PERMIT • CE B06" insure or a cenificote of Workers Compensation Insurance COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec 3800 Lab C ) Polity No Company FOR APPLICANT TO FILL INJADDRESS ADDRESS ❑ Certified copy a hereby furnished New Residential Bldgs 8 Pools �'� NO ❑ f — ALITY lion p copy n filed with the county budding mspec 1 8 2 Family Sa Ft 1 hon department Multi family Sq Ft — EST 1/0 CqOResidential Swimming Foals FR OR Date Applicant NNAE CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec_Light_Sw_ COMPENSATION INSURANCE (This section need not be completed H the Werk involved First 20 the permit Is for one hundred dollars ($I00)or less) Total No Additional T C� Tel No CHECK I certify that in the performance of the work for which this APPLICANT permit is Issued I shall not employ any person in any manner so m to become sublect to the Worker Co pe tro La Lighting Fixtures First 20 ADDRESS Total No Additional CITY Tel No Dote —Applicant t Fixed Appliances Not Over I HP PERMIT NOTICE TO APPLICANT If after rVoking th,slitertificate 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 shall be Top _ FAU —WH — deemed WH —deemed revoked Hood _ Fan _Other_ CITY Tel No LICENSED CONTRACTORS DECLARATION LICENSE OR 1 hereby affirm that I am licensed under provisions of Chapter 9 Dnp _ Room Air Cond REG NUMBER Class } (commencing with Section 7000) of Division 3 of the BusinessDISTRICT NO BY O. and Professions Code and my license is in full farce and effect Power Apparatus 8 Large Appliances ifr ,Lir O Size 8 Type HP KW KVA or KVAR va V L License Number L¢ Class FINAL 0:Up to 1 Incl O Over 1 to 10 Ind DATE 7/7j V DATION d 0 Contractor Dote Over 10 to 50 Incl 13 I am exempt under Sec Over 50 l0 100 Inc BY BY N B BP C for this remon Oyer 100 Dote Services Swbd MCC 8 Panelboards 0 -200 Amp Under 600 V Signature 201 - 1000 Amp Under 600 V ❑ Exemption for Reg Mamt Elect Over 1000 Amp or Over 600 V SINGLE FAMILY Temp Power Pole 8 Appurtenances HOME OWNER BUILDER DECLARATION Sign with One Branch Circuit ( - - 2550 I hereby affirm that I am exempt from the Contractor's License Add ihonal Sign Branch Circuits Low for the following reason (Section 7031 5 Business and a . . 2 5 5 0 PPrrroo((essions Code) LYJ iS I as owner of the property, will do the work and the Mnc Conduits 8 Conductors I I ' 7 -c85 structure Is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ Q 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 3047 Civ C ) PLAN CHECKING FEE Lenders Nome / Lender's Address PERMIT ISSUING FEE O I candy that I hove read this application and state ;hot the TOTAL FEE above information Is correct I agree to comply with all County ordinances and State lows regulating Electrical wiring and hereby authorize representatives of this County to enter upon the Bove mentioned Pifer&for Inspects n purpose= SEE REVERSE FOR EXPLANATORY LANGUAGE I l0 nature of Pirinotee Date ' 4 5 1 ` WOFKEs u RS COMPENSATION DECLARATION 76A66310/81 i I hereby pff inn that I have a certificate of consent to self CE�' APPLICATION FOR ELECTRICAL PERMIT I mmle q a certificate of Workers Compensation Insurance COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec 3BOO Lob C ) ONT Policy No Company FOR APPLICATO FAL IN lD RESS / tified copy is hereby furnished New Residential Bldgs 8 Pools EACH NO FEE ADD `7 S AfI C Certified copy is filed with the county budding inspec 1 8 2 Family Sq Ft : — f 1 1 LOCALITY I deponme Multi-fomily Sq Ft — NEAREST p � Q.�Vh L Residential Swimming Pools OOWWNER OR Date. �7" � 8 Applican FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERSMAIL COMPENSATION INSURANCE Outlets Rec_Light_Sw_ AOOREA This section need not be completed If the work lnvc4ved by First 20 the permit Is for one hundred dollars ($100)or lea) Total No Additional CITY Tel No I certify that in the performance of the work for which thisjPLAN CHETCK permit is issued, I shall not employ any person in any manner so as to become subject to the Workers Compensation Laws Lighting Fixtures First 20 ADDRESS Total No Additiortal CITY Tel No Date Applicant Fixed Appliances Not Over 1 HP PERMIT ^ NOTICE TO APPLICANT If after making this Certificate of APPLICANT Exemption you should become subject to the Workers Range_ Hearer_D W _ w Compensation provisions of the Labor Code you must forth Oven _ Dryer — W M — ADDRESS 1Z7--`] }�� A#j(2- with comply with such provisions or this permit shall be To FAU W H deemed revoked P — — CITY Q (/\ Tel No OJf{7 075 Hood _ Fan _Other_ LICENSED CONTRACTORS DECLARATION LICENSE NOR Class Ci^[o I here affirm that I am licensed under � Disp — Room Air Cond REG NUMBER 32�J g G by provisions of Chapter 9 } (commencing with Section 7000) of Division 3 of the Business power Apparatus 8 Large Appliances DISTRICYNO SAY PROCESn a.$ and Professions Code and m license is in full force and effect Size 8 Type HP KW KVA, or KVAR License Number-'2508 Uc Class GI O Up to I Incl dE O: �s.�L L� J Over I to IO Incl — VALID N Contractor P2LA0 I{{� c c-'�+te 9 g r Over 10 to 50 Incl W d am exempt under Sac Over 50 to 100 Inc N B 8P C for this reason Over 100 Z Dote Services, Swbd MCC 8 Ponelboards ► 0 - 200 Amp Under 600 V Signature 201 - IODO Amp Under 600 V ❑ Over 1000 Amp or Over 600 V Exemption for Reg Mamt Eject i SINGLE FAMILY Temp Power Pole 8 Appurtenances i 3 6 2 5 A HOME OWNER BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractors License Additional Sign Branch Circuits e 0.1 e e 2 Law for the following reason (Section 7031 5, Business and Professions Code) l — 2550 e ,2 5 5 0 Miu Conduits 8 Conductors I, as of the progeny will do the work and the Other (See Complete Fee Schedule)_ , e • e 2 S 5 0 5 structureurs is is not intended or offered for sole Section 70" Business and Professions Code) CONSTRUCTION LENDING AGENCY 1 2 0 9 c 8 5 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 Civ C ) PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender s Address I certify that I have read this application and state that the TOTAL FEE above mf«motion is correct I agree to comply with all County ordinances and State jaws regulating Electrical wiring, and hereby ihor¢e represenrahves of this County ro enter upon the ab a mentioned pr per for ectwn purposes 8 SEE REVERSE FOR EXPLANATORY LANGUAGE Signature o ermatee Dore