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Home My Public Portal About9616 VAL ST_Electrical__ 7ap333 DEV DB I0,72 APPLICATION40R ELICTRICAL PERMIT � ' COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER JOB BUILDING AND SAFETY DIVISION Aoowss F b V AL_'40`_ LOCALITY T �^ NEAREST FOR APPLICANT TO FILL IN CROSS ST aC a L OUTLETS NO EAUI FEE OWNER OR E S FIRM NAME IZEo ARAN\ RECEPT 1S1 MAIL LIGHT 1 TOTAL FIRST 20 25 ADDRESS SWITCH OVER 20 CITY TEt MFt. C_I TEL NO 10 PLAN CHECK LIGHTING TOTAL FIRST 20 25 APPLICANT FI%TU RES 10 OVER 20 ADDRESS RESIDENTIAL APPLIANCES CITY TEL NO PERMIT - RANGE_DRYER_WTR HTR_ APPLICANT A ,"7 2 1 C C.A.12 S STA COOK__DISP _F A U _ ADDRESS 30 '3 F l.a1GI L.A, D SPACE HTR AIR COND CITY 51151_217,4 r%4A TEL NO CLOTHES WASH DISHWASH _ LICENSE OR REG NUMBER I CLASS FAN_OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIP APPLICATION AND STATE THAT THE ABOVE 13 CORRECT AND AGREE TO COMPLY MOTORS TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REOULATING IND HEATERS ETC HP KW KVA ELECTRICAL WIRING SIZE B TYPE OVER TO I HERESY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 — I 100 LICENSED AS REOUIRED BY LOS ANGELES COUNTY AND STATE OF CALIfOR NIA OR THAI I AM THE LEGAL WNER OF THE ABOVE I — 10 30O DGSCAIPEO AES MTIA ROPIRTY oo 10 - 50 500 PERMITEE U SIGNATURE CC O SO - 100 I DAO C~j DISTRICT NO A.%w0c EO PV M3 100 - S00 1500 8y z_ SIGN GAS SIGN AND ONE CIRCUIT BOO APPROVALS DAT! viarzc sB10NATURE TUBE OR MARQUEE ADDITIONAL CIRCUITS 100 TEMP POWER POLE SERVI CENOT OVER 6DO VOLTS OR 200 AMP 300 UNDERSLAB WORK SERVI CEOVER 600 VOLTS OR 200AMP ION ROUGH CONDUIT TEMPSERVICE POLE, &APPURTENANCES BOO WIRING 1 TEMP LIGHT OR RECEPT SYSTEM 300 1 FIXTURES POWER AUTHORIZEp UTILITY CO NOTIFIED __dFINAL PERMIT FEE (SUB TOTAL) NOTES PLAN CHECK FEE / PERMIT ISSUING FEE 300 3 2�' O TOTAL FEE PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION cK M G CASH SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 1 6 8A-IRU) 7 2 Pa 5.5 O w WORKERS COMPENSATION DECLARATION 164863 ,Pyen APPLICATION FOR ELECTRICAL PERMIT J'7 CE 8060 L I hereby §ffhm that I Iha�e a certificate d consent to sell irlsurs ''LJII or a cerblc (S 04 3Workers800 L Compensation Ireurance o e certlihed COUNTY OF LOS ANGELES BUILDING AND SAFETY copy�lriered(sec 3aoo Lot, C) Policy NO Oonpery FOR APPLICANT TO RLL W JOB ❑ Certified copy rs hereby furnished EACH NO FEE ADDRESS New Residential Bldgs S Pools S _ S LOCALITY ❑" department copy is flied with the county building inspection 182-rrrily i Ft tlepeftrriertl Mulh-family SQ Ft — ROSS CS CROSS ST Date Applicant Residential Swsmming Poole OWNER OR OERTIFICATE OF EXEMPTION FROM WORKERS MAL FIRM�E Outlets Rep. Light Sw /10 COMPENSATION INSURANCE ADDRESS (This sectnn need not be completed It the work Involved by the �/ First 20 Derrrdt b for one hundred dollen($100)or lam) Total No 44--6 Additnnal CITU Tel No r I certify Hurt in the Performance of the work for which this permit PIAN CHECK is issued! I shall not employ, any person in any manner so as to APPUCAWr became mtb)ect to the Workers C i mpensaton Lewy Lghting Fixtures First 20 ADDRESS Total No Additional Date Applicant CITU Tel No NOTICE TO APPLICANT If after making this Gertifcate d Fixed Applances Not Over 1 HP PERMIT Exemption you should became subject to the Workers C impermaton Range— Heater— DW APPUC`M prowsons of the labor Code you must forthwith comply with such Oven _ Dryer— W M — ADDRESS ProvBnonM or this permit shall be deemed revoked Top — FAU _ WH _ LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other— I Tel No _ I hereby eNirm that I em 70GO)d under pr3 of to of in ass d Disp — Roam Aar Cord LICENSE B C� (commierharg Wndn$erClion 7000)d Drveion 3 of the Business and REO nIMBER Prdesaiaro Code and my license m in full force and effectDtSrRICr NO D By Power Apparatus 8 Largo APPliancas Q Size& Type HP KW KVA or KVAR Lucerx9e fkrnber Lo Class Up to 1 Incl FINAL Over 1 to 10 Ind DATE 2' VALIDATION 0:Coritracacr Date O Over 10 to 50 Intl FINAL r El I am exempt under Sec Over 50 to 100 Inc By 0W B&PC for this reason Over 100 a Services Swbd MCC& Pa boar ► Z Date 0-200 Amp Under 800 V Signature 201 - 1000 Amp Under 800 V ❑ Exemphon for Reg Maim Elect Over 1000 Amp or Wer 800 V SINGLE FAMILY Temp Power Pole& Appurtenances HOME OWNER-BUILDER DECLARATIONALT•* 1 hereby affirm that I am exempt from the Contractors License Law Sign with One Branch Grouit fo the following reason(Section 7031 5 Businese and Prdessons Additional Sign Branch Circuits wL17 IL�I.�1 Code) 1 ITEM py 'C I,as tuner d the prop" will tlo the work and Me structure Mtsc Conduits &Conductorsis not intended rtended offered for sale (Section 7044 Business Other(See Complete Fee Schedule) TOTAL 100 - 51 and Professions Code) t HEL Y. 1'J0,`1 CONSTRUCTION LENDING AGENCY CHANGE ,0; I hereby affirm that there is a construction herd ng agency for this perfomance of the work for which this permit is issued(Sec 3087 PERMIT FEE (Sub-Total) Cry C) _ PLAN CHECKING FEE IJu–I�IJ�1 1Lr..�IY1 Lendara Name PERMIT ISSUING FEEo fid! 0-4° 1 AM 10,' Larders Address I certify that I have read this application and state that the above TOTAL FEE D reformation Is correct I agree to comply with all County ordinances and State laws regulating Electrral wiring, and hereby adhmze representatives of this Ccunty, to enter upon the above-mentioned grope fa nape n purposes , n SEE REVERSE FOR EXPLANATORY LANGUAGE signa ✓T lure Permittee Date o ►t WORKERS COMPENSATION DECLARATION 863 ID,BI APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have o certificate cote of consent to self CE 8066 insure or a certificate of Workers Compensation Insurance COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec 3800 Lab C ) Pat icy No Company FOR APPLICANT TO RLL IN A�RESS Certified copy is hereby furnished New Residential Bldgs 8 Pools EACH NO FEE a.44 L41 ❑ 1 8 2-Femil Ft $ — f LOCALITY } Certified copy a filed with the county building impec- Y Sq tion deportment Multi-family Sq Ft — NEAREST s Residential Swimming Pools OWNER OR ST Date Appbcant FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec_Light_Sw_ MAIL COMPENSATION INSURANCE ADDRESS H (This section nod trot be completed the work Irwohed P by , Fiat 2(1 20 ^ C Tal No the permit Is for one hundred dollars($100)or loTotal No nal CITU s) I certify that in the performance of the work far which this APPLICANTT permit is Issued 1 shall not employ any person in any manner so as to become subject to the Workers Compensation Laws Lighting Fixtures First 20 ADDRESS n Total No Additional Dote /`�Z� Apphcanl Fixed Appliances Not Over I HP pB1RryN1T Tel No NOTICE TO APPLICANT If after ma g this Certificate of Exemption you should become subject to the Workers Range_ Heater_D W _ A� ANT Compensation provisions of the Labor Code you must forth- Oven _ Dryer )L— W M _ ADDRESS with comply with such provisions or this permit shall be Top _ FAU _WH _ , ideemed revokedCITY el No 2 LICENSED CONTRACTORS DECLARATION Hood _ Fan _Orhn— I hereby affirm that I am licensed under provisions of Chapter 9 Disp _ Room Air Cord LICENSE REG NU,RR 0 Chea C, } (commencing with Section 7000) of Division 3 of the Business Power Apparatus d Large Appliances DISTRICT NO BY d and Professions Code and my license is in full force and effect ^ D� U a Size 8 Type HP KW KVA or KVAR V/ License Number go09�' 2. Lic Class 1— 16FINAL Up to I Incl _� 0 /7 ��1 Over I to IO Incl DATE �� Contractor 9r(L =k � el Date L 2-72:ia V ATION ❑ Over 10 to 50 Incl FINA / d 1 am exempt under Sec Over 50 to 100 Im BV N B 8P C for this reason Over 100 Z ate Services, Swbd , MCC 8 Ponelboords 6 14.6 Signolure �,4C6_ - mp n er 600 V # e e e e s ❑ Over 1000 Amp or Over,60D V aint Elect ( e e 2 9.0 Exemption for Reg • • • 2 9,0 0 e SINGLE FAMILY Temp Power Pole 8 Appurtenances ) 2. 1 9-86 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 Law for the following reason (Section 7031 5 Business and Professions Code) ❑ 1, as owner of the property will do the work and the Mix Conduits 8 Conductors structure is not intended or offered for sale (Section 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 ) PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender s Address DD I certify that 1 have read this application and state that the TOTAL FEE above information is correct I agree to comply with all County ordinances and State jaws 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 ign j2� 3 ;f4 rA ermittee Dat��