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Home My Public Portal About9256 WEDGEWOOD ST_Electrical__ 76ASB8 DOS-.9A 9.59 APPLICATION FOR ELECTRIC PERMIT 1 DIVISION OF BUILDING AND SAFETY Department of County EngineerBUI County Of LOS Angeles ADDRESS ,G/�✓.� �� WM.J. FOX.COUNTY ENGINEER BU CASSATT D.GRIFFIN.SUPT OF BUILDING ' LOCALITY FOR APPLICANT TO FILL IN NEAREST PERMIT FEES CROSS ST. NUMBER EACH FEE . 7— OWNER ' LIGHT OUTLETS or RECEPTACLES MAIL ADDRESS WALL SWITCHES TOTAL OUTLETS g¢ $ CITY TEL.NO. ELEC.RANGES 25 ELECTRICIAN _ELEC.HEATERS 25 ADDRESS c �- C- Fir✓ KW EA CITY S. :S- r- TEL.NO FIXTURES 5 LICENSE NO. 2— NUMBER OF LIGHT CIRCUITS - DISTRICT NO. 1GROUP1 ZONE I READY FOR INSPECTION NUMBER OF RECEPTACLE CIRCUITS MOTORS NUMBER HORSEPOWER FEE INSPECTION RECORD NEW I MVD. HP OVER INC. EACH '%@ LESS $ .25 1h 2 .50 2 5 1.00 �• 5 15 1.50 15 50 2.50 50 200 5.00 M ISC. NO.SIGNS NO.TRANS. R NO.SIGNS NO.LAMPS FOR EACH PERMIT: WIRING 51.00 FIXTURES $1.00 SUPPLEMENTARY .50ks- APPROVALS y TOTAL FEE g DATE INSPECTOR'S SIGNATURE 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPL CATION CONDUIT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING •- ELECTRICAL WIRING. I HEREBY CERTIFY THA FHE PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED LNGELES COUNTY AND STATE OF . CALIFORNIA OR THA I A LEGAL OWNE F THE ABOVE POWER DESCRIBED III L P ERTY. I UTILITY CO.NOTIFIED SIGNATURE OF PERM IT FINAL ti WILLIAM J.F .COUNTY ENGINEER VALIDATION A.C.VEIT.CHIEF ELECT.INSPECTOR .009 5 .CCT r Al o I/V) • 20-0019 DPW 9/89 WORKER'S COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self insure, 7OM63 APPLICATION FOR ELECTRICAL PERMT or a certificate of Worker's Compensation Insurance,or a certified I COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec.3800 Lab.C.) Policy No. Company FOR APPLICANT TO FILL IN JOB C ❑ Certified copy is hereby furnished. EACH NO. FEE ADDRESS J (� New Residential Bldgs.&Pools LOCALITY – �� d"" j 1&2-Family,Sq.Ft. $ — $ ❑ Certified copy is filed with the county building inspection NEAREST department. Multi-family Sq.Ft. — CRosS 81. Date Applicant Residential Swimming Pools ASSESSOR MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec.*Light__LSw. OWNER ME L COMPENSATION INSURANCE First 20 D FIRM NAME \ FAV• C (This section need not be completed if the work Involved by the / MAIL __--pp permit is for one hundred dollars($100)or less.) Total No.�@ Additional ADDRESS -PGl I certify that in the performance of the work for which this permit CITY K is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. I Lighting Fixtures First 20 IAPP�ICHECK U CANT Total No. Additional ADDRESS Date Applicant 15 OR 20A,120V BRANCH CIRCUITS NOTICE TO APPLICANT: If, after making this Certificate of CITY Tel.No. Exemption,you should become subject to the Workers'Compensation j 1 TO 10 INCLUSIVE EACH PERMIT provisions of the Labor Code,you must forthwith comply with such 11 TO 40 INCLUSIVE EACH ?APPLICANT provisions or this permit shall be deemed revoked. 41 OR MORE BRANCH CIRCUITS EACH } LICENSED CONTRACTORS DECLARATION ADDRESS Q I hereby affirm that I am licensed under provisions of Chapter 9 16 OR 20A,208V TO 277V LIGHTING EACH 0 (commencing with Section 7000)of Division 3 of the Business and I CITY Tel.No. V Professions Code,and my license is in full force and effect. RESIDENTIAL APPLIANCES UP TO 3HP LICENSE OR Power Apparatus&Large Appliances REG.NUMBER Class. O License Number L•ic.Class Size&Type HP,KW,KVA,or KVAR DISTRICT NO. ,Q PM D BY V Up to 3 Incl. ,v (! L Over 3 to 10 Incl. FINAL d Contractor Date DATE 05 ❑ Over 10 to 50 Incl. Z Z I am exempt under Sec. J VALIDATION Over 50 to 100 Incl. B.&P.C.for this reason FINAL / Over 100 BY Services,Swbd.,MCC&Panelboards Date: i 0-200 Amp.Under 6.00 V Signature 201-1000 Amp.Under 600 V ❑ Over 1000 Amp.or Over 600 V Exemption for Reg.Maint.Elect. SINGLE FAMILY Temp.Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law' for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits Code): I,as owner of the property,will do the work and the structure 1 Misc.Conduits&Conductors Is not intended or offered for sale(Section 7044, Business' Other(See Complete Fee Schedule) --:5. _ s_ and Professions Code). ......... r s}r CONSTRUCTION LENDING AGENCY _ I hereby affirm that there is a construction lending agency for the ��•' '�=performance of of the work for which this permit is.Issued(Sec.3097,, PERMIT FEE (Sub-Total) Civ.C.) PLAN CHECKING FEE 3 (i Lender's Name � • PERMIT ISSUING FEE hi. Lender's Address I TOTAL FEE I certify that I have read this application and state that the above qA information is correct. I agree to comply with all County ordinances: and State laws regulating Electrical wiring, and hereby authorizef representatives of this County to enter upon the above-mentioned pr p ty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE 4 _3_ Q I lAt(/)_'ice• �Y I , SIO ATURE OF PLICANT OR AGENT DATE , r• ORKEAS'COMPENSATION DECLARATION 76A663 10/81 APPLICATION FOR ELECTRICAL PERMIT p --I ggrgby &Ili"that I have a certificate of consent to self insure, CE-806G or a certificate,of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY dW'thereof. (Sec:3800,Lab.C.) �/ 1 ,i.. Policy No: Company FOR APPLICANT TO FILL IN JOB ADDRESS .3 ,�QG� a '6 C Vl S V ❑ Certified copy is hereby furnished. New Residential Bldgs.&Pools EACH NO. FEE ❑ 1 &2-Family,S Ft. $ — $ LOCALITY JC— Certified copy is filed with the county building inspection y� q• department. Multi-family Sq.Ft. — NEAREST ro Residential Swimming Pools CROSS ST. Hd RM CN��A, LAGDate Applicant FIINAM LEC CERTIFICATE OF EXEMPTION FROM WORKERS' p2 �Sw. MAIL �� r Outlets:Rec—Light COMPENSATION INSURANCE f, OZ ADDRESS � (This section need not be completed If the work Involved by the First 20 CITY'7' r�� Tel. 1 certify that in the performance of the work for which this permit APPLICANT 14 , is issued, I shall not employ any'person I any manner so as to become subject to the Workers'Compan 'on Laws. Lighting Fixtures First 20 t ADDRESS Total No. Additional CITY Date_111K&K Applic 1� NOTICE TO APPLICANT: if, after .m g this Certificate of Fixed Appliances Not Over 1 HP' PERMIT Exemption,you should become subject tote Workers'Compensation Range_ Heater_- D.W. _ APPLICANT provisions of the Labor Code,you must forthwith comply with such Oven _ Dryer_ W.M._ ADDRESS provisions or this permit shall be deemed revoked. Top _ FAU W.H. _ LICENSED CONTRACTORS DECLARATION Hood— Fan Other_ CITY -Tel.No. I hereby affirm that I am licensed under provisions of Chapter 9 LICENSE OR Disp.. - Room Air Cond. REG..NUMBER Class. '(commencing with Section 7000)of Division 3 of the.Business and Professions Code,and my license is in full force and effect. DISTRICT NO. / PROCESS BY Power•Apparatus&Large Appliances Size&Type HP,KW,KVA,or KVAR License Number Lic..Clas's Up.to 1 Incl. FINAL Q Over 1 to 10 Incl. , DATE '� U{D{DATIONO n' Contractor Date Over 10 to 50 Incl. FINAL ❑ I am exempt under Sec. Over 50 to 100 Inc. BY W d- B.&P.C..for this reason Over 100 N Services,Swbd.,MCC&Panelboards Z Date: 0-200 Amp.Under 600 V S�1 c' Signature 201 - 1000 Amp.Under 600 V ❑ Exemption for Reg:Maint.Elect.. Over 1000 Amp.or Over 600 V SINGLE-FAMILY Temp.Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION, Sign with One Branch Circuit c 1 1 L),6 A' I hereby affirm that I am exempt from the Contractor's License Law for the following rdason(Section 7031.5,Business and Professions Additional Sign Branch Circuits # o. 0 0 0 0.2 Code): Misc.Conduits'&Conductors l o o 41.75 I,as owner of the property;will do the work and the structure Other(See Complete Fee Schedule) _ x is not intended or offered for sale (Section 7044, Business o 0 o 4 1.7 5 5 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(Sec.3097, PERMIT FEE (Sub Total) 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 above TOTAL FEE information is correct.I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize represents lyes of this County to enter upon the above-mentioned propert inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE ( Signaturermittee Date •a *Xm that I 'COMPENSATION DECLARATION 76A663CE-806 10/81 APPLICATION FOR ELECTRICAL PERMIT CE-806G�I hereby affirm that I have a certificate of consent to self insure, or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec.3800,Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB ` �-+ ^-'� Certified copy is hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE ADDRESS J ❑ 1 & 2-Family,Sq.Ft. $ — $ _ LOCALITY Certified copy is filed with the county building inspection NEAREST l department. Multi-family Sq.Ft. CROSS ST Date Applicant Residential Swimming Pools OWNER OR FIRM NAME .j CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec— Light Sw. ADDRESS ` 6 �t' -S/ COMPENSATION INSURANCE This section need not be com First 20 ( pleted if the work involved b Y the Total No. Additional CITY Tel. / _ permit is for one hundred dollars ($100)or less.) PLAN CHECK I certify that in the performance of the work for which this permit APPLICANT is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensatio L" s. Lighting Fixtures First 20 ADDRESS ? , C Additional or 11 Total No. CITY Tel.No. Date �" Applicant / � Fixed Appliances Not Over 1 HP MIT NOTICE TO AP. ICANT: If, after makin this Certificate of Exemption,you should become subject to th Workers'Compensation Range_ Heater_ D.W. APPLICANT provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer _ W.M._ ADDRESS provisions or this permit shall be deemed revoked. Top — FAU _ W.H. _ CITY Tel.No. LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other- 1 hereby affirm that I am licensed under provisions of Chapter 9Disp. — Room Air Cond. REG.NUMBER Class OR (commencing with Section 7000) of Division 3 of the Business and Professions Code,and my license is in full force and effect. Power Apparatus& Large Appliances DISTRICT NOS. J P O ES D e ``+.. LL Size& Type HP, KW,KVA,or KVAR Q License Number Lic.Class Up to 1 Incl. FINAL U Over 1 to 10 Incl. DATE /,,� Z, ` VALIDATION 0 Contractor Date Over 10 to 50 Incl. ❑ FINAL I am exempt under Sec. Over 50 to 100 Inc. B.&P.C. for this reason Over 100 / N Services,Swbd.,MCC& Panelboards / Z Date: 0- 200 Amp.Under 600 V Signature 201 - 1000 Amp. Under 600 V ❑ Exemption for Reg.Maint.Elect. Over 1000 Amp.or Over 600 V SINGLE FAMILY Temp.Power Pole & Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law for the following reason(Section 7031.5,Business and Professions Additional Sign Branch Circuits Code): Misc.Conduits & Conductors I,as owner of the property,will do the work and the structure is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) 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(Sec.3097, PERMIT FEE (Sub-Total) Civ.C.). PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE O Lender's Address I certify that I have read this application 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 of this County to enter upon the above-mentioned property r pection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature o ermittee Date