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Home My Public Portal About9537 WEDGEWOOD ST_Electrical__ 76A663A-_ 16A 4/72 APPLICATIO FOR ELECTRICAL PERMIT �`• COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS 00 LOCALITY a ylk V) 110 C, FOR APPLICANT TO FILL IN NEAREST 7TOTAL CROSS ST.TS NO. EACH FEE$ $ OWNER MAIL L LlFIRST 20 ADDRESS CL cc T L OVER 20 SCITY TEL. NO. PLAN CHECK FIRST 20 APPLICANT) FIXTURES OVER 20 ADDRESS RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT RANGE DRYER_WTR. HTR. APPLICANT STA. COOK DISP. F.A.U. ADDRESS SPACE HTR. AIR COND. CITY TEL. NO. CLOTHES WASH. " DISHWASH.-L— LICENSE NO. CLASS. FAN OTHER I`HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING V IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. I= SIZE & TYPE OVER TO /� 1 HEREBY CERTIFY THA 1 AM PROPERLY REGISTERED AND/Op 0 - 1 LICENSED AS REQUIRED B IDS ANGELES COUNTY AND STATE OF C.2 I CALIFORNA OR THAT I A T LEGAL OWNER OF, AND INTEND TO LLA 1 - IO RESIDE N, THE ABOV ES RIBED RESIDENTIAL PROPERTY. h �. SIGNATURE 10 - 50 OF PERMITTE 50 - 100 DISTRICTNO. CLASS ZONE ROCESS BY 100 — SOD '5-0O. /)-- SIGN, SIGN, GASSIGN AND ONE CIRCUIT NOTES: V �IR�� "J TUBE, OR r MARQUEE ADDITIONAL CIRCUITS SERVI CENOTOVER 600 VOLTS OR 200 AMP SERVICEOVER 600 VOLTS OR 200AMP � APPROVALS DATE INSPECTOR'S SIGNATURE ��I///��_ D TEMP.POWER POLE TEMP SERVICE,POLE,&APPURTENANCES UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM ROUGH CONDIUT WIRING FIXTURES POWER AUTHORIZED PERMIT FEE (SUB TOTAL) UTILITY CO. NOTIFIED PLAN CHECK FEE FINAL PERMIT ISSUING FEE 00 TOTAL FEE U PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION OCKM.O. CASH 2 9 1 t-WR 22 . _ 20.6 () I0 • A WORKERS'COMPENSATION DECLARATION 10/81 APFUCATION FOR ELECTRICALPERMIT I 'hereby affirm that I have a certificate of consent to self CE-8M CE-BO6G � insure;.ord certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof(Sec. 3800, Lab. C.) Policy No. � Company FOR APPLICANT TO FILL IN JOB �- 7 ` Certified co is hereby furnished. EACH NO. FEE ADDRESS f c� &J-d ell-Lod PY Y New Residential Bldgs. &Pools _ $ LOCALITY 749 Certified copy is filed with the county building inspec- 1 $2-Family, Sq. Ft. $ _ tion department. Multi-family Sq. Ft. NEAREST CROSS ST. d,kewe/�� Residential Swimming Pools Date Applicant OWNER OR FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' /'J °� JAAIL COMPENSATION INSURANCE Outlets: Rec-�F-Light Sw.-g= ADDRESS 5 s section neenote completed if the work Involved b C First 20 (Thitineed b p y Total No. !_� Additional CITY � ��• Tel. the permit is For one hundred dollars($100)or less.) I certify that in the performance of the work for which this APPLICANTK permit is issued,I shall not employ a person in any manner so as to become subject to the Work Compensation Laws. Lighting Fixtures First 20 ADDRESS '�-� Z11 Total No.. Additional CITY Tel. No. Date Z- t Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after aking this Certificate of APPLICANT Exemption, you should become subject to the Workers' Range_ Heater_D.W. — Compensation provisions of the Labor Code, you must forth- Oven —Dryer —W.M.— ADDRESS SdCI�A �$ 61,la01--c- with comply with such provisions or this permit shall be Top _ FAU —W.H. — CITY Tel. IVo. deemed revoked. Hood _ Fan _Other_ LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. _ Room Air Cond. REG. NUMBER Class. (commencing with Section 7000) of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NO. (, PR ES BY _. and Professions Code,and.my license is in full force and effect. �r 0. Size 8 Type HP, KW, KVA, or KVAR r 0 License Number Lic. Class09 Up to 1 Incl. FINAL Over 1 to 10 Incl. DATE VALIDATION Contractor , Date � 09❑ Over 10 to 50 Incl. FINA I am.exempt under Sec. Over 50 to 100 Inc. BY U8 Over 100 B.&P.C, for this reason aA Services, Swbd., MCC&Panelboards Date: 0 -200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V ;2 7 5 1,Q A ❑ Over 1000 Amp. or Over 600 V Exemption for Reg. Maint. Elect. # 0'0 0 0 0 2 SINGLE FAMILY Temp. Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION ° ° 2&25 Sign with One Branch Circuit Vhereb firmthat I am exempt from the Contractor's License Additional Sign Branch Circuits o•0 0 2 a,2 5e following reason (Section 7031.5, Business and Code): 0 72 2 8 7 owner of the property, will do the work and the Misc. Conduits&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 AQ Lender's Address I certify that I have read this application and state that the TOTAL FEE above information is correct. I agree to comply with all County ordinan s and State laws regulating Electrical wiring, and hereb uthorize rep entatives of this County to enter upon the v enfion property for inspection purposes. nneet� p SEE REVERSE FOR EXPLANATORY LANGUAGE , � o�d—0 • S 'nature of Permittee Date