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Home My Public Portal About9703 WEDGEWOOD ST_Electrical__ 'Y-11.3 Fa I6AGBS.CEBOG.6.57 APPLICATION FOR ELECTRIC PE.RMI7 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENG1NIZER BUILDING�>J��' ��. BUILDING AND SAFETY DIVISION ADDRESS f JOHN A.LAMBIE,COUNTY ENGINEER CASSATT D.GRIFFIN,SUPT of BUILDING LOCALITY pp�� FOR APPLICANT TO FILL IN cRossST.�' G p .v PEBMT FEES Lr OWNER - LIGHTS. a RECEPTACLES SWITCHE NUMBER ITEM EACH FEE MAIL ADDRESS TOTAL OUTLETS $ .10 $ - ELEC. RANGES, WATER HEATERS, CITY TEL.NO. CLOCHES ORYEAS •5O ELECTRICIAN R7,chards0 Mae.00 ELEC. gpeee aC6TFna eTAT'Y. 000E- INT UNITS• RS, D SH DISPOSERS, ADDRESS AUTO WASHERS, DISHWASHER .2s' 91923 F1,71roadway LIGHTING FIXTURES AO I',) CITY T PiTEL.NO. t MOTORS STATE LICENSE NO. HORSEPOWER DISTRICT NOS/ GR� ON READY FOR INSPECTION H.P OVER INC. y5&LESS .25 Ar A 2 .50 INSPECTION RECORD 2' — 5 1.00 s is I.sO IS so 2.50 50 200 5.00 r MISC. SIGNS[ I NO.TRANS NO.LAMPS f SERVICE O-GOOV 1.00. c SERVICE OVER GOOV 5.00 WIRING PERMIT 1.00 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT 50 APPROVALS TOTAL FEE S DATE INSPECTOR'S SIGNATURE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APP [CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING I HEREBY CERTIFY T I AM PRO R RE I ED "D/OR FIXTURES ` JV LICENSED AS REQUIRED Y LOS ANG ES OUN D A E OF CALIFORNIA OR THAT M THE A OW T E BOVE POWER DESCRIBED RES T ROPBRTY. SIGNATURE UTILITY CO.NOTIFIED OF PERMITTE •..: _. -.. [NAL IOHN ALA ATION ARTHUR C.VEIT. .OUNTY�NG MO CASH SUPERVISING ELECTRICAL ENGINEER , LTo 1 0 8 6 IN MAY 21 2 A 1 4.0 5 P c'l l ' ®p SA603-CE806_9.87 APPLICATION FOR ELECTRIC PERMIT IlMIT 1 COUNTY OF LOS ANGELES t• DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS O3 JOHN A.LAMBIE,COUNTY ENGINEER CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY FOR�APPLICANT TO FILL IN CROSS S7 f PERNIIT FEES ITEM NUMBER EACH FEE OWNER OUTLETS: $ $ MAIL ELEC.RANGES 'CLO.DRYERS ELECTRICIAN WATER HEATERS •50 ADDRESS ELEC.SPACE HTRS. DISHWASHERS - L GARBAGE DISPOSERS AUTO.- CITY TEL.NO V WASHERS STA.COOKING UNITS ,25 STATE LICENSE / 3 LICENSE NO. 1L MOTORS: OVER INC. H.P. 0— va .25 DISTRICT NO. I GRQJLP ;QNEJ READY FOR INSPECTION I/s 2 .. .SO INSPECTION RECORD 2 — 5 1.00 5 — 15 1.50 15 — 50 2.50 50— 200 5.00 �v SIGNS: NO.TRANS. I r! _ ��. \ • NO.LAMPS uak SERVICE 0-800V 1.00 I ?'e-5 J, SERVICE OVER 600V 5.00 MISC. WIRING PERMIT 1.00 / 00 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .50• TOTAL FEE $ 7. APPROVALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT 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 AND STATE OF FIXTURES CALIFORNIA OR THAT .1 AM THE LEGAL OWNER OF THE ABOVE POWER DESCRIBED RESIDENTIAL PROPERTY. SIGNATURE UTILITY CO.NOTIFIED OF PERMITTEE FINAL ,W41DAWN AR HUR C.VEIT. CK/l MO CASH S.UPERV181NG ELECTRICAL E NEER .O'3 4 7w APR 29 2"A 2.20 WORKERS'COMPENSATION cerci DECLARATION 76A6163 10/81 EA I'13_?UCAT0®[+,ap FOR ELEC RIC A L PERMIT gel I hereby affirm that I.have a certificate of consent to self CE-ti06G �rYi11.rt'l!� INTI LIQ v� �r/'i insure, or a certificate of Workers'Compensation Insurance, f COUNTY OF LOS ANGELES BUILDING AND SAFETY, or a certifiedJcopy thereof(Sec. 3800`,✓Lab. C. sf� r�/•�/� f f Policy No. 0 Company! rZIO � I FOR APPLICANT TO FILL IN JOB ADDRESS IJ f(/IT�by Certified copy is hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE {� 1 8 2-Family, S Ft. $ _ $ LOCALITY 1101 Certified copy is filed with the county building inspec- Y. q• _ tion department. Multi-family Sq. Ft. NEAREST Date Applican(� Residential Swimming Pools CROSS ST. �gQLJI'�L�'/V f3� �• ? OWNER OR W FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw._ MAIL COMPENSATION INSURANCE ( First 20 ADDRESS (This section need not be completed if the work involved by I Total No. Additional CITY Tel. I certify that in the performance of the work for which this PLAN ICANT 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. Additional CITY Tei. No. Date Applicant Fixed Appliances Not Over 1 HP NOTICE TO APPLICANT: If, after making this Certificate of , PERMIT Exemption, you should become subject to the Workers' Range_ Heater_D.W. — APPLICANT 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 —W.H. — deemed revoked. Hood _ Fan _Other_ CITYHDA)RD 1/),4Tel. N 6 LICENSED CONTRACTORS DECLARATION LICENSE O I hereby affirm that I am licensed under provisions of Chapter 9 i Disp. _ Room Air Cond. REG.NUMBER Q Class.0—► c7 (commencing with Section 7000)of Division 3 of the Business DISTRICT NO: PROCESSED BY and Professions Code,and m license is in full force and effect. Power Apparatus&Large Appliances } y ✓� I Size&Type HP, KW, KVA, or KVAR / f�� License Number •✓ Q0 G •Z Lic,Class Cd Up to 1 Incl. FDATEINAL ad�� /S /• -2 -r� 3 .Over 1 to 10 Incl. • �Z C VALIDATION Contractor .G _ate !O I Over 10 to 50 Incl. FINA ElU I am exempt under Sec. Over 50 to 100 Inc. BY /_!9_13Ul B.&P.C. for this reason ( Over 100 Date: (Services, Swbd., MCC&Panelboards o -200 Amp. Under 600 V ;01 &9 A Signature 201 -1000 Amp. Under 600 V ❑ Over 1000 Amp. or Over 600 V # o o o o o 2 Exemption for Reg. Maint. Elect. •° - 17.50 SINGLE FAMILY Temp. Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit o o 0 1 7.5 0 5 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 0 6 0 8-�-8 7 Professions Code): ❑ I, as 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 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, Cly. C.). PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE log Lender's Address I certify that I have read this application and state that the TOTAL FEE f �D 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 above-mentioneq property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE MAA:�� 6 , ,17 ,r_ Signature of Permittee Date