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Home My Public Portal About5446 WELLAND AVE_Electrical__ 76A663-CE808 9-64 APPLICATION FOR ELECTRIC L PE MIT COUNTY OF LOS ANGELES IL DEPARTMENT OF COUNTY ENGINEER BUILDING L BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER !f COLEMAN W. JENKINS, SUPT. OF BUILDING LOCALITY -NEAREST' FOR APPLICANT TO FILL IN CROSS ST. T RECEPT. OTAL - NO. EACH FEE LIGHT OUTLETS FIRST 20 $20 $ OWNER MAIL '- ADD'L .10 ADDRESS 7 (p SWITCH. OVER 20 TOTAL CITY TEL.NO. LIGHTING 1 t Flpsr 20 .20 FIXTURES 1 _ AOD'L1O ELECTRICIAN. Ov R 20 RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS; GARB.13I8P. STA.COOK CITY TEL.NO. DISHWASH. AUTO.-WASH. STATE SPACE HTRS. BTA.APP.(ys H.P.MAX.) .50 LICENSE NO. MOTORSI OVER NOT OVER H.P. DISTRICT O. G P O O 1 1.00AFf 1 3 1.50 INSPECTION RECORD 3 s 2.00 B is 2.50 v 1s so 3.00 O0 O f- so 100 5.00 V W SIGNSI NO.TRANS. O. to NO.LAMPS .Z SERVICE 0-SOOV-NDT OVER 200A 1.00 SERVICE 0.800V-OVER 200 A. 2.00 SERVICE OVER SOOV 5.00 MISC. PERMIT ISSUING FEE 2.00 (� SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE i 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY WITH ALL-COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT ELECTRICAL WIRING. WIRING 1 HEREBY.CERTI FY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUITHApED BY LOS ANGELES COUNTY AND STATE OF BE IDE AL FORM THE RABOVE I AM THE LEGAL OWNER ESCRIBED RESIDENTIAL PROPER ERTAND INTEND TO POWER SIGNATURE UTILITY CO.NOTIFIED I�!_.V !° OF PERMITTE ��/burr FINAL VA' ATION JOSEPH C. ROOHAN C_- MO CASH SUPERVISINd ELECTRICAL ENGINEER J60 4 6 4 7 gut 16 2 D 4.00- 76A68CE-80616/76) APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN JOB ADDRESS New Residential Bldgs.&Pools EACH NO. FEE A- 1.&2-Family,Sq.Ft. $ :025 — $ LOCALITY Multi-family Sq.Ft. .02 — NEAREST CROSS ST. Residential Swimming Pools 25.00 OWNER OR FIRM NAME Outlets:Rec_LLight Sw. 50 ADDRESS / First 20 Total No. Additional .30 CITY Tel.No. )c-feu, DA-'" -*�.,.� PLAN CHECK APPLICANT Lighting Fixtures First 20 •50 ADDRESS Additional .30 Total No.�_ CITY Tel No. Fixed Appliances Not Over 1 HP PERMIT Range—Heater—D. APPLICANT W._ ADDRESS • Oven—Dryer_W.M.— Top_ _FAU —W.H._ CITYTel.No. Hood_Fan —Other y �C 9a 2.50. LICENS EOR / Class. Disp.—Room Air Cond. REG.NUMBE ��Z J �� I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP LICA- Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO Size&T COMPLY•WITH ALL COUNTY ORDINANCES AND STATE LAWS Type HP,KW,KVA,or KVAR REGULATING ELECTRICAL WIRING. 6 Up 2,.50 U to 1 Incl. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR Over 1 to 10 Incl. 5.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTYAND STATE CIE Over 10 to 50 Incl. 12.50 CALIFORNIA OR THAT I.AM THE LEGAL OWNER OF THE ABOVE Over 50 to 100 Inc. 25.00 DESCRIBED RESIDENTIAL PROPERTY.. Over 100 40.00 PERMITEE SIGNATURE Services DISTRICT P BY g 0-200 Amp.Under 600 V 12.50 201.1000 Amp. Under 600 V 25.00 - A Over 1000 Amp.or Over 600 V 50.00 Z O Temp.Power Pole&Appurtenances 10.00 Sign with One Branch Circuit 10.00 G Additional Sign Branch Circuits 2.00 41 41 10,0o INFORMATION W 0 0 0 2 Misc..Conduits&Conductors ON REVERSE s Other)See Complete Fee Schedule) SIDE Z 1 01 0 0 0 0 0 2 PERMIT FEE (Sub-Total) 2 ° ° 1250 PLAN CHECKING FEE (One-Fourth Permit Fee) p° 00012505 PERMIT ISSUING FEE $7.00 0 1228-78 TOTAL FEE j > INSPECTION INALED �� W 'date: 11617B( ses WORKERS'COMPENSATION cerci DECLARATION CE-806 1081 APPLICATION FOR ELECTRICAL PERMIT I,hereby affirm that I have a certificate of consent to self CE-806G insure, ora certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND,SAFETY or a certified copy thereof(Sec. 3800, Lab. C'.) If Policy No. Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE ADDRESSJ7 ❑ 1 &2-Family, S Ft. $ _ $ LOCAUTY0�,/� G�� Certified copy is filed with the county building inspec- Y. q• tion department. Multi-family Sq. Ft. _ EAREST %��S ROSS ST. Residential Swimming Pools OWNER:OR,�7S}�N�,(� yti/o.gy- 'J t! Date Applicant FIRM!NAM� �a.V S ' CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw.J_ r— COMPENSATION INSURANCE First 20 ADDRES$> y 6 !J� /}(� (This section need not be completed if the work involved by Total.No. Additional CITY � C e ~�" Tel. No. ' !S` the permit is for one hundred dollars($100)or less.) I certify that in the performance of the work for which this A PLICANTK 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 \f Date-7--7� p 3 Applicant Total No._, Additional CITY Tel. No. ` ��' 0 9�C!/l'" �' � NOTICE TO APPLICANT, If, after making this Certificate of Fixed Appliances Not Over 1 WP' PERMIT Exemption, you should become subject to the Workers' Range_ Heater_D.W. _ APPLICANT / �E/Y � Compensation provisions of the Labor Code, you must forth- Oven _Dryer —W.M. ADDRESS,4V5/�, y a/d��Nb �U with comply with such -provisions or this permit shall be Top _ FAU —W.H. — deemed revoked. Hood _ Fan _Other_ CITYT ��' Tel. No. LICENSED CONTRACTORS DECLARATIONLICENSE 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 DISTRICT IVO. PROCE BY and Professions Code,and my license is in full force and effect. Power Apparatus&Large Appliances Size&Type HP, KW, KVA, or KVAR- License Number Lic. Class Up.to 1 Incl. FINAL 29 Over 1 to 10 Incl. DATE VALIDATION Contractor Date Over 10 to 50 Incl. FINAL U " ❑ I am exempt under Sec. Over 50 to 100 Inc. BY Lu Over 100 B.&P.C. for this reason Date: Services, Swbd.,MCC&Panelboards , 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 63 '7 A SINGLE FAMILY Temp. Power.Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 0 0 0 0 0 I hereby affirm that Additional Si I am exempt from the Contractor's License Additin Branch Circuits n Law for the following reason (Section 7031.5, Business and g i ° 0 C Prof Bions Code): I, as owner of the property, will do the work and the Misc. Conduits&Conductors o = I structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)_ , a 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 .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 r ordinances and State laws regulating Electrical wiring, and hereby authorize representatives of this County to enter upon the above-mentioned pro rty for in pection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE dJ j�f-z5: , `�/K Signature of Permit ee Date