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Home My Public Portal About8730 WENDON ST_Electrical__ 76AG63-CEBO6 9-1* APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DI&ARTMENT OF COUNTY ENGINEER BUILDING SUILDI G AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDINGLOCALITY NEAREST FOR APPLICANT TO FILL IN JCROSS ST. Avolv NO. EACH FE $ $ OWNER RECEPT._ MAIL LIGHT TOTAL FIRST 20 .20 ADDRESS SWITCH_ OVER 20 .10 CITY TEL. NO. LIGHTING 1TOTAL FIRST 20 .20 CONTRACTOR - lC FIXTURES I OVER 20 10 ADDRESS S RANGE—DRYER—WTR.HTR._ CITY A TEL. NO. STA.COOK—DISP..—F.A.U._ LICENSE NO. Q SPACE HTR. AIR COND. 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CLOTHES WA'SH.-DISHWAS H._ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. FAN-OTHER 1.00 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF MOTORS,TRANSFORMERS RATING CALIFORNIA OR THAT IAM THE LEGAL OWNER OF, AND INTEND TO IND. HEATERS, ETC. HP. KW. KVA. RESIDE IN, THE ASOVE DESCRIBED REIIIDENTIAL PROPERTY. SIZE & TYPE OVER TO SIGNATURE 0 - 1 1.00 OF PERMITTEE 1 — 10 t 3.00 DISTRICT GR Z E P C ED BY V 10 50 5.00 0 50 - 100 10.00 NOTES: ri sw W 100 -. Soo 15.00 / � e �dp" N SIGN,GAS SIGN AND ONE CIRCUIT 3.00 Z TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 SERVICE OVER 600 VOLTS OR 200 AMP 5.00 TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP. POWER POLE UNDERSLAB WORK .ROUGH CONDUIT WIRING ISSUING FEE 2.00 FIXTURES SUPPLEMENTARY ISSUING FEE 1.00 POWER AUTHORIZED PERMIT FEE UTILITYCO.NOTIFIE PLAN CHECK FEE. (50% PERMIT FEE) FINAL TOTAL FEE 17 D® JOSEPH C. ROOHAN SUPERVISING ELECTRICAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIONOCK-, M.O. CASH ,3 4 .5-.3.�. mm 6 2 u .00� g EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE WORKERS'COMPENSATION DECLARATION t16 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self CE-806-BO6G . insure, or a certificate of Workers'Compensation Insurance, �I COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof(Sec. 3800, Lab. C.) r cc Policy No. Company FOR APPLICANT TO FILL IN JOB ADDRESS J Certified copy is hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE ❑ 21 Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. $ — $ LOCALITY1 65L tion department. Multi-family 5q. Ft. — NEAREST V � Residential Swimming Pools CROSS.ST. Date Applicant OWNER OR FIRM NAME / CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw. MAIL _ COMPENSATION INSURANCE ADDRESS This section need not be completed if the work involved b First 20 the permit is for one hundred dollars($.100)or less.) Y Total No. Additional PLAN ��_-�, Tel. No. r�� I certify that in the performance of the work for which this APPLICANT permit 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 _ tl CITY Tel. No. Date pplicant Fixed Appliances Not Over 1 HP PERMIT c NOTICE'TO APPLICANT: If,. after making this Cer ificate of APPLICANT Exemption,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 o&Ag/� d Q with comply with such provisions or this permit shall be Top _ FAU —W.H. — a deemed revoked. Hood _ Fan _Other_ CITY S,,+ B je Tel. LICENSED CONTRACTORS DECLARATION LICENSE OR +�p I hereby affirm that I am licensed under provisions of Chapter 9 Disp. _ Room Air Cond. REG.NUMBER 30 16, Class.' 'v (commencing with Section 7000)of Division 3 of the Business DISTRICT NO. PROCESS BY and Professions Code,and my license is in full.force and effect. Power Apparatus&Large Appliances Size&Type HP, KW, KVA, or KVAR' A. License Number.—!-" /�� Lic. ClassUp to 1 Incl. FINAL %# � Over 1 to 1.0 Incl. DATE ,la r,`!�' VALIDATION Contractor �JUld4 d� Date I Over 10 to.50 Incl. FINAL e V I- ❑ I am exempt under Sec. Over 50 to 100 Inc, BY res B.&P,C. for this reason Over 100 C- "r�l.C, 9L i Services, Swbd.,.MCC&Panelboards Date: la—x4250 -200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V ❑ Exemption for Reg. Mainf. Elect. I Over 1000 Amp. or Over.600 V I , SINGLE FAMILY j Temp. Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 8 1 3 A 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 Additional o 0 0 0 0 2 Professions Code): � , ❑ Misc. Conduits&Conductors ev I, as owner of the property, will do the work and the j o - 2S50 structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)_ 7044, Business and Professions Code). { ® o'o o 2 Q. r; x CONSTRUCTION LENDING AGENCY I hereby affirm that there iso 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 n 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 ordinances and State laws regulating Electrical wiring, and hereby authorize representatives of his County to enter upon t above-m n'oned roperty fo specfion purposes. " SEE REVERSE FOR EXPLANATORY LANGUAGE r Signature of Permittee• Date l I