HomeMy Public PortalAbout9819 WENDON ST_Electrical__ 78A883-CE808 8=89 �� //�. /�;
APPLICATION FOR EL TRICAL PERM
COU14TY OF'LOS ANGELES
OEPARTMENT�OF COUNTY ENGINEER �
BUILDING AND SAFETY DIVISION ADD ESSf/G/�olJ.00 U e-
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST /7
CROSS ST.
NO. EACH FEE
$ $ OWNER JeO AjArk=jL �J
RECEIPT.11 MAIL f/���
LIGHT� TOTAL FIRST 20 .20 ✓ d ADDRESSQ AJ &4f
SWITCH1 ]$ OVER 20 _ f1 70 CITY "' TEL.NO. 8 1}�
PLAN CHECK
LIGHTING TOTAL FIRST 20 ,20 / (, APPLICANT.
FIXTURES !,L- OVER 20 ,10 ADDRESS
RANGE_DRYER_WTR. FNf1.±� CITY TEL.NO.
STA. COOK_DISP._F.A.U.I� CONTRACTOR-
SPACE HTR.-j—AIR COND. wG. ADDRESS
CLOTHES W}SR-=L- ISHWASH.� n, y CITY TEL.NO.
FAN_OTHER // 1.00 �L 66 LICENSE NO. CLASS.
MOTORS,TRANSFORMERS RATING `T" 7 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
IND. HEATERS, ETC. HP. KW. KVA. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
SIZE B TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING.
0 - 1 1.00 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
1 - 10 3.00 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. \`
10 - 50 5.00
SIGNATURE
50 - 100 10A0 OF PERMITTEE
100 - 500 15.00 DIST I T NO. GROUP 7p. P SSED BYSIGN GAS SIGN AND ONE CIRCUIT 3.00 � � -
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS Lkoo NOTES:
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 INSPECTORS SIGNATURE
TEMP. POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
WIRING
PERMIT FEE (SUB TOTAL) FIXTURES
PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED 1J (>
PERMIT ISSUING FEE 2.00 -2 v0 UTILITY CO.NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL
TOTAL FEEJOSEPH C. ROOHAN
S SUPERVISING ELEzn
ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIONM.D. CASH
{ Ar�5 9 7 32 A-2.1 2 0 15.4 0" oql
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE /) J�
WORKER$'COMPEN$ATIONDECLARATION
CE-806G (2.80) APPLICATION FOR ELECTRICAL PERMIT
•. CE-806
I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELESG' BUILDING AND SAFETY
insdre,or a certificate of Workers'Compensation Insurance,or / /
�a certified copy thereof(Sec.3800,Lab-C.)
`Pdlicyt ���• sCom any FOR APPLICANT TO FILL IN JOB �4 �-
40/01 1600/t/
�a��, EACH NO. FEE ADDRESS �f
New Residential Bldgs.&Pools - /
Certifie copy is hereby furnished. 1 &2-Family,Sq. Ft. $ — $ LOCAL'ITY
Multi-family Sq. Ft. NEAREST �r
Certified copy is filed with the county building inspection CROSS ST ,/V
de a m t, /• Residential Swimming Pools OWNER OR
Dat opil-Applican Z ✓ FIRM NAME
Outlets: Rec...._Light Sw. MAIL
First 20 ADDRESS
`CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY Tel Nom
COMPENSATION INSURANCE PLAN CHECK n,
(This section need not be completed if the work involved APPLICANT V
by the permit is for one hundred dollars ($100) or less.) Lighting Fixtures First 20 ADDRESS
Total No. Additional
I certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No. 0
permit is issued, I shall not employ any person in any manner PERMIT• W
so'as to be om subject to th. Workers'Comp tion Laws. Range_Heater D.W._ APPLICANT l a
Oven _ Dryer_W.M._ ADDRESS Z
Da Applicant Top _ FAU _W.H.
Hood _ Fan _Other_ CITY Tel No
NOTICE TO APPLICANT: If, after making this Certificate of Disp. —Room Air Condom LICENSE OR �r
Exemption, you should become subject to the Workers' REG.NUMBER Class V
Compensation provisions of the Labor Code, you must forth- power Apparatus&Large Appliances DISTRICT NO. PROCE SED BY•
with comply with such provisions or this permit shall be
deemed revoked. Size&Type HP,KW,KVA,or KVAR
O
Up to 1 Incl. "
FINAL
Over 1 to 10 Incl. DATE VALIDATION
LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl. °
I hereby affirm that I am licensed under provisions of Chapter. Over 50 to 100 Inc. FINAL
9 (commencing with Section 7000)of Division 3 of the Busi-' Over 100 BY r �
ness and Professions Code,and my license is in full force and
effect. Services
License NtimberLic.Class � ✓ 0-200 Amp.Under 600 V � A'
201-1000 Amp.Under 600 V
Contra Date Over 1000 Amp.or Over 600 V ig
HOME OWNER-BUILDER DECL RATION Temp.Power Pole&Appurtenances
I hereby affirm that I am exempt from the Contractor's Sign with One branch Circuit - r
License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits z 3 3 1„3'A
ness and Professions Code): - a�0 0 0 0 2
Misc.Conduits&Conductors,
1, as owner of the property, will do the work and the Other(See Complete Fee Schedule)— 2 3 El 5 0
structure is not intended or offered for sale (Section
7044,Business and Professions Code). o'o y° 3 8.Jr Q
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency a 3 8-82
for the performance of the work for which this permit is PERMIT FEE'
(Sub-Total) 6
issued(Sec.3097,Civ.C.).
Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee)
Lender's Address PERMIT ISSUING FEE
I certify that I have read this application and state that the TOTAL FEE �0&
above.informson correct.I agree to comply with all County
*.boe
-laws regulating Electrical wiring, and
esentatives of this County to enter port
roperty for inspection purp es. SEE'REVERSE FO.R EXPLANATORY LANGUAGE
_ _7DatA
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