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Home My Public Portal About10919 WILDFLOWER RD_Electrical__ .BAB 3-CESOS.S_S7 APPLICATION FOR ELECTRIC PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER_ BUILDING BUILDING AND SAFETY DIVISION l� ADDRESS JOHN A.LAMBIE,COUNTY ENGINEER CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY NEAREST FOR APPLICANTPEIS ILL IN CRO ST. OWNER LIGHTS RECEPTACLES� SWITCHES NUMBER ITEM EACH MAIL ADDRESS o TOTAL OUTLETS $ .10 $ ELEC. RANGES, WATER HEATERS, CITY TEL.NO. CLOTHES DRYERS '$0 ELECTRICIAN r ELEC. SPACE HEATERS,STAT'Y. CODE• ING UNITS. GARBAGE DISPOSERS. ADDRESS AUTO WASHERS, DISHWASHER .2& 1 I LIGHTING FIXTURES ,10 CITY Tz.NO v MOTORS STATE LICENSE NO. HORSEPOWER DISTRICT H.Pr OVER INC. NO. GROUP READY FOR INSPECTION V2 B LESS 25 1/2 - 2 Bo INSPECTION RECORD E 5 1.00 5 i8 Lad IV so 2.50 50 200 S.Od MISC. SIGNS I NO.TRANS NO.LAMPS SERVICE O-800V 1.00 SERVICE OVER 600V 5.00 WIRING PERMIT 1.00 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT so APPROVALS TOTAL FEE $ 0 DATE INSPECTOR'S SIGNATURE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP LIC ION ' -AND STATE THAT THE ABOVE IS CORRECT AND AGREE O COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. . WIRING I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES -/) �/ _GIq/L •1r� LICENSED AS REQUIRED BY LOS AN ELES COUNTYD STATE OF CALIFORNIA OR THAT AM THE GAL VNN THE ABOVE POWER DESCRIBED RESIDENT PERTY l SIGNATURE l' UTILITY CO.NOTIFIED ! �� lT1?�t�ig c':;•�!' OF PERMITTE _ ! FINAL aYry"`�� 6wOyt�- [OHN A.LAMBIE, ARTHUR C.VEIT, ''OUNTY ENGINEER VALIDATION SUPERVISING ELECTRICAL ENGINEER CIC NO CASH L,AC0 4 1 066; NOV 7 2 9.9 0 76AG63-CS806 14-68 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING FIL D I N IG BUILDING AND SAFETY DIVISION ADDRESS n w q c It JOHN A. LAMBIE. COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILOING'7 LOCALITY--u I% ift-c NE S_j NEAREST C i OSSSI CL A ,. of FOR APPLICANT TO FILL IN CROSS ST NO. EACH F E OWNER RECEPT.— L.)Arirfw r—O 3111-tJ MAIL LIGHT— TOTAL FIRST 20 .20 ADDRESS I'L4 til SWITCH— OVER 20 .10 CITYc ilk PLAN CH CK r LIGHTING JTOTALI FIRST 20 .20, APPLICANT FIXTURES _ OVER 20 .10 IADDRESS RANGE—DRYER—WTR.HTR.— ICITY TEL. NO. STA.COOK—DISP.—F.A.U.— CONTRACTOR SPACE HTRAIRCOND. ADDRESS CLOTHES WASH.—DISHWASH.— CITY TEL. NO. FAN—OTHER — / 11.00 Z LICENSE NO. CLASS. MOTORS,TRANSFORMERS RATING IND. HEATERS, ETC. HP. KW. KVA. HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE Is CORRECT AND AGREE TO COMPLY SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING 60 ELECTRICAL WIRING. 0 — 1 1.00 1HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR I — 10 3.001 LICENSED AS REQUIRED By LOS ANGELES COUNTY AND STATE or CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO 10 - 50 5.001 RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. > SIGNATURE n. c:) so - 100 10.001 OF PERMITTE'x C.1) 100 - 500 15.001 C= DISTRICT NO-IGRDUP ZONE P OCESSEDBY -ji!t,G 0 SIGN AND ONE CIRCUIT 3.001 6 fir I 'AtS S R Qr MARQUEE ADDITIONAL CIRCUITS 1.001 NO SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 wv SERVICE OVER 600 VOLTS OR 200 AMP 5.00 TEMP SERVICE.POLE. &APPURTENANCES 13.00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP. POWER POLE uNoERSLAB WORK ROUGH CONDUIT WIRING,- PERMIT FEE (SUB TOTAL) W FIXTURES PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED PERMIT ISSUING FEE 2.00 d UTILITY CO.NOTIFIED SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL &ZA&V TOTAL FEE i p C. R0014AN ' S0?f!jgVHlSINf-ELECTRICAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH IA 8 9 3 4ka MAR 2— 2 D 4.00- lql :E BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE ell WORKERS'COMPENSATION DECLARATION 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self CE-806�CE-8066 insure, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES1 BUILDING AND SAFETY or a c!�rtified copy thereof(Sec. 3800, L / PolicyCompany FOR APPLICANT TO FILL IN JOB 1:1 Certified copy is hereby furnished. j New Residential BldDRESS d Certified cgs. &Pools EACH NO. FEE AD — OCUC ® $ $ LOCALITY opy is filed with the county building inspec- � 1 &2-Family, Sq. Ft. —' tion department. Multi-family Sq. Ft. — 'NEAREST L 2..4-T3 p bso, i Residential Swimming Pools CRFIRM OSS ST. A L O /,1 Date 3? Applicant � a S e y� �/ CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: RecLight��Sw.20 F ADDRESS COMPENSATION INSURANCE a�d First 20 (This section need not be completed if the work involved by CITY Tel. No. v the permit is for one hundred dollars($100)or less.) I, Total No. Additional d .� G ( 3 PLAN CHECK I certify that in the performance of the work for which this j APPLICANT A Al O V L permit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. Lighting Fixtures �� First 20 ADDRESS Total No._I Additional q CITY Tel. No. Date Applicant Fixed Appliances Not Over 1 HPPERMIT 5 ?4 NOTICE TO APPLICANT: If, after making this Certificate of PERITAPPLICANT �j'� Exemption, you should become subject to the Workers' Range— Heater—D.W. — Compensation provisions of the Labor Code, you must forth- 4 Oven —Dryer —W.M.— ADDRESS �O ,.. with comply with such provisions or this permit shall be Top — FAU —W.H. — CITY Tel. No. ^fit deemed revoked. Hood — Fan —Other_ 51 LICENSED CONTRACTORS DECLARATION { LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. REG.NUMBER 9 7 1 Class. (commencing with Section 7000)of Division 3 of the Business DISTRICT NO. PROCES BY and Professions Code,and my license is in full force and effect. Power Apparatus 8 Large Appliances Size A Type HP, KW, KVA, or KVAR' Q ILO License Number , Lic.Class_ I FINAL Up to 1 Incl. J/'FQ/_G S �6$a Ca J(^4 ^Sl rg Over 1 to 10 Incl. DAT l VALIDATION Contractor t Date Over 10 to 50 Incl. ❑ I FINAL `y I am exempt under Sec. Over 50 to 100 Inc. BY /� /t AU B.&P.C. for this reason i Over 10.0 ` [`/ U1 Date: Services, Swbd., MCC&Panelboards 0 -200 Amp. Under 600 V -r66 1.!A Signature 201 - 1000 Amp. Under 600 V 2 ❑ Over 1000 Amp. or Over 600 V r Exemption for Reg. Maint. Elect. 9 7 6 C V SINGLE FAMILY Temp. Power Pole&Appurtenances n (:C HOME OWNER-BUILDER.DECLARATION Sign with One Branch Circuit 1 hereby affirm that I am exempt from the Contractor's License i Additional Sign Branch Circuits I 1 G 7—.8 3 Law for the following reason (Section 7031.5; Business and 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 I 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 1 Lender's Name PERMIT ISSUING FEE. p Lender's Address I certify that I have read this application and state that the TOTAL FEE 6 above information is correct. I agree to comply with all County I ordinances and State laws regulating.Electrical wiring, and hereby authorize representatives of this County to enter upon j th ove-mentioned pro rty for inspection purposes. I SEE REVERSE FOR EXPLANATORY LANGUAGE C� / - -� 31 ignature o Per ittee 7 Date