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Home My Public Portal About8602 WORTHINGTON DR - Electrical - 1990-05-25 WORKERS'COMPENSATIONCE-h06G DECLARATION 10/81, APPLICATION FOR ELECTRICAL PERMIT CE-HO6 I hereby affirm that I hive'a certificate of eonscnt to self insure, or a certificato of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec 3 0 LC.) Policy NO�Wt mpany Cn.IIL�J1�rJ✓f FOR APPLICANT TO FILL IN JOB y� Certified copy is hereby furnished. EACH NO FEE ADDRESS G _ 1 New Residential Bldgs.&Pools ❑ 1 &2-Family, Ft. $ _ $ LOCALITY f� (� G•1'r Certified copy is filed with the county ow!ding inspection y��• dopartme t Multi-family Sq.Ft. NEAREST L//1C� / Residential Swimming Pools CROSS ST Date 0 Applicant ^r� �-+ OWNER OR Li F'RM NAME I CERTIF'ATE OF EXEMPTION FROM WORKERS' Outlets:Rec_Light _Sw.— MAIL oY 1+1„4 -�T COMPENSATION INSURANCE ADDRESS 4 1 L �U . (This section need not be completed if the work involved by the First 20 CITY—' /+ Tel. I certify that in tho performance of the work for which this permit PLAN CHECK APPLICANT is issued, I shall not employ any person in any manner so as to become subject t tApplicant he Workers'Compensation Laws. DLighting Fixtures First 20 ADDRESS c 0 r t Additional .C� ' Iu/CI� 1i I IG Total No. CITY Tel.No. at 1yi[� l� u!�w3 Fixed Appliances Not Over 1 HP PERMIT rr'r�.�,,, NOTIC TO PPLICANT If, after making this Certificate of APPLICANT YMOi2 L I<J wan Exemption,you should become subject to the Workers'Compensation Range_ Heater_ D.W. _ �h 3 Ir provisions of the Labor Code,you must forthwith comply with such Oven _ Dryer_ W.M._ ADDRESS �'-t`73� �.12040YIA- glyd . provisions or this permit shall be deemed revoked. Top — FAU _ W.H. _ CITY ��Y7 �, Tel.No.339 LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other_ I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. LICENSE OR (commencing with Section 7000)of Division 3 of the Business and REG NUMBER Professions Code,and my license is in full force and effect. Power Apparatus& Large Appliances DISTRICT!-J PRSSE e } ��JQ� Size&Type HP,KW,KVA,or KVAR ✓ j J ' IL License Number Lic.Class Up to 1 Incl. FINAL p v Qi3Yt�lD�P_ ,�C2IDI�tlate �1 Over 1 to 10 Incl. DATE F_ � Contractor L t"U3Y l 1O VALIDATION 0 ❑ Over 10 to 50 Incl. FINAL I am exempt under Sec. Over 50 to 100 Inc. BY4- W B&P.C.for this reason Over 100 N Services,Swbd.,MCC&Panelboards Z Date: 0-200 Amp.Under 600 V R Signature 201 - 1000 Amp.Under 600 V ❑ Exemption for Reg.Maint.Elect. Over 1000 Amp.or Over 600 V SINGLE FAMILY Temp.Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law ii;•i i os for the following reason(Section 7031.5,Business and Professions Additional Sign Branch Circuits Code): '"I_' Misc.Conduits&Conductors L s T' '" _ i I,as owner of the property,will do the work and the structure .. is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) and Professions Code). CONSTRUCTION LENDING AGENCY -; I hereby affirm that there is a construction lending agency for the ,srtl�,]E Performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total) Civ.C.). PLAN CHECKING FEE 4(:[ii, _ �. e t:•_ Lender's Name - ' PERMIT ISSUING FEE J Lender's Address 3 Vic: I certify that I have read this application and state that the above TOTAL FEE i information is correct.I agree to comply with all County ordinances and S to lavas regulating Electrical wiring, and hereby authorize rep s t ryes of this County to enter upon the above-mentioned p e o epection purposes. l 3 SEE REVERSE FOR EXPLANATORY LANGUAGE Sig ure of Permittee Date 76A663-CE806 468 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS �O� W06-r�1/�YCQIO -- JOHN A. LAMBIE. COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY ~ FOR APPLICANT TO FILL IN NEAREST /� 7 CROSS ST. +y�U2. D NO. SAC S FEE OWNER RECEPT._ MAIL // oq� LIGHT TOTAL FIRST 20 .20 ADDRESS YJ(7rC SWITCH_ OVER 20 .10 CITY .5�/ �PFIEL. NO. PLAN CHECK LIGHTING ITOTAL FIRST 20 .20 APPLICANT FIXTURES OVER 20 .10 ADDRESS RANGE—DRYER—WTR.HTR._ CITY TEL, NO. STA.COOK_DISP.—F.A.U.— CONTRACTOR �/9 I�G 9�' C SPACE HTR. AIR COND. / ADDRESS ;� / I-IL1i G',,*A—' CLOTHES WASH._DISHWASH._ CITY �� TEL. NO.Y^A46/101 FAN—OTHER 1.00 A0 LICENSE WO. 3 CLASS. C-/D MOTORS,TRANSFORMERS RATING IND.. HEATERS, ETC. HP. KW. KVA. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION SIZE & TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING 0 - 1 1.00 / ELECTRICAL WIRING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 1 - 10 3.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF } 'CALIFORNIA OR THAT i AM. E LEGA WNER OF, AND INTEND TO 10 - 50 5.00 RESIDE IN, THE ABOV ESCRI RESIDENTIAL PROPERTY. C) SIGNATURE U 50 - 100 10.00 OF PERMITTEE Ye p 100 - 500 15.00 V DISTRICT NO. GaQUP Z92NE PROCESSED BY SIGN,GAS SIGN AND ONE CIRCUIT 3.00 .'� .�— OC' 1 CA) TUBE, OR Z MARQUEE ADDITIONAL CIRCUITS 1.00 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 INSPECTOR'S SIGNATURE TEMP. POWER POLE UNDERSLAB WORK ROUGH CONDUIT PERMIT FEE (SUB TOTAL) WIRING. = ]FIXTURES PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED PERMIT ISSUING FEE 2.00 Qp UTILITYCO.NOTIFIED SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL TOTAL FEE JOSEPH C. ROOHAN SUPERVISING ELEC RICAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH L IAr^ 9 7 081%`, MAY 2 A 4.0 Q- M pEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE m.CEeo.e.e, APPLICATION FOR ELECTRIC PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING / BUILDING AND SAFETY DIVISION ADDRESS�QlQ JOHN A. LAMBIE. COUNTY ENGINEER ,p CASSATT D. GRIFFIN,SUPT OF BUILDING LOCALITY {r FOR APPLICANT TO FILL 1N CROSS s� ( ' r� PFJWT FEES �p At ITEM NUMBER EACH PEE OWNER OUTLET MAIL. LIGHTS ' RECEPT. SW. $ .to $ .0 ADDRESS - LIGHTI G FIXTURES .i0o CITY TEL.NO. ELEC.RANGES CLO.DRYERS ELECTRICIA ,� WATER HEATERS .50 ADDRESS _ ELEC.SPACE HTRSWISHWASHERS CITY AAf TEL.N s GARBAGE DISPOSERS I AUTO.- STATE /a� .�• WASHERS STA.COOKING UNITS .28 LICENSE NO. V 7 MOTORS: OVER INC. H.P. ' DIST. T NO. IGROUPI ZONE PR ESSED SY 0— I/z .219 2 •50 INSPECTION RECORD 2— 5 1.00 5— t5 1.50 _ t5— 50 2.50 BO—200 8.00 SIGNS: NO.TRANS. NO.LAMPS SERVICE 0-60OV 1.00 (, SERVICE OVER 600V 5.00 f MISC. WIRING PERMIT 1.00 .ry FIXTURE PERMIT f.00 SUPPLEMENTARY PERMIT 50 TOTAL FEE $ I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICAMON APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS.CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATS LAWS REGULATING CONDUIT' ELECTRICAL WIRING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR WIRING LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THEB AOVE FIXTURES '� /9b - DESCRIBED RESIDENTIAL PERTY. POWER SIGNATURE .� UTILITY CO.NOTIFIED 7-10 -4m 29Gc� r-.. FINAL pp 9a A ATION SUP6RIYISNG EL.EGI RICAU ENGINEER 61S ffiQ .CASH 0 7 3 :;A'l 13 2 A 10.9 5 7GA663-CE000 1-67 APPLICATION FOR. ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING. LOCALITY jQ NEAREST FOR APPLICANT TO FILL IN CROSS ST. RECEPT. TOTAL No. eacH Fee POUTLETB FIRST 20 $.20 $ OWNER LIGHT MAIL SWITCH ADD'L 10 ADDEIES �) OVER 20 LIGHTING FIXTURES TOTAL FIRST 20 .20 CIT L,NO. FIXTURES CONTRACTO OVVERER 20 .10 2 RANGESDRYERS• WTR.HTRS. 1.00 Q ADDRESS GARB.DISP. v STA.COOK CITY TEL.NO. i DISHWASH.Z----- AUTO.-WASH. STATE SPACE HTR8. STA. APPL. .50 LICENSE NO. MOTORS, OVER NOT OVER H.P. DISTRICT NO. GROUP Z E P D BY 0 1 .1.00 �j 1 8 1.50 INSPECTION REC RD e S 2.00 8 is 2.50 IS so 8.00 d 50 100 5.00 V SIGNS: NO.TRANS. NO.LAMPS 0 SERVICE O•GOOV-NOT OVER 200A 1.00 tiW SERVICE O-GOOV•OVER 200 A. 2.00 d N SERVICE OVER SOOV 5.00 ? OTHER (SEE COMPLETE FEE SCHEDULE) PERMIT ISSUING FEE 2.00 SUPPLEMENTARY PERMIT ISSUING FEE 1.00 APPROVALS DATE INSPECTOR'S SIGNATURE TOTAL FEE $ 0V 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION UNDERSLA13 WORK AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ROUGH-CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES'COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO POWER RESIDE IN,THE ABO DESCRIBED SID (AL PROPERTY. SIGNATURE UTILITY CO.NOTIFIED OF PERMITTED, FINAL PF VALIDATION JOSEPH C. ROOHAN CK MO CASH SUPERVISING ELECTRICAL ENGINEER Lk,o 0 4 1 S,cZ SEP �. 2 A 5.0 O N