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Home My Public Portal About8616 WORTHINGTON DR - Electrical - 1973-03-15 j6A663s5 11_71 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER FC - / BUILDING AND SAFETY DIVISION d + FOR APPLICANT TO FILL IN OUTLETS N0. EACH FEE n OWNER RECEPT._ $ $ MAIL LIGHT TOTAL /� FIRST 20 25 ADDRESS ! N D2 s S,e w �l6L CITY TEL. N0. [ � SWITCH_ OVER 20 .10 'PLAN CHECK LIGHTINGTOTAL FIRST 20 25 APPLICANT FIXTURES OVER 20 •10 ADDRESS RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT / G W RANGE W DRYER_WTR. HTR. APPLICANT V STA. COOK DISP. F.A.U. ADDRESS Io/ Aoej SPACE HTR. AIR COND. CITY 412C m TEL. NO. CLOTHES WASH. DISHWASH. LICENSE N0. b-3 CLASS. FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO ' I HEREBY CERTIFY THAT i AM PR OPEiILY REGISTERED AND/OR 0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF d CALIFORNIA I AM THE LEGAL 0 NER OF, AND INTEND TO 1 - 10 9.00 RESIDE I THE OVE DES ENT L ERTY V SIGNATU at 10 - 50 5.00 OF PERMITT O 50 - 1100 1040 �j DISTRICT NO. CLASS E PRO SEED B t1J 100 - S00 15.00 3 ( N SIGN, GAS ][SIGN ONE CIRCUIT 5.00 NOTES: ? TUBE, OR MARQUEE ADDITIONAL CIRCUITS 140 SERVICE NOTOVER 600 VOLTS OR 200 AMP 3.00 - APPROVALS DATE INSPECTOR'S SIGNATURE SERVI CEOVER 600 VOLTS OR 200AMP 1040 TEMP.POWER POLE TEMP SERVICE,POLE,&APPURTENANCES 5.00 TEMP LIGHT OR RECEPT. SYSTEM 3.00 UNDERSLAB WORK ROUGH CONDI UT WIRING + FIXTURES ' POWER AUTHORIZED PERMIT FEE (SUB TOTAL) UTILITY CO. NOTIFIED PLAN CHECK FEE PERMIT ISSUING FEE 3.00• ' 00 FINAL J TOTAL FEE �� PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION CK. M.00Q . CA9 e00SE0 0 0 473 MAS 15 2 A 6.00- SEE E BACK OF APPLICATION FOR COMPLETE SCHEDULE 76A663-CE806 11_71 APPLICATION FOR ELECTRICAL PERMIT V COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING ��f �plZfJf�ry to BUILDING AND SAFETY DIVISION ADDRESS LOCALITY Q,�` ` FOR APPLICANT TO FILL IN CROSS ST . OUTLETS NO. EACH FEE 4 OWNER &Y/v RECEPT. $ $ MAIL T // LIGHTOTAL FIRST 20 25 ADDRESS l0� t VVtZ7//�/X,6 O� OVER 20 (J CITY�-/V �j/L/KpL TEL. NO., SWITCH .10 PLAN CHECK LIGHTINGTOTAL FIRST 20 .25 APPLICANT R 20 OVER ADDRESS FIXTURES Z' .10 RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT RANGE DRYER_WTR. HTR. APPLICANT +✓ ®a�LS STA. COOK DISP. F.A.U. ADDRESS It7I Ury w /( . SPACE HTR. AIR COND. CITY f TEL. NO CLOTHES WASH. DISHWASH. LICENSE NO. Z,,l3 Z&-.3 CLASS6 3 FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW.KVA. ELECTRICAL WIRING. SIZE-& TYPE OVER TO I HEREBY CERTIFY THAT I AM LY REGISTERED AND/OR 0 - 1 100 LICENSED AS REQUIRED BY �LAS NGEL COUNTY AND STATE OF CALIFORNIA OR THAT I A THE LEGAL WNER O AND IN NO TO 1 - 10 3.00 RESIDE IN, THE AB DESCRIB REST NTIAL P PERTY. V 10 - 50 5.00 SIGNATURE ca OF PERMITTEE O 50 - 100 10.00b DISTRICT NO. JCLASS � PROC ED BY IJJ 100 - 500 15.00 N SIGN, GASSIGN AND ONE CIRCUIT 5.OD NOTES: TUBE, OR MARQUEE ADDITIONAL CIRCUITS IAO SERVI CENOT OVER 600 VOLTS OR 200 AMP 3.00 SERVI CEOVER 600 VOLTS OR 200 AMP 10.00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP.POWER POLE TEM P SERVI CE,POL E.&APPU RTENANCES 5.00 UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM 3.00 ROUGH CONDI UT WIRING FIXTURES POWER AUTHORIZED PERMIT FEE (SUB TOTAL) UTILITY CO. NOTIFIED PLAN CHECK FEE PERMIT ISSUING FEE 3.00 300 FINAL i TOTAL FEE PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH LAL;on695 JM 2:5A 2 A SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 6A699.GE000e.a. APPLICATION ":2:!/, 4��FOR ELECTRIC PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS f j/ / / JOHN A. LAMBIE, COUNTY ENGINEER r CASSATT D. GRIFFIN,SUPT OF BUILDING�IM 0Z LOCALITY 7 1 ,FOR APPLICANT TO FILL IN NEAREST PEBMT FF RS CROSS ST. elge-7-o'49 ITEM NUMBER I EACH FEE OWNER MAI L LOIGHTS TS RECEPT. /'roBW. i $ .70 $„/ An ADDRESS LIGHTING FIXTURES �� .10 CITY TEL.NO. ELEC.RANGES CLO.DRYERS ELECTRICIAN WATER HEATERS .50 ADDRESS F^ ` ELEC.SPACE HTRS.ap,IBHWASHERB CITY ' ,d TEL.NO. "? GARBAGE DISPOSERS J AUTO.- � STATE WASHERS BTq.COOKING UNITS '"� .25 LICENSE NO. Q7 MOTORS: OVER INC. H.P. 1 D15TRICT NO. GROUP ZONE P SSED BY 0— I/a .25 V2— 2 .50 INSPECTION BE ORD 2— 5 1.00 5— is 1.50 is- 50 2.50 50-200 5.00 SIGNS: NO.TRANS. NO.LAMPS' SERVICE 0-600V 1.00 ffr� SERVICE OVER 800V 5.00 MISC. WIRING PERMIT 1.00 6i FIXTURE PERMIT 1.00 (Jt� - SUPPLEMENTARY PERMIT .s0 TOTAL FEE $1130 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT ELECTRICAL WIRING. WIRING Jr'!/�e -�/1 `! /'I F-• -�% 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES —�� D CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL P OPERTY. POWER SIGNATURE * UTILITY CO.NOTIFIED OF PERMITTE FINAL U�. �R Or ATION SUPERVISING THUR C. ELECTRICAL ENGINEER CK MQ CASH '�:'J�0765G i'-y 3 2 A 11 .30 WORKERS'COMPENSATIONDECLARATION 76A663 I APPLICATION FOR ELECTRICAL CE,806G (2-80) PERMIT - J CE-806 I hereby affirm that I have a certificate of consent to self I COUNTY OF LOS ANGELES BUILDING AND SAFETY insure,or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) Policy No. Company I FOR APPLICANT TO FILL IN JOB `� New Residential Bldgs.&Pools EACH NO. FEE ADDRESS ` Ar. [� ❑ Certified copy is hereby furnished. j 1 &2-Family,Sq. Ft. $ — $ LOCALITY &,Q,/ 7 ❑ — NEAREST r Certified copy is filed with the county building inspection Multi-family Sq.-Ft. CROSS ST department. I Residential Swimming Pools tZ OWNER OR %,� FIRM NAME 01616_C� 1e ¢ Date Applicant I Outlets: Rec Light_ First ADDRESS (j(�/�C— . CJ�1 JZn `t7 � ��,, First 20• CERTIFICATE OF EXEMPTION FROM WORKERS' Total No.� Additional CITY �/;C(16el No. } COMPENSATION INSURANCE PLAN CHECK a (This section need not be completed if the work involved Q [ APPLICANT O by .the permit is for one hundred dollars ($100) or less.) Lighting Fixtur First 20 °" ADDRESS U Total No. Additional CC I certify that in the performance of the work for-which this Fixed Appliances Not Over 1 HP CITY Tel No. O permit is issued, I shall tiot employ any person in any manner, PERMIT /� U so as to become subject to the rkers'Compensation Laws. Range_Heater D.W. _ APPLICANT �� W ' a Oven _ Dryer_W.M._ ADDRESS Cl) Date — L/�" pplicant d? °te r Top _ FAU —W.H. Z Hood —.Fan —Other CITY Tel No. NOTICE TO APPLICANT: If, after making this Certificate of Disp. —Room Air Cond— LICENSE OR Exemption, •you should become subject to the Workers' REG.NUMBER Class . Compensation provisions of the Labor Code, you must forth- Power Apparatus,&Large Appliances DISTRICT N PROCESSED BY with comply with such provisions or this permit shall be Size&Type HP,KW,KVA,or KVAR �� /} deemed revoked. Up to 1 Incl. �/ FINAL Over 1 to 10 Incl. DATE LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl. VALIDATION 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 ness and'Professions.Code,and my license is in full force and effect. Services U-200 Amp.Under 600 V License Number Lic.Class 201-1000 Amps Under 600 V Contractor Date Over 1000 Amp.or Over 600 V HOME OWNER-BUILDER DECLARATION Temp.Power Pole&Appurtenances I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits r ness and Professions Code): Misc.Conduits&Conductors ❑ I, as owner of the pro.perty,.will do the work and the' Other(See Complete Fee Schedule)— structure is not intended or offered for sale (Section 7044,Business and Professions Code). 4 5 5 9 A CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency 0,o 0 0 o 2 for the performance of the work for which this permit is PERMIT FEE' (Sub-Total) ' issued(Sec.3097,Civ.C.). 1 `! 2 0 0 1570 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 'P TOTAL FEE 06,24-82. above information.is correct..I agree to comply with all County , ordinances and State laws regulating Electrical wiring, and hereby authorize representatives of this County to enter upon the above-m ntioned property for ipection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE 6-2 Signature of Permittee Date '7