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Home My Public Portal About6009 AGNES AVE_Electrical__ DB 5 A 12 43 25M "PUC TION FOR ysERMT \ DEPARTMENT of BIJI AND SAFE'T'Y ELECTRIC 1 COUNTY OF IASS ANGELES WM J FOX CHIEF ENGINEER I a &NAME C S Oki. /7 DISTRICT NO GROUP ZONE PERMIT NO NO F/ �/ �� C 0 • Vs— U ADDRESS U / TEL NO /J� RECEIlglED BY READY FOR DATE ISSUED W FIRST INSPECTIONS/'j CERT NO EXPIRES .3,1/�b �� ` APPLICANT FIU IN HEAVILY OU LINED PORTION ONLY p DESCRIPTION OF WORK ADDRESS D OIr Q HSS NUMBER OF OUTLETS ON CIRCUITS LOCALITY L�✓�9 �� r / IJ LOCATION BY ROOMS NEAREST LIGHT OUTLETS Isw PLUGS FIXT CROSS ST Cl I CIRCUIT A Ila C I D I E F G IH W NAME Z MAIL c a I 3 ADDRESS J CITY TEL NO AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OgrgeJ�IFI ��ON ELECTRICIAN I 1 AM THS LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE OWNER I CORRECTIONS J Q 2 C7 fr O TOTAL / NO OF OUTLETS $ O APPROVALS NO OF FIXTURES $ DATE INSPECTOR S NAME NO OF MOTORS HIP $ CONDUIT LNSIGNS TRANS $L WIRING RANGES OR HEATERS $ FIXTURES ANEOUS $ ii POWER FEE $ pG� UTILITYCO NOTIFIEDEE r 7 FINAL 76A663 DBS SA I1 SO APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES ELECTRIC 1 WILLIAM J FOX CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICTrNO GROUP ZONE PERMIT NO EL GYRICIAN / S �-3 r RECEIVED BY READY FOR DATEISSUED ADDRESS / ? FIRST INSPECTION CITY TEL-NO COUNTY LICENSE NO EXPIRES Y -„�+... BUILDING aPERMIT FEES ADDRESS O /teM 1 NUMBER EACH FEE LOCALITY LIGHT OUTLETS NEAREST RECEPTACLES v� CROSS ST 6 WALL SWITCHES -OWNER P TOTAL OUTLETS Sc $ J MAIL ELEC RANGES 25 ADDRESS' Q ELEC HEATERS 25 CITY 0_ C t-TEL NO t/� '7N FIXTURES g U 1 MiSC 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING MOTORS 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBERHORSEPOWER FEE ANGELES COUNTY LICENSE OR I AM THE LEGAL OWNER NEw MVD HP 02R1Nc EACH OF THE RESIDENTIAL PROPERTY DESCRIBED AIL BOVVE�..C.-1.1�1� VI1/2 9LESS $ 25 SIGNATURE OF �( a 1/2 2 50 PERMITTEE/\ 2 5 100 INSPECTION RECORD 5 15 1 50 15 50 2 50 50 200 500 200 , Soo 10 001 J Soo 1000 15 00 Z OVER 1000 20 00 M G SET/FREQ CHANGER HP WCLDERS AC KVA O GENERATORS KW TRANSFORMERS KVA TEMP MOTORS (75%OFORIG ) MOVED MOTORS (75%OF ORIG ) MISC z SIGNS NO a NO TRANS I I APPROVALS NO NO LAMPS FOR EACH PERMIT DATE INSPECTOR S NAME WIRING $1 00 ICj-� CONDUIT FIXTURES $1 00IG� WIRING SUPPLEMENTARY 5o I- FIXTURES r s POWER TOTAL FEE $ UTILITY CO NOTIFIED ® FINAL WORKER'S COMPENSATION DECLARATION 20-0079 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self insure, 76A663 or a certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec.3800 Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB ADDRESS ! Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE $ $ LOCALITY ❑ Certified copy is filed with the county building inspection 1 &2-Family,Sq. Ft. NEARESTdepartment. Multi-family Sq-Ft. CROSS ST. Date Applicant Residential Swimming Pools ASSESSOR ' MAP PAGERS PARCEL// CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER OR Outlets:RBC. Light SW. ; ® D FIRM NAME .� o_-q COMPENSATION INSURANCE First 20 , (This section need not be completed if the work involved by the MAIL Total No. Additional ADDRESS b,/�� L Jv permit is for one hundred dollars($100)or less.) I certify that in the performance of the work for which this permit CITY /� L � Tel.No. is issued, I shall not employ any person in any manner so as to z f/O vJ become subject to the Workers' Compensation Laws. lighting Fixtures First 20 APPnm LIICANTK Total No. Additi I ADDRESS Date Applicant RESIDENTIAL APPLIANCE NOT Ole- VER /�/�? `�� NOTICE TO APPLICANT: If, after making this Certificate of CITY Tel.No. Exemption, you should become subject to the Workers' Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code, you must forthwith comply with such PERMIT provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances APPLICANT LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. (commencing with Section 7000) of Division 3 of the Business and CITY Tel.No. Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. LICENSE OR } Over 50 t0 100 Incl. REG.NUMBER Class. a Over 100 DISTRICT NO. PR ED BY O License Number Lic.Class V Services,Swbd.,MCC&Panelboards I��, ��at/�/� Cc Contractor Date 0-399 Amp.Under 600 V FINAL 0 DATE p _� ^ 0 El am exempt under Sec. 400-1000 Amp, Under 600 V Iv "�[i VALIDATION W Over 1000 Amp.or Over 600 V FINAL n a B.&P.C.for this reason BRANCH CIRCUIT FEES BY 15A,or 20A, 120V,Lighting or Recept. z ' Date: 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits El Exemption Or More Branch Circuits Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits _ SINGLE FAMILY Temp.Power Pole&Appurtenances y HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits 73303 6 q Code. TT-; I, as owner of the property,will do the work and the structure Misc.Conduits&Conductors L i I C'f is not intended or offered for sale Section 7044, Business Other See Complete Fee Schedule T; TA L 83 = and Professions Code). _ 77 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the titii±+si �L)I_7 performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total) Civ.C.) s= ; PLAN CHECKING FEE ifE,1,iU—+i=`- 3 1_i�•'?•t Lender's Name =f^^ c PERMIT ISSUING FEE fI 4 B;;; a s Lender's Address I certify that I have read this application and under penalty of purjury state TOTAL FEE , that the 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-mentioned property for' ction purposes. j SEE REVERSE FOR EXPLANATORY LANGUAGE SIGN IRE OF PERMITTEE DAT ' WORKERS COMPENSATION DECLARATION CE 8 6G (280) ° l APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to�-self COUNTY OF LOS ANGELES ( BUILDING AND SAFETY L t insure or a certificate of Workers Compensation Insurance or a certified copy thereof(Sec' 3800 Lab C) r ` , i FOR APPLICANT TO FILL IN JOB // /� 1 Policy No Company New Residential Bldgs &Pools 'EACH NO FEE ADDRESS 'r7W 1 s vZ- ❑ ` �y / Certified copy is hereby furnished 1 &2 Family Sq Ft $ $ LOCALITY l-C i d� Multi family Sq Ft y — NEAREST r ❑ Certified copy is filed with the county building inspection - - CROSS ST y department Residential Swimming Pools OWNER OR FIRM NAME Date ' Applicant ry - Outlets Rec Light, Sw �10 MAIL J r First 20 ADDRESS is CERTIFICATE OF EXEMPTION FROM WORKERS Total No Additional CITY 1 Tel No _ COMPENSATION INSURANCE - } PLAN CHECK d APPLICANT (This section need not be completed if the work involved , O by the permit is`for one hundred dollars ($100) or less) Lighting Fixtures First 20 U Total No ' ti Additional ADDRESS t ° I certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY i Tel No _ O permit is issued I shall not employ any person in any manner PERMIT , U so as to become subject to the Workers Compensation Laws Range I Heater_D W APPUICANT W (Oven Dryer_W Ma- Date ) N Date Applicant Top FAU _W H Z Hood Fan _Other— t CITY Tel No NOTICE TO APPLICANT If after making this Certificate of D°sp _ Room Air Cond_ LICENSE OR I Exemption you should become subject to the Workers REG NUMBER Class Compensation provisions of the Labor Code you must forth Power A (�// with comply with such Apparatus& Large Appliances DISTRICT N� Al P E D BY p y provisions or this permit shall be Size&T �./ deemed revoked \ Type HP KW KVA or KVAR Up to 1 Incl FINAL LICENSED CONTRACTORS DECLARATION ` Over 10,t Over 1 10 Incl DATE o 50 Incl VALIDATION I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc FINAL d 9 (coB mmencing with Section 7000) of Division 3 of the Busi Over 100 ness and Professions Code and my license is in full force and effect Services f v l /License NumberLic Class 0 200 Amp Under 600 V J�a I S ° f ` v 201 1000 Amp Under 600 V � Contractor Date Over 1000 Amp or Over 600 V I ° _ i HOME OWNER BUILDER DECLARATION Temp Power Pole& Appurtenances I hereby affirm that I am exempt from the Contractors Sign with One Branch Circuit Additional Sign Branch'Circuitsj 2'2471 A L , License Law for the following reason (Section 7031 5 Busi � i ' ` � i 2� ness and Professions Code) k r 0'Q 'e o 0 Misc Conduits&Conductors u?", as owner of the property will do the work and the (Other (See Complete Fee Schedule)— 1 2Ao'o 3 0 7 0 structure is not intended or offered for sale (Section 7044 Business and Professions Code) _ 00030702: 1 CONSTRUCTION LENDING AGLNCY I hereby affirm, that there is a construction lending agency for the perf6rmance of the work for which this permit is i 12 3 0 811 --1 PERMIT FEE (Sub Total) 070 issued (Sec 3097'Civ C) - u Lender s Name �} ,PLAN CHECKING FEE (One Fourth Permit Feel / Lender s Address % 1 PERMIT ISSUING FEE E I certify that I have read this application and state that the TOTAL FEEj , a ,above information is correct I agree to comply with all County v { ordinances and State laws 'regulating Electrical wiring and f I hereby authorize representatives of this County to enter upon% the above mentioned `operty for i spec on purposes 1 SEE REVERSE FOR EXPLANATORY LANGUAGE / Signature of Permittee Date it 1