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HomeMy Public PortalAbout6302 AGNES AVE_Electrical__ �J 1 !/rs rJ l � rL 76A869G .6,7APPLICATION FOR ELECTRIPERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN JOB New Residential Bldgs &Pools EACH NO FEE ADDRESS 1 &2 Family Sq Ft $ 025 — $ LOCALITYMTIZ ly Multi family Sq Ft 02 — NEAREST 25 00 CROSS ST Residential Swimming Pools OWNER OR 'AMO j FIRM NA Outlets Rec Light Sw MAIL First 20 50 ADDRESS Total No Additional 30 CITYF. CTTY ' Tel No PLAN CHECK APPLICANT Lighting Fixtures First 20 50 ADDRESS Additional 30 Total No CITY Tel No Fixed Appliances Not Over 1 HP PERMIT t APPLICANT HCC Range_Heater_D W Oven—DryerW M— ADDRESS 203/4 LST RECK Top _FAUj l,�C_W H CITY Tel N Hood_Fan i Other_ LICENSE OR Disp —Room Air Cond 2 50 REG NUMBER Class ,--I n I I HEREBY ACKN E E THAT I HAVE READ THIS APPLICA Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO Size&T COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS Type HP KW KVA or KVAR 2 50 REGULATING ELECTRICAL WIRING Up to 1 InHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR Over 1 to 10 Incl 'S 00 ^ LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF Over 10 to 50 Incl 1250 CALIFORNIA OR THAT I AM THE LEGAL OWN OF THE ABOVE O 25 00 DESCRIBED RESIDENTIAL P TY 0 Over 50 to 100 Inc 1 1 Over 100 4000 PERMITEE SIGNATURE Services _ DISTRICT NO OCE ED BY 0 200 Amp Under 600V 12 50 --j C 201 1000 Amp Under 600 V 25 00 1 )Over 1000 Amp or Over 600 V 5000 �et� Z O Temp Power Pole&Appurtenances 10 00 Sign with One Branch Circuit 1000 JINI DO b 607/oy o Additional Sign Branch Circuits 2 00 SPECTION > ORMATION U Misc Conduits&Conductors 1000 N REVERSE i Other(See Complete Fee Schedule) SIDE u ;94660A Z S # o o o o o 2 d 2ao14,50 PERMIT FEE (Sub Total) r Z aoo14,506 PLAN CHECKING FEE (One Fourth Permit Feel O PERMIT ISSUING FEE $7 00 �� G 0 S3 V-79 J TOTAL FEE > INSPECTION FINALED o�c date ��� By QLG� ---�} Os 76A663 CES06 9 66 APPLICATION FOR ELECTRICAL PERMIT ,ul COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS JOHN A LAMBIE COUNTY ENGINEER COLEMAN W JENKINS SUPERINTENDENT OF BUILDINGLOCALITY NEAREST FOR APPLICANT TO FILL IN cRoss sr RECEPT TOTAL NO EACH FEE OUTLETS $ $ OWNER O S LIGHT /O FIRST 20 2020 O MAIL SWITCH-/ / ADD OVER L 1 10 O ADDRESS TOTAL CITY TEL NO LIGHTING FIXTURES FIRST 20 �'Q 20 0 O . FIXTURES ADD L OVER 20 10 CONTRACTOR _ RANGES DRYERS WTR HTRS 100 ADDRESS I ~g GARB DISP STA COOK CITY 1q/i�T L� TEL NO DISHWASH AUTO WASH ��ff STATE A� O _- SPACE HTRS STA APPL 5O L O LICENSE NO a( \"J -MOTORS OVER NOT OVER HP G` DISTRICT NO GROUP ZONE PR C SSED BY 0 1 100 1 3 150 INSPECTION RECORD s a 200 y �� 8 15 250 is 50 300 50 100 500 0 SIGNS NO TRANS 0 NO LAMPS SERVICE O 600V NOT OVER 200A 100 QQ SERVICE O 600V OVER 200 A 200 SERVICE OVER 600V 500 OTHER (SEE COMPLETE FEE SCHEDULE) v J PERMIT ISSUING FEE 200 2 L SUPPLEMENTARY PERMIT ISSUING FEE too APPROVALS DATE INSPECTOR 8 SIGNATURE TOTAL FEE / (� 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION UNDERSLAB 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 / '����J ` ,� 1HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I THE LEGAL OWNER�END TO POWER RESIDE IN THE ABOVE CR ED RE IDENTI SIGNATURE UTILITY CO NOTIFIED OF PERMITTEE ALIDATION JOSEPH C ROOHAN CK MO CASH SUPERVISING ELECTRICAL ENGINEER LAuo 8 0 5 8 a APR 13 2 D 1460- WORKERS COMPENSATION DECLARATION 720 6A663 oPw3ie7 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self ��� insure or a'eertificate of Workers Compensation Insurance COUNTY OF LOS ANGELES - DEPT OF PUBLIC WORKS or n certified copy thereof (Sec 3800 Lab C ) Policy No Company FOR APPLICANT TO FILL INJOB Certified copy is hereby furnished New Residential Bidgs & Pools EACH NO FEE ADDRESS Certified copy is filed with the county building inspec 1 & 2 Family Sq Ft $ — $ LOCALITY tion department Multi family Sq Ft NEAREST c C Residential Swimming Pools CROSS ST O 10CvVIOWNER OR Date Applicant nn hh 1 FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec�_bi ht�LSw L o L ` t ' MAIL p COMPENSATION INSURANCE g ADDRESS (This section need not be completed if the work involved by Total No AddiFirst tional CITY pLi— Tel No ?_ the permit is for one hundred dollars ($100)or less ) PLAN CHECK I certify that in he performance of the work for which this APPLICANT permit is issued I shall not employ any person in any,monner so as to become subject to the Workers Compensation Laws` Lighting Fixtures First 20 ADDRESS Additional Total No — CITY Tel No Date Applicant NOTICE TO APPLICANT If after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT APPLICATION Exemption you should become subject to the Workers Range— Heater_D W Compensation provisions of the Labor Code you must forth Oven — Dryer —W M — ADDRESS ' with comply with such provisions or this permit shall be Top — FAU —W H — deemed revoked Hood — Fan -I—.Other'1 . CITY Tel No LICENSED CONTRACTORS DECLARATION Disp — Room Air Cond LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 REG NUMBER Class (commencing with Section 7000)of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NOCESSED BY >_ and Professions Code and my license is in full force and effect ,n a_ Size &Type HP KW KVA or KVAR O License Number Lic ClassJV 14 1 C) Up to 1 Incl FINAL Over i to 1l Incl J Contractor Date DATE VALIDATION CC ❑ Over 10 to 50 Incl FINAL F- I am exempt under Sec Over 50 to 100 Inc BY Q B&P C for this reason Over 100 4 i 11 Z Services Swbd MCC& Panelboards coZ Date 0 200 Amp Under 600 V % — Signature 201 1000 Amp Under 600V EJExemption for Reg Maint Elect Over 1000 Amp or Over 600 V SINGLE FAMILY HOME OWNER BUILDER DECLARATION Temp Power Pole &Appurtenances ' 3:07 9: 3j 1 hereby affirm that I am exempt from the Contractor s License Sign with One Branch Circuit 1 ITEMS Law for the following reason (Section 7031 5 Business and Additional Sign Branch Circuits Professions Code) - - TIITAt_ 52. 00 V 5J0 I as owner of the property will do the work and the Misc Conduits&Conductors L}UK ;:.1 structure is not intended or offered for sale(Section 7044 Other (See Complete Fee Schedule)_ , � .00Business and Professions Code) CONSTRUCTION LENDING AGENCY r r I hereby affirm that there is a construction lending agency for 11309100-GOO j ]/ 7/�C� the performance of the work for which this permit is issued PERMIT FEE. T (Sub Total) (Sec 3097 Civ C ) a 1 774 1 AM S,41 Lender s Name No 4)�- PLAN CHECKING FEE 6 PERMIT ISSUING FEE Lenders Address_,/ I certify that I have read'this application and state that the TOTAL FEE above i formation is correct I age o comply with all County / ordrnanc s and State laws regulate Electrical wiring and hereby thorize representativef t is County to enter upon theFal�v mentioned property/forirspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Signature 7 ermittee Vote ©s