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HomeMy Public PortalAbout10826 ARROWOOD ST_Electrical__ 78AeB9-CHBO9 9-H9 f/'6 P P II M A 1T O® 1N FOR E L E C lTl ��C P E ISS'I V Y II COUNTY OF LOS ANGELES u 11 11 DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION . ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER �� u �; CASSATT D. GRIFFIN,SUPT OF BUILDING LOCAL I'TY ' FOR APPLICANT TO FILL IN NEAREST }JfL I/J PERMIT FEES cRoss sr. ]T E NUMBER I EACH FEE OWNER a OUTLET ' - - ,� MAIL ADDRESS LIGHTS RECEPT. SW. .10 1/L� _ LIGHTING FIXTURES I0 CITY TEL.NO: ✓, ELEC.RANGES CLO.DRYERS. ELECTRICIAN TAT; 'G' Ti+ r, WATER HEATERS .50 ADDRESS 8023 F'_ RTAAAIeral.9 EL RS. DISHWASHERS CITY UP Gatirl el T EGeMlt- AL-7-0539 GARBAGE DISPOSERS AUTO.- STATE W SHERS STA.COOKING UNITS .25 ✓'�+FDISTRI, NO. ? MOTORS: OVER INC. H.P. �TNO. GROUP "ZONE PROC SSED BY O— 1/2 "25 I I I lie— z .50 INSPECTION RECORD 2 5 1.00 5— 15 1.501s— 5o2.5050—200 5.004r- - v U NO.TRANS.SIGNS: NO.LAMPS e SERVICE0-600V1.00 ' T (} U U SERVICE OVER 600V 5.00 MISC. r WIRING PERMIT 1.00 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .50 TOTAL FEE 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APP ICATION APPROVALS DATE INSPECTOR'S SIGNATURE .AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO,COMPLY g WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT ELECTRICAL WIRING. ' 1 HEREBY CERTIFY THA AM PROPERLY R ]$TER AND OR q WIRING –7"�' O �L�...�� LICENSED AS REQUIRED' OS ANGELES O T A STA OF o FIXTURES A �' CALIFORNIA OR THAT 1 A THE LEG O NE O HE OVE DESCRIBED RE5P T OPERTY. POWER SIGNATURE / Zinn UTILITY CO.NOTIFIED OF PERMN. FINAL OF NAPDATION ARTHUR C.VETT, CK Mo CASH SUPERVISING ELECTRICAL ENGINEER J M72 7 O:,.o. t;AR 4 2 A. 7..65 ko WORKERS'COMPENSATION DECLARATION 20-0019 6oPw3iez n nnn C n��OO uN FOR EL�EC'�'I1��CAL�, l�ISII�IIV T I hereby affirm that I have a certificate of consent to self CE-8066 G=�1lT l!"LS G�1 IT ll� insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certif;ed copy thereof (Sec. 3800, Lab. Policy NWA-047 Company FOR'APPLICANT TO FILL IN JOB ❑Certified copy.is,hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS $ _ $ LOCALITY /+ Ir]�p�Certified copy is filed with the county building ' spec- 1 &..2-Family, Sq. Ft. Act. de artme Multi-family Sq. Ft. NEAREST Residential Swimming Pools CROSS ST. Date C Applicant �'h`'� OWNER FIRMNAMM E CERTIFI ATE OF EXEMPTION FROM WORKER ' Outlets: Rec Light�Sw.3_" MAIL COMPENSATION INSURANCE O First 20 20 p ADDRESS i�wc (This section need not be completed if the'work involved by -Total No. Additional CITY, Tel. No. the permit is for one hundred dollars ($100)or less.) PLAN CHECK I certify that in the performance of the work for which this - APPLICANT permit is issued, I shall not employ any person in any manner so-as to become subject to the Workers'Compensation Laws. Liglting,Fixtures First 20 Q ADDRESS Additional ` Date' Applicant Total Nc CITY Tel. No. NOTICE TO APPLICANT: If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT Exemption, you should become subject to the Workers' Range— Heater—D.W. — APPLICATION 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. /Q CITY t o Tel. No. LICENSED CONTRACTORS DECLARATION' Hood- Fan, —Other— LICENSE t OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. Room Air Cond. REG, NUMBER �2��� Class. (commencing with Section 7000)of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO. ESSED BY >_ and Professions Code, and my license is in full force and effect. - - a- Size &Type HP, KW, KVA, or KVAR .�� Q License Number(( Lic. Class — Up to 1Incl. FINAL ^'� V Contractor w '`�' Date « Over l to l0 Incl. DATE /L VALIDATION Over 10 to 50 Incl. FINAL / U ❑. I am exempt under Sec. Over 50 to 100 Inc. BY. W B.U.C. for this reason Over 1000- D Services, Swbd., MCC& Panelboards. Z ` Date: 0.- 200 Amp..Under 600'v � Z Signature 201 - 1000 Amp. Under 600 V I F-1Exemption 1000 Amp. or Over 600 V Exemption for Reg. Maint. Elect. SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Temp. Power Pole &Appurtenances I hereby affirm that I am exempt from the Contr'actor's License Sign with One Branch Circuit Al. �" Law for the'following reason (Section 7031.5, Business and Additional Sign Branch Circuits Professions Code): ❑ Misc. Conduits&Conductors I, as owner.of the property, will'do the work and the structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)— D ?i[??''_ �o Business and Professions Code). 34 p .Li r -�--i CONSTRUCTION LENDING AGENCY ps__•:. •=4_ _i I hereby affirm that there is a construction lending agency for ) 70 ..1( rj;jL s the performance of.the work for which this permit is issued PERMIT FEE (Sub-Total (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name `` _Ail PERMIT ISSUING FEE Lender's Address / �� `il'."y I certify that I have read this application and state that the TOTAL FEE 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 thea ove- property for inspect, rpose . SEE REVERSE FOR EXPLANATORY LANGUAGE ©s Signature of Permitte - D e