Loading...
HomeMy Public PortalAbout6148 AVON AVE_Electrical__ of that COMPENSATION DECLARATION 76A669 DPW 9/89 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I'have a certificate of consent to self insure, 76A663 or ecertificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(S@c.3800 Lab.C.) � Cy No. Company FOR APPLICANT TO FILL IN JOB ADDRESS q' - Q 4 v I5• Certified copy is hereby furnished. New Residential Bldgs.&Pools EACH NO. FEE ❑ $ _ $ LOCALITY A N L Certified copy is filed with the county building inspection 1 &2-Family,Sq.Ft. ��,�� _ NEAREST department. Multi-family Sq.Ft. CROSS ST. �N Date Applicant Residential Swimming Pools ASSESSOR �p MAP BOOK PAGE O PARCEL W CERTIFICATE OF EXEMPTION FROM WORKERS' 0 7 _ 10 OWPM b"T6V�N ES ilJ0 1t Outlets:Rec.hr Light Sw. FIRMMAME NAME NAME COMPENSATION INSURANCE . First 20 0MAIL (This section need not be completed if the work involved by theADDRESS permit is for one hundred dollars($100)or less.) Total No. Additional / Vora I certify that in the performance of the work for which this permit CITY A b ` Tel.No/� s is issued, I shall not employ any person in any manner so as to PLAN CHECK (•�' become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 1 APPLICANT Total No.. Additional _ ADDRESS Date Applicant 42 15 OR 20A,120V BRANCH CIRCUITS4no f. . > /�� NOTICE TO APPLICANT: If, after making this Certificate of CITY4. Tel.No. Exemption,you should become subject to the Workers' Compensation 1 TO 10 INCLUSIVE EACHIlly provisions of the Labor Code, you must forthwith comply with such 11 TO 40 INCLUSIVE EACH IT APPLICANT provisions or this permit shall be deemed revoked. 41 OR MORE BRANCH CIRCUITS EACH LICENSED CONTRACTORS DECLARATION ADDRESS } I hereby affirm that I am licensed under provisions of Chapter 9 15 OR 20A,208V TO 277V LIGHTING EACH a (commencing with Section 7000) of Division 3 of the Business and CITY fjl&oTel.No. a/$') O Professions Code, and my license is in full force and effect. RESIDENTIAL APPLIANCES UP TO 3HP LICENSE OR r U Power Apparatus&Large Appliances REG.NUMBER Class. fs License Number r/ / 7S Lic.Class13 Size&Type HP,;KW,KVA,or KVAR DISTRICT NO. P OC ED BY Up to 3 Incl. W Contractor A VC©fJS Date Over 3 to 10 Incl. DATE U) ❑ Over 10 toI am exempt under Sec. Over 50 to 15VALIDATION Z 00 Incl. pp1f )/J Over 100 Q_.) FINAL B.&P.C.for this reason BY Services,Swbd.,MCC&Panelboards P Date: 0-200 Amp.Under 600 V 60 q 60 Signature 201 -1000 Amp.Under 600 V ) , - ❑ Over 1000 Amp.or Over 600 V Exemption for Reg.Maint.Elect. kri SINGLE FAMILYt 4} HOME OWNER-BUILDER DECLARATION Temp.Power Pole&Appurtenances I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit yY for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits ;'±{ Code): _. 'f » ❑ I, as owner of the property,will do the work and the structure Misc.Conduits&Conductors — •-_=3'> is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) ' k :`•'; «" and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the (t-i +. „E ;»I performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total) Z ? T Civ. C.) PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Z� ' ^'} Lender's Address 1 certify that I have read this application and state that the above TOTAL FEE a 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 inspectio urposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Y'`Z5=9'r SIGNATURE OF AP ICAOR AGENT DATE *< x 0.90-erl 11 Nis p son 0 Da •-A r-40 10m -` APPLICATION FOR PERMIT tu[D q DEPARnIENT OF BUILDING AND SAFETY ELECTRIC COUNTY OF LOS ANGELES WM J FOX CHIEF ENGINEER i Ir NATURE OF INSTALLATION o15T�TINO GRc UP I tNE PE7Rhif T No I WIRrNA FIXTUREflix i SERVICE 1 77 % D BY READY ►OR DAT[ I• U[D RAM09 H[AT[R POWER FIRST INSPECTION A };�y1 MItCELLAN[OU6 �� 1 �t.i `s APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY Joe r NANi ADDRESS db i dADDRESS LE+ R/ r r LOCALITY NEAR ^ y CITY��( (JCG.{/UA TCL No �� CROeaRSTCOUNY ^at f'• 1 n C [ C RT TNO [XPIRIES /� itNAM[ r i +y DESCRIPTION OF NOK-9 Z MAIL A I ADDRESS NUMBER OF OUTLETS ON CIRCUIO T! LOCATION RT ROOMS CITY TEL No LIGHT OUTLETS law l PLUGS n>R I AM THE LEGAL POSSESSOR OF THE ABOVE LOS 1 "e`LItT ( . n r r ►J ANGELES COUNTY CERTIr�E OF ALIFIC�710`� I n - l i +" LIVING ROOM 6LZGTMCIA3Q e / DINING ROOK ABOVE TME LEGAL OWNER OFTHE PROPERTY DESCRIBED t BRFST RM I _ � ' ornru BATH -- CORRECTIONS � 5 ENT HALL -- i, HALL NO 1 �Fi10NT 1'oRr;I'1 _ l.kA 'r w A, i�T .^ r`JT. h Ifi I KITCHEN II Y 1 '♦ Y — u r `L°SET — So" No O CLOBET ' •`r O F lJ A l A-*f � T S y To-At +� • : I tx s r NO OF OUTLETS ' '' ` ' + r APPROVALS I nI`Y jy X OAT[ h•?P[G'TOR a IaA1tt a 'wK Ia1�`„li r A4 f� l�"� h lko DP NIOTopt" t N P w v CONDUIT l a i^ • r^r�J Y: fy Ay, Y .A..n.�.1�1 .J�fi Y Cam v - �l •..un �-�wrr T as<s+ h^f n. ! �r Y` tris - TaAtis .� w,NINO a NO Or RANGES OR NEATERIIk"iItA'— 1 < rc� �3 FIXTURES y M "'� .' �s";♦,1�.T°Yn> $^, y:4 'I H.'; ," {<_"' POW[R t a ° '^.�,�i'1,1?4 1 v rd rc MPT r vla .e)+�&�u �3z f 2 I ILITYCO NOTIFIED 4 i ' 6t7k ti FINAL - r�tq�,"'i�"y��, wf KI�r 1t i^ DR S ,ti.. APPLICATION FOR PERMIT DEPARTbiENT OF BUILllING AND SAFETY �� 11�� COUNTY OF'LOS ANGELES WM J FOX cHler [NOt/JEC�. 4 NATURE OF INSTALLATION DIM RIOT No GROUP 2oNE PERMM No ,- WIRING FIXTURES fi+'RVIC[ �• 1 �{�� -_5 7 RANGE HEATER RECEIVru IIY READY FOR DAT[ ipV[D K POWER FIRST INSPt �I/oN r StGNB MISC[LLANEOUf .�^ .�/Q APPLICANT FILL I HEAVILY DUTLINED PORTION ONLYY zEA ME JOB [� 3 DRe LL.s LOCALITY NKARrsT J I c TV EyMJ/ TEL No CROSS fT ' G f �r I CERT NO EXPIRES K NAM[ ti DESCRIPTION OF WORK i MAIL NUMBER Or OUTLETS ON CIRCUITS 3 IADDRESS LOCATION BY ROOMS 0 r I LIGHT OUTLETS 18W I PLUGS nxT CITY TCl No i I 1 AM THE LEGAL POSB[SSOR OF THE ABOVE LOS CIRCUT A I B � C D E ! c ( r y ANGELES COUNTY CERTI�Or A ' �Nj LIVING ROOM I (iw/aG,�fF'C�iQtQo tL[CTRICIAN i DINING ROOM ABOVE 1 AM�[L[IIAL OWN[R Or THE PROPERTY D[[CRIt[D j BRFST RM -� ry BATH 1 I O�►N[R ENT HALL / _ CORRECTIONS f HALL NO .k t"ONT►nRw4 ! ' fw.Fl: K- ITCHEN ! I-II 4 rv/w1r.�+ IG BORN No ZCLOSET BDRM CLOB[T '�- t � SY TOTAL T i NO OF OUTLETS s APPROVAL$ NO OF FIXTLREf S v DATr NO OF MOTORS N P A+ CONDUIT TRAMS ■b \ L Y - _ ,t "r NO Or [ATERf S S FIXTUR[S r �7 POWER PERMIT�_ ' - r � t1TILI7Y TOTAL NOTfIt[D` ,��tpywx TOTAL FE[ FINAL- bra V•, .'...`. ' _ �-._. .'.- .. � � mow..• ' ,j � .u NAME • : Electric. • • w • • - 7-. • • . f r _ • w • LOCALrnr Temple owe _ • • �� t = 11 • �■■�■��■■ i iXof I role NOW ■ �■� IN■ w _ R Will - � .• _ _- '.meq ltlt'..._ , . ... . .. � . ._ :ter. = -�