HomeMy Public PortalAbout5208 BARELA AVE_Electrical__ CITY OF TEMPLt 0th
78AGGS-CE906 10:82 APPLICATI.ON FOR ELECTRICAL •PERMIT .�
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER _BUILDING •5 �1 U
BUILDING AND.SAFETY-DIVISION ADDRSSS �+
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A.JENSEN,SUPT.OF BUILDING .,LOCALITY.
NEAREST
FOR APPLICANT TO FILL IN CROSS.ST.
RECEPT. TOTAL NO. EACH FEE
OUTLETS. FIRST 20' $20 IIIOWNER ' .
.
LIGHT MAIL � e
ADD'L ADDRESS 2lp• iy (/li1J C.r/YGQ !a
SWITCH'. OVER 20,4" .10 ���.� _
TOTAL CITY
LIGHTING FIRST 20 :20 !ti TEL.N
FIXTURES ADD'Lf0 ELECTRICIAN �e ,
OVER 20
RANGES CLO.DRYERS WTR.HTRB. 1.00 ADDRESS '
GARB.DISP. - STA.COOK i
CITY TEL....Pz
DISHWASH. AUTO.-WASH. STATE
SPACE HTRS. STA.APP.(y$H.P.MAX.) .50 LICENSE
MOTORS: OVER NOT OVER H.P. DISTRICT NO GROUP -Z NE jPROCEfjSED BY
o 1 .1.00 s
1 s., ayY f.so INSPECTION RECOR y
3 s 2.00
a
s ss 2.50 Aiv
15 so 3-.00 "
so foo 5.00 ►�-�t�-�'`tfil.C��"` r" % •;` O
NO.TRANS.
S`GN3: NO.LAMPS .
SERVICE 0-600V=Nor OVER 200A 1.00
SERVICE 0-600V-OVER 200 A..' 2.00
SERVICE OVER 600V 5.00
MISC.
PERMIT ISSUING FEE 2.00 ( Oo
SUP-ELEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE $ '
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREETO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES. AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING J l'7,� (f � ;✓�+„/w _;1'Iry
I 11EREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR ,.!
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES 701/6 rP`F�Y
CALIFORNIA OR THAT I A THE LEGAL OV�DFER�OF THE ABOVE , ; :• '
DESCRIBED RESIDENTIAL P PERTY. J �Q .POWER -
SIGNATUR e (\`// —
Ft UT LITY CO.NOTIFIED
OR PERMITTEE FIN \ / n°� {, ,��• /YJarf/r/l it J
ALID I.ON ARTHUR-C. VEIT
O CASH SUPERVISING ELECTRICAL ENGINEER
:9:9 6.5;3 JUN-11 2 D 3:50- V.
WORKERS'COMPENSATION DECLARATION 10/81 APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I have a certificate of consent,to self CE-806G ,
insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY
or a certified copy thereof(Sec. 3800, Lab. C.)
PolicyNo.—Company FOR APPLICANT TO FILL IN JOB
EJCertifiedcopy is herebyfurnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS 6:` (n V T3,Q fe .,o `.
❑ Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. C�U $ —Is LOCALITY r o f'i)
tion department. Multi-family S . Ft. — NEAREST 1
P Y q
CROSS ST. &I i�
Residential Swimming Pools OWNER OR
Date Applicant ` FIRM NAME (-7 - �p 4 1-1
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec /O Light Sw.� DDRESS ' / �-e
COMPENSATION INSURANCE First 20
JA
(This section need not be completed if the work involved by Total No. �� CITY Tel. No.
the permit is for one hundred dollars ($100)or less.) Additional �/' 7
PLAN CHECK
1 certify that in the performance of the work for which this APPLICANT
permit is issued, I shall not employ person in any manner
so as to become subject to the Wo rs`Compensation Law . Lighting Fixtures First 20 ADDRESS
Additional
/�`C�.� 1 � �� Total No. CITY Tel. No.
Date Applicant Fixed Applicm es Not Over 1 HP PERMIT
OTICE TO APPLICANT: If, after making this Certificate of APPLICANT
E emption, 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 _Other— CITY Tel. No.
LICENSED CONTRACTORS DECLARATION LICENSE OR
I hereby affirm that I am licensed under provisions of Chapter Disp. — Room Air Cond. REG. NUMBER Class.
(commencing with Section 7000) of Division 3 of the Business Power Apparatus&Large Appliances DISTRICT NO. FIR SED BY >_
and Professions Code,and my license is in full force and effect.
Size&Type HP, KW, KVA, or KVAR' O
License Number Lic. Class Up to 1 Incl. FINAL tJ
Over 1 to 10 Incl. DATE/ VALIDATION
Contractor Date FINAL I.-
❑ Over 10 to 50 Incl.
1 am exempt under Sec. Over 50 to 100 Inc. BY e to t_ LU
B.&P.C. for this reason Over 100
Date: Services, Swbd., MCC& Ponelboar ,
0 -200 Amp. Under 600 V
Signature 201 - 1000 Amp. Under 600 V
❑ Over 1000 Amp. or Over 600 V
Exemption for Reg. Maint. Elect.
SINGLE FAMILY Temp. Power Pole &Appurtenances
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 8 2 2.2 R
I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits
Law for the following reason (Section 7031.5, Business and + 0 0 0 0 0 2
Professions Code):
❑ I, as owner of the property, will do the work and the Misc. Conduits&Conductors 2 o 0 J 6 7 0
structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_
7044, Business and Professions Code). , 0 0 0,v 6, l 0
CONSTRUCTION LENDING AGENCY. 12,09-82
I hereby affirm that there is a construction lending agency for
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
PERMIT ISSUING FEE �
Lender's Address
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
hereb uthorize representatives of this County to enter upon
the ve-mentioneperty fo inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Permittee Date