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Home My Public Portal About9422 BLACKLEY ST_Electrical__ 76A663.CF_ 806R'1.077 APPLICATION FOR ELECTRICAL PERMIT��"'41` � . COUNTY OF LOS ANGELES I� y DEPARTMENT OF COUNTY ENGINEER JOB 7ADDRESSBUILDING AND SAFETY DIVISIONFOR APPLICANT TO FILL IN New Residential Bldgs.&Pools $EACOH25 NO. $ FEE NEAREST 1 &2-Family,Sq. Ft. R Multi-family Sq. Ft. .02 — ME Residential Swimming Pools 25.00 MAIL ADDRESS Outlets: Rec Light_Sw. CITY Tel.No. G/ First 20 .50 PLAN CHECK Total No. Additional .30 APPLICANT ADDRESS Lighting Fixtures First 20 .50 CITY Tel. No. Additional .30 PERMIT Total No. APPLICANT Fixed Applionces'Not0 er 1 HP ADDRESS Range—Heater D.W.` CITY Tel. No. Oven _Dryer_W.M. LICENSE OR Top —FAU —W.H. REG.NUMBER Class. Hood,Fan `Other, ry t HEREBY ACKNOWLEDGE THAT HAVE READ THIS APPLICATION AND STATE Disp.. _ Room Air Cand. 2.50 I K `� THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDIN- ANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. Power Apparatus&Large Appliances Size&Type HP, KW, KVA, or KVAR I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM y� Up to 1 Incl. 2.50 THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY, Over 1 to 10 Incl. 5.00 Over 10 to 50 Incl. 12.50 PERMITTEE SIGNATURE O Over 50 to 100 Inc. 25.00 ES C) Over 100 40.00 DISTRICT NO. PRO SED,BY a S'y Z�� al rrr ,r z Services 0- 200 Amp.Under 600 V 12.50 INSPECTOR'S 201-1000 Amp.Under 600 V 25.00 APPROVALS DATE SIGNATURE Over 1000 Amp.or Over 600 V 50.00 TEMP. POWER POLE 10.00, UNDERSLAB WORK Temp. Power Pole&Appurtenances 00 ROUGH CONDUIT0,/� � � �®,;�-e • z Sign with One Branch Circuit 10. , Additional Sign Branch Circuits 2.00 WIRING Misc.Conduits&Conductors 10.00 FIXTURES Other(See Complete Fee Schedule) POWER AUTHORIZED UTILITY CO.NOTIFIED FINAL PERMIT FEE (Sub-Total) NOTES z PLAN CHECKING FEE (One-Fourth Permit Feel �y PERMIT ISSUING FEE $7.00 TOTAL FEE PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.0. CASH 6 1MAY 24 2 U SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 76A663 if* 604k It/77 APPLICATION FOR ELECTRICAL PERMIT - COUNTY OF LOS ANGELES t DEPAOTMENT OF COUNTY ENGINEER JOB BUILDING AND SAFETY DIVISION ADDRESS FOR APPLICANT TO FILL IN LOCALITY /d New Residential Bldgs.&Pools EACH NO. FEE CNEAREST ROSS SL /T �� S 1`}i� %� G� 1 &2-Family,Sq. Ft. $ .025 - $ OWNER OR Multi-family Sq. Ft. 02 - FIRM NAME a•-L'f Residential Swimming Pools 25.00 MAIL ADDRESS 5 41 2- A L-J�PLGZ L_.1 Outlets: Rec .210 Light 10 Sw. CITY T c_- Tel. No -Zea 2 First 20 .50 20 PLAN CHECK Total No. 33 Additional 30 1Z VO APPLICANT ADDRESS Lighting Fixtures First 20 .50 f0 CITY Tel. No. Additional .30 PERMIT Total No. APPLICANT Fixed Appliances Not Over 1 HP ADDRESS Range_Heater-D.W._ CITY Tel. No. Oven_Dryer-x-W.M.-y- LICENSE OR Top -FAU -W.H. REG. NUMBER Class. Hood- Fan _Other__ �+� 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE Disp. - Room Air Cond. 2'50 L V THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDIN- ANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. Power Apparatus&Large Appliances' Size&Type HP, KW, KVA, or KVAR I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM S•' Up t0 1 Incl. 2.50 THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. - C Over 1 to 10 Incl. 5.00 v PERMITTEE Over 10 to 50 Incl. 12.50 SIGNATURE C C i( i Over 50 to 100 Inc. 25.00 Over 100 40.00 DISTRICT NO. ED BY d M Services ` 0-200 Amp.Under 600 V 12.50 APPROVALS DATE IN NATOURE 201-1000 Amp.Under 600 V 25.00 Over 1000 Amp.or Over 600 V 50,00 TEMP. POWER POLE r Temp. Power Pole&Appurtenances 10.00 UNDERSLAB WORK 10.00 ROUGH CONDUIT s 7 9 J Sign with One Branch Circuit -'"�• Additional Sign Branch Circuits 2600 WIRING Misc.Conduits&Conductors 10.00 FIXTURES Other(See Complete Fee Schedule) POWER AUTHORIZED UTILITY CO.NOTIFIED FINAL . PERMIT FEE (Sub-Total) NOTESLZ Az PLAN CHECKING FEE (One-Fourth Permit Feel PERMIT ISSUING FEE $7.00 TOTAL FEE p PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK: M.O. CASH SEE BACK OF APPLICATION FOR COMPLETE SC FDULE - 76A663 CE 806R 10,77APPLICATION FOR ELECTRICAL PERMIT� � j � COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER 7ADDRESS BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN New Residential Bldgs.&Pools EACH NO FEE 1 &2-Family,Sq. Ft. $ 025 — $Multi-family Sq. Ft. .02 — Residential Swimming Pools 25.00 MAIL ADDRESS Outlets: Rec Light_Sw. CITY Tel. No. First 20 .50 PLAN CHECK Total No. Additional .30 APPLICANT ADDRESS Lighting Fixtures First 20 .50 CITY Tel. No. Additional .30 PERMIT Total No. APPLICANT Fixed Appliances Not Over 1 HP ADDRESS fRange_Heater_D.W._ CITY Tel. No. Oven_Dryer_W.M. LICENSE OR Top —FAU —W.H._ REG.NUMBER Class. Hood_Fan _Other- 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE Dlsp. - Room Air Cond. 2'50 THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDIN ANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. Power Apparatus&Large Appliances a Size&Type HP, KW, KVA,or KVAR I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS U 2.50 REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM Up to 1 Incl. THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. W Over 1 to 10 Ind. 5.00 J_ Over 10 to 50 Incl. 12.60 PERMITTEE Over 50 to 100 Inc 25.00 SIGNATURE Over 100 40.00 DISTRICT NO. PROCESSED BY O ;r a Services `" ►��+-I 0-200 Amp, Under 600 V 12.50 APPROVALS DATE INSPECTOR SIGNATURE01-1000 Amp.Under 600 V 25.00 Over 1000 Amp.or Over 600 V 50.00 TEMP. POWER POLE UNDERSLAB WORK Temp. Power Pole&Appurtenances 10.00 10.00 ROUGH CONDUIT Sign with One Branch Circuit 2.00 WIRING Additional Sign Branch Circuits Misc.Conduits&Conductors 10.00 FIXTURES Other(See Complete Fee Schedules POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL PERMIT FEE (Sub-Totol) NOTES PLAN CHECKING FEE (One-Fourth Permit Feei PERMIT ISSUING FEE $7.00 TOTAL FEE PLAN CHECK VALIDATION CK M O. CASH PERMIT VALIDATION CK M O CASH SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 76A663-CE806 9-64 APPLICATION FOR ELECTRIC L PERMIT1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER FADDRESS ILDING �` /� BUILDING AND SAFETY DIVISION ,2 G- ,C7 /e JOHN A. LAMBIE, COUNTY ENGINEER y�� r//�� () COLEMAN W. JENKINS, SU P'T. OF BUILDING CALITY ��// /C.AREST ke SSCi r' FOR APPLICANT TO FILL IN cRoss sr. REC EPT. TOTAL NO EACH FEEFETS u OU7 V FIRST 20 $20 s � MAIL OWNER UL LIGHT ADD'L 10 ADDRESS 'Z, I l QGI\ 'T� SWITCH. OVER 20 Jay 7-1 LIGHTINGF-T- IFIRST 20 20 CITY Y oll CLT TEL. NO. LVL`FIXTURES I ADD'L 10 ELECTRICIAN O'r R 20 RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS GARB.DISP. STA.COOK CITY TEL. NO. DISHWASH. AUTO.-WASH. STATE SPACE HTRS. STA.APP.(ys H.P.MAX.) .5O LICENSE NO. MOTORS: OVER NOT OVER H.P. DI�T�ICLT pI•q: GR P Z E P ED O 1 1.00 (��)[J�/ a 1 3 1.5o INSPECTION RECORD 3 8 2.00 IL 8 15 2.50 15 50 3.00 O H so 100 5.00 V W SIGNS: NO.TRANS- D- NO.LAMPS N Z SERVICE 0-600V-NOT OVER 200A 1.00 SERVICE 0-600V-OVER 200 A. 2.00 SERVICE OVER 600V 5.00 MISC. PERMIT ISSUING FEE 2.00 SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING _ ELECTRICAL WIRING. WIRING I HEREBY .CERTIFY THAT AM PROPERLY REGISTERED AND/OR FIXTURES `'• LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. POWER SIGNATURE /_��{�rUTILITY CO.NOTIFIED OF PERMITTEE C` -[ t // FINAL _ /, A IDATION JOSEPH C. ROOHAN CK MO CASH SUPERVISING ELECTRICAL ENGINEER LiLc3 4 5 3'103 JUL 8 2 D 5A0- WORKERS'COMPENSATION DECLARATION -663 10/$1 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self insure, CE-806G or IA certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY coF7 thereof (Sec.3800,Lab. C.) A• � �K/ J ' FOR APPLICANT TO FILL IN JOB y NO.2 �`� Company ADDRESS Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ❑ 1 & 2-Family,Sq.Ft. $ — $ LOCALITY cls Certified copy is filed with the county building inspection _ NEAREST dep tment. Multi-family Sq.Ft. CROSS ST. Date a 3 9- Applicant �j_� Residential Swimming Pools OWNER OR , FIRM NAME r CERTIFICATE OF EXEMPTION FROM WORKERS' � ` MAIL COMPENSATION INSURANCE Outlets:Rec Light — Sw. / ADDRESS (This section need not be completed if the work involved by the First 20 love vg7yl permit is for one hundred dollars($100) or less.) Total No. Additional CITY 4ekC"` Tel. PLAN CHOCK I certify that in the performance of the work for which this permit APPLICANT is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS Additional Total No. CITY Tel.No. n Date Applicant Fixed Appliances Not Over 1 HP NOTICE TO APPLICANT: If, after making this Certificate of PERMIT Exemption,you should become subject to the Workers'Compensation Range_ Heater_ D.W. _ APPLICANT provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer W.M._ ADDRESS provisions or this permit shall be deemed revoked. Top — FA W.H. _ LICENSED CONTRACTORS DECLARATION Hood _ Fan Other_ CITY Tel.NoOR . I hereby affirm that I am licensed under provisions of Chapter 9 LICENSE DiSp. ROOMB •Air Cond. REG.NUMBER Class. (commencing with Section 7000) of Division 3 of the Business and Professions Code,and my license is in full force and effect. Power Apparatus& Large Appliances DISTRICT NO. �(N P SSED BY e �,p Size& Type HP, KW,KVA,or KVAR �v �� 0 License Number Lic.Class p Up to 1 Incl. FINAL Contracts Date 3 /� Over 1 to 10 Incl. DATE �7 . �/l� VALIDATION M Over 10 to 50 Incl. ! T FINAL E] 1.1 I am exempt under Sec. Over 50 to 100 Inc. BY CLB.&P.C.for this reason Over 100 Z Services,Swbd.,MCC& Panelboards ® _ Date: 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 y I hereby affirm that I am exempt from the Contractor's License Law . •(-` °s for the following reason(Section 7031.5, Business and Professions Additional Sign Branch Circuits Code): 330 !I°(!-.'• ❑ I,as owner of the property,will do the work and the structure Misc.Conduits & Conductors ITEMS is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) ® i f i HL 5O 7 C' and Professions Code). CHECK CONSTRUCTION LENDING AGENCY _ I hereby affirm that there is a construction lending agency for the }=FiA,lt of=' ' performance of the work for which this permit is issued(Sec.3097,.- PERMIT FEE (Sub-Total) Civ.C.). PLAN CHECKING FEEj}[(; )]_I j(Ji(I 7/13/95. Lender's Name PERMIT ISSUING FEE Q 13161 1 AM 11'.;, Lender's Address I certify that I have read this application and state that the above TOTAL FEE *1'70 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 inspection puraps SEE REVERSE FOR EXPLANATORY LANGUAGE _'SMna ure of Permittee Zate