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HomeMy Public PortalAbout9527 BLACKLEY ST_Electrical__ 76A663,+E 8W5R 9/76 f V�H�k� APPLI � ION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES j DEPARTMENT OF COUNTY ENGINEER JOB 7ADDRESIS /� L BUILDING AND SAFETY•DIVISION, p FOR APPLICANT TO FILL IN TY re M New Residential Bldgs &Pools EACH NO FEE NEAREST ST1 &2-Family,Sq Ft $ 025 — $ T Multi-family Sq Ft 02 — FIRM NAME l l- Residential Swimming Pools 2000 ) MAIL cP� ADDRESS J M 2 Outlets Rec Light Sw_ _ CITY Tel No _ JQ 6 First 20 50 PLAN CHECK Total No Additional 30, APPLICANT ' ADDRESS Lighting Fixtures First 20 50 CITY el No Additional 30 PERMIT Total No APPLICANT ' Fixed Appliances Not Over 1 HP ADDRESS 1-2 MorAda. ra 9()637 Range_Heater=D W CITY Tel No Oven i Dryer—W M_ LICENSEOR Top —FAU _WH _ REG NUMBER © Class 'Q Hood—Fan _Other— - I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE Disp _'Room Air Cond 2 00 THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDIN- ANCES AND STATE LAWS REGULATING ELECTRICAL WIRING I 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 Up to 1 Ind 2 00 THE LEGAL OWNER OF THE ABOVE DESCRIBED RES; ENTIAL PROP TY Over 1 to 10 incl 5 00 Over 10 to 50 Incl 1000 PERMITTEE 0 Over 50 10 100 Inc 2000 SIGNATURE V 30 00 Over 100 DISTRICT NO PROCE ED BY Services �� 0- 200 Amp Under 600 V 12 50 APPROVALS DATE INSPECTOR URE 201-,1000 Amp Under 600,V' 25 00 Over 1000 Amp or Over 600 V '• 5000 TEMP POWER POLE UNDERSLAB WORK Temp Power Pole&Appurtenances 1000 -1000 ROUGH CONDUIT Sign with One Branch Circuit 200 Additional Sign Branch Circuits WIRING M;sc Conduits&Conductors 1500 FIXTURES ' Other(See Complete-Fee Schedule) POWER AUTHORIZED UTILITY CO NOTIFIED ' Q e FINAL / —7 i7 PERMIT FEE (Sub Total)' NOTES PLAN CHECKING FEE (One-Fourth Permit Fee) PERMIT ISSUING FEE $600 a TOTAL FEE � - PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK -M O CASH r 2 6 2"','VkR. G ? .0 0 at;�, SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE - ®f i 78A883 DBS SA 5-49 ® APPLICATION FOR PERMIT DEPARTMENT OF,BUILDING AND SAFETY pp�� COUNTY OF LOS ANGELES E Ear T I 1' WILLIAM J, FOX, CHIEF ENGINEER FOR APPLICAN^TO FIL��IN DISTRI O. GROUP ZONE PERMIT NO. ELECTRICI _ r /b��� RECEIVED BY READY FOR - DATE'ISSUE'D ADDRESS FIRST INSPECTION 2-L CITY yy��I� EL NO d I .: 47 COUNTY LICENSE NO. 0 EXPIRES d BUILDING 1,12?Jn fj1 PERMIT FEES ADDRESS !/K I/u FEE NUMBER OUTLETS EACH ... LOCALITY ' LIGHTS Sc i$ NEAREST e RECEPTACLES 5 7- CROSS ST. /V / /©q FIXTURES 5 I �(/ OWNER / r t V WALL SWITCHES 5 _ MAIL ELEC. RANGES 25 'L ADDRESS ELEC HEATERS 25 I S CITY - TEL NO, MISC. -, I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS NUMBER OF CIRCUITS INSTALLED: ,�z APPLICATION AND STATE THAT THE ABOVE IS CORRECT LIGHTS , RECEPTACLES / AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES MOTORS AND STATE LAWS REGULATING ELECTRICAL WIRING. NUMBER HORSEPOWER 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS- FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER NEw •Mvo. HP OVER I INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. a LESS $ .25 I/2 •2 .50 SIGNATURE OF - PERMITTED✓' l /JI i(/t,.T` 2 5 1 00 5 15 1.50 INSPECTION RECORD 15 50 2.50 50 200 5 00 200 500 10 00 ' 500 1000 1s 00 - _ _ J OVER 1000 20 00 Z M G SET/FREQ CHANGER-HP WELDERS: AC-KVA O GENERATORS - KW ' TRANSFORMERS - KVA TEMP. MOTORS (75% OF ORIG.) , MOVED MOTORS (75%,OF ORIG.) MISC SIGNS I•- TYPE: ��. NO TRANS - TYPE: NO LAMPS , APPROVALS DATE INSPECTOR'S NAME FOR EACH PERMIT- WIRING - $1.00 Qej CONDUIT q� WIRING FIXTURES $1 00 .0 V' SUPPLEMENTARY s0 - FIXTURES . ' POWER / n TOTAL FEE $ [ro UTILITY CO: NOTIFIED yam/0//! v FINAL / ..!/ ezz'47—1— viv f COUNTY OF LOS ANGELES, APPLICATION FOR PERMIT DEPARTMENT OF COUNTY ENGINEER ELECTRIC 1 -' DIVISION OF BUILDING & SAFETY WILLIAM . FOX COUNTY ENGINM FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRICIAN 0 Cs 5 = A— 99► s1 ADDRESS' NO RECEIVED BY READY FOR DATE ISSUED CITY TEL. r FIRST INSPECTION •�•� 3i—t O'c5 `4 COUNTY LICENSE NO. EXPIRES ADDREISS PERMIT FEES NUMBER EACH FEE / C 4 J LOCALITY ;/ LIGHT OUTLETS - NEAREST G!O7- RECEPTACLES ,Jr ROSS T. / e!' WALL SWITCHES OWNER L TOTAL OUTLETS 5c S - d MAIL ELEC. RANGES 25 ADDRESS ELEC. HEATERS 25 _ ,C FIXTURES 5 / CITY NO. MISC. I HEREBY ACKNOWLEDd THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITSAND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER New MYo. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. _ 1/z 8 LE86 $ 25 - - SIGNATURE OF 1/2 2 .50 PERMITTEE (((CCC���••• 2 ' s 1.00 INSPECTION RECORD 5 - 15 1.50 15 50 2.50 7/ .!C' dFld _W 50 200 5.00 � y 200 Soo 10.00 , J 500 1 1060 1 15.00 OVER 1000 20.00 M.G. BET/FREQ. CHANGER-HP WELDERS: AC-KVA " O GENERATORS -KW TRANSFORMERS mKVA TEMP. MOTORS (75% OF ORIG.) MOVED MOTORS (75% OF ORIG.) MISC.- SIGNS NO. NO. TRANS. APPROVALS NO NO. LAMPS FOR EACH PERMIT: DATE INSPECTOR'S NAME WIRING $1.00 OD CONDUIT WIRING FIXTURES $1.00 00 SUPPLEMENTARY - .80 FIXTURES y POWER, TOTAL OWER- TOTAL FEE' $ UTILITY CO. NOTIFIED \� FINAL- �Q 2.4 -s-1 76A 663 OBS# 6A. 4-62 , ' •' WORKERS'COMPENSATION DECLARATION 76-663 '' 10,81 APPLICATION� FOR ELECTRICAL PERMIT _ `I hereby affirm that I hake a`certdicate of consent tn'self insure, ,'CE-6osG ' yX a'certlicate of Workers' Compensation Insurance, or,a certified c ,".COUNTY OF LOS ANGELES 'BUILDING DING AND SAFETY o�reof S�e�/{ 3800 ab•C) f r O N 'COmpany FOR APPLICANT T_O,FILL IW,,. ," , JOB- - ❑ ,'Certified copy is herebyfurnished EACH* NO FEE ADDRESS ti New Residential Bldgs & Pools 1 & 2-Faintly, Sq Ft " $ — $ LOCALITY Certified 'copy is'ftled with the county bwldi! 'i0s NEAREST. 4 departm Multi-family Sq Ft CROSS ST Date Applicant' ' Residential Swimming Pools OWNER OR /� CERTIFICATE OF EXEMPTION FROM WORKERS, FILL NAME +' /L Outlets'Rec'�•Light Sw 7 '.,,COMPENSATION INSURANCE ' .'� .,,_ ADDRESS < r (This;section'need not-be completed if-the work involved-by.the First 20,,'•w; l permit•is for one hundred dollars($100) or less.), ,. } Total No Additional `"CITY ��� Tel No _ -J •'' - PLAN CHECK - ,P I certify that in the,performance of-,the work,for which this-permit,' ; APPLICANT' is'issued, I shall not.employ-any person in any manner so as to become subject to the Workers'Compensation Laws 'Lighting Fixtures First 20, ADDRESS-.`- ' Y 'Additional x Total No CITY Tel No Date'• Applicant Fixed Appliances Not Over'll HP PERMIT NOTICE TO APPLICANT, If,,after making this Certificate' of , APPLICANT p/L /Z /✓ Exemption,you should become subject to the Workers'Compensation Range_ HeateP_ DW , , 'provisions of,the'Labor.Code, you mustforthwith comply'with such Oven'_ Dryer W M ADDRESS provisions'or"this permit shall be deemed revoked " Top ' FAU W H' — `' CITY / Tel No" LICEN$ED'CONTFtACTORS DECLARATION ' Hood Fan Other' I hereby,affirm that,I am licensed under provisions of Chapter 9. LICENSE OR ". C Disp Room Air'%Cond- Class. (commencing wit h•Sectlon�7�000) of Division 3'of the Business and REG NUMBER 03;7 Professions Code,and'my license'is in full force`and effect`" DISTRICT NO PROCESS BY Power Apparatus& Large_Appliances rCZ0 - `,�3 O Size & Type HP, KW, KVA, or KVAR License Number OJ Lic Class (� a Up°to 1~Incl FINAL U• oN�,O/L R �/� pl Over 1 to 10,lncl . DATE ',�S/i� ,. IDATIONP" Contractor Date C 8 CJ O ,,Over 10 to 50 Incl`, FINAL to ETI,am exempt under Sec Over 50 to 100 Inc, BY LLJU B&PC for this reason ° Over 100 p„ Services,Swbd MCC ,&,& Z Panelboards ' ►' Z Date A 9 0 6 _ 0.- 200 Amp Under 600 V • Signature ' 201 1000 Amp'Under,600 V f -,_ q---- - - �-s' Over 1000'Amp or'Over 600 V # o'o-0 0 0 2 i Exemption for Reg Maint Elect „_ c _ .. } ° , SINGLE FAMILY_'' Temp Power Pole& Appurtenances • �'o o`23`25 HOME OWNER-BUILDER DECLARATION "o Sign with O ne Branch Circwt I hereby affirm that I am exempt from the Contractor's License,Law Y • o 0 0 2 3.2 S,cT3 d dinal;Sign Branch Circuits . for'the following reason(Section 70315, Business and Professions Add Code) r 0226-88' ❑, -+Misc Conduits'& Conductors _ I,as owner of the property,will clothe work and the structure isnot intended or offered for sale,(Section 7044, Business Othe�f(See Complete,Fee Schedule) and Professions Code)' CONSTRUCTION LENDING AGENCY I hereby'affirm that there ig'a construction lending"agency for the performance of the work for which this permit is'issued(Sec 3097, -PERMIT FEE:'- (Sub-Total),s ,Civ C) n _ PLAN CHECKING FEE Lender's'Name i. ,-PERMIT+ISSUING FEE Lender's Address ;: n`„ " -, ' [. I certify that I have read this application and state that the.labove TOTAL•FEE; / 'JJC information'is correct,I agree to comply-with all County ordinances and'State laws regulating'Electrical wring, and hereby authorize y" representatives"of this,County tito enter upon the above-mentioned ;. •' ' ' , , prop t or inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE.; ignatur f Permittee pate-