Loading...
HomeMy Public PortalAbout9535 BLACKLEY ST_Electrical__ 76ASS3 DBS SA 3-SO APPLICATION FOR PERMIT I ' bEPARTMENT OF BUILDING AND SAFETY ' COUNTY OF LOS ANGELES t ( WILLIAM J. FOX, CHIEF ENGINEER 1 FOR APPLICANT TO FILL INDISTRICT NO. GROUP ZONE PERMIT N.G. ELECTRICIAN Pte\ �" �" j_{,� tRECEIVED BY READY FOR DATE ISSUED ADDRESS "! C�l• �✓ �q, -- FIRST INSPECTION C CITY O L N0. A-; ��qa 8 C.dam'. COUNTY LICENSE NO. f EXPIRES J BUILDING(,j a yr PERMIT FEES ADDRESS (I NUMBER EACH FEE LOCALITY /'fn Bd D T! ,A' , `L- s`� L LIGHT OUTLETS NEAREST CROSS Q CROSS ST. ( I 'I) V e PZ RECEPTACLES �p �y WALL SWITCHES —OWNER '� R� D e A I �® '1 tlA O TOTAL OUTLETS 5c $ MAIL ELEC. RANGES 25 ADDRESS ELEC. HEATERS 25 �- 6 2 CITY ,Q -y��,{� (o_i TEL. NO. 74 FIXTURES 5 I HEREBY VACKNOWLEDGE THAT i HAVE READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT I POSSESS THE ABOVE VALID LOS _NUMBER HORSEPOWER FES ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER NEw MvD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. %2 & LESS $ .25 SIGNATURE OFA _ I/2 2 .50 PERMITTEE..dd�1�2 :A,,)f t�" '�/`�„�i�..l'�-ti..Si_%r--ti•--� l+ 2 s 1.00 INSPECTION RECORD 5 15 1.50 15 5o 2.50 so 200 5.00 ,�N1y-�t/�.�A' �.�,/�?o.✓t /t/ G� F�� K" 200 500 10.00 ',� 4 ov to Q Soo 1000 15.00 Z OVER 1000 20.00 � ' �' e:)" �,OQ 5 M.G. SET/FREQ. CHANGER-HP D WELDERS: AC-KVA � 'Q i / /I __ __-r= O GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF ORIG.) MOVED MOTORS (75% DF BRIG.) MISC. SIGNS NO. NO.TRANS. APPROVALS No. NO. LAMPS DATE INSPECTOR'S NAME FOR EACH PERMIT: WIRING !$1.00 � �9'® CONDUIT / FIXTURES $1.00 WIRING SUPPLEMENTARY .50 FIXTUREB POWER TOTAL FEE 1$ 2, -� UTILITY CO.NOTIFIED FINAL y6A663 DBS SA 6-49 ® APPLICATION FOR PERBUT DEPS RTANT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER ELECTRIC 1 FOR APPLICANT TO FILL IN DISTRICTNO. GROUP ZON/ // E 'EMIT NO. ELECTRICIAN n RECEIV,ED,BY READ FOR DATE ISSUED ADDRESS FIRST INSPECTION CITY TEL. NO. COUNTY LICENSE NO. EXPIRES BUILDING / PERIyiIT FEES ADDRESS g� / .15-(' Lek �. NUMBER OUTLETS EACH FEE't� LOCALITY //�� 22 I� LIGHTS Sc I$ �' v NEAREST RECEPTACLES 5 I D CROSS ST. fIlf FIXTURES 5 >--10 OWNER BB7�it gam.. ��✓I _ 1� f, WALL SWITCHES 5 I �rU MAIL ADDRESS /67 ELEC. RANGES ELEC. HEATERS 25 I� CITY (6 ,� 570 Al TEL. NO. I MISC. I 1 HEREBY ACKNOWLEDGE THAT 1 /HAVE READ THIS NUMBER OF CIRCUITS INSTALLED: 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 i POSSESS THE ABOVE- VALID LOS FEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER NEW MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.` %¢&LESS $ 2S Yz 2 .50 SIGNATURE OF PERMITTEE 2 5 1.00 5 15 1.50 INSPECTION RECORD 15 50 2.50 50 200 5.00 I - 200 500 10.00 - 500 1000 15.00 - J Q 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.) I� MISC. SIGNS TYPE: NO. TRANS. TYPE: NO. LAMPS APPROVALS DATE INSPECTOR'S NAME FOR EACH PERMIT: WIRING $7.00 CONDUIT t� FIXTURES $1.00 WIRING SUPPLEMENTARY .50 FIXTURES ^^� POWER TOTAL FEE $ 3 y v UTILITY CO. NOTIFIED h FINAL - ��' WORKERS'COMPENSATION DECLARATION za8DPW 3/87 APPLICATION FOR ELECTRICAL PERMIT O i hereby,Affirm that have a+certificate of consent to self CE76A663 -806G insure,•ov a certificof� of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a oertified copy thereof (Sec. 3800, Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB ❑Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS ❑Certified copy is filed with the county building inspec- 1 & 2-Family, Sq. Ft. $ — $ LOCALITY tion.department. Multi-family Sq. Ft. — NEAREST Residential Swimming Pools CROSS.ST. Date Applicant ' y OWNER OR t CERTIFICATE OF EXEMPTION FROM WORKERS' J & MAIL FIRM NAME COMPENSATION INSURANCE Outlets: RecTLight Sw. D2�0 / O ADDRESS t� First 20 (This section need not be completed if the work involved by Total Na. 6;7-v Additional CITY Tel. N :,.gb-�1 ' the permit is for one hundred dollars ($100)or less.) PLAN CHECK I certify that in ;he 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. Lighting Fixtures First 20 ADDRESS Additional Total No.� CITY Tel. No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of APPLICATION Exemption, you should become subject to the Workers' Range—1leater—D.W. — 44 4,tj Compensation provisions of the Labor Code, you must forth- Oven :2 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 9 Disp. — Room Air Cond. — REG. NUMBER Class. (commencing with Section 7000)of Division 3 of the Business Power Apparatus & Large Appliances DISTRICT NO. P CESSED BY >_ and Professions Code,and my license is in full force and effect. t1 Size &Type HP, KW, KVA, or KVAR ,fGa t- � U License Number Lic. Class Up to 1 Incl. FINAL U Contractor Date Over 1 to 10 Incl. DATE f �l VALIDATION Cc Over 10 to 50 Incl. FI_NA / H ❑ I am exempt under Sec. Over 50 to 100 Inc. gY ,/%._/ U B.&P.C. for this reason Over 100 M a Services, Swbd., MCC& Ponelboards ZZ 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 F,-.;: tr I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit H+::_. r e Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits :{ - It 1 1 4 Professions Code): i T 11 L =; I, as owner of the property, will do the work and the Misc. Conduits& Conductors structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ # jj m - Business and Professions Code). r"" C i I CONSTRUCTION LENDING AGENCY ``HECK L° I hereby affirm that there is a construction lending agency for s 1,if ­_ the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) 8 (Sec. 3097, Civ. C.). PLAN CHECKING FEE 41S0 1'1— lil !� ;' Lender's Name s PERMIT ISSUING FEE / x• i A. PERMIT {o ?t 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 hereby authorize representatives of.this County to enter upon bove-mentioned propert for inspection purposes. .3� NM �)?_ SEE REVERSE FOR EXPLANATORY LANGUAGE Signature o Permittee ' ate ©s WORKERS' COMPENSATION DECLARATION 20-0019 DPW 3/87 APPLICATION FOR ELECTRICAL PERMIT O ' I hereby CE.806 affirm that I have a certificate of consent to self CE-eoeG insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or Q certified copy thereof (Sec. 3800, Lab. C.) Policy NCompany FOR APPLICANT TO FILL IN JOB 1/4e Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS Certified copy is filed with the county building inspec- 1 & 2-Family, Sq. Ft. $ _ $ LOCALITY tion department. Multi-family Sq. Ft. NEAREST CROSS ST. v Residential Swimming Pools ((J� Date Applicant FOIRM NAME l� �k�-,.. �Yl.4 f-'atf- CERTIFICATE OF EXEMPTION FROM WORKERS' : Re o �" MAIL COMPENSATION INSURANCE Outlets —LightI Sw._ ADDRESS (This section need not be completed if the work involved byTotal No. AddiFirst 2onal [� ` CITY TelNo 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. Lighting Fixtures First 20e57,0ADDRESS Additional Total No. Is— CITY Tel. No. Date Applicant TO APPLICANT: If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT- NOTICE 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. Hood — Fan —Other— CITY Tel. No. LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. REG. NUMBER Class. (commencing with Section 7000)of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO. P OCESSED BY >- and Professions Code,and my license is in full force and effect. Gr- C�� 0 \Size 8 Type HP, KW, KVA, or KVAR O License Number Lic. Class �Y Up to 1 Incl. 7,70 FINAL U Contractor Date Over 1 to 10 Incl. DATE F g.� VALIDATION 01 Over 10 to 50 Incl. 1 !/ F- I U I am exempt under Sec. Over 50 to 100 Inc. BY LU B.&P.C. for this reason Over 100 d g Services, Swbd., MCC& Panelboards z 1 / Q Z Date: 0- 200 Amp. Under 600 V 1 — Signature 201 - 1000 Amp. Under 600 V QOver 1000 Amp. or Over 600 V Exemption for Reg. Maint. Elect. SINGLE FAMILY Temp. Power Pole& Appurtenances HOME OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit :_,::; e Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits Pro essions Code): '' r -i -._. I, as owner of the property, will do the work and the Misc. Conduits&Conductors structure is not intended or offered for sale Section 7044, Other (See Complete Fee Schedule)_ 0 Business and Professions Code). r ` CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for s_• 11'i' % 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 s 11_!! PERMIT ISSUING FEE O - -- Lender's Address 320 `' - 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 the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date ©s