The URL can be used to link to this page

Home My Public Portal About9542 BLACKLEY ST_Electrical__ °s �J COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer n� L DIVISION OF BUILDING & SAFETY WILLIAM J. FOX, County Engineer FOR APPLICANT TO FILL IN _ DISTRICT NO. GROUP I ZONE PERMIT NO. ELECTRICIAN J2_PJt.Pff' Q/ �l ��`I R( RECEIVED BY READY FOR DATE ISSUED ADDRESSc FIRST INSPECTION TY CIi /1 , w rk_MTEL. NO. A/ V COUNTY LICENSE NO. EXPIRES - ADDRESS IXC PERMIT FEES NUMBER EACH FEE LOCALITY � LIGHT OUTLETS NEAREST CROSS 9T. AP RECEPTACLES WALL SWITCHES OWNERD TOTAL OUTLETS L::25 MAIL ryp� /� nn ELEC. RANGES ADDRESS / ! O 1 cl_ewELEC. HEATERS- - - � ��anr- CITY� �/�/1/ery� TEL. NO."�Q,QFIXTURES - - - 1 HEREBY ACKNOWLEDGE THAT,-1 _HAVE_ READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE 19 CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWERFEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER New MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESMR'143ED ABOVE. i %2 a LESS .25 SIGNATURE OF ��2 2 .60 PERMITTE ---- 2 s 1.00 INSPECTION RECORD 5 is 1.50 is 50 2.50 50 zoo S.DO zoo 600 10.00 lJ H Soo 1000 15.00 Q — —— L7 OVER 1000 20.00 .j M.G. BET/FREQ. CHANGER-HP ll WELDERS: AC-KVA GENERATORS - KW TRANSFORMERS - KVA _ 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 ' 00 CONDUIT t FIXTURES $1.00WIRING SUPPLEMENTARY .50 FIXTURES POWER TOTAL FEE s cb 361 UTILITY CO.NOTIFIED r FINAL 76A663 DBS #5A 4-52 WORKER'S COMPENSATION DECLARATION 760-0019 DPW 9/89;3 -APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self Insure, or a certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec 3800 L9b C) - Policy No + Company _ FOR APPLICANT ATO FIL'L•IN _ - '-' _'_'OB ❑ i �. > v• r "„; , ADDRESS Certified copy is hereby furnished New Residential Bldgs &Pools EACH- NO - FEE t $ — $ LOCALITY I L ❑ Certified co Is filled with the count buildin ms ection• 1 &2-Family,Sq Ft I PY Y' 9 P NEAREST department ,, _ Multi-family Sq Ft CROSS ST Date' �Applicant =t Residential Swimming Pools MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION'FROM,WORKERS' Outlets Rec _Light Sw _ r_ _ _ FlRM NAME bWNER OR COMPENSATION INSURANCE First 20 (This section need not be,completed if the work Involved by the ADDRESS permit is'for one hundred dollars($100)or less) Total No Additional I certify'that in the performance of the work fog which this permit _ _ CITY Tel No Is Issued, I shall not employ any perso lin any-mar;n`e s to ` 'PLAN CHECK become subject,to t e,Workers',}Cc tion Laws Light ng Fixtures First 20 -- - - -- - APPLICANT - Total No Additional _ ADDRESS Date Applicant 15 OR 20A,120V BRANCH CIRCUITS - - NOTIC TO PL CANT •If, 1 making'thist i to of _ - - CITY Tel No Exempt on,you should•become subject,to the Workers;Compensation 1 TO 10 INCLUSIVE EACH roWsions of the Labor Code, ou must forthwith coni I with such 11 TO 40 INCLUSIVE EACH - PERMIT__ P �Y P Y,� j �- ` - - APPLICANT pFovis�ons or this permit shall be deemed revoked 41 OR MORE BRANCH CIRCUITS EACH } LICENSED CONTRACTORS DECLARATION - 15 OR 20A208V TO 277V LIGHTING EACH - ADDRESS .4 I hereby'affirm that I am licensed ,under provisions of Chapter 9 0 (commencing'with Section 7000) of Division 3''of the Business and -__,. - ._ CITY Tel No 4,cj;z4r Professions Code, and my license Is in full force and effect RESIDENTIAL APPLIANCES UP TO 3HP LICENSE OR • // rC7 Cc j� ,Power.Apparatus&Large,Appliances _ REG NUMBER Class O �� +/� C_;1 /3 SIZe&Type HP,KW,KVA,or KVAR ' DISTRICT NO PROCESSED BY "' - I'" License Number Llc Class U 11, •i...: _ - -Up to 3 Incl Over 3 t0 10 Incl FINAL Contractor Lam'`- Date - Ove�'10 to 50 Incl - DATE Z q�- Z ❑ I am exempt under Sec Over 50 to 100 Incl `0 y ! VALIDATION Over�100 -� - - - BY AL --- - - - B&P C for this on "" ` Services�w CC&Panelboards ate OJ2 w A 600 V _ I r1 Signal ur 20,1 -1000 Amp Under g 2- ❑ -_ _ - Over 1000 Amp or Over 600 V _ ACV, Exemption for Reg Maint Elect .4 SINGLE FAMILYTemp Power Pole&Appurtenances _ '}`/0{ i ITEMS Jy'. t HOME OWNER-BUILDER DECLARATION Slgmwith One Branch Circuit - 1 I hereby affirm that I am exempt from the Contractor's License Law �i t for the following reason (Section 7031 5, Business and Professions Additional Sign Branch Circuits - TOTAL Code) - CHECK a ❑ 1, as owner of the property,will do the work and the structure Misc Conduits&Conductors- - - CHECK 57.55 Is not Intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) CHANGE .011 and Professions Code) - - - - -' - CONSTRUCTION LENDING AGENCY 1 1 hereby affirm that there Is a construction lending agency for the _ y CIIGW70001 38/24/92 performance of the work for which this permit is Issued (Sec 3097, PERMIT FEE _ (Sub-Total) _ CIV (•i) � - 51T6 1 AM11:18 PLAN CHECKING FEE Lender's Name - ' PERMIT ISSUING FEE ' Lender's Address I certify that 1 have read this application and state that the above TOTAL FEE Information Is correct I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize representatives of this C nter upon the above-mentioned `- pr rt for inspection urposes SEE REVERSE FOR EXPLANATORY LANGUAGE t S URE OF APPLICAN ORA v 7' ` ' WORKER'S COMPENSATION DECLARATION 200019 DPW 9/89 APPLICATION FOR ELECTRICAL PERMIT u 76A663 hereby affirm t¢at I have a certificate of consent to self Insure, or a certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec'3800 Lab C) I I1 .1 .. " POhCy Z�S�� O pany4 FOR APPLICANT TO FILL IN '' JOB - F ADDRESS- 2— [P' , Certhed copy Is hereby furnished New Residential Bldgs &Pools EACH NO FEE - LOCALITY ❑ 'Certi ied co Is'filed with the count buildm ms ection') 1 &2-Family,Sq Ft $ — $ _ PY Y 9 P — � NEAREST 1, department ti _ -1 Multi-family Sq Ft _ - CROSS ST i Z 2 A licant' c d Residential Swimming Pools ASSESSOR Dale PP ¢- _ MAP BOOK 3 Q PAGE OD PARCEL r4l CERTIFICATE OF EXEMPTI FROM WORKERS' �( Rt OWNER OR COMPENSATION INSURANCE Outlets ec1L Light Sw �0- O' FIRKNAME 1 First 20 Q This section need not be completed If the work,involved b the MAIL ^ ' (, P Y, - ADDRESS permit is for one hundied dollars($100)or less) Total No Additional l �d- I certify that in the performance of the work for'whicti this permit CITY_. i` is Issued, I shall not employ any person in°any manner'so'as t0 PLAN'CHECK becomersubject to,the Workers'Compensation Laws Lighting Fixtures First 20 - - APPLICANT ,r•_ Total No Additional - ADDRESS �' v' Date Applicant' } _�- , _•- 15OR•20A;120V BRANCH CIRCUITS NOTICE TO APPLICANT If, after making this Certificate of -- • CITY � C.f� Tel No' � Exemption„you should become subject to the Workers',Compensation 1 TO 10 INCLUSIVE EACH provisions of the Labor Code, you must,forthwrth comply,with such 11 TO 40 INCLUSIVE EACH - - pppu ANT J•�' '� provisions or this permit shall be deemed revoked- ,• 41 OR MORE BRANCH CIRCUITS EACH LICENSED CONTRACTORS DECLARATION ADDRESS %f(l jr. a I hereby affirm that•I am licensed under provisions of Cha15 OR 20A,208V TO 277V LIGHTING EACH pter 9 _ p � p (commencing with Section 7000) of Division 3 of the Business`and _ _ _ _ CITY eI No 0 QZs Y(� U Professions Code,and my license is in full force and effect RESIDENTIAL APPLIANCES UP TO 3HP LICENSE OR Power Apparatus&Large Appliances REG NUMBER 6 ee-lp Q 3 Class 3 cc /d 3 —Size&Type HE,KW, A,Or KVA DISTRICT NO PROCESSED BY 0 License Number Llc Class =� V /// p to 3 incl' -- W Contractor %07—# 6'/'/�T/{ l Date FINAL 2Z Z._-` Over 3 t0 10 Incl r _ DATE.- (n ❑ - -- - - `—Over 10 to 50 Incl /� Z I am exempt under Sec Over 50 to 100 Incl -1 Z VALIDATION B&P C for this reason -” Over 100 _ FINAL Z Services,-Swbd,MCC&Panelboards - i Date 0-200 Amp Under 600 V Signature - -201 -•1000 Amp•Under 600-V- - - - - -'---••-- _ Over 1000 Amp or Over 600 V w Exemption for Reg Maint Elect SINGLE FAMILY. Temp Power Pale&Appurtenances _ HOME OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit • a IV for the following reason (Section 7031 5, Business and Professions Additional Sgn Branch Circuits �« E? I ''_ Code) ❑ I, as owner of the property,will do the work and the structure Misc Conduits&-Conductors - _ _ _ _ _ 1 F ME is not Intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) ® ;+k Z iz'-. and Professions Code) 42 CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the - ryA`{'~� o�*: performance of the•work for which this permit Is Issued (Sec 3097, PERMIT,„FEE-- _ (Sub-Total) /a-- Civ C) PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE 2 4 Lender's Address / I certify that I have read this application and state that the above TOTAL FEE 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 APPLICANT OR AGENT DATE