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Home My Public Portal About10109 BOGUE ST_Electrical__ 76A663-CE80611-71 APPLICATION FOR ELECTRICAL PERMIT LJ COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER FING ® %+� �j BUILDING AND SAFETY DIVISION SS l/ jITY 7iSTFOR APPLICANT TO FILL IN STOUTLETS NO. EACH FEEONR e RECEPT._ MAIL LIGHT TOTAL FIRST 20 25 ADDRESS CITY TEL. NO. SWITCH OVER 20 10 PLAN CHECK LIGHTINGFIRST 20 25 APPLICANT TOTAL ADDRESS FIXTURES OVER 20 10 RESIDENTIAL APPLIANCES CITY TEL. N0.PERIT RANGE DRYERWTR. HTR. APPLICANT STA. COOK DISP. F.A.U. ADDRESS SPACE HTR. AIR COND.� CITY ` �� TEL. NO. /p 3 72jp CLOTHES WASH. DISHWASH.-/— n ,/� LICENSE NO. CLASS. -/V FAN OTHER y 100 / Q y 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING W ITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW KVA. ELECTRICAL WIRING. SIZE IN TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF a CALIFORNIA OR THAT I AM THE LEGAL OW OF, AND INTEND IINNTTEENND TO 0 1 - 10 300 RESIDE IN, THE IBED 5 ENTII, PROPERTY. V 10 - 50 500 SIGNATURE OF PERMITTEE Q 50 - 100 1000 ~ DISTRICT CLASS ZONE PROCESSED BY W 100 - 500 1500 s D SIGN, GAS =SIGN ONE CIRCUIT 500 NOTES: Q TUBE, OR MARQUEE' ADDITIONAL CIRCUITS 100 SERVICENOTOVER 600 VOLTS OR 200 AMP 300 31 OD APPROVALS DATE INSPECTOR'S SIGNATURE SERVI CE OVER 600 VOLTS OR 200 AM P 10.00 TEMP.-POWER POLE TEMPSERVICE,POLE, &APPURTENANCES 5.00 UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM 300 ROUGH CONDIUT WIRING FIXTURES POWER AUTHORIZED PERMIT FEE (SUB TOTAL) UTILITY CO. NOTIFIED PLAN CHECK FEE PERMIT ISSUING FEE 3.00 (�3 FINAL TOTAL FEE 900 PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDA kONCK. M 0. CASH L " 4 4 4,N' -AUG 10 2'0 .00- cu SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 76A663 DBS SA 3-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES l WILLIAM J. FOX, CHIEF ENGINEER FORAPPLICOT TO FILL IN DISTRICT 'NO. GROUP ZONE PERMIT NO. ELECTRICIAN �— � �1 a. R ADDRESS /' J RECEIVED BY READY FOR D IBHU€� EA FIRST INSPECTION CITY ` TEL NO. w COUNTY LICENSE NO. ZA EXPIRES ADDRESS PERMIT'FEES NUMBER EACH FEE LOCALITY I LIGHT OUTLETS NEAREST CR089 ST. RECEPTACLES p j WALL SWITCHES � OWNER TOTAL OUTLETS Sc $ MAIL ELEC. RANGES 25 ADDRESS ELEC. HEATERS 25 CITY TEL. NO. FIXTURES 5 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE 18 CORRECT NUMBER OF LIGHT CIRCUITS S AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS 1 CERTIFY THAT I POSSEB8 THE ABOVE VALID LOS NUMBER HORSEPOWERANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER FEE NEW MVD. HP OVER INC. EACH OF THE RESIDEP��TTTIAfL PROPERTY DESwRIBED ABOVE. I/2 a LESS. $ .25 f SIGNATURE OR �/2 2 .50 PERMITTEE 2 5 1.00 &INSPECTION RECORD 5 15 1.50 15 50 2.50 50 200 5.00 200 500 10.00 J 500 1000 15.00 Z OVER 1000 20.00 jg M.G. SET/FRED. CHANGER-HP' R' WELDERS: AC-KVA O GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF ORIO.) MOVED MOTORS (75% OF CRIB.) MISC. SIGNS NO. NO.TRANS. APPROVALS NO. NO. LAMPS FOR EACH PERMIT: DATE INSPECTOR'S NAME WIRING $1.00 •'� CONDUIT FIXTURES $1.00 WIRING SUPPLEMENTARY .50 FIXTURES POWER TOTAL FEE $S UTILITY CO.NOTIFIED C FINAL WORKERS' COMPENSATION DECLARATION 76A663 aw3ie7 APPLICATION FOR ELECTRICAL PERMIT O I hereby affirm that I have a certificate of consent to self ,CE-806G insure, or a certificate of Workers' Compensation Insurance, I COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS ora tified co thereof (Sec. 3800, Lab C`)t 0ic o 4 3��g-b3 Company��o"D� FOR APPLICANT TO FILL IN JOB Q Certified copy is hereby furnished. New Residential Bldgs & Pools EACH NO FEE ADDRESS (Certified co is filed with the count building inspec- 1 & 2-Famil S Ft. $ — $ LOCALITY 7� PSE e 7-� u` PY �. Y 9 P Y, q� tion department. Multi-family Sq. Ft. — NEAREST T. Date11-2-92Apphcantf-OLs- s45o��s Residential Swimming Pools OWNERCROSS OR FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw_ MAIL COMPENSATION INSURANCE ADDRESS / D�D _ - U Cu� First 20 (This section need not be completed if the work involved by Total No. Additional CITY �MPL_ C 7 Tel. No.L/4) $Ga3 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 20 ADDRESS ` Additional Date Applicant Total No. CITY - Tel. No. NOTICE TO APPLICANT: If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT �7 Exemption, you should become subject to the Workers' Range— Heater—D.W. — APPLICATION QV I� JLs`U/C'�s �C— Compensation provisions of the Labor Code, you must forth- Oven — Dryer —W.M.— ADDRESS 3U-7 V 1rn 0 M---"T with comply with such provisions or this permit shall be Top — FAU —W.H — r deemed revoked. Hood — Fan —Other— CITY Q(_E�DDOA- Tel. No.'153Q_S yg LICENSED CONTRACTORS DECLARATION Disp. — Room Air Cond — LICENSE OR �7 � Class C D I hereby affirm that I am licensed under provisions of Chapter 9 REG NUMBER V (commencing with Section 7000)of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO PROQFSSED BY >_ and Professions Code,and my license is in full force and effect. j g 77�2 C� Size&Type�KW, KVA, or KVAR �d Z Q License Number 7 Lic. Class Up to 1 Incl. FINAL �vpSOf✓S ' 1!22 =- — Over 1 to 10lncl. DATE -7—/ ��/ VALIDATION Cr Contractor, l Date- ❑ Over 10 to 50 Incl. FINAL Q I am exempt under Sec. Over 50 to 100 Inc. BY (J/ U LLJ i B.&P C. for this reason Over 100 d Z Services, Swbd , MCC& Panelboards Date: 0-200 Amp. Under 600 V Z Signature 201 - 1000 Amp. Under 600 V ❑ Exemption for Reg. Maint. Elect Over 1000 Amp. or Over 600 V SINGLE FAMILY n with One Branch Circuit HOME OWNER-BUILDER DECLARATION Temp. Power Pole &Appurtenances I hereby affirm that I am exempt from the Contractor's License SigNO :r_a Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits -y Professions Code): ❑ Misc. Conduits&Conductors I, as owner of the property, will do the work and the structure is not intended or offered for sale(Section 7044,- Other (See Complete Fee Schedule)_ Business and Professions Code) , 11-1,H _} 00 J CONSTRUCTION LENDING AGENCY C6"HEK I hereby affirm that there is a construction lending agency for ..._ i the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) i_I I i.4 _ (Sec 3097, Civ C ) PLAN CHECKING FEE Lender's Name }`i 11�:= "_`!i i i ' i_/ PERMIT ISSUING FEE Lender's Address I certify that I have-read this application and state that the TOTAL FEE, 2 060 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 " t a ve-mentio pro erty for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE 7-/)- • Signot r of rmi ee DeAe ®5