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HomeMy Public PortalAbout10127 BOGUE ST_Electrical__ DBS-SA 3.55 B DAPPLICATION FOR -ELECTRIC PERMIT 1 S•SA , DIVISION OF BUILDING AND' SAFETY Deportment of County Engineer County of Los Angeles BUILDING WM.J. FOX, COUNTY ENGINEER ADDRESS ^v , CASSATT D.GRIFFIN, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST PERMIT FEES CROSS ST. NUMBER EACH FEE OWNER LIGHT OUTLETS _ RECEPTACLES MAIL '�, 9 ADDRESS WALL SWITCHES TOTAL OUTLETS _ 5¢ $ CITY TEL. NO. ELEC.RANGES 25 ELECTRICIAN _ELEC. HEATERS 25. ADDR SS KW EA CITY TEL.N FIXTURES - 5 LICENSE NO. NUMBER OF LIGHT CIRCUITS DISTRICT NO. I GROUP I ZONE I READY FOR INSPECTION NUMBER OF RECEPTACLE CIRCUITS MOTORS NUMBER HORSEPOWER FEE INSPECTION RECORD NEW MVD. HP OVER INC EACH 1/2&LESS $ .25 _ 1/2 2 .50 2 5 1.00 5 15 1.50 15 502.50 50 200. 5.00 MISC. NO.SIGNS - NO.TRANS. _ NO.SIGNS NO. LAMPS FOR EACH PERMIT: WIRING $1.00 J 1,00 �" FIXTURES ,$1.00 SUPPLEMENTARY .50 APPROVALS TOTAL FEES IP DATE INSPECTOR'S,SIGNATURE I HEREBY ACKNOWLEDGE THAT 1 HAVE-READ-THIS- APPLICATION iP AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT y ; WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING - WIRING '� r ELECTRICAL WIRING: 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR TH T I 'AM T E LEGAL OWNER OF THE ABOVE POWER DESCRIBED RESIDE L P PE Y. SIGNATURE UTILITY CO.NOTIFIED r OF PERMITTEE FINAL WILLIAM J.FOX, COUNTY ENGINEER VALIDATION A. C.VEIT, _ IEF ELECT. INSPECTOR LA-C,64 6372.7 Q In ► JAN31 2 7GASF3 DBS SA 3-SO APPLICATION FOR' PERMIT DEPARTMENT OF BUILDING AND SAFETY/a LEC-T lC I COUNTY OF LOS ANGELES J WILLIAM J. FOX, CHIEF ENGINEER FOR)APPPLIICANTTO FILL IN DISTRICT'NO. GROUP 'ZONE PERMIT NO. ELEC TRICIANy , ./ 4&Algl'a READY ADDRESS �/a�C Q RECE'V.ED BY FIRST INSPECTION 4%7� /�AT ED CITY v TEL NO. Y Y /// / COUNTY LICENSE NO. EXPIRES BUILDING /�1 /�1 r PERMIT FEES ADDREBB UU eG NUMBER EACH FEE LOCALITY LIGHT OUTLETS S NEAREST v 4 RECEPTACLES CROSS ST. WALL SWITCHES �t OWNER TOTAL OUTLETS 5C $ �V '� _ MAIL ELEC. RANGES 25 ADDRESS ELEC. HEATERS 25 CITY TEL. NO. FIXTURES 5 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS / 7'GJ 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 LOB NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR IAM THE LEGAL OWNER NEw MvD. HP OVER INC. EACH OF THE RESIDENTIAL P�ROPERTY DESCRIBED ABOVE. LESS $ .25 .2SIGNATURE OF %2 2 .50 PERMITTEE 17 %J 2 s 1.00 /'INSPECTION RECORD s is i.So is 50 2.50 50 200 5.00 200 500 10.00 J 500 1000 15.00 Z OVER 1000 20.00 0 M.G. SET/FRED. CHANGER-HP (Y WELDERS: AC-KVA GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF DRIG•) MOVED MOTORS (7S% OF ORIG.) MISC. SIGNS NO. N O.TRANS. APPROVALS NO. NO. LAMPS DATE INSPECTOR'S NAME FOR EACH PERMIT: WIRING $1,00 CONDUIT FIXTURES $1.00 Q WIRING 1<'�.���G�✓-`�' a w v7 i SUPPLEMENTARY .50 FIXTURES POWER TOTAL FEE $-3- UTILITY CO.NOTIFIED / FINAL WORKERS' COMPENSATION DECLARATION CE-806 10ie1 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of content to self CE-806G insure, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec 3800, Lob C ) Policy No Company FOR APPLICANT TO FILL IN JOB ADDRESS Certified copy is hereby furnished. New Residential Bldgs & Pools EACH NO FEE Certified copy is filed with the county building inspec- 1 & 2-Family, Sq. Ft $ — $ LOCALITY ef , tion department. Multi-family Sq Ft. NEAREST CR OSS S Residential Swimming Pools OWNER T Date Applicant OR FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets- ReC� ht LI � MAIL First 2 COMPENSATION INSURANCE g First 20 1 ADDRESS Q (This section need not be completed if the work involved by Total No Additional CITY Tel. No. " 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 �p yii4 J� 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 Total No Additional hh (� 21 CITY Tel. No. Date � 4`Apphca�'�A � l..d�oi� Fixed Appliances Not Over 1 HP PER IT NOTICE O APPLICANT If, after making this Certificate of APPLICANT Exemption, you should'become subject to the Workers' Range— Heater DW — 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 Room Air Cond Class. LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp — REG NUMBER �6► (commencing with Section 7000) of Division 3 of the Business DISTRICT NO PROCESSED BY and Professions Code,and my license is in full force and effect Power Apparatus& Large Appliances c1���/ Size &Type HP, KW, KVA, or KVAR 0 License Number_ - Lic Class Up to 1 Incl. r i FINAL Contract GA �ate /d oZ Over 1 to 10 Incl DATE VALIDATION Q ❑ Over 10 to 50 Incl FINAL/\ V I am exempt under Sec Over 50 to 100 Inc.. BY W HB.&P.0 for this reason Over 100 Services, Swbd , MCC & Ponelboards ► Date. 0 -200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V Over 1000 Amp. or Over 600 V Exemption for Reg Mamt. Elect. ' SINGLE FAMILY Temp Power Pole& Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits t Law for the following reason (Section 7031 5, Business and g o Professions Code): ' z 7 0.7. TA Miac Conduits& Conductors I, as owner of the property, will do the work and the structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)— 2 p ' ° 63.0 7044, Business and Professions Code). � CONSTRUCTION LENDING AGENCY o`lo Ito v 0 U I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) 0 2 2— 8' (Sec 3097, Civ. C ). PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE 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 the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE �n. Pe mittee Date WORKERS'COMPENSATION DECLARATION 76A663 10/81 APPLICATION FOR ELECTRICAL PERMIT 'I hereby affirm that I have a certificate of consent to self CE-806G insure, or a certificate of Workers' Compensation Insurance, - COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec 3800, Lab. C ) l I . Policy No Company FOR APPLICANT TO FILL IN JOB �7 Certified co is hereby furnished EACH NO FEE ADDRESS © Z [ &,- o El PY Y New Residential Bldgs. & Pools � — Certified copy is filed with the county building inspec- 1 8 2-Family, Sq. Ft $ — $ LOCALITY / G� tion,deportment. Multi-family Sq. Ft 'NEAREST Residential Swimming Pools CROSS ST Date Applicant OWNER OR FIRM NAME /e1�la G CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw_ t1 r/ COMPENSATION INSURANCE This section need'not be completed if the work involved b First 20 ADDRESS the permit is for one hundred dollars ($100)or less.) Y Total No.— Additional CITY Ism LG �7�-T Tel. No. - v I certify in e that the performance of the work for which this PLAN CHECK APPLICANT J G� 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 2"2- Z I Total No Additional rlxi CITY ��CAP_� Tel. No. �S�(��3 Date Applicant Fixed Appliances Not Over 1 HPPERMIT NOTICE TO PLICANT:Jf, after, making this Certificate of APPLICANT ��� Exemption, you should become subject to the Workers' Range_ Heater_D.W _ 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`-]am licensed under provisions of Chapter 9 Disp Room Air Cond REG NUMBER Class. (commencing with Section 7000) of Division 3 of the Business DISTRICT NO PROCESSED BY and Professions Code, and m license is in full force and effect. Power Apparatus & Large Appliances y. 7 /�j� Size & Type HP, KW, KVA, or KVAR e 0 License Numberz /f 7[f ��ee�� yyLic Class r Up'to 1 Incl FINAL �j ' . V Contractor /� � Z,15§ (:hiolDate // Over 1 to 10 Incl.. DATE / Y� �J( VALIDATION 0 ❑ Over 10 to 50 Incl. FINAL j am exempt under Sec Over 50 to 100 Inc' BY d Over 100 B&P C for this reason Services, Swbd , MCC& Ponelboardspd pop- Signature Z Date: 0 -200 Amp Under 600 V Signature 201 - 1000 Amp Under 600 V Over 1000 Amp. or Over 600 V 2 7 8,3 3 A Exemption for Reg. Maint. Elect r SINGLE FAMILY # o o'o o o`2 • -- Temp. Power Pole 8 Appurtenances ' HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 2•°'° 2 3.5 0 j hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits Law for the following reason (Section 7031.5, Business and ° ° °.2 3.5 0 c=> Professions Code) Misc Conduits&Conductors 'l.'2'2'—8 2 j, as owner of the property, will do the work and the structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)— ► 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this peFmit is issued PERMIT FEE (Sub-Total) (Sec 3097, Civ.'C ) PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE 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 jaws regulating Electrical wiring, and, hereby authorize representatives of this County to enter upon fhe ove-mentioned roperty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signatur of Permittee D to