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HomeMy Public PortalAbout10646 BOGUE ST_Electrical__ 11-SS Lot #1 DBS-SAAPPLICATION omICATIO w®REL•ECTqI/ PERMIT DIVISION OF BUILDING AND SAFETY Department Of County Engfnee! BUILDING County of Los Angeles ADDRESS 1 6 / j6%3 Qgjj A Ste JOHN A. LAMBIE, COUNTY ENGINEER CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY Te4ie city- FOR APPLICANT TO FILL IN NEAREST j+,] Monte AVe>s PERMIT FEES CROSS ST. NUMBER OWNER miller Price. 14 LIGHT OUTLETS MAIL 24 RECEPTACLES ADDRESS 19 WALL SWITCHES FEE CITY TEL. NO. TOTAL OUTLETS @ 5¢ $ ELECTRICIAN SOUthlancl Electric Co. ELEC. RANGES 25 ADDRESS 403. E Broadway San' Gabriel ELEC. HEATERS 25 CITY TEL. NO. KW EA STATE 14 FIXTURES 5 7 LICENSE NO. MOTORS DISTRICT NO. GROUP ZONE READY FOR INSPECTION NUMBER HORSEPOWER ,FEE I �L L— 1 NEW MVD. HP OVER INC. EACH INSPECTION RECORD 3 LESS $ .25 Ifz 2 .50 2 5' 1.00 5 15 1.50 1550 2.50 50 200 5.00 a, MISC. NO. SIGNS NO.TRANS. NO. SIGNS NO. LAMPS - FOR EACH PERMIT: ' WIRING $1.00 FIXTURES $1.00 SUPPLEMENTARY 5O APPROVALS TOTAL FEE $ DATE INSPECTOR'S SIGNATURE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING ELECTRICAL WIRING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES � "—,W- LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE POWER DESCRIBED RESIDENTIAL PROPERTY. SIGNATURE UTILITY CO.NOTIFIED OF PERMITTEE FINAL JOHN A.LA 81E,COUNT ENGINEER VALIDATION ARTHUR C.VEIT.CHIEF ELECT. INSPECTOR CK MO CASH , L f&2874 tyv2 2 6.5:5 76A663-CE606 9-64 APPLICATION FOR ELECTRICAL PERM IT ,e COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING 'D 50 C/ BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W JENKINS, SUPT. OF BUILDING LOCALITY 7 NEAREST FOR APPLICANT TO FILL IN CROSS ST. RECEPT. TOTALNO. EACH FEE OUTLETS FIRST 20 $ $ OWNER LIGHT �� / .20 • 0 d MAIL ADD'L ADDRESS tJ SWITCH /O OVER 20 •10 Q LIGHTING TOTAL rF1RS7 20 20 OO CITY / TEL. NO. --�r- FIXTURES } V _ I ADD'L 10 ELECTRICIAN T OV R 20 s /^y�./ RANGES CLO.DR -TR.H7RS. 1.00 Q Q ADDRESS I` V �J [' GARB.DISP. STA.COOK / CITY � TEL. NO. 5 -z�O!`3 ic DISHWASH. AUTO.-WASH. STATE - STA.AP .( i H.P.MAX.) D LICENSE NO. > SPACE HTR MOTORS: OVER NOT OVER H.P. DISTRICT NO. GROUP XNEIPR(112ESSED O 1 1.00 ^� 1 3 1.50 - INSPECTION RECORD 3 s 2.00 � D_ - O 8 15 2.50 aloe V 15 50 3.00 50 100 5.00 O SIGNS: NO.TRANS d NO.LAMPS H Z SERVICE 0.600V-NOT OVER 200A 1.00 SERVICE 0.60OV•OVER 200 A. 2.00 SERVICE OVER 600V 5.00 MISC. PERMIT ISSUING FEE 2.00 Q SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE $ e O 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECT 'S IGNATURB AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT i. WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ''''11 ELECTRICAL WIRING. WIRING -O�- /(! I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM HE GAL OW R OF, AND INTEND TO RESIDE IN, THE ABOVE DES IB E IAL PROPER POWER SIGNATURE UTILITY CO.NOTIFIED OF PERM!-- ' FINAL /VALIDATION JOSEPH C. CK MO CASH SUPERVISINGG ELECTRICAL ENGINEER L riLo 0 4.8 6:01 (BAR 15 2 D 1 1.10- WORKERS' COMPENSATION DECLARATION DPW 3/87 76A663 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, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or;a certified copy thereof (Sec 3800, Lobb C,_) C- Policy Not _Company )rmY r FOR APPLICANT TO FILL IN JOB ❑Certified copy is hereby furnished. ADDRESS New Residential Bldgs. & Pools -EACH NO FEE ertified copy is filed with the county building inspec- 1 &2-Family, Sq Ft. $ _ $ J LOCALITY Y�P(E C( CA EaF tion department. Multi-family Sq. Ft. NEAREST �.•- r CROSS ST G L r�01(lE, ST Date �`�144t Applicant i Residential Swimming Pools OWNER OR `�� FIRM NAME N A. It ft n�l �H141 U— CERTIFICATE OF EXEMPTION FROM ORKERS� q MAIL Outlets: Rec-CLLight-Lq-Sw._ Q v ADDRESS COMPENSATION INSURANCE '-First 20 i (This section need not be completed if the work involved by Total No. Additional CITY Tel. No.4tp,-t the permit is for one hundred dollars ($100)or less.) I certify that in the performance of the work for which this PLAN CHECKAPPLICANT 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 U d 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 ] �1°1oDE7Enf 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 Lt% with comply with such provisions or this permit shall be Top — FAU —W H — py deemed revoked Hood — Fan —Other— CITY WQ C6,41 CA Tel. No 490- - LICENSED CONTRACTORS DECLARATION LICENSE OR 22 I hereby affirm that I am licensed under provisions of,Chapter'9 Disp. — Room Air Cond REG NUMBER 3 Class;!7 (commencing with Section 7000)of Division 3 of the Business Power Apparatus & Large Appliances DISTRICT NO PROCESSED BY >_ and Professions Code,and my license is in full force and effect. p 'ee5e �' O q O� Size &Type HP, KW, KVA, or KVAR O License Number J Lic. Class U Up to 1 Incl. FIN Z Over 1 to 10 Incl. Contractor �� Date �� �� DAT VALIDATION Cr ❑ Over 10 to 50 Incl FIN 0 I am exempt under Sec. Over 50 to 100 Inc BY U W Over 100 a B.&P.C. for this reason Services, Swbd., MCC& Ponelboards fn Date: (� Z 0-200 Amp. Under 600 V � - Signature 201 - 1000 Amp. Under 600 V ❑ Exemption for Reg. Maint Eject Over 1000 Amp. or Over 600 V �1 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 _ > Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits Professions Code)- 0 ode)-❑ j, as owner of the property, will do the work and the Misc Conduits&Conductors _� c ti* _ structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ , I I_1•)ESL :��_af Business and Professions Code) ';•I'; CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for ('� _J, 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 _ PERMIT ISSUING FEE r A " N ` Ll•' Lender's Address P, I certify that I have read this application and state that the TOTAL FEEZi0 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 the abov -mention property for inspection purposes - -- SEE REVERSE FOR EXPLANATORY LANGUAGE � L�/ Signature of PeVA e Date ©s WORKERS'COMPENSATION DECLARATION 76A663 10/81 I hereby affirm that I have a certificate of consent to self insure, CE-8066 - APPLICATION FOR ELECTRICAL PERMIT or•a certificate'of Workers' Compensation Insurance, or a certified COUNTY OF LOS-ANGELES BUILDING AND SAFETY copy thereof(Sec 3'8100,Lab C) G� Policy No�Q.3pCompany !� FOR APPLICANT TO FILL I,N - JOB pp Certified copy is hereby furnished. New Residential Bldgs &Pools E EACH NO FEADDRESS BO tU E_ LOCALITY-Certified copy is filed with the county building inspection 1.& 2'Family,Sq Ft $ — $ C department — NEAREST nt Multi-family Sq.Ft , ��- G _ _ - CROSS ST Date 2- It Applicant Residential Swimming Pools OWNER OR y i s•- - FIRM NAME R i Ili . CERTIFICATE.OF EXEMPTION FRO WORKERS' � I MAIL COMPENSATION INSURANCE Outlets:Rec Light' Sw., ! ADDRESS First 20. (This section need not be completed if-the.work involved by the CITY Tel No.cfpl_ �p6 permit is for one hundred dollars($100) or less.)- Total No Additional . I certifythat in the performance of the work for which.this permit PLAN CHECK t P G��f�p d �' APPLICANT is issued, I shall not employ'any person in any manner so as to �rV 1 c •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 APPLICANT (�1Cil7�,r A'LAYa- Exemption,you should become subject to'the Workers'Compensation Range-7- Heater_ D.W provisions of the Labor Code, you must forthwith comply,with such Oven Dryer _ W.M. < ADDRESS �- provisions or this permit shall be deemed revoked Top FAU _ W:H: LICENSED CONTRACTORS DECLARATION Hood — Fan Other_ CITY cov,44S Tek. Clio'/ 5( I hereby affirm that'1 am licensed under provisions of Chapter 9 LICENSE OR L�'r 3 Disp. Room Air Cond. REG NUMBER 1 7 Class(B-- (commencing with Section 7000) of Division 3 of the Business and 17 Professions Code,and my license is in;full force and effect. Power Apparatus& Large Appliances DISTRICT NO PROCESSED BY 'Size& Type HP,KW,KVA,or KVAR ° y✓"V CrG�� a1/_��f �• License Number Lic.Class A�1 Up to 1 Incl. FINAL _ U AllOver 1 to 10 Incl. DAT Q 'Contractor' D 'S"�� % ` I VALIDATION O aate Over 10 to 50 Incl FI' I am exempt rider Sec. Over 50 to 100 Inc. B , W B&P.C.for this reason Over 100 HIE d Services,Swbd.,MCC&Panelboards • N Date 0-200 Amp Under 600 V , Signature 261- 1000 Amp Under 600 V ❑ Over'1000 Amp. or Over 600Y " Exemption for Reg.Maint Elect. SINGLE FAMILY Temp.Power Pole& Appurtenances qq2 HOME OWNER-BUILDER DECLARATION Sign with One Branch.Circuit tl�ri•Ta�O I hereby affirm that I'am exempt from the Contractor's License Law AdditionaPSign Branch Circuits . "7- for the following reason(Section 7031.5,, Business and Professions j'r7, _�,a;;f Code). Misc.'Conduits & Conductors � 10 I,as owner of the property,will do the work and the structure Other See;Com lete Fee Schedule 1'- s not intended or offered for sale (Section 7044, Business ( p )`= TO i I AL' a�A�a- � �� and Professions Code) n CONSTRUCTION LENDING AGENCY �'HECK +t1 a ill I hereby affirm that there is a construction lending agency for the t_.6"}NNGE a 0;1 performance of the work for which this permit is issued(Sec.3097,. PERMIT FEE (Sub-Total) I 0 -Civ C) PLAN-CHECKING,FEE i I;�':h►-1iIL) ` " r: !tf 7 Lender's Name PERMIT ISSUING FEE3 +i�-1 °'V'r 1302 1' Ail �a�L4 Lender's Address �O 1 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 ection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE gnature of Perm d a Date