HomeMy Public PortalAbout9965 BOGUE ST_Electrical__ 78A663•CE606 70.69
APPLICAT104FFOORR ELE TRIC PERMIT 1.
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE. COUNTY ENGINEER e--
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL 1N NEAREST
PERMIT FEES CROSS ST.
1 T E M NUMBER EACH FEE OWNER -6
OUTLETS:' $. $ MAIL
LIGHTS RECEPT. SW. ' .10 ADDRESS
LIGHTING FIXTU S 10 CITY TEL.
ELEC.RANGES V .CLO.DRYERS ELECTRICIAN
WATER HEATERS � .50 DO S
ELEC.SPACE HTRS. DISHWASHERS
NOi
GARBAGE DISPOSERS. AUTO.-
STATE
WASHERS STA.COOKING UNITS .25 LICENSE NO.
MOTORS: OVER INC. H.P. DISTRICT NO. I GR UP ZONE I P SSE D BY
O— 1/2 .25
1/2- 2 .50 INSPECTION RECORD
2 5 1.00
5— 15 1.50
15— 50 2.50
50—200 5.00
SIGNS: NO.TRANS.
NO.LAMPS
SERVICE 0-600V 1.00
SERVICE OVER 600V 5.00
MISC
WIRING PERMIT 1.00 L' Ll
FIXTURE PERMIT 1.00
SUPPLEMENTARY PERMIT .50
TOTAL FEE per
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT
ELECTRICAL WIRI .
1 HEREBY RTIFY TH I AM PROPER 1 RED AND/OR WIRING
LICENSED REQUIRED OS ANGEL AND STATE OF FIXTURES
CALIFORNI OR THAT 1 THE LE OF THE ABOVE
DESCRIBE RESIDEN A P Y. POWER
SIGNAT RE UTILITY CO.NOTIFIED
OF PER ITT FINAL
DATION ART UR C.VEIT,
OF 7VAcK mo IOCASSUPERVISING ELECTRICAL ENGINEER '
' 6 J 1
SES 6 2 D 3 .00 -
WORKER S'COMPENSATION DECLARATION CE-806 APPLICATION FOR ELECTRICAL PERMIT
_.i CE-806G (2-80)-
4ertified
reby'affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY
e, or a certificate of Workers'Compensation Insurance,or r
copy thereof(Sec. 3800,Lab. C.) -
�G.�`� '�AAp,,AN�� FOR APPLICANT=TO FILL IN'= .106 �F
Policy No. s� Company EACH NO. FEE ADDRESS 6�,y
New Residential Bldgs.&Pools
Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ — $ LOCALITY
Multi-family Sq. Ft. — NEAREST
Certified copy is filed with the county building inspection CROSS ST N
department. Residential Swimming Pools OWNER OR
FIRM NAME
Date X15 ApplicanOutlets Rec&ight-11- Sw. st7 5 !S� MAIL
First 20 ADDRESS
CERTIFICATE OF EXEMPTION•FROM WORKERS' Total No Additional CITY Tel No.
COMPENSATION-INSURANCE 1� PLAN CHECK d
APPLICANT 0
(This section need not be completed if the work involved
Lighting Fixtures First 20
by the permit is for one hundred.dollars (5100' ' Total No.
) or less.) ADDRESS U -
Additional �
'
I"certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No. Q
permit is issued, I shall not employ any person in any mannerF-
PERMIT
so as to become subject to the Workers' Compensation Laws. Range Heater D.W. APPLICANT LU
Oven _j Dryer W.M. ADDRESS'71to CL
Date Applicant Top FAU I-W.H. z
Hood r Fan Other_ CITY �
NOTICE TO APPLICANT- If, after making this Certificate of DispRoom Air Cond. Tel No
. _ �� LICENSE OR
Exemption, you should become subject to the Workers' REG. NUMBER Class as
Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO. PROCESSED BY
with comply with such provisions or this permit shall be
deemed revoked. Size&T pe HP,KW, KVA,or KVAR
Up to 1 Incl. I O v
FINAL
Over 1 to 10 Incl, DATE �0 --/z—�- VALIDATION
LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl.
I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL
BY
9 (commencing with Section 7000) of Division 3 of the Busi- Over 100
ness and Professions Code, and my license is in full force and
effect. Services l(� '�-r
License Number 4 '• Lic. Class � 0-200 Amp Under 600 V + J /,�c,
01-1000 Amp.Under 600 V,
Contractor�iP►\[.lL?�MA, Date -?s' k S 00'i Over 1 000Amp.or Over 600 V
HOME OWNER-BUILDER DECLARATION Temp.Power Pole& Appurtenances
I hereby affirm that, I am exempt from the Contractor's Sign with One Branch Circuit �' 17J,
License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits o'o 0 0 o 2
ness and Professions Code): ,
Misc.Conduits& Conductors 2 0;0 9 Q,00
I, as owner of the property, will do the work and the Other (See Complete Fee Scheduler
structure is not intended or offered, for sale (Section o•'o,o 90.0 Q z
U
7044, Business and Professions Code).
CONSTRUCTION LENDING AGENCY o 3. 1 5'-8
I hereby affirm that-there is a construction lending agency ,
for the performance of the work for which this permit is PERMIT FEE (Sub-Total), Vey
issued (Sec. 3097,Civ.C.)
Lender's Name PLAN CHECKING FEE (One-Fourth,Permit Fee)
Lender's Address1
PERMIT ISSUING FEE 0 "
I certify that I have read this application and state that the TOTAL FEE �O
above in 'on is correct.I agree to comply with all County
ordina s and tate laws regulating Electrical wiring, and
hereb thorize eprese atives of this County to enter upon
the a nti ed p e ty for inspection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
3-vs
N-Sigqlfature ofPermittee Date
1 '