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Home My Public Portal About9027 BROADWAY_Electrical__ 76AG63-CEOOS f0-62 APPLICATION F® ELECTRICA PERMIT ` I COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS U Z 7 JOHN A. LAMBIE. COUNTY ENGINEER - WILLIAM A. JENSEN. SUPT OF BUILDING LOCALITY = NEAREST FOR APPLICANT TO FILL IN CROSS ST. e7t RECEPT. 33 TOTAL NO. EACH FEE ' OUTLETS FIRST 20 S 20 $ f OWNER uGXi ao MAIL �T noo'L- C ADDRESS �✓ 9WITC X. OVER 20 l .ID �' TOTAL CITY / TEL. NO.. LIGHTING l nn FIRST 20 '.20 FIXTURES Y� ovcn 20 .10 �Q ELECTRICIAN A RANGES CLO.DRYEfl9 WTR.HTRS. I 1.00 App RES6 GARB.DISPl' STA.COOK}� CITY TEL. NO. DISHWASH.k/, AUTO.-WASH. STATE �� 1 � SPACE HTRSY STA.APP.(yy H.P.MAX.) E .50 ' .� LICENSE NO. MOTORS: OVER NOT OVER H.F. - _ DISTRICTn NO.., GROUPZONE P/ROC SSED BY 0 1 3 1.00 �V } 1550 INSPECTION RECORDP. OA1 IIrr qq �/� �J ��11 Y 3 6 2.00 A'{�P', d. %J� S t Ii�•.�i 6 Is 2.60 IS50 3.00 so 100 5.00I N44 &Irv0�'- SIGNS: NO.TRANS. I NO.LAMPS V SERVICE O.6000.NOT OVER 200A SERVICE O-600V-OvER 200 A. 2,00 SERVICE OVER 600V 5.00 1 C I! /L1/^T - e♦� ly MISC. v PERMIT ISSUING FEE 2.00 ' SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE 9 ` -THEREBY 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 WIRING. WIRING VJ.- "' , I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED ANO/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTI,ALL`PPP60P RTY.��//y POWER ' OF PERMITTEE_SIGNATURE ,'-✓U"'kGVN �� . UTILITY CO.NOTIFIED FINAL A �� J LIDATION ARTHUR C. VEIT- . CK MO CASH SUPERVISING ELECTRICAL ENGINEER t1o8183— FEB , 3 2 D 2,3.80 . Q 74A563 CEe1806R 10/77 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTM ENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN LOCALITY New Residential 81dgs.&Pools EACH NO. FEE NEACROSSS ET. Ct 1 &2-Fomily,Sq. Ft. $ .025 — $ OWNER T Multifamily Sq. Ft. .02 — FIRM NAME / l /� Residential Swimming Pools 25.00 MA ADDRESS 3 J p ADDRESS / y/j�0.11dL./� Outlets: Rec�_Light L Sw. Z CITY� �I��L+�P Tel.No�B/ 'SC/ First 20 .50Ing PLAN CHECK Total No.� Additional .30 APPLICANT ADDRESS Lighting Fixtures First 20 .50 CITY Tel. No.. �_ Additional '30 IT APPLICANT Total No. _ Fixed Appliances Not Over 1 HP ADDRESS LG' Range_Hearer_D.W.— CITY Al /x(f Tel. No.17,� Oven—Dryer_W.M— LICENSE OR Top —FAU —W.H._ REG.NUMBER p, Class. Hood_ FOO —Other— HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE Disp. Room Air Cond. 2.50 THAI THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDIN- ANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. Power Apparatus&Large Appliances Size&Type HP, KW,KVA,or KVAR I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM Y Up to I IOCI. 2.50 THE tEGALOWNEROF THEABOVE DESCRIBED RESIDENTIAL PROPERTY. Over 1 to 101ad. 5.00 v Over 10 to SO Incl 12.50 PERMITTEE m Over 50 to 100 Inc. 25.00 9GNATURE Over 100 40.00 DISTRICT NO. PR ESSEQ'�Y d J Q Yj w. Z Services 0 200 Amp,Under 600 V 12.50INSPECTOR'S 201�1000 Amp.Under 600V 25.00 APPROVALS DA"' SIGNATURE Over 1000 Amp.or Over 600 V 50.00 TEMP. POWER POLE' UNDERSLAB WORK Temp. Power Pole 8 Appurtenances 10.00 Sign with One Branch Circuit 10.00 ROUGH CONDUIT 2.00 Additional Sign Branch Circuits � WIRING � Misc.Conduits&Conductors 10.00 FIXTURES Other(See Complete Fee Schedulei POWER AUTHORIZED UTILITY CO.NOTIFIED FINAL' PERMIT FEE ISub-Torah NOTES PLAN CHECKING FEE (One Fourth Permit Feel PERMIT ISSUING FEE $7.00 TOTAL FEE /O•J ' PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH 6 4�OJUN 14 2 D 1 C).5 i) 630 3 -7 �l aS / - 76 SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE WORKERS'COMPENSATION DECLARATION 76A66310/81 I hereby affirm that I have a certificate of consent to self CE-a066 APPLICATION FOR ELECTRICAL r ERMIT insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or o certified copy thereof (Sec. 3800, Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE ADDRESS Cl Certified copy is filed with the county building inspec- I & 2-Family, Sq. Ft. $ — S LOCALITY A tion department. Multi-family Sq. Ft. NEAREST CROSS BT. TVTeGI Residential Swimming Pools .. OWNER T. .Date Applicant 'FIRMNAME CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL D ✓�BCta�$74 Outlets: Rec_Light_Sw._ COMPENSATION INSURANCE First 20 ADDRESS (This section need not be completed If the work involved by Total No. CITY / Tel. No.the permit is for one hundred dollars ($100)or less.) Additional ?hexyl Gt ' I certify that in the performance of the work for which this - - PIAN CHECK permit is issued, I shall not employ ci erson is any manner APPLICANT so as to h co a subject to the Wo rs Compen i n Laws. Lighting Fixtures First 20 - ADDRESS Total No. Additional 'DateA�pplicon — CITY 1 0. NOTICE TO APPLICANT: If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT Exemption, you should become subject to the Workers' Range_ Heater—D.W. — APPLICANT 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. — CITY Tel. No. deemed revoked. Hood _ Fan _Other_ LICENSED CONTRACTORS DECLARATION 'LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. _ Room Air Cond. REG, NUMBER Class. (commencing with Section 7000) of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NQS FIR D Y and Professions Code, and my license is in full force and effect. 0 Size 8 Type HP, KW, KVA, or KVAR' 5L a t1 O License Number lic. Class - � U Up to 1 Incl. FINAL Over 1 to 10 Incl. DATE / 0C Contractor Dote VALIDATION ❑ Over 10 to 50 Incl. U FINAL I am exempt under Sec. Over 50 to 100 Inc. BY GL Luis B.&P.C. for this reason Over 100 Is. N Services, Swbd., MCC 8 Panelboards D - ? Date: 0 -200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V ❑ Over 1000 Amp. or Over 600 V -2 6 2 9.5 A Exemption for Reg. Maint. Elect. e e e e • SINGLE FAMILY Temp. Power Pole & Appurtenances n 2 _ ( -,- 2S50 2 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit e o e 2 S 5 Q 5I 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 0 �.Q 6 a 7Professions Code 11TApTlI I, as owner of the property, will do the work and the Misc. Conduits& Conductors structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ D 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 permit is issued - PERMIT FEE - (Sub-Total)- (Sec. 3097, Ci, C.). PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address r I certify that i have read this application and state that the TOTAL FEE lJ l above information is correct. I agree to comply with all County or ' onces and State laws regulating Electrical wiring, and ' e e authorize re resemot.ves of this County to enter upon bmenti `roperty for inspect' n rposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Zi - 1<< ✓A Signature of Permittee Uafe