Loading...
HomeMy Public PortalAbout9154 BROADWAY_Electrical__ i 7OA863_CE606_9_57 APPLICATION FOR ELECTRIC* PERMIT COUNTY OF LOS ANGELES aa DEPARTMENT OF COUNTY ENGINEER FU'LDiNc ��I ��' BUILDING AND SAFETY DIVISION DRESS.JOHN A.LAMBIE.COUNTY ENGINEER �CASSATT D.GRIFFIN,SUPT aF BDILDING CALITY Imo({AREST J� FOR APPLICANT TO FILL IN CROSS Sr. I IA J� PERMIT FEES ITEM INUM.ERI EACH FEE OWNER �t l7(l _ /3 .i•VL.G•- A MAIL OLIGHTST RECEpT. SW. V S .10 S ADDRESS ,/ C— . �Y T�1 LIGHTING FIXTURES .10 r} CITY ,\}w I (,LD1 ELEC.RANGES CLO.DRYERS ELECTRICIA (/ WATER HEATERS _50 ELEC.SP ACE HTRS. DISHWASHERS ADDRES GARBAGE DISPOSERS + AUTO.. CITY TEL.Ng��!kM WASHERS STA,COOKING UNITS .25 STATE LICENSE NO. -Gl MOTORS; OVER INC. H.P. • "' - - 0 — I/a .25 DISTRICT NO. •.{fGResjl• Z9,N E, READY FIR insrEcrlon VA — 2 3 ' .50 INSPECTION RECORD -2 — 5 - - -1.00- 5 _ 15 1.50 IS — 50 2.50 50— 200 5.00 ' SIGNS: NO.TRANS. NO.LAMPS SERVICE 0-600V 1.00 SERVICE OVER 600V 5.00 MISC. WIRING PERMIT1.00 FIXTURE PERMIT 1.00 IiO SUPPLEMENTARY PERMIT .50' TOTALFEE s, APPROVALS i HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY I CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS R LATING ELECTRICAL WIRING. WIRING I HEREBY CERTIFY IH I AM AGEN T R N /OR LICENSED AS REQUIRED Y LOS AA OF ' FIXTURES CALIFORNIA OR THAT 1MTHET E BDESCRIBED RE NTIA OPERTY SIGNATURE UTILITY CO.NOTIFIED OF PERMI _ FINAL VALIDATION ARTfHU C.VETT. A � MO CASH SUPERVISING ELECTRICAL ENGINEER.' MAY 2,0 '2 A 29,0 —. 76A663 ERs�^ =-sE ( APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES � �� �� n WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO, GROUP ZONE PERMIT NO. ELECTRICIAN I ' / �� RECEIVED BY READY FOR DATE IBBDEO ADDRESS /V �.• .lkfl/N�f�/"')`K��� /)- rrgq FIRST INSPECTION � ^' ���•_,�/ ITY TEI— O. COUNTY LICENSE NO. EXPIRES BWLDING ���••'O_'iF/�' T! �✓�J// ` PERMIT EE AODRE99 FEE NUMBER EACH LOCALITY U LIGHT OUTLETS NEAREST CROSS ST. RECEPTACLES WALL SWITCHES OWNER !/��/N/{'�F�L--/•I MViC) TOTAL OUTLETS Sc $ MAIL ELEC. RANGES 25 ADDRESS ELEC. HEATERS 25 CITY TEL N0. FIXTURES 5 MISC. Jdew S K /CE - I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT 'NUMBER OF LIGHT CIRCUITS - . AND.AOREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID L65 ANGELES COUNTY LICENSE, OR I AM THE LEGAL NENI HORSEPOWER FEE OF THE RESIDENTIAL PROPERTY DESCR BED ABOVE.OWNER NEW MVO. HP OVER INC. I/ s LESS $ .25 SIGNATURE OF ��� k0 ��� I/¢ 2 .50 PERMITTEE 2 s 1.00 INSPECTION RECORD 5 is 1.50 _ 1s so 2.50 Its — P4 Y- —f SO 200 5.00 in Lmo E x/ s7- e- 20O soo 10.00 J 500 1000 15.00 Z OVER IDD❑ C7 M.G. SET/FRED. CHANGER-HP n' LG ' —� WELDERS• AC-KVA D GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF ORM-) MOVED MOTORS (75% OF ERIC.) - MISC. SIGNS ND. NO.TRANH. 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 8 UTILITY CO. NOTIFIED kFINAL A -Ylrl WORKERS' COMPENSATION DECLARATION ,CE-E019 ovw srez APPLICATION PP ICA TION FOR ELECTRICAL N' ICA1L Ir IG II' MIT O I hereby affirm that I have a certificate of consent to self ,cEAM3 PV Ir Ir IL PY insure, o'Ita certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certified copy Cher of (Sec. 3800, Lab ) Poficy N Comp,ny L FOR APPLICANT TO Flll IN JOB ❑Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. $ $ LOCALITY C • 'TyW IQ NEAREST An tion d art N. .tT" Residential Sq. m CROSS ST. ��� t4^J /y/�..Qi•—� Residential $wimmin Pools _ Date Applicant 1.�L g FIWNERRM NAME CER KATE OF EXEMPTION FROM WORKERS'. Outlets: Rec—LightMAIL COMPENSATION INSURANCE r ADDRESS /LTL Zts (This section need not be completed If the work involved by First 20 _ CITY the permit is for one hundred dollars ($100)or less.) Total No. Additional DA.J, Tel. No. _ 2/J I certify that in the performance of the work for which this PLAN CHECK� 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 Total No. CITY Tel. No, Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of APPLICATIO 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 c el. No.Ffl 41� LICENSED CONTRACTORS DECLARATION Dis _ LICENSE OR 13 1 hereby affirm that I am licensed under provisions of Chapter 9 p' — Room Air Cond. _ - REG. NUMBER Class. (commencing with Section 7000)of Division 3 of the Business Power Apparatus & Large Appliances DISTRI PROCE BY Y and Professions Code,and my license is in full farce and effect. r 0 a Size 8 Type HP, KW, KVA, or KVAR O License Number Lic. Class Up to 1 Incl. FINAL DATE yy//k� VALIDATION ���� �r Over 1 to 10 Ind. 5_9f ?o O Contractor Date❑ Over 10 to 50 Incl: H FINAL O I am exempt under Sec. Over 50 to 100 Inc. BY B.&P.C. for this reason Over 100 - 0- Services, Swbd., MCC& Ponelboards D W Dote: 0-200 Amp. Under 600 V _ Z Signature .201 - 1000 Amp. Under 600 V -" ❑ Exemption for Reg. Mainz. Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY emp. Power Pole 8 A enances 15 00 HOME OWNER-BUILDER DECLARATION a I hereby affirm that I am exempt from the Contractor's License Sign wit ne Branch Circuit AOCT.T Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits 'J7"JJO7 - s5[I Professions Code): '- ' Ell, as owner of the property, will do the work and the Misc. Conduits& Conductors - 1 ITEMS structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ D .,,,_.,_ _ TOTAL `,� .e CQ Business and Professions Code). . . CONSTRUCTION LENDING AGENCY CALK - 25.50 1 hereby affirm that there is a construction lending agency for r. CHANGE .CICI the performance of the work for which this permit is issued PERMIT FEE (Sub-Totol) . (Sec. 3097, Civ. C.). .. Lender's NameffV OD- - PLAN CHECKING FEE 000001 11/30/89 PERMIT ISSUING FEE 7168 1 AM 11:42 Lender's Address TOTAL FEE - S I certify that I have read this application and state shot above inform n is c t. I agree to comply with all Couthe v nty - ordinances e I s r uloting Electrical wiring, and hereby ou r' repr enc ves of this County to enter upon the abov octane pro erty for inspection purp//o//ses. SEE REVERSE FOR EXPLANATORY LANGUAGE azure o rm ittee Date��� ©s DEC WORKERS't I have a certificate cafe of conte CE-806 loiel APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self CE-8066 insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES \ BUILDING AND SAFETY or a certified copy thereof (Sec. 3800, lab. C.) a. Policy No. Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH NO, FEE ADDRESS Certified copy is filed with the county building inspec- 18 2-Family, Sq. Ft. 6 — E LOCALITY tion department. Multi-family Sq. Ft. — NEAREST Residential Swimming Pools CROSS ST .rte+OWNER OR Date Applicant FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light-4— MAIL COMPENSATION INSURANCE First 20 "ADDRESS (This seition 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.) 1 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 Work rs' o ens ion Laws. Lighting Fixtures First 20 ADDRESS ^ Total No.—&-- Additional L ' 27 CITY Tel. No. DatNO C� -Xpplicaft ' Fixed Appliances Not Over 1 HP PERMIT //�I NO IC TO AP LICANT: If, after makin his Certificate of APPLICANT 4 �G��C /�/ L 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 0 .236 with comply with such provisions or this permit shall be Top _ FAU —W'H. — deemed revoked. . Hood _ Fan _ Other_ CITY �' A. T.I. N .oz LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby off irm that I am licensed under provisions of Chapter 9 Disp. Room Air Cond, REG. NUMBER 314 Class. le (commencing with Section 7000)of Division 3 of the Business power Apparatus 8 Large Appliances DISTRICT NO. PROZD BY 7, and Professions Code,and my license is in full force and effect. A. Size 8 Type HP, KW, KVA, or KVAR' Q O License Number ��5�h Lic. Class_ s Up to 1 Incl. FINAL ^ /� V �� cc �'G�� Date__(r j Over 1 to 10 Incl. DATE / ,24 —�¢ VALIDATION F_ Contractor^ ! - 0 ❑ Over 10 to 50 Incl. FINAL V I am exempt under Sec. Over 50 to 100 Inc. BY spm j— d B.BP.C. for this reason Over 100 ��t/F y= Do e: Services, Swbd., MCC 8 Ponelboards 0 -200 Amp. Under 600 V D �s Signature-7 '201 - 1000 Amp. Under 600 V :92965A F-1Over 1000 Amp. or Over 600 V , Exemption for Reg. Maint. Elect. .#'- -.e o e 'Z SINGLE FAMILY - Temp. Power Pole 8 Appurtenances HOME OWNER-BUILDER DECLARATION - 26. 75 1 hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits e e e 2[L']5 Law for the following reason (Section 7031.5, Business and , Professions Code): Mi.sc. Conduits 8 Conductors El 1,s 0620-83 as owner of the property, will the work and the 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, Civ. C.). PLAN CHECKING FEE I Lender's Name PERMIT ISSUING FEE Lender's Address 1 certify that I have read this application and stateshot the TOTAL FEE ( above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and her authorize representatives of this County to enter upon th ov - ention pr perty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Las b'3 S,gnoturf erminee D e