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Home My Public Portal About9834 BROADWAY_Electrical__ / COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY WILLIAM J. FOX, County Engineer FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRICIAN / i.�+f� r� . ��.��r..� s Vie? '" UiD ADDRESS / // tA{ G .�p/,i��t/_ RED IVE HYT FIRST INSPECTION READY FOR DATE CITY yr..e. A/0 Cl� R r TEL NO.�4y7 feie7o9 COUNTY LICENSE uNNo. //!/z rXP.I� BUILDING //�/] PERMIT FEES ADDRESS �`� NUMBER EACH FEE LOCALITY J �LI� LIGHT OUTLETS NEAREST CROSS BT. RECEPTACLES WALL SWITCHES OWNERCair1/ TOTAL OUTLETS Sc e MAIL ADDRESS �/J ELSE. RANGES 29 � ELEC. HEATERS 25 CITY J. f-.l-4q y/ ��/ TEL NO. P / . x1 4 FIXTURES 6 i MISC. ��M12�r -- 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS !° a..nn APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS 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 Nune[n HORSEPOWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER NEW MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED,ABOVE. !/p A LES. S .29 SIGNATURE OF A ' // l/ 4 -/2 Z .9O PERMIT' TE [�LC�C[ `�� 2 H 1.00 INSPECTION RECORD 9 19 1.90 _ _ TS 90 2.90 _ 90 200 9.00 'zDo; 900 10.00 Soo IOOD 19.00 a Z OVER 1000 20.00 0 _MOVED MOTORS (79!2 of CRIS.) ar M.O. BCT/FRED. CHANGER-HP O WELDERS: AC-KVA qAID C GCNERATORB - KW TRANSFORMERS - KVA MIBC.�� u(�(11 (yG! SIGNS N0. , NO.TRANS. APPROVALS NO. NO. LAMPS FOR EACH PERMIT: DATE INSPECTOR'S NAME WIRING e1.00 CONDUIT 61%TURES $1.00 WIRING ISUPPLEMENTARY .90 FI%TURES IV& POWER / A TOTAL FEE • / UTILITY CO. NOTIFIED FINAL ✓- ~ 7"663 Des#9A Cd6 12.53 OBS 5A 25M SETS 2-47 - APPLICATION FOR P BIL T (DEPARTMENT OF BUILDING AND SAFETY APPLICATION S E3 �� L COUNTY OF UOS ANGELES �i��i Orr C M. J. FOX F CHIEENGINEER <' NAME DISTRICT NO. GROUP ZONE PERMIT NO. U ADDRESS �-�- E RECEIVED BY READY FOR DATE ISSUED U U CITY TEL.NO. FIRST INSPECTION �//�� J COUNTYCERT.NO. EXPIRES 1 .,Arl ' 4, _ APPLICANT FILL IN HEAVILY OUTL NED PORTION ONLY DESCRIPTION'OF WORK oA .RESS NUMBER OF OUTLETS ON CIRCUITS LOCALITY 1 L J/ LOCATION BY ROOMS NEAREST LIGHT OUTLETS SW. PLUGS Edi CROSS ST. zp CIRCUIT A B C D E F G H K NAME zL '(, LAY .J./?vj - { 3W MAIL �9 ADDRESS 302 CITY TEL.NO. t AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION.. ELECTFICIAN. I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE OWNER. CORRECTIONS r 4.0. _ c If, r. / T e /Y-ecfs r 0 J ' Q — Z L7 tY TOTAL 14 No. OF OUTLETS 4fo $ APPROVALS NO. OF FIXTURES ��} $ 70 DATE INSPECTOR'S NAME NO. OF MOTORS H.P. $ CONDUIT NO. OF SIGNS TRANS. $ WIRING "1%J/ - ✓ R lim OR HEATERS J FIXTURES nERFE S $ POWER $ ICJ UTILITY CO.NOT!FIER 4 FINAL WORKERS'COMPENSATION DECLARATION 76A663 APPLICATION ®R ELECTRICAL NG AND PERMIT CE a06G (2-80) 1 hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES TY BUILDING AND SAFETY insure, or a certificate of Workers'Compensation Insurance,or w , h7of 3900, /�'!��/p(� `./A/ /j4 OV;FOR APPLICANT TO FILL IN JOB Policy No. Com an ADDRESS 2 �!/. New Residential Bldgs.&Pools EACH NO. FEE _ ❑ Certified copy is hereby furnished/-7/ 1 &2-Family,Sq. Ft. $ — $ LOCALITY • �i ® Certified Multi-family Sq. Ft. — NEAREST py is filed with the county building inspection CROSS ST depar[men ///, Residential Swimming Pools OWNER OR Date l Ap li an[� �� '��L-�- x FIRM NAME A) 7 Outlets: Rec.—Light Sw._ MAIL First 20 ADD'"RESS CERTIFICATE OF,.EXEMPTION FROM WORKERS' Total No. Additional CITY/ Tel N6. COMPENSATION INSURANCE d PLAN CHEC (This section need not be completed if the work involved - APPLICANT O" U by the permit is for one hundred dollars ($100) or less.) Lighting Fixtures First ADDRESS 2 Total No. Additional 0 1 certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No. U permit is issued, i shall not employ any person in any manner PERMIT 11.1 so as to became subject to the Workers' CompensationLaws. Range_Heater—D.W. APPLICANT d Oven _ Dryer_ M._ ADDRESS. I A Z Date Applicant Top FAU L� W.H.. - Hood _ Fan _Other_ /fj CITY �r Tel No. NOTICE TO APPLICANT If, after making this Certificate of Disp. _ Room Air Cond-_ OC ' KENS OR / „ Exemption, you should become subject to the Workers' REG.NUMBER /'/~ Class Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO. PR CE D SY with comply with such provisions or this permit shall be deemed revoked. Size&Type HP, KW, KVA,or KVAR Up to 1 Incl. INAL Over 1 to 10 loci. ATE _�f/ VALIDATI N LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl. (,�fJi I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL . 9 (commencing with Section 7000) of Division 3 of the Busi- Over 100 BY ness and Professions,Code, and my license-is in full force and effect. ServicesyAke.[�� License Number Lic. Class 0-200 Amp. Under 600 V k Ir O OrJ"Y/ 201-1000 Amp. Under 600 V Contractor Date Over 1000 Amp.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 License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits ness and Professions Code): 2,0 7 9.3 A r - Misc.Conduits& Conductors - r] I, as owner of the property, will do the work and the Other (Sea Complete Fee Schedule)— # 0,0.9.0 e 2 structure is not intended or offered for sale (Section 7044, Business and'Professions Code). 2.O a�) k 5 0 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency a;a'a for the performance of the work for which this permit is ) Q.5 issued (Sec. 3097,Civ.C.). PERMIT FEE (Sub-Total) Lender's Name PLAN CHECKING FEE (One-Fourth Permit Feel O & 1 —8 , Lender's Address PERMIT ISSUING FEE I certify that 1 have read this application and state that the TOTAL FEE , above information is correct.I agree to comply with all County ordinan es and State laws regulating Electrical wiring, and herehy uthorize re r`�sen tatives of this County to enter upon [IIg, a e-me ions propert.-for inspection ur oses. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permitae Date / WORKERS'COMPENSATION DECLARATION 76A663CE-B060 (2-80) APPLICATION FOR ELECTRICAL PERMIT lu' I hereby affirm that I have a certificate of consent to self _ COUNTY OF LOS ANGELES BUILDING AND SAFETY insure, or a certificate of Workers'Compensation Insurance,or (\ t a certified copy thereof(Sec:3800, Lab.C.) FOR APPLICANT TO FILL JOB Policy No. EACH NO. FEE ADDRESS Company N New-Residential Bldgs. &Pools Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ — $ LOCA LITV 1'(_ 1 - ❑ Certified.copy is filed with the county Multi-family Sq. Ft.—building inspectionCROSSNEAREST ST IJ FLJ 1 department. Residential Swimming Pools OWNER OR ' FIRM NAME Date Applicant Outlets: Rec._L,ght_ Sec MAIL First 20 ESS . �� Dv///I` q .CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY �B� r - Tel No. - 3/ } COMPENSATION INSURANCE PLAN CHECK a O (This section need not be completed ifthe work involved APPLICANT U by the permit is for one hundred dollars ($100) or less.) Lighting Fixtures First ADDRESS cc Total No. Additional O I certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No. U permit is issued, I shall not employ any person in any manner I PERMIT ,may W so as to become subject to the Workers' Compensation Laws. Range_ Heater_D.W. _ APPLICANT ^.1 Q N Oven Dryer .W.M. / ADDRESS 4�',3 �0W 17� Z Date Applicant Top _ FAU _W.H. — / } Hood Fan _Other— CITY 1 C`J'v�� ii3el No. 'SZ3 NOTICE TO APPLICANT: If, after making this Certificate of Disp. _ Room Air Cond.— C7!/ LICENSE OR Exemption, you should become subject to the Workers' REG. NUMBER Class Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances OISTRICT NO. PRO BY with comply with such provisions or this permit shall bea deemed revoked. Size&Type HP,KW, KVA,or KVAR D • Up to 1 Incl. FINAL Over 1 to 10 Incl. DATE P. � 3en VALIDAT ON LICENSED CONTRACTORS DECLARATION Over 10 to 501net. I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL v7 9 (commencing with Section 7000) of Division 3 of the Busi- Over 10 BY - ness and Protessions.Code, and my license is in full farce and e effect. Servo-20 � + License Number Lie. Class 0-200 n , 6 0 / 201-1000 Amp. Under 600 V Contractor Date Over 1000 Amp.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 r License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits . ness and Professions Code): Misc.Conduits&Conductors 1, as owner of the property, will do the work and the Other (See Complete Fee Schedule)— Structure is not intended or offered for sale (Section 7044, Business and Professions Code). - CONSTRUCTION LENDING AGENCY i 25 G S A 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) # e -1-'o a `L issued(Sec. 3097,Civ.C.). - - , Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) 2 -1- 2.200 . Lender's Address PERMIT ISSUING FEE e,o e 2 2 0 0 I certify that I have read this application and state that the TOTAL FEE 1 G 0 7_8 0 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-n ction purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Slgnatur ermittee __�—� ate p p� a e, p PERMIT 111 \VORKERS'COMPENSATION I�EC! ARATION CE-806 -APPLICATION FOR 'ELECTRICAL PERMIT I hereby affirm that 1 have a certificate of consent to self COUNTY OF LOS ANGELES r BUILDING AND SAFETY insure, or a certificate of Workers'Compensation Insurance,orl a'certified copy thereof(Sec. 3800, Lab.C.) , FOR APPLICANT TO FILL IN '0B Policy No. Company New Residential Bldgs. & Pools EACH NO. FEE ADDRESS ❑ Certified copy is hereby furnished. 1 & 2-Family,Sq. Ft. $ — $ LOCALITY –fn et, II- "✓ ❑ Multi-family$q. Ft. NEAREST Certified copy is filed with the county building inspection CROSS ST Cy 0(, o E7/J oJ E & department. Residential Swimming Pools OWNER OR �) FIRM NAME Date Applicant Outlets: RecLLightZ Sw !/ MAIL //nn First p CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. 1Additional CITY VA Qf. IT Tel No. OS COMPENSATION INSURANCE Y PLAN CHECK tl _(This section need not be completed if the work involved 6v APPLICANT O First by the permitAdditional ADDRESS cr Total No. Q 1 certify that in the � v performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No. 0 permit is issued, I shall not employ any pzrsonomp in any manner PERMIT so as to become subject to the )Yorkers' Compensation Laws. Range_ Heater_O.W. APPLICANT -rf46hf Al 4n/ LU Oven _ Dry&_W.M. ADDRESS (i 93 lti t} Z Date Applicant Top _ FAU —W.H.._ . Hood _ Fan —Other— CITY — i Tel Not 2 NOTICE TO APPLICANT: If, after making this Certificate of Disp. _ Room Air Cond.— LIDEN E OR Exemption, you should become subject to the Workers' REG. NUMBER Class Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances. DISTRICT NO.- PRSS BY with comply with such provisions or this permit shall be deemed revoked. Size&Type HP,KW, KVA,or KVAR IO • O` Up to 1 Incl. Q Over 1 to 10 Incl. FINAL DATE LICENSED CONTRACTORS DECLARATION Over 10 to SO Incl. VALIDATION I hereby affirm that 1 am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL 9 (commencing with Section 7000) of Division 3 of the Busi- Over 100 BY ness and Professions.Code, and my licenseis in full force and !� effect. - Services License Number Lic. Class 0-200'Amp.Under 600 V 2011000 Amp. Under 600 V q / ✓ l Contractor Date Over 1000 Amp.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 A ness Additional Sign Branch Circuits Law for the following reason (Section 7031.5, Busi- I r ness nd Professions Code): Misc.Conduits& Conductors �y Yn–X I, as owner of the property, will do the work and the Other (See Complete Fee Schedule)— ,�'�,' ��'✓ .structure is not intended or offered fur sale (Section - 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency 1\\ for the performance of the work for which this permit is PERMIT FEE (Sub-Total) -2 3 9 T6 A issued (Sec. 3097,Civ.C.). Lender's Name # o e o s e 2 PLAN CHECKING FEE (One-Fourth Permit Feel � � ' Lender's Address PERMIT ISSUING FEE j.a e 3 O 0 I certify that I have read this application and state that the - TOTAL.FEE t . 1300X above information is correct. 1 agree to comply with all County 0 O S–8 ) ordinances and State laws regulating Electrical wiring, and ' hereby authoriZ re resentatives of this County to enter upon _ the a - ery aned pr� for to n purposes. ` � ' SEE'REVERSE FOR EXPLANATORY LANGUAGE Signat r'e of Permittee--- - Date 1 •6ffirm that COMPENSATION DECLARATION CE 863 10/8I APPLICATION Im l�B IC p TION F09 ELECTRICAL A LmERMI T CE806GPYIr Ir IL 'fir l'90 OCI Ir II't IG IG'6. 110'( 'bi'Y lL Ir IG Y'19HG 0 I•nereby affirm that I have a certificate of consent to self v insure, or o certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec. 3800, Lab. C.) ^ Policy Na. Compony FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE ADDRESS ❑ 18 2-Family, LOCALITY' Certified copy is filed with the county building inspec- y Sq� FL $ — 5 yJ�J( -72 - tion _ ] _ tion department. Multi-family Sq. Ft. CROSS ST. G [ = ' (}l j Date Applicant Residential Swimming Pools OWNER OR �uQ ��^ ��j/ F M NAME' CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Recff_Light P(a_Sw.fT� COMPENSATION INSURANCE First 20 /L{/ ADDRESS (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.) I certify that in the performance of the work for which this PLAN CK PIANAPPLICANT CHEE permit is issued, I shall not employ any person in any mannerL - so as to become subject to the Work 'M1 , Lighting Fixtures - First 20 ^� ADDRESS tel' /^ / Total No. x� Additional Dote J1/ 1' 1CITY e. No. NOTICE TO APPLICANT: If, after m mof Fixed Appliances Not Over I HP PERMIT Exemption, you should become subject to the Workers' Range_ HeQ�tt�r�D.W. APPLICANT Compensation provisions of the Labor Code, you must forth- Oven _ DryeirW.M.— ADDRESS with comply with such provisions or this permit shall be Top — FAU —W.H. — deemed revoked. Hood _ FanOther_ CITY Tel. No. 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 DISTRICT ER. p/ PROC BY d' and Professions Code, and my license is in full force and effect. Power Apparatus 8 Large Appliances Size 8 Type HP, KW, KVA, or KVAR' s/ 0 License Number Lic. Class Up to I Incl. FINAL '0 0 Over 1 to 10 Incl. DATE VALIDATION �' Contractor Date Over 10 50 Incl. FINAL/ ]it • V ❑ I am exempt under Sec. Over 50 to 100 Inc. BY O_' B.BP.C. for this reason Over 100 / Jim U) Date: Services, Swbd., MCC 8 Ponelboords D 0 -200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V 241 a 9 A ❑ Exemption for Reg. Moint. Elect, Over 1000 Amp, or Over 600 V a0 0. a¢J9 e e SINGLE FAMILY Temp. Power Pole 8 Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit a e 06005 I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits Low for the following reason (Section 7031.5, Business and 0 310-86 Pro essions Code): NKI, as owner of the property, will do the work and the Misc. Conduits 8 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) 's (Sec 3097, Ci, C.). ev PLAN CHECKING FEE Lender's Name �( PERMIT ISSUING FEE U Lender's Address I certify that I have read this application and state that the TOTAL FEE Ad.510 above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby author' representatives of this County to enter upon t ti p a ✓inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE I JAM tgnat Pe i1 — Date