HomeMy Public PortalAbout6212 BURTON AVE_Electrical__ 76AS63-CE806-6-57 APPLICATION FOR ELECTRIC PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER 8uI LDI NG Z
BUILDING AND SAFETY DIVISION ADDREss az
JOHN A.LAMBIE,COUNTY ENGINEER ' L1
CASSATT D.GRIFFIN,SUP'T OF BUILDING LOCALITY /�J
NEAREST /1
FOR APPLICANT TO FILL IN CROSS ST.
PERMIT FEES
OWNER
LIGHTS RECEPTACLES SWITCHES MAIL
NUM ITEM EACH E ApDRES O!
TOTAL OUTLETS $ 10 $
ELEC. RANGES, WATER HEATERS, CITY!' TEL.N(14'
CLOTHES DRYERS .5o ELECTRICIAN
ELEC. SPACE HEATERS, STAT Y. COOK-
ING UNITS, GARBAGE DISPOSERS, ADDRESS
AUTO WASHERS, DISHWASHER .25
LIGHTING FIXTURES .10 CITY - TEL.NO.
MOTORS STATE
LICENSE NO.
HORSEPOWER I]IA,'I'RICTNO. GROUP ONE READY FOR INSPECTION
H.P: OVER INC. L'
yi H LESS .25
2 so INSPECTION RECORD
2 — 5 1.00
s is I.so ��� G D NGL �ECf �A�GL,r e_Fr�Sq�
15 — 50 2.50 I—lc-& `rF��.`-"/
50 — 200 5.00 A ` '/,
`
/�At G?' if
MISC. - LL' / -J A L C/ /
GoMPG 1�lI
SIGNS NO.TRANS
NO.LAMPS
SERVICE 0-600V
SERVICE OVER 600V 5.00
WIRING PERMIT 1,00
FIXTURE PERMIT 1.00 _
SUPPLEMENTARY PERMIT .50
TOTAL FEE APPROVALS
$ DATE INSPECTOR'S SIGNATURE
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED ANO/OR FIXTURES
LICENSED AS REOU I RED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE POWER
DESCRIBED RESIDENTIA ROPERTY.
SIGNATURE UTILITY CO.NOTIFIED z -//— '7 2_
OF PERMITTE FINAL � '�l %// �✓
JOHN A.LAMBIE. VALIDATIPAP-�n ARTHUR C.VEIT,
COUNTY ENGINEER CK mo !6H SUPERVISING ELECTRICAL ENGINEER
_ Co a 5 0 i Nov 21 2 4.8 0
APPLICATION FOR ELECTRIC PERMIT 1
COUNTY OF LOS ANGELES -
DEPARTMENT OF COUNTY ENGINEER BUILDING 2 s� N f3 U9CESSEDBY
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMSIE, COUNTY ENGINEER
WILLIAM A.JENS EN.SU P'T De BUILDING _LOCALITY J u V1 l T Q V FOR APPLICANT TO FILL IN NEAREST
PERMT FEES CROSS$T.OWNER ITEM NUMBER EACHMOUTLETS: $ S IADDRESS C e- Qo!.IGHTS RECEPT. SW.IGHTING FIXTURES1OCITY TEL.NO.
ELEC.RANGES CLO.DRYERS ELECTRICIAN V1 '� /WATER HEATERS .50 ADDRESS
ELEG SPACE HTRS. DISHWASHERSCITY TEL. NO.
6ARBgGE DISPOSERS pUTO.-
STATE
WASHERS STA.COOKING UNITS ,25 LICENSE NO.
MOTORS: OVER INC. H.P. DITIUTNU. IG ZONE
0— Yz
— 2 so INSPECTION RECORD y
2— 5 12.50
_— 3/C ��� d /nii�f'/Ri1 dr�.!7 ` "L��✓[Y^F
5- 15
15— 50 50-200 SIGNS: NO.TRANS'
NO.LAMPS
SERVICE 0-600V ERVICE OVER 600V
MISO.
'I RING PERMIT 1.00
FIXTURE PERMIT 1.00
S UPPLEMENTARY PERMIT .50
TOTAL FEE
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
ANO STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT
ELECTRICAL WIRING.
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR WIRING CD 1✓b(1'•(- //
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDE ,ILAL',PR_OP'ERTTY.p POWER
SIGNATURE
� ,/!%I� UTI CITY CO.NOTIF
OF PERMI-R'
FINAL _ 1l��dl' C/✓✓ut/
®, AATION ARTHUR C.VEIT.
CK O CASH
>l SUPERVISING ELECTRICAL ENGINEER
M
Lj Ur3 7 3 6 JUL 18 2 A 2 .8 0 °
..uMPENSATl0 CLARATION 76A663 10/81 02, Z, 50- 11r?,
mat.l nave a certitic a consent to self insure, CE-6060 APPLICATION FOR ELECTRICAL PERMIT �
-run ate of Workers' Compen ati In or r a certitie COUNTY OF LOS ANGELES BUILDING AND SAFETY �J
copy thereof (Sec.3800,Lab.C.)
Policy No, Compan FOR APPLICANT TO FILL IN JOB ' /
Certified c y is hereby fur New Residential Bldgs.&Pools EACH NO, FEE ADDRESS �� N TO
/1 Cardiff i d co 1 & 2-Family, S Ft. $ _ $ LOCALITY rj lti G
���/// copy is filed the Count b ' ing ins cf y q
deft /LMUIti-f "ily Sq.Ft. NEAREST
/Y (XJ CROSS ST
Date A plicant ential Swimming Pools ,* OWNER OR nnn
-OM ,% I I FIRM NAME r S
C TIFICATE OF E MP710 AN WORK S' bO /
CO PENS SURANCE Outlets:Ree_ Light Sw. o /� ADDRESS .IC
(This action need not be completed if the work involved by the First 20 4t� ^_ �I
permit is for one hundred dollars($100)or less.)
Total No. Additional CITY i. p Tel.No.
I certify that in the performance of the work for which this permit PLAN CHECK
P P APPLICANT
is issued, I Shall not employ any person in any manner s0 as to
become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS i
Additional
Total No. CITY C' Tel.No.
Date Applicant Fixed Appliances Not Over 1 HP
NOTICE TO APPLICANT: If, after making this Certificate of PERMIT
Exemption,you should became subject to the Workers'Compensation Range_ Heater_ D.W. APPLICANT ry �� f /•rte
provisions of the Labor Code,you must forthwith comply with such Oven Dryer W.M._ ADDRESS ZZ� � A
i
provisions or this permit shall be deemed revoked. Top FAU z W.H. CITY Tel.No.
LICENSED CONTRACTORS DECLARATION Hood Fan Other_ ^�
I hereby affirm that I am licensed under provisions of Chapter 9 LICENSE OR
(commencing with Section 7000) of Division 3 of the Business and Disp. Room Air Cond. REG.NUMBER Class.
Professions Code,and my license is in full force and effect* Power Apparatus& Large Appliances DISTRICT N050( PROCESS BY
�f a
P - /•/ Size 8 Type HP,KW,KVA,or KVAR O
License N e Lia Class / t_ Up to 1 Incl. FINAL / U
�� Over 1 to 10 Incl. DAT i Z/n e-- V DATION 0
Contra - to Over 10 to 50 Incl Fl ll F-
I am exempt under Sec. Over 50 to 100 Inc. W
B&P.C.for this reason Over 100 IL
Date:
Services,Swbd.,MCC&Panelboards ► Z
0- 200 Amp.Under 600 V
e Signature 201 - 1000 Amp.Under 600 V 9 4 Q 7 A
' ❑ Over 1000 Amp.or Over 600 V
Exemption for Reg.Maint.Elect. # 0 0 0 o a 'z
SINGLE FAMILY Temp.Power Pole& Appurtenances
HOME OWNER-BUILDER DECLARATION1 o1 -1 2 Q Q
hereby affirm that Sign with One Branch Circuit am exempt from the Contractor's License Law Additional Sign Branch Circuits - . 1 ,12005
for the following reason(Section 7037.5.Business and Professions
Code):
ElI,as owner of the property,will do the work and the structure Misc.Conduits&Conductors 4,1 8-88
(
is not intended or offered for sale (Section 7044, Business Other (See Complete Fee Schedule) ,
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(Sec.3097, PERMIT FEE (Sub-Total)Civ. C.).
PLAN CHECKING FEE
Lender's Name
Lender's Address
PERMIT ISSUING FEE I certify that I have read this ap ca on and state that thea ove TOTAL FEE 0
information is correct. I agree to crop with all County ortlin es
and regNating EI ncal iring, and hereby a orize
r esentative o his Cou to or upon the above-m tipppne
property for' s io - se .
( SEE REVERSE FOR EXPLANATORY LANGUAGE
Sign a of Peuni tt D e