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Home My Public Portal About6222 BURTON AVE_Electrical__ 76A663-CE80610/72 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES .f DEPARTMENT OF COUNTY ENGINEER noo BUILDING AND SAFETY DIVISION ADDRESS LOCALITY <l (�jLc.<,( ��44, NEAREST FOR APPLICANT TO FILL IN CROSS ST. OUTLETS N0. EACH FEE OWNER OR $ $ FIRM NAME REC EP T._ MAIL LIGHT TOTAL FIRST 20 25 ADDRESS SWITCH OVER 20CITY L-NO� 10 PLAN CHECK LIGHTING FIRST 20 25 APPLICANT FXTURES TOTAL .10 OVER 20 ADDRESS RESIDENTIAL APPLIANCES CITY TEL, No. / /^,� „ RANGE ORY EP. 'N TR. HTR. PERMIT _ APPLICANT 4, !"+ 1 STA. COOK DISP. F.A.U._ ADDRESS j fi S/_I Iv C-/\ y-Ll ej �I SPACE HTR. AIR COND. CITY N G Q f7jZ/0 TEL. NO.?-'/-7 64i-'7'1 1 CLOTHES WASH. OISHWASH. REG. NUEVEMBER S/ 2oG CLASS. FAN OTHER 1.00 1 MERE151 ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS. ETC. HP. KW. HVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 - 1 .100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE Y I - 10 300 OESCPMET RESIDEN PNOPERTY. � IERI U ' 10 - 50 5.00 SIGNATURE O 50 - 100 1000 DISTRICT NO. P 0 BY W 100 - 500 1SOO N Z_ SIGN, GAS SIGN AND ONE CIRCUIT 5,001 APPRDVALS DATE INSPECTOR IGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 �{� TEMP. POWER POLE SERVICENOTOVER 600 VOL TS OR 200 AMP 3.00 / UNO ER SLAB WORK SERVICEOVER 600 VOLTS OR 200 AMP IO.OD ROUGH CONDUIT TEMPSERVICE, POLE, &APPURTENANCES 5.00 WIRING -I% TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL PERMIT FEE (SUB TOTAL) NOTES: PLAN CHECK FEE PERMIT ISSUING FEE 3.013 TOTAL FEE i PLAN CHECK VALIDATION CK. M.o a PERMIT VALIDATION CK M.O. CASH 1 �.y4rnrr, i2 2 A r 6.00e�t3 SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE .j.- }WORKERS',COMPEN(SATION DECLARATION 76A663 10,81 APPLICATION FOR ELECTRICAL PERMIT `• CE806G •I'"he rejpy gfFirm That (•hove a <ertificote of consent to self re,'or ,�-certificote of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY o�rw t'fied copalth f (Sec. 3�800�, Lab. C_) O Tral y o. Compo n}/��;_tel FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE ADDRESS Qt� cy7 l 4 — 4 i' Certified copy is filed with the county building inspec- 1 8 2-Family, Sq. Ft. LOCALITY- �-./:7i tion deportment Multi-family Sq. Ft. — NEAREST (� CROSS Si Dotl✓U�l�•2�V Applicant Residential Swimming Pools OWNER OR FIRM NAME JC CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: RecLightSw.� MAIL COMPENSATION INSURANCE _First 20 ADDRESS (This section need not be completed if the work involved by Total No. CITY Tel. No. �7 the permit is for one hundred dollars ($100)or less.) Additional S�.�lls 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 Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS Total No. Additional CITY Tel, No. Date Applicant Fixed Appliances Not Over I HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT 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. CITY Tel. No. s LICENSED CONTRACTORS DECLARATION Hood — Fon _Other— LICENSE OR ,� I hereby affirm that am licensed under provisions of Chapter 9 Dip. _ Room Air Cond. REG. NUMBER Class. } (commencing with Section 7000) of Division 3 of the Business ppDISTRICT NO. PROCES BY d Power Apparatus 8 Large Appliances and Professions Code,and my license is in full force an <t. (' /� u 0 Size 8 Type HP, KW, KVA, or KVAR t(f D V License Number Lic. Class Up to 1 Incl. Of FINAL e�� u Over I to 10 Ind. DATE ,� / C VALI TION V Contractor Dat Over 10 to 50 Incl. ! lJ ❑ FINA W IkI I am exempt under Sec. Over 50 to 100 Inc. BY 0- B.BP.C. for this reason Over 100 z Dale: Services, Swbd., MCC 8 Ponelboards 0 - 200 Amp. Under 600 V Signature J '�"'-'� 201 - 1000 Amp. Under 600 V R 3 3 1.4 A ❑ Over 1000 Amp. or Over 600 V Exemption for Reg. Maint. Elect. f) # e o 0 0 0 2 SINGLE FAMILY Temp. Power Pole 8 Appurtenances / V ( o o 2 3 5 0 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License o o 0 2 5 50 5 Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits Professions Code): Misc. Conduits 8 Conductors s 1G28-85 as owner of the property, will do the work and the structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)— , 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.). Lender's Name s �L �jr�� PLAN CHECKING FEE /J% PERMIT ISSUING FEE Lender's Addreszs I certify that I have read this application and state that the TOTAL FEE 2Y 5- above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize Sepses tatives of this County to enter upon the 46ove-m �6 € roperty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE � -lS�-��b•071J V+ ign a ermittee Date 1 Of I WORKERS'that t I have a certificate of TIONcorse 76A6CE863 10,9, APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self CE-8066 insure, ore copy a Workers' Compensation Insurance, COUNTY OF LOS ANGELES �7�n,,le CityBUILDING AND SAFETY or a certified copy thereof (Sec. 3800, Lab. C.) �`�'•Y' fi�ulicy Ni450II5 Com pony State Fund FOR APPLICANT TO FILL IN 10B Certified copy is hereby furnished. New Residential Bldgs Is EACH NO, FEE ADDRESS 6 2 BurtonAve. ® I & 2-Fa mil H 9 $ — $ LOCALITY Certified copy is filed with the county building inspec- y, Sq. Ft. - 4 92 76 lion department. Multi-family Sq. Ft. — 'NEAREST r Residential SwimmingPools CROSS ST, Dote I2�2O�85 Applicant Jeriy S -eC7triC OWNER OR PP FIRM NAME DiiiseRs S DeVelOP11111I CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light_Sw._ MAIL 4275 N. Baldwin Ave. INSURANCE First 20 ADDRESS (This section need not be completed if the work involved by Total No. Additional •x CITY 1'hoR Tel. No 575-0503 the permit is for one hundred dollars ($100)or less.) 1 certifythat in the of the work for which this PLAN CHECK e performance 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 Total No. Additional CITY Tel. No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT J r5 Electric IRC. 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._ ADDRESS3876 Dimmingrd- with comply with such provisions or this permit shall be Top _ FALL —W.H. — CITY + Tel. No"; deemed revoked. LICENSED CONTRACTORS DECLARATION Hood _ Fan _Other_ r1?IdSd�A }�.imT'F CI1. 3R— 55c. _ _ I hereby affirm that I am licensed under provisions of Chapter 9 Dis p Room Air Cond. LICENSE REG NUMBER ClassBER 259475 CIO- (commencing with Section 7000) of Division 3 of the Business DISTRICT NO—_ �/ PROCES D and Professions Code,and my license is in full force and effect. Power Apparatus 8 Large Appliances (f a IL Size & Type HP, KW, KVA, or KVAR• J t 0 License Number 259475 Lic. Class CIO— Up to 1 Incl. FINAL W JerrV'S EleCtr16;te 12/20/85 Over 1 to IO Incl. DATE VALIDATION 0 Contractor❑ Over 10 to 50 Incl. I--FINAL 1 am exempt under Sec. Over 50 to 100 Inc. BY d B.BP.C. for this reason Over 100 W Date: Services, Swbd., MCC 8 Ponelboards , 0 -200 Amp. Under 600 V Signature 201 - 1000 Amp, Under 600 V ❑ Over 1000 Amp. or Over 600 V Exemption for Reg. Moinl. Elect, SINGLE FAMILY Temp. Power Pole 8 Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I 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 Professions Code): ❑ I, 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)_ 3 9 ) 8 7044, Business and Professions Code). ` 4 CONSTRUCTION LENDING AGENCY ( ° O a 2 6 1 hereby affirm that there is a construction lending agency for ° Fly pX v the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) O �' (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE 10 .50 Lender's Address 1 certify that I have read this application and state that the TOTAL FEE _ 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 4theaveentioned roper y for in ection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE 2/20/85 ure of Permittee Date