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Home My Public Portal About5320 BUTTONS AVE_Electrical__ 76AGGZ-CES06_9.E7 APPLICATION FOR ELECTRIC PERMIT �. 'COUNTY OF LOS ANGELES DD 1,J DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION - ADDRESS J 6 JOHN A.LAMBIE.COUNTY ENGINEER r CASSATTD.GRIFFIN,SUP•TOF BUuo1NG LOCALITY - .. .,. NEAREST FOR APPLICANT TO FILL IN CROSS ST. PEFMT FEES �Al� ITEM NUMBER EACH FEE OWNER Y• 4Y%hll ff (�..s. OUTLET I�p (`_ S S MAIL , 22 '8VZCO)I .J L LIGHTS RECEPT./�( SW.� )G� .10 6 /n AD DR ES$ J) �( /� ry n LIGHTING FIXTURES 1 7 .10 T O CITY '!'E ��• TEL.NO. -49-oa 2'/ ELEG RANGES CLO,ORYERS �. ELECTRICIAN • A SC�j/pot`jA WATER HEAT � RS / .SO � LEG SPACE HTRS. DISHWASHER ADDRESS /O C! J . /YEC✓ T e GARSAGE�ISPOS �U� J� CITY / TEL.NO. I-ADD YG ASHERS STA.COOKING UNITS .25 / , OV STATE LICENSE NO.-MVTCTr7 a 7D $: OVER INC. H.P. O — 9z 25 DIS RIOT NO. GROUP NE READY FOR irvsrecnoN z — 2 .50 INSPECTION RECORD 2 — 5 1.00 5 — 15 1.50 15 — 50 2.50 SO— 200 5.00 SIGNS: NO.TRANS. NO.LAMPS ' SERVICE 0-600V 1.00 " cO SERVICE OVER 600V 5.00 MISC. WIRINGPERMIT 1.00 , QQ FIXTURE PERMIT 1.00 1 OO SUPPLEMENTARY PERMIT .50 TOTAL FEE S a. s- APPROVALS 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ° CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING , ELECTRICAL WIRING. WIRING 1 I HEREBY CERTIFY THAT I AM PROPERLYREGISTERED AND/OR FIXTURES 71- L� 1 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNS F THE ABOVE POWER DESCRIBED RESIDENT1 OPE TY, /h �'tir SIGNATURE r UTILITY CO. NOTIFIED OF PERM ITTE A / d FINAL .IDATION ARTHUR C,VETT. K MO GADN SUPERVISING LEGTRIGL ENGINEER , I ( i35 1s MAR12 2 12.55 9 76 A 663-C E806 II/)D APPLICATION FOR ELECTf�pC�m llrtO ` COUNTY OF LOS ANGELES L • DEPARTMENT OF COUNTY ENGINEER BUILDING J 3ZD U O N BUILDING AND SAFETY DIVISION COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. OUTLETS NO. EACH FEE OWNER C".F RECEPT.-L $ S MAIL J1\ FIRST 20 25 ADDRESS LIGHT_ TOTAL J CITY TEL. NO. SWITCH_ OVER 20 .Ip PLAN CHECK GHTING TOTA LL FIRST 20 25 APPLICANT FIX .IO I OVER 20 ADDRESS TURES - APPLIANCES CITY TEL. NO. PERMIT RANGE_DRYER_WTR. HTR._ APPLICANT IV STA. COOK_DISP._F.A.U._ ADDRESS If a o V SPACE HTR. AIR.COND.'Idt_ CITY L q/Tg TEL. NO./t'7 CLOTHES WASH.' DISHWASH._ LICENSE NO. Q CLASS. FAN OTHER / 1.00 OO I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE,ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC, HP. KW. KVA. ELECTRICAL WIRING. SIZE B TYPE OVER TO I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR 0 - I 1.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO } 3- •P IRCD 1 - 10 3.00 O O RESIDE IN, THE ABOVE SCRIBED RESIDENTIAL PROPERTY. O V 10 - 50 5.00 SIGNATUREOF PERMITTEE D! $0 - 100 1000 DISTRICT NO. LASS ONE PR C SSED Y Q 100 - 500 1500 — C W CL SIGN, GAS SIGN AND ONE CIRCUIT 5.00 NOTES: H Z TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 SERVI CENOT OVER 600 VOLTS OR 200 AMP / 3,00 3 00 APPROVALS DATE INSPECTOR'S SIGNATURE S ER VICE OV ER 600 VOLTS OR 200 AMP 10.00 TEMP.POWER POLE TEMP SERVICE,POLE, &APPURTENANCES 5.00 UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM 3.00 ROUGH CONDIUT WIRING FIXTURES ' PERMIT FEE (SUB TO POWER AUTHORIZED UTILITY CO. NOTIFIED 14 PLAN CHECK FEE FINAL PERMIT ISSUING FEE 3.00 CIO JOC. ROO AN . TOTAL FEE 2 SUP RV SING ELECTRICAL ENGINEER. , PLAN CHECK VALIDATION CK. M.O. CASH PERMIT V✓A LI A�ION—OSK. M.O. CASH p.6 in, 6;4- W 17 2 D 1 025,-, V SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE WORKER'S COMPENSATION DECLARATION 20.0019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT LI 0.001 I hereby affirm that I have a certificate of consent to sell insure, or a certificate of•Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS_ BUILDING AND SAFETY DIV. cop thereof(Sec 3800 Lab.C.) yN _0 onpa-n,y / FOR APPLICANT TO FILL IN JOB O f ADDRESS Certifiedcopy'ia hereby furnished New Residential Bldgs.&Pools .NO. EACH FEE _ - _ $ $ LOCALITY C rtified copriis filed with the county building inspe ion 1 8 2-Family,Sq. Ft. d pa ment. Multi family Sq.Ft. CAREST ROSS ST. Date 't •' `•Applicant Residential Swimming Pools ASSESSOR .� MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER OR COMPENSATION INSURANCE Outlets: Rea—Light_Sw. FIRM NAME ,.a. - First 20 MAIL (This_section need not be completed If the work involved by the ADDRESS permit•.is for one hundred dollars(BIBB)or less.) Total No. Additional ('certify that`in the performance'of the work for which this permit CITU - Tel.No. Z is issued, I shall not employ any person in any manner 50'a5 t0 - PLAN CHECK become,subject to the Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANT Total No. Additional ADDRESS Date' Applicant - ' .RESIDENTIAL APPLIANCES NOT OVERS HP. NOTICE TO. APPLICANT:,If, after making this Certificate of - CITY T.I.No. - .Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions o(the Labor Code, you must forthwith comply with such PEMIT provisions or this permit shall`the'deerI revoked' Power Apparatus&Large Appliances APPRLICANT + LICENSED CONTRACTORS DECLARATION _ Size&T a HP,KW,KVA,or KVAR ADDRESS 1 IHI affirm that'( am licensed under provisions of Chapter 9 Over 3 to tO Ind. �+1 (commencing with Section ]000) Of'Division'3 of the Business and - CITY Ter Nl Professions Code, and my license is in full force and effect. Over 10 to 50 Ind. �{ Over 50 to 100 Incl. LICENSE B } V REG.NUMBE a /��(�/�� //,�p� /U Over 100 DISTRICT NO. PR SEED BY 0 License Number V' 1 r Lic.Class `� ✓ V I /,� Services,Swbd.,MCC&Panelboards �(� /,/+ ,, 0-399 Amp.Under 600 V FINAL p Contractor Date DATE ❑ - -" 400-1000 Amp.Under 600 V a V (lY VALIDATION ' am exempt vntler Sec. Over 1000 Amp.or Over 600 V FINAL LU -B.&P.C.for this reason - - By it ' r.. a- BRANCH CIRCUIT FEES 4 y/ rn I 15A,or 20A, 120V,Lighting or Recept. ^tri`• / - Z Date: 1 To 10 Branch Circuits Signature . 11 To 40 Branch Circuits ❑. - - - 41 Or More Branch Circuits Aa�g Exemption for Reg.Maiot:Elect. 15A,20A,208V To 277V Lighting Sr.Circuits SINGLE FAMILY Temp.Power Pale&Appurtenances 1- HOME OWNERBUILDERDECLARATION _- I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit = for the following reason(Section 7031.5, Business and Professions Additional Sign Branch Circuits •Y + Code): a - % 3 I, as owner of the property, will do the work and the structure Misc.Conduits Conductors is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule)_ U .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 - flub-Tot - Civ: CJ - - PLAN CHECKING FEE / —4 F ' Lender's Name PERMIT ISSUING.FEE �. Lender's Address I certify that I have read this application and under penalty of purjury slate TOTAL FEE n• E" Yj that the information is correct: I agree to comply with all County rdinanc s to laws regulating Electrical wiring,and hereby authorise 0", r es v of County to enter upon the above-mentio ed property D CO I _ foil a For os SEE REVERSE FOR EXPL/6ATOW LANGU&E 0 f SIGNAToF OF PERM( DATE V O ti.