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Home My Public Portal About5349 BUTTONS AVE_Electrical__ 76AS63 DBS.SA a.ss APPLICATION FOR ELECTRIC PERMIT •DIVISION OF BUILDING AND SAFETY Deportment of County Engineer ' County of Los Angeles BUILDING WM.J. FOX. COUNTY ENGINEER, ADDRESS CASSATT D. GRIFFIN, SUPT OF BUILDING _ LOCALITY FOR APPLICANT TO FILL IN NEAREST PERMIT FEES CROSS sr. lz NUMBER EACH FEE OWNER(A'2.-�zA 'to'-i LIGHT OUTLETSMAIL �J A— � RECEPTACLES ADDRESS [ S�7 to C G•—.LP WALL SWITCHES - A TOTAL OUTLETS 5¢ 5 CITY EL. NO�Gf. ZSY C ELEC. RANGES 25 ,p ' _ELEC. HEATERS 25 ADDRESS KW EA CITY TEL.NO. FIXTURES 5 LICENSE NO. NUMBER OF LIGHT CIRCUITS DISTRICT NO. I C�,Q.uj'�.�REAOY FOR IXS VECT ION NUMBER OF RECEPTACLE CIRCUITS LIT�LI IFI MOTORS � r NUMBER HORSEPOWER FEE INSPECTION RECORD NEW MYO. HP OVER INC. EACH Ift&LESS $. .25 _ _ /2 2 .50 _ 2 5 1.00 5 15 1.50 15 50 2.50 50 . 200 5.00 MISQ� NO.SIGNS NO.TRANS. NO. SIGNS NO. LAMPS FOR EACH PERMIT: WIRING $1.00 FIXTURES $1.00 SUPPLEMENTARY .50 //� APPROVALS _ TOTAL FEE M ' $ // ! DATE INSPECTORS SIGNATURE 1 HEREBY ACKNOWLEDGE THAT. I HAVE READ THIS AP/ICAT CONDUIT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING ELECTRICAL WIRING. 1HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE POWER DESCRIBED RESIDER L PROPERTY. SIGNATURE UTILITY CO.NOTIFIED A �f F. OF PERMITTE FINAL �-U I�L �-1-JI Cl%h^� •� � WILLIAM J. FOX. COUNTY ENGINEER VALIDATION A. C.VEIT,CHIEF ELECT. INSPECTOR LAL000 4 5 a ncr 3 2 . 1 .10 ' in '8A669 APPLICATION FOR ELECTRIC PERMIT DBS-Sq fl-55 DMSION OF BUILDING AND SAFETY Department of County Engineer 6uILDINc County of Los Angeles aooREss JOHN A. LA GRIFFIN, COUNTY ENGINEER C HN A.D. GRIFFIN. OUT OF BunpING LOCALITY FOR AP (CANT TO FILL IN NEAREST PERMIT FEES caoss ST. [UM OWNER LIGHT OUTLETS MAIL RECEPTACLES ADDRESS WALL SWITCHES FEE CITY TEL.®NO. �� TOTAL OUTLETS @ 5¢ $ ELECTRICIAN 2.fi1►�.F 6r ELEC. RANGES 25ADDRESSELEC. HEATERS 25KW EACITY TEL.NO. STATEFIXTURES 5 Q LICENSE NO. MOTORS DIST 'rO. GROU� z.Q1�E _READY FOR INSPECTION HORSEPOWER FEE I J�LF�jSif��}y'I NEW MVa. HP OVER INC. EACH 14 @ LE55. $ .25 INSPECTION ECORD 2 .50 2 5 1.00 5 15 1.50 IS 50 2.50TI 30 1 200 5.00 MISC. NO. SIGNS NO.TRANS. NO. SIGNS NO. LAMPS FOR EACH PERMIT: L G $1.00 ES $t.00EMENTARY .50 APPROVALSTOTAL FEE $ / DATE INSPECTOR'S SIGNATURE REBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIONTATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING a "1]RICAL WIRING.REBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES SED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF RNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE POWER n IBED RESIDENTIA ROP RTY. UTILITY CO.NOTIFIED . . @) TUREERMITTEE I FINAL V JOHN A.LAMBIE,COUNTY ENGINE ATH DION ARTUR C.VEIT.CHIEF ELECT.INSPECTOR �y(/ m0 CASH s CDS 7 .4 9- .wv27 2 . 7.95 "- W 01&COMPENSATIONDECLARATION 9DPW(,2-B„ APPLICATION FOR ELECTRICAL PERMIT LI 6-0 I futhatI reby affirm That have a certificate of consent to self inre su , 7BA66 or a certificate of Worker's Compensation Insurance. or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec3800Lab.CCb..fipany e0�f CW P, y4+iS340 .. JOB FOR APPLICANT TO FILL IN ADDRESS 4 Ave ® -Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE LOCALITY ❑ Certified co is filed with the count building ins ection 1&2-Family,Sq.Ft. — $ $ �^ PY Y 9 P NEAREST- depa''rlltment.yy Multi-family Sq.Ft. CROSS ST. Date oz3"((1S ApplicantA,.,_, Residential SwimmingPools ASSESSOR FAMMAP BOOK PAGE PAPCEL CERTIFICATE OF EXEMPTION F M WORKERS' Outlets:Hac._Light Suv. 2 anNnEnl�nOnE �f\ 1 ,r COMPENSATION INSURANCE First 20 (This section need not be completed If the work involved by the MAIL ��-0DDRESs 3 49 S �/� permit is for one hundred dollars(5700)or less.) - Total No. Additional I certify that in the performance of the work for which this permit- CIT I±V - Tel.No is issued, I shall not employ any person in any manner so as to - wv become subject t0 the Workers' Compensation Laws.. Lighting Fixtures First 20 PLAN CHECK 9 9 � APPLICANT Total No. Additional ADDRESS t Date ^ Applicant RESIDENTIAL APPLIANCES NOT OVER 3 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 of visPERMIT tthehis Labor Cade, you must forthwith comply with such Power Apparatus&LAppliances APPLICANT�� provisions'or this permit shale ppus Large as be deemed revoked. p LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS 8 s C- I hereby affirm that I am licensed under provisions of Chapter 9 �, �D ) (commencing with Section 7000) of Division 3 of the Business and A,— Over 3 to 10'net CITY � CAfel.N (�i� 1 - Professions Code, and my license.is in full force and effect. Over 10 t0 50 Ind. fly } LICENSE OR Class /1 /,/.1{ EL Over 50 to 100 Ind. REG.NUMBER C O O 11 li./� Over 100 DISTRICT NO. P EBBED BY U License. �`2�p Liu Class s`�tai _ /�,{� '- -� ,, IIcc 1- - �T �7� Services,Swbd MCC&Panelboards . !JU Contractor NF�tdtP,hl ate /�.!✓�� ir 0 399 Amp.Under 600 VDATE O ❑- 400-1000 Amp.Under 600 V an exempt under Sec. Over 1000 Amp.Or Over 600 V VALIDATION 111 FINAL d BAP.C.for this reason - - BY U " BRANCH CIRCUIT FEES Date: 15A,or.20A,120V,Lighting or Recept. ., Z - _ 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits - ❑ - Exemption for Reg. Maint.Elect. 41 Or More Branch Circuits15A.20A,208V To 277V Lighting Br,Circuits SINGLE FAMILY " °` :]$°95 Temp.Power Pole&Appurtenances HOME OWNER exempt BUILDER DECLARATION Sign with One Branch Circuit ' I hereby affirm that am exempt from the Contractor's License Law for the following reason (Section 7031 5, Business and Professions Additional Sign Branch Circuits _ Code):. rj'jk fij. S 1 d h a ❑ 1, as owner of the property,will do the work and the structure - Mice Conduits&,Conductors is not intended or offered for sale (Section 7044, Business Other(Sae Complete Fee Schedule) ® i Fill Oct. and Professions Code). CONSTRUCTION LENDING AGENCY _ _ Irn�r_n�w;• —'?']t I hereby affirm that there is a construction lending agency for the - -0U,i_i v'll0 _. _1 r gJ performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total) Civ.C.) . . PN 1 11:0k PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE •� - - Lender's Address - I certify that I have read this application and under penalty of purjury state TOTAL FEE that the above information is correct. I agree to comply with all County - - - ordinances and Statelaws regulating Electrical wiring and herebyauthorize - -- - - - --- -- - representatives of this County to enter upon the above-mentioned property - for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE QZ, 6-03-q5 SIGNATOR FPERMI DATE