The URL can be used to link to this page

Home My Public Portal About9032 CALLITA ST_Electrical__ WORKER'S have a certificate of consent to 2HD6,9DPw.c,2-9n APPLICATION FOR ELECTRICAL PERMIT 20 0019 I hereby affirm,that I have a certificate of consent to self insure, . 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(Sec..3800 Lab.C.) POIICy NO. COmpanY FOR APPLICANT TO FILL IN ADORES$ D3Gp L(LR ySC ❑ Ce`rtified-copy is hereb furnished NO. EACH FEE Y ,- New Resitlential Slogs.&Pools LOCALITY , ❑� Certified copy is filed with the count building inspection 1&2.Family.,Sq.Ft. — $ $ Y 9 P - - - - NEAREST - department. Multi family Sq.Ft. CROSS ST, /•n e, Date Applicant Residential Swimming Pools ASSESSOR 'MAP BOOK I PAGE PARCEL ,CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER OR COMPENSATION INSURANCE ' Outlets:ReC T7 Light�—SeFirst 2 t� a IRM NAME ?or5e. :. 4a ra oq (This,section;nee' not be completed If the work involved by the MAIL permit is.for'one hundred dollars IS 100)or less.) Total No. Additional Z certify that in the performance of the work for which-[liis permit - CITY ie,iis�� Tel.r y j7/Z Pd-3'7741 is issued. I Shall not employ any.person In any manner so zs t0 - - PLAN.CHECK ' become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANT Total No Additional Date If " 1Z—g2 Applicant 610 rth /"arQ� ADDRESS NOTICE TO,ARPLICANT:;,If, atter making is Cerlif ice RESIDENTIAL APPLIANCES NOT OVER 3 HP. of CITY Tel.No. Exemption, you should become subject to the Workers' Compensation OTHER APPLIANCES NOT OVER 3 HP. PERMIT provisions Or the Labor Code, a deemed forthwith with such Power Apparatus&Large Appliances APPLICANT provisions or this permit shall be tleemed revoked. LICENSED CONTRACTORS DECLARATION- Size&Type HP,KW,KVA,orKVAR ADDRESS I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl.(commencing with Section 7000) of Division 3 of the.Business and CITY Tel,No. Professions,Code,and my license is in full force and effect. Over 10 to 50 Ind. } LICENSE OROver 50 t0 100 Incl. REG.NUMBER ER sass. d License Number LIC.Class Over 100 DISTRICT NO. PROCESSED BY O C) p�. Services,Swbd.,MCC 8 Panelboards �flir��i/ 2 Contractor Date 0-399 Amp. Under 600 V FIATE NALO ❑ I am exempt under Sec. 400-1000 Amp.Under 600 V -!r/L W' Over 1000 Amp.or Over 600 V FINAL /nJ VALIDATION EL .B.&P.C.for this.reason - BY // f7 BRANCH FEES � 'Lt��:Y Date: 15A,or 20A, 120V,Lighting or Recept. Z 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits ' - ❑ _ 41 Or More Branch Circuits Exemption for Reg. Maint.Elect. 15A,20A,208V TO 277V Lighting Br.Circuits SINGLE FAMILY Temp.Power Pole&Appurtenances 7 HOME OWNER-BUILDER DECLARATION 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 - - Code): - . 3307 40.05 I,as owner of the property,will do the work and the structure 'Misc.Conduits&Conductors " 1 1 i ENC. ttbb is not intended Or offered for sale(Section 7044, Business. Other(See Complete Fee Schedule)_ D �117ALV�'h Vc ® and Professions Code). - F CONSTRUCTION LENDING AGENCY CHECK 41i.UZI ' I hereby affirm that there is a construction lending agency for the i.rIFIHGt performance of the work for which this permit is issued (Sec. 3097, PERMIT.FEE (Sub-Total) Civ.C.) - PLAN CHECKING FEE Lender's Name ij1]Qp—U!)! 1 11. 13cv PERMIT ISSUING FEE LA Z5 Lender's Address - - - 6476 1 FlitLs :01 -- I certify that I have read this application and under penalty of purjurystate TOTAL FEE 1 - that the 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-mentioned property - f/orr iinssppP/�J�II n purpose SEE SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE QVIEHIVITTEE �I UATE. 76A6 WORKERS' that have COMPENSATIONDECLARATION of corse CE.863 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self CE�806G insure, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec. 3800, Lab. C.) 7 7 Poticy No. ❑ Company FOR APPLICANT TO FILL IN JOB ADDRESS J Z Certified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE s ❑ Certified copy is filed with the county building inspec- 18 2-Family, Sq. Ft. S — $ LOCALITY tion department. Multi-family Sq. Ft. — NEAREST Residential Swimming Pools CROSS ST. OWNER OR Date Applicant FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec_LightSw._ 'MAIL r COMPENSATION INSURANCE ADDRESS (This section need not be completed if the work involved by First 20 ' '` the permit is for one hundred dollars ($100)or less.) Total No. Additional CITY j. Tel. No� I certify that in the performance of the work for which this PLAN CHECK permit is issued; I shall not em Io APPLICANT p p y any person in any manner so alto become subject to the Workers'Compensation laws. Lighting Fixtures First 20 ADDRESS Additional Date ,,rr��""'' L +^ A' Total No. CITY Tel. No. —��7 Applicant 74�,� �fP'�!s-LL� Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT ,L 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 N < with comply with such provisions or this permit shall be Top _ FAU —W.H. — deemed revoked. Hood Fan _Other_ CITY Tel. No. LICENSED CONTRACTORS DECLARATION EN E OR Disp. Room Air Cond. Class. t hereby affirm that I am licensed under provisions of Chapter 9 REG. NUMBER �,�� (commencing with Section 7000) of Division 3 of the Business DISTRICT NO. PROMY BY EL and Professions Code,and my license is in full force and effect. Power Apparatus 8 Large Appliances �`/'�� /r�/ 0 A Size 8 Type HP, KW, KVA, or KVAR' License Number�/'��7!%Z Lic. Class Up to 1 Incl. FINAL e��O �s.-/�� .3 'z'� Over 1 to 10 Ind. DATE VAL ATION Contractor l7]IIG�CC�t Date Over 10 to 50 Incl. FIN W ❑ 1 am exempt under Sec. Over 50 to 100 Inc. BY d Over 100 Z BAP.C. for this reason 3-2.-e7 ,�p Z_ . . D te: . J—z (J 7 Services Swbd., MCC 8 Panelboards D 2 6 6 O,b A 200 m oder 600 V 5'gnaturr�r,e2✓�-C - 1000 Amp. Under 600 V # e e.e e e 2 '❑ Over 1000 Amp. or Over 600 V 1,( ,e e 2 6 5.O Exemption for Reg. Moint. Elect. SINGLE FAMILY Temp. Power Pole 8 Appurtenances •,e;° 2 5.5.00 HOME OWNER-BUILDERDECLARATION Sign with One Branch Circuit I hereby affirm that l am exempt from the Contractor's License Additional Sign Branch Circuits O 31 O 2.'-8 7 Low 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)_ 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-Totol) T 7 (Sec. 3097, Civ, C.). PLAN CHECKING FEE, L Lender's Name 'a PERMIT ISSUING FEE Lender's Address ( .) V 1 certify that I hove 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 the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE 3-2 ign r f Permittee Date WORgERS'COMPENSATION DECLARATION 20 0(19 opw sie> p ��p '�p��®�A ®� ELECTRICAL �t�� •I hereby affirm that I have o certificate of consent to self CEA8D6G APPLICATION A N L (L E insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certified copy thereof (Sec. 3800, Lab. C.) i Policy No. Company FOR APPLICANT TO FILL IN JOB p ❑Certified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE ADDRESS /0 z. �< ❑Certified copy is filed with the county building inspeo- 18 2-Family,.Sq. FL LOCALITY $ _ $ ( tion department. Multi-family Sq. Ft. NEAREST CROSS ST. Dote ApplicaN Residential Swimming Pools OWNER O // FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Re< ight�_Sw.L MAIL '\ COMPENSATION INSURANCE ADDRESS CS7 111; First(This section need not be completed if the work n`volved by Total No. Additional CITY S' 4 (J Tel. No. the permit Is for one hundred dollars ($100)or less.) CHECK I certify that in the performance of the work for which this PLAN N CHECK LICANT permit is issued, I shall not employ any person in any manner Lighting Fixtures First 20 ADDRESS so as to become subject to the Work rsAdditional'Compensation Laws. Total No. CITY Tel No Date �Applicant 6142$. Fixed Appliances Not Over I HP PERMIT TO APPLICANT: If, after making tA" nificate APPLICATION 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. Hood — Fan —Other— CITY Tel. No, LICENSED CONTRACTORS DECLARATION LICENSE OR Disp. — Room Air Cond. — REG. NUMBER Class. I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NO.C� OPROCESSED D d and Professions Code,and my license is in full force and effect. J Size &Type HP, KW, KVA, or KVAR y O License Number Lic. Class Up to I Incl. FINAL —y/n�r�/ O G --S V� VALIDATIO Over 1 to 10 Incl. DATE QC/CCCIII Contractor Date Over 10 to 50 Incl. FIN O ❑ I am exempt under Sec. Over 50 to 100 Inc. O LU B.BP.C. for this reason Over 100 a Services, MCC 8 Panel boards U) Z Date: 0-20000 Amp. Under 600 V �� Signature 201 - 1000 Amp. Under 600 V Exemption for Reg. Mainz. Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY Temp. Power Pale 8 Appurtenances HOME OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit 0 0 9,7 A Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits t Prof ssions Code): #'s e e s,e 2 ffI, as owner of the property, will do the work and the Misc. Conduits 8 Conductors Other Complete Fee Schedule ') �• °:1 7.2 5 See Clete structure is not intended or offered for sale(Section 7044, ( P )— Business and Professions Code). D x •'•.••1 ;7.2 CONSTRUCTION LENDING AGENCY ' 1 hereby affirm that there is a construction lending agency for 7„0 7;c 88 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 Lender's Address I certify that I have read this application and state that the TOTAL FEE )Y 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. 2th above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE ignoture f e � Date O'