HomeMy Public PortalAbout5033 CAMELLIA AVE_Electrical__ 76ASS3 DBS SA 5-49 (V APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY ELECTRIC 1
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTR NO. GROUP ZONE PERMIT NO.
ELECTRICIAN L_ / ' D n) /
ry ,,r RE FIVE�Y'EY READY FOR DATE ISSUED
ADDRESS "(�(±' Al, �/ '/�;' _:_ �} f _� FIRST INSPECTION
CITY _� `T(t' .TEL. NO. ,Il/,^
mmmillill
r r /'rcf/rNS
COUNTY LICENSE NO. / EXPIRES - _ BUILDING L•� r'
PERMIT FEES ADDRESS .•J G/
NUMBER OUTLETS EACH FEE LOCALITY AC7 M hr--
LIGHTS Sc $ ✓N NEAREST
CROSS ST. 4 h (~ �
RECEPTACLES 5 I �...
FIXTURES 5 ..a:..r OWNER (}'':,ii� f.' �^ �-� ','/"
WALL SWITCHES 5 MAIL
ELEC. RANGES 25 ADDRESS
ELEC. HEATERS 25 CITY TEL. NO,
MISC.
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
NUMBER OF CIRCUITS INSTALLED: APPLICATION AND STATE THAT THE ABOVE IS CORRECT
I
LIGHTS RECEPTACLES AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
MOTORS AND STATE LAWS REGULATING ELECTRICAL WIRING.
NUMBER HORSEPOWER1 CERTIFY THAT i POSSESS THE ABOVE VALID LOS
FEE
NEW Mvo. HP OVER INC. EACH ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
8 LESS .25
1/2 2 .50 SIGNATURE OF
PERMITTEE
2 5 1.00
5 Is 1.50 INSPECTION RECORD
15 50 2.50
50 200 5.00
200 500 10.00
500 I 1000 15.00 "I
a
OVER 1000 20.00 Z
M.G. SET/FREQ. CHANGER-HP
lr
WELDERS: AC-KVA O
GENERATORS - KW
TRANSFORMERS - KVA
TEMP. MOTORS (75% OF ORIG.)
MOVED MOTORS (75% OF ORIG.)
MISC.
SIGNS
TYPE: NO. TRANS.
TYPE: NO. LAMPS APPROVALS
DATE INSPECTOR'S NAME
FOR EACH PERMIT-
7-
ERMIT:
WIRING r. ., CONDUIT
$1.00 I
FIXTURES $1.00 WIRING'
SUPPLEMENTARY 50 FIXTURES
POWER
TOTAL FEE $ UTILITY CO. NOTIFIED
FINAL2-
76A66C-CE#806 5-61 APPLICATION FOR ELECTRICAL PER T
COUNTY OF LOS /ANGELES
DEPARMENT OF COUNTY ENGINEER BUILDING j
BUILDING AND SAFETY DIVISION ADDRESS G AO
JOHN A. LAMBIE. COUNTY ENGINEER 7�
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY JA C L
NEAREST C
FOR APPLICANT TO FILL IN CROSS ST. /�
PERMIT FEES OWNER
I T E M NUMBER EACH FEE MAIL
/V /1 U
OUTLETS: / $ $ /? ,
LIGHTS RECEPT. SW. .10 (i
CITY /= � ( T TEL. NO.Ar
LIGHTING FIXTURES 10 _
ELEC. RANGES- ,y-CLO. DRYERS �C.,, ELECTRICIAN �-
WATER HEATERS / .50 } ADDRESS
ELEC.SPACE HTRS. DISHWASHERS
CITY TEL NO.
GARBAGE DISPOSERS AUTO.- STATE
WASHERS STA.COOKING UNITS .25 LICENSE NO.
MOTORS: OVER INC. H.P. DISTRICT 70, GR013'P Z N PRQCESD SY
.25
1/2- 2 .50 INSPECTION 'R CORD -
2— 5 1.00 d
5— 15 1.50 - U
IS— 50 2.50 O
50— 200 5.00 ~
U
W
SIGNS: NO TRANS. A
NO.LAMPS N
Z
SERVICE 0-600V
1.00
SERVICE OVER 600V 5.00
misc.
WIRING PERMIT 1.00
FIXTURE PERMIT 1.00
SUPPLEMENTARY PERMIT .50
TOTAL FEE $ ,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI &TION APPROVALS 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
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. POWER
ry ..
SIGNATURE - UTILITY CO.NOTIFIED
OF PERMITTEE
FINAL
VALIDATION ARTHUR C. VEIT
CK MO
SUPERVISING ELECTRICAL ENGINEER
CASH
UIt o 7 5 8 2 JAN 3 0 20 2.6 0
f-
"
�A�l".6 W VAN. 1
DESMI I' 1 OF WORK
W. .i.��
LOCATION BY ROOM
19190FVRWA�W ME
r�r.� n■e■■n■e■n
���►r��: rte■■■■n■�nr� _.��
rr�►�en■■■■r�■e■n
n■■■■nnr�■r• F 1 1 ; . NUN
" P 1
FA�M
ANNIE ; ■■■
NNE Will .. ran=
'�+dNOR}�F(�COMPENSATIONDECLAAATION DPW(12-21) �;PPLICATION FOR ELECTRICAL PERMIT
I y afflrm that I have 4 cortlflcate of ooneent to self Ineure,'
or a certtnoate of Worker'6 Compensation Insurance, or a certlfled COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND AFEiY DIV.
oopy thereof(8eo.aA Lab.C.)
Policy No. Company FM APPL)CANT TO RLIJOB
N
F1 5D-35 �'jqt-t Ea_[,1
Certified oopy Is hereby tumfahed New Realdwrtial B.16W.S Pools NO. EACH FEE �^
F11 a 2-F mfty,Sq.Ft. — : : LOCALITY !�P LF, G T-j
Cardfled department Dopy b filed with the county building Incpeotlon Murt>ramify sq FFtCFKM NEARESTdo,
sr.
Delle AP~ Residential Swimming Poole
O i w�oE O/ Pnxa7'Y/
CERTIFICATE OF EXEMPTION FROM WORKERRS' /n �
COMPENSATION INSURANCE O Rao. 1SC_�
(This seotlon need not be oompfeted ff the work Involved by the . ALDOFiF88 Q
permlt Is for one hundred dollars($100)or less.) Total No' A& ora!
I certify that In the performance of the work for whloh this permit C Tel. 6—
cl
Is Issued, I shall not employ any person In any manner so ae to PLAN CHECK
become subject to the workers' Compensation Laws. Lig"Free Rirst 20 APPLICANT
Total No.. Z Additional
ADDRESS
Date Applloant RESIDENTIAL APPLUNCES NOT OVER 3 HF. �' — 40
NOTICE TO APPLICANT: If, after making this Certificate of CITY Tel.No.
Exemption,you should become subject to the Worker'Compensation -OTHER APPLU,NCE8 NOS"OVER 3 HP.
provisions of the Labor Code, you must forthwith comply With such
prgvielona or this permit shall be deemed rwoked. Power Apparatus 8 Large Applkanoee
LK)ENSM CONTRACTORS DECLARATION Size S Type HP,KW,KVA,or KVAR ADDRESS
I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Ind.
(oommenoing with Section 7000) of Dlvislon 3 of the Business and CfTY Tel.No.
Professions Code,and my license Is In full force and effect. Over 10 to 60 Ind. LIC>3v8E OR
Over 60 to 100 Ind. REST NULUMP Class. d
Over 100 1393TR1CT No. PROCESSED BY S
Lloerre Number Lla Claw
Ssry 91MCC 8 PanelboardsIZ
Contractor Data DATE n o
❑ 400-1000 Amp.Under 600 V
I am exempt under Sec. Over 1000 Amp.or Over 800 V RNAL G- VALIDA�(1 W
HY
B.BP.C.for this reason BRANCH CIRCUIT FEE'S�t�y�r/gy�e��
Dais: 16Ay 20A,or 1 Z
1 To 1SkLnbh Circuits
Sig nahire 11 To 40 Branch Clroults
41Or►fore Branch Cka�te
El Exemption for Reg.Mafnt.ElsoL 1644 20A,209V To 2T7V Br.Clrctis 2
SINGLE FAMILY Temp.Power Po{e S Appurterunoss ACCT.HOME OWNEFI-BUILDER DECLARATION Sign with One Branch Cirouft
I hereby affirm that I am exempt from the Contraotor's Llcenee Law ��y o
for the following reason (Section 7031.6, Business and Professions Additlonal Slgn Branch Circuits J � 191.`?S
Code): 1 ITEMS
I,as owner of the property,will do the work and the etruoture Mlsc.Condom S �l 191 - 25
le not Intended or offered for sale (Section 7044, Buelnesa Other(See Complete Fee SohedWe) ' TOTAL
and Profesabna Code).
(tEGi'.
CONSTRUCTION LENDING AGENCY CHANGE
I hereby affirm that there Is a conetruotlon lending agency for the CE
performance of the work for which this permit Is Issued (Sec. 3097, PERMIT FEE (Sub-Total) 6
CIV.C.)
PLAN CHECKING FEE 0000—Q001 8/ 5/96
Lender's Nuns PERMIT ISSUING FEE 7810 1 AM 10:45
L.wxWe Address
I perWy that I have reed thb appkafJon and under peruity of purjury elate TOTAL FEE a
that the above InbrnxLdm Is correct. I agree to oomply with a0 County
ordlnuioee and State laws regulating Electrical wtri ng,and hereby authorbm
to enter upon the above-mentioned property
t&1 74'.PZ 4 SEE REVERSE FOR EXPLANATORY LANGUAGE
a