HomeMy Public PortalAbout5821 CAMELLIA AVE_Electrical__ T{AWIC- CK0061111 13/75 APPLICATIOFOR ELECTRICAL PERMIT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN JOB
FR(aldantlal
Bldgs &Pools
EACH NO. FEE ADDRESS
Sq. Ft $ — $ LOCALITY
q. Ft — NEAREST
CROSS ST.
imming Pools OWNER OR
FIRM NAME ,
Outlets: Light,Switch &Receptacle MAIL '
First 20, ADDRESS
Addltibnel CITY 22249LTel. No.
PLAN CHECK
Lighting Fixtures APPLICANT
First 20 ADDRESS
Additional CITY Tel. No.
PERMIT
Fixed Appllarces Not Over 1 HP APPLICANT
Range Heater_ D.W. ADDRESS
Oven Dryer W.M_ /
Top FAU W.H. CITY Tel. No.
Hood Fen LICENSE OR r D
Dbp. A.0 REG. NUMBER v� Cle O
1 H1R911 ACKNOWL■Dot THAT 1 HAIL "LAD THIS APPLICATION OG
AND ■TAIL THAT TH■ AIS OI< 19 CORRSCT ANO A.II . TO COMPLY 0
Power Apparatus& Large)4ppliances ..TH ALL COUNTY OR D IMAM C.
AND ■TAT< LAW• RLGULATIM. 1
KLLCTRICAL WINING.
SizeW_&Type HP, KW, KVA,or KVAR o_
Up to 1 Incl. I HSR<WY CSRTIFY THAT I AY MOrCRLY R<OI■TKRLD AMD/OR
Over 1 tor10 Incl. LJCL /[O AS RKQUIRKD BY LOS ANQ■LM■ COUNTY AND STATK OF
CALIrNORNIA OR THAT 1 NL LZOAL CIS MR OP THIS AMOV<
Over 10 to 60 Incl. DRSCRIESD Ri.IDKNT1 PRO, TY.
Over 60 to 100 Incl. PERMITEE IL
Over 100 SIGNATURE
RI T NO. P ES BY
Saw i cels
0-200 Arne. Under 600 V �u
201 - 1000 Amp. Under 600 V APPROVALS INSPff R
Over 1000 Amp.or Over 600 V SIGNATURE
TEMP. POWER POLE
Temp. Power Pole&Appurtenances UNDERSLAB WORK
Sign with One Branch Circuit
ROUGH CONDUIT
Additional Sign Branch Circuits
(Other) WIRING
FIXTURES
POWER AUTHORIZED
PERMIT FEE (Sub-Total) UTILITY CO.NOTIFIED
PLAN CHECKING FEE (One-Fourth Permit Fee) FINAL
PERMIT ISSUING FEE NOTES
TOTAL FEE / 3 1
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT V ID TION K. M.O. CASH
2 3 819-M. 21 'S.9 0 •M
10/81
W)7R}(ERS'9OMPEt"-noNi)r=qA-A�ON "%6.3APPLICAMON FOR ELECTRICAL PERMIT' �, that i nave a re oorreent to eetr k,aur>3
ce�oao
did �"0 csrtfff�fe of Wortrere' (3orru�ueneatbn Insurance, or a owttfied COIJNTY'.OF LO$ ANGELB5 BUILDING AND ' AFEM
Qop+y.theev,}sap 3aoo,Lab.C)
P-6-�, a S J FOR"ApN-r-&AT To'Fm- iN • ice
1
❑ Carl f Dopy to hefeby,f4rnisi- . New% de-m BOW-a EfvC}I No.
Certffled copy Ye,fled C unty buldtrng knepectfon 1 a 2-Famlly,3q.Ft: $ — LOCA11�T1
depertmQrrt Mu tl-f6m1ly 34 Ft 1 NF�sr
cRCsa sT. .
fi 3 - HeeldernriAl 3w4nfnkig Pooh bV44ER OR
NALC
CEaTf1'1 -h=-of EXEMPTION FRom woRKER9' Outfetm Rec Light T_Sw.' i MAL
CQMPEN-9. I N.IN3UFIANCF SS ,'..
(Th Is.section need not be rofrpieted If the Work tnroty by the Fkat 20 .
l f le for one hundred dol lure(1100)pr We&) ibtal Na_ CrTI Tel.Na
1•c6rttfy'#0 hr the Perfornrl�—of.the work Tor whbh tf* permit APPPPtJC N7
Id laaued,I sWI nq(.4rpioy any person fn.anY,manner sa ES, to
beoPrne•aub} tq the.Wor"'Corr>�n Leve. ' Lighting FUturee rw 2b ADDR)=33
Totaa•Na Addrtiorn�f CITY- TeL'No
Apo;oapt Fixed AppMrtces Not Over 1 HP.
fi TQ (f: .•abw mekfnp this CerltfiRate of PERlfr,
,4P�LIc"�rr�..
you should,become pub}ectto the~W31 Qwpeaeatbrr Range_'Heater, D.W. rr
pr�blogs Qf the Labor_Code,you sun# forthwith oompty,wkh such Oven._ dr`yer WY ADDRE83
pray bns 0r this permit d-fl be de9rnefl Ie lop FAU ._WN CfTY
LiCEN q CANTRAgroRS DECLARAT ON .. Hood Fac _.Other_ ;
I herby amgn ttlat 1,9M Ik;enlyed un dw-provldbns.of Chapter D p = Rpqnj Ur Cord Gi*a
(gd�na WWe�rr Soq5w 70001:of dhrlebn'3 of the&mkueee and
pr6feeelons Codg and Friy fbenae b In fuA force epd efreot Power AMe��&Large pilaroft
Dt9THCTtJO $Y _
- / SU,6 a Type HP,KW,KN#k,or Kv4R
License NumberI/_7 IJo C19f>s l� U4�)0 1 lid FINAL
Over Y to 10•Ind. DATE,
�''�j{ T Over 10 tD,r o hic- FINAL
ISI I ern qw pt under Sea Over 60 to.100 Jna By.
BAP. for thla rogson Oyer 100"
C. U
Sorvlcec,Swt d; OC a Pwwk erds Z.�
p 0-'200 Arno.Under 6Q0 V
Signature 241 - l000 Amp.Under saa>T _
Over 1000 Amp.or Over 600 V
Ex rptbn t«Rog--MaSht.Fieot _ _ . 9 7.3.4 A
El -
SINGLE FAMILY T Power P*a/,Wffteruentee.- _ - #.-o.o o 0 2
. .FK)-ME OWNBUILDER DSW with Floe Br�h Ckt A ,
.111 herbby that.dHlIO �
rm I am m"frprri the s Lber,ee Add- I °'o 9 Q 7 0
for the TOil wfng mosoh (Socoon 7031.6, BuNneep enlor�
d ProteasSign aanch Clraftn
Code): o a o g Q 7 U 25
.
iAec.C«nddts,a-Condabt rs.
❑ 4 as owner o(the property,wiI do the,Nork.and the etr d other ESea Gbrtrp{etQ Fee sotledc�e? o.5,3,] ^8 8
Is not lfrtandad or offered for sale (Section 704-4, a,etr,eee _
and Profeesbns Coa4
ODl49rRt.►cr LENDNQ AOENGr -
I.hereby affirm that two Is a'cortgt'4uotion lending apgrxy ibf the
pwk mancce of the work for which this pwmlt b tussuba(Set.3097, PEFMff F`EE (Sub-Total)' r
Ctv. G`.). .
PLAN,CNECKINQ FEE -
"Lender's Name r _ .
REpMQf OWING FEE. .
Lender's Adcvoa o
I certfly that) have teed thl9 ap0cation and gtaW that the above -. - BD.TAL FEE .
1rktmat1orl le correct. fagree tib corrpfy with all County ordlrarn
and State la%v wlrtrQ and hereby auth�
Of fhb County, upon the above-mentbned
f� SEE REVERSE FOR t=XRLANAT LANdLIUAGE
Date