HomeMy Public PortalAbout5841 CAMELLIA AVE_Electrical__ 'f6A6 63
Dm*-ZAA 7.59 APPLICATION FOR ELECTRIC PERMIT I•
Dri=ON OF BUMDING AND SAFETY
Depart-ent of County Enefnew
Com of Los ■,,,,�� eurLDING
WM.J. FO�c COUNTY NOIN� ADDRE85
CAMSATT D. GRIFFIN,OU', I of IMUMMIHO r
LOCALITY
p
F_O�t_A� NT TO FILL IN N�
}�,jlljjr �'�$ 11111111m c ae et.
NUMBER EACH FEE
OWNS
LIGHT OUTLETM
MAIL
RECEPTACLES AIDDRE.SD
WALL SWITCHES
TOTAL OUTLETS 15 • CITY ,
EL-EC. RANGES 25 Ll ELECTRICIAN
ELEC. HEATERS 215 ADDREIG
KW ILA CITY TIKL,NO.
FIXTURES D g
NUMBED OF LIbHT CIRCUITS - DISTRICT NO. GROUP ZONE I 2LUY F01 IIIfrlCT10{
NLYM19ER OF RECEPTACLE CIRCUITS
MOTORS
mfr
HUMBIR HORSEPOWER "m INSPECTION BECOBD
Hlw WD. HP ovz:k IHc. [ACH
a Lria 111 .215
2 .150
2 15 1.00
5 15 1.00
115 150 2.150
50 200 5.00
M18C-
NO.SIGNS NO.TRANS.-
GNS NO MPS
FOR EACH PEIJMjTv
WIRING 1111.00
FIXTURES 41.00
SUPPLEMENTARY - Do AMOVAIS
TOTAL FEE s DATE I1115PECTOR'S SIGNATURE
I HER BY ,Y,C[NON•LEDGE'1HAT I HAVE READ IS APPLICATION CONIJUIT
AHD BY TE TkAT TH8 ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCO AND STATE LAWS REGULATING JVVIRING � 7"
ELECTRICAL WIRING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AIIDJOR FLXTUREQ
LICENSED AS REQUIRED BY LAS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AY THE LEGAL OW14KR OF THE ABOVE POWER
DEBCRIBED RE/IDXNTIA OPERTY:
UTILITY CO.NOTIFIED
SIGNATURE -
OF P[RMI'iTEA4�� FINAL• I i II v
WI 1 leu J. FOX.COUNTY l NCHNIl= VALMAXION A. C.VETT,CHIR E>_zaT.lHapicrort
8334 JL 19 2 X25 �.
• m
COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Department of County Engfn F ELECTRIC
DNI$ION OF BUII..DINC3 8c BAFEZ'Y
WILLIAM L FOX. Osouhy EagImew
FOR APPLICANT TO FILL IN DIBTR IOT NO. 0�P � PER IT NO.
ELECTRICIANZVH RED I t1I READY FOR DA
ADDREM 2 FIRST INfHOTION
CITY 21 .•� Z ZTICL. NO.C/ j A r
COUNTY LIP[H- W-Z 44
MIK XXPIRTA ■UILDING
P� ADDRESS
Fu r
NUNo[R EACH LLSSALALITY
LIGHT OUTLETS NEAREST
RED[PTAD LEN
WALL ■WITOHEf OWNER
TOTAL OUTLETS So MAIL
EL[a RANGES an ADDR[■1• {� (�
�~
[Lia HEATERS >u ar Y6 TEL N
F I XTL Rmw ■
I HEdEffy AOKNOWLIDG[ THAT 1 HAVE READ THIN
APPLICATION AND STATE THAT THE ABOVE 1■ OURRE17T
HUMMER OF LIGHT CIRCUITS AND ADRs[ TO OOMPLY WITH ALL COUNTY ORDINANCE■
NUMBER OF R [PTAOL[ CIRCUITS AND O'TATE LAW■ REOULATINS dE0TR1OAL WIRING,
�— R I O RTIFY THAT 1 POSSE THE ASDV[ VALID LOS
NL1Mt[w HORSEPOWER FL[ ANGIO-EX COUNTY LIO[Nfi, DR I AM THE L INAL DINNER
NEW MVD. Hr avow 1"im lOr THE RESIDENTIAL QROP I■[D A■CVL.
Ya i •25 011NATLRi OF
.SO P[RMI --
f s 1.11 INSPECTION RECCqW
IS 115 1.60
1■ BO 2.50
013 =00 S.DO LS'
Sao Bog 1 aD0 /S. J
■oo 1000 1■.00 Q
� Z
DV[R 1000 20.01 p
Md. SET FR CHANGER-HP - r
W[LD[Rfs AC-KVA O
G[N[RATURS - KW i l
TRANSFORMERS - KVA
TEMP. MOTORS (76 or owl■.)
MOVED MOTORS (7111or amisO �-
MIND.
81ON8
N0 N0.TRAM■
NIL N APPROVALS
FOR EACH P[RMITI DAT[ IHSP[OT'OR7 NAM[
WIRING 1.00 / CONDUIT _
FIXTURES GI,� WIRING
stippLzmgKTAilry AUL F lX'TU RES
POWER
TOTAL FRa Ij/ 0 UTILITY Ca NOTIFIED
`V FINAL
TUM DBS#6J 4-62
NORKFBS' COMPENSATION DECLARATION 76A663 10/B1 APPLICATION FOR ELECTRICAL PERMIT
I•hereby afflrFft that I have a certificate of consent to self a�G' �j
Insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY lul
or a certified copy thereof (Sec. 3800, Lab. C.)
Policy No. Company FOR APPUCJ1Nf TO ILL IN AJOBDORE55
LrJ} Certified copy Is hereby furnished. New Residential Bldgs. 8 Pools EACH NO.
— Y
Certified 1 8 2-Family,copy Is filed with the county building Inspec- Y, Sq• Ft. _ $ LOCALIT
tion department. Multi-famlly Sq. Ft. — NFAREST
Residential Swimming PoolsCRCSS ST.
Date Applicant OWNER OR
FIRM NAME
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw._ MAIL
COMPENSATION INSURANCE ADDRESS /V
(This section need not be completed H the work Involved by First 20
the permtt Is for one hundred dollars (=100)or leu.) Total No Additional CITY U Tel. No. – 3
I certify that In the performance of the work for which this PLAN
CHIECY
permit Is Issued, I shall not employ any person In arty manner
APPU ANT
so a,to am subject to the Work Com pensatIan Laws. Lighting Fixtures First 20 ADDRESS
Additional
r� Total No. CITY Tel. No.
Date llcan Fixed Appliances Not Cher I HP
NOTICE T APPLICANT: If, after making this rem
l a of PH2AAlT
Ran Heater_D.W. APPUC NT
Exemption,_ tj
you should become wblect to Workers' 4e—
Compensatlon provltlons of the Labor Code, yost forth- Oven — Dryer W.M. ADDRESS
with comply with.such provisions or this per
shall be Top — FAU —W.H. —
deemed revoked. Hood — Fan —Other— CITY Tel. No.
LICENSED CONTRACTORS DECLARATION t1ffNM
I her affirm that I am licensed under OR
p Disp. — Room Air Cond. Class
ebY provisions of Cha 9 REG. NUA%BER }.
(commencing with Section 7000) of Division 3 of the Business Power Apparatus 8 Large Appliance: DISTRICT NO P BY it
and Professions Code,and my license Is In full force and effect. O �(_f� �'
Size 8 Type HP, KW, KVA, or KVAR J (J 11
License Number I Ic. Gass Up to 1 Incl. FINALl�
Over 1 to 10 Incl. DATE jLJ ]�C3 V TFON
Contractor pate Over 10 to 50 Incl.
FINAL lit
I am exempt under Sec. Over 50 to 100 Inc. BY ❑.
B.BP.C. for this reasonOver 100 Z
Services, Swbd., MCC b Panelboards
Date: 0 -200 Amp. Under 600 V ► ,f �S _ $ Ca �ts1�
Signature 201 - 1000 Amp. Under 600 V
DOver 1000 Amp. or Over 600 V
Exemption for Reg. Malnt. Elect.
SINGLE FAMILY Temp. Power Pole 8 Appurtenances
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit
I hereby afflrm that I am exempt from the Contractors Lice r" Additional Sign Branch Circuits c o 5
Law for the following reason (Section 7031.5, Business and
Professions Code): o 0 0 1 '�.5
06
I, as owner of the property, Mlsc. Conduits 8 Conductors
p perty, will do the work and the ,
structure Is not Intended or offered for sole (Section Other (See Complete Fee Schedule)_ 1 1,2 1 "8 5
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 Iswed PERMIT FEE (Sub-Total)
(Sec. 3097, Civ. C.).
PLAN CHECKING FEE
Lender's Flame
PERMIT ISSUING FEE
Lender's Address
certify that I have read this application and state that the TOTAL FEE
bove Information Is correct. I agree to comply with all County
rdinances and State laws regulating Electrical wiring, and
ereby authorize representatives of this County to enter upon
e bove-ment nod property for Inspedllonn pu SEE REVERSE FOR EXPLANATORY LANGUAGE
nature f Permittee to