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Home My Public Portal About5957 CAMELLIA AVE_Electrical__ COUNTY OF LOS ANGELES APPLICATION FOR PERMIT DEPARTMENT OF COUNTY ENGINEER ELECTRIC 1 DIVISION OF BUILDING & SAFETY WILLIAM J. FOX, COUNTY ENGMEIEI FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. /Q ELECTRICIAN ;✓ + "� ' ��~ f ADDRESS S(� RECEIVED BY READY FOR DATE/ISSUED FIRST INSPECTION er , CITY TEL. NO. COUNTY LICENSE NO. 0 EXPIRES BUILelSB PERMIT FEES- `� � ` r Y� NUMBER EACH FEE LOCALITY / C k LIGHT OUTLETS ^ NEAREST RECEPTACLES CROSSST. WALL SWITCHES •� - OWNER TOTAL OUTLETS Sc $ ,`, ,, MAIL - ELEC. RANGES 25 ADDRESS ELEC. HEATERS 25 FIXTURES 5 CITY TEL. NO. MISC. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS NUMBER OF LIGHT CIRCUITS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER NEw MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. 1/2&LESS $ .25 SIGNATURE O I/2 2 .50 PERM]' 1 ' 2 5 1.00 INSPECTION RECORD 5 15 1.50 15 50 2.50 50 1 200 5.00 7__n ..•k/.r - 200 500 10.00 J 500 1000 15.00 Z OVER1000 20.00 /� M.G. SET/FREQ. CHANGER-HP `1� Col. It WELDERS: AC-KVA r mflf Z eeQ-1? W617')" '712 GENERATORS -KW e TRANSFORMERS-KVA TEMP. MOTORS (75% OF ORIG.) 116 %r le-._ �R�v! F^, e,,/�`• MOVED MOTORS (75% OF ORIG.) 1� ` )•' �Y`'�� MISC. SIGNS NO. NO. TRANS. APPROVALS NO. NO. LAM FOR EACH PERMIT: 'DATE INSPECTOR'S NAME WIRING $1,00 (� J •',7 CONDUIT FIXTURES $1.00 WIRING SUPPLEMENTARY .50 FIXTURES POWER TOTAL FEE $ l �{D UTILITY CO. NOTIFIED 5 FINAL 76A 603 DBS 5A. 4-5Y. COUNTY OF LOS ANGELES APPLICATION FOR PERMIT DEPARTMENT OF COUNTY ENGINEER DIVISION OF BUILDING & SAFETY ELECTRIC 1 WILLIAM J. FOX, COUNTY ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GRO-UP ZONE PERMIT NO. -� ELECTRICIAN �-� ? ADDRESS Q RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION CITYaz&atzi� •TEL. NO.-AA7vj[(y/ZQn- l COUNTY LICENSE NO. ,S EXPIRES BUILDING .{� PERMIT FEES ADDRESS v - FEE I NUMBER EACH LOCALITY LIGHT OUTLETS NEAREST i RECEPTACLES CROSS ST. WALL SWITCHES _ OWNER TOTAL OUTLETS Sc- $ MAIL ELEC. RANGES 25 ADDRESS ELEC. HEATERS 25 CITY TEL. NO. FIXTURES 5 MISC. 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS - AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER NEw MVD. HP OVER INC. EACH OF THE RESIDENTIAL P7PERTY.-DES RIB OV I/2 a LESS $ .25 SIGNATURE OFZ_ �V /�-j 1/2 2 .50 PERMITTEE 2 5 1.00 INSPECTION RECORD 5 15 1.50 - 15 50 2.50 _- 50 200 5.00 200 500 10.00 500 1000 15.00 Q Z OVER 1000 I 20.00 3 M.G. SET/FREQ. CHANGER-HPFt WELDERS: AC-KVA �;i O GENERATORS - KW TRANSFORMERS-KVA TEMP. MOTORS (75% OF ORIG.) _ MOVED MOTORS (75% OF ORIG.) MISC. SIGNS NO. NO. TRANS. APPROVALS NO. NO. LAMPS DATE INSPECTOR'S NAME FOR EACH PERMIT: WIRING $1.00 G a CONDUIT - FIXTURES $1.00 op WIRING SUPPLEMENTARY .50 FIXTURES POWER TOTAL FEE $ UTILITY CO. NOTIFIED FINAL 76A 663 DBS# 5A. 4-52 6 I � V COMPENSATION DECLARATION CE-806G (2-80) 4 CE� APPLICATION FOR ELECTRICAL PERMIT - I hereby affirm that I have a certificate of consent t self COUNTY OF LOS ANGELES ILPING AND SAFETY Insure, or a certificate of Workers'�!� F cc,or a�,�e "l i certified copy thereof(Sec. 3800 OR APPLICANT TO FILL IN JOB Policy No. Comparey EACH NO. FEE ADDRE New Residential Bldgs.&Pools ❑ Certified copy is y furnished. Y.Sq.1 &2-Famil Ft. _ — $ LQOALIT ` CertNEAREST ified y Is filed with the county building inspection Multi-family Sq. Ft. CROSS ST dap ant. Residential Swlmmlpg Pools OWNER OR r FIRM NAME Da Applicant Outlets: Roc—Light Sw. MAIL r —�Irst 20 ADDRESS CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. . Additional COMPENSATION INSURANCE Cl Tel N J Y PLAN-CHECK.,- APPLICANT LAN CHET APPLICA T 8 (This section need not be completed tf the work tavolved Lighting Fixture FIrct 20 by the perraft'ts for one hundred doiars ($1010) or len.) Additional ADDRESS Tote No. I certify that in the performance of the work for which this Fixed Appllences Not Over 1 HP CITY Tel No. 0 permit is Issued, I shall not employ any person In any manner PERMIT LU u to become subject to the Worker' Comperuatlo❑ Laws. Range_ Heater_D.W. PP CANT 0. _ v Oven Dr,er_W.M. ADDRESS 6 Z Det Applicant/ Top FAU W.H. Hood Fen _Other_ CITY Tel No. NOTICE TO APPLICANT: If, after making this Certificate of Disp. _ Room Air Condom LICENSE OR Exemption, you should become subject to the Workers' REG. NUMBE leis C - Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO. PROCE SED BY with comply with such provisions or this permit shall be Size&Te HP,KW, KVAKVA /) deemed revoked- yp ,or U Up to 1.Incl. LICENSED CONTRACTORS DECLARATION Over 1 to 10 Incl. b DAL TEVALI TION Over 10_t6 60 Incl. ✓✓� L/�� I herebyaffirm that I am licensed under p FINAL provisions of Chapter Over 60 to 100 In.c. 9 (commencing with Section 7000) of DtvWon 3 of the Busi-, Over 100 BY new and Professions,Code, and my license ii in full force and effect. Services License Num / Ic Class G- Id 0-200 Amp. Under 600 V 9 9 1 A _ 201-1000 Amp. Under 1500 V Contract Date Over 1000 Amp.or Oyer 1500 V # 0 0 0 0 0 2 HOME OWNER-BUILDER DECLARATION Temp. Power &Appurtenances — 5250 er P I hereby affirm that I am exempt from the Contractor gn with One Branch Circuit License Law for the following reason (Section 7031 1- Additional Sign Branch Circuits o ° ° 5 2 506 neva end Professions Code): s Mlsc.Conduits&Conductor o 5 p 7 , 8 5 I, u owner of the property, the work and the Qther'(See Complete Fee Schedule)— structure is not intended o fared for sale (Section 7044,Business and Prof Code). CONSTRU LENDING or sale I hereby affirm th ere is a construction lending agency for the perfor cc of the wort for which Ihls permit Is PERMIT FEE (SutrTotal) Issued(Sec. 7,Civ.C.). Lender ams PLAN CHECKING FEE (One Fourth Permit Fee) Len r'a Address PERMIT ISSUING FEE I certify that I have read this application and state that the TOTAL FEE 2� above Information Is correct.I agree to comply with all County ordinances and State laws ftulating Electrical wiring, and hereby authorize representatives oft L County'to enter upon the abovemen oned pro for act n purposes. SEE-REVERSE FOR EXPLANATORY LANGUAGE T / ' Signature of Permittee Ds 6