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Home My Public Portal About4540 CLOVERLY AVE_Electrical__ COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY WILLIAM J FOX, County Engineer FOR APPLICANT TDF DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRIC IVSD BY READY FOR DATE ISSUED ADDRESS _ (./ / FIRST INSPECTION r CITY //`v 1 TEL NO COUNTY LICENSE NO EXPIRES BUILDING L/� 0 Al, G�Cay�� PERMIT FEES ADDRESS FEE NUMBER EACH LOCALITY LIGHT OUTLETS NEAREST Q} RECEPTACLES R COBB ST Y w� R 2.v 2.4 WALL SWITCHEB OWNER �rr/� (��5 /'� TOTAL OUTLETS 5c b MAIL �/(p �/�d/ r� ' ELEC RANGES 2g ADDRESS IGS ELEC HEATERS 25 CITY �� i�� TEL NO FIXTURES 5 I HEREB ACKNOWL DGE THAT 1 HAVE READ THIS MISC APPLICATION AND STATE THAT THE ABOVE 19 CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING MOTORS 1 CERTIFY THAT I POSBE98 THE ABOVE VALID LOS NUMBER HORSEPOWERFEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER NEW MVD HPI OVER INC EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE I/y a Lcss $ 25 SIGNATURE OF �� I I/2 2 BO PERMITTE 2 B 100 INSPECTIOR RECORD 5 15 ISO -- 15 5015 50 250 50 200 Boo 200 500 1000 J 500 1000 11500 Z OVER 1000 2000 0 M O SET/FREW CHANGER-HP fY WELDERS AC-KVA 0 GENERATORS - KW TRANSFORMERS - KVA TEMP MOTORS (75% Or ORIG) MOVED MOTORS (75% OF DRIG) -MIS-c- SIGNS NO NO TRANS APPROVALS NO NO LAMPS FOR EACH PERMIT: DATE INSPECTOR'S NAME WIRING $1 OO CONDUIT FIXTURES $1 OO WIRING SUPPLEMENTARY 50 FIXTURES POWER TOTAL FEE $ UTILITY CO NOTIFIED 7�i J 0 FINAL 76A663 DBS#6A 4-52 m COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY WILLIAM J FOX, County Engineer FOR AP (CANT TO FILL IN DISTRICT GROUP ZONE P�jERMIT NO. loll ELECTRICIAN / J; "- � (i.L ` ,/)p RECEIVED BY READY FOR DATE ISSUED ADORE H as�� /n FIRST INSPECTION / CITY / T L NO "3L'1 Y/ii�/nr/wV — COUNTY LICENSE NO C' EXPIRES 194--1--1 BUILDING �f PERMIT FEES ADDRESS �1 J 7 FEE "--�� NUMBER EACH LOCALITY �h LIGHT OUTLETS �� 4 C NEAREST RECEPTACLES CRDSS8T WALL SWITCHES OWNER ' TOTAL OUTLETS 5c $ .� _ MAIL ELEC RANGES 85 ADDRESS ELEC HEATERS 25 AS, CITY TEL. NO FIXTURES 5 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS MISC APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS 31 D AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING MOTORS I CERTIFY THAT I POBBEBB THE ABOVE VALID LDS NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER NEW MVD HP OVER INC EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE %2 6 yeas !$ 25777- SIGNATURE OF' /f r I/2 2 50 PERMITTEE. 1 2 5 100 INSPECTION RECORD 5 is 1 so 15 50 250 s0 200 500 zoo SOO 113130 J CSG 'L J SOO 1000 1500 Z OVER 1000 20 013 M G BET/FREW CHANGER-HP WELDERS AC-KVA 6144�4r O GENERATORS - KWv�, TRANSFORMERS - KVA - �--i TEMP MOTORS (75% OF ORIG) MOVED MOTORS (75% OF ORIG) MISC SIGNS NO NO TRANS APPROVAL NO NO LAMPS , ,VALS D TE INSPE�oTO/RIH NAME FOR EACH PERMIT WIRING $1 OO CONDUIT FIXTURES $1 00 WIRING _ SUPPLEMENTARY SD FIXTURES C a. POWER TOTAL FEE �id UTILITY CO NOTIFIED FINAL � T6A663 DBS#5A 4-52 F rWORKERS COMPENSATION DECLARATION 76A663 CE 10/81 APPL16ATION FOR ELECTRICAL PERMIT i hereby affirm that I have a certi.icate of consent to self Insure , CE I `fl or a certificate of Workers Compensation Insurance or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec 38001 Lab C) ` 1 ' Policy No �7- Company S ( J` --—�L��+� FOR APPLICANT TO FILL IN JOB ❑ EACH NO FEE ADDRESS5bb C�{/ Certified copy is hereby furnished New Residential Bldgs & Pools r • ^1 & 2-Family Sq Ft $ $ , LOCALITY ,eG Certified copy'is'filed with the county building Inspection ` — department Multi-family Sq Ft NEAREST 77 ^ - ^s` CROSS ST tt7E Date ��J� g`1 Applicant (S ry �J� , Residential Swimming Pools " OWNER OR ' I A a 5 ' FIRM NAME' r CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec ,Light � Sw ` D COMPENSATION INSURANCE ADDRESS d (,�I Ft (This section need not be,completed If the work Involved by the ° First 20 + permit is for one,hundred dollars ($100)or less) Total No �� Additional CITY , 1 Tel No JT y.r77 19 I certify that„m PLAN CHECK the.performance of the work for which this permit � - , ` APPLICANT � is Issued, I shall not;employ'any,person in any manner so as to become subject to the Workers Compensation Laws Lighting Fixtures First 20 - ADDRESS tG 1 'r, Total No 2 Additional - CITY - Tel No f Date Applicant - Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT If after making this 4Certificate of Exemption you should become subject to the Workers Compensation Range_ Heater_ DW _ APPLICANT provisions of the Labor-Code, you must forthwith comply with such Oven'_ Dryer _ W M t • ADDRESS; / provisions or this permit shall be deemed revoked i Top — FAU _ WH CITY �' Tel No LICENSED CONTRACTORS DECLARATION. Hood — Fan _Other= _ I hereby affirm,that I am licensed under provisions of Chapter 9 .Disp — Room Air Cond LICENSE OR Class (commencing with Section 7000) of Division 3 of the Business and + REG NUMBER Professions Code and my license is In full force and effect Power Apparatus& Large Appliances DISTRICT NO PROS D BY, GSize& Type HP KW KVA,or KVAR C �1 License Number .3 3 f 9 2 Llc Class i3 I Up to 1 Incl FINAL 0'GLJG 3 „ ,% Over 1 to 10 Incl DATE .� � VALIDATION � Contractor jDate Over 10 to 50 Incl FINAL 0 ❑ I am exempt under Sec'' Over 50 to 100 Inc BY _ LLJ Over 100 B&P C for this reason fn iServices Swbd Date MCC & Panelboards , Z 0- 200 Amp Under 600 V Signature201 - 1000 Amp Under 600 V ❑ - r w Over 1000 Amp or Over 600Y y Exemption for Reg Maint Elect - SINGLE FAMILY Temp Power Pole& Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractors License Law Additional Sign Branch Circuits for the following reason(Section 7031 5 Business and Professions Code) }E j n5 Misc Conduits &'Conductors I as owner of the property,well do the work and the structure Other (See Complete Fee Schedule) t ` Is not intended or offered for sale (Section 7044 Business Other_ � „ _ and Professions Code) .s ri 2 V TOT'' r ' _,.d CONSTRUCTION LENDING AGENCY - t r 22a.LC v 25 1 hereby affirm that there Is a construction lending agency for the r performance of the work for which this permit Is Issued(Sec 3097 PERMIT FEE (Sub-Total)•. = CY'0 5-E I It P CIV C) PLAN CHECKING FEE , Lenders Name PERMIT ISSUING FEE Lender s Address An' S T. I certify that I have read this application and state that the above TOTAL FEE a ^ Information Is correct I agree to comply with all County ordinances and State laws regulating Electrical wiring and hereby authorize representatives of this Count o enter upon the above-mentioned ' property for pection purp /(��,, .- SEE REVERSE FOR EXPLANATORY LANGUAGEJ/), ri�— J ` f Sig 6re of P15rmittee f Date