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Home My Public Portal About5725 CLOVERLY AVE_Electrical__ 76A663 DBS SA 11.49 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES ELECTRIC 1 WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRICIAN C RECEIVED BY READY FOR DATE HODUED ADDRESS �J t —/ FIRST INSPECTION CITY � TEL. N k COUNTY LICENSE NO IO /q EXPIRES BUILDING , PERMIT FEES ADDRESS' Y NUMBER OUTLETS EACH FEE LOCALITY LIGHT Sc NEAREST �q !8 CROSS ST. ��` V RECEPTACLES 5 00 FIXTURES 5 OWNER iEI' WALL SWITCHES 5 MAIL ADDRESS ELEC RANGES 25 ELEC HEATERS 25 CITY TEL NO MISC 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS NUMBER OF CIRCUITS INSTALLED TOTA1 .4 APPLICATION AND STATE THAT THE ABOVE IS CORRECT LIGHTS RECEPTACLES AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES • MOTORS AND STATE LAWS REGULATING ELECTRICAL WIRING NUMBER HORSEPOWER FEE I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS New MVD HP oven IHc EACH ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE V2 6 LESS >$ 25 I I/2 2 50 SIGNATURE OF 2 5 1 00 PERMITTEE VVVV IIII'"'��' IIII"'' 1 5 is 1 so INSPECTION RECORD 15 so 2 50 I so 200 500 I J ' A—/ ' 200 500 10130 1/k/i 'i t'�� .�✓/�/A/�j 500 1 Ooo 1500 " Q OVER 1000 20 OO Z /VGA 5,c-'r/ U- C9 /V M G SET/FRE4 CHANGER-HP U' WELDERS AC-KVA a O GENERATORS - KW ./ +�'�/ TRANSFORMERS - KVA TEMP MOTORS (75% OF DRIG) MOVED MOTORS (75% OF CRIG) MISC ' ` SIGNS .v TYPE. NO TRANS TYPE NO LAMPS APPROVALS DATE INSPECTOR'S NAME FOR EACH PERMIT WIRING $1100 QCONDUIT FIXTURES $1 OO QO WIRING SUPPLEMENTARY 50 FIXTURES 6 Q POWER ` TOTAL FEE >B UTILITY Co NOTIFIED FINAL ��G �.✓! ��`�—_.� � v DBS SA 3 55 APPLICATION FOR ELECTRIC PERMIT DMSION OF BUILDING AND SAFETY Deportment of County Engmeer County of Los Angeles BUILDING y � / J /y WM J FOX, COUNTY ENGINEER ADDRESS 63/ BZ .5r,5r Cee, / y CASSATT D GRIFFIN SUP T OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST PERMIT FEES CROSS ST l 4 LIGHT OUTLETS NUMBER EACH FEE OWNER RECEPTACLES Q MAIL A4DRESS !� WALL SWITCHES TOTAL OUTLETS 52 S CITY TEL NO ELEC RANGES 25 ELECTRICIAN _ELEC HEATERS 25 ADDRESS p� 'L , KW EA CITY /S TEL NO FO V4 %11 FIXTURES 5 T0c> LICENSE NO NUMBER OF LIGHT CIRCUITS DISTRICT NO GROUP ZONE READY FOR INSPECTION NUMBER OF RECEPTACLE CIRCUITS I I MOTORS r I` 1 1 NUMBER HORSEPOWER FEE INSPECTION RECORD NEW I MVD HP OVER INC EACH 1/2&LESS S 25 1/2 2 50 2 5 1 00 5 15 1 50 15 50 2 50 50 200 500 MISC NO SIGNS NO TRANS ' NO SIGNS NO LAMPS FOR EACH PERMIT WIRING $100 00 FIXTURES $100 SUPPLEMENTARY 50 APPROVALS TOTAL FEE DATE INSPECTOR S SIGNATURE I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICA ION CONDUIT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY Lr WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING ELECTRICAL WIRING 1HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE POWER i DESCRIBED RESIDENTIA 0 Y ^^ SIGNATURE UTILITY CO NOTIFIED / \1 OFPERMITTEE FINAL 140 AIR/� WILLIAM J FOX.COUNTY ENGINEER VALIDATION A C VETT,CHIEF ELECT INSPECTOR Y ' L AC0 6 9 3 2 JUN 13 2 3.7 0 0 I WORKER S COMPENSATION DECLARATION 20 DPW(12 91) APPLICATION FOR ELECTRICAL PERMIT LJ 76A663 I hereby affirm that I have a certificate of consent to self insure 76A663 or a Eertificate of Worker s Compensation Insurance or a certified COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV copy thereof(Se 38 0 b C PO Cy NbG Ompany1 FOR APPLICANT TO FILL IN JOB ADDRESS )Certified copy is hereby furnished New Residential Bldgs &Pools NO EACH FEE S Family q Ft $ $ LOCALITY — Certified copy is filed with the county building I n 1 &2 NEAREST depa ment Multi family Sq Ft CROSS ST Dat Applicant Residential Swimming Pools ,ASSESSOR f3 ti ' MAP BOOK �v PAGE D PARCEL dtlS CERTIFICATE OF EXE ION FROM WORKE Outlets ReC2� Li ht SW OWNER OR' COMPENSATION INSURA g Gv FIPM NAME G First 20 C MAIL �- (This section need not be completed if th volved by the Total No __f7_ Additional - ADDREFry; permit is for one hundred dollars($100)or less)' I certify that in the performance of the work fog which this permit CITY /I i Tel No is issued I shall not employ any person in an ' nner so as to become subject to the Workers Com ensat aws Lighting Fixtures First 20 PLAN CHECK 1 P 9 a ✓) p APPLICANT Total No Additional ADDRESS Date +E Ap ant RESIDENTIAL APPLIANCES NOT OVER 3 HP NOTICE,TO APPLICA If after making this Certificate of CITY Tel No Exemption_you shou ecome subject to the Workers Compensation OTHER APPLIANCES NOT OVER 3 HP provisions of the Labor Code you must forthwith comply with such PERMIT Power Apparatus&Large Appliances APPLICANT provisions or this permit shall be deemed revoked' 1 LICENSED CONTRACTORS DECLARATION Size&Type HP KW KVA or KVAR ADD hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl (commencing with Section 7000) of Division 3 of the Business and CITY No Professions Code and my license is in full force and effect Over 10 to 50 Incl } LICENSE OR Class Over 50 t0 100 IDCI REG NUMBER rJ a OCESSED BY License Number � Lic Class Over 100 DISTRICT NO P Op V Services,Swbd,MCC&Panelboards 0 393 Am Under 600 V FINAL Contract o �Dater � P DATE O ❑ 400 1000 Amp Under 600V 1 am exempt under Sec Over 1000 Amp or Over 600 V FINAL - / VALIDATION LL J B&P C for this reason BRANCH CIRCUIT FEES BY /�/ � 15A or 20A 120V,Lighting or Recept ( _ Z 1 To 10 Branch CircuitsSgnat�re _ 11 To 40 Branch Circuits❑ 41 Or More Branch Circuits ExemSINGElect 15A 20A 208V To 277V Lighting Br Circuits ;y �;4-t( g _ SINGL Q�UU—iF"f�14�Yy1 [l j 11' 65 Temp Power Pole&Appurtenances .-� �Y`.�- HOME OWNER BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractors License Law Sign with One Branch Circuit 9055 f ii T l �.1- for the following reason (Section 7031 5 Business and Professions Additional Sign Branch Circuits i lE Code) tc ❑ I, as owner of the property will do the work and the structure Misc Conduits&Conductors IC is not intended or offered for sale (Section 7044 Business Other(See Complete Fee Schedule) and Professions Code) _ [1 CHA IGE ,6 1 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097, PERMIT FEE (Sub Total) Civ C) - PLAN CHECKING FEE Lender s Name PERMIT ISSUING FEE Lender s Address I certify that I have read this application and under penalty of purjury state TOTAL FEE that the above information is correct I agree to comply with all County ordinances and State laws regulatin Electrical wiring and hereby authorize representatives of this C be pon a above mentioned property for inspection pur a SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNIKT015 OF PERMITTEE DATE • f Wm that I S COMPENSATION DECLARATION 76A663 DPW(12 91) APPLICATION FOR ELECTRICAL PERMIT 76A663 I hereby affirm that I have a certificate of consent to self Insure or a certificate of Worker s Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV copy thereof,(Sec 3800 Lab C) tiw `•, FOR APPLICANT TO FILL IN JOB y -J P❑OIICy NO •2 Company ��I � ADDRESS 'Certified copy is hereby furnished New Residential Bldgs &Pools NO EACH FEE LOCALITY ❑,-• c 1&2 Family Sq Ft $ $ n Certified copy is filed with the county building inspection NEAREST department Multifamily Sq Ft CROSS ST ' ApplResidential Swimming Pools ASSESSOR Date + icant �t � pl „ MAP BOOK �G, 7 PAGE�/D PARCEL [g/s— CERTIFICATEOF EXEMPTION ROM WORKERS y ! Cutlets Rec Light Sw OWNER OR ' COMPENSATION INSURANCE, _ �f) FIRM NAMEL � ° nvFirst 20 (This section needanot be completed If the work Iolved by the � MAIL permit is for one Hundred`dollars($100)or less) Total No Additional AD s y I certify t6at,in"the perfor"mance of the work for which tliis'permit CITY / �/ Tel No is Issued I shall"not employ any pe'rson in any manner so as to PLAN CHECK become subject io lthe Workers Compensation Laws 1 Lighting FIXtLreS First 20 APPLICANT t Total No Additional "^ r ADDRESS - Date" = APPhcant -- —` - Y - - '_ __-- - - - - - _ -- -_ NOTICE,T LAPP ICANT If after making this Certificate of RESIDENTIAL APPLIANCESANOT OVER.3 / _ / CITY- Tel No Exemption youshould become subject to the Workers Compensation OTHER APPLIANCES NOT OVER 3 HP provisions of the•Labor Code PERMIT p you'must forthwith comply with such power Apparatus&Large Appliances - APPLICANT provisions or this permit'shall be deemed revoked t' '"`LICENSED CONTRACTORS DECLARATION '' Size&Type HP KW KVA,or KVAR ADDRESS I hereby affirm'that I am'licensed'under provisions of Chapter 9 Over 3 to 10 Incl (commencing with Section 7000)1of Division 3 of the Business and CITY Tel No Professions Code and my license is in full force and effect Over 10 to 50 IncLICENSE l d Over 50 to 100 Incl REG NUMBER,,r 7 79 7 Class��.a O Over 100 DISTRICT NO PRO SSED BY License Number Llc Class �� / V s F Services Swbd MCC&Panelboards - �p X Contractor i— Date 0 399 Amp Under 600 V FINAL O 400 1000 Amp Under 600V DATE II q Z V ❑ I am exempt under Sec 4 l Gam— I VALIDATION W Over 1000 Amp or Over 600 V FINAL d B&P C for this reason - BY BRANCH CIRCUIT FEES Z Date 15A or 20A 120V Lighting or Recept _ / _ - - - -->- -- 1 To 10 Branch Circuits Vv Signature 11 To 40 Branch Circuits 041 Or More Brancti Cucuits ' Exemptiori fo;Reg Mamt Elect 15A 20A 208V To 277V Lighting Br Circu is 4 - L• - SINGLE FAMILY Temp Power Pole&Appurtenances HOME OWNER BUILDER DECLARATION �a8 I hereby affirm that I am exempt from the Contractors License Law Sign with One Branch Circuit - _ *5. c for the following reason (Section 7031 5 Business and Professions Additional Sign Branch Circuits O Code) ' ❑ ,I as owner of the property will do the work and the structure Misc Conduits&Conductors _ - is not Intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) TOTAL 45 - -15 and,Professions Code) H V _ c 15 CONSTRUCTION LENDING AGENCY -1 a00 I hereby affirm that there Is a construction lending agency for the _ CHANGE performance of the work for which this permit is issued (Sec 3097 PERMIT FEE (Sub Total) ` �� _ Civ C) „ - _ PLAN CHECKING FEEtl -(ffj� 4' ter/C_ z Lenders Name PERMIT ISSUING FEE � r� � � � �i�r4 i mli=+.r? Lenders Address I certify that I have read this application and under penalty of perjury state TOTAL FEE that the above information is correct I agree to comply withtall County + ordinances and State laws regulating Electrical wiring and hereby authorize representatives of this County to enter upon the above mentioned property for Inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE yll /15 SIGNATU E OF PER EE DATE