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Home My Public Portal About5850 CLOVERLY AVE_Electrical__ TEMPLE QT 76A663-CE806 8-62 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER FADDRESS G BUILDING AND SAFETY DIVISION JOHN A LAMBIE COUNTY ENGINEER WILLIAM A JENSEN SUP T OF BUILDING Y T FOR APPLICANT TO FILL IN T RECEPT TOTAL NO EACH FEE OUTLETS FIRST 20 $20 $ OWNER LIGHT MAIL ADD'L ADDRESS6 (� SWITCH OVER 20 10 LIGHTING TOTAL F)RST20 20 C TFL NO FIXTURES ADD'L 10 ELECTR IA OV R 2O RANGES CLO DRYERS WTR HTRS 1001 ADDR S -Y—Y GARB DISP STA COOK CITY TEL NO DISHWASH AUTO WASH ST TE / SPACE HTRS STA APP (ya H P MAX ) 50 LICENSE NO (� MOTORS OVER NOT OVER H P DISTP.CT NO G OUP ZONE P ESSE4 BY 0 100 1 4 3 iso INSPE ION RECORD 3 S 200 8 115 250 15 50 300 IL 50 100 500 u SIGNS NO TRANS O NO LAMPS SERVICE O 600V NOT OVER 200A 100 G a SERVICE O 600V OVER 200 A 200 Z SERVICE OVER 600V 500 MISC PERMIT ISSUING FEE 200 Z SUPPLEMENTARY PERMIT ISSUING FEE 100 TOTAL FEE $ 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING WIRING I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED^BY LOS ANGELES COUNTY AND STATE OF FIXTURES / CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RE8IDENTIAL RTr - POWER SIGNATURE UTILITY CO NOTIFIED OF PERMITTEE FINAL p �V•J IDATION ARTHUR C VETT CK MO CASH SUPERVISING ELECTRICAL ENGINEER LACO 5 9 2 9 140V 17 2 D 4.00— a 76AG63-CEi006 10/74i��c APPLICATION FOR SLECTRICZ PERMIT ILEI COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER .JOB BUILDING AND SAFETY DIVISION ADDRESS LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST ✓(.�Y-c��;` OUTLETS NO EACH I FEE OWNER OR $ Is FIRM NAME RECEPT MAIL ADDRESS "V LIGHT FIRST TOTAL 25 0 e CITY EL NO OVER 20 SWITCH_ 10 PLAN CHECK y LIGHTINGTOTAL FIRST 20 25 APPLICANT OVER 20ADDRESS FIXTURES 10 RESIDENTIAL APPLIANCES CITY TEL NO RANGE DRYER- PERMIT WTR HTR APPLICANT STA COOK DISP F A U ADDRESS L v�-'L z" SPACE HTR AIR GOND" _ CITY TEL NO CLOTHES WASH DISHWASH LICEOR REGNUMBER ell r CLASS _14 A6 FAN OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION i AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING , WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND HEATERS, ETC HP KW KVA ELECTRICAL WIRING SIZE & TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 — 1 ' 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF }. CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE 1 — 1O 300 DES GRIPED RESIDEN PR ERT C) PERMITEE l= 10 - 50 500 SIGNATURE ' O� U 50 - 100 1000 uA DISTRICT NO I SED BY d N 'Do - 500 1500 • 0 z c SIGN GASSIGN AND ONE CIRCUIT 500 APPROVALS DATE INSPECTOR'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 TEMP POWER POLE SERVICENOTOVER600VOLTS OR200AMP 300 UNDERSLAB WORK SERVICEOVER600VOLTS OR200AMP 1000 ROUGH CONDUIT TEMP SERVICE,POLE &APPURTENANCES 500 WIRING TEMP LIGHT OR RECEPT SYSTEM 3D FIXTURES POWER AUTHORIZED UTILITY CO NOTIFIED FINAL PERMIT FEE (SUB TOTAL) NOTES PLAN CHECK FEE - PERMIT ISSUING FEE 3`00 TOTAL FEE r 1 PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION cK M O CASH x 4 2 9 f1CT 9 2 D SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE y'� 76A663-CE:806 10,74 APPLICATION FOR ELECTRICAL PERMIT ' COUNTY OF LOS ANGELES �.p DEPARTMENT OF COUNTY ENGINEER JOB .C� x-71 BUILDING AND SAFETY DIVISION ADDRESS V 1.J '-' LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST OUTLETS NO EACH FEE OWNER OR $ $ I MAIL FIRM NAME RECEPT T FIRST 20 00 ADDRESS l�� LIGHT TOTAL CITY TEL NO SWITCH OVER 20 10 PLAN CHECK LIGHTING 1 F 10 FI 20 APPLICANT FIXTURES 2g r ' )) TOT L OVER 20 ADDRESS RESIDENTI L APPLIANCES CITY TEL NO PERMIT RANGE DRYER_WTR HTR APPLICANT /J STA COOK DISP -' F A U ADDRESS iyyt SPACE HTR AIR COND CITY /1' )-/" TEL NO CLOTHES WASH DISHWASH LICENSE OR REG NUMBER d 2. CLASS -/ FAN OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THISAPPLICATION AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING W ITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING , IND HEATERS, ETC HP KW KVA ELECTRICAL WIRING SIZE & TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR O - 1 100 LICENSED A9 REQUIRED BY L09 ANGELES COUNTY AND STATE OF } CALIFORNIA OR THAI I AM THE LEGAL OWNER OF THE ABOVE 1 - 10 300 OESCRIPED REBID AL ROPERTY U PERMITEE 10 - 50 600 SIGNATURE I— U 50 - 100 100 DISTRICT NO ROC-SEEO BY a 100 - 500 113001 % N Z SIGN, GAS SIGN AND ONE CIRCUIT 500 APPROVALSv DATE INSPEC 'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 TEMP POWER POLE SERVICENOTOVER600VOLTS OR20OAMP 300 UNDERSLAB WORK SERVICEOVER 600 VOLTS OR 260AMP 1000 ROUGH CONDUIT TEMPSERVICE,POLE, &APPURTENANCES 500 WIRING TEMP LIGHT OR RECEPT SYSTEM 300 FIXTURES POWER AUTHORIZED UTILITY CO NOTIFIED FINAL '? / i PERMIT FEE, (SUB TOTAL) NOTES PLAN CHECK FEE PERMIT ISSUING FEE _ 300 ` TOTAL FEI- - PLAN CHECK VALIDATION CK 0 CASH PERMIT VALIDATION cK M o CASH 3'2 3tiOrT 22 2 14.6-0,At,G SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 4 WORKERS COMPENSATION DECLARATION CE806 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self insure, CE 906G ' or a certiNate of Workers Compensation Insurance, or a certified L J— o COUNTY OF LOS ANGELES, BUILDING AND SAFETY copy th r_eQof(Sec 3800 Lab C) "( �, D, I O Q_,A ��T J16 S' 1� FOR APPLICANT TO FILL IN ADDRESS �d LO V&11�+ ` Policy Com anyJOB Certified copy is hereby furnished New Residential Bldgs & Pools EACH NO FEE .� .l ElCertified'co 1 & 2-Family Sq Ft $ — $ LOCALITY 'copy is�filed with the county building inspection department Multi-family Sq Ft — NEAREST Residential Swimming Pools CROSS ST Date Applicant OWNER OR i, FIRM NAME �3IA �� KS 1� � {Oy t CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec Light Sw 'MAIL COMPENSATION INSURANCE I , , ADDRESS 7 (This section need not be completed If the work Involved by the First 20 CITY J ` Tel'No permit Is for one hundred dollars($100)or less) Total No Additional PLAN CHECK I certifythat in the performance'off the work for which this permit - is Issued I shall not employ any'person in any manner so as to APPLICANT y become subject to the'Workers Compensation Laws Lighting Fixtures First 20 - ADDRESS ' ,i Additional Total No CITY � ° Tel No , Date ApplicantM NOTICE TO APPLICANT If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT w'� `tCAJ 5 Exemption you should become subject to the Workers Compensation Range_ Heater_ DW _ APPLICANT /ri �S ff (�• provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer _ W M _ ADDRESS Gi,gl:k �/ b provisions or this permit'shall be deemed evoked Top — FAU _ WH _ LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other_ CITY Tel No 71;!p I,hereby affirm that I am licensed under provisions of Chapter 9 Disp I— Room Air CondLICENSE OR AJ (commencing with Section 7000) of Division 3 of the Business and '`REG NUMBER f4& Class Professions Code and my license is in full force`and effect DISTRICT NO PROCE SE Y Power Apparatus& Large Appliances License Number r J TJX`� �-�� Size& Type HP KW KVA or KVAR v A 1 U Lic Class Up to 1 Incl FINAL ♦ Over,1 to 10 Incl DATE Contractor ;�t�L►Q�iip 8/ - VALIDATION 0 ❑ Over 10 to 50 Incl FINA 0 I am exempt under Sec Over 50 to 100 Inc BY ' W B&PC for this reason Over 100 C V N Services Swbd MCC& Panelboards Date 0- 200 Amp Under 600 V Signature 201 - 1000 Amp Under 600 V ' T ❑ ` Over 1000 Amp or Over 600 V Exemption for Reg Maint Elect 5 A SINGLE FAMILY Temp Power Pole& Appurtenances 2 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit l I hereby affirm that I am exempt from the Contractors License Law Additional Sign Branch Circuits - r ACh''°0 for Code) `following reason (Section 7031 5 Business and Professions Y 50 ❑ I I as owner of the property will do thew ork and the structure Misc Conduits& Conductors I is not intended or offered for sale (Section 7044,Business Other(See Complete Fee Schedule) 50 and Professions Code) Y�T�- ��m CONSTRUCTION LENDING AGENCY OEM 25050 1 hereby affirm that there is a construction lending agency for the V f -a00 performance of the work for which this permit is is (Sec 3097 PERMIT FEE (Sub-Total) - Civ C) , PLAN CHECKING FEE =a 6/15/89 PERMIT Lenders Name / , i�JJ77 PERMIT ISSUING FEE q wq p� " + 191 f 7 Lenders Addre , r 25 I certify that I have read this a plication ap state that the above TOTAL FEE G information is correct I agree to comply with all County ordinances and State laws regulating Electrical wiring and hereby authorize representatives of this County to enter upon the above-mentioned proaty for inspectionpose , SEE REVERSE FOR EXPLANATORY LANGUAGE , Signature of P mittee Aate if