HomeMy Public PortalAbout6203 CLOVERLY AVE_Electrical__ 76A663-CE806 12/75 APPLICATION FOR ELECTRICAL PERMIT ,
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER FADDRE
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fr BUILDING AND SAFETY DIVISION ADDRESS62L9,
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F PP F ITY /� C I \ '`
New Residential Bldgs & Pools EACH NO FEE ST
1 & 2-Family,Sq Ft $ 025 — $ ST .r OR
Multi-family Sq Ft -02 — FIRM NAME �+ (,f G ��
Residential Swimming Pools 2000 MAIL
ADDRESS
Outlets Light, Switch & Receptacle 11 CITY V. lj Tel No yZ - 2
First 20 ILL PLAN CHECK
Additional / 38 APPLICANT
< ADDRESS
Lighting Fixtures
First 20 50 g _ CITY Tel No.
Additional 30 PERMIT 'F-et
APPLICANT e� /D
Fixed Appliances Not Over 1 HP ADDRESS
Range—HeaterrD W CITY(' 0 V jk7& Tel.Nola• _
Oven_Dryer_W M _ LICENSE ORNot?
•Top _ FAU —WH REG.NUMBER 27� Class.Cr/Q
Hood_ Fan ___
I HEHE61 ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
Dlsp_A C ___ 2.00 AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
_ ELECTRICAL WIRING
Power Apparatus&-Large Appliances
Size& T e HP, KW, KVA, or KVAR I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
YP LICENSED AS REQUIRED BY LOS ANG ES COUNTY AND STATE OF
Up t0 1 Incl 2 00 CALIFORNIA OR THAI I AM THE LEGELA'L�OWNER OF THE ABOVE. ��„ 1
DESCRIrED RESIDENTIAL PROPr.RTY9
Over 1 to 10 1 ncl 5 00 yi O
Over 10 t0 50 Incl 1000 PERMITEE V
SIGNATURE
Over 50 to 100 Incl 2000 rN
CC
Over 100 30.00 DISTRICT NO PR CESS D BY
ServicesLLI
/ INSPECTOR'S CI.--
0- 200 Amp Under 600 V
201-1000 Amp Under 600 V 25.00 APPROVALS DATE SIGNATURE In
Over 1000 Amp or Over 600 V 5000 TEMP POWER POLE
UNDERSLAB WORK
Temp Power Pole & Appurtenances 10.00
Sign with One Branch Circuit 10.00 ROUGH CONDUIT
Additional Sign Branch Circuits 200 WIRING b�76
(Other)
- FIXTURES
POWER AUTHORIZED
UTILITY CO.NOTIFIED
]FINAL
PERMIT FEE (Sub-Total) NOTES
PLAN CHECKING FEE (One-Fourth Permit Fee) `-
PERMIT ISSUING FEE $600
TOTAL FEE
PLAN CHECK VALIDATION CK. M O CASH PERMIT VALI TION CK MO. CASH
88702 EC 2.+ 2 122,UGA�:6
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
76A663 069 SA 3-50 APPLICATION FOR PERMIT �o
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMIT ND.
ELECTRICIAN R. F. WA1 i:nTl
RECEIVED BY READY FOR DATE ISSUED
ADDRESS N i 'YFIRST INSPECTION i
CITY 58.21 Gab TEL. NO. T 68583
COUNTY LICENSE NO. 3,104 EXPIRES BUILDING 6203 Cloverly Ave*
PERMIT FEES ADDRESS
NUMBER EACH FEE LOCALITY Temple City
LIGHT OUTLETS 13 NEAREST
RECEPTACLES - 22 CROSS ST.
WALL SWITCHES 18OWNER Meeker
TOTAL OUTLETS 5 5C $ MAIL
ELEC RANGES 25 ADDRESS
ELEC HEATERS 1 25 CITY TEL. NO.
FIXTURES 13 5
1 HEREBY ACKNOWLEDGE 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 I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
NUMBER HORSEPOWERFEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
�
New MVD. HP OVER INC- EACH OF THE RESIDENTIAL PROPERVC.,DESCRIBED ABOVE.
l4 I2 6 LESS $ .25 BIONATURE OF
I/2 2 .s0 PERMITTEE
2 5 1.00 INSPECTION RECORD
s is 1.50
is 50 2.50
50 200 s.00
200 SOO 10.00 J
8130 1 1000 15.013 Z
OVER IOOO 20.00 E3
M.O. SET/FREQ. CiiANL3ER-HP'
WELDERS: AC-KVA O
GENERATORB - KW
TRANSFORMERS - KVA -,
TEMP. MOTORS (75% Or ORIG) w
MOVED MOTORS (7S% Dr ORIS.)
MISC.
SIGNS
NO. NO.TRANS
. � APPROVALS
NO. NQ LAMPS
FOR EACH PERMIT: DATE INSPECT/ORIS NAME
WIRING $1.00 l 00 CONDUIT 9' tArM/
FIXTURES $1.00 1 00 WIRING �hh r1(i' �•rvAl
y, ��
SUPPLEMENTARY .50 FIXTURES I/�+r t'A WV
5 80 POWER
TOTAL FEE UTILITY CO.NOTIFIED I A AA,lif /FHA-1
r FINAL I� 1 1 v { Vv: VII
V '
41 u
76l�6 3-E806>t1-62 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
• DEPARTMENT OF COUNTY ENGINEER B
UILDING
l�0 �r
BUILDING AND SAFETY DIVISION
JOHN A. LAMBIE, COUNTY ENGINEER �/-
WILLIAM A JENSEN, SUPT OF BUILDING OCALITY ! 1
FOR APPLICANT TO FILL IN OSS ST t�L
RECEPT TOTAL NO EACH FEE
LIGHT OUTLETS FIRST 20 / $20 $ Q M
ADD'L ( WNER
ADDRESS
AIL
SWITCH S OVER 20 .10
TOTALCITY TEL,NO
LIGHTING 1 F1RST20 20 yC
FIXTURES 1 DVDR 20 1O ELECTRICIAN/ (�
RANGES CLO DRYERS WTR HTRS tool ADDRESS (� G
GARB DISP STA COOK I[/ n
• CITY � C TEL NO (y 7`(J 6 -S�
DISHWASH AUTO-WASH STATE
SPACE HTRS STA.APP ('/H P MAX ) 50 LICENSE NO
MOTORS OVER NOT OVER HP I DISTRI T GROLP E I PR CE D BY
O 1 1 00 ` /r—
1 3 1 5O [` /r��/INeS�PECTION RECORD tel' -e�%
8 15 250
15 50 300
50 100 5000
-0/",
1_7 n
V
cz
SIGNS NO LAMPS -PiI�G�J l� • O
NO TRANS
SERVICE 0.60OV-NoT OVER 200A 100 w
a
SERVICE 0.60OV•OVER 200 A 2 00 `—_a e S— — cn
Z
SERVICE OVER 600V 500 ,
MISC
PERMIT ISSUING FEE 200 (�
SUPPLEMENTARY PERMIT ISSUING FEE 1 00
TOTAL FEE I Is
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
EA.DSTATE
COUNTY ORDINANCES AND STATE LAWS REGULATING
L WIRING WIRING
Y CERTIFY THAT 1 AM PROPERLY REGISTERED AND/ORAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
IA OR THAT I AM THE EGAL NER OF THE ABOVE
RESIDENT PERT POWERREUTILITY CO NOTIFIEDITTE
FINAL
LIDATION ARTHUR C. VETT
SUPERVISING ELECTRICAL ENGINEER
CK{ MO CASH ( ( �J
LIZLc 6 8 0 i.0 Jlj� 28 2 U C /•-.0 f,
V— rt
� e
4
76Af,VC- CES06B 12,75 APPLICATION FOR ELECTRICAL PERMIT
r
BUILDING A Uhl SAFETY DIV 1 N
FOR APPLICANT TO FILL IN ,JOB
EACH NO FEE ADDRESS G///✓JVl /V' ✓ L-
rResidential
Bldgs & Pools
Sq Ft $ — $ LOCALITY
q Ft NEAREST
CROSS ST
wimming Pools OWNER OR
FIRM NAME
Outlets Light, Switch& Receptacle MAI L
ADDRESS GCJ ✓
First 20 f' )
Additional CITY ! Vt± /e Tel No
PLAN CHECK
Lighting Fixtures APPLICANT ,/ %6045
•First;20sa) ADDRESS a/;6
Addrtlonal2 ,6
- CITY Z45:5—� Tel No 'GGO
PERMIT
Fixed Appliances Not Over 1 HP APPLICANT r�/
Range_ Heater D W ADDRESS �v(p DN
Oven Dryer W M
Top FAU W H CITY ?_(Tel No 29�'-2,a,6
Hood Fan LICENSE OR d
-Disp A C REG NUMBER / l� Class U
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION '
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY O
Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING I-
Size&Type HP, KW, KVA,or KVAR ELECTRICAL WIRINGUp W
o_
1 Incl HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
Over Z
Over 1 to 10 InCI L ENSED AS REQUIRED By LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
Over 10 to 50 Incl DESCRIBED RESIDE TIAL PROPE Y
Over 50 to 100 Incl PERMIT
Over 100 SIGNATURE
Ir'DISTRICT NCr, PROC SSQD
Services U '$
0-200 Amp Under 600 V o
201 - 1000 Amp Under 600 V APPROVALS DATE I NECTOR'S
IGATURE
Over 1000 Amp,or Over 600 V
tTEUGH
MP POWER POLE
Temp Power Pole&Appurtenances DERSLAB WORK
Sign with One Branch Circuit Additional Sign Branch Circuits CONDUIT
(Other) WIRING
FIXTURES -
POWER AUTHORIZED
rP�ERMIT
(Sub-Total) UTILITYCO NOTIFIED q /f
ING FEE (One-Fourth Permit Fee) FINAL
ING FEE �/ j•
NOTES
��
PLAN CHECK VAL_N„T D �+ �, . H PERMIT VALIDATION CK° M O CASH
9 4-'7-MAR 8 � D 1 59
POLICY HOLDER:
f�".�`'CY NUMBER: 1103 V jra � ►�
` WORKERS'COMPENSATION DECLARATION- 76A663 1 10/81
CE-806G.` APPLICATION FOR ELECTRICAL PERMIT 4
t ` hereby affirm that I have a certificate'of consent to self insure, ` t �= a
or a certificate of Workers;Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY `
copy•thereof(Sec 3800,Lab'C)
POhCy NO ��' Company ;,"`` FOR APPLICANT TO'FILL IN ��• JOB •",- //,, �
EACH NO `�_ FEE ADDRESS'.'(oDl
63 . GLO L VV
Certrfied copy,is hereby_�furnished ,,, a New Residential Bldgs &'Pools O
' "'Certified 1.&a 2-Family,Sq'Ft $ .LOCAL•ITK'/�M G U 1 C 0} / p o
copy is filed'`v ith�thecounty building inspection
'.department Multi,family Sq•Ft t <` NEAREST,f
'. •, , r y - t CROSS ST �. ,
D
Residential Swimming Pools ,r OWNER OR, ,, _ t - t
APPhcant FIRM NAME•.,L O U { �:d� 7 U a'
1'
"CERTIFICATE OF EXEMPTION FROM WORKERS' ' " �' g � 4 + MAIL'
COMPENSATION`INSURANCE• Outlets Rec LI ht �tTT� Sw J X_ C y�g��
•' .-0, ., a. ADDRESS i
(Thisa''sectiori�need not be completed if the work involved,by the , =1r a , 20 ,w L s CITY,:,,` , n+ Tel No �T ? ,
Additional,
permdlis for one'hundred dollars($100)or less) Total No '�` .
PLAN CHECK
I certify.that in the,performance,of the work for which this permit b, - uCAN7
is'issued,al,shall not,em to 'an erson,in an manner so as;to. � ,.
LI htm Fixtures First 20- 1 ADDRESS
become subject'to the-Workers'Compensation Laws 9 9 i
' Total No Adddional CITY
Date " 3 0 Applicant C•- � �� Fixed Appliances Not Oveu Y ; +PERMIT g es No Y 4 BT
NOTICE TO(APPLICANT,,, If,_after making-this uCertficate of 1 HP, r' ti
Exemption,.ou should become subject to,the Workers'Com ensation _+ "Range Range__Heater_ OWN_ w APPLICANT
Y p r5 k < « ; ,
yprovlslons of;the,Labor,Code,,you must forthwith comply,with such,, Oven Dryer W M ADDRESS
_provisions or,this permit shall be deemed revoked Topp._ FAU _'W H CITY`
, LICENSED CONTRACTORS DECLARATION , i Hood Fan Other_
' I,Kereb affirm that'I.am licensed under rovisions'of3Cha tet 9 LICENSE OR
Y p p { Dis`pµ— Room Air Cond �° -REG NUMBER, Class
(commencing,with'Section 7000)kof Division 3 of,the Business and M s
Professions Code,and my license is in full force and effect" power Apparatus& Large Appliances , DISTRICT NO PROCE D
11
"' at Size&I Type�HP,,KW,'KVA,or KVARr = �J Q
License Number Lic Class Up to 1 Incl FINAL'
Over 1 t610 Incl, DATE / _ A DATION
Contractor DateOver`s" " a ' / 'O
❑ -a. 10`'to 5
0 Incl FIN
,Over 50 to 100'Inc V
I am exempt under Sec B W
for �
this reason' ' Over 100 �-
Service's,Swbd',MCC'& Panellioards ",' '� ` Z_
k ' v Date 10.- 200 Amp Under 600 V ;
S Signature %
2 _
01,'._',
Under 600 V. ',` _ o j"
Over 1000 Amp or Over'600,V % ". r' X ,2 0 0 61 S k, e' .
Exemption for'
Reg Ivtaint Elect,� r r r" rv' za
,,r'1,,7SINGLE,FAMIL•Y` - � Temp'PowerPole,&Appurtenances �_.' ;,. 2� .
' 4 `HOME OWNER-BUILDER'DECLARATION F>_ `Yt'
Sign with One,Branch Circud t- ,,� o,°5� a,Q Q
I hereby affirm that I am exempt from the Contractor's License Law r Additional Sign Branch Circuits
i
for the'�following reason(Section 7031 5, Business and Professions t
Code) , ' ' ' - c ' ,'T f 5 c ""''„ o,o o}� 00c�•
Misc Conduits&'Conductors �_ 1' �'�MQ f1 f�$$ r'
�i
'I,as owner of the property,will do the work and the structure .~Is not,intended'or offered for,sale (Section 7044, Business Other (See Complete Fee Schedule) _
< and,Pr`ofessions Code) �i
1 "CONSTRUCTION LENDING AGENCY'
1. j. 'a , - , .� . .• ,• 'j -' ��`" z
I hereby affirm that ttiere is-a construction lending,agency for.the ,
performance of the work for'which this'permtt is issued(Sec 3097, PERMIT•FEE - "
r -�� (Sub-To 'i�, `,,_ ';-'"• ".`�'� '
Civ C) t °
,•i ` L
CHECKING°FEE a �, f _ i ,, - 'r �•"
Lenc er's Name T ISSUING,FEELender's Address I certify that I have read this application'and state that the aboveFEE
information is correct I-agree to comply with all County ordinances
and State laws regulating Electrical wiring, and hereby authorize kr i
representatives of this County,to,enter upon the above-mentioned
property for inspection purposes
r.//^ {��r7 s•t. •�'SEE-REVERSE FOR EXPLANATORY-LANGUA'GE',
Signature'of Permittee 0 Date