HomeMy Public PortalAbout9617 CRAIGLEE ST_Electrical__ 76A663-CE806 9-64 QppUCAIMN FOR EL M o L PERM04
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPT. OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
REC EP T. TOTAL NO. EACH FEE
OUTSrTS FIRST 2O $20 $ OWNER
LIGHT ADD'L f0 ADDRESS , S
SWITCH. OVER 20
TOTALCITY TEL. NO. T-
LIGHTING FIRST 20 .20
-Ifo CIFIXTURES } I V R 10 ELECTRICIAN
20
OV R
RANGES CLO.DRYERS WTR.HTRS. 1.00 1 ADDRESS
GARB.DISP. STA.COOK
CITY TEL. NO.
R -
AUTO.-WASH. STATE '
SPACE HTRS. STA.APP.('/x H.P.MAX.) .50 LICENSE NO.
MOTORS: OVER NOT OVER H.P. DISTRICT GR P TE P BY
O 1 1.00
1 3 1.50 INSPECTION RECORD
a-
3 8 2.00 - a-
0 O
8 15 2.50 V
15 50 3.00
O
50 100 5.00 H
U
w
SIGNS: NO.TRANS C
N
NO.LAMPS
Z
SERVICE 0.60OV-NOT OVER 200A 1.00
SERVICE 0.60OV-OVER 200 A. 2.00
SERVICE OVER 600V 5.00
MISC.
PERMIT ISSUING FEE 2.00
SUPPLEMENTA13Y PERMIT ISSUING FEE 1.00
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
1 HEREBY .CERTIFY THAT I AM PROPERLY REGISTERED AND/OR V
FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN, TME ABOVE DESCRIBED RESIDENTIAL PROPERTY. POWER
s�
SIGNAT UTILITY CO.NOTIFIED
OF PERM I FINAL
VALIDJOS PH C. ROOHAN B
CK M ,C SH SUPERVISING ELECTRICAL ENGINEER
LAW8 1 2'D JUL 20 2 D 4.0 0-
COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Department of County Engineer ism&76 Ew
DIVISION OF BUILDING & SAFETY
WILLIAM J. FOX, County Engineer
FOR APP ANT TO FILL IN DISTRICT NO. GROUPI ZONE PERMIT NO.
ELECTRICIAN D g 4 WV3 7—
' TEL. NO. aQO �Q R�1 IVED% READY FOR ISSUEDD
ADDRESSIFIRST INSPECTION
CITY ��JJ ,,�• '�v` �,r�
COUNTY LICENSE NO. EXPIRES BUILDING'!S(!l
PERMIT FEES ADDRESS /gin
FEE
NUMBER EACH LOCALITY
LIGHT OUTLETS Z NEAREST
RECEPTACLES �/D P�
CROSS ST. l.._
WALL SWITCHESems/ _ OWNER �t L
TOTAL OUTLETS 5C _� �o MAIL
ELEC. RANGES 25 ADDRE89
ELEC. HEATERS 25 CITY TEL. NO.
FIXTURES m B _
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
MISC. 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 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOB
NUMDER HORSEPOWERFEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
NEW MVD. HP DYER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
#hAUZ 6 LESS $ .25 .T SIGNATURE OF
%z 2 .50 PERMITTEE__ 1 ^` —
2 5 1.00 INSPECTION RECORD
s 15 1.50
15 so 2.513
50 200 5.00 _
200 500 10.00U�.� CJ J
_ Soo 1 000 1 s.00 • Q
Z
OVER 10130 20.00
M.G. SET/FREQ. CHAN13ER-HP ,oma M
WELDERS:AC-KVA _ f Q /y+ O
GENERATORS - KW _ ✓
TRANSFORMERS - KVA , 'ecc5s^ �wG//�y / //,--i-1 /
TEMP. MOTORS (7S% OF ORIG•) //`f d !_ �Y A/
MOVED MOTORS (75% OF ORIG.) ✓ ��
MISC. '
SIGNS t/ (� �l0lfl fr�ld f�t'i�
NO. NO.TRANS. S -
AFPROVALS
NO. NO. LAMPS
DATE INSPECTOR'S NAME
FOR EACH PERMIT:
WIRING $1.00 / CONDUIT
LA
FIXTURES $1.00 -Z WIRING J 4/ fWWI
SUPPLEMENTARY .50 FIXTURES
POWER
TOTAL FEE $y UTILITY CO. NOTIFIED /Ql",ii t-A jfi
�y
4B' FINAL
76A663 DSS#SA 2-53
WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91)
76A663 u` �APPLICATION FOR ELECTRICAL PERMIT
I hereby affir}n that I Fave'6 certificate of consent to self insure,,
or a:certificale of Worker's Compensation Insurance, or a certified, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV.
/Pcooppyy thereof,(Sec..3800 Lab. C.)�• ; - - - -
'`� r y-IV(Y' � COmpa FOR APPLICANT TO FILL IN JOB
ADDRESS �'
� Certified copy is hereb_y furnished. New Residential Bldgs.&Pools NO. EACH FEE
_ $ $ LOCALITY
❑ Certified copy is filed with the county builbuil ing tion 1 &2-Family,Sq.Ft. _ NEAREST
department. f Multi-family Sq.Ft CROs ST.
'Applicant ( Residential Swimming Pools ASSESSOR
Date
MAP BOOK PAGE O PARCEL'eW
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec.AIL Li ht Sw.
COMPENSATION INSURANCE, g p/7 / FIRM NAME O-/►din t .
First 20 O!/ /` MAIL
This section need not be completed if the work involved b the r
permit'is for'one hundred dollaps'($100)or less.)' Y Total No._ Additional ADDRESS
I certify that.in th'e'performance of the work for which this permit CITY ✓G Tel' o.
is issued, I m
shall not eploy:'any person in any manner_so as to PLAN CHECK
becomeisubjecf to the Workers',Compensation Laws. Lighting Fixtures First 20 APPLICANT
Total No. Additional ADDRESS
Date �r ' Applicants ( RESIDENTIAL APPLIANCES NOT OVER 3 HP,.
NOTICE.TO APP.LICANT:
Exemption,;you shouldbecome subject to the Workers' Compensation OTHER APPLIANCES NOT OVER 3 HP.
P RMIT '''7'''�
provisions of the,Labor Code, you must forthwith comply with such, / + �.- C
provisions or this permit shall be.deemed revoked: Power Apparatus&Large Appliances PpuCANT `
LICENSED CONTRACTORS DECLARATION Size&Type HP;KW,KVA,or KVAR ADDRESS � _ S
I 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 ,• c� Tel.N� o:; -k
Professions Code, and my license is in full force and effect. Over 10'to 50 Incl.
LICENSE OR Class.
Over 50 to 100 Incl'.' REG.NUMBER FZ
License Number 6M / ,e? ./_. Lia Class Over 100- DISTRICT NO. P SSED BY Q
�T
` Services,Swbd.,MCC&Panelboards
Contractor �' S-C"C f^/L—Date IV/ 0-399 Amp.Under 600 V FATE 0
❑ 400-1.000 Amp.Under 600 V _2
I am exempt under Sec. VALIDATION W
Over 1000 Amp.or Over 600 V FINAL
B.&P.C.for this reason - BRANCH CIRCUIT FEES EEI BY IZ
U)
15A,or 20A, 120V,Lighting or Recept. Z
Date: _
- -- 1 To 10 Branch Circuits
Signature 11.To 40.Branch Circuits
El Exemption
Or More Branch Circuits
Exemption for R'eg. Maini.Elect. 15A,20A,208V To 277V Lighting.Br.Circuits
SINGLE FAMILY Temp:Power Pole&Appurtenances ,-.E-- x
HOME OWNER-BUILDER DECLARATION -anch Circuit
r'- •i
I hereby affirm that I am exempt from the Contractor's License Law Sign with One Br
il
for the following reason (Section 7031.5, Business and Professions. Additional Sign Branch Circuits.. i?::+ -• _--
Code):
❑ I, as owner of the property;will do the work and the structure Misc.Conduits&•Conductors y' _
is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) •_
and Professions Code).
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) 3
Civ. C.) - _
PLAN CHECKING FEE = ''°�'
Lender's Name
PERMIT ISSUING FEE4H
O(L�
Lender's Address TOTAL FEE 60
I certify that I have read this application and under penalty of purjury state
that the above 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 property
for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
SIGNATURE OF PERMITTEE DATE -