HomeMy Public PortalAbout5132 DALEVIEW AVE_Electrical__ COUNTY OF LDS ANGELES APPLICATION FOR PERMIT
IVISFY of County Engineer-
DIVISION
ngineer' ��������
DIVISIONION OOF BUILDING & SAFETY
a WILLIAM J. FDX, County Engineer
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONEPERMIT NO.
ELECTRICIAN v A_IFOR
ADDRESS �A� �_ {1RECEIVED By FIRSTADY INSPECTION GATE ISSUED
CITY TEL. NO. Ilam a I�—�1�1�
COUNTY LICENSE NO. EXPIRES BUILDING
PERMIT FEES ADDRESS
NUMBER EACH FEE LOCALITY ���eere�•�/K ft- gr e ) u
LIGHT OUTLETS NEARARNEAREST ST. / � d
NEIII���
RECEPTACLES p A
WALL SWITCHES OWNER I l'O .n♦U TQ M.a p� Al 10
TOTAL OUTLETS Sc S / A \
ELEC. RANGES 25 ADDRESS .5 ✓Y JDA J-Fr V/IS=W py V
�-}�
ELEC. HEATERS 25 CITY •1_P Y✓
FIXTURES s __ 1 HEREBY ACKNOWLEDGE'THAT 1 HAVE READ THIS
MISC. ^ APPLICATION AND STATE THAT THE ABOVE IS CORRECT
NUMBER OF LIGHT CIRCUITS P AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING.
MOTORS 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
NuwaER HORSEPOWER ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
FEE A
NEw MvO. HP Oven IHe. EACH OF THE RESIDENTIAL PROPE DESCRIBED
}-ABOVE
It .
%2 A LESS S .25 SIGNATURE OF
_ I�x 2 .50 PERMITTEE—_�
2 s 1.00 INSPECTION RECORD
s is 1.50 `,I —
_ is so 2.50 / V
50 200 S.00
200 Sao 10.00 J /
_ Soo 1000 15.00 a
Z
OVER 1000 20.00 n
M.O. BET/FREQ. CHANGER-HP D:
WELDERS:AC-KVA D
GENERATORS - KW
TRANSFORMERS - KVA
TEMP. MOTORS (75% OF ORIG-) _
MOVED MOTORS (75% OF OHIO.)
MISC.
SIGNS
NO. NO.TRANS. APPROVALS
NO. NO. LAMPS
DATE INSVIECTOR•S NAME
FOR EACH PERMIT:
WIRING $100 /100 CONDUIT
FIXTUREB $1.00 00_ WIRING
SUPPLEMENTARY .50 FIXTURES -11
74DPOWER
TOTAL FEE 9fjj� UTILITYCO.NOTIFIED g7'16 S1 �Gaowfi•+�
FINAL /' ��� ��� m!'�Jya"'✓/
7GA663 DBS#SA 5-53.
` A663-CE906 4-66
APPLICATION FOR ELECTRICAL/PERMT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEERJE
DING
BUILDING AND SAFETY DIVISIONa Ess
JOHN A. LAMBIE. COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUIALITY ^
RESTFOR APPLICANT TO FILL INSS ST.
NO. ACH FRECEPT. $ EL
LIGHT TOTTAL FIRST 20 .20RESS
SWITCH _aZ OVER 20 .10 CITY TEL. NO.
PLAN CHECK
LIGHTING lTOTAL FIRST 20 .20 APPLICANT
FIXTURES I( OVER 20 .10 ADDRESS
RANGE—DRYER_WTR.HTR.— CITY TEL. NO.
STA.COOK_DIS P.—F.A.U._ CONTRACT-013
SPACE HTR.—AIR COND.— ADDRESS i
CLOTHES WASH._DISHWASH.— CITY TEL.
FAN—OTHER 1.00 LICENSE CLASS.
MOTORS,TRANSFORMERS RATING
IND. HEATERS, ETC. HP. KW. KVA. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
SIZE & TYPE OVER TO AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITH pLL COUNTY ORDINANCES AN STATE LAWS REGULATING
ELECTRICAL WIRING.
0 - 1 1.00
1_ HEREBY CERTIFY THAT I AM Pfl OPERLYTEflEO AND/OR
L I 10 3.00 LICENSED A5 REQUIRED BY LOS ANGELES COUNTY
NTT 4N0 STATE OF
THATI
CALIFORNIA OR THAT AM THE LEGAL I OOF, AND INTEND T
f.
10 - 50 $.00 RESIDE IN, THE ABOVE OESPIPEO RESIDENTIAL
ESRESDENTIAL PROPERTY.
Y
50 - 100 10.00 OF PERMITT
FE CD
100 - 500 15.00 DI GT•TRI C} O. U Z NE P ES E BY
SIGN,GAS
TUBE, OR SIGN AND ONE CIRCUIT 3.00 -5
/G •V
MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES:
D-
h
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 Z
SERVICE OVER 600 VOLTS OR 200 AMP 5.00
TEMP SERVICE, POLE, & APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP. POWER POLE
' UNDERSLAB WORK
• ROUGH CON y�
PERMIT FEE (SUB TOTAL) WIRING �/ G.tf(7
FIXTURES -71
PLAN CHECK FEE ISOs: PERMIT FEET POWER AUTHORIZED
PERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL Zvi V
TOTAL FEE J EPH C. ROOHAN
SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION c -' M.O. CASH,
.80"Eplf I S 9 3-9&: f'LSR 1 �J2 D'J 3.80-
EE
E BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
76A663-CE8061/70 APPLICATION FOR ELECTRICAL IT
1� COUNTY OF LOS ANGELES �( �1`y�
DEPARTMENT OF COUNTY ENGINEER BUILDING /
BUILDING AND SAFETY DIVISION ADDRESS Atj
JOHN A. LAMBIE. COUNTY ENGINEER LOCALITY
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
OUTLETS N0, EACH FEE ,
OWNER
RECEPL_ $ $ MAIL
LIGHT TOTAL
FIRST 20 Zp ADDRESS
CITY TEL.
SWITCH_ OVER 20
.ID PLAN CHT
FXTURES K
I
LIGHTING FIRST 20 20 APPLICA
TOTAL
OVER 20 ADDRESS
.10
APPLIANCES CITY TEL. NO
PERMIT
RANGE_DRYER_WTR. HTR._ APPLICANT /
STA. COOK_OISP. F.A.0._ ADDRESS
SPACE HTR. AIR COND. CITY 'TEL. N0.
CLOTHES WASH. DISHWASH. LICENSE NO. V CLASS.C- D
FAN__OTHER 1.00 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING WIT ALL COUNTY ONOINANCES AND STATE LAWS REGULATING
IND. HEATERS, ETC. HP. KW. KVA, ELECTRICAL WIRING.
S 12E 0 TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 — 1 100 LICENSED ASREQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM T E LEGAL OWNER OF, AND INTEND TO
1 — 10 3.00 RESIDE IN, THE ABOVE SCRIP.ED RESIDE PROP RTY.
n }
SIGNATURE 1
10 - 50 5.00 OF PERMITTEE f
U
50 - 100 1000
DISTRICT NO. CL455 GNOU ZON PR CE Y Y.
100 - 500 1500 (� /
SIGN, GAS SIGN AND.ONE CIRCUIT 3.00 NOTES: .W
L
TUBE, OR N
MARQUEE AODI TIONAL CIRCUITS 1.00 Z
SERVICE NOTOVER 600 VOLTS OR 200 AMP 2.00
APPROVALS DATE INSPECTOR'S SIGNATURE
SERVICE OVER 600 VOLTS OR 200AMP 500
TEMP.POWER POLE
TEMP SERVICE,POLE, &APPURTENANCES 300 -
UNDERSLAB WORK
TEMP LIGHT OR RECEPT. SYSTEM 3.00
ROUGH CONDIUT
WIRING
PERMIT FEE (SUE TO FIXTURES
POWER AUTHORIZED
PLAN CHECK FEE (50% PERMIT FEE)
UTILITY CO. NOTIFIED
PERMIT ISSUING FEE 2.00 ,.
FINAL ,4`�
SUPPLEMENTARY PERMIT ISSUING FEE LpD
J E C. ROOHAN
TOTAL FEE ' SUPERVISING ELECTRICAL ENGINE
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. I CASH
Ihr,y � Oiizz APR 7 2 0 4.00- Q
BEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
WORKERS' COMPENSATION DECLARATION CE-806 ,D,B, APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I have a certificate of consent to self CE-506G �l
insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY
or a certified copy thereof (Sec. 3800, Lab. C.) - T
P❑ollcy No.7„JCompany OMl O CASu4(_r FOR APPLICANT TO FILL IN - JOB 2
Certified copy is hereby furnished. New Residential Bldgs. & PoolsEACH NO, FEE ADDRESS I
]�
Certified copy is filed with the county building i pec- 1 & 2-Fomil y, Sq. Ft. -%Z � $ — $ LOCALITY �C��S-�C—� L
'NEAREST nn
tion departm nt. Multi-family Sq. CROSS Si.
Residential Swimming Pools OWNER OR
Date Applican FIRM NAME (L-.l. Z
CERTIFI ATE OF EXEMPTION FROM WORKERS' � 4 -MAIL
Outlets: Rec Light Sw._
' COMPENSATION INSURANCE � ADDRESS ( ,
This section need not be completed If the work involved b ��++ First 20
( P T Total No. CITY el. No.
the permit is for one hundred dollars (5100)or less.) Additional 7
I certifythat in the performance of.the.work for which this PLAN CHECK
P APPLICANT
permit 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 J J ADDRESS
Total No. 2 Additional CITY Tel. No.
Date Applicant Fixed Appliances Not Over 1 HP PERMIT
NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT
Exemption, you should become subject to the Workers' Range— theater_D.W. — r
Compensation provisions of the Labor Code, you must forth= Oven _ Dryer — W.M._ ADDRESS
with comply with such provisions or this permit shall be Top _ FAU . —W.H. —
deemed revoked. Hood Fan _Other_ CITY L_TATel. No--19,9-O4
LICENSED CONTRACTORS DECLARATION LICENSE OR /
hereby affirm that am licensed under provisions of Chapter 9 Disp: _ Room Air Cond. REG. NUMBER 4 Class.
(commencing with Section 7000) of Division 3 of the BusinessDISTRICT NO. PROCES D BY
and Professions Code,and my license is in full force and effect. Power Apparatus 8 Large Appliances d
_ Size & Type HP, KW, KVA, or KVAR' 5,0 O
`�
License Number4334 74 Lic. Class +--s Up to 1 Incl. FINAL 9 r7 V
j� py Over 1 to 10 Ind. DATE ��/j��- cc
Contractor L�Ulrr Date 2 L—f0 VALIDATION - O
❑ Over 10 ro 50 Incl.' FINAL / ~
I am exempt under Sec. Over 50 to 100 Inc. BY
B.&P.C. for this reason Over 100 Z
Date' Services, Swbd., MCC & Panelboards -
0 - 200 Amp. Under 600 V / J •-
Signature 201 - 1000 Amp. Under 600 V -
❑ Over 1000 Amp. or Over 600 V
Exemption for Reg. Mainz. Elect.
SINGLE FAMILY Temp. Power Pole&Appurtenances
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ;i2 3 5.O A
I hereby affirm that I am exempt from the Contractor's license Additional Sign Branch Circuits # s o e's e 'Z
Low for the following reason.(Section 7031.5, Business and _ 7 ,
Professions Cade):
I, as owner of the property, will do the work and the Misc. Conduits&Conductors .2:.;o 2 3.2 5.
structure.is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ D e .1..2 3,2 5�
7044, Business and Professions Code).
CONSTRUCTION LENDING AGENCY ,0,6 '— '4
2 8 8
I hereby affirm that there is a construction lending agency for
the performance of the work for which this permit is issued - PERMIT FEE -(Sub-Total) - -
(Sec. 3097, Civ. C). -
PLAN CHECKING FEE -
Lender's Name -
PERMIT ISSUING FEE �V U
Lender's Address 9
I certify that I have read this application and state that the TOTAL FEE -2 3.
above information is correct. I agree to comply with all County
ordinances and State laws regulating Electrical wiring, and
hereb t r' e rep esentatives of t is County to enter upon
p p rty for i pedion urpos .SEE,REVERSE FOR EXPLANATORY LANGUAGE
naN a of ermiBee
Date