HomeMy Public PortalAbout5226 DALEVIEW AVE_Electrical__ ;76A663-DOS 5A 9-51 - APPLICATION FOR PERMIT
DEPARTMENT OFLOS NG AND SAFETY
COUNTY OFF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT_ TO FILL IN DISTRICT NO. GROUP ' ZONE PERMIT NO.
,0
ELECTRICIAN --
RECEIVED eY READY FOR DAT ISSUED
ADDRESS FIRST INSPECTION
CITY TEL NO. '1 -n/
COUNTY LICENSE NO. EXPIRES ADDRESSLDING �� /X. Ol— /A ♦I )' UILYA/%.C��J�/'
PERMIT FEES
NUMBER EACH FEE .LOCALITY
LIGHT OUTLETS NEAREST
CROBBBT. �iI/i i.(O/m J11lNJI �7H10..w./�I �.RECEPTACLES
WALL
WALL SWITCHES _OWNER
TOTAL OUTLETS 5. B MAIL
ELEC. .RANGES 26 ADDRESSn
,( � �/ ����•[ �J-j1J�/f/��p^�'/ /J��
ELEC. HEATERS 26 CITY /�.y��C yj Cf,(//.�/j TEL NO.
.FIXTURES S I MEREBYfACKNOWLEDGE THAT I ±IAVE READ THIS
MISC. APPLICATION AND STATE THAT THEABOVE 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 I CERTIFY THAT I POSSESS THE ABOVE VALID LOS
NUMBER HORa POWERF[[ ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
New MvO: HP Pveq INC. [ADH OF THE RESIDENTIAL PROPERTY DESCRIBEDS ABOVE.
n
I . iu[ 0 .55 SIGNATURE OF
a .60 PERMITTEE
a s 1.00 INSPECTION RECORD
as BD a.eo '
_ eo avo s.oD '
am 600 1MAO - J
500. 'LOGO 16.= - Q
Z
OVER IMO 2moD
M.G. BET/FRED. CRAM R-HP
W[LOMPOSAC-KVA O
GENERATORS
TRANSFORMERS- KVA
TEMP. MOTORS (96% Pr RneaJ
MOVED MOTORS (95 Or Re1B.)
MISC.
e1GNs
NO. ND.TRAN&
NO. NO. LAMPS APPROVALS _
FOR EACH PERMIT:' - DATE INSPECTOR'SNAME
WIRING $1.00 CONDUIT 4_ -
FIXTUR[B 81.00 WIRING
Bum-EMENTARY .50 FIXTURES.
POWER
TOTAL FEE O/ , UTILITY CO. NOTIFIED
FINAL / ��J
S 76A663 OBB SA 7-51 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES � � �
WILLIAM J. FOX, CHIEF ENGINEER Imi
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO.
ELECTRICIAN - y - / - r � 6 '45 w e
RE IVED BY READY FOR DATE ISSUED
ADDRE
RS` - •✓d-L� !J Q.Ga� FIECTION'
CITEL N ��
I--
COUNTY LICENSE NO, EXPIRES �' �r BUILDING C
PERMIT FEES ' ADDRESS V
FEE LOCALITY
NUMBER EACH
LIGHT OUTLETS NEAREST
CROSS ST.
RECEPTACLES .j/��•
WALL SWITCHES OWNER L,�
TOTAL OUTLETS Sc $ �y MAIL
ELEC. RANGES 25 ADDRESS
ELEC. HEATERS 25 CITY TEL. NO.
FIXTURES 5
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
MISC. APPLICATION AND STATE THAT THE ABOVE 15 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 HORSEPOWER ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL .OWNER
FEE
NEw MVO. HP vvER INC. EACH OF THE RESIDENT PROPERTY D CRISED ABOVE.
A LEss $ .25 SIGNATURE OF
1/2j�W2 50 PERMITTEE fff!!!
z s 1.0DSPECTION RECORD
_ 5 is I.so (/
15 5p 2.50 �•
50 z0a s.o0 1"L c r4G C � V. ,�•r✓r?G..�f
200 Soo 10.00 �.
FIT B g G K
s00 lana 15.00 ��7
OVER 1000 za.DD 9*7l PO S Cr G{ez M P-% N 0 R Z
t� 1fl I�J'8 1I�T'T. r!9 -.
M.G. SET/FREQ. CHANGER-HP 44 14, �
WELDERS: AC-KVA �L-# ,Hrq O
GENERATORS - KW s J`Y C6 le
TRANSFORMERS - KVA '
TEMP. MOTORS (75% cF vRIG.)
MOVED MOTORS (75% OF vRIG.) /
MISC.
SIGNS
NO. NO.TRANS:
APPROVALS
NO. NO. LAMPS
' DATE INSPECTOR'S NAME
FOR EACH PERMIT: .
WIRING $100 go CONDUIT -
FIXTURES $1.00WIRING 1 / V�SUPPLEMENTARY SO.50 FIXTURES
POWER /\
TOTAL FEE 9/.�" UTILITY CO.NOTIFIED ';IN
^lT FINAL
WORKERS'COMPENSATION DECLARATION I0/81 APPLICATION FOR ELECTRICAL PERMIT •.
I hereby affirm that (have a'certificate of <pnsen 6tCE-806o self' CE-8066.
insure of a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES .• e ° BUILDING AND SAFETY '
or a certified copy thereof (Sec. 3800,.Lab. C:) I / -
Policy No. Company - FOR APPLICANT TO FILL,IN _ JOB v
Certified c`apy is hereby furnished New Residential-Bldgs.$ Pools: 'EACH ' NO:. '_FEE. ADDRESS _ �'� �.
F_JCertified copy is filed with the county building inspec- I &2-Family, Sq. Ft. $ — $ r ^ LOCALITY. '
iiondeportment. - Multi-family Sq. Ff. — NEAREST- r;��
Residential'Swimmmg Pools - CROSSIST.
,', .
Date OWNER OR
-Applicant - - - FIRM.NAME ..,T• //
CERTIFICATE Of WORKERS' - - � IL ,
Outlets: Rec LighhSw.`
YCOMPENSATION INSURANCE - - ADDRESS -
Tis,section need not be com leted if the worAnvolved b First 20
P Y. Total No. Additional - CITY .. - - Tel.No.
( hk
.the permit is for one hundred dollars($100)or less:)'
PLAN CHECK"
omify t is isst in the performance ofnyper orcin which thiper - '
APPLICANT.
'permit is ,s om, I subject not to employ kers'Crsmpe any lion Laws.
+ - _
so as to"�becomesubjec(tothe Workers'Compensation Laws. Lighting Fixtures First 20 (� ADDRESS F -
'> = Total No. Additional
[[f�gyyTp (/��� /�/ 'CITY' Tel. No.
- -Date /` '[UApplicont-f "" Fixed Applidnces Not Over t HE PERMIT n
NOTICE O APPEfCANT If, after ma�in'9'this Certificate of � � ( � -
Exemption,' you .should become subject to the Workers" Range— Heater DW
W: APPLICANT
Compensation,provisions of the Labor Code, you must.forth- Oven. _ Dryer W.M. ADDRESS D .� I: /
with com I with such, provisions or this permit shall be - v
P.Y P Top — fAU —W. —
deemed revoked' - _ F -" - - -- ' -CITY - -Tel.No.
Hood Fan _Other-
- LICENSED CONTRACTORS DECLARA710Nr - L LICENSE OR
/
I hereby affirm thaal am licensed under provisions of'Chapter 9 Disp:-— Room Air Cond. REG..NUMBER 6'6 I - Class.&/,')
(commencing with Section 70D0).of Di6oion'3 of the Business DISTRICT NO. - PROCES D BY
Power Apparatus 8 Large Appliances y
and Professions Code, and'mplicense,is in'fulLfarce arid'effect.. _ U-�/ - 6
113 C- .
Size 8 Type HP;•KW, KVA;or KVAR' � � _ O � O
License Number,93
--Q Lic. Class
� � Up to 1 Incl.- FINAL /} -. - '
ControctoeY-$I'X/U 4 Date 1-31- 5 - Over 1 10 l0 1ncL DATE 7ii� r�- VALIDATION - 0
❑ Over 10 to 50 incl. !!!// V
FINAL
am exempt under Sec Over 50 to 100 Inc... BY
8.$P.C, for this reason Over 100 <(� W
Services, Swbd., MCC & Panelboards -' - Z
Date: 0 -200 Amp. Under 600 V pop. 7/'� ,
Signature - 201 - 1000 Amp. Under 600'V,
❑ - Over 1000 Amp. or Over 600 V
'.Exemption for Reg. Maint. Elect'.
SINGLE FAMILY
Temp: Power Pole ,g C 2,G4 A
HOME OWNER-BUILDER DECLARATION B.Appurtena Appurtenances _. - - _
hereby affirm that am exempt from the Contractor's LicenseSign with.One Branch Circuit #{ e • • • • 'L
Law for the following reason (Section 7031.5, Business and •Additional Sign Branch Circuits
Professions,Cade):. - _ 4 2 b,z 5
a Misc. Conduits B.Cond uctors - -'_ '" " - ""' .:.2,6:2,5
-
J, as owner no'in property, will do the work and the 5 x
' �stru<ture is not intended. or offered for sole (Section _ Other (See Complete Fee Schedule)_ � • ^ e 26 2 SIU
7044, Business and Professions Code). ,Q Q � 4�-8 3 .•
CONSTRUCTION LENDING AGENCY
I hereby affirm that thereis a construction.lending,agencyfor
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'.
Lender's Address _
I certify thatil have read This application and statethat.the TOTAL FEE _ E
above.infarmation is corrected'agree to comply.with.all County, - -. •--' -
ordinances and State lawsregulating Electrical wiring,.and _
hereby authorize representotives-of this County to enter upon
the above-mentioned property for in ection purposes. -
,J � ion
`.SEE REVERSE FOR EXPLANATORY LANGUAGE _- - -
Sig(�e of Permittee Dale -
• i