HomeMy Public PortalAbout9115 DUFFY ST_Electrical__ COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Dof CD Engineer 127N 10
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DIVISIONSION OFF BUILDING & SAFETY
WILLIAM J. FOX, County Enpinoer
FOR APPLICANT TO FILL IN DISTRICT NO, GROUP ZONE PERMIT NO.
ELECTRICIAN
ADDRE9 RECEIVED BY FIRREADYPECST TION DATE ISSUED
CITY L TENO. 4 ~ ��—J
ARDR�
COUNTY LICENSE NO. EXPIRES BUILDIND /`
PERMIT FEES ADDRESS
NUMBER EACH FEC LOCALITY
LIGHT OUTLETS NEAREST
RECEPTACLES CROSS ST.
WALL SWITCHEfi -ISGWNER
TOTAL OUTLETS 5C $ MAIL
ELEC. RANGES 25 ADDRESS
ELEC. HEATERS 25 ay CITY TEL NO.
FIXTURES 5
c I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
MISC. y L APPLICATION AND STATE THAT THE ABOVE IS CORRECT
NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS ANO STATE LAWS REGULATING ELECTRICAL WIRING.
MOTORS I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
NUI+eER
ORB POWER FEE ANGELES CDUNTY LICENSE. O I AM THE LEGAL OWNER
NEW mV- I HP vYERI IHC. EACH OF THE RESIDENT PROPER DESCRIBE ABOVE.
_ -/,I s LEes $ .25 `J SIDNATURE OF �Yr
I/2 2 50 PERMiTTEC --
2 5 1.00
IN ECTION RE ORD
5 15 1.50
15 50 2.50 ew -_c 70o S.�s<GC
_ 50 200 S.00 tim yQ QMT F'QdA
200 500 1 10.00 TB "07—
Soo 100015.00 J a
OVER 1011 20.00 'SmL LG W 4� O//V Z_
L7
M.S. BET/FRED. CHANDER-HP /,0
WELDERS: AC-KVA O
GENERATORS - KW
TRANSFORMERS - KVA -
TEMP. MOTORS (75% OF oRIG.) OI• f� ��N� �
MOVED MOTORS (7S% OF ORIS.)
MISC.
SIGNS
NO. NO.TRANS.
APPROVALS
NO. NO. LAMPS
FOR EACH PERMIT: DATE INSPECTOR'S NAME
WIRING $1.00 CONDUIT w
FIXTURES $1.00 �f U. WIRING ' — A^�" ./�L_
SUPPLEMENTARY .50 FIXTURES
7 POWER
TOTAL FEE 5� 3J3 UTILITY CO. NOTIFIED
FINAL J" L. ��
76AGG3 DBS,$5A 4-52
76A663 C83 5q 71-51 APPLICATION FOR PERMIT
-DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES FR�� � Il
WILLIAM J. FOX, CHIEF ENGINEER IT
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE I PERMIT NO.
ELECTRICIAN ' .i ••11 �-- RECEIVED BY READ?ECTION FOR DATE ISSUED
AODRE9 �`t. pvFIRST IN �
CITY f. f (� E1_ NO. A VAI -s
COUNTY LICENSE NO. •v E� XPIRES V BUILDING
/ /✓ (/ /•
PERMIT FEES j
FEE
NUMBER EACH I�CAIITY
LIGHT OUTLETS NEAREST
CROSS ST.
RECEPTACLES re
_
WALL SWITCHES - , OWNER �.
TOTAL OUTLETS SC G MAIL
ELEC. RANGES25 ADDRESS
ELEC. HEATERS 25 _ - CITY TEL. NO.
FIXTURES 5 S 1 HEREBY ACKNOWLEDGE THAT I HAVE REAP 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 I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
NumuER HORSEPOWER ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
FEE OF THE RESIDENTIAL PROP TY DE9CR ED ABOVE.
NEW MVO. HP OVER INC. C4CN
I/2 6 LE66 $ .25 SIGNATURE OF
�/2 2 .50 PERMITTEE --- ----
2 5 1'00 INSPECTION RECORD
5 15 1.50 _
15 50 2.5O _
50 200 5.00 _
_ 200 50o 10.00 J
_ Soo 1000 15.00 - a
Z
11 OVER 1000 20.00
_ M.G. SET/FREQ. CHANGER-HP
WELDERS: AC-KVA O
GENERATORS - KW
TRANSFORMERS - KVA'
TEMP. MOTORS (75% OF ORiBJ
MOVED MOTORS (75% OF ORI..)
MISC.
SIGNS
NO. NO.TRANS. I APPROVALS
NO. NO. LAMPS
FOR EACH PERMIT: DA/TE INSPECTOR'S NAME
WIRING _ $1.00 j d-6 CONDUIT / �c
FIXTURES $1.00 Q� WIRING
SUPPLEMENTARY •50 FIXTURES
POWER 1
r _ _
TOTAL FEE $ L UTILITY CO. NOTIFIED
(, FINAL I IL-41
� Z
'' 9� iS
76A660 CE .06R 10/7] APPLICATION
P LICATIO FOR EYVTRIC-AL..PRMI4
COUNTY OF LOS ANGELES T�1L1'II
DEPARTMENT OF COUNTY ENGINEER JOB i
ADDRESS t , ✓
BUILDING AND SAFETY DIVISION _
FOR APPLICANT TO FILL IN LOCALITY
New Residential Bldgs.&Pools EACH NO. FEE NEAREST
1 &2-Fon dy,Sq.Ft. $ .025 — $ CROSS ST.
OWNEROR
Multifamily Sq. Ft. .02 — FIRM NAME
Residential Swimming Pools 25.00 MAIL 17 11 ep-
ADDRESS PAlie
Outlets: Rec LightSw. CITY tel.No. - �-
First 20 .50 PLAN CHECK
Total No. Additional .30 APPLICANT
ADDRESS
Lighting Fixtures First 20 .50 .CITY Tel. No.
Total No. Additional '30 PAPMIT
PLICANT ^ I Inc
Fixed Appliances Not Over I HP ADDRESS
Range—Hearer—D.W._ CITY Ig Tel. No. Q�
Oven _Dryer—W.M._ LICENSE O
Top — FAU —W.H._ REG.NUMBER Class.
Hood Fon _Other__ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE -
DISp. Room Au Cond. -- 2'50 THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDIN.
ANCES AND STATE LAWS REGULATING ELECTRICAL WIRING.
Power Apparatus&Large Appliances
Siie&Type HP, KW, KVA,Or KVAR I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS
REOUI RED BY L05 ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM Y
Up tOIInC. 2.5D THE LEGALOWNEROF THE ABOVE DESCRIBED TIAL PROPE TY QO
Over 1 to 10 Incl. 5.00 U
Over 10 to 50 Ind. 12.50 1 1 PERMITTEE �-
Over 50 to 100 Inc. 25.00 SIGNATURE O
U
Over IN 40.00 DISTRICT NO. Pg6E{iSSED BY i
Services { � f-><•s�
0-200 Amp.Under 600'V 12.50 /, _ INSPECTOR'S
201-1000 Amp.Under 600 V 25.00 APPROVALS DATE SIGNATURE
Over 1000 Amp.or Over 600 V 50.00 TEMP. POWER POLE
UNDERSLAB WORK
Temp. Power Pole&Appurtenances 10.00
-
Sign with One Branch Circuit 10.00 ROUGH CONDUIT
2.00
Additional Sign Branch Circuits WIRING
Misc.Conduits&Conductors 10.00 - FIXTURES
Other(See Complete Fee Schedules POWER AUTHORIZED
UTILITY CO.NOTIFIED
FINAL
PERMIT FEE ISub Total) NOTES
PLAN CHECKING FEE (One Fourth Permit Feel
PERMIT ISSUING FEE $7.00 - -
TOTALFEE L�
PLAN CHECK VALIDATION '.CK. M.9r a CWSH e- AB PERMIT VALIDATION - M O. CASH
0 e e e'
O e ' N
• .p .0 ,O a-- P,
51 BACK OF APPLICATION FOR COMPLETE SCHEL--p
cD N
WORKERS'COMPENSATIONDECLARATION 63
CE806G (2-80) APPLICATION FOR ELECTRICAL PERMIT .
+'.
I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY
insure, or a certificate of Workers'Compensation Insurance,or
q e- j466 ogy j)1,1�9f.,(Sec. 3600, Lab. C.) IL ��
'" r'I (y/y `/`7 //jj.�.,,,�� � � � � FOR APPLICANT TO FILL IN SOB
Policy No. Company�&j4,l. iSe ADDRESS
New Residential Bldgs. &Pools EACH NO. FEE
Certified copy is hereby furnished. 1 & 2-Family,Sq. Ft. $ — $ LOCALITY
�y Multi-family Sq. FT — NEAREST
IYl Certified copy is filed with the county building inspection CROSS ST
dep rime L Residential Swimming Pools OWNER OR
,&,:��,,Tr�1�Jl!,,,, • IJL r- /. FIRM NAME E
Date�LL Applicant F A Outlets: Rec'y6Light�Sw.. t0 r MAIL
T- 1' First 20 J ADDRESS g
CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY Tel No. I1 "7—
COMPENSATION INSURANCE }
PLAN CHECK 1
APPLICANT O
(This section need not be completed if the work involved Lighting Fixtur s First 20 :gODREss U
by the permit is for one hundred dollars (5100) or less.) Additional
Total No.
I certify that in the performance of the work for which this Fixed Appliances Not Over 1 He CITY Tel No. 0
permit is issued, I shall not employ any person in any manner PERMIT W
so as to become subject to the Workers' Compensation Laws. Range_ Heater_D.W. APPLICANT
Oven _ Dryer_W.M. ADDRESS "� 10
Date Applicant Top _ FAU ter_W.H: Ak z
Hood _ Fan ps Other_ CITY Tel No. rl_)
NOTICE TO APPLICANT: If, after making this Certificate of Disp. _ Room Air Cond,_ �.! ICE SE O ��
Exemption, you should become subject to the Workers' REG. NUMBER Class
Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO. P D BY
with comply with such provisions or this permit shall be
deemed revoked. Size&Type HP, KW, KVA,or KVAR
Up to 1 Incl. - •' � V
FINAL
LICENSED CONTRACTORS DECLARATION Over 1 to 10 Incl.
Over 10 to 50 Incl. DATE VALIDATION
I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINBY AL
9 (commencing with Section 7000) of Division 3 of the Busi- Over 100 -
ness and Professions,Code, and my license is in full force and '
effect. Services -
0-200 Amp p Under 600 V
License Number Lic.Class
201-1000 Amp. Under 600 V
Contractor Date ' Over 1000 Amp.or Over 600 V
r
HOME OWNER-BUILDER DECLARATION Temp. Power Pole& Appurtenances -
Sign with One Branch Circuit
I hereby affirm that I am exempt from the Contractor's Additional Sin Branch Circuits 2 2 3 a 7 A
Sign License Law for the following reason (Section 7031.5, Busi- # ore e e o 2
ness and Professions Code):
Misc.Conduits&Conductors i
L as owner of the property. will do the work and the Other (See Complete Fee Schedule)—
structure is not intended or offered for sale (Section _
7044, Business and Professions Code).
CONSTRUCTION LENDING AGENCY '
I hereby affirm that there is a construction lending agency - - 2 - - 3020
for the performance of the work for which this permit is '
issued (Sec. 3097,Civ.C.). PERMIT FEE (Sub-Total) e ojo 3 0.2 ps
Lender's Name PLAN CHECKING FEE IOne-Fourth Permit Fee)' ) 2. 1 '8.-81
Lender's Address PERMIT ISSUING FEE '
I certify that I have read this application and state that the TOTAL FEE
above information is correct. 1 agree to comply with all County
ordinances and State laws regulating Electrical wiring, and '
hereby authorize representatives of this County to enter upon
. the. the abovr.y for inspection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE '
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7A,.1�.4�L� RaS KC.a
40 ,
Signature of Permittee U te ,...