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HomeMy Public PortalAbout9909 DUFFY ST_Electrical__ 96A663 Des 6A 7-51 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FORP.P�L�IGANT Tip FILL IN VDISTRICT NO. GROUP ZONE PERMIT NO. S� ELECTRICLAN - / / /J RECEIVED BY READY FOR DATE ISSUED ADDRESS i / !per✓® ,L,.'� J!./ ; / _ FIRST INSPECTION CITY. ill �7 /� TEL. NO. �� n I//��q�-"-�• COUNTY/LICENSE NO. f%/'1 EXPIRES g '- 5'1 BUILDING G PERMIT FEES "// ADD RESB NUMBER EACH FEE _/pq LOCALITY ,� /04 .(/J 1 LIGHT OUTLETS NEAREST �y� RECEPTACLES � CROSS ST- WALL SWITCHES a`^ —"OWNER yi "I TOTAL OUTLETS Sc $ a S' MAIL ELEC. RANGES - 25 ADDRESS/�/( ,. ELEC. HEATERS 25 CITY u1 ' -"-/TEL. NO. FIXTURES 1Y 5 1 HEREBY ACKN('OWLEDGE THAT I 4AVE READ THIS MISC. / APPLICATION AND STATE THAT THE ABOVE 15 CORRECT NUMBER OF LIGHT CIRCUITS 3, 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 I AM THE LEGAL OWNER NEW MVD. H�P// DYER 'N0. EACH OF THE RE6IDENTI�A/Ly/I///�R'OPERTvOSSC RIBED/1A/BDLC; LY �/s 6 LE99 $ .25 SIGNATU OF /I Fi/^Y"���Y/f�C /— / I/2 2 .50 PERMITTEE IV 2 s 1.00 INSPECTION RECORD _ s Is 1.50 _ 15 so 2.50 50 200 5.00 -- 200 Soo 10.00 _ 500 1000 15.00 2 OVER IODU 20.00 M.G. SET/FRED. CHANGER-HP WELDER5: AC-KVA O GENERATORS - KW _ TRANSFORMERS - KVA._ - TEMP. MOTORS (75% DE oRIG.) _ MOVED MOTORS (75% GF R.G.) MISC. SIGNS ND. NO.TRANS. NO. NO. LAMPS APPROVALS FOR EACH PERMIT: O E INSPECTOR'S NAME WIRING $1,pp CONDUIT �!!� FIXTURES $1.00 L WIRING SUPPLEMENTARY .SO FIXTURES POWER TOTAL FEE $ C— UTILITY CO.NOTIFIED d FINAL WORKERS' COMPENSATION DECLARATION CE 863 to/BI APPLICATION Im®p ICA TION FOR ELECTRICAL PERMIT fr RMITt I hereby affirm that I have a certificate of consent to self CE806GP'i lr lr lL '�.rYY II Otl Ir II'l I�l�ll'(9tl9 0 insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec. 3800, Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB (] Q Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS -1 ® I & 2-Family, 5 FL $ — $' LOCALITY e Certified copy is filed with the county building inspec- Y� . lion dep rtment. /L Multi-family Sq. Fc — NEAREST /�(//fQR C� Residential Swimming Pools OWNERCROSS OT. Q Date 17, Applicant - OWNER M ( FIRM NAME CERTIFICATE OF EXEMPTION ROM WO ERS' lLiht Sw.! MAIL COMPENSATION INSURANCE a ADDRESS Outlets: Rec g 7-Y" First 20 (This section need not be completed if the work involved by Total No. Additional CITY T T L' o.IQ (3C -g� the permit is for one hundred dollars($100)or less.) I certifythat in the performance of the* PIAN CHECKIF p erwork for which this 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 ADDRESS Total No. Additional CITY Tel. No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers' Range_ Heater—D.W. APPLICANT Compensation provisions of the Labor Code, you must forth- Oven _ Dryer � W.M.— ADDRESS31 SCIII GQ 10{✓I 15 with comply with such provisions or this permit shall be Top _ FAU —W.H. — deemed revoked. Hood _ Fan _ Other— CITY Q Tel. No. LICENSED CONTRACTORS DECLARATION LICENSE M I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. REG"NUMBER p Class. (commencing with Section 7000) of Division 3 of.the.Business DISTRICT NOPROCESSED BY PowerApparatus 8 Large Appliances . IL >_and Professions Code,and my license is in full force and effect 'y O //''`` Size 8 Type HP, KW, KVA, or KVAR' License Num I 'c. Class IS L Up to I Incl. FINAL V Over 1 to 10 Incl. DATE VALIDATION Q Contractor Over 10 to 50 Incl. FINAL ✓ ! /' V ❑ I a /exempt and r SecOver 50 to 100 Inc. BY '.,s.�•[.^'�'-r�.J W d B.&P.C. for this reason Over 100 Services, Swbd., MCC & Ponelboards ll__ Z Date: 0 - 200 Amp. Under 600 V $. f2. Q ®G �T� 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 ��p„�,y,.w �' �'" r HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit c 18-29A I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits Law for the following reason (Section 7031.5, Business and e o ee-s 2 Professions Code): - ❑ I, as owner of the property, will do the work and the Misc. Conduits & Conductors - 2a0 3 1.2 rJ structure is not intended ar offered for sale (Section Other (See Complete Fee Schedule)_ D 7044, Business and Professions Code). o3 12 S ul CONSTRUCTION LENDING AGENCY 05 10-83 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued PERMITTEE (Sub-Total) - (Sec. 3097, Civ. G). PLAN CHECKING FEE Lender's Name PER ISSUING FEE Lender's Address - I certify that I have read this application and state that the - TOTAL FEE 31 S6 above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and , hereb��a,u thorize representatives of this County to enter upon -' the 15ob - en i operty for 'nspection purpose/s� �" � SEE REVERSE FOR EXPLANATORY LANGUAGE Si azure of PPermi Dee D to WORKERS'COMPENSATIONDECLARATION# 76A66 CE,806G 12-801 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 77(- k i a certified cop yereoJOB f�f See. 3800, Lab. C.)' ('� /1 Polic�N6. J(('' krCompany FOR APPLICANT TO EACH FILL N NO. FEE `ADDRESS �( 0q (f-f- r New Residential Bldgs. &Pools _ F-1 Certified copy is hereby..furnished. 1 &2-Family,Sq. Ft. $ — $ LOCALITY Teryipie, Ci Multi-family Sq. Ft. — NEAREST Certified copy is filed with the county building inspection CROSS ST depa Intent Residential Swimming Pools OWNER OR I Date-, /)��'�3^/'� '` R�. _^^� - n© FIRM NAME• r l� • PPlicant� (, )' �•I C.IlC �+ Outlets: Rec.—Light— Sw.— ' ,MAIL O U /l . TV—I First 20 ADDRESS 'f- CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY T Tel_N o. /9t. ? COMPENSATION INSURANCEn- PLAN CHECK 0 (This section need not be completed if the work involved APPLICANT U Lighting Fixtures First 20 by the permit is for one.hundred dollars ($100) or less.) g g ADDRESS � Total Nci Additional 0 1-certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No. U 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 I d Oven _ Dryer_W.M. ADDRESS S f N Z Date Applicants Top FAU _W.H. f Hood Fan 6lhCr�� CITY T No. NOTICE TO APPLICANT: If, after making this Certificate of Disp. _ Room Air Cond.— LICENSE OR 2r Exemption, you should become subject to the Workers' REG:NUMBER ss C. Compensation provisions of the Labor Cade, you must forth- Power Apparatus-& Large Appliances DISTRICT NO. PROCESSED BY with comply with such provisions or this permit shall be Size&Type HP, W, KVA,or KVAR S Q deemed revoked. K Up to Incl. FINAL .Over 1 to 101ncl. DATEVALIDATION LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl. ��� 1 hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL 1 9 (commencing with Section 7000) of Division 3 of the Busi- Over 100 BY 'Lr ness and Professions.Code, and my license is in full force and effect. ^ Services // > License Number CYS I m(Aic. Class- C�l C� 0-200 Amp. Under 600 V V .J n 201-1000 Amp, Under 600 V Contractor `. 010'alle_ /rOver 1000 Amp.or Over 600 V � a HOME OWNER-BUILDER DECLARATION Temp. Power Pole&Appurtenances Sign with One Branch Circuit I hereby affirm that i am exempt from the Contractors Additional Sign Branch Circuits License Law for the following reason (Section 7031.5, Busi- . ' ness and Professions Code): ' Misc. Conduits& Conductors ' I, .as owner of the property. will do the.work and the Other (See Complete Fee Schedule)— ;25 3.9.9'A. t structure is nointended or offered for sale (Section - _ 7044, Business and Professions Code). - 9 e e e s - 2 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency - 2 era 2 Ci 50 for the performance of the work for which this permit is PERMIT FEE (Sub-Total) issued (Sec. 3097,Civ.C.). - - e e o 24 5 0 U Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) O a 0 4-8 2 Lender's Address PERMIT ISSUING FEE '$ I certifv that I have read this application and state that the TOTAL FEE d W above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and r hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORYLANGUAGE Rg Mat iy , 7 -a3 Ra sigriaJure of flermittee Date