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Home My Public Portal About9915 DUFFY ST_Electrical__ 6A663 DBS SA 7-51 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APP L CANT T FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRICIAhY' 1i LTJ F :T,sv�, RECEIVED BY READY FOR DATE ISSUED _ADDRESS9 .% r� "F O m FIRST INSPECTION CITY ,/•�. .� / MEL. NO, COUNTY LICENSE NO: EXPIRES BUILDING ADDRES9 PERMIT FEES FEE NUMBER EACH LOCALITYQfpf LIGHT OUTLETS NEAREST / fir CROSS ST. RECEPTACLES �. .�i A 1 WALL SWITCHES DWNER � TOTAL OUTLETS ® ) 5c $$ 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 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 HORSEPOWERFEE Y ANGELES COUNTLICENSE, OR 1 AM THE LEGAL OWNER NEW MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROJPEERTz7z CID ABOVE. � 'r2 6 LESS $ .25 SIGNATURE OF �� 1 ! %2 2 .50 PERMITTEE , 2 s 1.00 INSPECTION RECORD S is 1.50 15 50 2.513 /i X7Z'12-k7yyJ '• - 50 200 5.00 _ 200 500 10.00 J 500 1000 15.00 Q Z ❑VER 1000 20.00 L7 M.G. SET/FRE4- CHANGER-HP WELDERS: AC-KVA. O GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF ORIG.) _ MOVED MOTORS (75% OF ORIG.) MISC. SIGNS NO. NO.TRANS. APPROVALS ALS NO. NO. LAMPS FOR EACH PERMIT: DATE INSPECTOR'S NAME WIRING $1.00 s:7 CONDUIT _ FIXTURES $1.00 �-{-�- WIRING SUPPLEMENTARY ,50 f FIXTURES POWER TOTAL FEE $ :�7 7t UTILITY CO.NOTIFIED l 7 FINAL WORKERACOMPENSATION DECLARATION 76A663 CE-806G (2-801 APU L�CATMN FOR EL E Il UCAL PERMH I hereby' 4firm 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 certified copy thereof(Sec. 3800,Lab.C.) W(p JUN ZN FOR APPLICANT TO FILL' IN JOB. n o]-y N �I Company /� ! EACH NO. FEE ADDRESS i New Residential Bldgs.&.Pools Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ - — Is - LOCALITY T� �e �f Multi-family Sq. Ft. —' NEAREST ��gJ} Certified copy is filed with the count)i building inspection CROSS-ST department. Residential Swimming Pools OWNER OR AN A N f r /n FIRM NAME T'CfOfJ Date '`"/Y�w Applicant P Outlets: Rec.-1—Light_L Sw. MAIL First20 ADDRESS .` CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY Tel No. COMPENSATION INSURANCE ;- O PLAN CHECK (This section need, notbe .completed if the work involved APPLICANT 0 by the permit is for one hundred dollars ($100) or less.) Lighting Fixtures First 20 ADDRESS � Additional Total No.+I certify that in the,performance of,the work for which this Fixed Appliances Not Over 1 HP CITY Tel No. F- permit is issued; I shall not employ any person`in any manner PERMITIL , so as,to become subject to the Workers' Compensation Laws. Range_ Heater_D.W. APPLICANT 1610 d. Oven Dryer_W.M._ ADDRESS' •�� Z- Date Applicant Top — PAU W.H. — �r N� - Hood Fan �' Other_ CITY e /� c� TeLNo. S�.S��Y NOTICE TO APPLICANT: If„after making this Certificate of Disp. Room.Air Cond._ LICENSEOR �-r -Exemption, you should become subject to the Workers' REG'.NUMBER d' Class Compensation-provisions of the Labor Code,, you must forth- Power Apparatus& Large Appliances, DISTRICT NO. PROCESSED BY with comply with. such provisions or this permit shall be Pl deemed revoked. Size&Type.HP,KW, KVA,orKVAR (0 Up to 1.Incl_ FINAL Over 1 to 10 Incl DATES VALI ATION LICENSED CONTRACTORS DECLARATION Over 10 to 50 Iricl. I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. F11VA BY 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 j 8 4,2 A effect. Services License Number W Lic.Class r 0-200 Amp'.'Under 600 V .. 0 ° o o ° 2' Jy/ 201-1000 Amp.Under 600 V. Contractor 690A/G d Date / —87 O P Over 1000 Amp.or Over 600 V -J,° °,1 6.2 5 HOME OWNER-BUILDER DECLARATION Tem ° °. o.1 6,2 5 2 • p,. Power Pole&Appurtenances �, v I, hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit License Law for the following,reason (Section 7031.5,'Busi- Additional Sign Branch Circuits C'.1.1 5 8 b, ness and Professions Code): Misc.Conduits.&Conductors O1, 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 for' the performance of the work for which this permit is PERMIT FEE (Sub-Total) issued(Sec. 3097,.Civ.C.). Lender's Name PLAN CHECKING FEE (One,Fourth Permit Fee) Lender's Address PERMIT•ISSUING FEE Q I certify that I.have read-this application and state that the TOTAL FEE 6 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 propert for inspection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE Y �� S gnature of Permittee Date TWO�KERS' COMPENSATION DECLARATION 76A663 10/81 22fp1 22 no //�� (p� 0nn22((0��(��//�� 4 hereby offir9?✓`h'at 11�ave a certificate of consent to self CE-806G /i�1l�l�LSG�1UV lJ-Oh� 'LSI�LSC�Q�CAL� IJ'L�,U�M57 insure, or a cer�iticate 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 Certified copy is hereby fur ed. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS / J ❑ g = g LOCALITY Certified copy is with the county building inspec- 1 & 2-Family, Sq. Ft. tion depart Multi-family Sq. Ft. NEAREST CROSS ST. Residential Swimming Pools OWNER OR Date Applicant FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw. MAIL COMPENSATION INSURANCE, ADDRESS First 20 (This section need not be completed if the work involved by Total No.—. Additional CITY y✓ Ter No. the permit is for one hundred dollars ($100)or less.) PLAN CHECK I certify that in the performance of the work for which this APPLICANT permit is issued, l 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. Do e Applican 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_ Heater_D.W. _ Compensation provisions of the Labor Code, you must forth- Oven _ Dryer — W.M.— ADDRESS �� NL/ with comply with such provisions or this permit shall be Top _ FAU —W.H. — deemed revoked. Hood _ Fan _Other_ CITY Tel. No: j� LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. REG. NUMBER -L, Class. - 1 (commencing with Section 7000) of Division 3 of the Business DISTRICT NO.. PRO D BY and Professions Code,and my license is in full force and effect. Power Apparatus& Large Appliances �( / Si z 8 ype HP, KW, KVA, or KVAR r ®U 0 r 11 License Numbe - �i 1 1--- Lic. Class Up to 1 Incl. ® FINAL I Over 1 to 10 Incl. DATE _�/Q VALI TION �' Contra�4ei Date Over lO to 50 Ind. �! ❑ FINA W' I am exempt under Sec. Over 50 to 100 Inc. BY a B.&P.C. for this reason Over 100 Z Date: Services, Swbd., MCC& Ponelboards' ; 0 - 200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V ;23.9 7.-3 A ❑ Over 1000 Amp. or Over 600 V # 0 0.0 0,0 2 Exemption for Reg. Moint. Elect. II ° o29.50 SINGLE FAMI Temp. Power Pole&Appurtenances HOME OWNER-BUILDE DECLARATION ,o o 0 Sign with One Branch Circuit 2 9.5 O v I hereby affirm that I am exemp rom the Contractor's License Additional Sign Branch Circuits Law for the following reason Section 7031.5, Business and U 2 0 4'.;.-8 6 Professions Code): ❑ I, as owner of the roperty, will do the work and the Misc. Conduits&Conductors structure is not tended or offered for sale (Section Other (See.Complete Fee Schedule)_ 7044, Business nd Professions Code). CO RUCTION LENDING AGENCY I hereby affirm at there,is a construction lending agency for the performo a of the work for which this permit is issued PERMIT FEE (Sub-Total) (Sec. 3097, w. C.). PLAN CHECKING FEE Lender's ame PERMIT ISSUING FEE Q Lend 's Address Ice ify that I have read this application and state that the TOTAL FEE 9 i ab ve information is correct. I agree to comply with all County o dinances and State laws regulating Electrical wiring, and ereby authorize represent t' es of this County to enter upon he ove- entioned ro ty f r inspection purposes. I SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee DFbte