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HomeMy Public PortalAbout8817 ELM AVE_Electrical__ 78A889 CE808 10-59 A P 11 `V- //a. A Il MN FOR E II ECT M C II E Il O 0 V II U T �• , COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS z ec �i JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A.JENSEN,SUPT OF BUILDING - LOCALITY I-L ✓ZC FOR APPLICANT TO FILL IN NEAREST PERMIT MES ST. OWNER !� . I T E M NUMBER EACH FEE MAIL _ o OUTLETS: p $ $ ADDRESS LIGHTS RECEPT. W. J .10 . LIGHTING FIXTURES d 10 ZQ CITY TEL.NO. ELEC.RANGES CLO.DRYERS ELECTRICIAN e.Q WATER HEATERS .50 ADDRESS / ' ELEC.SPACE HTRS. DISHWASHERS CITY ..ei� TEL. NO (p GARBAGE DISPOSERS AUTO.- 00, STATE G +� WASHERS STA.COOKING UNITS .25 LICENSE NO. / , MOTORS: OVER INC. H.P. DISTRICT4NO.M I G -UP Z NE P ESSED BY 0— 1/2 .25 1/2— 2 ,50 INSHCTION RECORD K 2— 5 1.00 5— 15 1.50 is— 50 2.50 / . 50-200 5.00 y SIGNS: NO.TRANS. NO.LAMPS SERVICE 0-600V 1.00 - SERVICE OVER 600V 5.00 MISC. WIRING PERMIT 1.00 _ FIXTURE PERMIT 1.00 i SUPPLEMENTARY PERMIT .50 6 TOTAL FEE $ 00 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION - APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY , WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT ELECTRICAL WIRING. c- I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR WIRING LICENSED AS REQUIRED BY.LOS ANGELES C UNITY AND STATE OF t FIXTURES D J 9/Q,�, 77t CALIFORNIA OR THAT 1AM E LEGA N R - THE ABOVE DESCRIBED RESIDENTIAL PR, TY POWER e' SIGNATURE / - UTILITY CO.NOTIFIED OF PERMITTEE v �.,-...�a. FINAL ®F VALIDA ARTHUR C.VEIT, CK MOCCSASHSUPERVISING ELECTRICAL ENGINEER 76A869•CEB08 10-68 APPU/'- AT( M N FOR E 11 E/�wry- M C PERM T -COUNTY OF LOS ANGELES uv IIV 11.�J IIII III�II lulVVu DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION li ADDRESS fcctI z JOHN A. LAMBIE. COUNTY ENGINEER /+ WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST PERNIIT FEES CROSS ST. 441-1.5/CA L ITEM NUMBER I EACH FEE OWNER e OUTLETS:) ADDRESS $ $ MAIL G� LIGHTS / RECEPT. - SW. .10 LIGHTING FIXTURES 1 10CITY TEL.NO. k ELEC.RANGES CLO.DRYERS ELECTRICIAN O G WATER HEATERS .50 ADDRESS .S(j a4- ELEC.SPACE HTRS_ DISHWASHERS v CITY �'-C TEL. NO. x GARBAGE DISPOSERS AUTO.- _ STATE /!Q xe ` WASHERS STA.COOKING UNITS .25 LICENSENO. _ CJ .rte•• N:: - - MOTORS: OVER INC. H.P. - DISTRICT NO. [hGjROUp I ZONE I P ESSEDBY O— 1/2 .25 Z 1/2— 2 .50 �' INSPECTION RECORD 2— 5 1.00 5— 15 1.50 15— 50• 2.50 a 50-200 5.00 - NO.TRANS. 6 SIGNS: NO.LAMPS - SERVICE 0-600V 1.00 - P SERVICE OVER 600V 5.00 a '• MISC. .. WIRING PERMIT. 1.00- FIXTURE PERMIT 1.00 ' T '. SUPPLEMENTARY PERMIT .50 TOTAL FEE 1HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY _ - U WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING S� CONDUIT -- ELECTRICAL WIRING. 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ,e WIRING - J' LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES ()i . CALIFORNIA OR THAT 1 AM THE LEGAL WNER OF THE ABOVE DESCRIBED RESIDENTIAL P. E >; POWER SIGNATURE UTILITY CO.NOTIFIED ��O''GG �i w(�� OF PERMITTE _ FINAL OFAJ IDATION ARTHUR C.VEIT, CK Mo cases SUPERVISING ELECTRICAL ENGINEER t 76A663-CE806 3-64 QppUCATM FOR MEET OCad PERNU COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING ffl 7 ,-BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER ) �f WILLIAM A.JENSEN, SUPT OF BUILDING LOCALITY /bi lYy - -.-. NEAREST �r FOR APPLICANT TO FILL IN CROSS ST. f�j C�,OV Z�e REC EPT. TOTAL NO. EACH FEE OUTLETS FIRST 20 `� $2p $ / OWNER LIGHT MAIL / ADD'L .10 ADDRESS' SWITCH. OVER 20 LIGHTING TOTAL FIRST 20 .20 CITY �6N Q- TEL. NO.AIA FIXTURES } ADD'L 10 ELECTRICIAN O V R 20 RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS ���yyy GARB.DISP. .STA.COOK `' /Q�'L[.. CITY O/U e,'v / TEL.NO.,009 DISHWASH. AUTO.-WASH. STATE SPACE-I+TRB. STA.APP.('/s H.P.MAX.) .50 � LICENSE NO. 7 MOTORS. OVER NOT OVER H.P. DISTRISsT NO. GRO P OZ P f ESSED B O i 1.00 I 3 1.50 IINSPECTION! RECORD �. f 3 8 2.00 (l 7 `ES �1 i /G Gly LL� / BK to 8 15 2.50 18 50 3.00 (A �JJtic.(1 O V 50 100 5.00 W a N SIGNS: NO.LAMPS _ ��c. �'� -�'� Z } SERVICE 0.600V-NOT OVER 200A 1.00 SERVICE 0.60OV-OVER 200 A. 2;00 , A/G�f w SERVICE OVER 600V 5.00 //////,��/_ MISC. CA✓fs✓�(�Cf/ /j-`vy'^'I/!91✓ 1i �i' .� PERMIT ISSUING FEE 2.00 s/ a SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE Q 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS /J DATE INSPECTOR'S SIGNATURE AND,STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING 9/J k 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR - LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT1 A E LEGAL W R OF HE ABOVE DESCRIBED RESIDENTIAL-P ErrrY. POWER SIGNATURE UTILITY CO.NOTIFIED `- OF PERMITTEE FINAL VALIDATI ARTHUR C. VEIY CK MO CASH SUPERVISING ELECTRICAL ENGINEER n LALo 8 24 8" FEB L� 2 A 8.30 17 DBS-SA 3.55 APPLICATION ®® I ATION p R ELECTRIC LECTRIC qE p_ -DIVISION OF BUILDING AND SAFETY Department of County Engineer .County of Los Angeles BUILDING N� WM.J. FOX, COUNTY ENGINEER ADDRESS CASSATT D.GRIFFIN, SUPT OF BUILDING "jam �,,,j (/^a LOCALITY / / �!(i t "' G' FOR APPLICANT TO FILL IN NEAREST PERMIT FEESCROSS ST. N I U 5ER EACH FEE LIGHT OUTLETS OWNERMAIL RECEPTACLES ADDRESS WALL SWITCHES ' TOTAL OUTLETS u $ CITY TEL.NO.. ELEC. RANGES 25 ELECTRICIAN ELEC. HEATERS 25 ADDRESS KW EA ` CITY TEL.NO. FIXTURES 5 ✓ LICENSE NO. NUMBER OF LIGHT CIRCUITS - DISTRIC NO. fI GROUP /4PN READY FOR INSPECTION NUMBER OF RECEPTACLE CIRCUITS MOTORS NUMBER HORSEPOWERFEE I INSPECTION RECORD NEW MVD. HP OVER I INC. EACH 1/2&LESS $ .25 _ 1/2 2 .50 44] 25 1.00 5 15 1.50 7a7- �� AtY1�.f'9i ( J���l frr 15 50 2.50 WIRES I RES,yff-Q-T d'Z��q.k ^50 200 5.00. f lid {�cr=-/Gbt e /f r/J✓,4L I misc.. NO.SIGNS - NO.TRANS. NO.SIGNS NO. LAMPS FOR.EACH PERMIT: WIRING $1.00 FIXTURES $1.00 SUPPLEMENTARY .50 APPROVALS TOTAL FEE $ o? I� DATE INSPECTOR'S SIGNATURE I HEREBY ACKNOWLEDGE THAT '1 HAVE READ THIS APPLICATION CONDUIT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING �`ZD ELECTRICAL WIRING. ,,, I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES s F`� �� ;q" LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE POWER L0 ESCRIBED RESIDENTIAL PROPERTY. SIGNATURE UTILITY CO.NOTIFIED OF PERMITTEE� ° N /� FINAL "C7 C-� �✓ WILL J. FOX. COUNTY ENGINEER VALIDATION A.C.VEIT.CHIEF ELECT. INSPECTOR W4 8':3 5 JUiV 1.'7 2 2.6 5 in 76A66°_J Ci 806 10/72 !^1����� ��011 V Ol1U ELIS UMICAL PUNY LI COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER JOB BUILDING AND SAFETY DIVISION __JADDRESS LOCALITY A NEAREST FOR APPLICANT TO FILL IN CROSS ST. _ OUTLETS NO. EACH FEE OWNER OR $ $ FIRM NAME ((.- RECEPT.� MAIL / FIRST 20 i ADDRESS ! LIGHT TOTAL .25 ' _ �' CITY TEL. N��� C SWITCH OVER 20 .10 PLAN FIRST 20 APPLICANT LIGHTING TOTAL .25 FIXTURES OVER 20 .10 ADDRESS RESIDENTIAL APPLIANCES 'I D. PERMIT RANGE DRYERWTR. HTR. APPLICANT STA. COOK DISP. F.A.U. ADDRESS SPACE HTR. AIR COND. CITY TEL. NO. LICENSE OR CLOTHES WASH. DISHWASH. REG. NUMBER CLASS. FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND 5.TATE LAWS REGULATING IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR O - 1 1.00 LICENSED AS REO BY LOS ANGELES C TYAND STATE OF r CALIFORNIA OR HAI AM THE LEGAL 0 E OF THE ABOVE 1 - 10 3.00 DESCRIP,ED RES IAL PROPERTY. v PERMITEE 10 - 50 5.00 SIGNATURE p _ F-- 50 - 100 10.001 1 v DISTRICT NO. PROCESS D..BY W 100 - 500 15.00 SIGN, GAS =,,GN ONE CIRCUIT 5.00 APPROVALS DATE INSPEC 'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE SERVICE NOTOVER 600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK SERVICEOVER600VOLTS OR200AMP 10.00 ROUGH CONDUIT TEMPSERVICE,POLE, &APPURTENANCES 5.00 WIRING TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL PERMIT FEE (SUB TOTAL) NOTES: PLAN CHECK FEE PERMIT ISSUING FEE 3.00 3 0 TOTAL FEE PLAN CHECK VALIDATION CK. Il CASH P 'RMIT VALIDATION CK. M.O. CASH i E ^_ :a c '3"A ."030 2 � 4.756 SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE L 76A663-y 8806 ,I OG72 APPUC 70 /. p I� � 6%II PERI ���f' _ CG�r>UPNTY OF LOS ANGELES I�LLSS �J (j �J l� uVU u DEPARTMENT OF COUNTY ENGINEER JOB �q � BUILDING AND SAFETY DIVISION ADDRESS � , E A/ LOCALITY NEAREST , ` I FOR APPLICANT TO FILL IN CROSS ST OUTLETS NO. EACH FEE OWNER OR RM NAME RECEPT. MAIL FIRST 20 ADDRESS LIGHT 7 TOTAL .25 �, `� CITY TEL. NO. SWITCH_ '�' OVER 20 .fd PLAN CHECK LIGHTING TOTAL FIRST 20 .25 APPLICANT FIXTURES I 1 ,T ADDRESS Z OVER 20 10 .RESIDENTIAL APPLIANCES CITY TEL. NO. PERMT RANGE DRYER_WTR. HTR. APPLII ANT_2,1'`.',_ ®te l!lJ STA. COOK DISP. F.A.U. ADDRESS ' , A/ SPACE HTR. AIR COND. CITY � cZ TEL. NO. CLOTHES WASH. DISHWASH. LICENSE OR REG. NUMBERCLASS. C'�i'� j 3 Q FAN OTHER 1.00I. HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 — 1 100 LICENSED AS REQUIRED Y LOS ANGELES COUNTY AND STATE OF ' CALIFORNIA OR THAI AM THE LEGAL OWNER OF THE ABOVE 1 — 10 3.00 DESCRIBED RESIDENT PROPERTY. I U PER MITEE 10 — 50 5.00 SIGNATURE p M- 50 — 100 10.00 DISTRICT NO. PROC)SSED BY U W c- 1 0 100 — 500 15.00 ° Z i SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPE OR'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE SERVI CENOTOVER 600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK - SERVI CEOVER 600 VOLTS OR 200 AMP 10.00 ROUGH CONDUIT TEMP SERVICE,POLE, &APPURTENANCES 5.00 WIRING TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL PERMIT FEE (SUB TOTAL) NOTES: PLAN CHECK FEE PERMIT ISSUING FEE 3.00 2 �. TOTAL FEE f PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH { 2 4 7L�3. JDL'7 '2 D 4 .7 5 °LL SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE ` 76A663-CFF806 1,1'7;1 •AP UC(f' IM V FOR ELECT WUCAL PlSRN'T " LJ z COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY-:ENGINEER BUILDING BUILDING AND SAFBTY DIVISION ADDRESS C V� LOCALITYIV/0'4 _i ,, -.. . _,. ... ., .,. ,:.. _... NEAREST •1 FOR APPLICANT TO FILL IN CROSS ST. (J OUT ETS NO, EACH FEE OWNER $ $ -' RECEPT.- MAIL LIGHT TOTAL FIRST 20 .25, ADDRESS CITY TEL. NO s- C SWITCH J-0— OVER 20 10 , PLAN CHECK _ LIGHTING F.IRST.20 25 /�11 APPLICANT TOTAL !O V FIXOVER 20 .10 ADDRESS TURES RESIDENTIA _ APPLIANCES CITY TEL. No. RANGE DRYERN�`�"VJTR. HTR. PERMITAPPLICANT STA. COOK DISP. F.A.U. `+: ADDRESS SPACE HTR. AIR COND. - CITY TEL. N0. CLOTHES WASH. DISHWASH.• LICENSE NO. CLASS. FAN 'OTHER 1.00 © 1 HEREBY,ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE -TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE .LAWS REGULATING IND. HEATERS, ETC. NP: KW. KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO I HEREBY CERTIFY T I AM PROPERLY RE ISTERED AND/OR 0 - 1 1.00 LICENSED AS REQUIR BY LOS ANGELES COU A STATE OF D. CALIFORNIA OR THAT I A -THE LEGAL OWNER INTEND TO 1 - 10 3.00 RESIDE. IN, THE DESCRIBED REST TI PROPERTY. I 0 U SIGNATURE 10 - 50 5.00 OF PERMITTEE Y✓1ti. 0 50 100 10.00 OtS7RiC7 NO. CLASS PROCES i ~ ED B W 100 - 500 15.00 CL � N SIGN', GAS SIGN AND ONE CIRCUIT 5.00 NOTES: ? TUBE, OR . .MARQUEE ADDITIONAL CIRCUITS 1.00 SERVICENOTOVER 600 VOLTS OR 200 AMP 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE SERVI CEOVER 600 VOLTS OR 200 AMP 10.00 TEMP.POWER POLE TEMP SERVICE,POLE, &APPURTENANCES 5.00 UNDERSLAS WORK TEMP LIGHT OR RECEPT. SYSTEM 3.00 ROUGH CONDI UT - 'r WIRING 2-Z&-73 FIXTURES POWER AUTHORIZED - PERMIT FEE (SUB TOTAL) ' UTILITY CO. NOTIFIED PLAN CHECK FEE . -FINAL PERMIT ISSUING FEE 3.00 (� TOTAL'FEE PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALID T N CK. M.O. CASH 01 - Rl SEE BACK OF APPLICATION FOR COMPLETE SCII qwE 2 4 ,1 L..} "r-CU 26' a D 7.50- � - 76A663-CE806 10/72 APPMc// ino V FOR ISLECTIIU CAL KRiffiff " COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER ADDRESS ,C� �l/ ' d/ BUILDING AND SAFETY DIVISION LOCALITY c'y t•� NEAREST r FOR APPLICANT TO FILL IN CROSS ST. OUTLETS NO. EACH I FEE OWNER OR R $ $ M NAME RECEPT. MAILS LIGHT � TOTAL FIRST 20 25 ✓ .4",� ,-� CITY lr 4- ! !n °•TEL. NO V�� r I Al OVER 20 SWITCH 10 PLAN CHECK � LIGHTING FIRST 20 ,25 APPLICANT a TOTAL ADDRESS FIXTURES P I OVER 20 '10 RESIDEN TIAL.APPLIANCES CITY TEL, NO. PERMIT RANGE DRYER_WTR. HTR. APPLICANT i. STA. COOK DISP. F.A.U. ADDRESS /`'' +` SPACE HTR._ AIR COND. CITY TEL. NO. CLOTHES WASH.. 01SHWASH. LICENSE OR REG. NUMBER CLASS. FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW. KVA, E LECTR[CAL WIRING. SIZE & TYPE OVER TO r I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 - 1 100 LICENSED AS REQUIRED BY LOS ANGEL C UNTY AND STATE OF CALIFORNIA OR HAI I AM THE LEG NER OF THE ABOVE >_ 1 - 1O 3.00 DESCR IF•ED R TIAL PROPERTY O U � PERMITEE � - 10 - 50 5.00 SIGNATURE i- 0 50 - 100 10.00 U DISTRICTNO. PRO SSED BY w 1 00 - 500 15.00 Y -'"✓ � SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTOR'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE SERVICE.NOT OVER 600VOLTS OR200AMP 3.00 UNDERSLAB WORK SERVI CEOVER 600 VOLTS OR 200 AMP 1.0.00 ROUGH CONDUIT TEMPSERVICE,POLE, &APPURTENANCES- 5.00 WIRING TEMP LIGHT OR.RECEPT• SYSTEM 3.00 FIXTURES - POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL 10 /6173 PERMIT FEE (SUB TOTAL) NOTES: PLAN CHECK FEE PERMIT ISSUING FEE 3.00 TOTAL FEE j PLAN CHECK VALIDATION CK. M'O. CASH PERMIT VALIDATION CK. M,O. CASH 44.0 o 4 stiOCT 2e 2.0 5.2 5 ,&9,0 o 4 91"'OCT 26 2 Q 4_.2 5 ,&,�6 SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE �" WORKERS'COMPENSATION DECLARATION i CE-806 ,DAB, APPUCAMH FOR ELEC�TMAL PERWT I hereby affirm that I have a certificate of consent to self j CE-806G insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES `� BUILDING AND SAFETY or a certified copy thereof (Sec. 3800, Lab. C.) / f f� Policy No. Company FOR APPLICANT TO FILL IN JOB Certified co is hereby furnished. ADDRESS PY Y ( New Residential Bldgs..& Pools EACH NO. FEE ❑ 1 & 2-Family, S Ft. $ — $ LOCALITY Certified copy is filed with the county building in'spec- Y. 9 tion department.' Multi-family Sq,Ft. i — 'NEAREST CROSS ST. Date Applicant Residential Swimming Pools OWNER OR FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw._ MAIL COMPENSATION INSURANCE ADDRESS This section neenot be completed if the work involved b i First 20 ( tid p Y Total No. Additional CITY Tel. No. QQ the permit is for one hundred dollars ($100)•or less.) " C� tl I certify that in the performance of the work for which this PLAN HE K APPpermit is issued, I shall not employ any person in any manner so as to become subject to the W rke� Compe tion Lo Lighting Fixtures First 20 ADDRESS Total No. Additional CITY Tel. No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, aft making this Certifi ate of APPLICANT. Exemption, you should beco a subject to the Workers' Range_ Heater--D.W. 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. Tel. No. LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 - Disp. _ Room Air Cond. REG. NUMBER Class.. (commencing with Section 7000)-of Division-'3-of the BusinessDISTRICT NO. PROCESSE BY and Professions Code, and m license is in full force and effect. Power Apparatus & Large Appliances y y Size &Type HP, KW, KVA, or KVAR' Ue O License Number Lic. Class Up to 1 Incl. FINAL Over 1 to 10 Incl. DATE . tea_ VALIDATION o Contractor Date Over 10•to 50 Incl.- / FINAL ,(��_� � V ❑ I am exempt under Sec. Over 50 to 100 Inc. BY ,�, V— "� d B.&P.C. for this reason Over 100 ( h r • 'Services, Svvbd., MCC& Panelboards Z Date: "0 -200 Amp. Under 600 V 9,4 5 32 A Signature 201 - 1000 Amp. Under 600'V Over 1000 Amp. or Over 600 V #i o o o o o 2 ' ❑ Exemption for Reg. Maint. Elect. SINGLE FAMILY Temp. Power Pole&Appurtenances 2,o a 2.5-5.0 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits ;o o a 2 5,;5 05 • Law for the following reason (Section 7031.5, Business and Professions Code):❑ , 08. 1 6.-81 3 Misc. Conduits Conductors I, as owner of the property, will do the work and the L structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ _ 7044, Business and Professions Code). D CONSTRUCTION LENDING AGENCY 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 d Lender's Address I certify that I have read this application and state that the TOTAL FEE above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and here y authorize representatives of this County to enter upon the ove-mITO operty �inspection purpo es. SEE REVERSE FOR EXPLANATORY LANGUAGE 6A Signature of Permi tee Crate ' WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) . 76A663 LL u Q� USI IS tldu APP C p N TMFOR ELECT CAL PERNT ' �f I hereby affi,-M that I have a certificate of consent to self insure, or&•certificate of'Worker's-Compensation Insurance, or a certified COUNTY OF LOS ANGELES. DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. , copy thdreof(Sec.3800 Lab. C.) 91—Company ` �`- Vi ✓r FOR APPLICANT TO FILL IN 30B P^OIiCy ADDRESS V L1� Certified copy is here6y'furnished. New Residential Bldgs.&Pools NO. EACH FEE LOCALITY 1/' I El _ Certified copy is filed wit hthe,county building 1 &2-Family,Sq.Ft. $ $ inspection NEAREST depa tme /,//� //, Multi-family Sq,Ft. CROSS ST. (n Date Applicant 'L/r+t '1 �e / cl�/1�I Residential Swimming Pools ASSESSOR ,ry _ + MAP BOOK PAGE [/�D PARCEL .CERTIFICATE OF EXEMPTION FROM WORKERS. Outlets:Rec. Li ht L Sw. owNER OR ) COMPENSATINSURANCE g FIP,M NAME G'/7 h ION First 20MAIL (This section need not be completed if the work Involved by the Total No. -:y�dfr/ Additional ADDRESS permit Is for one hundred dollars($100)or less.) �%/ -I certify that'In the performance of the work for which this permit CITY Tei.No. is issued,'I shall not employ any person in any manner so as to PLAN CHECK becomesubject,to the Workers' Compensation Laws. Lighting Fixture First 20 APPLICANT Total No. Additional -ADDRESS Date •'• Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP.- NOTICE TO APPLICANT:'If, after making this Certificate of CITY Tel.No. Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. roylsions of the Labor Code, ou must forthwith comply with Such; PERMIT P y - P Y - APPLICANT ) ) provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances Size&Type HP,KW,KVA,,or KVAR ADDRESS a f f. LICENSED CONTRACTORS DECLARATION- YP - I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. (commencing with Section 7000) of Division,3.of the Business and. CITY a Professions Code,and my license Is in full force and effect. Over}0 to 50 Incl. LI Professions Over 50 t0 100 Incl. REG.NUMBER G CI'ass. d Over 100 DISTRICT NO. P SED BY Q License Number J. 1-�_ Lia Class �/ (� / d � Services Swbd.,MCC&Panelboards (/ f Contractor L �iw�y 0-399 Amp.Under 600 V" FINAL "<�a{e. DATE .fir ❑ 400-1000.Amp.Under.600 V —'�—ll� I am exempt under Sec.. VALIDATION V . Over 1000 Amp.or Over 600 V FINAL a B.&P.0 for this reason BRANCH CIRCUIT FEES BY Y1 (tel Cco L Dater 15A,or 20A, 120V,Lighting or Recept.•' Z_ 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits El ' 41,Or More Branch Circuits Exemption for Reg:Ni Elect. 15A,20A,208V To 277V Lighting Br.Circuits s SINGLE FAMILY Temp. Power Pole.&Appurtenances ro HOMEOWNER-BUILDER DECLARATION - I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit _ - s �= s for the following reason'(Section 7031.5, Business•and Professions Additional Sign Branch Circuits t ,L! --• = Code): EAC, , Misc.Conduits&Conductors' _r x , _ I, as owner of the property,will do the work and the structure .rCIT r ` is riot intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule). 9.—_40 and Professions Code)r D CHECK jos_ i 1..' tl_` CONSTRUCTION LENDING AGENCY CHANGE "€ s I hereby affirm that there is a construction lending agency for the n .performance of'the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total) .JS Civ.C.) PLAN CHECKING FEE s, I I..;IJI Lender's Name - PERMIT ISSUING FEE r.� j ;'`s3t€�`r Lender's Address I certify that I have read this application and under penalty of purjury state TOTAL FEE that the 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 property for inspection pure G SEE REVERSE FOR EXPLANATORY LANGUAGE C_ rJJ SIG URE OF PERMITTEE D E .. WORKER'S COMPENSATION DECLARATION 200019 DPW 9/89 ������n�B®� ®� �n( ��y�����nL� ������ 76A663 �,52� � u u I hereby affirm that I have a certificate of consent to self insure, � or a certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec,38000//Lab.C.). ...�• 124­74',4F_� �"l r1 ) JOB P G , FOR APPLICANT TO FILL IN - - . Policy No. a n ompany�J - - ADDRESS � Y��� Certified copy is hereby furnished. New Residential Bldgs.&Pools EACH NO. FEE d f $ — $ LOCALITY ❑ ..Certified co is filed with•the count building inspection, 1 &2-Family,Sq.Ft. — PY Y 9 P NEAREST ` departure t., Multi-family Sq.Ft. CROSS. 1,0-1 ' (e pp 0_ k G -1" �, Residential Swimming Pools ASSESSOR Date Applicant• .; - .. MAP BOOK _ PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rea Light�Sw. - OWNER OR ` COMPENSATION INSURANCE 9 10 �.. FIRM NAME I a ti • n,� - , '- _-First 20 � MAIL • ' (T.his.section need not be completed if the work.involved by the /^ ADDRESS ermit is for one hundred dollars $100 or less. Total No. Additional i !L � P ( ) )'..., .r CITY 1 + I certify that in the performance,of the work for which this permit Tel.No. 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 APPLICANTK Total No. Additional ADDRESS Date Applicant "' 15 OR 20A;120V-BRANCH CIRCUITS NOTICE TO APPLICANT: If, after making tMs'Certifi'cate of CITY Tel.No. Exemption,you should become subject to the Workers'Compensation 1 TO 10 INCLUSIVE EACH provisions of the Labor Code, you must forthwith comply with such 11 TO 40 INCLUSIVE-EACH PERMIT f. P. Y - P Y , - .._ ____ - APPLICANT �A,�� (�'d provisions or this permit shall be deemed revoked. 41 OR MORE BRANCH CIRCUITS EACH + , LICENSED CONTRACTORS DECLARATION ADDRESS I hereby affirm that I am licensed under provisions of'Chapfer 9 p 15 OR 20A,208V TO 277V LIGHTING EACH 1 N + a (commencing with Section 7000) of Division 3'of the"Busi6ess and CITY Citi�+'_� `) - Tei.No. / � 0 Professions Code,and my license is in full force and effect. RESIDENTIAL APPLIANCES UP TO 3HP LICENSE OR 2 J ` j Power Apparatus&Large Appliances REG.NUMBER 1� l{ j Class. f O Size&Type HP,KW,KVA,Or KVAR DISTRICT NO. PROF �v W License Number / Lic,Class (/ t /J / L U to 3 Incl. U !` l Ji f Y-1 �- �C f1 ZD`�+ / .�/ �^" Over 3 to 10 Incl. _ _ DATE 0- Contractor, F_ ate El Over 10 to 50 Incl:. . •• I am exempt under Sec. , Over 50 to 100 Incl. Z `(�i VALIDATION FINAL B.&P.C.for this reason - Over 100 BY Services,Swbd.,MCC&Panelboards;_ Date: 0-200 Amp:Under 600 V Signature 201 -.1000 Amp.Under 600 V. - -- ❑ _ 41- Over 1000 Amp,or Over 600 V Exemption for Reg.Maint.Elect. SINGLE FAMILY Temp.Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION -- -' I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit for the following reason (Section 7031.5, Business and Professions Additional_Sign_Branch-Circuits Code): ❑ I, as owner of the property,will do the work and the structure Misc.Conduits&Conductors - -- — - is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) 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 issued (Sec. 3097, pERMIT.FEE__ .(Sub-Total) -- Civ.C.) ' PLAN CHECKING FEE _``LITO Lender's NameP_..... I ` PERMIT ISSUING FEE Zg 7 .. -� -� :_3-5 Lender's Address C,•. j;'i_.= I certify that I have read this application and state that the above TOTAL FEE 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 pro�tp(/etyfor inspection pur/p`gses. /J / ^� SEE REVERSE FOR EXPLANATORY LANGUAGE 'fi f'' --,)`w€'e r:` =' .. <, SIGNATURE OF APPLICANT OR AGENT DATE - ° •••