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Home My Public Portal About9038 EMPEROR AVE_Electrical__ 76A663C- CE806B 12,75 APPLICATION FOR ELECTRICAL PERMIT BUILD AND SAFETY ISION FOR APPLICANT TO FILL IN I JOB l New Residential Bldgs & Pools EACH NO FEE ADDRESS �nl v 1 &2 Finaily Sq Ft $ — $ LOCALITY 4C G otq Multi-family Sq Ft — NEAREST r CROSS ST J Residential Swimming Pools OWNER OR FIRM NAME Outlets Light, Switch&Receptacle MAI L First 20 ADDRESS12 d (/ Additional CITY 4 / Tel No PLAN CHECK Lighting Fixtures APPLICANT First 20 ADDRESS Additional CITY Tel No PERMIT Fixed Appliances Not Over 1 HP APPLICANT Range— Heater D W Oven _ Dryer W M ADDRESS Top FAU W H CITY Tel No Hood Fan LICENSE OR O Disp A C REG NUMBER Class U 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION O AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY V Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING LLI Size&Type HP, KW, KVA,or KVAR ELECTRICAL WIRING a Up to 1 Inclz 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED ANO/OR Over 1 to 10 Incl LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE Over 10 to 50 Incl DESCRIBED RESID NTIAL P PERTY Over 50 to 100 Incl PERMITEE Over 100 SIGNATURr_ y A Services DISTRICT N--0 RO SSED BY 0-200 Amp Under 600 V 201 - 1000 Amp Under 600 VAPPROVALS DATE I ECTOR'S Over 1000 Amp or Over 600 V SIGNATURE TEMP POWER POLE Temp Power Pole&Appurtenances UNDERSLAB WORK Sign,with One Branch Circuit Additional Sign Branch Circuits ROUGH CONDUIT (Other) WIRING FIXTURES POWER AUTHORIZED PERMIT FEE (Sub-Totai) UTILITY CO NOTIFIED PLAN CHECKING FEE (One Fourth Permit Fee) FINAL 4'7 PERMIT ISSUING FEE TOTAL FEE NOTES PLAN CHECK VALIDATION CK MO CASH PERMIT VALIDATION CK MO CAS 404r1_'ND 22 2 'U -9,C) 0As_ Q vV 76A863;- CE606B 12,75 APPLICATION FOR ELECTRICAL PERMIT s BUILDING AND ETY DIVISION L FOR APPLICANT TO FILL IN JOB ADDRESS New Residential Bidgs & Pools EACH NO FEE s 46 1 &2 Finaily Sq Ft $ — $ LOCALITY Multifamily Sq Ft — NEARESTOc7��Jj� � CROSS ST �7 ��'F�•T►i- Residential Swimming Pools OWNER OR i FIRM NAME , Outlets Light, Switch & ReceptacleO MAI L • (I.j First 20 ADDRESS Additional CITY Tel No �V✓ / PLAN CHECK Lighting Fixtures APPLICANT Y First 20 ADDRESS Additional CITY Tel NoPERIT ��oo��A� L, Fixed Appliances Not Over 1 HP APPLICANT J1Qf►0 C g&4, r Range Heater_ D W ADDRESSE Oven Dryer W M Top FAU W H CITY Tel No >_ Hood Fan LICENSE OR CCD L_ Disp A C REG NUMBER Class I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION Q AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY (— Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING V Size&Type HP, KW, KVA,or KVAR ^ ELECTRICAL WIRING CW ' a UpU to 1 Incl z I HEREBY CERTIFY THAT I AM PROPERLY LV REGISTERED AND/OR -� Over 1 to 10 Incl LICENSED AS REOU IRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE Over 10 to 50 Incl DESCRIBED RESIDE L PROPERT Over 50 to 100 Incl PERMITEE Over 100 SIGNATURE DISTRICT NO OC SSEWB Services 0-200 Amp Under 600 V 201 - 1000 Amp Under'600 V APPROVALS DATE Over 1000 Amp or Over 600 V TEMP POWER POLE Temp Power Pole&Appurtenances UNDERSLAB WORK Sign with One Branch Circuit Additional Sign Branch Circuits ROUGH CONDUIT (Other) WIRING FIXTURES POWER AUTHORIZED PERMIT FEE (Sub-Total) aINAL TILITY CO NOTIFIED PLAN CHECKING FEE (One-Fourth Permit Fee) PERMIT ISSUING FEE OTES TOTAL FEE PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION CK M O CASH 4 8 8'-MAY 2 5 2 6.9 0 Abd 76A66'SC- CES06B 12/75 APPLICATION FOR ELECTRICAL PERMIT l BUILDING AN FETY DIVISION FOR APPLICANT TO FILL IN JOB New Residential Bldgs &Pools EACH NO FEE ADDRESS 9038 eror 77 v'<_ 1 &2 Finaily Sq Ft $ — $ LOCALITY Multi family Sq Ft — NEAREST CROSS ST Residential Swimming Pools OWNER OR FIRM NAME Outlets Light, Switch& Receptacle MAIL First 20 ' ADDRESS Additional CITY T Tel No PLAN CHECK Lighting Fixtures APPLICANT First 20 ADDRESS Additional CITY Tel No a PERMIT Fixed Appliances Not Over 1 HP APPLICANT ' Ti Range Heater_ DW ADDRESS 8 1 Oven _ Dryer W M 3 IvJazsion Drive Top FAU W H CITYTel No �^ y Hood Fan LICE OR-- REG NUMBER 2-27962 Classn_ Q Disp AC 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION Q AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY V Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING LtJ Size&Type HP, KW, KVA,or KVAR ELECTRICAL WIRING cn F 4 .II U to 1 In z P 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR 31 t.nn A,/Mer 1 to 10 Incl LICENSED AS REQUIRED BY LOS A ELES OUNTY AND STATE OF N -{.� VjV CALIFORNIA OR THAT I AM THE EGAL R OF THE ABOVE Over 10 to 50 Incl DESCRIBED REST 6NTIaL PROPER Over 50 to 100 Incl PERMITEE Over 100 SIGNATURE t 71 DISTRICT NO OCES D BY Services q 0-200 Amp Under 600 V (J 201 - 1000 Amp Under 600 V APPROVALS DATE INSP OR'S SIGNATURE Over 1000 Amp or Over 600 V TEMP POWER POLE Temp Power Pole&Appurtenances UNDERSLAB WORK Sign with One Branch Circuit Additional Sign Branch Circuits ROUGH CONDUIT (Other) WIRING FIXTURES POWER AUTHORIZED PERMIT FEE (Sub-Total) UTILITY CO NOTIFIED /J PLAN CHECKING FEE (One-Fourth Permit Feel ! 12- —1%7' FINAL J, PERMIT ISSUING FEE TOTAL FEE v1�1�7Q NOTES PLAN CHECK VALIDATION CK M o CASH PERMIT VALIDATION C CASH 0 5.8r'--AUG 8 2 0 10.5 0 ®� C� V6P WORKERS'COMPENSATION cafe of consent APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self CE 8066 insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec 3800, Lab C ) - P❑olicy No Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished New Residential Bldgs & Pools EACH NO FEE ADDRESS 1 & 2-Family, S Ft $ — $ LOCALITY � C Certified copy is filed with the county building inspec- Y. q tion epart ent Multi-family Sq Ft — NEAREST (� Residential Swimming Pools CROSS ST Date Applicant 6cm �- �1] OWNER OR FIRM NAME 6 CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec Light Sw�B= MAIL �J COMPENSATION INSURANCE ADDRESS i I' This section need not be completed if the work involved b R! First 20 ( p Y Total No�L�— Additional 42Z� CITY --C_. Tel No the permit is for one hundred dollars ($100)or less ) i I PLAN CHECK I certify that in the performance of the work 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 iADDRESS Total No_ Additional CITY Tel No Date Applicant Fixed Appliances Not Over 1 HP PERMIT c 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 �� J with comply with such provisions or this permit shall be Top — FAU —W H ;o ! 0 deemed revoked CITY Tel No7 Hood _ Fan i--Other— LICENSED CONTRACTORS DECLARATION LICENSE OR Q Q I hereby affirm that I am licensed under provisions of Chapter 9 Disp — Room Air Cond REG NUMBER 2-0 [J 7 J Class -j a (commencing with Section 7000) of Division 3 of the Business DISTRICT NO PROCESSED BY Power Apparatus& Large Appliances _ and Professions Code, and my license is in full force and effect (/t Size &Type HP, KW, KVA, or KVAR :J d 0 License Number / —Lic Class —1 6 Up to 1 Incl FINAL I DATE s' l�Date Over 1 to 10 InclO _ VALIDATION 09Contractor❑ Over 10 to 50 Incl FINAL I am exempt under Sec Over 50 to 100 Inc BY B&P C for this reason Over 100 Date Services, Swbd , MCC& Panelboards 0" n Z 1!0 -200 Amp Under 600 V /f� i ' Signature 201 - 1000 Amp Under 600 V SSl Ci« (v Over 1000 Amp or Over 600 V ❑ Exemption for Reg Maint Elect SINGLE FAMILY Temp Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ;9 3 5 35 A I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits Low for the following reason (Section 7031 5, Business and 0 0 0 0 0 2 Professions Code) ❑ 1, as owner of the property, will do the work and the Misc Conduits& Conductors .2 0 - 144,50 structureis not intended nor offered for sale (Section Other (See Complete Fee Schedule)_ 7044, Business and Professions Code) ► 0 4,,50 5 CONSTRUCTION LENDING AGENCY 0"7. 1 1 -83 1 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 Lender's Address 3 1 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 jaws regulating Electrical wiring, and ` hereby authorize repr sentatives of this County to enter upon �` thea o e-me i n property for inspection p pos s SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Perms ee Date