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Home My Public Portal About9068 EMPEROR AVE_Electrical__ WORKERS' COMPENSATION DECLARATION 720 6A663 DPW 3/87 APPLICATION FOR ELECTRICAL PERMIT y , I hereby affirm that I have a certificate of consent to self CE 8066 ' ' +1 insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS i or a certified co(�y ther Sec 3800, Policy No Company � K�N FOR APPLICANT TO FILL IN JOB / 140- ❑Certified copy is hereby furnished New Residential Bidgs & Pools EACH NO FEE ADDRESS Q i/ ❑Certified copy is filed with the county building inspec- 1 & 2-Family, Sq Ft $ _ $ LOCALITY tion department Multi-family Sq Ft NEAREST i �j idential Swimming Pools CROSS OWNER ST i Date Applicant OR FIRM NAM CERTIFICATE OF EXEMPTION W&WORKERS' Outlets RecLLight—uSw vADDREMAIL SS COMPENSATION INSURANCE First 20 (This section need not be completed if the work involved by Total NO Additional Tel No I16 the permit is for one hundred dollars ($100)or less ) Additional PLAN CIrIECK 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 t - ADDRESS Additional al-No t CITY Tel No Date ApplicantFixedAppliances Not Over I HP PERMIT NOTICE TO APPLICANT If, after ❑king this Certificate of APPLICATION 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 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 LICENS 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 Power Apparatus & Large Appliances DISTRICT NO PROCESSE Y >_ and Professions Code,and my license is in full force and effect '1 a- Size &Type HP, KW, KVA, or KVAR �, V O License Number P Lic Class Up to 1 Incl FINAL U �� Over 1 to 10 Incl DATE � �-y VALI ION � Contractor ate LJ ❑ Over 10 to 50 Incl FINA U I am exempt under Sec Over 50 to 100 Inc gy B 8P C for this reason Over 100 9 9 9. cJ pl a Services, Swbd , MCC& Panelboards , # o o o e e l Z Date Z 0-200 Amp Under 600 V Signature 201 - 1000 Amp Under 600 V I o - 2,1. 00 ❑ Exemption for Reg Maint Elect Over 1000 Amp or Over 600 V o e o 21.0,0 v SINGLE FAMILY Temp Power Pole &Appurtenanceso&27 88 HOME OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit Law for the following reason (Section 7031 5, Business and Additional Sign Branch Circuits Professions Code) , ❑ j, as owner of the property, will do the work and the Misc Conduits &Conductors structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ ' 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 issued PERMIT FEE (Sub-Total) (Sec 3097, Civ C ) PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address I certify that I have read this application and state that the III TOTAL FEE 9 hod above information is correct I agree to comply with all County=, ordinances and State jaws regulating Electrical wiring, and e hereby authorize representatives of this County to enter upon the abov mentioned property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE / ,gyp ature of Permittee ate Os DSS SA 11 PA-46 OF �LT¢LI)ING AND SAFETY �YLluxulUPI PUN irzt(11a A: COUNTY OF LOS ANGELES 0C WM FOX CHIEF ENGINEER _a NAME / �,�-r RJy DISTRICT O: GROUP ZONE ,PERMIT NO. U 0 k _ F -- ADDRESS pmt ¢� UN CITY �r 4l ,J, TEL NO t�ST!l d", "` RECEIV BY FIRST INSPECTION DREADY FOR AT ISSUED COUNTY CERT NO /! 10 _ T� EXPIRES (((JJJ APPLICANT FILL IN HEAVILY OU'T'LINED POR'T'ION ONLY JOB DESCRIPTION OF WORK ADDRESS S NUMBER OF OUTLETS ON CIRCUITS LOCALITY LOCATION BY ROOMS NEAREST LIGHT OUTLETS SW PLUGS FIXT CROSS ST CIRCUIT A B C D E F G H W NAME MAIL ADDRESS I ® ' O CITY_ TEL NO AM THE LEGAL POSSESSOR OF THE ABOVE LOS 1 ANGFELES COUNTY CERTIFICATE OF QUALIFICATION. ELECTRICIAN. 1� i AM TH8*r�OWNER OF THR PROPERTY DESCRIBED ABOVE d 0 OWNER. COP iEC7.TIONS j4A Z rs lz a TOTAL ' NO OF OUTLETS $ APPROVALS NO OF FIXTURES $ DATE INSPECTOR'S NAME NO OF MOTORS H P $ CONDUIT h NO OF SIGNS TRANS $ WIRING NO OF RANGES OR HEATERS $ FIXTURES MISCELLANEOUS $ �P_OWER PERMIT FEE $ 2- UTILITYCO NOTIFIED.,1,j ,�A TOTAL FE FINAL �� -1 l 711A663 CEBOB 125" APPLICATION FOR ELECTRIC PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION 'ADDRESS JOHN A LAMBIE,COUNTY ENGINEER CASSATT D GRIFFIN,SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST PERMIT FEES o OWNER ITEM NUMBER EACH FEE OUTLET $ $ MAIL LIGHTS RECEPT SW 10 O ADDRESS LIGHTING FIXTURES 10 CITY TEL NO ELEC RANGES CLO DRYERS ELECTRICIAN A-%C e C W A T E R HEATERS 50 ADDRESS ELEC SPACE HTRS DISHWASHERS L CITY TEL NO L GARBAGE DISPOSERS AUTO- STATE � / �' p WASHERS STA COOKING UNITS 25 LICENSE NO MOTORS OVER INC H P DISTRIC O OUP ZONE I P OCESS D BY O— 1/z 25 1/2— 2 / 5o f"� INSPECTION RECORD 2— 5 1 00 5— 15 150 15— 50 250 50-200 500 SIGNS NO TRANS NO LAMPS SERVICE 0-600V 1 00 U Co rP SERVICE OVER 600V 500 frjIV r MISC WIRING PERMIT 1 00 p FIXTURE PERMIT 1 00 SUPPLEMENTARY PERMIT 50 TOTAL FEE $, � 570 APPROVALS 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION DATE INSPECTOR S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY G>''12 WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT Q ELECTRICAL WIRING WIRING IHEREBY CERTIFY THAT I PROPERLY REGISTERED AND/OR ^!� LICENSED AS REQUIRED BY LOSS ANGELES COUNTY AND STATEE OF FIXTURES rS/' CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL OPE POWER SIGNATURE UTILITY CO NOTIFIED OF PERMITTEE FINAL ®F $uPERVISING ELECTRICAL ENGINEER CK f MOo CASH CASH LG 1, 2 9 v AUG 17 2 A 2.9 011.0 J t 16A663_CE906-9-57 APPLICATION FOR -ELECTRIC PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING p' BUILDING AND SAFETY DIVISION ADDRESS j' sf ' -s1 lily . f JOHN A LAMBIE,COUNTY ENGINEER y' f f r k CASSATT D GRIFFIN,SUP T OF BUILDING LOCALITY �? yl .✓l -�_ v- FOR APPLICANT TO FILL IN NEAREST v �•�% G - PERMT ITEMT E M NUMBER EACH FEE OWNER OUTLETS MAIL LIGHTS RECEPT SW 10 C/ ADDRESS LIGHTING FIXTURES 10 CITY TEL NO ELEC RANGES CLO DRYERS ELECTRICIAN WATER HEATERS SO ADDRESS { r- JR ELEC SPACE HTRS� pDISHWASHERS ,rr _ 9 (GABAGE DISPOSERS` AUTO- _ CITY C L L� .� It TEL NOiY� 1 STATE J t l J ( r WASHERS STA COOKING UNITS 2S LICENSE NO/V t�` 'r MOTORS OVER INC H P 0 — 1/z 25 DISTRICT NO. G RQU P I ZONE READY FOR INSPECTION 1/2 - 2 5o S z — s 100 INSPECTION RECORD 5 — 15 ISO 15 — 50 250 50— 200 Soo SIGNS NO TRANS NO LAMPS A SERVICE 0-600V 100 SERVICE OVER 600V Soo MISC WIRING PERMIT too FIXTURE PERMIT 100 i SUPPLEMENTARY PERMIT 50 TOTAL FEE g i APPROVALS I; 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION DATE INSPECTOR(SIGNATURE "AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT ,WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING I ELECTRICAL WIRING I WIRING ` I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR yLICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES 'CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE POWER DESCRIBED RESIDENTIAL ROPERTiY. SIGNATUREF � � UTILITY CO NOTIFIED OF PERMITTEE FINAL i# + VALIDATION:- ARTHUR C VEIT, 4 �1 CK m0 CASH SUPERVISING ELECTRICAL ENGINEER COUNTY OF LOS ANGELES - APPLICATION FOR PERMIT DEPARTMENT OF COUNTY ENGINEER ELECTRIC 1 DIVISION OF BUILDING IS SAFETY WII.I.IAM 1. FOX, COUNTY ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO GROUP ZONE PERMIT NO ELECTRICIAN Iz— a S- ADDRESS �` Q y rjl� RECEIVED BY READY FOR DATE ISSUED `' FIRST INSPECTION /� �1 CITY `J ('� TEL NO CID v ,1 2- HCl -S3 COUNTY LICENSE NO ® EXPIRES BUILD14G e O r PERMIT FEES ADDRESS f� 6r NUMBER EACH FEE LOCALITY LIGHT OUTLETS NEAREST ` q RECEPTACLES CROS ST ®Te / S.Q al �1 I ml WALL SWITCHES OWNER B'fikey Isce TOTAL OUTLETS . Sc $ MAIL v �//�} ELEC RANGES 25 ADDRESS Ol �cl Y r , ELEC HEATERS 25 .C'(�1 • CITY ,io?"I 4-"' f9 '"/3fF�N TEL. NO S 5 - MISC 4 1 HEREBY ACKNOWLEDGE' THAT I HAVE READ THIS 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 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER NEw MVD HP OVER INC EACH OF THE RESIDENTIAL PROPERTY OESCRRIIBED"ABOVE 1/2 a LESS $ 25 SIGNATURE OF I/2 2 50 PERMIITE 2 5 1 00 INSPECTION RECORD 5 15 1 50 15 50 2 50 50 200 5 00 200 500 10 00 J 500 1000 15 00 a Z OVER 1000 20 00 M G SET/FREQ CHANGER-HP (� WELDERS AC-KVA 0 GENERATORS KW TRANSFORMERS-KVA ,TEMP MOTORS (75% OF ORIG ) MOVED MOTORS (75% OF ORIG ) MISC SIGNS NO NO TRANS APPROVALS NO NO LAMPS FOR EACH PERMIT DATE INSPECTOR'S NAME WIRING $1 00 CONDUIT ' FIXTURES $1 00 WIRING SUPPLEMENTARY 50 FIXTURES POWER TOTAL FEE $ / UTILITY CO NOTIFIEDf '`- INAL 76A GGS D13S# GA 4-52