HomeMy Public PortalAbout6018 ENCINITA AVE_Electrical__ 76A663 DRS SA 7-5I APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
� � ��
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMIT NO.
ELECTRICIAN IQW/E' Y --
�} ,/ RECEIVED BY READY FOR DAT ISSUED
ADDRESS XqJ� .� SLS �l� .S FIRST INSPECTION
CITY S (} TEL. NO./��.�75
COUNTY LICENSE NO.7 � EXPIRE5l9—SQ-Sr BUILDING /O/ ry �p
PERMIT FEES ADDRESS Eif/C /j WT ,
FEE
NUMBER EACH LOCALITY
LIGHT OUTLETS NEAREST
CROSS ST.
RECEPTACLES
WALL SWITCHES OWNERt//✓f
TOTAL OUTLETS Sc $ 9.S MAIL
ELEC. RANGES 25 ADDRESS
ELEC. HEATERS 25 CITY TEL. NO.
FIXTURES 5 1 HEREBY ACKNOWLEDGE THAT I HAVF 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
NUMEER HORSEPOWERANGELES COUNTY LICENSE OR I AMI)THE LEGAL OWNER
FEE
NEW MVD. HP DYER mc. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
'/e s Lass $ .25 SIGNATURE OF
I/2 a -sp PERMITTEE CCC ' Y `�_
2 S 1.00 INSPECTION RECORD
5 IS 1.50
IS 50 2.SO _
�so 200 5.00
zoo Soo 10.013
50❑ 1000 15.00 Q
Z
OVER 1000 20.00
M.G. SET/FRED. CHANGER-HP d'
WELDERS•AGKVA _ _ O
GENERATORS - KW _
TRANSFORMERS - KVA
TEMP. MOTORS 175% OF ORIy)
MOVED MOTORS (75% OF ORID.)
MISC.
SIGNS
NO. NO.TRANS.
APPROVALS
ND. NO. LAMPS
DATE INSPECTOR'S NAME
- FOR EACH PERMIT:
WIRINB $1-pp Q O CONDUIT
/If 1F
FIXTURES $I-pp WIRING
SUPPLEMENTARY .50 FIXTURES
POWER
TOTAL FEE III/ 3(!J UTILITYCO. NOTIFIED
FINAL \ 1• ry
TDA'a'Das.nA Dss APPLICATION! FOR ELECTRIC PERMIT
DIVISION OF BUILDING AND SAFETY
Department of County Engineer
County of Los Angeles BUILDINGy� r�
WM. J. FOX. COUNTY ENGINEER AO DRESS � L /^,
CASSATT D. GRIFFIN. SUPT OF BUILDING
_LOCALITY
FOR APPLICANT TO FILL IN NEAREST ^ '�
PERMIT FEES caoss sr. r
NUMBER EACH FEE
_OWNER ESSE-
LIGHT OUTLETS
MAIL
RECEPTACLES ADDRESS
WALL SWITCHES
TOTAL OUTLETS gQ $ CITY TEL.NO.
ELEC. RANGES 25 ELECTRICIAN O
_ELEC. HEATERS 25 ADDRESSC/ S
KW EA CITY S//-� TEL..N
FIXTURES 5 LICENSE NO.
T
NUMBER OF LIGHT CIRCUITS - DISTRICTNO. G OUP 7 NE a EADY 1011 INSPECTION
NUMBER OF RECE
MOTORS
CIRCUITS I 4.
MOTORS JJJJ���� tl`G(Jf
rvuMaER I I HORSIPOWER FEE INSPECTION RECORD
NEW MVO. HP OVEN INC. EACH
11/2 A LESS IS ,25
I/2 2 .50
2 5 1.00
5 I5 1.50 r '.. . bn,.•r- ,
15 50 2.50
50 200 5.00
�n I
MISC. „ A
NO.SIGNS NO.TRANS. -
NO.SIGNS NO. LAMPS _
FOR EACH PERMIT: - I�
WIRING $1.00
FIXTURES 51.00
SUPPLEMENTARY .50 _ APPROVALS
_ TOTAL FEE DATE IN
SPE
C
T
ORS SIGNATURE
IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION CONDUIT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY v .. .. v�.• •�..�---.�j
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING
ELECTRICAL WIRING.
I HEREBY CERTIFY THAT I M PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REOUIRED OS ANGELES OUNTY AND STATE OF
CALIFORNIA OR THAT AM E EGA WNER OF THE ABOVE POWER
DESCRIBED RESIDENT L R
UTILITY CO.NOTIFIED �/
SIOF PERM TTEE Y FINAL -r� t
WILLIAM J. FOX. COUNTY ENGINEER VALIDATION A. C.VEIT.CHIEF ELECT. INSPECTOR
1 1
37 :.x JAN 3 2 1 .2 5
L.
Wm that I have a COMPENSATION DECLARATION CE-883 10/81 APPLICATION FOR ELECTRICAL PERMIT {�
I hereby affirm that I have a certificate of consent to self insure, CE-806G LJ
or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY
copy thereof(Sec.3800.Lab.C.)
JOB
Policy No. Company FOR APPLICANT TO FILL IN ADDRESS 6 O I a
Certified copy is hereby furnished. New Residential Bldgs.& Pools .EACH NO. FEE
❑ $ _ $
Certified copy is filed with the county building inspection 1 & 2-Family,Sq.Ft. LOCALITY
department. Multi-family Sq.FL NEAREST
CROSS ST.
Date Applicant Residential Swimming Pools OWNER OR
FIRM NAME .L
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec— Light _ Sw. MAIL p� p�
COMPENSATION INSURANCE ADDRESS 6 o 18 E1'v/�•^�/h•W�I v )
(This section need not be completed if the work involved by the First 20
CITY Tel.No. �•S l— ( 13
permit is for one hundred dollars ($100) or less.) Total No. Additional _
I certify that in the performance of the work for which this permit PLAN CHECK
APPLICANT
is issued, I shall net employ any person In any manner so as to I
become subject to the Workers'Compensation Laws Lighting Fixtures First 20 �• ADDRESS
A- C/ •,--1 Total No. Additional CITY Tel. No.
Date Applicant `•'•^' f `' """"" Fixed Appliances Not Over 1 HP
NOTICE TO APPLICANT: If, after making this Certificate of PERMIT
Range_ Healer_ D.W. APPLICANT
Exemption,you should become subject to the Workers'Compensation —
provisions of the Labor Code, you must forthwith comply with such Oven _ Oryer _ W.M. _ ADDRESS 113 S . 2
provisions or this permit shall be deemed revoked. Top — FAU _ W.H. _ CITY �. Tel.No. `4 _
LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other_
I hereby affirm that I am licensed under provisions of Chapter 9Disp. Room Air Cond. UCENSE OR Class
(commencing with Section 7000) of Division 3 of the Business and REG.NUMBER O C`
Professions Code,and my license is in full force and effect. Power Apparatus& Large Appliances DISTRICT, . Di'/ PROC ED BV
^� Size& Type HP,KW,KVA,or KVAR O
License Number y ° 4 / Lie.Class C — ( 0 Up to 1 Incl. MFINALAOver1 to 10 met. VALIDATION Q
Contractor °° f�Y1's°-.�-J Date Over 10 to 50 Incl.❑ am exempt under Sec. Over 50 to 100 Inc.B.&P.C. for this reasonOver 100
Services,Swbd.,MCC& Panelboards Z
Date: 0-200 Amp. Under 600 V
Signature 201 - 1000 Amp.Under 600 V
❑ Over 1000 Amp.or Over 600 V
Exemption for Reg.Maim.Elect.
SINGLE FAMILY Temp.Power Pole& Appurtenances 2
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ACCT.i
I hereby affirm that I am exempt from the Contractor's License Law additional Sign Branch Circuits 71•�
for the following reason (Section 7031.5,Business and,Professions 3307 ..r
Code): M
El 1,
Conduits & Conductors 1 ITEMS
IS
I,as owner of the property,will do the work and the structure Other (See Complete Fee Schedule)
is not intended or offered for sale (Section 7044, Business D TOTAL 31 .00
and Professions Code).
C:HEC:Y, 31.00
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the CHANGE •GG
performance of the work for which this permit is issued(Seo.3097, PERMIT FEE (Sub-Total)
Civ.C.).
PLAN CHECKING FEE 0(1300—(]0131 5/31/90
Lender's Name
PERMIT ISSUING FEE 130 1033 1 AM 8:21
Lender's Address
I certify that I have read this application and state that the above TOTAL FEE V
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
properly for inspectio our ses. SEE REVERSE FOR EXPLANATORY LANGUAGE
9/3// 1 b
ature of Permittee Date