Loading...
HomeMy Public PortalAbout10601 FAIRHALL ST_Electrical__ COUNTY OF LOS ANGELES -- ' APPLICATION FOR PERMIT DEPARTMENT OF COUNTY ENGINEER" DIVISION OF BUILDING & SAFETY ELECTRIC WILLIAM J. FOX, COUNTY ENGINEER ' FOR C TO'�1 IN DI RICT-NO. GRTOUP AZONE PERMIT NO. " ELECTRICI =+— / ' 91 ADDRESS j RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION _ CITY T NOS PYPQJ_Z,�, COUNTY LICENSE NOBUILDING PERM FEES ADDRESS, 1 FEE - NUMBER EACH LOCALITY LIGH.T'OUTLETS' NEAREST- - RECEPTACLES 038 ST WALL SWITCHES ' OWNER . TOTAL OUT 5c $ �• MAIL ELEC. RANGES 25 •ADDRESS I - ELEC: HEATERS '25• t / FIXTURES f . 5 TEL NO. MISC. .I HEREBY' ACKNOWLE E THAT. 1 HAVE READ THIS NUMBER OF LIGHT CIRCUITS , APPLICATION AND STATE 'THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH'ALL' COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITSAND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS —Num ER HORSEPOWER FEE ANGELES,COUNTY LICENSE, OR 1 AM THE -LEGAL OWNER NEW MVD. HP OVER INC. EACH OF THE RESIDENTIAL P PE Y DES IBE •A 1/z&_LESS $ .25 - SIGNATURE OF 1/2 t2 .50 PERMITTEE 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 Z OVER 1000 20.00 - - M.G. SET/FREQ.,CHANGER-HP WELDERS AC-KVA •• -O GENERATORS -KW TRANSFORMERS-KVA TEMP. MOTORS (75% OF,'o RIG.) , MOVED:MOTORS (75% OF ORIG.) MISC. , SIGNS , NO. NO. TRANS. 7y No. NO. LAM .•APPROVALS - - FOR EACH"PERMIT: DATE-' INSPECTOR'S NAME' WIRING' $1..00_���� CONDUIT WIRING FIXTURES' $1.00 Z FIXTURES A• d4 SUPPLEMENTARY .50 ' POWER i1,,awl TOTAL 'FEE $ / UTILITY CO. NOTIFIED ,� _ - FINAL -. 1 /L■ 78A 663 DBB# 8A. 4-81 - _I -• •. WORKERS' COMPENSATION.DECLARATION 20-00wDPW 3,e7 APPLICATION FOR ELECTRICAL PERMIT !(hereby offiim-that I have a certificate of consent to self cE s06� insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or:-i certified copy thereof (Sec 3800, Lab. C.) • Policy No. Company FOR APPLICANT TO FILL IN JOB ;5W �/ ❑Certified co is hereby furnished EACH NO FEE ADDRESS b /' ;5WIA PY Y New Residential Bldgs 8 Pools ❑Certified copy is filed with the county building mspec- 1 & 2-Family, Sq. Ft $ — $ e. LOCALITY hon department Multi-family Sq. Ft. NEAREST Date Applicant Residential Swimming Pools CROSSOWNEST FIRM NAME �-> �1 A r C_/ CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets- Rec Light Sw_ MAIL + COMPENSATION INSURANCE ADDRESS' S ��X—___ This section need not be com leted if the work involved b' First ti _ ( P y Total No. Additiorial CITY Tel. 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, I shall not employ any person in any manner so as to become subject to the WWK. 'Compens tion Laws. Lighting Fixtures First 20 ADDRESS ; �' � Total No. Additional Date l�-ZyApplicant � '� ��/ T /. CITY Tel.iJo. NOTICE TO APPLICANT- If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT _ Exemption', you should become subject to the Workers' Range— Heater—D W. _ APPLICATION Compensation provisions of the Labor"Code, you must forth- Oven — Dryer —W.M.— ADDRESS j pp1/ n with comply with such provisions or this permit shall be Top — FAU —W.H — .� deemed revoked. Hood — Fan —Other— CITY t' ' Tel. IN LICENSED CONTRACTORS DECLARATION Disp. _ Room Air Cond LICENSE OR I hereby affirm that I am licensed under provision's of Chapter 9 REG NUMBER Z Class.L_16j (commencing with Section 7000)of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO PR ESSED BY >_ and Professions Code,and my license is in full force and effect + G a Size &Type HP,_KW, KVA, or KVAR Q License Number Lic ClassUp to,l Incl V FINAL U Contracto'r H/3 v '� Date Over 1 to 10 Incl DATE '�J �2 VALIDATION 0 ❑ Over 10 to 50 Incl. FINAL i- I am exempt under Sec. 9 Over 50 to 100 Inc. BY U Over 100 LU B &P.C. for this reason � Services, Swbd., MCC& Ponelbo6rds , Date: ! 2^ 'Ly-/�' b Z r 0-200 Amp Under 600 V Z Signature ems' - 201 - 1000 Amp.'Under 600 V ❑ Over 1000 Amp. or Over 600 V Exemption for Reg. Maint Elect. ' SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Temp. Power Pole&Appurtenances 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): - =�' '7 i ❑ I, as owner of the ro ert will do the work and the Misc. Conduits&Conductors - - FM-Z` P P Y� �. .k�_�i_ structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ Business and Professions Code). , _ ..,_ 3 1 a 0 0 CONSTRUCTION LENDING AGENCY _y F; II_I 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) t- (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Namej?;_lr I- ( PERMIT ISSUING FEE Lender's Address }r�j 3 j AM I I 6 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 laregulating Electrical wiring,,and hereby authorize repr ent 'ves of this.County to enter upon the above-mentio d erty for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Signature rmittee Date ©s