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HomeMy Public PortalAbout10770 FAIRVIEW AVE_Electrical__ COUNTY OF LOS ANGELES APPLICATION FOR PERMIT DEPARTMENT OF COUNTY ENGINEER _ ELECTRIC DIVISION OF BUILDING & SAFETY WILLIAM J. FOX, COUNTY ENGINEER FOR APPLICANT TO FILL-4 DISTR197-VO. GROUP ZONE PERMIT NO. ELECTRICIAN .-� 3 24-IC ADDRESS —�� J�s /l„��r R C VE BY READY FOR DATE ISSUED FIR TI CITY COUNTY LICENSE NO� / �CPTRES BUILDING PERMIT / ADDRESS �� u//_ , iJ,�� L�:l+� Pv L Ip NUMBER EACH FEE LOCALITY LIGHT OUTLETS NEAREST RECEPTACLES CROSSOT 1.JAL4z*11 l'_�-Ili 11-4 I ,Nfy�6-./-[?'� WALL SWITCHES OWNER ; /A...� TOTAL OUTLETS 5c $ &0 ti )A MAIL ELEC RANGES 25 ADDRESS ii `�' f � i o fI��l�-_'11.h ELEC HEATERS 25 "� FIXTURES 5 CITY y - f'I~ `"'-'' TEL. NO X/PJ0,� �� MISC I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS NUMBER OF LIGHT CIRCUIT'S APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING MOTORS I 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 DESCRIBED ABOVE. I/2 a LEss $ 25 SIGNATURE OF ��A> _ I/Q 2 50, PERMITTER 2 s 1 00 INSPECTION RECORD 5 15 1 50 / Is so 2 50 50 200 5 00 200 Soo 10 00 Soo 1000 1s oo OVER 1000 20 00 M.G. SET/FREQ. CHANGER-HP WELDERS AC-KVA 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 q FIXTURES $1 00 WIRING IC� SUPPLEMENTARY s0 FIXTURES 7 POWER TOTAL FEE $v UTILITY CO NOTIFIED FINAL �:;;%Z I A;� 76A 663 DBS# 6A 4-82 I ^� WORKERS'COMPENSATION DECLARATION IrCE 806G 10/81 APPLICATION FOR ELECTRICAL PERMIT f �, - �reb�`d'Ffirm that I have a certificate of consent to self insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec 3800, Lab C ) Policy No Company FOR APPLICANT TO FILL IN JOB ADDRESS l© / �� ���U��� RUC ❑ Certified copy is hereby furnished New Residential Bldgs & Pools EACH NO FEE ❑ Certified copy is filed with the county building inspec- 1 & 2-Family, Sq Ft $ —Is LOCAL IT Q� tion department Multi-family Sq Ft — NEAREST v Residential Swimming Pools CROSS ST - - =— ep Date Applicant OWNER OR �j� FIRM /h/NAME Sc el /aeW,J7 CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL Outlets Rec Light Sw_ ����UCer� i COMPENSATION INSURANCE ADDRESS G � A (This section need not be completed if the work involved by First 20 Total No Additional CITYTe Q oTel No the permit is for one hundred dollars ($100)or less.) . �j¢ . —�� I certifythat in the performance of the work for which this PLAN CHECK P APPLICANT permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' ompensation Laws Lighting Fixtures First 20 ADDRESS otal No Additional Date��7'�9—g yA hcant CITY Tel No pp ixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT If, after making this Certificate of APPLICANT Exemption, you should become subject to the Workers' Range_ Heater—DW s / Compensation provisions of the Labor Code, you must forth- Oven _ Dryer — W M — ADDRESS with comply with such provisions or this permit shall be Top — FAU —W H — deemed revoked Hood — Fan _ Other_ CITI° �� A Tel No r^,$ LICENSED CONTRACTORS DECLARATION ICEN E OR 1 hereby affirm that I am licensed under provisions of Chapter 9 Disp — Room Air Cond REG NUMBER Class �6 (commencing with Section 7000) of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO PROCESSED BY and Professions Code,and my license is in full force and effect >' H 7 / y 7 7 —�� Size&Type HP, KW, KVA, or KVAR 0 License Number 1 7j Lic Class Up to 1 Incl FINAL V tiFG S/�y� s G�� ;/ S p_O!� Over 1 to 10 Incl DATE o Contractor to / O 7 VALIDATION Over 10 to 50 Incl a ❑ FINAL I am exempt under Sec Over 50 To 100 Inc BY All B&P C for this reason Over 100 H Services, Swbd , MCC & Panelboards Dare 0 -200 Amp Under 600 V Signature 201 - 1000 Amp Under 600 V ❑ Exemption for Reg Maint Elect Over 1000 Amp or Over 600 V SINGLE FAMILY Temp Power Pole &Appurtenances s HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 5 3 a I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits # ° ° ° ° ° 2 Law for the following reason (Section 7031 5, Business and Professions Code) 2 0 0 2 7, 0 0 ❑ I, as owner of the property, will do the work and the Misc Conduits 8 Conductors + structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ ° °+° 2 9 0 Q m 7044, Business and Professions Code) 0529•—g4 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 li(Q 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 hereby uthorize representatives of this County to enter upon the ab e_mentioned property for inspection purposes 00, SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date WOthat I S COMPENSATION DECLARATION 20 0019 DPW(12.91) APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that have a certificate of consent to self Insure, 76A663 or a cwtifk;atLecli Worker's Compensation Insurance, or a certified COUNTY OF LO$ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV copy thereof(Sec 3800 Lab C) , Policy NO Y S Company `-�/ �''� �'��� FOR APPLICANT TO FILL IN JOB `► Certified co is hereby furnished NO EACH FEE ADDRESS u� C) PY Y New Residential Bldgs &Pools LOCALITY •� S l Famiy, q Ft = $ $ Certified copy is filed with the county buil inspe n �71 &2- NEAREST department Multi-family Sq Ft CROSS ST Dat �-—FW lica Residential Swimming Pools ASSESSOR qq QQ ��qq PP MAP BOOK PAGED" PARCEL0O CERTIFICATE OF EXEMPTION FROM WORKERS' ��^^ �s OWNER OR COMPENSATION INSURANCE Outlets Rec�L Light Sw G / O� Q` O FIRM NAME `� w (This,section need not be completed if the work involved by the � First 20 �J(O MAIL permit is for one hundred dollars($100)or less) Total No Additional O ADDRESS A V tom) C I certify that in the performance of the work for which this permit CIT fla"Ie, CCV Tel No is issued, 1 shall not employ any person in any manner so as to ��ss become subject to the Workers' Compensation Laws Lighting Fixtures First 20 JI�P O PLAN CHECK APPLICANp�F `6 Total No A ditional / �� .7 ADDRESS Date Applicant NOTICE TO APPLICANT If, after making this Certificate of R IDENTIAL LIANCES NOT OVER 3 HP CITY ' u--1 Tel N Exemption, you should become subject to the Workers' Compensation OTHER AP LIANCES NOT OVER 3 HP S trrl�+ 7 provisions of the Labor Code, you must forthwith comply with such PERMIT provisions or this permit shall be deemed revoked Power Apparatus&Large Appliances F APPLICA T LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRE 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 Tel No Professions Code, and my license is in full force and effect Over 10 to 50 Incl LICENSE /��` Over 50 t0 100 InCI REG NUMBER Class d License Number? LiC CIeSS Over 100 DISTRICT NO P OCE BY 0 _ Sero s w d M C&Panelboards Q Contractor • ,w� �0 Date � -IF9 p r 6 n 0 S A 0 V FINAL DATE . El 400-1000 Amp Under 600 V 0 I am exempt under Sec VALIDATION W A Lf Over 1000 Amp or Over 600 V FINAL B&P C for this reason BRANCH CIRCUIT FEES BY a Date 15A,or 20A, 1120V,Lighting or Recept Z �^ 1 To 10 Branch Circuit Signature d- -�-}No 4 _ El41 Or More Branch Circuits Exemption for Reg Maint Elect 15A,20A,208V To 277V Lighting Br Circuits 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 i �r for the following reason (Section 7031 5, Business and Professions Additional Sign Branch Circuits Code) fig 2 0 _a ❑ I, as owner of the property,will do the work and the structure Misc Conduits&Conductors r i y�_+• ic is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) SASH 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) I D Gf' ; CIC-1 t Z. Civ C) PLAN CHECKING FEE j. Lender's Name r6i, !O PERMIT ISSUING FEE Lender's Address �9CO D 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 f urposes SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE OF PERMITTEE DATE 75AOSS-CE80610.59 APPLICATION FOR ELECTRIC PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING ,r BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER i WILLIAM A JENSEN,SUPT OF BUILDING LOCALITYQ/e7 Cl�ti FOR APPLICANT TO FILL IN NEAREST PERNIIT FEES CROSS ST k Si 177,77 e It, }1/ - /. 1 T E M NUMBER OWNER CC✓S%-/ EACH FEE MAIL OUTLETS. r $ $ ADDRESS �•P /y/� LIGHTS RECEPT / SW 10 /! LIGHTING FIXTURES 10 CITY C /T� TEL NO 6 / `Y- ELEC RANGES CLO DRYERS ELECTRICIAN WATER HEATERS .50 ADDRESS /1� ELEC SPACE HTRS DISHWASHERS CITY a�c�-/� TEL NO W (o.P- GARBAGE DISPOSERS AUTO- STATE // WASHERS STA COOKING UNITS 25 LICENSE NO / 7 MOTORS OVER INC H P DISTRICT NO. I GROJ P I ZONE PRO E SED BY O— 1/2 25 f 1/2— 2 50 INSPECTION RECORD 2— 5 too 5— 15 150 is— SO 250 50—200 500 SIGNS NO TRANS NO LAMPS SERVICE 0-600V 100 SERVICE OVER 500V Boo MISC WIRING PERMIT 100 Q Q FIXTURE PERMIT too SUPPLEMENTARY PERMIT 50 TOTAL FEE S I HEREBY ACKNOWLEDGE THAT 1 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 I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR WIRING LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL P OPE TY. POWER SIGNATURE UTILITY CO.NOTIFIED OF PERMITTEE Of, ALIDATION ARTHUR C.VEIT, CK MO CASH SUPERVISING ELECTRICAL ENGINEER 16483 2 A