HomeMy Public PortalAbout5201 FARAGO AVE_Electrical__ YE V7"e"Cue"a ao APPLICATIO lel FOR CT R I C PERMIT
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COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER fA
UILDING
BUILDING AND SAFETY DIVISION DDRESS
JOHN A LAMBIE COUNTY ENGINEER
CASSATT D GRIFFIN SUP T OF BUILDING CALITY
FOR APPLICANT TO FILL IN NEAREST
PERMT FRRG CROSS ST
I
ITEM NUMBER 1 ACH FEE OWNER
OUTLET MAIL
LIGHTS RECEPT 17 SW v $ 1O $ ADDRESS
LIGHTING FIXTURES 10 6d CITY TEL NO
ELEC RANGES CLO DRYERS ELECTRICIA
op
WATER HEATERS SO AODRES26Q,04 /
ELEC SPACE HTRS DISHWASHERS CITY TEL NO
GARBAGE DISPOSERS AUTO
WASHERS STA COOKING UNITS STATE
1 25 S LICENSE NO o
MOTORS OVER INC H P DISTRI T O I G eaQHaP Z I P O S Y
0— vi 25
2 So INSPECTION RECORD
2— 5 too A
5- 15 150 r
15— 50 250
50-200 500
SIGNS NO TRANS
NO LAMPS
SERVICE O 600V 100
SERVICE OVER 600V 500 1
MISC
WIRING PERMIT too
FIXTURE PERMIT 100
SUPPLEMENTARY PERMIT 50
TOTAL FEE $
1 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 /
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR WIRING —
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AM TH. LEGAL OWNag ,
'fHE ABOVE
DESCRIBED RESIDENTIAL fiOP TY POWERSIGNATURE ,� UTILITY CO NOTIFIED I ,
OF PERMITT u
mmmmmmm FINAL /r
OF /PR1i.I ARTHUR C VETT
/1 'C/IC/ MoO CASH CAeH SUPERVISING ELECTRICAL ENGINEER
' Lt;t 1 7 3 8 AUG G 2 G 7 �
y5 Y
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WORKERS COMPENSATION DECLARATION CE 806G 1
0
/81 APPLICATION FOR ELECTRICAL PERMIT
firm that I have a certificate of consent to self insure `
RW ate of Workers Compensation Insurance`or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY
copy thereofSec 13800 Lab C) "fl
Policy No 3 / i tCompany ' FOR APPLICANT TO FILL IN JOB
❑ Certified copy is hereby furnished New Residential Bldgs & Pools EACH NO FEE ADDRESS
1 & 2 Family Sq Ft $ — $ LOCALITY^ >
Certified copy is filed with the county building inspection ,
department ` f Multi family Sq Ft *� NEAREST
`� CROSS ST `
Date ¢�^ on
�� Applicant l ._ /�D Residential Swimming Pools `y y` r OWNER OR n
va < c� , u 3 , 4 a Q '4 '� y�+� i-,..,,y iFIRM NAME S I �IG
I `CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec` Light Sw k q ` 1 MAIL
t , , r COMPENSATION INSURANCE , ` ADDRESS U Q
This section need not be completed if the work involved b the First'20 ti µ /k L
( p Y Total No Adddional » * ' *' CITY �� C [+ Tel o
perm is for one hundred dollars($100)or less) f I A ni pL+pN CHECK
I certify that in the performance of the work for which this permit ``^ } APPLICANT
is issued I shall not employ anyaperson in any manner so as to
become subject to the Workers Compensation Laws Lighting Fixtures First 20 ADDRESS
Total No Additional- ` ` t` CITY ' Tel No ,
Date Applicant Fixed„Appliances Not Over 1 HP yrs PERMIT ,
NOTICE TO`APPLICANT A,if+ after making this Certificate of - T� 4
Exemption you should become subject to the Workers Compensation _ Range Y Heater_ D W _ t APPLICANT 4 /2 — R�- ,
provisions of the Labor Code,you must forthwith comply with such Oven _"Dryer _ WM~_ ADDRESS { 6 3`Q�
provisions or this permit shall be deemed revoked,. Top _,FAU _ WH f 4 �7 �
r LICENSED CONTRACTORS DECLARATION CITY i sr�� j Tel No e�,
k a i Hood Fan _ Other_ /Vr0 V ti
I hereby affirm that I am licensed under provisions of Chapter 9 ' r _ 1" LICENSE OR+ 2�� . , . - `1 ` 'd�
(commencing with Section 7000) of Division 3 of the Business and Disp — Room Air Cond REG NUMBER L�7 2 " .- Class
Professions Code and my license is in full force and effect DISTRICT NO PROCESSE . b
n , Power Apparatus& Large Appliances
S 0
r VZ` Size& Type HP KW KVA or KVAR � � ° 0
License Nu mberZ � Lic Class ` ~�� Up to 1 Incl FINAL V
6 2a� Date `— Over 1 to 10 Incl DATE VA IDA ON 0
Contractor Over 10 to 50 Incl
❑ FIN V
lam exempt under Sec ' Over 50 to 100 Inc ' g � W
Over 100 CL
B&PC for this reason N
Services Swbd MCC& Panelboards /) Z
` Date 0 200 Amp Under 600 V (/
Signature 201 1000 Amp Under 600 V ,
I - Over 1000 Amp or Over 600 V 4 0
Exemption for Reg Maint Elect "
SINGLE7FAMILY } Temp Power Pole & Appurtenances
HOME OWNER BUILDER DECLARATION *`
Sign with One Branch Circuit `
I hereby'affirm that I am exempt from the Contractors License Law 9 9 7 5 A
for the following reason(Section 7031 5 iBusiness and Professions Additional Sign Branch Circuits 1_11
# {o 0 0 0 e 2
Code) '+ ',e r x
❑ y ` Misc Conduits'& Conductors + ' -,o3250 '
I as owner of the propert will do the work and the structure o 0032505
is not,intended or offered s for sale (Section 7044 Business ,,I Other(See Complete Fee Schedule) c602-88
and Professions Code) r x k
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 j (Sub Total)
Civ C) '
PLAN CHECKING FEE r
Lenders Namei` PERMIT ISSUING FEE
i,
' Lenders Address r
' I certify that I have read this application and state that the above TOTAL FEE 3 ?150
information is'correct I agree to comply with all County ordinances
and State laws regulating Electrical wiring and hereby authorize
repres tatives of this County o enter upon the above mentioned
proper
for inspe ion purpo 1 ,
�' �� �-SEE REVERSE FOR EXPLANATORY LANGUAGE
L. r , ,
Si nature�FPermdtee Date ;
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