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HomeMy Public PortalAbout4823 FIESTA AVE_Electrical__ LE U 7V J 76A663-CE806 8-62 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER F ILDINGBUILDING AND SAFETY DIVISIONDRESS JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A.JENSEN, SUPT OF BUILDING CALITYARESTFOR APPLICANT TO FILL IN OSS Sr. � � FDISHWASH. TOTAL NO. EACH FEE OUTLETS FIRST 20 $.20 $ OWNER MAIL ADD'L 10 ADDRESS OVER 20 NG TOTAL FIRST 201 20 CITY ��«^- �, ?U�� TEL. NO. RES ADD'L //((� , 111 oY R 20 -f0 ELECTRIC&/N '-r.�" •1. CLO.DRYERS WTR.HTRS. 1.00 ADDRESS / P. STA.COOK ,C� J CITY /„-��-+,nom” j -1""„_,.. TEL . AUTO.-WASH. STATES. 9TA.APP.(1/s H.P.MAX.) ,rj0LICENSE NO.: OVER NOT OVER H.P. DISTRICT O. GOI.I ZQNE P SSED.8 O 1 1.00 1 3 1.50 INSPECTION RECORD 3 8 2.00 8 15 2.50 15 50 3.00 } a 50 100 5.00 O V SIGNS: NO.TRANS NO.LAMPS 0 V SERVICE 0.600V-NOT OVER 200A �,,�� /f 1.00 to SERVICE 0.60OV-OVER 200 A. 2.00 d N SERVICE OVER 600V 5.00 z MISC. PERMIT ISSUING FEE 2.00 SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE f l� 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 CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRINGWIRING 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS.REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT I AM THE LEGAL OWNE OF THE ABOVE DESCRIBED RESIDENTIAL P 0 ERTY. POWER �� SIGNATURE4!' �'+r UTILITY CO.NOTIFIED OF PERMITTEE -' IDATION ARTHUR C. VEIT CK �O CASH SUPERVISING ELECTRIC ENGINEER n 7 3 7 2 E JAN 8 2 D 4,00- 76A663 CE-806(11 /78) APPLIAAI® FOfREL ECL PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY', FOR APPLICANT TO FILL IN JOB New Residential Bldgs.&Pools EACH NO. FEE ADDRESS �iLS /. . ,�E.S•b/i� 1 &2.Family,Sq. Ft. $ .025 — $ LOCALITY :iE41:5� e6 _ Multi-family Sq. Ft. .02 — NEAREST /J Residential Swimming Pools 25.00 CROSS , OWNER—OR FIRM NAME O Outlets:Rec Light Sw. MAIL First 20 .50 ADDRESS Total No. Additional .30 CITY el.-No 7 PLAN CHECK APPLICANT - Lighting Fixtures First 20 •50 ADDRESS Additional .30 Total No. CITY Tel. No. Fixed Appliances Not Over•1 HP PERMIT APPLICANT Range_Heater_D.W:— ADDRESS Oven_Dryer —W.M.• i ex Top _FAU W.H._ CITY, Ll _7,11A Jel.'Nb Hood_Fan _Other_ LICENSE OR Disp.—Room Air Cond. 2'50 REG. NUMBER '3 Class. _ I HEREBY ACK170VVLEDGE THAT E9 1 Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE Gt ARf Tj+ iz &'T COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS S .` ype HP, KW, KVA,or KVAR REGULATING ELECTRICAL WIRING. 96 Up to 1 Incl. 2.50 0 Over 1 to 10 1 ncl. 5.00 LICEN1 HEREBY'CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF as Over 10 to.50 Incl 12.50 CALIFORNIA OR THAT I AM.THE LEGAL OWNER OF.THE.ABOVE 25.00 DESCRIBED RESIDENTIAL PROPERTY. Over 50 to 100 Inc. _ 40.00 PERMITEE 1-_�. Over 100 SIGNATUR 1A Services DISTRICT NO. PROCESSE ifBY 0-200 Amp.Under 600 V 12.50 201-1000 Amp. Under 600 V 25.00 v Over 1000 Amp.or Over 600 V 50.00 O Temp. Power Pole&Appurtenances 10.00 G Sign with One Branch Circuit 10.00 Additional Sign Branch Circuits 2'00 INSPECTION.: > INFORMATION u Misc.Conduits&Conductors 10.00 ON REVERSE z Other(See Complete Fee Schedule) SIDE u g 031.3A '. o o' o 0 0 2 PERMIT FEE (Sub-Total) Z 2 0 0 12.00 PLAN CHECKING FEE: (One-Fourth Permit Fee) O "a 0 0 1 2.00F PERMIT ISSUING FEE $7.00 — G �7 Q5, 13 0 TOTAL FEE ,OL e > r INSPECTION FINA LED W •� a date: I ,- t� �4 BY ©s WORKERS' COMPENSATION DECLARATION 76-663 10/81 CE-806G APPLICATION FOR ELECTRICAL PERMITI hereby effirm that I have a certificate of consent to self insure, 'of a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy lthereof`'(,Sec.3800,Lab. C.) Pplic;!No. QSS 05Z Z Company ` ' � FOR APPLICANT TO FILL IN - JOB Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS 4 8171�-+'l 1-11 & 2-Family,Sq.Ft. $ — $ LOCALITY ; C't KJ Certified copy is filed with the county b 'Iding inspection dep rtmen Multi-family Sq.Ft. — NEAREST ^ CROSS ST. �. �q Residential Swimming Pools OWNER OR Date Applicant c FIRM NAME CERTIFICATE OF EXEMPTION FROM WOR iRS' Outlets:Rec a Light Sw. — MAIL �+ COMPENSATION INSURANCEADDRESS J (This section need not be completed if the work involved by the i First 20 permit is for one hundred dollars ($100)or less.) Total No. ` Additional CITY Tel.No. PLAN CHECK I certify that in the performance of the work for which this permit APPLICANT is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS Total No. Additional CITY Tel.No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT ,, NOTICE TO APPLICANT: If, after making this Certificate of r �-. SC:JA a C i Exemption,you should become subject to the Workers'Compensation Range_ HeaterAPPLICANT q �U _ D.W. r e t provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer W.M._ ADDRESS ,"3 S —Dy– provisions or this permit shall be deemed revoked. Top — FAU W.H. �7 LICENSED CONTRACTORS DECLARATION CITY rro�dic. Tel. No.3�S Z 7� Hood Fan Other_ I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. LICENSE OR �+ „ Class. (commencing with Section 7000) of Division 3 of the Business and REG.NUMBER �– Professions Code,and my license is in full force and effect. DISTRICT NQ. �' PROC S D BY Power Apparatus& Large Appliances ,-^�� f � �f / Size& Type HP,KW,KVA,or KVAR ✓I l.f � Q License Number 1 /r Lic.Class C /o T Up to 1 Incl FINAL 0 SGbbiij• P 4 i 1 Over 1 to 10 Incl. DATE VALIDATION 0 Contractor Wt– Date Over 10 to 50 Incl. V FINAL ❑ I am exempt under Sec. Over 50 to 100 Inc. BY V u w Over 100 B.&P.C.for this reason f fn Services, Swbd.,MCC & Panelboards i n Date: 0-200 Amp.Under 600 V Signature 201 - 1000 Amp.Under 600 V ❑ Over 1000 Amp. or Over 600 V Exemption for Reg.Maint.Elect. 2 SINGLE FAMILY Temp. Power Pole& Appurtenances qqt�rr HOME OWNER-BUILDER DECLARATION ° Sign with One Branch Circuit ACtTO� I hereby affirm that I am exempt from the Contractor's License Law "' 1 for the following reason(Section 7031.5, Business and Professions Additional Sign Branch Circuits 3307 Code): 1 d f fG! S ' ❑ I,as owner of the property,will do the work and the structure Misc.Conduits & Conductors y p1 is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) TOTAL 1 ®.25 and Professions Code). ® 4HECK 18.25 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) Civ.C.). n q 29e PLAN CHECKING FEE Ob 9� /1 u8 Lender's Name 5983 1 RM11�39 PERMIT ISSUING FEE i Lender's Address I certify that I have read this application and state that the above TOTAL FEE information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize representatives of t is County to enter upon the above-mentioned prope y sp io urposes. SEE REVERSE FOR EXPLANATORY LANGUAGE gnatu .of ermi ee Da� e l�y C r*11*t * aal-ao 3