HomeMy Public PortalAbout5032 FIESTA AVE_Electrical__ '16463-CE606 8-a9 APPLICATION E®R ELECTRIC PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER -BUILDING
BUILDING AND SAFETY DIVISION ADDRESS O 3 al V Elc;%I�
JOHN A. LAMBIE, COUNTY ENGINEER '�'``
CASSATT D. GRIFFIN,SUPT OF BUILDING ! ZT1 fP� �
LOCALITY
FOR APPLICANT TO FILL IN y NEAREST J
PERMIT FEES CROSS ST. '
ITEM NUMBER y1y
EACH FEE OWNER -- .
OUTLE : $ $ MAIL
TS
LIGHTS RECEPT. W. 10 ADDRESS
LIGHTING FIXTURES 10 60 CITY T NO.
ELEC.RANGES CLLO.DDRYERS /� ELECTRICIAN
WATER HEATERS .50 O ADDRESS � QIL.{' Zy�— 11% -� f?
ELEC.SPACE HTRS. DIS SHER
.AGE CITY TEL. NO.
GARBAGE DISPOSERS UTO.- ./ry \/ STATE �
WASHERS STA.COOKING UNITS .25 / �J LICENSE NO. ILJ 19
MOTORS: OVER INC. H.P. ^DI��T I GROUP I ZONE I P CESSED BY
0— 1/2 .25 �®
1/2— 2 .50 INSPECTION RECORD
2— 5 1.00 -f�
5— 15 1.50
Is— 50 2.50
50-200 5.00
SIGNS: NO.TRANS.
NO.LAMPS
SERVICE 0-600V 1.00
SERVICE OVER 600V 5.00
MISC.
WIRING PERMIT 1.00
FIXTURE PERMIT 1.p0
SUPPLEMENTARY PERMIT .50
TOTAL FEE I
1 HEREBY ACKNOWLEDGE THAT i 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.
1HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR WIRING C•I,i�fi L� a,'��LLgy,Li (' /;�� _
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES i—, 0'
CALIFORNIA OR THAT I AM THE LEGAL OWNER
�O,F/{/THE
�ABOVE � ..
DESCRIBED RESIDENT L P OPERTY. t
�/ ! ���✓fO�r"7! POWER
SIGNATURE UTILITY CO.NOTIFIED
OF PERMITTEE
FINAL
OF VA DATION SUPERVISING ELECTRICAL ENGINEER
CK MO CASH
ILJ s `n 3 0 1 2 Ju,� 3 0 2 AN
1 2.4 5 N,
WORKERS'COMPENSATION DECLARATION CE-806 10/81 APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I have a certificate of consent to self CE-806G
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
ElCertified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS V J�Z� Al- i
❑ 1 & 2-Famil S Ft. $ — $ LOCALITY
Certified copy is filed with the county building inspec- y q
tion department. Multi-family Sq. Ft. — 'NEAREST
CROSS ST.
Residential Swimming Pools
Date Applicant OWNER OR .s
FIRM NAME
CERTIFICATE OF EXEMPTION FROM WORKERS' OutMAIL
lets: Rec Light Sw._
COMPENSATION INSURANCE ADDRESS
completed if the work involved b First 20
(This section need not be com P Y Total No. Additional CITY l� 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 Workers'Compensation Laws. fighting Fixtures First 20 ADDRESS
�.11Q�1� Total No. Additional
CITY Tel. No.
Date ' Applicant Fixed 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—D.W.
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. — �j/
deemed revoked. CITY Tel. No. 7 Sio D .
LICENSED CONTRACTORS DECLARATION Hood Fan _Other_
Disp. — Room Air Cond. LICENSEOR J ��. XX
I hereby affirm that I am licensed under provisions of Chapter 9 REG. NUMBER ass.
�/ ClC/
(commencing with Section 7000) of Division 3 of.the Business DISTRICT NO. P S D BY
and Professions Code,and m license is in full force and effect.
///41�� Power Apparatus& Large Appliances
Size 8 Type HP, KW, KVA, or KVAR' i D
License Number yy Lic. Class Up to 1 Incl. FINAL
09
Over 1 to 10 Incl.
�
Contractor r/� Date 17 DATE SVALIDATION 11—
Over 10 to 50 Incl. FIN CCL
I am exempt under Sec. Over 50 to 100 Inc. BY 7
B.&P.C. for this reasoner Over 100
D ! 62 , Services, Swbd., MCC & PonelboardsIle Poo
-200 Amp. Under 600 V
Signature natured�' a 201 - 1000 Amp. Under 600 V
❑ Over 1000 Amp. or Over 600 V
Exemption for Reg. Maint. Elect.
SINGLE FAMILY Temp. Power Pole& Appurtenances
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit
I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits
Law for the following reason (Section 7031.5, Business and
Professions Code):
❑ I, as owner of the property, will do the work and the Misc. Conduits& Conductors,
structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ Pool :2 Jr 9 9 5A
7044, Business and Professions Code).
CONSTRUCTION LENDING AGENCY # o 0 0 ® o 2
I hereby affirm that there is a construction lending agency for o - 31.00
the performance of the work for which this permit is issued PERMIT FEE (Sub-Total)
(Sec. 3097, Civ. C.). 0 0 . 31.003
PLAN CHECKING FEE
Lender's Name 1 1,L 0-8 6
PERMIT ISSUING FEE �U
Lender's Address
I certify that I have read this application and state that the TOTAL FEE f
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 roperty for spection,p�urpose�s. SEE REVERSE FOR EXPLANATORY LANGUAGE
Sirt'g-nature o Permittee Date