Loading...
HomeMy Public PortalAbout9521 FLAHERTY ST_Electrical__ 76A663 DBS 5A 11-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY ELECTRIC COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRICIAN R. F. Walton �oREADY FOR ADDRESS 5134 N. Acacia Ste RECEIVED BY FIRST INSPECTION DATE ISSUED CITY San Gab® TEL. No. AT 68583 p/1"t- 7 -/6 -''e-1 COUNTY LICENSE NO. 1104 EXPIRES BUILDING PERMIT FEES ADDRESS 9521 Flaherty NUMBER EACH FEE LOCALITY Temple City LIGHT OUTLETS 14 NEAREST RECEPTACLES 23 CROSS ST. WALL SWITCHES 19OWNER Meeker TOTAL OUTLETS 56 Sc $ 2 80 MAIL ELEC. RANGES y 25 ADDRESS 1 ELEC. HEATERS 25 25 " r1 CITY TEL. NO. FIXTURES 14 5 I 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS 1 CERTIFY THAT I .POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER FEE NEW MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. e� i 1/2 &LESS $ .25 25 SIGNATURE OF 1/2 2 .50 PERMITTEE 6-1 2 5 1.00 INSPECTION RECORD 5 15 1.50 15 50 2.50 50 200 5.00 200 500 10.00 .J Soo 1000 15.00 Q Z 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%OFORIG.) MISC. SIGNS NO. NO. TRANS. I APPROVALS NO. NO. LAMPS FOR EACH PERMIT: DATE INSPECTOR'S NAME WIRING $1.00 1100 CONDUIT C-lp)'K _ FIXTURES $1.00 1100 WIRING 0 SUPPLEMENTARY 50 FIXTURES 6 00 POWER TOTAL FEE I $ UTILITY CO. NOTIFIED ® FINAL J 76A663 CES06 3 69 Ui I APPLICATION FOR ELECTRICA R IT d COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION ADDRESS JOHN A LAMBIE COUNTY ENGINEER COLEMAN W JENKINS SUPERINTENDENT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN CROSS NEAREST CROSS ST NO JEACH FEE ,y r/ $ $ OWNER /17/Z$, RECEIPT./ MAIL //�� ADDRESS S�1 LIGHT oma- TO AL FIRST 20 20 Q SWITCH OVER 20 10 CITY C-h, C0 7 EL NO PLAN CHEC LIGHTING TOTAL FIRST 20 20 d APPLICANT FIXTURES } o?, I OVER 20 10 ADDRESS RANGE DRYER WTR HTR CITY TEL NO STA COOK_DISP _F A U CONTRACTOR SPACE HTR AIR COND ADDRESS ,�,Q 41,). r dCd?[ CLOTHES WASH DISHWASH CITY1J/[� TEL NO FAN OTHER 1 00 LICENSE NO C�ac� CLASS .81 MOTORS TRANStORMERS RATING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION IND HEATERS ETC HP KW KVA AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING 0 - 1 1 DO 1 HEREBY CERTIFY THAT I A PROPERLY REGISTERED AND/OR ICENSED AS REQUIRED BY LO ANGELES COUNTY AND STATEOF a 1 - 10 3 00 CALIFORNIA OR THAT I AM H LEGAL NER OF AND INTEND TO RESIDE IN THE ABOVE DE ED RES ENTIAL PROPERTY V( 10 - 50 5 00 . V SIGNATURE 1 ad 50 - 100 10.00 OF PERMITTEE )c 100 - 500 1500 DISTRICT NO G UP NE OCE ED BY W a SIGN GAS SIGN AND ONE CIRCUIT 3 00Q J TUBE OR MARQUEE ADDITIONAL CIRCUITS 1 00 NOTES SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00 SERVICE OVER 600 VOLTS OR 200 AMP 5 00 TEMP SERVICE POLE &APPURTENANCES 3 00 APPROVALS DATE INSPECTORS SIGNATURE TEMP POWER POLE UNDERSLAB WORK ROUGH CONDUIT WIRING PERMIT FEE (SUB TOTAL) FIXTURES PLAN CHECK FEE (507 PERMIT FEE) POWER AUTHORIZED PERMIT ISSUING FEE 2 00 UTILITY CO NOTIFIED SUPPLEMENTARY PERMIT ISSUING FEE 1 00 FINAL 7-14'- 70 TOTAL FEE JOSEPH C ROOHAN SUPERVISING ELECT ENGINEER PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK M O CASH 5 3 9 OR JW15 2 D 420` SEE BACK OF APPLICATION FOR COMPLETE FEE aCH EDUIE //��C�2I/t1%/✓1���%r/G' WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT I herSby affitm,ahat I have a certificate of consent to self insure, 76A663 or a certificate of worker's Compensation Insurance. or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec. 3800 Lab. C.) �y Policy N0. Company FOR APPLICANT TO FILL IN JOB ADDRESS Z Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE _ LOCALITY El Certified $ Certified copy is filed with the county building inspection 1 &2-Family,Sq.Ft. NEAREST department. Multi-family Sq.Ft. CROSS ST. Date Applicant Residential Swimming Pools ASSESSOR MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER OR Outlets:Rec._Light Sw. � FIRM NAME COMPENSATION INSURANCE19,6 First 20 MAIL (This section need not be completed if the work involved by the ADDRESS permit is for one hundred dollars($100)or less.) Total No. Additional I certify that in the performance of the work for which this permit CITY Tel.No22 3 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 PLAN CHECK I p 9 9 APPLICANT Total No. Additional ADDRESS Date G1 1 C fn Applicant '0 RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: If, after makin this ertificate of CITY Tel.No. Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code, you must forthwith comply with such PERMIT /l�5'! provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances APPLICANTCA ,J LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS (0 2 .S I hereby affirm that I am licensed under provisions of Chapter 9 / Over 3 to 10 Incl. d (commencing with Section 7000) of Division 3 of the Business and CITY S' I J Arl� r� Tel.No.v 8S I Z 8 Professions Code, and my license is in full force and effect. Over 10 to 50 Incl. } Over 50 to 100 Incl. LICENSEOR Class. REG.NUMBER S b l0 d a License Number''')Q//(0 V, Lic.Class ` — v Over 100 DISTRICT NO. 01 p PRD SSED BY 0 Services,Swbd.,MCC&Panelboards 5f.* 9 FINAL T_ Contract�ae�.empt to 3 0-399 Amp. Under 600 V DATE 0 El 400-1000 Amp. Under 600 V ~ I under Sec. VALIDATION 0 Over 1000 Amp.or Over 600 V FINAL W B.&P.C.for this reasonBRANCH CIRCUIT FEES BY � Date: 15A,or 20 120V,Lighting or Recept. Z 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits Exemption for Reg.Maint. Elect. 15A,20A,208V To 277V Lighting Br.Circuits 2 SINGLE FAMILY Temp.Power Pole&Appurtenances A T y HOME OWNER-BUILDER DECLARATION 1-rU a n r I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit ��t�11 for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits 3303 ITEMS T 87.00 Code): i 1 1�I Mr+t7 ❑ 1, as owner of the property, will do the work and the structure Misc.Conduits&Conductors TOTAL awe ® � is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) and Professions Code). , CHECK 87°00 CONSTRUCTION LENDING AGENCY CHANGE .00 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.) �3 PLAN CHECKING FEE 0000-0,901 6/13/96 Lender's Name D 6881 1 AN 8Q3 PERMIT ISSUING FEF_ Lender's Address 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 v for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE I ATURE OF PERMITTEE DATE WQthatI COMPENSATION DECLARATION 20.0019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT LJ I hereby affirm that have a certificate of consent to self insure, 76A663 or a certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec, 3800 Lab. C.) _ r Policy No. Company FOR APPLICANT TO FILL IN JOB l� ADDRESS ._.? I Certified copy is hereby furnished. New Residential Bldgs. NO. EACH FEE LOCALITY ❑ ham' X1 180 _ $ $ Ft S -Family, q. . Certified copy is filed with the county building inspection 1&2 NEAREST /' � department. Multi-family Sq.Ft. CROSS ST. Date Applicant Residential Swimming Pools ASSESSOR MAP BOOK PAGE 10 PARCEL v CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rea 2 Light 1 Sw. 1 OWN ER OR NAME ��114114j COMPENSATION INSURANCE First 20 (This section need not be completed if the work involved by the MAIL permit is for one hundred dollars($100)or less.) Total No. 4 Additional ADDRESS I certify that in the performance of the work for which this permit CITY Tel.No. is issued, I shall not employ any person in any manner so as to PLAN CHECK become subject to the Workers' Compensation Laws. Lighting Fixtures One First 20 APPLICANT Total No. Additional ADDRESS Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: If, after making this Certificate of CITY Tel.No. Exemption,you should become subject to the Workers' Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code, you must forthwith comply with such PERMIT provisions or this permit shall tie deemed revoked. Power Apparatus&Large Appliances APPLICANT LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS 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. } LICENSEClass. Over 50 t0 100 Incl. REG.NUMBB ER d License Number Over 100 DISTRICT NO. PRO C 0 Lic.Class Services,Swbd.,MCC&Panelboards S© IY FINAL Contractor Date 0-399 Amp.Under 600 V DATE 0 El I am exempt under Sec. 400-1000 Amp.Under 600 V LLI Over 1000 Amp.or Over 600 V FINAL VALIDATION B.&P.C.for this reason BRANCH CIRCUIT FEES BY IL 15A,or 20A, 120V,Lighting or Recept. Z Date: _ 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits Exemption for Reg. Maint. Elect. 15A,20A,208V To 277V Lighting Br.Circuits 2 a SINGLE FAMILY Temp. Power Pole&Appurtenances f��•i e oa HOME OWNER-BUILDER DECLARATION ., 33 't= 1 hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit 3307 ,r.�o+:.r for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits` Code): I, as owner of the property,will do the work and the structure Misc.Conduits&Conductors TOTAL. 33. .a—•-- is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) ,'tLs , and Professions Code). i'_'ASH 33.24" CONSTRUCTION LENDING AGENCY CHANGE 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.) 1.,Ci,I 4-til 4L i Ili�.�}i`�2 PLAN CHECKING FEE o 1; Lender's Name - fir•i10 1 AM PERMIT ISSUING FEE Lender's Address 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 represent a es of this C u t enter on the above-mentioned property for ins on p os SEE REVERSE FOR EXPLANATORY LANGUAGE _ 11 -16-92 y VSI URE OF*_R*VWE7_ I � DATE ..