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Home My Public Portal About9174 FORTSON DR_Electrical__ DBS S-A 6 46. APPLICATION FOR PERMIT DEPARTMENTBUILDING AND SAFETY ELECTRIC COUNTYTY OF LOS ANGELES WM. J. FOX CHIEF ENGINEER a NAME ' DISTRICT NO. GROUP ZONE PERMIT NO. ADDRESS O T�J U CITY RECEIVED BY READY FOR DATE ISSUED N /- 21,6 TEL. AFIRST INSPECTIONA COUNTY � W CERT.NO. /p &O EXPIRES ' APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLYJOB ° DESCRIPTION OF WORK ADDRESS / T41-0 3 NUMBER OF OUTLETS ON CIRCUITS LOCALITY LOCATION BY ROOMS NEAREST LIGHT OUTLETS JSW. PLUGS FIXT CROSS ST. CIRCUIT A B C D E F G H W NAME 3 MAIL ADDRESS O CITY TEL.O. 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION.. ELECTRICIAN. I AM THE"GAL OWNER OF THE PROPERTY DESCRIBED ABOVE OWNER. CORRECTIONS J Z_ O TOTAL 'J NO. OF OUTLETS $ APPROVALS NO. OF FIXTURES $ S DATE INSPECTOR'S NAME NO. OF MOTORS H.P. $ CONDUIT NO. OF SIGNS TRANS. $ WIRING NO. OF RANGES OR HEATERS $ FIXTURES MISCELLANEOUS $ POWER n PERMIT FEE $ UTILITY CO.NOTIFIED TOTAL FE '-'`_ 2FINAL COUNTY OF LOS ANGELES APPLICATION FOR PERMIT DEPARTMENT OF COUNTY ENGINEER DIVISION OF BUILDING & SAFETY ELECTRIC 1 WILLIAM J. FOX, COUNTY ENGINM FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRICIAN Iv' ADDRESS r/ __RECEIVED BY READY FOR DATE 1 SUED FIRST INSPECTION �) CITY I TEL. NO. / COUNTY LICENSE O. EXPIRES BUILDIN PERNIIT,FEES . NUMBER EACH FEE / LOCALITY LIGHT OUTLETS NEAREST �L RECEPTACLES CROSS ST. Jr�/ WALL SWITCHES. OWNER i / TOTAL OUTLETS 7 5c $ /) MAIL ELEC. RANGES 25 ADDRESS ELEC. HEATERS 25 FIXTURES 5 CITY TEL. NO. MISC. I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS NUMBER OF LIGHT CIRCUITS 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 I POSSESS THE ABOVE VALID LOS NUMBER MORS POWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER New MvD. HP OVER INC. EACH OF THE RESIDENTIAL JP�R�O/P�E/RTT1Y�DESr-RIBED BOVE. / - SIGNATURE OF � 1/2 2 .50 .PERMITTEE z 5 1.00 1INSPECTION RECORD 5 15 1.50 15 so 2.50 50 200 5.00 200 500 10.00 J 500 1000 15.00 Z OVER 1000 20.00 M.G. SET/FREQ. CHANGER-HP WELDERS: AC-KVA 0 GENERATORS -KW TRANSFORMERS-KVA TEMP. MOTORS (75% OF ORIG.) A MOVBD MOTORS (75% OF ORIG.) i MISC. SIGNS r NO. NO. TRANS. - APPROVALS NO. NO. LAMPS FOR EACH PERMIT: DATE INSPECTOR'S NAME WIRING $1.00 CONDUIT FIXTURES $1.00 WIRING SUPPLEMENTARY .50 FIXTURES POWER TOTAL FEE $ No UTILITY CO, NOTIFIED _FINAL -1 c- 76A 663 OBS# SA. 4-52 I I 78A889•CE8088.89 APPLICATION FOR ELECTRIC PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING �� BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER CASSATT D. GRIFFIN,SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL 1N NEAREST PERMIT ES CROSS ST. OWNER ITEM NUMBER I EACH FEE MAIL OUTLET ' SW $ $ ADDRESS LIGHTS .RECEPT. . .IO O LIGHTING FIXTURES f0 a CITY TEL.NO, p� ELEC.RANGES CLO.DRYERS ELECTRICIAN y67A-...� / WATER HEATERS .50 ADDRESS �/�,70 /T64/BLq.4 1C ELEC.SPACE HTRS. DISHWASHERS CITY sdVL TEL. N0. / +J'11r,0 GARBAGE DISPOSERS AUTO.- STATE ) /��•�► WASHERS STA.COOKING UNITS .25 LICENSE NO. % LV MOTORS: OVER INC. H.P. - DISTR"CT NO. IG OUP I ZONE `P ESSED BY 0— 1/2 25 S 1/2- • 2 .50 INSPECTION RfCOR6 2— 5 1.00 5— 1S 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. y i WIRING PERMIT 1.00 Q FIXTURE PERMIT 1.00 0 SUPPLEMENTARY PERMIT .50 I TOTAL FEE $ �� 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. WIRING I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT 1 MX HE AL WNER HE ABOVE DESCRIBED RESIDENTIAL ROP RT" POWER SIGNATURE UTILITY CO.NOTIFIED '"T OF PERM ITTE FINAL +' '�f�9�I � °•• .{f .Y'.,� 6� OFATION ARTHUR C.VEIT, SUPERVISING ELECTRICAL ENGINEER CK MO CASH 2.8 C (,0 3 47 4 i; OCT 2 A WORKERS' COMPENSATION DECLARATION 10/81 APPLICATION FOR ELECTRICAL PERMIT !0'I here Sy 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 y� Certified co s hereby furnished ADDRESS 9 !/ PY Y New Residential Bldgs & Pools EACH NO FEE I mN sm N��9 ❑ LOCALITY Ceftified copy is filed with the county building inspec- 1 & 2-Family, Sq Ft $ — $ ltJt?Z �/ T tion'department. Multi-family Sq. Ft CROSS ST. Residential Swimming Pools ! �! Date Applicant % ; s ORM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' OutMAIL o / lets: Rec Light Sw._ i 7 AO�Y 6, - COMPENSATION INSURANCE ADDRESS First 20 --�-� ry (This section need not be completed if the work involved by Total No Additional CITY /fid? K 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 Lighting Fixtures First•20 ADDRESS / Total No. Additional _ CITY A ITel No Date Applicant Fixed Appliances Not Over 1 HPPERMIT LP 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 — deemed revoked Hood _ Fan >Other_ CITY Tel No. LICENSED CONTRACTORS DECLARATION' 'LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. Room Air Cond. REG NUMBER Class. (commencing with Section 7000) of Division 3 of the Business DISTRICT NO PROCESSED BY and Professions Code,and my license is in full force and effect Power Apparatus& Large Appliances > Size &Type HP, KW, KVA, or KVAR' 0 License Number Lic Class Up to 1 Incl. FINAL V Over 1 to 10 Incl DATE VALID ION 0 Contractor Date Over 10 to 50 Incl ❑ FINAL ; I am exempt under Sec Over 50 to 100 Inc. BY W CL B.&P C. for this reason Over 100 Z Date Serve Swbd., MCC 8 Panel oords 0 - 200 Amp. Under 600 V Signature 201 - 1000 Amp Under 600V ❑ Over 1000 Amp. or Over 600 V 91 6 7,OA Exemption for Reg. Maint Elect SINGLE FAMILY Temp. Power Pole &Appurtenances `# o o o,o o 2 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit n,n r _ n �I ( o o 2.5,55 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 1 0 0 0 2 5 5 0,5 Pryryr77o��fessions Code): (I , ILEI I, as owner�of the property, will do the work and the Misc Conduits&Conductors, 0�j V 031 2,=85 structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ 7044, Business and Professions Code) , g 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 C_ 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 authorize representatives of this County to enter upon the above-mentioned roperty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE F :5- Ix�B�� Signature o r rttee Date