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HomeMy Public PortalAbout5053 FRATUS DR_Electrical__ 7SA663 DSS SA 11-SO APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELESELECTRIC 1 WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRICIAN j1'� al inn RECEIVED BY READY FOR DATE ISSUED ADDRESS .9j1 ';4 N- Angci A. S-h. If} ,� FIRST INSPECTION �� CITY $a.Y1 Cr]b TEL NO AT 68583 COUNTY LICENSE NfiJ.04 EXPIRES BUILDING PERMIT FEES ADDRESS 5053 Fratus Dro FEE Temple City NUMBER EACH LOCALITY LIGHT OUTLETS NEAREST CROSS ST. RECEPTACLES WALL SWITCHES OWNER Bo Eo Turner TOTAL OUTLETS 5C $ rrI-(J MAIL ELEC RANGES 25 ADDRESS ELEC HEATERS 25 CITY TEL. NO. FIXTURES 'S I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS MI5C 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 I CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWERFEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER NEW MVD HP OVER INC EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. �!✓ I/2 6 LESS $ 25 SIGNATURE OF I/2 2 .50 PERMITTEE 2 5 1 DD INSPECTION RECORD 5 15 1 50 15 50 250 SO 200 Soo _ 200 Soo __ 1000 �I Sol] 1000 1500 Q Z OVER 1000 2000 M G SET/FREQ CHANGER-HP Q' WELDERS. AC-KVA O GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF ORIG) MOVED MOTORS (75% DF ORIG.) MISC SIGNS NO NO TRANS APPROVALS NO NO LAMPS FOR EACH PERMIT DATE INSPECTOR'S NAME WIRING $1 00 CONDUIT /' j l!/1 FIXTURES $1 OO WIRING ,U(f � tl SUPPLEMENTARY 50 FIXTURES POWER J TOTAL FEE ¢�' v UTILITY CO. NOTIFIED ✓ FINAL ^ �y�SG' 76 WORKERS'COlvft�ENSATION DECLARATION CE 806G (2 80) - APPLICATION , FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY insure, or a certificate of Workers'Compensation Insurance,or C�� a certified copy thereof(Sec 3800,Lab C) 11 li FOR APPLICANT TO FILL EACH_ JOB NO FEE ADDRESS Policy No Company �����"+� �r'`� �— New Residential Bldgs'&Pools Certified copy is hereby furnished �� �- 1 &2-Family,Sq Ft $ — $ LOCALITY L f l i n': Cf,, Multi-family Sq Ft NEAREST Certified copy is Bled with the county building inspection CROSS ST departmentI Residential Swimming Pools OWNER OR n n ` / ✓1 1 Date /— Z&plicant 6/424 /I y/ FIRM NAME Outlets Rec��Light I Sw 20 Z1V ADDRESS �� � I J S �� CERTIFICATE OF EXEMPTION FROM WORKERS' ] ' First io COMPENSATION INSURANCE Total No �� Additional CITY / CIi Tel No�$�— �,� 7 } PLAN CHECK �r 7�ldl (l Q� APPLICANT Q C',� F., (�1--��� U ,/,mac,-y� (This section need not be completed if the work involved U by the permit is for one hundred dollars ($100) or less) Lighting Fixt First 20 ADDRESS 7/ _ I !r X Total No Additional I certify that m the performance of the work for which this Fixed Appliances Not Over 1 HP CITY U v f � )l[_ Tel No " 63 s8' 7 � permit is issued, I shall not employ any person in any manner PERMIT /— I V so as to become subject to the Workers' Compensation Laws Range_Heater_D W _ APPLICANT Oven _ Dryer_W M ADDRESS r �7 5 c7 hC'l Z Date Applicant Top _ FAU _W Hi� � Hood _ Fan _Other_ CITY W 1— Tel No X ib/ j NOTICE TO APPLICANT If, after making this Certificate of Disp _ Room Air Cond_ LICENSE OR -- r Exemption, you should become subject to the Workers' REG NUMBEPd-56 q>/ Class / Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO PRVE with comply with such provisions or this permit shall be deemed revoked Size&Type HP,KW, KVA,or KVAR , Up to 1 Incl FINAL Over 1 to 10 Incl DATE VALIDATION LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl ©� C� I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc FINAL f 9 (commencing with Section 7000) of Division 3 of the Busi- Over 100 BY ' ness and Professions Code, and my license is in full force and effect Services License Number ^ Lic Class I 0-200 Amp Under 600 V � .�J�,.,. T� 201-1000 Amp Under 600 V 2 3 7 G 0 A �r7 Contractor 1144 CF'—&I /"dd�y1\1 Over 1000 Amp or Over 600 V HOME OWNER-BUILDER DECLARATION # o�0 0 0 0 'Z Temp Power Pole&Appurtenances I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit 2 0!0 2 3 3 0 License Law for the following reason (Section 7031 5, Busi- Additional Sign Branch Circuits = 0;0;o 2 3,3 0 ness and Professions Code) Misc Conduits& Conductors 04 2 3—8 2 D1, as owner of the property, will do the work and the Other (See Complete Fee Schedule). structure is not intended or offered for sale (Section 7044, Business and Professions Code) CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is PERMIT FEE (Sub-Total) issued(Sec 3097,Civ C) Lender's Name PLAN CHECKING,FEE (One-Fourth Permit Fee) i Lender's Address PERMIT ISSUING FEE 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 property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Signature Permittee Date t