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Home My Public Portal About10534 FREER ST_Electrical__ •76A663 OSS 5A 7-51 APPLICATION FOUR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES ELECTRIC 1 WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRI O. GROUP ZONE PERMIT NO. 5 0L ELECTRICIAN E iVE BY REA FOR DATE ISSUED ADDRESS FIRST INSPECTION CITY TEL. NO. _ COUNTY LIC NO. EXPIRES BUILDING PERMIT FEES ADDRESS FEE �� NUMBER EACH LOCALITY LIGHT OUTLETS NEAREST CROSS ST. RECEPTACLES WALL SWITCHES OWNER TOTAL OUTLETS 56 $ MAIL �►, - ELEC. RANGES 25 ADDRESS ELEC. HEATERS 25 CITY J, -0p , TEL. NO. V FIXTURES B �s 1 HEREBY AND 1 HAVE READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE 18 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 LOB NUMBER HORSEPOWER ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER FEE NEW MVO. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DEBC IBE ABOVE. V2 a LESS $ .25 SIGNATURE OF I/2 2 .50 PERMITTE 2 5 1.00 INSPECTION RECORD 5 1S 1.50 . ` - Z 15 50 2.50 50 200 5.00 200 600 10.00 500 1000 15.00 Z OVER 1 000 20.00M.G. BET/FREQ. CHANGER-HP WELDERS: AC-KVA O GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORB (75% Or ORIO.) MOVED MOTORS (75% OF ORIG.) MISC. SIGNS 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 J _ TOTAL FEE $? =� UTILITY CO.NOTIFIED FINAL WORKERS'COMPENSATION DECLARATION 76-663 10/81 APPLICATION`I=OR ELECTRICAL PERMIT I hereby affirm that I have a.certificate of consent to self insure, CE-806G or a certificate of Workers' Compensation Insurance,,or a certified COUNTY OF LOS ANGELES BUILDING,AND SAFETY copy hereof-(Sac 3800,Lab.'C.) Policy No Company, FOR APPLICANT-TO,FILL IN JOB 5 /G) F-1Certified copy is hereby,furnished. New Residential Bldgs & Pools• -EACH .NO,l FEE ADORES El':Certified copy is. filed;with the county building inspection 1 & 2-Family,Sq Ft $ - — $ LOCALITY, department Multi-family Sq Ft NEAREST r>:j i, Residential Swimming Pools CROSS ST C("j�Sf OWNER OR Date' Applicant " * FIRM NAME AS-SVP L► p� CERTIFICATE OF,EXEMPTION FROM WORKERS' Outlets Rec Light Sw. MAIL M �1 /��/i, COMPENSATION INSURANCE. ADDRESS � YJ 7�T�'r✓ This section need not be completed if the work involved b the First ion ( P y CITY Tel N .. permit-is for one hundred dollars,($100) or less.). _ ;Total No • Additional PLAN CHECK I certify that in the,performance of'the wo k for which-this.permit APPLICANT s issued, I shall not employ any person ' a manner,so as to , become subject to the Workers',Comp s' a Lighting Fixtures First 20 ADDRESS_ �/� Additional c Total No. -• CITY � Tel No Date � f� Applicant ' NOTICE TO,. APPL ANT If, after a , is ertificate of Fixed Appliances Not Over 1 HP -PERMIT Exemption,.you shou become"subfect t the Workers'Compensation Range= Heater_ DN/_ 'APPLICANT s provisions of the Labor'Code, you'mus forthwith comply with'such Oven _ Dryer W M._ ADDRESS /' CltiTa provisions or this permit shall be deem d.revoked. Top — FAU W.H. LICENSEb CONTRACTORS DECLARATION CITYMnrAV Tel N Hood Fan Other_ Ihereby affirm that I am licensed•under provisions of Chapter 9 LICENSEOR, '(commencing with Section 7000) of Division 3 of the"Business and Disp.- — Room Air Cond' REG NUMBER - Class Professions Code,and my license is in full fdree and effect:` DISTRICT NO PROCESSED BY Power Apparatus& Large Appliances Size& Type HP,KW,KVA,or KVAR O 0 License Number Lic Class Up to 1 Incl + FINAL 0 Over 1 to 10 Incl DATE VALIDATION Contractor Date Over 10 to'50 Incl U ❑ FINAL.. I am exempt under Sec Over 50,to 100 Inc BY W v B&PC for this reason' . , Over 100 / � Services,Swbd,-MCC& Panelboards Z Date. 0- 200 Amp Under 600 V Signature 201 -,1000 Amp Under 600 V ? F-1Exemption 1000 Amp:or Over 600 V Exemption for Reg Maint.Elect. SINGLE FAMILY,, Temp.Power Pole& Appurtenances t'] 2 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit AC I hereby affirm that I am exempt from the Contractor's License Law 6 for the following reason (Section 7031.5, Business and Professions Additional Sign.branch Circuits.. PWCTs7 Code)'. 3307 25.5U I,as owner of the property,will do the work,and the structure Misc Conduits & Conductors 1 ITEPI5 is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) and Professions Code) TOTAL 25,.50 CONSTRUCTION LENDING AGENCY CHECK 25.50 performance m the where is a construction lending agency for the CH**E ' I hereby affirm that they l�E .� for which this,permit is issued(Sec 3097, PERMIT FEE (Sub-Total) Civ C). PLAN CHECKING FEEe89 Lender's Name =-=I 8/' 3/89 PERMIT ISSUING FEE Lender's Address 4872 1 PM12:18 � • ,, � � -, , I certify that I have read this application and state that the above TOTAL FEE �,,,� O information-is correct I agree to comply with all County ordinances _ andState I s ulating Elegtgcal wiring, and hereby authorize representati es t enter upon,the above-mentioned . property to a ses. • SEE REVERSE FOR EXPLANATORY LANGUAGE Signatu• of ermittee Date 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 Certified copy is hereby furnished New Residential Bldgs. & Pools EACH NO FEE ADDRESS Certified copy is filed'with the'county building mspec_ 1 & 2-Family, Sq Ft. $ — S LOCALITY—NEAREST OCALITY tion department. Multi-family Sq Ft. L CROSS 9T Residential Swimming Pools <<v `' )� Date Applicant ;i�', f ,�° t'• FOWNER OR,IRM NAMEf' CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec Light Sw MAIL COMPENSATION INSURANCE i nd ADDRESS "(This-section eeriot bco ' e e m letedif=th 'work involved b First 20 p Y Total No CITY Tel. No. ,the permit is for one hundred dollars ($100)or less.) Additional ,I certifythat in the erforman'ce of the work for which this PLAN CHECK . P _ APPLICANT permit is issued; I shall not employ any person in any anner so-as to become subject to the Worker ' om �n Laws Lighting Fixtures First 20 ADDRESS Additional /Q��I'-t� �� Total No. CITY Tel. No Date / Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE.TO APPLICANT- If, after making, this Certificate of APPLICANT} 1d Exernpiion, 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 '?4-) ° `? with comply with such provisions or this permit shall be Top _ FAU —W.H: — t deemed revoked Hood _ Fan _Other_ CITY i4 00'e-2—W4 Tel. No ISS�-21 rj LICENSED CONTRACTORS DECLARATION LICENSE OR Dis Room Air Cond. T ��;i' Class. (_,-,o";,0 hereby affirm that I am licensed under provisions of Chapter 9 p'• REG NUMBER � ✓: ' ' �',o";+0 (commencing,with Section 7000) of Division 3 of the.Business DISTRICT NO PR C ED BY p ,and Professions Code, and my ficense,ts,in full force and effect Power Apparatus& Large Appliances- ' �• �. Size &Type HP, KW, KVA, or KVAR �/r leyU License Number b�f jLic. Class ' Up to 1 Incl. FINAL Over 1 to 10 Incl.. DATE VALIDATION . Contractor Date - T Over 10 to 50 Incl FINAL W ❑ I am exempt under Sec. Over 50 to 100 Inc. BY CL Over, 100 fn B &P C for this reason Z Date. Services, Swbd., MCC& Panelboards 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. #9,3129, SINGLE FAMILY Temp Power Pole& Appurtenances I a o 20 �0 HOME OWNER-BUILDER DECLARATION Sign with'One Branch Circuit o 0 0- ] Q I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits a Law for the following reason (Section 7031 5, Business and Professions Code)- , ❑ 1, 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)_ pop. 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 issued PERMIT FEE (Sub-Totcil) sd (Sec 3097, Civ C ) PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE 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 2_1 71 ordinances and State law regulating Electrical wiring', and here b. uthonze r r�yy airves of this County to enter upon t Fm o e- n e rdperty Inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE 47 igncture o Permittee Date T. WORKERS' COMPENSATION DECLARATION 76- 1081 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self insure, CE-806806G or a certificate of WorkersCompensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY cgp�y1 (Sed. SOO,Lab. C.) tt' p t Policy No. Company r f#� FOR APPLICANT TO FILL IN JOB /l �. is Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO, FEE ADDRESS $ — $ r LOCALITY ❑ Certified copy is filed with the county building inspection 1 & 2-Family,Sq. Ft. ..r y. %� / /E department. Multi-family Sq.Ft. — NEAREST CROSS ST. Date Applicant Residential Swimming Pools OWNER OR .G FIRM NAME "r: r. •!,_ - /'�...:_.L ;y'J CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL COMPENSATION INSURANCE Outlets:Rec Light Sw. ADDRESS ! =✓ ,`f - �;. +' ' (This section need not be completed'f the work involved by the First 20 p L Total No. Additional CITY=r.�', T61 0l4 X;4 permit is for one hundred dollars($100)or less.) �' 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 Additional Total No. CITY Tel.No. Date Applicant Fixed Appliances Not Over 1 HP NOTICE TO APPLICANT: If, after making this Certificate of PERAPPLICANT ,x a ` 1 IT Exemption,you should become sublect'�o the Workers Compensation Range_ Heater_ D.W. _ provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer W.M. _ ADDRESS provisions or this permit shall be deeiin0d revoked. Top _ FAU _ W.H. LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other_ CITY . Tel No, ll. I hereby affirm that I am licensed under provisions of Chapter 9 LiCENSE OR Disp. Room Air Cond. REG NUMBER Gass. CL (commencing with Section 7000) of Division 3 of the Business and Professions Code,and my license is in full force and effect. Power Apparatus& Large Appliances DISTRICT NO. PROCESSED BY O Size& Type HP,KW,KVA, or KVAR LL.I License Number Lic.Class Up to 1 Incl. FINAL J r;•; , i' / r�! DATE Over 10 to 50 Incl. FINAL Over 1 to 10 Incl. Contractor r Date '�" VALIDATION ❑ � I am exempt under Sec. Over 50 to 100 Inc. BY < B.&P.C. for this reason Over 100 d Services,Swbd.,MCC& Panelboards , "Date: 0- 200 Amp.Under 600 V W Signature 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 Law for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits Code): 4 ❑ -— Misc.Conduits& Conductors I,as owner of the property,will do the work and the structure is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) 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 issued(Sec.3097, PERMIT FEE (Sub-Total) ✓ Civ.C.). /G- PLAN CHECKING FEE e # Lender's Name PERMIT ISSUING FEE 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 this County to enter upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date