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HomeMy Public PortalAbout10868 FREER ST_Electrical__' 75A663-LAO5 a-sa APPLICATION FOR ELECTRICAL PERMIT 'COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS L 6 r JOHN A. LAMBIE, COUNTY ENG1N[iRINEAREST -1-� /� j COLEMAN W. JENKINS, SUPIMM -KNDKNT OF 19USLDING LOCALITY ,o r C l ' (j` i ^ 1 FOR APPLICANT TO FILL IN CROSS ST. fCAC FE OWNER400'IZ• �I ! RECEPT.E Q fj C {j 1 LIGHT TOTAL FIRST 20 .20 ADRESS SWITCH_ OVER 20 .10 CITY Cbl TEL. NO. ddb PLAN CHECK LIGHTING TOTAL FIRST 20 .20 APPLICANT FIXTURES OVER 20 .10 ADDRESS RANGE_DRYER—WTR.HTR.— CITY TEL. NO. STA.COOK_01SP.—F.A.U._ CONTRACTOR SPACE HTR AIR COND. ADDRESS CLOTHES WASH—DISHWASH_ CITY TEL. NO. FAN—OTHER 1.00 LICENSE NO. - CLASS. MOTORS,TRANSFORMERS RATING IND. HEATERS, ETC. HP. KW. KVA. I HERESY ACKNOWLFDSi THAT I HAVE READ THIS APPLICATION SIZE h TYPE OVER TO AND $TAT[ THAT THE ABOVE IS,CORR[CT AND ASREE TO COMPL• WITH ALL COUNTY 0 DINANCES"AND STATE LAWS-R kSULATINS ELECTRICAL WIR IN . 0 - 1 1.00 I HEREBY TIF THAT I AM PROPERLY REGISTERED AMD/011 1 - 10 9.00 LICENSED ]RED BY LOS ANGELES COUNTY AND STAT OF CA LI FOR MIA R THAT I A1,1 T LES AL N[R OF, A E O 10 - 50 5.00 RKSIDE I THE ASO V[ GRIPED EMT PRO RT SO - 100 10.00 OF PERM TE�� p 100 - 800 15.0 r DISTRICT NO-1 GRO ZONE PIRLD.CESSED BY LLJ SIGN,GAS SIGN AND ONE CIRCUIT 9.00 -Z N TUBE, OR Z MARQUEE ADMTION/1L CIRCUITS 1.00 NOTES: SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 SERVICE OVER 600 VOLTS OR 200 AMP 5.00 TEP SS:RVICE,.POLE, &APPURTENANCES 9.00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP. POWER POLE UNDERSLAB WORK ROUGH CONDUIT WIRING PERMIT FEE (SUB TOTAL) FIXTURES PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED zz PERMIT ISSUING FEE 2.00 Z UTILITY CO.NOTIFIED_ SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL TOTAL FEE �Q JOSEPH C. ROOHAN SUPERVISING ELECTRICAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. AS tflfn9893Q� KRY 9 D 5.6.0- V BACK QF APPLICATION FOR COMPLETE FIZ SCHEDULE ( 1 i:hIsc Aooil P 1 1 ' lam t l l 1 1 ' ;rrti So i• •,. • ®ORM ' 1 I :i: 1 RXIIIIII k p 10 1111 1 1 1 1 ' , "1 ' ��. M ' M�EM�■��©■ .J. ori AN ■■■■■■■■■� -M■NEM■■■■ -■■NEEM■■■■ ■IMMMM■■M■M■ ■ � . ■M■■■■M■M■ IN �M■■■■M■■MM■ ` �MM■MMM■MMM•■ MIMEM■M■■■■MMM■ CMN■■■■■■■■■ :PEEVE , :!NM I MINE !E O � MINE !EE AMWAVM WORKERS'COMPENSATIONDECLA" ON CE-88ftG (2-11� APPLICATION' FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY inure, or a certificate of Workets'Compensation"utance,or r a certified copy thereof(Sec.3800,Lab.C.) FOR APPLICANT TO FILL IN JOB Policy No. Coilupany EACH NO. FEE ADDRESS ❑ New Residential Bldgs.&Pools Cartined copy is hereby furnished. 1 &2-Famlly,Sq. Ft. _ — $ LOCALITY ❑ Multl-family Sq. Ft. Certlfied copy is filed with the county building Inspection CROSS ST 2Q/ d9Partment. Residential Swimming Pools OWNER OR Date Applicant / FIRM NAME Outlets: Rec,LLight iS1 [�Q MAIL FFFF ADDRESS CERTIFICATE OF EXEMPTIOr4'FROM WORKERS' Total No. 14;1, Additional CITY Tel No._ COMPENSATION INSURANCE PLAN CHECK (This section need not be conspfeted if the wort tnvotved APPLICANT 8 by the pemitt it for one hundred douses (5100) or lees.) Lighting rIxtureairst20ADDRESS �V Total No. S Additional0 rso I certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY,------ ITY Tel No. W permit Is issued,I thall not employ any pen in any manner PERMIT to as to become subject to.the Workpn' Compensation Laws. Range_ Heater_D.W. APPLICANT // � _ / Oven _ Dryer_W.M._ ADDRESS Date�[� Fy�/Appllcant •W`-�.� Top _ FAU _W.H. ' Z ����GGGS Hood Pen _Other_ CITY Tel No. NOTICE TO APPLICANT: If, after making this Certificate of Dlsp. _ Room Air Condom N R Exemption, you should become- subject to the Workers' REO.NUMBER Claw Compensation provisions of the Labor Code, you murt forth- Power Apparatus& Large Appllences 3ED B'f, *ftdeeType ,or deemed revoked.m comply with such provisions or this permit shall be deeSlze&THP,KW, KVAKVA ' Up to 1 Incl. FINAL LICENSED CONTRACTORS DECLARATION Over 1 to 101ncl. DATE [�/ VALIDATION Over 10 to 60 Incl. J— I hereby affirm that I am licensed cinder provisions of Chapter Over 60 to 100 Inc. FINAL 9 _(cbmmenCing with Section 7000) of Division 3 of the Busi- Over 100 BY nes& and Profeasions,Code, and my License Is In full force and effect. Services 0-200 Amp. Under 600 V License Number Lie. Clare 201.1000 Amp. Under 600 V Cohtrector Date Over 1000 Amp.or Over 600 V HOME OWNER-BUILDER DECLARATION Temp. Power Pole&Appurtenances I hereby effh-m that I am exempt from the Contractor's Sign with One Branch Circuit r License Law for the following reason (Section 7031.5, Bud- Additional Sign Branch Circuits news and Professions Code): Mime.Conduits&Conductors 4 6 a 7 A I, as owner of the property, will do the work &nd the Other (See Complete Fee Schedule)—.� structure L not (mended or offered for sale (Section #'0'0 0 0 o 2 '7044, Businm and Profesaions Code). . , . CONSTRUCTION.LEN DING AGENCY 2.e 0 1 75 0 I hereby affirm that there Is a construction lending agency for the performance of the work for which this permit is PERMIT FEE (Su o 0'0 .7.5 0 5 issued(Sec. 3097,Civ.c.>W/� 3 Lender's Name / PLAN CHECKING FEE (Ona-Fourth Permh Fee) 0'& 0 9 2 Lender's Addfess�/ 4 PERMIT ISSUING FEE I certify that I have reed this application and state that the TOTAL FEE aboye Information L correct.I agree to Comply with all County ordinances and State laws regulating Electrical wising, and hereby authorize representatives of this County to enter upon the abovementioned property for inspection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE ignature of Permittee Data '"°' C°'y'PE"8A11O''° a' ATK)1`4 � '°. APPLICATION FOR ELECTRICAL PERMIT I hereby edftan th&t I have a carlicate of cone«rt to setl h& G, or a oertffionie of Wwicars' Compensation Insurance;of a ceiifw COUNTY OF LOS ANGEL.DS BUILDING AND SAFETY copy thereof(Sec 3800Lab.C.) �- Polho Na %n r, } co" L 3 L t t+i+� FQFI APPLICANT 7C�FILL IN JOB © CerWW copy b hereby furnlatredEACH Na FEE AIDRFM, f 2S iti 7 Newt I�edderttiel Bldpa S.Pbde cerltried Dopy Is filed with the My buAding tzpaction 1 a 2-FamBy,Sq•Ft_t flT + 3 — ffi LocWry dePWV-Tt y� tvtH-famfySq.17L' — NEAREET %p Date % r '3 ,- APPI1ca�lt , --- RAelderttiel Swimming Poole ^ CiWtER OR E!W NAW CERTIFICATE OF EXEMPTION FROM WDRS MAL COMPENSATION INSURANCE Deets Rao�_I#rt—sw. �- . IEST ���' r A C. k (fhb NIoCtiOm nMd not be com�M tt»wor)c Irtvotved by tip Flrist 20 t M Totsl No. Additlonel CtfY i,. >`L'1' rel,Na perni for orm hundred do[* (S1Q0) dr$aM} . PLAN CHECK I certffy that h the pwfmmmnce of the work for wfiicfl th!a M-rrg APPLh In Wane(i.I she➢ riot ertpicy any perbon lh any manner so of to become eub)eot to tf-*mrkers'C,omPeneation Lawd- Li�rtlng lIxt red' Rost 2a ADDRESS m , AckNonal �(e4*fbarrt -Totbl No. CfIY Tel.No NMGI TO APRJC.ANr: H, after mok fhb Cei-(fficafa. oW F6ed Appllenoee Not Over 1 I� PST Range—xmptton,you shodid become sub}6ot to the Vkrkslrs'.CAmpeaearion Heet D.W. APPLXN�T Em provfeiorm bf the Labor Code, you most fb&m4th cm* With 40' _Oven Dryer W.M._ ADDRESS �y } � �.A,-if,�- tam Jit,`1, Vfaioris proor this permit ahall be,de9nie�revoked Top FAU W.FL UCENSED COWMAMRS MCLi RATION J-bod Fan Other_. ,Y CTy G vic R� �T-L Na ' 119ereby affirm that I am pcQneed under prwbtmb of Chapter B bisp.. Floonl AIr Cord, ' 1, LrENSE . (cofnnwdn�with 8ecbm,7008) of Wsico 3 of tfle &rheas and - REQ ProfeealoFe Code,and my 6eerk}e to d1 furl force sort Off tPower APPa�d Large Apolancee Dt3TRiCT NO. i � ,, yBy C3. Stze d Type HP,KW,KA or KNAR License NumbQr A °n r Lio.Ciaas�—� T_Up to 1,Ind. FINA7_ ' 0%W 1 to 1 P ind. DATE _ r• - } CEXItr'aCtm r...+" Uara .. . r Over 10 to 50.110J.. .' FINAL E I e exempt under Seo. i Over 60 to 100 Loc. BY RAP.C.for thb reason 7tif- 11 p%*.100 I p - 5A ( Services,Swbd.,MCC,,&Panelboerda ba{ 0-.2W Amp.Ander 600 V: siatrue �:^ �-�� 201 - 1000 Amp.Under 000 Y Over 1000 Amp.or Over 600 V i Exernptfmi for Reg.NWnt Elect BINDLE FAMILY Temp.Power Pole h Appurtenances HOME OWN"ER--BUILDER DEC1_ARATK�N 4 I hereby aff-thet I am exempt from the Contradtor`6 LSoenae Law gn with Oche Bram Clraft for the fbibwirg reeeo(i(Section 7G3 1.6.Businees and professions Additimrai Sign.Rranch Ciraits „ Code): do thQ work a owner Mleb•ConduRe& Gror0,ctora I as d the property,wio grid the structure Other{See CampkAe Fee Saheduie) b not Intended or,ofiered for sale (Section 7044, Buaineee �i And,Pro(easlorw Code).' f OVA•L CONSTRUCTION LENDING AQENQY ri. LA I hereby afl rm that there b a construction Wnding fperrry for the' ' perio n--of the work for whioh thb permit IS"Jed JS ac.X097, PERMIT FEE (Sub-TotAq Civ.C.). yt PLAN CHECKING FEE L.erKWa Address PERMrr I$SUINQ Fl I owdfy thEd I Gave read this am&l aHon end state thet the above TOS FEE ' Infmmathn la correct 1 agree bo bonpfy wfth•a➢ County'adlnanoes atld State law® fequiat#ng Eleotrioaf.wiring, end hereby authortze repmeerr tfvee-of•thb County to enter upon the above-memdxled ptjrp? J SEE REVERSE FOR EXPLANATORY LANGUAGE re of Permittee Pete