HomeMy Public PortalAbout9409 GARIBALDI AVE_Electrical__ ' d-806'(1-1 7% APPLIC010N fOR EU08CAI PEOMIT .
` COUN'.Y OF 105 ANGELES _ BUILDING AND S%11=EfYt
r. FOR APPLW-ANf TO FRl rNJOB
New fde 6ntlal BLdgL 3 ftooff EACH NO.- FEE A
- DD
1 &2-Family,Sq.Ft. � $ .025 $ LOCALITY _
MuItL-family Sq,'R. 02 -
RasldQntlgl5 Im7-77
m.I Pools 25. 0
Outlets
M&NAME
First 20� Light�` Sw��. _. .,•50 D L
-
RM
•--Total No, - Additional .30 CrtYEC ' TeL No - _
LIRN
Lighllri Fixtures Fiat 20 50 AflDRE55
AddRlbnal 30.
Total No:' C1TY - Tel. No.i7iY
Flxe4-Appllantes Nof-Over l--HP
APPLICANT
Rarl'ge_Heater D.W_ -
-.Win—Drypr W�C�' - ADDRESS -
Top ',FAU W.H._ _ -' Q -Tel No.; —
�Hooci on _Other_ LICENSE OR
.4Isp.—ROOMKir_c-p9d._ + r.-- - 2.50 REG.NUMBER O
I'HER�Y ACKNOWLETIGE THAT'HAVE READ THIS APPLICA-
Power Apparatus S Large Appliances TION ANO $T?,TE PIAT THE ABOVE 1�CORRECT'AND AGREE TO
Sim T HP, KW,KVA,or KVAR QOMPLY Wf7H ALL COLNW`ORDINANCES -AND-STATE_LA4�S
ype- 2. 0 REGULATING aEC7JCAL WIRING.
Qp to 1 jod:_ -i-HEREBY-CERTIFY THATt AMMXO-E LYREGISiERED7MD7OR
Over 1 to 10 Incl. 5.00 UCR45ED AS REQLIIRE�-BY LC ANGELES COUNTY AND STATE OF3. .
Over-10 to 60-Ind: 12.50. _ CALIFORN OR•TH1T L AM lEGAL_0.�NFR_OE.,THEABQVE
D � 3E] TIAL PRO PE
Ovpr 50 to 100 Ind 25.00
40.00'- - PERMTEE - - -
Ove7' SIGNATURE
D RICT NO. PR�B�
0-200 Amp.Under 6001/ 12.50 {
201 11000 Amp. Unden600 V 25.00
Over 1000Amp.*ordver`600 V 50.00
Temp. Power Pole&Appummbhce,; .10.00'
S n with One Branch Circuit 10.00 -
' lg
AddItlonal Slgn BranchCircults 2.NIN5PECTION >
a Coc Co tiduRs drectors _ ON REVERSE INFbRMAT10N
1 .00 $fl b�,7 A
Mh
Other(SwComplete Fee Sd)eduIel `
SIDE �. # °"0-01010°!o ° 2
2oP12fl0
PERMIT FLE 15u6-Total) ` _#J.. ° Q ° 1 2006
R1AN CHECKING FEE (One-FourtKNrm{ Feel_ _. Q 016 1 1.._8 0
P"T ISSUING FEE $7.00 C
TOTAL FEE O Q >
INSP FINAnLED
dater { BY m+
R
75AO53-CEBOB 1/70 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER 13UILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. L.AMBIE, COUNTY ENGINEER LOCALI
COLEMAN W. JENKINS u T OF UILDING
NEAREST
FOR APPLICANT TO FILL IN C R OS 3 ST.
OUTLETS NO, Y.ACHIIF[
OWNER
RECEPT._ MAIL
FIRST 20 2p ADD
LIGHT TOTAL
CITY TEL.
SWITCH_ OVER 20 1p
PLA CHECK
LIGHTING TOTAL
l FIRST 20 201
APPLICANT
FIXTURES �10 Jl(
OVER 20 ADDRESS
APPLIANCES CITY Ao,
PERMIT
RANGE DRYER_WTR. HTR._ APPLICANT
STA. COOK DISP. F.A.U. ADORES
f
SPACE HTR. AIR COND. CITY EL. N
CLOTHES WASH. DISHWASH. LICENSE NO. CLASS.
FAN OTHER 10o I HERESY ACKNOM THIS APPLICATION
AMC' STATE THAT THEABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS MTIMS WITH ALL COUNTY ORDINANCES AND STAT[ LAWS REGULATIMS
IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING.
SIZE TYPE OVER TO
I HEREBY CERTIFY THAT I AM P11 OP[R LY REGISTERED AND/OR
0 — 1 1D0 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR TLLL{H�AT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN, THp ABOVE ESCRI ED RESID TIAL PROPERTY.
1 - 10 5.00 1
SIGNATURE 0
10 - Sb 0.00 OF PERMITTEE V
30 - 100 IODO DIST TNO. to GROUP ZON P C BY OC
100 - 500 1 B AK) ,�, (� lIr
SIGN, GAS SIGN AND ONE CIRCUIT 3.00 NOTES: Ual d
N
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1D0 ?
3ERV1 CENOTOVER 6DO VOLTS OR 200AMP
APPROVALS DATE UftECTOR'S SNRMTIlRE
SERVICE OVER 600 VOLTS OR 200 AMP BDo
TEMP.POWER POLE
TEMPSERVICE,POLE, &APPURTENANCES SDO
UNDERSLAB WORK
T GHT OR RECEPT, SYSTEM BDo
ROUGH CONDIUT
WIRING
FIXTURES
PERMIT FEE V (SUB TOTAL)
POWER AUTHORIZED
PLAN CHECK FEE (50% PERMIT FEE)
UTILITY CO. NOTIFIED
PERMIT ISSUING FEE
FINAL
SUPPLEMENTARY PERMIT LSDUING FEE 100 JOSEPH C. ROO A
TOTAL FEE SUPERVISING ELEC I LENOINEE
PLAN CHECK VALIDATION
CR. M.O. CASH PERMIT VALIDATIO CK. .0. CASH
Lko 5 a Q FLAY 5 2 D 6.0 oN Q
■E[ BACK OF APPLICATION FOR COMPLETE SCHEDULE
r
WORKERS'COMPENSATION DECLARATIPN 7&6.643 10/81 PLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I have a certificate of consent to self + ,
Insure, or a certificate ef.Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY
or a certified copy thereof (Set. 3600, Lab. C.)
Policy No. Company POR APPLW_&NT TO FILL IN
Certified copy Is hereby fumishad. New Residential Bldgs. & Pools PACJ NO. FEE
El Certlfled copy is filed with the county building Inspec- t &2-Family, Sq, Ft. _ — 1 LOCALITY • �y `
tron,department. Multi-fomlly Sq. Ft. CRCSS NEAREST
Residential Swimming Pools CWMER OR
Date Applicant RM NAME
CERTIFICATE OF EXWPTION FROM WORKERS' Outlets: Rec�Ight_kSw. MAILADDRESS
GOMPBJSATION INSURANCE . Fiat 20
(This section need not be compYerted If the wcA Imrohred Ey Total No- Additional FEY Tel. rlo,�
the permit V for one hundred dollars (=100)or less:) PUN cHEfJC
I certL that in thew performance of the work for which this APFLrCANT
permit Is Issued, I sholl'hot employ any person Ih any manner
so as to become subJ6cf to the Workers Compensation Laws. Lighting Fixtures First 20 ADDRESS
Total No. Additional _
CFTY Tel. No.
Date ATplicant Elxed Appllonoes Not-Over 1 HP PERMIT
NOTICE TO APPLICANT: If, after making this C6rtlfIcGt6 ofAPPLHqANT
Exemption, you should become subject to fhe Worker' Rgnge— Hgqtpr_D.W. ,
Compensation provisions of the Gabor Code, you must forth- Overt — Qryer — W.M.— ADDRESS
with,
comply with such provisions or this permit shall Eje Top T FAU W H, — CITY T61. No.
deemed revoked. Hid Fan _Z_Othor—
- UCENSFD CONTRACTORS DECLARATION IB
LM OR
I hereby affirm that I am Ilcenaed under provisions of Chapter 9 fllsp. Room Alr Cgnd. REG NUMBER Class _
(comrYierking with Section 7000) of Division 3 of the Buslnets DISTRICT NO. BY
arld Profeglons Code,and'my license Is In full farce andeffect. PO��Apparatus 8 Lorge Appliances
Size d Type HP,KW, KVA, or K`/AR'
License Nembar I Ic. Class Up to 1 Incl.. FINAL {J
Ovef 1 to 10 Ind. DATE r � 4- VAUDATFON O
Contractor Date Over 10 to 50 Incl.
Q I am exempt under SeG• Over 50 to 10
FINAL
, 0 Inc. BY ILB.SP.C. for this reason fiver 100
Servlcesr Swed.,MCC 8 Panelb�orcis
`
Data: 0 -200 Amp. Under 600 V
Signature 201 - 1000 Amp. Under 600 V
❑ Exemption For Reg. Malnt. Elect. Over 1000 Amp. or Over 600 V
SINGLE FAMILY Temp.bower Pole &Appurtenances.
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuli
I hereby affirm thgt I am exempt from the Contfactor's Lloer%e
Law for the following reason (Sectlon 7Q31.5, Bwlneu and Additional Sign Branch Circuits
Professions Code):
29084A
1, as owner of the will do the work and the
Misc. Conduits&Conductors '#'
properfy, o o;o 0 0
structure Is not Intended 4r offered for safe jSectlon Other (See Complete Fee Schedule) I
7044, Business and Professions Code). , 2 0 - 3 1.26
CONSTRUCTION LENDING AGENCY e10 3 1,25-5
I herebyaffirm (i there In a construction lending agency for
the perFormpnce the work-for this permit Is Issued PERMIT I$ (Sub-Total) 0 1. 1 4—8 3
(Sbc. 3097, CIV. C.).
PLAN CHECKING FEE
Lenders Name
PERMIT ISSUING FEE
Lender's Addr
I certify the a read this a on and Efate that the TOTAL.FEE
above Ihformation Is correct. I ooree to comply with all County
ordinances and State laws regulating Electrical wiring, and
hereby authorize representatives of this County to enter upon
M 4thea ,,antIan operty for Inspection rposes. SEEREVERSE FOR EXPLANATORY LANGUAGE
e of Perm) Date