HomeMy Public PortalAbout9716 GARIBALDI AVE_Electrical__ 7.A,a DM.w-.7-SI APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY ELECTRIC i
COUNTY OF L08OS ANGELES
WILLIAM J. FOX, CHIEF ENOINtTIR 1
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMIT NO.
ELECTRICIAN _
/ REOEIV M BY READY FOR DATE IMUEA
ADDRESS � O / d CY .✓ FIRST INTPEOTION
CITY d. TEL. NO --da X#tA !/-3 �v
OUNTY LICENSE N0. 1711 impipme o<—3!0-,I—A-- BUILDIN■
PERMIT FEES ADDRESS
I" LOOALITI'
HUMMER EACH
LIBHT OUTLETIM MEAR EST
D IR ova R.
RECEPTACLES
WALL NWIT13HES OWNER
TOTAL OUT-ETA ISo MAIL
[L[0. RANBES 25 ADDRESS
[L[0. H[ATYRS 28 CITY TEL H0.
FIXTURES 5 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIB
M150. APPLICATION AND STAT[ THAT THE ABOVE 12 CORRECT
NUMBER OF LIBHT CIROUITM AND ABREE TO COMPLY WITH ALL COUNTY ORDINANCE■
MUMMER OF RECEPTACLE CIRCUITS AND RAT[ LAWS RYMULATINO CL[OTRICAL WIRINB.
MOTORS I CERTIFY THAT 1 POSB[MS THE ABOVE VALID LOS
Nuwua HORSEPOWERFL[ ANCIll" COUNTY LICENSE. OR I AM THE LEBN
AL OWER
NEW MYD. HP Oven ISO. [.ADH OF THE REMIDENTI/7ROPNXTY DGiCR [D QV[.
Ya • LIME M •26 ■IBNATURE OF
M .50 rERMITT
' 6 1.00 INSPECTION RECORD
5 15 1.50
15 so 2 513
50 800 5.00
ZOO 500 10.00 J
BOO . 11300 16.00 <
- Z
PVICR
11=30 20.0O Q
M.O. ■ET FR CHAMBER-HP
WELDERSIAO-KVA
BENERATORB - KW
TRA.NM ORM[RB - KVA
TEMP. MOTORS (76 or owo.
MOVED MOTORS (76 or DRImJ
BIONS
NO. NO.TRAHa
MD. Pe APPROVALS
FOR EACH P[RMITI DATE INiP[OTOR'S NAM[
WIRINB +t,OO leo CONDUIT
FIXTURE• jpl.DO op WIRINBMUPPUMENTARY ate' 3 'E.� ✓r
.6O FOCTU RLS
rOWiR
TOTAL FEE ZV/ UTILITY C0.NOTIFIED
Ft MAL 4
I a1'8 COMPENSATION DCCC4-ARATION 20-0019 DPW 8/89
7BA� APPLICATION FOR ELECTRICAL PERMIT
I hereby af�r the have a oertlflcate 01 convent to sell Insure,
or a oertiffoate of Worker's Gompansatlon Insurance, or a certlfled COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV.
copy thereof(Sao.3800 Lab.C.)
Policy No. Company, POR APPUCAMT TO PrLL N uoe C
ADDS
❑ C%rttfied copy Is hereby ftm. red. Nen Reddantlal Bldgs.S Pools EACH NO. FEE
❑ 1 S 2-Family,
Ft. LOCALITY
ied
Certtfted copy le flwith the county building kwpecifon _ _ j NEAREST
dopa&—t- MutWamBy S4•El• CROSS ST. '
Date App6carri Residenilad
l%mmtg Pods A88EBBOR
YAP BOOT( PAS t3nnca
C ERTIRCATE OF EXEMPTION FROM WORKERS' Outists:Rec.LL Light S.W.3— oFl
COMPENSATION INSURANCE
(This*action need not be completed the work Involved by the Rml 20
H MAR-
Y—
permit
permit t•for one hundred dollars($100)or less.) Total Na AddRlonal ADDS �✓ a /
I certify that In the performance of the work for which this permit CITY TOL Na
It Issued, I shall not employ any person In any manner so as to ``` PLAN CHECk
Lighting beoome subject to the Workers'Compensation Laws. ting Fixtures /� Ftu 20 APPLICANT
T �r
Total No. Addttk nal
Date 1"G-� 1 ADDRESS
E , f 16 OR 20&120V BRANCH CIRCUITS
NOTICE TO APPLICANT: If, after making tit s Certlflo to of CITY TK No.
Exemption,you should become sub)ect to the Workers'Compensation 1 TO 10 INCLUBNE EACH
provisions of the.Labor Code, you must forthwith comply with such 11 TO 40 1NCLU8NE EACH Pt T
provisions or this permit shall be deemed revoked. 41 OR MORE BRANCH CIRCUIT8 EACH
LICENSED CONTRACTORS DECLARATION 16 OR 2�206V TO 277V LOHT1NG EACH CL
I hereby affirm that I em licensed under provisions of Chapter 9 Q
(commencing with Section 7000) o1 Division 3 of the Business and CITY T
Professions Code,and my Iloense Is In full force and effect RESIDENTIAL APPLIANCES UP TO 3HP i 031 rw OR cc
`�G�' Ponw Apparatus 4�APpb— REG-NUMB61 i O
Lken*e N=ber 0- L0 lJa Claes ra 8txe S Type HP KW,I(VA or KVAA DISTRICT NO. p� PROCESS»BY U
Llp to 3 InoL ��/ CL
lAl q .� Over 3 to 10 Ind. FINAL
Contra(�sv Y ! Over 10 m 60 Ind. DATE 2_ Z
er
❑ I am exempt undSea Over I50 to 1 D Ind. VALIDATION
B
B.SP.C.for this reason Oyer 100 BY
�
Services, r�Q,MCC S Peneboerds
Dau. Fro
^ 0/�^CJ',l„�' Under Boo V
201 -1000 Amp.Under 000 V
Over 1000 Amp.or Over 800 V 7
❑ Exemption for Reg.Mahn.Elect
ACCT.'
SINGLE FAMILY Temp. i
•per le �Po �
HOME OWNER-BUILDER DECLARATION ,with One Branch graifl7 90.1�
I hereby aMrm that I am exempt from the Contraotor's Llcenae Law Lir
for the following reason (Section 7031.6, Buslnesa and Professions AMtlortal Sign Brandi Ck-cuita 1 ITEMS
Code): r� r 7
F-1 1.as owner of the property,will do the work and the structure Mica Condults a Conduotore TOTAL 90 - 15
Is not Intended or offered for sale (Seotlon 7044, Business Other(See Complete Fee Schedule) , CHEWt90.15
and Professions Code).
CONSTRUCTION LENDING AGENCY .00
I hereby affirm that there Is a construction lending agency for the
performanoe of the work for which this permit Is Issued (sec. 3097, PERMIT FEE (Sub-Total) 000111-MID
yy y11 /y wy1 f,yi I,
PLAN CHECKING FEE 1 MW 1 AM 9:27
LerxWe Name
PERMIT ISSUING FEE
Lender's Address
I oertlfy that I have read this application and state that the above TOTAL FEE ,
Information Is oonvcL I agree to comply with all County ordinances
and State laws regulating Eleotrlcal wiring, and hereby authorize
representattvev of this County to enter upon the above-mentioned
property for Inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
ftWTU RE or APPLIC.ANT OA AGENT bATE