HomeMy Public PortalAbout9516 GIDLEY ST_Electrical__ """WC"°'" ' APPLICATION FOR ELECTRICAL PERMIT
1 COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
FNEAREST
BUILDING AND SAFETY DIVISIONt9s-1k 01,4TY
FOR APPLICANT-TO FILL IN CROSS ST. / G
OUTLETS NO. EACH IOWNER OR
S S FIRM NAME
RECEPT�3- MAIL
LIGHML
LSha
FIRST 20 ADDRESS
OVER 20 I O CITY e /� TEL. NO.
BWITPLAN CHECK
LIGHTING FIRST 20 O APPLICANT
TOTAL
OVER 20 ADDRESS
FIXTURES .10
RESIDENTIAL APPLIANCES CIT' TEL. NO.
PERMIT
RANGE DRYER_WTR. HTR. APPLICANT
BTA. COOK DISP. F.A.U. ADDRESS zz
SPACE HTR. AIR COND. Cl TEL. NO�7 8 70
CLOTHES WASk. D19HWASH. REG"UEM%6lit IR 7 2 CLASS.C-/
FAN OTHER 1.00 1 HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND [TAT[ THAT THE ABOVE IS CORRECT AND AGR[[ TO COMPLY
MOTOR[, TRANSFORMER[ RATING WITH ALL COUNTY ORDINANCE[ AND STAT[ LAWS REGULATING
IND. HEATERS, [TC. HP. KW. KVA. [L[CTR ICAL WIR INS.
SIZE i TYPE OVER TO
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/U11
0 - t t-00 LICENSED A[ REQUIRED BY LOS ANGELES COUNTY AND STAT[ OF
CALIFORNIA OR THAT I AM TH[ LEGAL OWNER OF THE ABOVE
1 - tD 8,00 DEBCRIEED RESIDENTIAL PROF RTY. O
oo PERM1 EE
10 - 50 Bue
SIGNATURE
50 - 700 10D0 DISTRICT NO. PROCESSED BY p,
t/S
100 - 300 15.00 49 \ Z
SIGN, GAS SIGN AND ONE CIRCUIT 8.00 APPROVALS DAT[ DWEC TORN SYMMTUIE
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE
SERVICENOT OVER 600VOLTS OR200AMP 3.00 UNDERSLAB WORK
SERVICE OVER 600 VOLTSOR200AMP f0 ROUGH CONDUIT
TEMPSERVICE,POLE, &APPURTENANCES 8.00 WIRING
TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES
POWER AUTHORIZED
UTILITY CO. NOTIFIED.
FINAL
PERMIT FEE (SUB TOTAL) NOTEit
PLAN CHECK FEE
PERMIT ISSUING FEE
TOTAL FEE
PLAN CHECK VALIDATION CK. M.0. PERMIT VALIDATION CK. M.0. CASH
QCAS �lov �-Z# w o 2 1.7 v vx
S[[ SACK OF APPLICATION FOR COMPLETE SCHEDULE
.- - '""' °"'" 11-49 APPLICATION FOR PERK=
DEPARTMENT OF HUnMING AND SAFETY
COUNTY OF LOS ANGELES ELECTRIC i
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO.
I S' , -F Z /Z 532
ELECTRICIA 1
R I ■Y READYDA
FOR T[ 1o1Um
ADDREM 7 FIRfT INOP[CTIO /
CITY T NO.
COUNTY L1131ENICIC NO. EXPIRES „6 BUILDING
rJG.o.W11 FEES ADDRESS
HUNGER OUTF1QL[T1 [ADH 1 LOCALITY
LIGHT fO NEAREST
OR OJLQ UT.
RECEPTAOL[H 6
rIxTuREs Is OWNER
WALL SWITCHES 6 MAIL
EL RANOFJ 26 ADDRESS
ELEQ. HILAT[Ro 25 CITY TEL. NO.
Mina,
I HERESY AO KNOWLEDGE THAT I HAVE READ THIS
NUMBER OF OIRCUITIi INOTALL1iD1
TOTAL APPLICATION AND STAT[ THAT THE ABOVE ID OORRECT
LIPHT13 RE AND AGREE TO OOMPLY WITH ALL COUNTY ORDINANCES
MOTORS AND STAT[ LAWS REGULATING ELECTRICAL WIRING.
MUMMER HORSEFEE I CERTIFY THAT I POBs[U1 THE ABOVE VALID LOS
Nltw Mvo. HP w[ll —H ANOELKS COUNTY LICENCE, OR I AM THE UMAL OWNER
111 .46 OF THE R[DID[NTPRCP[RTY DE<DRIS[D ABOVE.
L
.60 ■IONATLR[ Or
2 1,pp PERMI
15515 1.■D SPECTION RECORD
113 60 2.613
6C zoo E.pO
ZOO 600 IO.DO '3/ Q
600 1000 16.00 J
OVER 1000 YC.00 Z
M.O. ar-r/rRErjL DHANO[R-HP
WELDERSI AD-KVA Q'
OEN[RATORS - KW - O
TRANSFORMER/ - KVA
TEMP. MOTURB (76 or oma.
MOVED MOTDRB (76 or oRInJ
I e
BIONS
TYPEI NC.TRANL
TYPES Na APPROVALS
FOR EACH PERMITS DATE IMBPECTCR'O NAM[
WIiHNO 01.13 dp CONDUIT
rIXTLRKa $1.00 WIRING
EUPPLKMKMTARY 6 FIXTURES .
POWER
TOTAL FEE • l- UTILITY CC.NoTlrl[D
FINAL
vaORK► 5, I; V,
aTION DECLARATION CE-936 to�el t 'APPLICATION FOR ELECTRICAL PERMIT
bye a�flrm that 7q,certlflcate of consent to self � Gor�xFerttflcateiors'�ompensatlon Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY
certified copy the �. 380p0, Lab. C.)
cy No. Company Mt APMXA dT tO JOU IN ADDRESS � ��
Certified copy Is hereby furnlshed. New Resldentlal Bldgs. 8 Pools EACH NO. FEE
Certified copy Is filed with the county building I 1 8 2-Famlly, Sq. Ft. ' $ — t LOCALITY
tion department. Multl-family Sq. Ft. — NEAREST
Q CS ST.
to �I �—y / App llca Residential Swimming Pools FF RM NAME ;cxkq O L 6
CERTIFICATE OF EXEKE
EXEMPTION FROM WORKERS' Outlets: Rec Light Sw._ MAJL
J
COMPENSATION INSUk NZE F11st 20 ADDRESS
-his sectton need not be completed If the work Involved by Total No_ Additional CITY 2/5n O � Tel. No.
-e perm Ft Is for one hundred dollars ($100)or less.)
CHECK
'certify that In the performance of the work for which thiPLAN
ermlt Is Issued, I shall notemploy any person In any manner
as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS
Total No. .1 Additional Crry Tel. No.
Datb 4 +Ilcant Fixed Appliances Not Over I HP PERMIT
NOTICE TO APPLICANT: If, after making this Certificate of APPLJCANT bite lk) VOW-"
Exemption, you should become subject to the Workers' Range_ Heater_D.W. —
Compensatlon provisions of the Labor Code, you must forth- Oven — Dryer —W.M.— ADDRESS 61jjtc
with comply with such provisions or this permit shall be Top FAU —W.H. —
deemed revoked. Hood Fan '�_ CITY Tel. No.
LICENSEDEC
CONTRACTORS DECLARATION LICENSE OR
-I hereby affirm that I am Ilcerned under provisions of Chapter 9 Dlsp. — Room Alr Cond. REG NUMBER Class
(commencing with Section 7000) of Division 3 of the Business DISTRICT NO. BY
and professions Code,and my license Is In full force and effect. Power Apparatus 8 Large Appliances [` >¢'
Size 8 Type HP, KW, KVA, or KVAR' i O O
License Number-3&3Z-7 Llc. Class (f/p0 Up to 1 Incl. FINAL 09
�� ��?ato �l~7—off Over 1 to 10 Incl. DAA `�� VAUDATK>N O
Contractor Over 10 to 50 Incl.
ElTFINAL
I am exempt under Sec. Over 50 to 100 Inc. BY CL
Over 100
B.BP.C. for this reason ► z
Services, Swbd., MCC 8 Ponelboards
Date: 0 -200 Amp. Under 600 V
Slgnaturo 201 - 1000 Amp. Under 600 V
Over 1000 Amp. or Over 600 V �-1 0 21 A
F] Exemptionfor Reg. Malnt. Elect. # o o a o-o 2
SINGLE FAMILY Temp. Power Pole$ Appurtenances
HOME OWNER-BUILDER DECLARATION Signircuit # e o o o 02
I here affirm that I am exempt from the Contractor's License Add with Ono Branch Circuits oo 7 5Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits ( .
Professions Code):
El1, will the work and the
I, as owner of the Misc. Conduits 8 Conductors o 0 0 l Q 7 5 T5ac Other See Complete Fee Schedule
structure Is,not Intended or offered for sate (Section ( p )— 111110. - 1 1. 07—84
44
70 , Business and Professions Code).
CONSTRUCTION LENDING AGENCY
I hereby afflrm that there Is a construction lending agency for
the performance of the work fqr which this permit Is Issued PERMIT FEE (Sub-Total)
(Sec:3097, Civ. C.).
PLAN CHECKING FEE
�ander's Name
PERMIT ISSUING FEE Q
Lender's Address
I certify that I have read this application and state that the ITOTAL FEE
above Information Is correct. I'agree to comply with all County
ordrnonces and State laws regulating Electrical wiring, and
hereby authorize representatives of this County to enter upon
the above-mentioned pro rty for Inspection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
7 8�
$Ifln re of Permltt Date i