HomeMy Public PortalAbout5612 GLICKMAN AVE_Electrical__ . �'_'" KE " T°"° ''"'°" 7VW8
., 1°'B1 APPLICA-nON FOR ELECTRICAL PERMIT
I wee affirm that I have a 0&ttficate d Cohaent to 60if Vmure,
or e certtRcatewbrkern' Corrpneation I•neurarxe, ora certlfied COUNTY OF LOS ANGELES BUILDING AND SAFETY.
Dopy ttlbreoT( ,380
'Pc(by No.j off_, 'F=OR AF�PLlC�1l1T TO F111!1 ice
AD
Gw C b�y.h?rT�hed New FieAideri$ei BkiQa h Pools EACH Na' E �
� . s — s LOCAIJTY
9d copy b 114dwith-bie, WIMIng hWootlor 1 h 2-Femfty,Sd.F{ NEARE— '
Multi-faulty.Sq,Ftp
V o
QWNER OR
., �� .r r ,''T�i � .Fir�Fa NAAE •
TE'OF EXEMlsT10N�FtOM F) Cubefg'R c y Lk"' Sw.'
COIv PEt4SATTON INSURATCCERrat 20
,•:
fThfs mon nerrd rw be compM04Itthq wpdt hv6h d by theCfTY T.4.No
pertntt. for or»;hundred doli4rs(> �00) or(Ks). Totel No. Add �`
id—tfy tho In &)q p-lbf rtanCa Of the•Work.,fpr whictx tpis perrhft. PLAN.
is ienied, I ehe7t not.r3rr1PV1Y ON pai-,In,arh' n�'riOf po ea,.to
I�Corre,eub tACofn` Wcerp' oeriattoh i aria- ' Llphtirp Fbchres Flret 20 -. ADDRESS
Date .�PdhQ rft Addltiorusl Tel. .
NOTICE, TO, f. -rl npr,ttp,�Carttfbate Of Fuad Appfferioee Not Over 1 HIP
,Ezerup ,you shwbjbeGorne sub d'.tq the Nk*kam'CoMpenaatiorl Reagan Fieafer_ D.W.
prgvfpiorp-af#Me igbgr Cgtyg,you.?f* forthw oorn@fy with Bich Oven � DrYbr � V1r.M._ AbDs3
bn?Yi�orta Q ffda'Per#shy➢be deemed 4.40c Tpp }� FALI CITI def.
LICENSED C16N`�6RS,6Eb_A ADON Flood— Fen .CtherT
1 tlete� atf�fTt� that.I �rh`li d roiaer prbvVp rlq of Chppter a per. T Room AIr CogcL `C'N q.erL
'(dommer`>t�wttti OA
Section 7000)of Dhiiaion 3'of the Busirieee and
»NUMBER
Yro#eabiorrb G`od9,and my tVc6gde la In fW bme`aM eff6tt Pay.gr Appafatua S Larg6.ApdWnoea DETRICT NO.
Size it Type HP,KW,Kl or K\AkR ,
tbTse Number 7 Lb.,cfaas Utxlo 1 hid_ NAL _ {}
over 1 to 10 inoL .. . .. _ DATE - 1 �
I fTK^i o/fib�1� t Oyer#a to 6fi tnd, FINAL ]
0 I Arn exerrifit undef Sato' flvet 60 to 160 ho. �y
_8 5F� for tide reason -� Over 100
Services,Swbd.;-MCC&Panelboarde -
- � -200'Amp.Under 800 V
201 - 1000 A•rw Under 800 V
F gvee 1000 Amp.or bvbr L800 V .-
E>4empWn for Hog:ktafnt.EIAct.�
y OLE FAMILY ' Term Pbv'r+br Fble,&Apourterrarxced
.'HOME OWNS ILDEA DECV,WON 1 3 9.4.A
t.hwo0y ERrrrthat L am m rrp(from No Coniraptor's Uci3nee Law Add with One 61 anoh G[rou
for the fo(bwtV room(SKtlon 7031.6,Busineas and PToTesa' _ A¢dttlonal S1GP Branoh.GrrniRa. : # o e o, 0 2
cnods�.
I.0,02`S50
i'As owner c$tW property,will do the work'"the'structum' °4 (8 a Conductors - _ ._
La'not ht6fa or offered for sale(seotk+n 7044,•Bu*vee Otter(sae com*ts F86 schedule}.T o 0 0 2 5,5 0�i '.
and vmfeeeibm code).
CONSTF{UCIION LENDPJQ'AGE 2 2 2 y'8 8
1 effYrn fhet there is a cxwtj- tbti wxi�v aDmw-fol the
p�kxlrrance Qf the work for wNch thio PwmK Is Yesued(Sea 006 T, - PERMIT FEE - (SUb-Total) _
C.):
. ' . PLAN Ck[ECKINO FLE
Lenders NHme• PERMFF ISSUWO FEE -
Lendw'8,Address. -
f osrttfy that,I heve read dila a*batfon and sh t9 that the above TQC.FEE
h(ormafion is corned.I agree Jo•compty wRh a1 Courrty orc nences
'end-State Lave raW attnp Eleotri¢al wlrVu aryl hweby authorize
of thio td erjter upon'tie above-rrie boned '
Tor,tdpeafi
,. on W 0. � SEE REVtRSE.FOR EXPL.pFigTOFfY LANqU/10F_
s
"`°�" "°"° ` "'° 10'x' APPLICATION FOR. ELECTRICAL PERIVIT
�I ieret einrrt mal I nage d oeritn�e d co-",,t to serf l w
Ffa'oertffloata of Vkrkwe' Compensation Insurance, or a certfW COUNTY OF LOS ANGELS BUILDING AND.SAFM
Dopy fiaerecf(SaQ-36 ��
PCOQY N. OR PAPPPCANT TO EI.L a J06
`•F] Cortffted.'oopy b hereby furd hed, New Reeidenttal 06Q&S PocI16 NQ -FEE S
Cer"ed oopy b flied with fl-,a county txilldlnQ h 9pec6on 1 A-2FAmlfy,Sq Ft G°C Y
de7Mrft)=fames S.Ftp ST 4
Dew V ApQlkam./ qAe Reeldenw StM mmbv Paolo a-loas
'-`y' OWNER OR
C pF F30=MPTK N FROM WORKEE,S' - - oubefa Rec Llprrt sw. 11 MAL
COMPEJJSATIOfJ INSURANCE , . U
_ (Thr.ectkm rw o rot bb o«r�pimted @.'tho work mvofv d by tt� dd 20
perrtHt Is for one.hurfd-d,dolt{rs J$1M or iew) Total Na Additional CITY Tel:
11 certify that-fn �+of the.work fdr which ails,p&Tnit =
Iq Issued I shell not employ' oeram In arty rfianner so as to
beCor>tie eub}eot ko tho 1�br{aer CLaws. LVYdno hXturQe Flret Qo Af3DRESs
6rnperieat
or
Total Na Additional C1Ty
-- •. TQI.No.
Dete Ap~ Fixed Appr)ahcee,Not Ober 1 HP PERW
►a0�10E H, after mgkkV tt*.,,C6rtffiCate
Rte— I festal D.W.
'r'� r
Ex$Mptbn,You ehqutd aub)ep frkthA C,omper}eation ADDREs3
provtskirns of,;tfte�ab4r po*e You tr,&wp comply.� such Oren T Dryer_ W M.—
psovkekir .. or tris pe I - sinal l.be deemed revoi sti, - Top ,FAU -',W.H. — ,crFy Ter.
IJCEIJ9ED TLS.RE {PT1PN,w Hood Fan _ Otf7er_
I herbby pfflrm ft-cat,i"am{beneed under, of Chaptet 8
°nD.' Dlsp —_ Hoorn 4r L ond. jWLMZtFp - e1
(commenoinQ wftti'Sectlon Jbqp) of RNV�bra 3 d;the*rdneee and .
Ry%msbtm Code,and nly'kerma to to fulE forge and-eff6dt`' M$T�T"a PFCCES$D BY -
, P1cv+)erAPP'9tadue S Letye•Ap¢(fAr�e' - - _
•
Size-S,Ype Hp,KW,Kor KVM' ✓f
Lbbnee lyumber Llc Oiaee _ , �.�.� did� F1NAL
u B+^ 1 O�er 1 to-1-o hid. DATE
-ContrTactor r {)ate
-(;N-et 10-to 60 Ind. Fl `
t arr -under Seo. Qyer,-C)0.to'1-00 Ina
r, sBP.C.for thls'r9ebon �f ]°°.
3ervioee,SWM,MCC S Panerboacrie -
` 9 x•200 Amp.Urdor 600 V ► -
1 mag —
201— 1-000 Amp'UndiWGOQ.V �.
Over 1000 Amp.or.Over 600V
[� Examptbn for Flap.Mafat
Si FAMILY" Temp•Flg—PolIe d Appurberarroee _ ,b
HOME' - BUIL R dEOtA&ION $�
3rgr Wfkh ane Brarroti Ctroytt
l hereby that},ain 0MInVi from the GpctracW&Ucmw , Q 9.0 �50 �
for the tol6aWnreaeQrr(SoGdon 7031.6,Bu5lrpes� ed Profeeabns -Addbona $IQ9rarlch C�
Codbj , .
7 ey er Mieb'Conduits d Corxhjcforo'
s ownof tlla prbpertyr. l do the wa k end.ttr�etn,c i 137 .88
Other(See.Gompieta Fee Sched4e)
Is not Intended or offgreta for sale (Section 7014, sustr)ess ,
and PmfawO pa Code)
011.5 tnTION LENDING.SAENCY _
I hereby affirm that.there le &coraitucHon lgrdlrrd 0gancy for the
>iertorrrience of tris work for WNCh tt9a permit�a'bailed(Sec.309Y, PERMIT FEE - (Sub-Total)
GM 0.).
FtV�C4-4EPK4NO FEE
Lender's Name s
PERMIT'1$sUINO FE,�
I car* that 1 have read-this appkation end Mate that the'aly" TOTAL FEE_... J !V.
hrfprrnaoon.le oorroc 1 09 roe tin convty with all County 4rdlnencee
end Staha leve requiating Eleotni wtdw. and hereby auttbrh's '
d.this City Pto eater �r the ebo,e mentioned RCK r�f SEE REVER$9 FOR EXPLANKFORY LANGUiAE
re of Pef I t
WORKERS' COMPENSATION DECLARATION 20-W19&k663 "yam APPLICATION FOR ELECTRICAL PERMIT O
I Hereby affirm that I have a certificate of consent to 7
self ,�
Insure, or a certificate of Workers' Compenzatiort Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS
or a certified copy thereof (Sec. 3800, Lab. C-)
Pgllcy Np Company POR AnLICANi TO Ell IN JOBG
"Certlfled copy Is hereby furnished. New Resldeatlal Bldgs. 8 Pools EACH NO. FEE AMRIESSt6 2=
9&00z Avy-
❑Certlfled copy Is filed with the county building Inspec- 1 8 2-Family, Sq. Ft. $ _ $ LOCALITY
tion department. Multi-family Sq. Ft.
Residential Swimming Pools CROss ST. .�
Date Applicant L
RM NAlWE
CERTIFICATE OF EXEMPTION FROM WORKERS' -L MAIL
COMPENSATION INSURANCE Outlets: R Light Sw. D RFS
.�{ First 20
(This section need not be comp4eted If the work Involved by Total NAdditional CITY Tel. No.
the permtt Is for one hundred dollars (=100)or less.) PIAN
CHECK
I certify that In the performance of the work for which this APPLICANT
permit Is Issued, I shall not employ any person In any mannerAlk/
Lighting Fixtures First 20 ADDRESSso as to become subject to the Workers'Compensatlorr Laws.
Additional
Date ' Appllca Total No. CITY Tel. No.
PERMIT
NOTICE TO APPLICANT: If, after making thls Certificateof Fixed Appliances Not Over 1 HP APPUUTFON
AIP11-
Exemption, you should become subject to the Workers' Ronge— Heater—D.W. —
Compensation provisions of the Labor Code, you-must forth- Oven — Dryer —W.M_— ADDRESS
with .comply with such provisions or this permit shall be Top — FAU —W.H. —
deemed revoked. Hood — Fan —Other— CITY Tel. No.
LICENSED CONTRACTORS DECLARATION LJCENM Ott
ss
Dlsp. — Room Air Cond. Cla .
I hereby affirm that I am licersed under provisions of Chapter 9
(commencing with Section 7000)of Division 3 of the Business Pow&r Apparatus 8 Large Appliances DISTRICT NO. BY d
and Professions Code,and I Is In full force and effect. �D
C-,
`a C 2_4 Sim 8 Type HP, KW, KVA, or KVAR O
License Number Lic. Class Up to 1 Incl. FINAL
,i/� / Over 1 to 10 Incl. DATE � � VALIDATION �
Contractor a Over 10 to 50 Incl. FINAL
❑ _ U
I am exem t under Sec. Over 50 to 100 Inc. BY W
B.BP.C. for this reason Over 100 d.
Services, Swbd., MCC& Panelboards , Z to
Date: 0-200 Amp. Under 600 V —
Slgnature 201 - 1000 Amp. Under 600 V
❑ Over 1000 Amp. or Over 600 V
Exemption for Req. Maint. Elect.
SINGLE FAMILY Temp. Power Pole 8 Appurtenances
HOME OWNER-BUILDER DECLARATION L
I hereby cr flrm that I am exempt from the Contractor's License Sign with One Branch Circuit ACCT
Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits
Professions Code):` 7 24.7(1
Ell, as owner of the property, will do the work and the MIK• Conduits 8 Conductor 1 ITEMS
ffe
structure Is not Intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)— ,
Business and Professions Code). TOTAL 24 - 70
CONSTRUCTION LENDING AGENCY 24.—A)
I hereby affirm that there Is'a construction lending agency for ( .[f1
the performance of the work for which this permit Is Issued PERMIT FBE (Sub-Total)
(Sec. 3097, CIv. C.).
PLAN CHECKING FEE 3
Lender's Name DXO–m 1 7/155 1
PERMIT ISSUING FEE
Lender's Address 7999 1 AM 8:41
I certify-that I have rood this application and state that the TOTAL FSE
above 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-menti nee for Inspectlon purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
Slgnatu of Permittee Date / ms