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Home My Public Portal About4929 GOLDEN WEST AVE_Electrical__r 76A6CE806 10/74 APPLICATION FOR ° LECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER JOB BUILDING AND SAFETY DIVISION ADDRESS LOCALITY ' NEAREST FOR APPLICANT TO FILL IN CROSS ST,' ' OUTLETS NO. EACHI FEE OWNER OR VV 7FIRM NAME RECEPT.! $ $ 1 MAIL 1 ADDRESS GOjU C(/33 FIRST 20 � ✓ LIGHT T00� 2S GL _ CITY EL. N0. SWITCH OVER 20 10 PLAN CHECK LIGHTINGFIRST 20 .25 G OT L FIXTURES OVER 20 ADDRESS APPLICANT T 10 RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT RANGE DRYER_WTR. HTR._ APPLICANT STA. COOK DISP. F,A.U. ADDRESS a SPACE HTR. AIR COND. CITY C�.yJ� �J iL. NO.2i7,017 CLOTHES WASH. DISHWASH. LICENSE OR REG. NUMBER CLASS. FAN OTHER 1.00 G;`� I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION JJ AND STATE THAT THEABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW, KVA, ELECTRICAL WIRING. SIZE IN TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 — 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF >_CALIFORNIA OR T I AM THE LEGAL OWNER OF THE ABOVE a 1 — 10 900 DESCRIPED E TIAL PROPERTY, p U PERMIT 10 — 50 5.00 SIGNATOR �' '`�r CD H-- 50 — 100 10.00 LU RICT NO. PRO SSEO cl- 100 — 500 15.00 0 ,L Z SIGN, GAS SIGN AND ONE CIRCUIT 5,00 APPROVALS DATE INSPE R'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE SERVICENOTOVER600VOLTS OR20OAMP 3.00 S'z) UNDERSLAB WORK SERVICEOVER600VOLTS OR200AMP 10.00 ROUGH CONDUIT TEMPSERVICE,POLE, &APPURTENANCES 5.00 WIRING TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES POWER AUTHORIZED i UTILITY CO. NOTIFIED FINAL PERMIT FEE (SUB TOTAL) NOTES: PLAN CHECK FEE PERMIT ISSUING FEE 3.00 TOTAL FEE PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VA ATION CK. M.O. CASH 0 1 2 R1t}�a 5 2 'Q 1 8.1 0 •" SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE wpRiC R'SCOMPEN3ATlON DECLARATION DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT I herpby`afilrm that-I have a certlfioate of consent to salt Insure, or a oar-0cate of Worker's Compensation Insurance, or a certlfled COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Seo.38dd Lab. C.) Poflcy N0. Comparry t'OR AP PL.FCAIri TO RLL IN ADDRESS Certified copy 1a hereby furnished. New Reeldentiel Bldgs.S Pooh NO.1 EACH FEE LOCAIJTY ❑ Certiiisd copy Is f1W with the county bull-ding on 1 b 2 family,Sq.Ft _ $ $ NEAREST Wit, Multi-fnmlly Sq.Ft CP088 9T. Dells APPIloarrt Residential Swimming Pools YAPAB BOOK PAaE PAFICg CERTIFICATE OF EXEMPTION FROM WORKERS' Off:Rec.4 L1pht Sw. K FIRM0�RN.A.ME I COMPENSATION INSURANCE Lo (Thlp mention need riot be completed H the work Involved by the Rrot onal A DRESS y G permh Is for one hundred dollars($100)or less.) Total No. Additio I certify that In the performance of the work for which this permit CITY TOL NO Is Issued, I shall not employ any person In any manner so as to PtAN CHECK become subject to the Workers'Compensation Laws. Lighting Fixtures IFrat 20 APPUGMT Total Nb. 2= Additional ADDRESS Date Applloenl RESIDENTIAL APPLIANCES NOT OVER 3 HP. RQTICE TO APPLICANT: If, after making this Certificate o1 , CITY TOL NM Exemption,you should become subject to the Workers'Compensation OTHER APPLLkN0E8 NOT OVER 3 HP. provisions of the Labor Code, you must forthwith comply with such PEMRrr provislons or this permit shall be doomed revoked. Power Apparatus d Large Appllanoee Lia NEED CONTRACTORS DECLARATION StLCkNT ✓4 Type HP,KW,KVA,or KVAR ADDRESS I hereby affirm that I am licensed under provisions d1 Chapter 9 Over 3 to 10 Ind. (commencing with Section 7000) of Division 3 of the Business and GrY T Professions Code, and my license is In full force and effect. Over 10.to 60 Ind. OR 0tese d Over 6o to 100 Ind. REG.NUMBER Over 1010 DrBTFIICT NO. Ucenee Number �} Lb.ossa SeMcee,8wbd.,MCC h Panetboards IZ ckx tri Data 0-399 Amp.Under 800 V DATE ❑ 400-1000 Amp.Under 600 V (V` ('p TI VALDAON W I em exempt under Seo. Over 1000 Amp.or Over 600 V RNAL W B.ALP.c.for n,le reason BRANCH aiRa.lrr BY FEES (n Z Date: 16A,or 12oV,Llghting or Recept4 — 1 To 10 Branch Circuits 16 Signature 11 To 40 Branch Clrcuflz 41 Or Mora ararxh Ctrculta ❑ Exen"m for Reg.Maint.Elect.. 16A,20A,201BV To 277V Ughdrq Br.Ctrcufts � HOME OWNSINGLE ER BUILpFJIILY DECtJWATION Temp.Po%w Pole d Appwio urtereeT: ir affirm I hereby arm that I am exempt from the Contractor's Ucenee Lew with Orta arouft for the following reason (Section 7031.6, Bgslneu and Professions Additional Slgn Branch Circuits I 3W 60.513 Code): El1,as owner of the property,will do the work and the structure Mlso.C xdufts 8 Conductors n 7..1 ITEM Is not Intended or offered for sale (Section 7044, Quelnesa Other(See Complete Fee Schedule) , TOTAL 60 - 9.0 and Professions Code). CONSTRUCTION LENDING AGENCY r . I hereby affirm that there Is a oonstruotlon lending agency for the tif7�TLlz performance of the work for which this permit Is Issued (Sec. 3097, PERMrr FEE (Sul}Totaf) Civ. C.) PLAN CHECKING FEE 0000-0301 7/19/94 Lender's Name PERMrr ISSUING FEE 6137 1 Ali 9:05- Lenders Addreei I certify that I have reed this apppcarion and under penalty of purtury state TOTAL FEE Utas the above Information la correct. I agree to oompty with all County ordinw)oee and State taws regulating Elecctrioal wiring,and hereby authortze representaitvee of this CqLLrq to enter upon the above-mentioned property for Insper.dw :-SEE-REVERSE FOR EXPLANATORY LANGUAGE B10NATlFE dF Po%rITEE DATE . WoR?} 'S COMPENSATION DECLARATION 20-Mg DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT 1 hereby-affifm+that I have a oertiflcate of oonsent to @elf Insure, 7e4ee3 or a cer~Iflcat� of YvprkComPAneatPon I c�r'a riaurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof C.) POR APPLICANT TO=IM �R8 _ Pon No. CompanyCerdfled copy Is hereby fumlahed. New Rasidential Bldgs.h Pooh NO. EACH FEE LOCALITY / ❑ Certffled copy is filed with.the couD ngI 1 S 2-Family,8q.FL _ i NEAREST Mufti-tnmUy Sq.Ft. CROSS 9T. Date Applloant Residential Swimming Pools MAP BOOK � Q P� CEATI TE OF EXEMpT10N FROM WORKERS' OutIGM:Rac.�Light Sw.L0 1 NtOWNER. Q COMPENSATION INSURANCE First 20 (This aeotJon need not be completed tf the work Involved by the Total No. Addhioal niDpMAIi�E88 yitr permit Is for one hundred dollars($11 O)or leg.) I certify, that In the performanoe of the work for whlbh this permit CTrY TOL W. to la-sued, I shall not employ any person In any manner so as to PI-AN CHE(X become subject to the Workers' Compensation Laws. Lighting Fbduree l� Rrst 20 APPUGwr Total No. / Additional ADDRESS Data Appkant REST ENTAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: If, after makFng this Certificate of CITY Tet Na Exemption, you should beoome subject to the Workers' Compensation OTHER APPLIANCES NOT OVER 3 HP.. provisions of the Labor Code, you must forthwith oomply with such PaGST POS APPu� LargeLarge �� proviel6ha or this permit shall be deemed revoked. LICENSED CONTRACTORS DECLARATION Sim 8 Type HP,KW,tCVA or KVAA ADDRESS I hereby affirm that I am licensed under provisions of Chapter B Over 3 to 10 Ind. (commencing with Sectlon 7000) of Dlvlslon 3 of the Bu@Ineas and CrrY eL No. J Profeeel6ne Code,and my license Is In full force and effect. Over 10 to fi0 Ind• — UCORSE OR &P7 P .3t4'/ 2 Clea p Over 60 to 100 Ind. R & E3.NUMBER V 2 .. Over 100 DISTRICT NO. �Y License Number LJc.Class SwAces,Swbd.,MCC S Panelboarde 0 Contractor Dade 0-399 Amp.Under BOO V FLNAL DTE (, F-1 400-1000 Amp.Udder 600 V I am exempt under Sec. Over 1000 Amp.or Over OW V E1�nL VAUDATfON d B.AP.C.for this reason BRANCH CIRCUIT FEES BYt Dere: 16A,or 20A, 12OV,Ughting or ReosM ]7«[Nr IT z Signature 1 To 10 Bfarwh Circuits 5 11 To 40 Branch CJrol�b 11 *a r ❑ More Exemption for Rep.Malnt-Elect 15A,M%206V To 277V U Cta�e SINGLE FAMILY Temp.Power Pole h Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.6, Business and Profeeslons Additional S1gn Branch Clrcrrjts Code): ❑ I, as owner of the property,will do the work and the structure Mlso.Condufte A Conductors Is not Intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) Opp. Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that th9re to a oonstruction lending agency for the performance of the work for whioh this psrml; Is Issued (Sea. 3697, PERMIT FEE (Sub-TOtaf) CN.C.) PLAN CHECIdNG FEE Lenders Name PERMrI ISSUING FEE Lendel'e Address I oertfiy that I have reed this appllcailon and under penalty of ptalury sleds TOTAL FEE / that the above Information is conact- I agree to comply with all County ordlnancee and State laws regulating ElecUical wlrtnp,and herby autfwrtn repreeerriatives of this County to enter upon the ebwe-merttloned property I-t W SEE REVERSE FOR EXPLANATORY LANGUAGE E$k�b re WORKERS'OMION DECLARATION ' '0'81 APPLICATION FOR ELECTRICAL PERMIT �� affirmI that hoveve a a cCertificate of consent to self ��ObG e, or a certificafe of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certffied copy thereof (Sec. 3800, Lab. C.) Policy No. Compdny FOR Al•ILIG NT TO M1 IN JOB Q. Certified copy It hereby fumished. New Residential Brdgs. 8 Pools NO. i$ "REW El Certified copy Is filed with the county building inspec- 182-Family, Sq. Ft. ' _ i LOCALITY� tion department. Multi-family Sq. Ft. NEAREST Residential Swimming Pools CROSS ST. Date AppIrcent OR FIRM CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec--_Llght Sw._ MAIL, COMPENSATION INSURANCE b•eefbn need not be (efed IIE the worst Involved First 20 �P � Tatar No— CITY CITY Tel. No. the permM L for ono hrfhdred dollars($IOQ)or lea..) N I certify that In the perfodnance of the work for which this � permit Is Issued,I shall hot employ any person In any rnp sc as to be*-b o the W Compensa Lighting Futures First20 ADDRESS Total No. AdditionalCrTY Tel. No. Date Fixed Appliances Not Over 1 HP pE�7 NbTI Of er makl Is Certificate of AAPLIGA,NTf�cempt onbecome to the V�orkgriRange_ Heater_D.W.Compensaof the Labor Code, you must forth- Oven _ Dryer W.M.— ADDRESS wUh comply with such provisions or this permit shall be ..Top — FAU W.H-— . deemed revoked. CITY Tel. Na, LICINSED CONTRACTORS DECLARATION Hood — _Other_ LIIJSE OR I herby of Irm Haat I am 4Icensed under provisions of Chapter9 Dlsp. — RRoom Alr Coad. REG NUAMBER Class (commencing with Sedlon 7000) of Division 3 of the Business DISTRICT NO. BY and Professions Code,and my license la IR full force and effect. Power Ap 'vtus$Large Applldnces ; a Size A Type HP, KW, KVA, or KVAR 000 License Number I Ic. Claw F Up to 1 incl. 4INAL V Im Over 1.to 10.lac[.- DATE r �r V AT0N -O Contct roor Date Over 10 to 5Q Incl. Q FF1 C I am exempt under Sec Over 50 to 100 Inc. 8Y r s++ B.BP.0 for this reason 100 + -/ZJZ� n , T - Services, Svrbd.,'MCC d Panelboards - Date: 0 -200 Amp. Under 600 V ' Signature 201 - 1000 Amp. Under 600 V ` Over 1000 Amp. or Over boa V 6 1'a 0 A Exemption for Reg. Malnt. Elect. # o o o o o 2 SINGLE FAMILY Temp. Rower Pole 8 Appurtenances HOME OWNER-BUILDER DECLARATION • o Sign with One Branch Circuit 5"0 I hereby affirm that I am exempt from the Contractor's License 1 6 Law for the following reason (Section 7031.5, Buslnqu and Additional Sign Branch Circuits o u'o Praf�ons Code): 1 5 0 LLJ 1,.as owner of the property, will do the work and the Mlsc. Condults&Conductors 1224-86 structure Is not Intended or offered for sale (Section Othdr mplete Schglule) , 7044, Business and-Professions Code). CONSTRUCTION LENDING AGENCY - i I hereby affirm that there U a copstructlon lending agency for the performance of The work for which this permit Is Issued PERMIT FSE (Sub-Total) (Sec. 3097, Civ. C } PLAN CRECY1NG Fly Lenders Name PERMIT ISSUING FIS Q Lender's Address I certify that I havb read this application and state that th0 TOTAL FEE above Information Is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hero uthorize represents his County to enter upon Q v Honed or Inspection purpqw. / SEE REVERSE FOR EXPLANATORY LANGUAGE 10 !d Slgnatura atee Dat