HomeMy Public PortalAbout4947 GOLDEN WEST AVE_Electrical__ ��66s o4{iliie) . 'AP OCATIO 1 FOk 5LE&RfC�L.,�L�l[�1��
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COUNTY QF LOS ANQELES
g. F I �r
OR API{1 IG 70 FI'L IN f. J4 DRFssa
New&;Identlal"Bldgi.&Pools - Fp'GH,` FEE-
1&2.Famil Ft. $ '.025 $ 1 OCALITY +
-MUlfl3amily$q,Ft." N EA REST I
II2 —
itefiential Sy7m�gJryg Pooh 29.Oa ST. O `
OWNEK RKAME
- - - �.-•
Ovtlpis. Light _ 6O' d _ DDes� 4
First 20
XotaLN6,: Q_,.' 'Addiiionall- .30 /O _
L4ghtlng xtures First 20 •50 ADDRESS• - -
4tal No. Add$lonal 30 CITY - Tel. No.
l=b&e Applldr,ce>Nofaver I.HP P=T - -•r -_. ._ _ ., �. T -. _ �_
r . APPLICANT .
Range_Heater_D.W-�.,_• AflDI�ES$ - - -
Ck nT0fYPr—_WNL— _. - - -
too _fAU .�W.H:' _ CITY
man Clrher_- 2.50 LICEf1SEOR Gass. _
DJsp. RQem Air Cond�.�= ._ RSG.N ^^-
1 HERBY AOCNOWLEOGE THAT I PLAVE REA.QTH15 APPLICA- _
Power,Apparafus&}Large Appliances TION AND STATE THAT THE ABOVE IS RREQ•AND AGREE TO
$lze&Type HP,KW, KV.4 dr KVAR COtAPt l -CM�-QRDI E$"7rt �AI'E`CA
Y RTI �ECI CAL WIRING. .
h{iEREBYCERTIFti'THAYtAMPROPE��LL��REGI REIIFND70R
Over T to 10_Incl. 5.00 LICENSED AS REQUIREDBY i05 ANGELES%Ut ND.STATE OF
.42.50- 7' 1A QR THA-i.J�M TNE�6Sic'1L_0G .4F THS A�?� �.
E� - �, -Over a 0 to 5QIntl.' - DESa BID REE PROP�VTY.'
Over 50 to 1x00 Irx. 2 '00 PERMUEE
Ovbr M 4 _ SIGNATURE _
D15TPJ 1V0.
A;200.Amp.Under 600 V
201'Y000 Amp Undgr 600'V - 26.00-
Ove[1000' mp.or Over 600 V SOHO
Temp. Power Pole&Appurtenances 10.00-
Sign
0.00 Sign with.One 5rbnch Clr�tt'1'. r.. . - 1t�00 .
ditlonal Stgn Srbnch Circuits, 2`00' _ LNSPECfIO[�
{ INFORMATIQN
Misc_Card-6&Conductors `1 .Od- -'ON hE1/EitSE
Ot er-lsae Complete Fee S&,dulel ;26830A
_Y SIDE .
#,odeao2
2 6,-,34.50
PERMhf FEE r lSublTatall _-'• -- I o a o 3 4,5 0
PL,AN.CHECKING FEE lOrib:Fo rth rmh_461 '
1 ;aT; _� 09,24.'-79
PERMIT.ISSUING FEE
TOTAL FEE 7
INSPECTION FINALED
i
date, � r � By r �s
WORKERS'COhaye a LION cafe of coot 7� ,ora, APPLICATION FOR ELECTRICAL PERMIT
I,h�rebyZafflrm that I have a certifICate of consent to self ��
[,sure,.dr a certfficate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING A-ND SAFETY
or a certified copy thereof(Sec. 3800, Lab. C.)
Policy No. Company POR APMkAW TO X7.1 N ADOR65 e
❑ .Certified copy Is hereby fcrnlshed. New Residential Bldgs. 8 Pools
❑ Certified copy Is filed with the county building Inapcc- 18 2-Family, Sq. Ft. ; = S LOCALITY
tioridepartment. Multi-family S9. Ft. T 2RT. bs
Date Applicant Rq;ldentlal Swimming Pools ��NIOR
_ 5
CERTIFICATE OF EXEMPTION FROM WORKER$' Outlets: Rec.�Light-i_Sw.�
COMPENSATION INSURANCE 5
Is sec"on need rot be corn Ieted tf th6 work Invoked /�0 First 20
� p �' Tbtal No_ �b Additional CITY � Tel. No.
the permit Is for qn-w hundred dollars(;100)or leas.)
I certify that In the perforancq of the work fpr which this APPLICANT
m
permit Is Issued, I shall not emplgy arty person'in any manner
so as to become subject to the Worker}'Compensation-Laws. Lighting Fixtures First 20 ADDRESS
Additional
Total No. CITY Tel. No.
Date pllcont Fixed Appllances Not Over 4 HP
PERMIT r r
NOTI TO APPLICANT: If, after, ma Ing this Certificate of G.)
Exempflon; you fhould become subject to the Workeri Rgn9°— Heaj4r—D,W�•
Compensatlon-provisions of the Labor Code, you must-forth- Oven _Dryer —W.M, ADDRESS494D 6,aldft S
with wmply with such prowl;Ions or this permit shall, be Top —FA W. . Tel. No
deemed revoked. Hood — Kan _Other—
LICENSED CONTRACTORS DECLARAT}ON LKINWOR
I hereby affirm that I am licensed under provisions of Chapter 9 Dlsp. — Room Air Cond. REG NLIM 5g Class.
(commencing with Section 7000) of Division 3 of the Business DISTRICT NO. BY
and ProfessiRns Code,and my license is Infull force and effect. Powbr AppaFvtus 8 Large Appliances '1 R
Size 8 Type HP, KW, KVA, or KVAR (JU
License Number I Ic Ciass T Up to 1 Incl' FINAL V
Ovw.l to l0 Incl. DATE17
Z�K � Y BION O
Contwctor, Date Over 10 to 50 Ind.
❑ I am exempt under Sec. Over 50 to 100 Inc. B s++
B.BP.C. for fills reason Over 100
°' Seryices, Swbd., MCC�& Panel boa rdl
0 -2W Amp. Under 600 V
Signatute, '201 - 4000 Amp. Under 600 V
E] Exemption
1000 Amp. or Over 600 V ��}}
Exemption for Reg. Mgint. Elect.
SINGLL FAMILY Temp, Power Role&Appurtenances
HOMEOWNER-BUILDER DECLARATION Sign with One Branch Circuit
I hereby affirm that I am exempt from the Contractor'sticense
Low for the following reason (Sectlon 7031.5,Business and Additional Sign Branch Clrcylt}
Professions code): 2 $5 0.�
❑ I, as owner of the property, will do'the work and the Mlic Conduits B,CohduCtprs ( 2 2 4 i 8 6
structure Is not Intended or offered for saie (Section .Other (Sev Complete Fee-Schedule)_ ,
7041,Business and Professions Code).
CONSTRUCTION LENDING AGENCY
I hereby affirm that there Is a constructloh lending agency for
the performance of the work for which this permit Is Issued PERMIT Fly (Sub-Total)
(Sec. 3097, civ. C.).
FLAN CHECKING FEE
Lender's Name
PERMIT ISSUING EEE
LeRders Address
I coHtfy that i have read this appllcatlon'and state that the TOTAL FEj=_
above Information Is correct. I agree to comply with all County
ordinances and State dews rogylpting Electrical wlring, and
hereby aLithorize representatives of this County to enter upon
the above-mentioned property for Inspection purposes.
y SEE REVERSE Fok EXPLANATORY LANGUAGE
N t- L .2!?
STgnature oo-Pe mltteb' ��"Date