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Home My Public Portal About5347 GOLDEN WEST AVE_Electrical__ 78A883-CES08 3-84 APPLICATION FOR EL ECTRICAL PERMIT, COUNTY OF LOS ANGELES D$PARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS K! JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY NEAREST / FOR APPLICANT TO FILL IN I CROSS ST. RECEPT/ff TOTAL NO. EACH FEE p FIRST 2O ffi 20 ffi OWNER LIGHT MAIL ADD'L 10 Q ADDRESS SWITCH. OVER 20 LI(-wrINGI TO F)RsT20 .20 CITY E FIXTURES ADD'L ELECTRIC AN OV9R 20 10 RANGES CLO DRYERS WTR.HTRS. 1.00 ADDRESS / GARB.DISP. STA COOK / CITY TEL. N DISHWASH AUTO.-WASH. / STA A SPACE HTRS. BTA.APP.(,/a H.P.MAX.) .50 LICENSE NO. MOTORS. OVER NOT OVER H P. DIS71C O. GROUP ONE P ESSED BY O 1 1.00 1 s 1.50 INSPECTION RECORD >- a s s 2.00 O 8 15 2.50 p� 15 50 5.00 V 50 100 500 UJ d N SIGNS: NO TRANS Z NO.LAMPS SERVICE 0.600V.NoT OVER 200A 1.00 SERVICE 0-60OV-OVER 200 A. 2.00 SERVICE OVER 600V 5.00 MISC. PERMIT ISSUING FEE 2.00 SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE 8 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY CONDUIT n �(A WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING 7. /� �1� ✓ T� a '� �f 1HERE93Y CERTIFY THAT I AM PROPERLY REGISTERED AND/OR p r -- LICENSED AB REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE • i DESCRIBED RESIDENTIAL PROPERTY. //� POWER SIGNATURE /U / UTILITY CO.NOTIFIED �!!/$ OF PERMITTEE '/, FINAL 6 V LIDATION ARTHUR C. VEIT CK MO CASH SUPERVISING ELECTRICAL ENGINEER LAL;o 1 2 1. 4 G 14AY 4 2 D 1 0.40' cv J _ 1 reby aN,rhmEthal�l ave Sa certNIDo PLAof consent to self CE 8066 '0'81 heAPPLICATION FOR ELECTRICAL PERMIT insure, or d certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a cer.fied-copy thereof (Sec 3800, Lab C ) Policy No Company FOR APPLICANT TO FILL IN, JOB5_3 �• Certified copy is hereby furnished New Residential Bldgs & Pools EACH. NO FEE ADDRESS tj� Q1A/uZi/�S Gr — / Certified copy is filed with the county building m1 & 2-Family,Y. S q Ft $ $ LOCALITY ' tion department Multi-family Sq Ft NEAREST Residential Swimming Pools CROSS ST UC �! i Date A IicanT 1 OWNER OR j PP FIRM NAME f C -CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec�Light�Sw_Z MAIL COMPENSATION INSURANCE ADDRESS �l9 ME j s section neenot completed if the work involved b First 20 / (Thitid t bm p y Total No Additional CITY Tel No b p(� � 5 the permit is for one hundred dollars (6100)or less.) 1 certifythat n the erforinance of the work for which this PLAN CHECK iP APPLICANT permit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Co sation LaVsLighting Fixtures First 20 ADDRESS Total No Additional Date 6 7Applicant CITY Tel No Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT If, aft -r- aking t Certificate of APPLICANT !C 4 ,� / Exemption, you should become' subject to the Workers' Range_ Heater_D W ` Compensation provisions of the Labor Code, you must forth- Oven _ Dryer W MADDRESS t!/7 �! with comply with such provisions or this permit shall be Top — FAU —W H — deemed revoked CITY i i� £ �� ` Tel No 'g4 LICENSED CONTRACTORS DECLARATION Hood Fan _Other_ Disp _ Room Air Cond LICENSE R Class I hereby affirm that I am licensed under provisions of Chapter 9 REG NUMBER - (commencing with Section 7000) of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO E ED BY.. and Professions Code, and my license is in full force and effect t� a (� d Size &Type HP, KW, KVA, or KVAR J U 0 License Number Lic Class Up to 1 Incl FINAL tJ Contractor Date Over 1 to 10 Incl DATE VALIDATI' 0 ❑ Over 10 to 50 Incl FINA F I am exempt under Sec Over 50 to 100 Inc BY tVu B&P C for this Over 100 �4p,--7 reason Services, Swbd , MCC & Panelboards Date Services, - 200 Amp Under 600 V Signature 201 - 1000 Amp' Under 600 V ❑ Over 1000 Amp or Over 600 V Exemption for Reg Maint Elect SINGLE FAMILY Temp Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits Law for the following reason (Section 7031 5, Business and Professions Code) I–as owner of the property, will do the work and The Misc Conduits 8 Conductors structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)— 11110.7044, Business and Professions Code) 7 3 4.5 A CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for # 0,0 0'0-,o 2 the performance of the work for which this permit is issued PERMIT FEE (Sub-Total)• Sec 3097, Civ C ( ) -� ',I -`- 24.,0 0 c� PLAN CHECKING FEE 05 Lender's NameLO o,0 - 24,0 PERMIT ISSUING FEE Lender's Address 626.&87 1 certify that I have read this application and state that the TOTAL FEE 0-6 above information is correct I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorizer presentotives this County to enter upon the above-m ti ed pr er f nspection purposes SEE REVERSE-FOR EXPLANATORY LANGUAGE Sign ure of(:)InKee rDate > tr,tn/O{7KERS' COMPENSATION;DECLARATION. CE-806G 10/81 APPLICATION' FOR ELECTRICAL PERMIT , Iaffirm thatd have a'certificate of consentto.self insure, + G tficate of Workers'•Compensation'Insurance, or.a certified COUNTYOF LOS'ANGELES BUILDING AND SAFETY a .cdt�? 'bof(Sec 3800,Lab C); ' , COUNTY,OF - Pohcy' r,• Company ,- FOR APPLICANT TO FILL IN' x JOB ? "7 ` w; ADDRESS', 5 J / 1 £ ,' S w .Cert111ed,copy is hereby furnished. " New Residential Bldgs & Pools EACH NO• FEE'- _ - - ,` w : 7" $ — $ LOCAL'ITY' 5 z t, Certified .copy is''flled.with the, county building inspection 1 & 2-Family,Sq Ft r �' a ' department, - ` Multi-family Sq+F,t NEAREST"- t :,,•' 9 �, r �,CROSS ST l'� Date A Iicant Residential Swlmmmg,Pools " OWNER OR "1 ,t • ' •` FIRM NAME, ,, c x.,• ,CERTIFICATE OF`EXEMPTION.FROM WORKERS' ,,,':'' � Outlets Re ,'Light '°'' 'Sw AIL` COMPENSATION INSURANCE i• 3 {ADDRESS (This section need•n'ot be corripleted•if the work Involved by,the First;20 , •• e` .t!.. ..+ .,permit Is for one fiundred dollars,($100)or,less.) Total No-•- Additional' '.CITY ,•Tel, I•certify�that-In'the,performance,of the work for,kwhibh this•permit y PLAN CHECK W �r APPLICANT isrissued,,,l•shall:not employ,any person in any.�manner so as to o; „ become subject to.;the-Workers'!CompensatiomLaws' Lighting°Fixtures`, First•�20', ,f, ADDRESS, ` i a Additional Dat -? Total No d CITY 1' Tel No e _ Applicant �, 3 ,, + Fixed Appliances Not Over,1 HP PERMIT ? NOTICE :TO'',APPLICANT, If; after; aking, this, ertifidate of s'Exemption;,you should becomesubject.to.the Workers'Compensation :t' Range_ ,Heater= DW APPLICANT •"� provislons-of;dhe Labor,,�Code,;you must`,forthwith comply,with`such Oven_ Dryer °.WM ADDRESS provisions•or;this;permd shall be deemed revoked ,Top i._ FAU,a._W H " `CITY " " z" a '" i.'.1�LICENSED CONTRACTORS DECLARATION', F Hood ' Fan `_ ,Other" Tel_No I hereby,affirm ,that I,ami licensed,'under provisions of•Chapter 9 F LICENSE OR F 'd . (commencing with.Sect+on 7000) of Dlvisiom3:of the Business and Disp —'Room'Air Ggnd ; �' ` Cla§s " 'REG NUMBER Professions Code,and"my license is in full force and effect - DISTRICT NO - PROCESSED BY. P.ower,Apparatus& Large Appliances, Size & Type HP,,KW,K,A. or KVAR License Number Lic Class a Up to 1.Incl U ' i FINAL C Over 1 to 10 Inc] DATE !/ „� Contractor W `+ Date• r c VALIDATION _ 0•, ❑ 'Over 10,to 50 Incl,, FINAL - i ~ 0,I am exempt under Sec Over 50.to,100 Inc BY, r B&P C for this re so Over 100 a r r Services,Swbd” nelboards Z MCC&Pa i• Date 0- 200 Amp'Under 600 V p'`t Signature i - 201'-"1000 Amp'6nd4r'600 V" 5jA' Over 1000,Amp.or;Over 600 V > c _ Exemption for Reg`Maint Elect �# "0-.0'0'-01-2 " - SINGLE'FAMIL-Y' , " Temp Power Pole&'Appurtenances 2 5 HOME OWNER-BUILDER,DECLARAT,tON• ,,' ' :�'M 1 7. ;Sign with One Branch Circuit, r ,' o' o o = I hereby affirm tliat.l'am exempt from the Contractor,'s License Law i r + Y }•. 1.,2 7 5 c>> for the•,following reason,(Section"7Q31 5, Business and Profess'lons'1 -Adddional'Sign Branch Circuits, Code) 4' x ' rc ; '0'3,,l,7'1=.8 8.^ I,as owner of the property,will do the wand the"structure ork n ' Misc Conduits& Conductors 1 ' Yt t ,.k^1 d Other(See'Complete Fee Schedule)' 4`s isnot Intended°or,offered for sale (Section 7044, Business _ r and,Professions Code) t CONSTRUCTION LENDING AGENCY,. ''` r. 'k � x` T`her'eby'affirm that-there is a eonstructlori lending agency for the j performance of the'work for which this'permit is Issued(Sec 3097, PERMIT FEE '(Sub,-,Total)qIv +t PL`AN'.CHECKING FEE Lender's Name a' 'PERMITzASSUING'�FEE W;•s �,� �� ,rx.';' ;Lenderls Address I certify that I have read this appllcation'and state that the above',, TOTAL FEE_, �*F• y µ information is'correct I"agree'to comply wrth;all County ordinances " ~ • and State laws regulating,Electrical wiring, and hereby authorize. ; ". representatives of this County to'enter on the above-mentioned property for inspec purpo -SEE REVERSE FOR.EXPLANATORY LANGUAGE-t Si ature of Per tt e t Date ,Y