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HomeMy Public PortalAbout6009 GOLDEN WEST AVE_Electrical__ C K 76A663 089 SA 7-51 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY m COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL I DISTRICT NO. GR/OUP ZONE PERMIT NO. ELECTRICIAN 1 CT -- - RECEIVED BY READY FOR DATE ISSUED ADDRESS FIRST INSPECTION CITY TEL NO. Jr— COUNTY LICENSE NO. EXPIRES BUILDING n �•� n 1A PERMIT FEES ADDRESS li D p�(/��l.W��r Aor - FEE NUMBER EACH LOCALITY 1� LIGHT OUTLETS CROSS ST. r RECEPTACLES S WALL SWITCHES _ OWNER 111,4 TOTAL OUTLETS Sc $ _ sMAIL ADDRESS � U �9j �•�4� �' ,VVif�s�_ ELEC. RANGES o 25 ELEC. HEATERS 25 CITYfeM Pk r, C 14 TEL. NO.A T—k- FIXTURES 5 OU- 1 HEREBY WLED E THAT 1 HAVE READ THIS MISC. 10 APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS / AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS 5 AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWERFEE ANGELES COUNTY LICENSE; OR 1 AM THE LEGAL OWNER _ NEW Mvo HP OVER INC EACH OF THE RESIDENTIAL PROPERTY DESC IBEO ABOVE. I�2 6 LESS $ .25 SIGNATURE OF '/2 2 .50 PERMITTEF� `•`�- 2 5 1.00 INSPECTION RECORD _ s 15 1.50 15 so 2.50 /�//"' so 200 5.00 ` S.B.12u lGO {.4/ .,��♦ti �^/�., r "' 200 Soo 10.00 500 10130 15.00 Z OVER 1000 20.00 _ En _ M.G. SET/FREQ. CHANGER-HP Q WELDERS: AC-KVA O GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF BRIG) MOVED MOTORS (75% OF ORIG) MISC. SIGNS 7� NO. NO.TRANS. APPROVALS NO. NO LAMPS FOR EACH PERMIT: DATE INSPECTOR'S NAME CONDUIT / WIRING $1.00 -- FIXTURES $1,00 WIRING SUPPLEMENTARY .50 FIXTURES 50 POWER TOTAL FEE $ UTILITY CO. NOTIFIED /e/J�6LCa.» y� Y!/rL T FINAL h - 76A663-CE606 9-67 APPL (,CATION F R ELECT CAL PERMIT '"r 4OUNTY OF LOS ANGELES I fl ) DEPARTMENT OF COUNTY ENGINEER rAA LDING BUILDING AND SAFETY DIVISION DRESS QO 3JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING ALITY 7eC&Ajil NEAREST FOR APPLICANT TO FILL IN CROSS ST NO EACH FEE RECEPT $ $ OWNER MAIL �— LIGHT TOTAL FIRST 20 20 ADDRESS O _ j�LjL�F C� SWITCH OVER 20 10 © CITY - •D� �'T EL. NO. LIGHTING �TOTAL FIRST 20 20 CONTRACTORFIXTURES OVER 20 10 ,ADDRESS RANGE—DRYER_WTR HTR.— CITY TEL NO STA COOK_DISP F A U LICENSE NO / SPACE HTR- AIR CONE) I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ,AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CLOTHES WASH _DISHWASH - WITH ALL COUNTY ORDINANCES AND STATE LAWS ,REGULATING ELECTRICAL WIRING FAN-OTHER 1 00 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS RED IRED BY LOS ANGELES COUNTY AND STATE OF MOTORS,TRANSFORMERS RATING CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO IND HEATERS, ETC HP KW KVA RESIDE IN, THE VEffiDEIBED RESIDENTIAL PROPERTY SIZE & TYPE OVER TO SIGNATURE 0 – 1 11 00 OF PERMIT TE 0 t – to 3 00 DIST ICT GR U Z E P BY U 10 – 50 5 00 � / T O ' 50 – 100 10 00 NOTES: G W 100 - 500 15 00 N A -TUBE, SIGN AND ONE CIRCUIT 3 00 MARQUEE ADDITIONAL CIRCUITS 1 00 SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00 0 SERVICE OVER 600 VOLTS OR 200 AMP 5 00 TEMP SERVICE, POLE, & APPURTENANCES 3 00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP POWER POLE UNDERSLAB WORK ROUGH CONDUIT ISSUING FE_ E 2 00 Q (' WIRING Q FIXTURES SUPPLEMENTARY ISSUING FEE 1 00 POWER AUTHORIZED PERMIT FEE UTI LI TY CO NOT]FI ED PLAN CHECK FEE (50% PERMIT FEE) FINAL ' TOTAL FEE JOSEPH C. ROOHAN SUPERVISING ELECTRICAL ENGINEER PLAN CHECK VALIDATION CK M o CASH PERMIT VALIDATION cK M o CASH I jAo 3'533 t12 2 D 11.90- _Q SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE �� WORKERS'COMPENSATION DECLARATION 76-663 �0/a`� ' APPLICATION' FOR ELECTRICAL PERMIT,,. 4 ' 7 -t hereby affirm that I,have a certificate'of consent to'self,insure, 'CE-806G or a certrfiohte'of Workers' Compehsatior Insurance;or a•certified' .COUNTY OF LOS ANGELES ' a BUILDING AND SAFETY ., p' copy thereof (Sec"3800;Lab C) , POhCy''NO° 'COmpany^ i' +' FOR APPLICANT,TO FILL,IN, ^"'JOB ' ., ., .., . - , ADDRESS Certified copy is'hereby,furnished i New Residential Bldgs & Pools EACH,,' NO FEE ` 1 &`2 Fa`mil Sq' Ft' ;1, $ �LOCALITY'l '�I��fc��C., y dertrfied copy,is filed with -the 'county'-budding inspection y,' 4 s. t a'•r• department ., sof b r. '� Multi-family Sq'Ft ' •� , NEAREST ,ter :CROSS ST �,Qf ✓/w./ � Date Applicant sidentiaC'Swimmm ✓ools ),:• OWNER OER / / b r° I ' "} ,FIRM NAME dee r ^•y, tiCOMFENS�ATION INSURANCE„a, Outlets Rec'� Light- Sw �:— ',MAIL '� 'i' ,.t,. ' -J ADDRESS First-20 I (This section need not be,completed rf;ttie work•rrivolved by the' c Total,No' Additional CITY_ e�!%►�LLCG� — Tel' No 'x.33 perm r:onehundred.dollars ($100)'or less)' "- r 7•�` ,t, PLAN,CHECK - •'� ••, I certify that-in, erformance of the work,for wh -this permit y - Y= - APPLICANT - is issued, l'shall'not• o pers n.an annerso as,to y : r becomes . ect,to the,W r Com Li mg Fixtures � First 20' - + = -ADDRESS b ",Additional Total No; CITY Tel No ate lica NOTICEy,TO ICANT •I,r er makm ificate of _ Fixed,Apphances Not Over 1.HP PERMIT Exemption " shouldlbecome'sub] c e,W� kers, pensation. ) Range_' Heater_ DW _ . ' APPLICANT' prove sof,the Labor Code, you;must forthw h comply v�t+z�such• ^, Oven Dryer _ W M ADDRESS' + -provisions 4,14 or,-this permit`,shall be deemed revoked To FAY., W H ', rI LICENSED CONTRACTORS DECLARATION, P ? p —} —~ CITY'` Hood Fan Other— I her. affirm.that I,am 1licensed under.provisions of Chapter 9 'L'ICENSE OR .,y Disp Room-Air Cond •Class -7(commencing with'Section 7000):of Division 3,of the Business and REG NUMBER' Professions Code,and"my license is'in'full force and'effect' * DISTRICT NO PROCESSE BY 3Power Apparatus& Large Appliances , _ ' Size•& Type HP,•KW,kVA1.,or KVAR; A QQ' License,Number Lie Class Up to 1-Incl _ - FINAL U 1-• t Over,1 to 10 tncl 's` DATE loo� VALIDATION Contractor " - ' `' Date ❑ s _ Over 10-to 50 Incl ^ FINAL V•. I am exempt:under Sec Over 50 to 100-Inc gY W B&PC for this reason Over 100 a' Services,SWI5d,MCC,& Parielboards - I Z - Date 0—,200 AmpUnder-600 V ,.Signature" 201,"-'1000 Amp Under'600'V .t'° ..• .- iOver'1000 Amp or,Over 600 V a Exemption for Reg Mamt Elect ' SINGLE FAMILY' ''Te'mp Power Pole'& Appurtenances "' I HOME'OWNER-BUILDER DECLARATION Sign with One Branch Clrcwt, I hereby'affirm that I am,exempt_from'the Contractor's'License Law, for the following Feason (Section 7031 5, Business'and:Profe_ssions Additional Sign Branch Circuits 1 ,Code) • ' ' ' a ) + pt y ti' e >.I ' n ;Mist",'Conduits & Conductors—'- :'7 I„as owner of the property,=wdl do the work and the structure is not intended'or offered for sale (Section 7044,-Business 'Other(See Complete Fee Schedule) � nit'Professions Code) ro +• , �` :. ,, - >`m lyes' CONSTRUCTION LENDING AGENCY � 36.75 s I hereby'affirm that'there is.a construction lending agency for-the performance Othe-work for which this permit is issued.(Sec 30979 PERMIT FEE -•` (Sub.Tota)k+ '<<'• )5' Civ C) r_ i "Y s° .•� '•`. �” r'' , s. PLAN CHECKING FEE, Lender's Name• F t ,,. i i, T1, r " v;yy0.z PERMIT ISSUING FEE - 4, , . 4 * ;f ,rw 41- to ^i ender's.Address'' L I certify that;I•have'read this application and state that the"above, TO_TAL FEE information is correct I agree to comply with all County ordinances Ad State laws regulating Electrical-,wiring`, and hereby authorize ;.,. nt_atives-of tliis'County'jo enter upon the-above-mentioned pro ,inspec I n Pur oses > r�°SEE,REVERSE.F OR EXPLANATORY LANGUAGE S ^ ,r i mit Date ,,