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HomeMy Public PortalAbout6138 GOLDEN WEST AVE_Electrical__ 76A653--.E8061/70 R ` v,, APPLICATION FOR ELECTRIC AL PEWT .. COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS W JOHN A. LAMBIE, COUNTY ENGINEER LOCALITY 1 COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING NEAREST P FOR APPLICANT TO FILL IN CROSS ST. -)./(/✓✓l OUTLETS NO. EACHI FEE $ $ OWNER RECEPT._ MAIL LIGHT TOTAL FIRST 20 .20 ADDRESS OVER 20 CITY A TEL. N0. (.4� SWITCH_ .10 PLAN CHECK 2-2 LIGHTINGTOTAL �_O FIRST 20 20 APPLICANT FIXTURES 10 VER 20 ADDRESS APPLIANCES CITY TEL. NO. PERMIT RANGE DRYER_WTR. HTR. APPLICANT STA. COOK DISP. F.A.U. ADDRESS SPACE HTR. AIR GOND. CITY TEL. NO. CLOTHES WASH. DISHWASH. LICENSE N0. � CLASS. FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 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 & 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 THrA7 AM THE LEGAL OWNER O NO INTEND TO 1 — 10 3.00 RESIDE INiHE AB VE 1)ES6, 1PED RES ENTI L PROPERTY. 10 — 50 5.00 SIGNATURE O OF PERMI`TEE u 50 — 100 10.00 � DISTRICTNO. CLASS JGROUP ZONE JqESSED BY O 100 — 500 15.00 SIGN, GAS SIGN AND ONE CIRCUIT 3.00 NOTES: f ✓ c� N TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 ,x, SERVI CE NOT OVER 600 VOLTS OR 200 AM P 2.00 APPROVALS DATE INSPECTOR'S SIGNATURE SERVI CE OVER 600 VOLTS 0 R 200 AM P 5.00 TEMP.POWER POLE TEMP SERVICE,POLE, &APPURTENANCES 3.00 UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM 3.00 ROUGH CONDIUT WIRING n PERMIT FEE (SUB TOTAL) FIXTURES POWER AUTHORIZED / ai 7t // , PLAN CHECK FEE (50% PERMIT FEE) ^ UTILITY CO. NOTIFIED J PERMIT ISSUING FEE 2.00 `��Q SUPPLEMENTARY PERMIT ISSUING FEE 1.00 1 FINAL W JOSEPH C. ROC AN TOTAL FEE SUPERVISING ELECT CAL ENGINEERPLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION CK. M.0. CASH .. 5 2 .a � _, 27 2 D 5.0,13 'SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE �. C' +LlL)-Fm r l e-- (�� 76A663 CE-806(6/78) APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN JOB FApplionces sidential Bldgs.&Pools EACH NO. FEE ADDRESS -Family,Sq. Ft. $ .025 — $ LOCALITY -family Sq. Ft. 02 — NEAREST 25.00 CROSS ST ential Swimming Pools OWNER r-- FIRM NAME Rec Light Sw. MAIL First 20 50 ADDRESS No. Additional 30 CITY Tel. PLAN CHECK APPLICANT Fixtures First 20 50 ADDRESS Additional 30 No. CITY Tel. No. ppliances Not Over 1 HP PERMIT e_Heater_ D.W. APPLICAN—Dryer_ W.M. ADDRESS ! Top _FAU — W.H. � Tel.No. Hood—Fan _Other a LICENSE OR Disp._Room Air Cond. 2.50 REG.NUMBE Class. IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLIC77. Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO Size&Type HP, KW, KVA,or KVAR COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. a Up to 1 Incl. 2.50 0I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR Over 1 to 10 Incl. 5.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF Over 10 to 50 Incl. 12.50 CALIFORNIA OR THAT I M THE LEGAL OWNER OF THE ABOVE O 25.00 DESCRIBED RESIDEN PR PERTY. b Over 50 to 100 Inc. CVJ Over 100 40.00 PERMITEE M SIGNATURE WD Services DISTRICT NO. PRSSE Y g 0-200 Amp. Under 600 V 12.50 C y 201-1000 Amp. Under 600 V 25.00 (l Over 1000 Amp.or Over 600 V 50.00 Z O Temp. Power Pole&Appurtenances 10.00 Q Sign with One Branch Circuit 10.00 0 ' 1 39.6A Additional Sign Branch Circuits 2.00 INSPECTION > $ 00oao2 10.00 INFORMATION W Misc.Conduits&Conductors ON REVERSE x 2 0 0 0 9 5 0 Other(See Complete Fee Schedule) SIDE V Jo o o o9,506 It17-75 PERMIT FEE (Sub-Total) Z PLAN CHECKING FEE (One-Fourth Permit Fee) O PERMIT ISSUING FEE $7.00 G J Q TOTAL FEE > INSPECTION FINALED o:c W date: A����� By s ©s 764663-CE806 1-68 APPLICATION FOR ELECTRIC L PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER qDD ESS BUILDING AND SAFETY DIVISION JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY ��(/✓�"��� NEAREST FOR APPLICANT TO FILL IN CROSS ST. NO. EACH FEE S $ OWNER _1900 �- RECEPTr •� MAIL LIGHT /6TOTAL FIRST 20 4t OVER 20 2 .?O � ADDRESS SWITCH-1-0 9 17 CITY TEL. NO. PLAN CHECK LIGHTING TOTAL FIRST 20 .20 3 APPLICANT FIXTURES OVER 20 .101 ADDRESS RANGEDRYERWTR.HTR.^ CITY TEL. NO. STA.COOK_DISP. F.A.U.Z - . / COiJTRAC'rOR "/,�y��" >, C.C .• SPACE HTR.L�AIIRR COND. �/' ADDRESS CLOTHES WASH.V'' DISHWASH.(� y CITY 1 C,�1[,t �„O{pPJ TEL. NO. FAN�OTHER G 1 .00 LICENSE: 1-40. -9-59 5 IK CLASS. Q — / d MOTORS,TRANSFORMERS RATING IND. HEATERS, ETC. HP. KW. KVA. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION SIZE & TYPE OVER TO AND STATE THAT THE ABOVE IS.CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. 0 - 1 1.00 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 1 - 10 3.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO d 10 - 50 5.00 RESIDE IN, THE ABO�V)E DESCRIFED RESIDENTIAL PROPERTY. O 50 - 100 10.00 SIGNATURE V l ' O�G� OF PERMITTEE V ed 100 - 500 15.00 DIST ICSIGN �tj�jT GRO P ZO P D Y. 0 TUBE, OR SIGN AND ONE CIRCUIT 3.00 0 � a MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES: Z SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 0-0 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 PERMIT FEE (SUB TOTAL) WIRING FIXTURES PLAN CHECK FEE (50% PERMIT FEE) w� POWER AUTHORIZED PERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED ] SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL -v TOTAL FEE JOS PH 6. ROOHAN SUPERVISING ELECTRICAL ENGINEER PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION ;( CK:' M.O. CASH 944- MR 1 2D 22 v EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULEJ�y^C✓R' ` WORKERS'COMPENSATION cafe of corse' CE-806 10/811' APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to sCE-806G insure, or a certificate of Workers' Compensation Insuranc COUNTY OF LOS ANGELES �' BUILDING AND SAFETY or a certifi th reof (Sec. 3800, La . C. / Policy No. Company FOR APPLICANT TO FILL IN JOB ❑ Certified co s hereby furnished. EACH NO. FEE ADDRESS PY Y New Residential Bldgs. & Pools 1 & 2-Family, S Ft. $ — $ LOCALITY Certified copy is filed with the county building inspec- Y, q• tion department Multi-family Sq. Ft. — NEAREST i _Q Residential Swimming Pools CROSS ST. Date ua Applicant � OWNER OR FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Re( Light Sw._ �' MAIL \If, a MPENSATION INSURANCE First 20 S ADDRESS (This sectionot be completed if the work involved by Total No. Additional CITY Tel. No the permit ine hundred dollars ($100)or less.) PLAN CHECK A I certify thaerformance of the work for which this APPLICANT f!r permit is isssh not employ any person in any manner so as to becubje to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS Total No. Additional CITY Tel. No. DateApf nt Fixed Appliances Not Over I HP PERMIT NOTICE TO ANT: If, a r making this Certificate of APPLICANT Exemption, should beco subject to the Workers' Range_ Heater_D.W. —Compensativisions of the L or Code, you must forth- Oven _ Dryer W.M.— ADDRESSwith complsuch provisions r this permit shall be Top _ FAU —W.H. —deemed revHood _ Fan _ Other— CITY Tel. No.LID CONTRACTORS DE RATION LICENSrORg 0 1 hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. REG. NUMBER Class. (commencing with Section 7000) of Division 3 of the Business DISTRICT NO. PROCES ED BY and Professions Code, and my license is in full force and effect. Power Apparatus& Large Appliances Q��3 Siie &Type HP, KW, KVA, or KVAR' �.0 License Number. U Lic. Class Up to 1 Incl. FINAL �. U Over 1 to 10 Incl. DATE _ @S Contractor Date VALIDATION ❑ Over 10 to 50 Incl. FINAL 1 am exempt under S c. Over 50 to 100 Inc. BY - _ { r B.& C. for this reason Over 100 tf. Services, Swbd., MCC& Panelboards Date: 0 -200 Amp. Under 600 V , -�2 1 4 8:A Signatu a 201 - 1000 Amp. Under 600 V }` o o o o o 2 ❑ Over 1000 Amp. or Over 600 V I Exemptio for Reg. Maint. Elect. 2 0 0 1 J�Q SINGLE FAMILY Temp. Power Pole& Appurtenances 1 HOME WNER-BUILDER DECLARATION 0 0 0 1 7j, rt v Sign with One Branch Circuit I hereby affirm that am exempt from the Contractor's License Additional Sign Branch Circuits O 2 1 —8 Law for the followin reason (Section 7031.5, Business and Professions Code): ❑ I, as owner of the roperty, will do the work and the Misc. Conduits&Conductors structure is not inte ded or offered for sate (Section Other (See Complete Fee Schedule)- 7044, Business and Pr fessions Code). CONSTRUCTION NDING AGENCY I hereby affirm that there is a c struction lending agency for the performance of the work fo which this permit is issued PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE O S,Z) Lender's Address I certify that I have read this application and state that the TOTAL FEE 113eJ above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and h.rA authorize representatives of this County to enter upon th ot�� erty for inspection purposes. V , ( SEE REVERSE FOR EXPLANATORY LANGUAGE SignaturDate yJ