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Home My Public Portal About6201-6201 1/2 GOLDEN WEST AVE_Electrical__ COUNTY of LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY WILLIAM J. FOX, County Engineer FOR ArPLICANT TO FILL IN : DISTRICT NO. (3ROUP ZONE PERMIT NO. ELECTRICIAN �{{{{{r�// ADDRESS /�/(,� `� , / RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION CITY TEL NO. COUNTY LICENSE NO. -/ L^' EXPIRES BUILDING PERMIT FEES ADDRESS ' `. [NUMBER FEE EACH LOCALITY LIGHT OUTLETS NEAREST RECEPTACLES CROSS ST. WALL SWITCHES .� OWNER f '*"v TOTAL OUTLETS Sc MAIL ELEC. RANGES 25 ADDRESS ELEC. HEATERS 25 CITY TEL. NO. FIXTURES 5 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE 19 CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, 014 1 AM THE LEGAL OWNER NEW MvD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. %2 a ices $ 25 SIGNATURE OI, - I/2 2 .50 PERMITTEE Y _ --- 2 s 1.00 INSPECTION RECORD 5 is 1.50 IS s0 2.50 50 200 5.00 200 SOO 10.00 W F SOO 1000 15.00 La] OVER 1000 20.00 .J M.G. SET/FRED. CHANGER-HP O- Q WELDERS:AC-KVA Q GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF ORIG.) MOVED MOTORS (75% OF DRIG.) MISC. S113NS N0. NO.TRANS. NO. NO. LAMPS _T7APPROVALS FOR EACH PERMIT: DATE INSPECTORIS NAME WIRING $1.013 L'J V CONDUIT FIXTURES 61.00 U WIRING SUPPLEMENTARY .50 FIXTURES POWER _ TOTAL FEE S UTILITY CO.NOTIFIED FINAL 76A663 DBS#5A 4-52 COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer � � DIVISION OF BUILDING & SAFETY WILLIAM J. FOX, County Engineer FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. in A ELECTRICIAN S 1 � A-1 /�. � RECEIVED BY READY FOR DATE 113SUED ADDRESS 4 �(� FIRST INSPECTION CITY TEL NO. `� V COUNTY LICENSE Na. O EXPIRES BUILDING PERMIT FEES ADDRESS �' / �+ -- FEE NUMBER EACH LOCALITY LIGHT OUTLETS 9 NEAREST RECEPTACLES CROSS BT. WALL SWITCHES OWNER TOTAL OUTLETS 5c $ 6 MAIL ELEC. RANGES 25 ADDRESS _ - ELEC. HEATERS 25 CITY TEL NO. FIXTURES 5 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER NEW MVD. HP OvER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. %2 6 LEBB $ .25 SIGNATURE OF A� %2 2 .50 PERMITTEr 2 5 1.00 INSPECTION RECORD 5 15 1.50 15 50 2.50 _ 50 200 5.00 200 500 10.00 J Soo 1000 15.00 Q Z OVER 1000 20.00 M.G. SET/FREQ. CHANGER-HP WELDERS: AC-KVA O GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% of DRIG.) MOVED MOTORS (75% OF CRIG.) MISC. SIGNS NO. NO.TRANS. APPROVALS NO. NO. LAMPS FOR EACH PERMIT: DA/TE INSPECTOR'S NAME WIRING $1.00 / 00 CONDUIT ( � a -- FIXTURES $1.00 / 0 X) WIRING SUPPLEMENTARY .50 FIXTURES 1 POWER TOTAL FEE $ UTILITY CO.NOTIFIED /J FINAL .6A663 DBS#5A 4-52 COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY WILLIAM J. FOX, County Engineer FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRICIAN RECEIVED BY READY FOR DATE ISSUED ADDRESS s/r eo FIRST INSPECTION CITY TEL. NO. COUNTY LICENSE NO. D EXPIRES ABUILDING DDRESS PERMIT FEES FEE NUMBER EACH LOCALITY C LIGHT OUTLETS NEAREST �— RECEPTACLES D CROSS ST. WALL SWITCHES I OWNER TOTAL 13UTLETS Sc 7 O MAIL ELEC. RANGES 25 ___ ADDRESS ELEC.- HEATERS 25 CITY TEL' NO. FIXTURES 5 '1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS Misc. APPLICATION AND STATE THAT THE ABOVE 19 CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS _ ANO.BTATE LAWS REGULATING ELECTRICAL-WIRING. MOTORS I CERTIFY THAT I POSSESS THE ABOVE VALID LOB NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER NEW MVD. HP DVEw INC. EACH OF THE RESIDENTIAL PROPERTY D�JBEDAeOVE. %2 d LE195 $ .25 SIGNATURE OF � I/ 2 .50 PERMITTEE 2 5 1.00 INSPECTION RECORD 5 15 1.50 _ is 50 2.50 SD 200 5.00 200 BOO 10.00 J F500 1000 1 S.00 Z OVER 1000 20.00 13 M.G. SET/FREQ. CHANGER-HP ly WELDERS:AC-KVA 0 GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS 175% or DRIG•) MOVED MOTORS (75% Or DRIG.) MISC. SIGNS NO. NO.TRANS APPROVALS NO. NO. LAMPS -- FOR EACH PERMIT: DATE IN PECTOR'S NAME WIRING $1.00 U d CONDUIT �� FIXTURES $1.00 WIRING r l r94 SUPPLEMENTARY ,50 FIXTURES nq. POWER TOTAL FEE UTILITY CO.NOTIFIED ✓ / / J�/�� FINAL 76A665 DBS $5A 4-52 WORKERS'COMPENSATION DECLARATION -663 ,DAB, -APPLICATION, FOR ELECTRICAL PERMIT I-hereby affirm that I have a'cerhficate of consenCE t to self insure, CE-ao6G = 4 - • , or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF'LOS ANGELES BUILDING AND SAFETY copy.thereof(Sec 3800,Lab C) Policy No Company' - FOR APPLICANT TO FILL IN _ ,� JOB' EACH NO o FEE ADDRESS" Certified copy is hereby,furnished :„• New Residential Bldgs & Pools LOCALITY Certified copy isr filed"with the county building Inspection 1 & 2-Family,Sq Ft $ — $' department" Multi-family Sq Ft — NEAREST / / ' CROSS ST 4- (C�( 1 Date' Applicant " Residential Swimming Pools OWNER OR, i . ,.•• ., _. '� 't FIRM NAME } CERTIFICATE OF EXEMPTION FROM WORKERS"'z ' .t " MAIL Outlets Rec— Light t 2 — ! 3 ,1 "COMPENSATION INSURANCE• � ADDRESS '- (This section need'not be'corgoleted if the work involved by the First 20 CITY, Tel No permit is for one hundred'dollars($,100)or less.) Total No Additional` ^ � _ PI AN CHECK I ce�tif that in the Performance of,the-work,for yGvhich•this Permit `APPLICANT isoissued„1„shall'not employ any person in,any manner-so as to • become subject to.the Workers';Compensation Laws- Lighting Fixtures First 20 ;,ADDRESS 'Additional Total Total No CITY Tel No Date s App scan Fixed A fiances,Not Over, 1 HP .NOTIC , To'.APPLI ANT. If, after- making ;this•'Certi icate' of PP `r PERMIT Range— Heater' DW -I: W APPLICANT,/ .1 Exemption,you should become subfect to the Workers',Compensation_ 9 t— - -� - - ,ro- t ADDRESS f provisions_of the Labor,Code, you must,_forthwith comply,,with such Oven-__Dryer _ W M d-�.'• r {provisions or this permitrshall be deemed revoked , .`Top FAU---_ W H cif _ /� /' - LICENSED CONTRACTORS DECLARATION,•, Hood Fan '-, Other_ LICENSE R 8"1 '` k Tel No I hereby affirm that I am.licensed under prdvisions of Chapter 9 - Disp' Room Air Cond REG NUMBER Class (commencing with Section 7000) of'Division 3 of the Business and Professions Code,and m licnse is in full force and effect ' 4r y DISTRICT NO, PROCESSED BY - Y' e- c - Power Apparatus& Large Appliances - � __ �{ �- -- :•. •_ ;, --- -- �.` - _ Size& Type HP,KW,KVA,or'KVAR License Number Lic Class' FINA� U Up to 1 Incl C" Over 1 to 10 Incl _ Contractor-' •bate DATA _ V -TION. �, ` Over 10 to 50 Incl , FINA i U ❑ , I am exempt under Sec Over 50 to 100 Inc BYLU B&PC for thisOver 100 a reason Cn Services,S%l6d,MCC& Parielboard _ Z Date 0-200 Amp,Under 600 VJ Signature 201 -'.1000 Amp Under 600 V Over 1000 Amp or Over 600 V y❑ Exemption for Reg-MainY Elect v _ 2 SINGLE FAMILY Temp Power Pole& Appurtenances r „.,,.,•_ _ ,.�.i-4. _ HOMEOWNER-BUILDER DECLARATION. Sign with One Branch Circuit r I hereby affirm that I am exempt from the Contractor's License Law 8 , for the following reason(Section 7031 5, Busi6ess;and Professionsj' i Adddional,Sign Branch Circuits -307 3 w9 Code) _ I � Misc Conduits& Co6ductors I,as owner of the property,will do the work,and the structure f ' ' -TOTAL 25 -`50- is'not'intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) ► and Professions Code) f'I CONSTRUCTION LENDING AGENCY' ” I•hereby affirm`that there is a construction lending agency for the performance of the•work for which this•permd is issued(Sec 3097, PERMIT FEE: (Sub-Total) Civ C), ' , r ,a V %J,`�1- (' r•.<7�^:.i•-J6�-: PLAN CHECKING FEEL Lender's Name rPERMIT ISSUING FEEa 7-- •,t • -. - Lender's Address I certify that I have read this application and state that the above TOTAL FEE information is correct I agree to comply with all County ordinances , and State laws regulating Electrical wiring, and hereby authorize representatives of this County to enter upon the above-mentioned i property for inspection purposes „ j/ -SEE REVERSE FOR EXPLANATORY LANGUAGE r Signature of Permittee Date .i,° ,;-�.W7RKERS COMPENSATION DECLARATIONCE-806G tC/81 �APPLICATION' FOR ELECTRICAL 'PE,RMIT ;'• + ycf i Aereby'yytm'that,I have a'certrficate of consent to self,insure, a or'a: rtifreaie`of'Workers''Compensatiori Insurance, or-a certified_ ',COUNTY OF.LOS ANGELES,` 1,-`'13UILDING AND'+SAFETY,:'' . copy thereof(Sec 3800,Lab C -d' �,�' 3 Policy N - Company-'�/JFK-+o :t, FOR APPLICANT TO_FILL`INF,.',, ' r � • +G•r >, JOB ❑ Certified copy/is hereby furnished _ .. EACH",J?NO, _ FEE, ADDRESS`'. , - New Residential Bldgs & Pools ;� Certified copy is filed-withlthel ounty�budding inspection '1 &-2-Family,Sq14Ft. "f'�"y�S'v�' w_ $� �.' "40CALITY department (, Multi-family Sq Ft s : — NEAREST F y.; 'CROSS ST Date' Applicant Residential;Swimming Pools we.` 1 OWNER OR ` CERTIFICATE OF EXEMPTION FROM WORKIERS4' ,r MAIL NAME ,0�1 C COMPENSATIOIJ INSURANCE'_ Outlets Rec 'Light. Sw ,r s r MAIL SS S 4" (This section need not be completed, work'mvolved,by'the' '' i° ' ^ Flrst,20' 1 i CITY Tel No permit,is for=one,hundred dollars ($,100),or less) Tota(1\16' Additional t pr ` ' '�' •Y y PLAN,CHECKY I,certify'that in thelperformance-of the work for which this permit,:;, - % s issued, shall.not_em to ail APPLICANT ' p y y person,.in any manner,so as to j become subject to'the Workers'Compensation Laws Lighting,Fixtures• -First,20= ;-- tADDRESS•° Additional" ;:Total No "'f. ir_ ,CITY`r (' ,Tel,No. Date " Applicant ; Fixed Appliances Not Over 1,HP' `'� PERMIT NOTICE TO- APPLICANT If, •afterh making this ,Certificate's-Of o- _ „ f Exemption,you should become subject to,the Workers'tompensation"' ° Range Heater= DW _ APPLICANT' -'--r„' ��ib_o.a. od'E+�=x,^-.,..-•-•-»v-...a.�r..s3w. -;u ..-d,•,.r.yr�.,.« __ :��-myr..y�.m prowsions'of the,Labor Code,-you must-forthwith comply,with such • Oven Dryer ! W M s- ADDRESS' ; fPrOvispns or,this permit shall be deeme6'revoked_. ' Top;.;'_ FAU W H _ CITY' "Tel IJCENSED.CONTRACTORS DECLARATION Hood Fan Other_ , I hereby affirm,that I am'licensed under.provisions`of Chapter 9•, Disp — 'Room Air Ccnd LICENSE OR _Class (eommencing'with'Section.7000) of Divisiori 3 of.the Business and, .REG NUMBER,, r" Professions Code;and'my'li"enseis'in full force and,effect - '' DISTRICT NO. PROCESSED 4 a '� .1 1-_ Power Apparatus�& Large Appliances, - {,, � ��'„ _r Size&-Type,,HP,KW,'K,VA,or KVAR License Nurriber� j ` ,1: Llc-Classy " Up to 1,Incl FINAL y Over 1 to 10 Incl y DATE ,r 9j ( F ContracterR� / '�' -Date "��' _ C✓ // VALIDATION .-� O ❑ Over 10,to'50 Incl FINAL I am exempt under'Sec, Over 50 to-11,00rnc. ByC1 B&P C for thi n ry Over 100 c _ 9 4 A• 10 Services, Swbd,MCC & Panelboards, r to 0,0'0,0 2 5f�r Z to , 0.-200,Amp Under 600 V �,. Sign 201 - 1000 Amp,Under 600 V x, Over,1000 Amp or Overr 600 V R on for Reg Ma lett 4.Q'� SINGLE FAMILY• Temp,Power.Pole&Appurtenances � r' HOME,OWNER'BUILDER DECLARATION ;'," ' Sign•with One Branch Circud�;1 i I hereby affirm;that I am exempt from the Contractor's License'Law` for the following reason(Sectioni7031 5„Business,and-Professions Additional Sign Branch Circuits* 9 a1 Code) v i, - ) .r Misc-Conduits-&'Conductors'-', =1,�as owner of the property?wdl'do the work and'the structure s not intended or'offered for sale;(Section'7044, Business Y Other (See Complete Fee'Schedule) ' ”and Professions Code) - _ _ _a �, . �e ,�• r� . . .y' ,CONSTRUCTION LENDING AGENC I hereby.affirm that there is,a�censtructiont leriaing agency performance of the'work'for which this permit.is issued(Sec-3097;' ";PERMIT FEE- 7- (Sub-Total;,' ' t�.a i CIN C);' •r . - ?• - i 4 PLAN CHECKING'FEE x a., • �, r,, , J i N ; Lender's,Name j PERMIT-,ISSUING FEE Lender's Address I certify that I have read this application and state that the•above, TOTAL FEE ' 7 information is correct I agree,,to co ply with all County ordinances,r'f , , , �t�e tate Vp regulating EI n Iwrong, andhereby authorize;gat enter upon'the above mentioned;,ns' Plia; W ',SEE,REVERSE FOR RY-LANGUAGE; EXPLANATO ' .,, `•' '' + �r i ure:of Per itte ,' 'Date C : * WORKERS' COMPENSATION DECLARATION 76-810/81 ' APPLICATION 'F.OR ELECTRICAL PERMIT , , I hereby�ff,im that I have a certificate of consent to self insure, CE-806G ora certificate of Workers' Compensation Insurance, or a certifiedCOUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec 3800,Lab C) - Pohcy No��1 v 2( mpany �, 'w - FOR APPLICANT TO FILL IN" JOB Certified copy,Is hereby,,furnished r, New Residential Bldgs & Pools EACH NO FEE;., -DDRESS- ect1 & 2-Family,Sq Ft $ _ $ LOCALITY Certified copy is filed with the couhty building inspion •department ; Multi-family Sq Ft NEAREST CROSS ST z ~ ' Residential Swimming Pools,, OWNER OR /J J Date Applicant /J }y'Y} 1 .rie . tit ^t, ,FIRM NAME, . /v CERTIFICATE OF EXEMPTION FROM;WORKERS', Outlets Rec! r' Light Sw� - 4 ,t�Cb- ' �' a ' j�a MAIL= COMPENSATION INSURANCE r (/t/ AI DRESS /, First' 20 J� (This section need not be completed If the work involved by the Total ] `' CITY. Tel No .permit Is for one-hundred dollars($100)or less) No AddI I certify.that ,n the performancet.of•the work for.which�this permit ti• t y" PLAN APPLICANT CHECK is issued, I shall not employ any person in any-,mariner•so as to become subject to the Workers',Compensation Laws Lighting Fixtures First 20 6 Q ADDRESS I 'AAdditiohal01 Total No CITY r .?' 1 Tel No 2� "fS Date Applicant i l NOTICE;TO APPLICANT If, after, making this Certificate of Fixed Appliances Not Over 1 HP PERMIT Exemption,you should become subject to the Workers'Compensation -Range__Heater_ DW APPLICANT' provisions.of the_L-abor'Code,-you must forthwith comply with such,, `Oven Dryer WM ADDRESS provisions'(r,this permd'shall be,deemed revoked Top — FAU J!L'W H CITY Tel No LICENSED CONTRACTORS DECLARATION Hood — Fan Other_ I hereby affirm that I am licensed under provisions of Chapter 9 ,_ _ UCENSE_OR Disp ,Room'Air Co6d �' REG NUMBER Class (commencing with Section 7000)of Division 3 of the Business and Professions Code,*and my license is in full force and effectDISTRICT NO - PROCESSED BY Power Apparatus&-Large Appliances _ - '.S,ze'& Type HP,KW,KVA,or KVAR License Number �• , Lic Class Up to 1'Incl FINAL 'Z " V Over 1 to 10 Incl DATE i � � VA -TION _nn Contractor 7Jt /�-�Tl 5�rDate t5 �• ^ E] , . Over 10 to 50 Incl - I am,ezempt under,Sec Over 50 to 100 Inc gY W B&PC for•ths rea Over 100 Services,Swbd,MCC-&Panelboai�ds• Z -Date 0- 200 Amp Under 600 V Signator 201 - 1000 Amp Under 600 V ;99356A _Over 1000'Amp or Over 600 V 4 ❑ •Exem on for Reg,Mamt-Elect 0,o 0.o 2 SINGLE FAMILY ` Temp Power Pole& Appurtenances, HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 1 - 15600 I hereby affirm that I am exempt from the Contractor's License Law, Additional Sign Branch;Circuits - -; for the following reason(Section 7031 5,Business and,Professions Code) ❑ M,sc Conduits&Coriductors 0 4, Q 8'-� 8 8 I,as owner of the property,will do the work.and the structure isnot intehd'ed or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) and Professions Code) ' CONSTRUCTION LENDING AGENCY I - I hereby affirm that there ,s a construction lending agency for the performance of.the.work for which this permit is issued(Sec 3097,' 'PERMIT FEE (Sub_ Total)' Civ C) --PLAN CHECKING,FEE + LL Lender's Name PERMIT ISSUING FEE' - Lender's Address I certify that*l have read this application and state that the above TOTAL FEE , �b information is correct I agree to comply with all County ordinances and State laws regulator ncal wrong, and hereby authonie _ repre Ives of thi cunt o enter upon the above-mentioned ; pert f nspe n p s • �� • ; •-SEE REVERSE FOR EXPLANATORYILANGUAGE - ature er itte Date 1' '