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Home My Public Portal About6227 GOLDEN WEST AVE_Electrical__ 7GA663 DBS SA 3-50 ; APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY, � �� COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER Cil DISTRICT NO. GROUP ZONE PERMIT NO. FOR APPLICANT TO FILL IN ELECTRICIAN REMIXED)BY READY FOR DATE ISSUED ADDRESS FIRST INSPECTION _L�'/ CITY TEL N Oe O//// COUNTY LICENSE NO. EXPIRE � !1�' ! BUILDING ADDR PERMIT FEE ESS NUMBER EACH FEE LOCALITY LIGHT OUTLETS NEAREST CROSS ST. RECEPTACLES j WALL SWITCHES OWNER TOTAL OUTLETS Sc $ MAIL 1I ELEC. RANGES - 25 ADDRESS ELEC. HEATERS 25 CITY TEL. NO. FIXTURES S 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS MISC. _ , APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LI T CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES ,NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER ORSEPOWER ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNERFEE OF THE RESIDENTIAL PTY ESNEW MVD. HP�_H OVER INC. EACH CRIB�ED ABOVE. 1/2 & LESS $ ' .25 SIGNATURE OF t/2 2 SD PERMITTE 2 5_ 1.130 INSPECTION RECORD 47 5 15 1.50 15 50 2.50 50 200 5.00 200 50o 10.00 - J 500 1000 15.00 Z OVER 1000 20.00 _ (� M.G. BET/FREQ. CHANGER-HP Q' WELDERS:AC'KVA - O GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF ORIG.) MOVED MOTORS (75% OF ORIM.) MISC. SIGNS NO. NO.TRANS. APPROVALS NO. NO. LAMPS FOR EACH PERMIT: DATE INSPECTOR'S NAME WIRING $1.00 CONDUIT WIRING c:! I-) •L) FIXTURES- $1.00 ' SUPPLEMENTARY .60 FIXTURES POWER TOTAL FEE $ UTILITY CO.NOTIFIED I FINAL ��1�'�� ('WlAn/ WORKERS'COMPENSATION DECLAW, ION 76AG • 63: .'; '( � r ' • CE-806G I2-ab1 APPLICATION FOR ELECTRICAL PERMIT =� I'hereby'affirm that I have a certificate of consent t.•self _ 1000NTY OF LOS ANGELES BUILDING AND SAFETY a insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800,Lab.C.) Policy No. FOR APPLICANT TO FILL IN JOB +- , Company EACH NO: FEE ADDRESS ' �7 ❑ New Residential Bldgs:&Pools Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ $ LOCALITY 1 �•' e ». Multi-family Sq. Ft: - NEAREST• Certified co CR O copy is filed with�the county building inspection SS'ST department. 'Residential Swimming Pools OWNER OR r FIRM-NAME Q_ Date •Applicant'' Outlets Rec./r { ,Light Sw a., 61 / MAIL First 20 ADDRESS �•e CERTIFICATE OF EXEMPTION FROM WORKERS' Total No Additional' CITY r Tel No. ( g Z �} COMPENSATION iNSURANCE PLAN CHECK - 0- ,(This section need not be completed-if the work involved APPLICANT 0• by the permit is for one hundred dollars ($100) or less:) Lighting Fixtures First Additional ADDRESS Total No. p Icertify that in fhe performance of the•work for which this Fixed Appliances Not Over 1 HP CITY Tel-No. permit is issued, I shall not`employ any personpin any manner PERMIT U D so as to become subject to the Workers' Compensation Laws: Range_Heater_D.W. APPLICANT lU Oven Dryer_W.M._ a l N ...��//pp y ADDRESS Z �, n`ate/o�GApplicant Top _ FAU _W.H. I�aed Fan _Other= CITY Tel No. NOTICE TO APPLICANT: If, aft making this Certificate of Disp. Room Air'Cond._ LICENSE OR Exemption, you should become subject to the Workers' REG. NUMBER Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO. PROCESS/_D BY with comply with such provisions or this permit shall be,, deemed revoked. Size&Type HP,KW, KVA,or kVAR 1 Up to 1 Incl. =� FINAL o -Over 1 to 10 Incl. DATE _ sf LICENSED CONATION' TRACTORS DECLARVALIDATION-z ` %-,y'•.• Over 10 to 50 Incl. CJ �� I hereby affirm that I am licensed under provisions of;Chapter Over 50 to 100 Inc. FIN AL BY 9 (commencing with Section 7000) of Division 3 of the Busi- Over 100 ness and Professions Code, and my license is in full force and effect. Services f 0-200 Amp. Under 600 V License Number' Lic:Class 201,-1000 Amp:Under 600 V Contractor Date Over 1000 Amp.or Over 600 V HOME OWNER-BUILDER DECLARATION Temp. Power Pole& Appurtenances' I hereby affirm that I am exempt'from the Contractor's Sign with One Branch Circuit License Law for the following reason. (Section '7031.5, Busi- Additional,Sign Branch Circuits ness and Professions Code): O Misc.Conduits&.Conductors I, as owner of-the property, will do the work and the Other (See Complete Fee,Schedule)—. structure is not intended or offered for sale (Section' _o o" M 7044, Business•and Professions Code). CONSTRUCTION LENDING AGENCY n S I hereby affirm that there'is a construction lending agency for the performance of the woik for which this permit is. } issued (Sec:,3097,Civ C.). _ PERMIT FEE (Sub,-Total) a Q R �(1-4(4 y Lender's'Name PLAN CHECKING FEE '' (One-Fourth'Permit Fee). Lender's Address PERMIT ISSUING FEE' MM 'I certify that I have read this application and state that the TOTAL FEE above 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 x the above-mentio d property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE S' tureof mi ,ee l Dat =1WORICERS'COMPENSATION DECLARATION • 76A663 10i81 APPLICATION F�I� 'ELECTRICAL PERMIT , I ,hereby affirm that I have a certificate of consent'to,self4 CE-8066 insure, or a certificate of Workers' Compensation`lnsurance or a certifigd copv4hereof (Sec 3800, Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No V Company FOR APPLICANT'TO FILL IN JOB Certified copy-is hereby furnished. - New Residential Bldgs A Pools EACH NO FEE ADDRESS � � , t Certified copy is filed with the county building inspec- y, Sq Ft. LOCALITY �L C tion department Multi-family'Sq FP " — 'NEAREST CROSS ST 'Residential Swimming Pools OWNER OR Date Applicant FIRM NAME h-B CERTIFICATE OF EXEMPTION FROM WORKERS' ' MAIL Outlets. Rec Light Sw 0 f n COMPENSATION INSURANCE AD First 20 DRESS ' ' (This section need not be completed if-the work Involved by - Total No . Additional CITY �� Tel. No q7641 the permit is for one hundred dollars ($100)or less:) I certify that in the performance of the'work for which this PLAN CHECK _ APPLICANT permit is issued, I shall not employ any person in any manner so as to become suble5_pci4e Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS �� Total No. Additional _ / pate` giGl�7fIG�1�!'� CITY - Tel. No pp an tFtxed.Ap'plicinces Not Over 1 HP P NOTICE T, APPLICANTIf, after making this Certificate of Exemption, you should become sublect to•the Workers' Range_ Heater_D.W. _ ' APPLICANT Compensation provisions of the Labor Code, you must forth- Oven _ Dryer' — W.M ADDRESS • ' with comply with. such provisions,or this permit shall be Top FAU ' —W.H. deemed revoked. CITY Tel No LICENSED CONTRACTORS DECLARATION Hood Fan _ Other_ -Dis Room Air Cond. LICENSE OR Class. I hereby affirm that I am licensed under provisions of Chapter 9 p REG. NUMBER (commenting with Section 7000) of Division 3 of-the Business Power Apparatus&.Large Appliances . DISTRICT NO PROCES D BY " , } and Professions Code, and my license is in full force and effect. Size &Type HP, KW, KVA, or KVAR' O License Number Lic. Class Up to 1 Incl. FINAL `Q Q Contractor Date - - Over 1 to 10 Incl: TATE VALIDATION Over 10 to 50 Incl. AL • ~ I am exempt under Sec. Over 50 to ,100 Inc. �� C B&P C. for this reason Over 100 r v1 Date: - Services, Swbd., MCC & Panelboards / ► 0 - 200 Amp Under 600 V Signature 201 - 1000 Amp Under 600 V Over 1000 Amp. or Over 600 V .Exemption for Reg •Mamt Elect. SINGLE FAMILY Temp. Power Pole-&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 1 C) Q 4 R 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 0 0 0'o 0 2 PPrrro}f-essions Code): L'J I, as owner of the property, will do.the work and the Misc, Conduits 8 Conductor's �0 0 2'5,';5 0 structure is not intended or offered for sale (Section Other (See-Complete Fee Schedule)_ 7044, Business and Professions Code) ► o 0 0•2 5:5 0 5 CONSTRUCTION LENDING AGENCY O 6 1 1 8-4 I hereby affirm that there is a construction lending agency for the performance of the wo�rk,for which this permit is issued PERMIT FEE -Total) _ (Sec. 3097, Civ C ) -PLAN CHECKING FEE •• - Lender's Name PERMIT ISSUING FEE _ Lender's Address 1,certify that I have read this application and state that the TOTAL FEE above 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' th ove-mentioned property for inspection purposes I SEE-REVERSE FOR EXPLANATORY LANGUAGE Signat re of Permittee, Date -