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Home My Public Portal About6244 GOLDEN WEST AVE_Electrical__ De5'-6A 3.55 APPLICATION LICAT'I®N F®■ ■ ELEC ■ RIC ■ ERMIT 1 DMSION OF BUILDING AND SAFETY Deportment of County Engineer -UI s County of Los Angeles ADDRBUILEISS �olg pt WM.J. FOX, COUNTY ENGINEER CASSATT D.GRIFFIN. SUPT of Bu1LDINo Mj LOCALITY dI')') Ig FOR APPLICANT TO FILL IN NEAREST / PERMIT FEES CROSS ST. to GFS. NUMBER EACH FEE , OWNER LI ! YG� rs .LIGHT OUTLETS MAIL RECEPTACLES, – ADDRESS WALL SWITCH ES - r TOTAL OUTLETS 5¢ S CITY 4+. TEL NO ELEC RANGES I 25 ELECTRICIAN ' _ELEC. HEATERS 25 S ADDRESS KW EA CITY v TEL NO. FIXTURES 5 LICENSE NO. _ NUMBER OF LIGHT CIRCUITS 'W DISTRICT NO. I G&O-P ONEREADY FOR INSPECTION NUMBER OF RECEPTACLE CIRCUITS Vd MOTORS NUMBER HORSEPOWERFEE INSPECTION RECORD NEW MVD HP OVER INC EACH 1/2&LESS $ 25 _ 1/2 2 .50 -2 5 1 00 5 15 1 50 15 50 250 / 9 S�/./'N oFt �7 r/7[/ -�✓ ��- 50 200 '5 00 r A/f41I71 Z? �"/N�iF)Y.*$R12 TF misc. E&ZAI-r Ai'l de—Ze ,"012 / NO SIGNS NO.TRANS.• - -i� J dV-/-75 A1.4 r TD Rc NO SIGNS NO LAMPSN FOR EACH PERMIT' WIRING $1 00 FIXTURES $100 SUPPLEMENTARY 50 APPROVALS TOTAL FEE S 7' /O DATEp!/ INSPECTOR'S SIGNATURE I HEREBY ACKNOWLEDGE THAT'1 HAVE READ THIS APIPLICATION CONDUIT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY IS �,� �yAF, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING �/J ELECTRICAL WIRING. �q 1 HEREBY CERTIFY .THAT I AM PROPERLY REGISTERED AND/OR FIXTURES AIrI �� 6 LICENSED AS REQUIRED BY LOS ANGELESCOUNTY AND STATE OF "•� CALIFORNIA OR THAT 1 AM THE LEGAL•OWNER OF THE ABOVE POWER " DESCRIBED RESIDEMUAL PROPERTY SIGNATURE UTILITY CO NOTIFIED 2-/7-a. OF PERMITTEE FINAL WILLIAM J. FOX.COUNTY NGINEER VALIDATION A. C.VEIT.CHIEF ELECT. INSPECTOR (AC01.6 28 u° JAN 9•- 2 4.1 0 to �. WCirm that DECLARATION CE-806 10181 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self CE-806G insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec. 3800, Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS 5 — Certified copy is filed with the county building inspec- 1 & 2-Family, 4� Ft. $ $ LOCALITY tion department. Multi-family Sq. Ft. — NEAREST CROSS ST. Residential Swimming Pools OWNER OR Date Applicant FIRM N CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Re�� Light��Sw.l� MAIL COMPENSATION INSURANCE — ADDRE S This section need not be completed if the work involved b L First 20 ( p Y Total No. Additional �� CITY Tel. No. the permit is for one hundred dollars ($100)or less.) that in the performance of the work for which this PLAN CHECK I certify P APPLICANT permit is issued, I shall not employ any person in any m nner , > �S rl so as to become subject to the ers' en Laws.Laws. Lighting Fixtures /- First 20 ADDRESS r Total No. 1/_Z? Additional CITY Tel. No. Date Appli aw Fixed Appliances Not Over 1 HP PERMIT O NIC TAPPLICANT: If, ter mac g this Certificate of Exemption, you should become subject to the Workers' Ranse 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. Hood L Fan _Other— CITY Tel. No. LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 Disp. Room Air Cond. 3 �v REGNNUMBER Class. (commencing with Section 7000) of Division 3 of the Business Power-Apparatus& Large Appliances DISTRICT NO. OC SED BY I]..• and Professions Code, and my license is in full force and effect. //'' V Size & Type HP, KW, KVA, or KVAR, ✓(J� License Number Lic. Class Up to 1 Incl. ,va. 0::FINAL Over 1 to 10 Incl. .00 O DATE 0 Contractor Date �� VALIDATION Over 10 to 50 Incl. FIN W I am exempt under Sec. Over 50 to 100 Inc. BY B.&P.C. for this reason Over 100 Z Date: Services, Swbd., MCC & Panelboards 0 - 200 Amp. Under 600 V :OD 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& Conductors structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ , 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY ;25638A I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) # o o o o,-2 (Sec. 3097, Civ. C.). PLAN CHECKING FEE ° ° 7 4 7 5 Lender's Nameo o - 74,752o: PERMIT ISSUING FEE d Lender's Address I certify that I have read this application and state that the TOTAL FEE �tJ� I Q 1 4-8 6 above information is correct. I agree to comply with all County ordinances and State ws regulating Electrical wiring, and hep1by uthorize re es nt s of thi ounty to enter upon ab ve-mention d ro ty for i on purpo es.j SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permit a ate