The URL can be used to link to this page

Home My Public Portal About6257 GOLDEN WEST AVE_Electrical__ """' APPLICATION FOR ELECTRIC PERMIT Z oa.aw s-u DIVISION OF BUMDING AND SAFETY Department of LO Eayin— os Angeles eUILDi Na f WM.J. FO COUNTY ENGINEER ADDR[SS f ` CASS TT D.GRIFFIN,Sur'T OF BUILDIN• LOCALITY OR APPLICANT TO FILL IN NI AREST FEES CROSS ST. NUMBER EACH FEE LIGHT a5UTLET8 OWNER RECEFTACI ES NAIL ADDRESS � WAL-SWITCHES TOTAL OUTurrs C ELEC.RANGES 20 ELECTRI 1 EL.EC. HEATERS 1 - 25 ADDRESS KW HA CITY NO. F IXTU R EG 0 LICENSE NO. NUMBER OF LIGHT qIRCUITS, - DIST R NO. JGROUP Z E aaAOT FOR ll'r[CTION NUMBER OF RECEPTACLE CIRCUITS M Oto RS HUYBge _ HORSEPOWER FEZ ++11�4TQ� E TON BWOBD WN RCW D. HP Ov" IC. [ACH e t.><sa .Y 0 • ` 2 .00 Y B 1.00 S 125 1 1.80 10 00 2.00 `00 200 0.00 M I BC. NO.SIGNS NO.TRANS. . NQl SIGNS N FOR CH PIMMITO WIRING 1pl.00 FIXTURES #1100 �p� SUPP ENTARY 0 AMOVAIS TOTAL FEE DATE INSPECTOR'S SIGNATURE I HEREBY ACXNOWLEDGE THAT'I RAYS READ THIS A LICAT70R CONDUIT AND STATE THAT THE WYE IS CORItECT AND AGREE TO COMPLY WITH ALL CQpUNTY ORDINANCES A" STATE LAW' REGULATING WIRING ELECTRICAL M+IklHe. 1 HEREBY CERTIFT THAT AY PROPERLT REGISTERED AND/OR FUTURES LICENSED AS ED BY ANGELES COUNTY AND STA OF CALIFORNIA OR I THE GAL ER OF THE ABOVE POWER D CRIBED RESID OPHRT�' SIGNATURE / UTILITY C0.NOTIFIED OF PRAWTTEE FINAL VO r 1AM J.FO UNTY ILNOIN VAMATION A.C.VETT,CHIEF ELECT.INSPECTOR . 'COB 9851UR OCT 14 2 1 .25 n : - m DBS SA 25M SETS 7-47 APPLICATWN FOR PERIOIIT DEPARTMENT OF BUILDING AND SAFETY 'ELECTRIC COUNTY OF LOS ANGELES WM. .D. FOX CHIEF ENGINEER Q NAME DISTRICT NO. GROUP ZONE PERMIT NO. U ADDRESS ` RECEIVED BY READY FOR DATE ISSUED UW CITY TEL.NO. FIRST INSPECTION J COUNTY W CERT.NO. EXPIRES - APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY JOB DESCRIP'T'ION OF WORK ADDRESS NUMBER OF OUTLETS ON CIRCUITS LOCALITY LOCATION BY ROOMS NEAREST LIGHT OUTLETS JSW. PLUGS IFlXT CROSS ST. CIRCUIT A B C D E F G IH 1 m NAME Z MAIL 3 ADDRESS O CITY TEL.NO. 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION.. ELECTRICIAN. I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE OWNER. CORRECTIONS J Q Z E7 D TOTAL NO. OF OUTLETS $ APPROVALS NO. OF FIXTURES $ DATE INSPECTOR'S NAME NO. OF MOTORS H.P. $ CONDUIT NO. OF SIGNS TRANS. $ WIRING I ' NO. OF RANf3f8'OR HEATERS $ FIXTURES MISCELLANEOUS $ POWER PERMIT FEE $ UTILITY CO.NOTIFIED TOTAL FEE FENA WORKERS'COMPENSATION 13ECLARATI�)N, Cepa l2�k APPLICATION POR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self CQUNTY OF LOS ANGELES T—�� BUJLDING AND St4FETY insur6j or a certificate of Workers'Compensation Insurance,or l r` a certified copy thereof(Sec.3800,Lab.C.) FOR APPLICANT TO FILL IN J013 r Policy No. Company EACH NO. PEE ADDRESS e& New Residential Bldgs.&Pools Certtn d copy L hereby furnished. 1 &2-Fpmlly,Sq. Ft. _ — i LOCALITY NEAREST _Certitled copy is filed with the county building inspection Multi-family Sq. Ft. Residential Swimming Pools CROSS ST department. OWNER OR FIRM NAME Date Applicant Outl6ts: Rec,&Light Sw. AIL Irst ADDRESS CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY Tel Nq. COMPENSATION INSURANCE PLAN C ('Phis section need not be completed if the work inrohed � APPLICANT hundred doRm ($100) or lea) Lighting Fixtures First 20 by the permit b for one h Addlttonel ADDRESS � - Total No. I certify that in the pbrformance of the work for which thisFixed Appllan Not Over 1 HP CITY s1 No. Q permit b Issued, I shall not employ any person In any manner PERMIT IU— so as to become s t t the orke s' Compensation Lacus. Range_Heater D.W. APPLICANT pLU Oven _ Dryer_W.M. ADDRESS )<Data jar Top _ FAU _W.H._ Z Hood — Fan _Other_ CITY L�G Tel,No. NO'T'ICE TO APPLICANT: If, after making this Certificate of Dlsp. _ Room Air CondomLICENSE 'Exemption, you should become subject to the Workers' RE .NU Class Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO. PROC ED BY with comply with such provisions or this permit shall be deemed revoked. Size&Type HP,KW, KVA,or KVAi0 � . Up to 1 Incl. FINAL LICENSED CONTRACTORS DECLARATION Over 1 to 10 Incl. DATE VALIDAT16N Over 10 to 60 Incl. I herebyaffirm that I am licensed under pt FINAL provisions of Chapter Over 60 to 100 Inc. BY 9 (commencing with Section 7000)of Division 3 of the Bust- Over.100 nese and Professions.Code, and my license L in full force and effect., Services License Number Lic,Class 6-200 Amp.Under 600 V C f` — 201-1000 Amp.Under 800 V `Y ; Contactor Data Over 1Q00 Amp.or Ova.r'600.V HOME OWNER-BUILDER DECLARATION Temp.Power,Pole&Appurtenances I hereby affirm that I am exempt from the Co¢tra'ctor's Sign with One Branch Circuit / License Laws for the following reason AddWpnal Sign Branch arcults on (Section 7031.3, Buri- ;F�,�2,�A nasi and Prpfessions Code): Mlsc.Conduits&Conductors ❑ I, as owner of the property, will do the work and the Other (See Complete Fee Schedule)— # 0'0'0.o o 2 structure is not intended'or offered for sale (Section ' ' 7044,Business and Professions Code). 2 o o 1 9,3.0 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency o 0 0 1 9,302i for the performance of the work for which this permit V PERMIT FEE. (Su trTotal) Q r Wao4(Sec. 3097,Civ.C.). •0 7 0 1 -8 2 Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) Lender's Address PERMIT ISSUING FEE 0 I certify that I have read thio application and state that the TOTAL FEE ` 4hary tion is correct.I agree to comply with all County M d State laws re"tlna Electrical wiring, and ise rep tatires of this County to enter upon boned p rty for lnsp¢ction pure SEE'REVERSE POR EXPLA14ATORY LANGUAGE � v f 9606 WORKERS'GOMPENSATIONDECLARAJ,lO13„_. CE-B0d12-SM- APPLICATION FOR ELECTRICAL PERMIT - I hereby ■fMrm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY lgsure, or a certificate of Workers'Compensation Insurance,of ■gertifled copy thereof(Sec.3800,Lab.C.) FOR APPLICANT TO FILL IN JOB / Policy No. Company ADDRESS fq yLI{y� C, New Residential Bldgs.&Pooh EACH NO. FEE Cartlfled copy Is hereby furnished. . 1 &2-Famlly,Sq. Ft. $ — $ LOCALLTY MultiCertified copy Y filed with the county.buildlhg inspection Residential Sq. Ft. Cf10$S ST department. Retidentlal Swimming Pools OWNER OR 6 FLRM NAME I 0 V �'ri► Date Applicant Outlets: Rec—Llyht SW. MAIL . —�Irst�— ADDRESS CERTIFICATE OF EXEMPTION FROM WORKERS' TotBI No. Additional. CITYTal No. COMPENSATION INSURANCE PIAN CHECK ('fhb section need not be a mpleted.if the work invoW APPLICANT by the permit Is for one hundred dollars ($100) or Ien.) Lighting Fixtures Flrrt 20 ADDRESS _15-7 �/ 2 Additionaloil Total No. I certify that lh the performance of the work for which this CITY ► • Tal No a 0 permit la inued,ishall not employ any person In any manner Fixed Appliances Not Over 1 HP' �" IU— APPLICPERMIT� a . r w so u to become subject to the Workers' Compensation Laws. Range-7—Reefer_D.W. CANT pp.. Overt Dryer_W.M. AflDRESS C!� Date Applicant FAU _W.H. 2_ AApliant Hood Fen _Other_ CITYTal No. 7 NOTICE TO APPLICANT: If, after making this Certificate of Dlsp. _ Room Air CondomLICENSE Exemption, you should become subject to the Workers' REQ.NUMBER OWN06rclass, Compensation provisions of the-Labor Code, you must forth-- Power Apperatus& Large Appliances DIgTRICT NO. PROC ED BY with comply with such provlalods or this permit.&hall be deemed reyoked. Size&Type HP,KW, KVA,or.KVA O� Up to 1 Incl. FINAL i Ov9r 1 to 10 Incl. DATE LICENSED CONTRAR CTORS DECLARATION Over 10 to 60 Incl. VALIDATION I hbreby Affirm that I am licensed under provUlons of Chapter Over-60 to•100 Inc, FINAL 9 (commencing with Section 7000) of Dtvbdon 3 of the Bust- Over 100 nese and PFofeesiom.Code, and my license is in full force'and r effect. Services Lcense Number Llc.Clan 0-200 Amp. Under 600 V IT 201-1000 Amp.Under 600 V Contractor Data Over 1000 Amp.or Over 600 V HOME OWNER-BUILDER DECLARtLTION Temp.Power Pole&Appurtenances 5 8 A I hereby affh-m that I'am exempt from the Contractor's Sign with One Breach Circuit Sign Branch CirGro 0 0 License Law for the following reason (Section 7031.5, Boal- Additional Sigults 0 0,#� L � 2 nese and Profeaafons Code): - Mist:.Conduits&Conductors 2 2350 M1, as owner of the property, will do the work and the Other(See Complete Fed Schedule)— y 2 5 0 structure I# not Intended or gffered for sale (Section '0.0 0 7044, Busiaesa.and professions Code). gONSTRUCTION LENDING AOENCY 0 8 2 5—8 2 I he.reby affirm that there is ■ construction lending agency 1 for the-performance,of the work for which this permit is PERMIT FEE (Sub-Totai) Issued(Sec. 3097,Civ.C.). Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) Lender's Addrbn PERMIT ISSUING FEE I certify that I have read this ■pplication'and state that the TOTAL FEE jay&-m rmation Is correct.I agree to comply with all County s and State law's a ■ting Electrical wiring and thorise re enta of this County to ente upon ention ropertyltot lrpposes pection pur . \ f r SEE'REVERSE FOR EXPLANATORY LANGUAGE JAA re ttee Date ' � 4