HomeMy Public PortalAbout6344 GOLDEN WEST AVE_Electrical__ " "°ash a°''c"SAT'°N of jo � 10181 APPLICATION FOR ELECTRICAL PERMIT'
I t,err3t,y hirtrnr mat I neve a e of t-to esti kiaraa,
or,a owtYkmde of Workers' iivurance, or a COUNTY OF LOS ANGELES BUILDING AND SAFETY
COPY 388010, C.)
perry J.J� FOR AAP1 KJ Wr TO.F01 IN J
❑ Ceriffled copy is I>Qr^ fUrhiat50d. New aidentlal Bldgs 8 Poole EACH Na FEE. Al)REM
-7- 16 LOCAISIr Y
' Certtfietl copy fa f11ed with the oou briidYip triapention 1 8 2-Fem!}Y,8-4 Ft WARESMuftl famRy S4 Ft Cf�SS 8T.
Residential Svrfnvntrrg Rode OMER ORbate
t
N
( ERl.1 M
MAL
C.OMPENSKWN INSURANCE Outlets Rao—.Light Law. 1— ADDRESS Z.3 2r
Mils.wction n"d.riot be mph
oo *C the work Iwav d by the Flrat 20
4)ermft Is Tor one hundrrrd dollarn(=100)or terra? Total Na Addkional r � Td.
1,oertffy tho:In the perfocrosncq of the work for whlch thin permk -PLAN CHECK. '
b Weaned, I shalt-not empigy any,pstaon In arty manner so as to APPLICANT
beoorne subject to the Wgricera'Cdfnpensab n Laws. Uahtng Fbcturee Ftrat 20 - ADDRESS
Total No Additforrel' CfTy Tel.No. .
Data " Fbced Applhancee Not Over 1 HP
NOTICE TO APPI.]C�ANT: If, a$ making aking t4a..C.erffloate .of PERitiT,
ExanVdon,you ehouid become euf?W to the Workers'ComperlsaHon Range Hedter.— [2W.
Wovfdone of the,Landr Code, you must.fortl7++fth corn pty wRh such Oven —.Dryer— W.M.— ADDRESS
provfdorre or this permit aha➢be deemed revoked Top —.FpU WA
LICFEN$E6-CONTRA=RS DECJR/UION Hood Fan Other_ -- TeL
jam
/
I hereby affirm PvA I am tbensed under provWoris.of Chapter 8OR ^'t
(oommenolnp tvbl
Section 7000)�of Don 3 of the Budneea and•, Disp. — Room Alr Cgr>d. REa MSR --..
Prufeaabne Cods and my floerree fe In Tull Lorne and effect Power!',pQer".d Large AW ak— - ED BY _ r
Lloerrae / Lk,Cfaee��O - HP,KW,ICN or K�AA FINAL
up to 1 fnoi. ■t •
Over 1 to 10 tnd �� 7\li11OA110N 2 t
Over 10 to 60.16d. FIS 7 % 22■
exefnpt Seo. �� bver 60.to,100 ho. BYxJ�
B C for this reason Over 100
SP --- ' 4
Dntx )UP
Swvfcee,SWbd,MCC 8 Panebboerds
0-200 An Urder 800 V D -
8lgrraturrj 201 - 1000 Amp.Under-800-V -
❑ Exemp}bh for Pigg Melnt.EVeat7. Over 1000 Arrlp ver or O8Q0 V 3307 y.y� '22.70
SINGLE FAMILY Temp.Power Pule k Appurtenances 1 I 1 CJ k7
HOME OWNER-BUILDER DEG AR410NJ TOTAL -. 22.90
1 hereby affirm ttiffi I em exempt from the CorrtracZ License.Law Sign wtth One Branch Clra>ft ry t +v1
for the kZowbv reason(Section 7481.6,Buelnesq and Pro(e4dore• A¢df(iorral Sign�rloh Otrafta 1 fL tL■ I
Cor#,):
❑ WON- COnddte S Corlduotore
I,as owner of the prgperty,wM do the work and the structure
Is not Interned or offered for pale (8ectidn 7044, Business Other(See�brnpleie Feb Sohed�e) _ �,r
and Profeaetav Code). , r�ary - 1 11��7��)
CONSTRUCTION LEt DM AGENCY - L 7 V� 1 .--.'AM 10 3 5!5
1 hereby affirm tliet there Is a construction Ianding ap-W for the
papbravMe of:the work for which thio permR is homed,(Spc 3087, ' Ptwrr FEE (Sub-Total) go -
ay. C.). -
PLAN CHECKING FEE 4
Carrier's Name 1�
PfAMir ISSUitJCd FEE _
LerKWa Addreds
I certffy that I he% read,this application and state that the above _. TOIL FEE • ,
Wormerion fa correct.I agree to-Cony Wtth a➢County adlnarxee
and State laws reguLOng ElDcbica wiring, and hereby authortze
thb Canty to enter upon the menUored
SEE REVERSE FOR EXPLANATORY LANGUAGE
ol a
Date
VVOAKERS'COMPENSATION cx*AITON CE ,ore, APPLICATION FOR ELECTRICAL PERMIT
I hereby-affirm tt>�t I have a y�rttM1mte"of
d corueot to "YImre, ��D6O
or a certlfiaate of Vlbrker6' Conperraation feurence,.or a cermtied COUNTY OF LOS ANGELES BUILDING AND SAFETY
copy thereof(Seo.3800,Lob.C.)
Poflcy No. Company FOR APPLYCAAIT TO FULL IN 'OB
❑ Certffled copy h hereby fumtehed. New Realdendal Bldg&&Pods EACH NO. FEE ADDRE89
❑ Cera l copy is Tiled with the county building hspectlon 1 & 2-Famlly,Sq.Ft $ — $ LOCALJTY !�
departnt Murd-famlly Sq.Ft NEAREST
er
CA03S 8T.
Date AppJlcant Resbantlal Swtmming Pools O"WR OR J
FRN NAME Lit/
CERTF)CATE OF EXEMPTION FROM WORKERS' Outlets Rio Light Sw, AMYL
COMPENSATION INSURANCE Fkat 20 A I MA ZA.'
(This section need not be completed tf tit•work krvolved by it» Total No. Addttioral Tel.Na
permh la Tor one hundred dollars($100) or Imo)
CITY
PLAN CHECK
I certify that In the performance of the work for whbh tt* permit APPU,gM
he laeued, I shall not employ arry person In arty manner so as to
becone subW to,the Workers'C n parAation Laws. Lighting Ftxturee Flrst 20 ADDRESS
Total No. AdditkxiW CITY Tel.No.
Date APPIoantFixed Appllarxree Not Over 1 HP PEFINTr
NOTICE TO APPLJCANT: If, after making th}s Certificate of
Exemption,you should become m
ecoe subiact to the Vkdom'Compenaatlon D W
m
provisions of the Labor Code, you rtxmt forthwith,comply with ouch Oven — Dryer — WM— ADDRESS
provtslons or this permit shall be deerned revoked. Top — FAU — WN.
LICENSED CONTRACTORS DECLARATIOfJHood Fen Other
CF Y 7e1.No.
LCE_ —
I hereby affirm that I am Iloensed under provWons of Chapter A Disp. Room REG-Nu Air Cord. ORC1u�a
(commencing with Section 7000) d DNiebd th
n 3 e Businees and er NLS
m
Protesslons Ccde,and my Ibense le In full forog and effect Foyer gwaratus& Large'Appllaricee DtsTR1CT NO. PROCESSED BY
Size& Type HP,KW,KA or KVAR O
Llcerse Number LJc.Ciam Up to 1 Ind. Fl
Over 1 to 10 Ind. N lop VAUDATIO
Carrtr�tor Date Over 10 to 60 Ind. �
❑ am exempt under Seo FINAL
Over 60 to 100 Inc. By
B.&P.C.for th!e mason Over 100
SerAc e,Swbd,MCC& Par"boards , Z
Date. 0- 200 Amp.Under 600 V f �+
SVgnature 201 - 1000 Amp.Under 600 V
Over 1000 Amp.or Over 600 V
F-1Exemptionfor Reg.Malrrt.Elect.
Si LE FAMILY Temp.Power Pole& Appurtenances
HOME OWNER-BUILDER DECLARATION Sign with One french Clraft
I hereby affirm that I am exempt from the Cortbac a License Law Additional B
for the fdbwhig reason(Sed4)n 7031.6, Buelness and Prdesalor�a ranch C1rculte ANT.'VL
Cade): 3307 31.00
I,as owner of the property,w01 do the work and the structure Mist Condufts& Conductors
le not Intended or offered for Bale (Sect n 7044, Badness Other(See Complete Fee Schedule) _ , 1 ITEMS
and Profasalons Code). TOTAL 3.1 _ O0
CONSTRUCTION LENDING AGENCY 31.0G
I hereby affirm that there is a conahuctbn landing agency for the CHECK
performance d the work for which thi6 permit Is famed(Seo.3087, PERMIT FEE (Sul).-Total) O .
Civ.C.).
PLAN CHECKING FEE
Landers Name PERMIT ISSUING FEE 0000'-0001 8/31/WG
Larders Address 2665 1 AM10:11
I certtfy that I have reed thl6 application and state that the above TOTAL FEE
hforrnatbn is oxmct. I agree to corroy with all County ordhances
and regulating Electrical w1d and hereby autCdzje
County the above-mentioned
f rpoees. SEE REVERSE FOR EXPLAN.ArORY LANGUAGE
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