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HomeMy Public PortalAbout5623 GRACEWOOD AVE_Electrical__ 76A663-CE806 1074 APPLICATION FeR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER JOB BUILDING AND SAFETY DIVISION ADDRESS 3 r2 Lt7 O� ' LOCALITY �' 1)4 NEAREST FOR APPLICANT TO FILL IN CROSS ST. e D14 OUTLETS NO. EACH FEE OWNER OR FIRM NAME IrC� RECEPT. 9 $ $ MAIL FIRST 20 � ADDRESS _ ff. 9- P G o LIGHT. TOTAL , V20 CITY TEL. N0. _)^ S SWITCH �� OVER .10 PLAN CHECK LIGHTING TOTAL FIRST 20 L g �.Ll APPLICANT FIXTURES f0 OVER 20 ADDRESS � RESIDENTIAL APPLIANCES CITY TEL. N0, PERMIT RANGE DRYER_WTR. HTR._ APPLICANT STA. COOK DISP. F.A.U. ADDRESS SPACE HTR, AIR COND. CITY TEL. NO. CLOTHES WASH. DISHWASH. LICENSE OR CLASS. REG. NUMBER FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF r CALIFORNIA OR THAI I AM THE LEGAL OWNER OF THE ABOVE 1 - 10 3.00 DESCRIBED RESIDENTIAL PROPERTY. U PERMITEE 10 - 50 5.00 SIGNATURE O F- 50 - 100 10.00 CLLj .1 DISTRICTNO. ROC SED B d 100 - 500 15.00 /� Z SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS C✓ DATE INSPECTO SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE SERVICE NOTOVER600VOLTS OR200AMP 3.00 UNDERSLAB WORK SERVICEOVER600 VOLTS OR200AMP 10.00 ROUGH CONDUIT TEMPSERVICE,POLE, &APPURTENANCES 5.00 WIRING TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL PERMIT FEE (SUB TOTAL) NOTES: PLAN CHECK FEE PERMIT ISSUING FEE 3.00 TOTAL FEE , PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE ©�O 7ewe63 Dai KA n-so APPLICATION FOR PERMIT DEPARTMM OF BUELDING AND B,AFF,TY COUNTYOF Los ANGELES WIELECTRIC 1 WILLIAM J. FOX, CHItF ENGINEER FOR LI TO FILL IN DIST NO. GROUP ZONE PERMIT NO. ELECTRICIAN 6T �`' ,f [IVIED WY READY FOR DAT[ISSUED ADDRE'8S /Irf N •� FIRST INSPECT] CITY 16.16&41 W4A4—T13— OT r CO [ BUILDINGPERMT FMS ADDRESS FEE '}� NUMBER EACH LOCALITY LIGHT OUTLETS NEAREST CROSS ST. RECEP'T'ACLES WAI1. BW CHES OWNER TOTAL:OUTLETS Sc MAIL �^ ELEC. RANGES IS ADDRESS v . ELIC. HEATERS lip CITY O FIXTURW e 1 HERESY ACKNOWLEDGE THAT I HAVE REALS THIS MISE. APPLICATION AND STATE THAT TH[ ABiOVK IS _CORRECT NUMBER OR LIGHT CIRCUIT! AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING IELECTRICAL WIRING. MOTORS I CERTIFY THAT I POSSESS THE ASOVIE VALID LOS HUuau HO KR ANGELES COUNTY LIC E, OR IIfiTHE LEGAL OWNER NCW HP oV[.R INC. Ga MVD. �[ OF THE RESIDKNTI PERTY ESCRISKD AB�OVE- 1 e Lx" Ti SIGNATURE OF . 1 .DO P[RMITT : e 1.00 IN ON RECORD a le t.eo IS bo it.S6 60 200 15,00 201Q Soo 1 Q.OO Soo IOQQ 15.oo . OVER IQOO 20.00 M. G. SET FRE . CHANGER-HP a WIn nKRSi AC-KVA GENERATORS-KW TRANSFORMERS-SENA TIEMP. MOTORS 7 of oltla. MOVE MOTORS 7 OF olUa. SIGNS NO. NO. TRANS. APPROVAIS DATE r[CTO 'B NAME FOR FACH PIER IT: ' CONDUIT WIRIN 1,00 b Q FIXTURES 1,00 On WIRING SUPPLEMENTARY .aO FIXTUREB POWER TOTAL FEE f � O UTILITYCO. NOTIFIED FINAL ` 1 79AGS3 13".A 11-00 APPLICATION FOR PE BUT DEPARTMENT OF NG ASAFETY E LE C'I�R I C 1 COUNTY OFF LOSLO$ ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DIST NO. GROUP I ZONEE PERMIT NO. ELECTRICIAN EIV[D fY READY FOR DATL I"UiD ADDRRSD FIR>iT INSPECTION CITY N r COUNTY LICKH61KBUILDING ADDREBf PERP= FEF FIE M■ XACH LOCALITY LIGHT OLrrUKT8 NEAREST � RECEPTACLES 7 CRO"ST. WALL SWITCHES +cif a OWNS TOTAL OuTLrrp ac MAIL K rC. RANGES in ADDRESS ELdC. HEATE319 Ea CITY O FIXTU12If a I HKREBY ACKNOWLEDGE THAT I HAVE READ THIP M iC. APPLICATION AND STAT= THAT THE A1OVE IS CORRECT NUMBER OF LIGHT CIRCUITIP AND AGRKK TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RICEPTAC-X CIRCUITS AND (TATE LAWS REGULATING aECTRICAL WIRING. MOTORS 1 CERTIFY THAT I POSSESS THE ADOVE VALID LOS NUNKIAORD<POW ANGEL" COUNTY LICENBE, OR 1 AM THE LEGAL OWNIR FIE OP D ■tD ABOVE. NM MVD. F THE RIa1DEM1AL P HP owe INC. L4Oi a r.. .IIB SIGNATURE OF 1 E .30 PERM 141 : a 1.00 INSPECTION RECORD a fa 1.50 a so X.so so Itoo a.00 loo oo 10.00 .J aoO 1 1a.oQ Q Z OVER 1000 10.OQ G M. G. srr/rFzrq. CHANGER-HP IY WELDIERSi AC-KVA 0 GENERATORS-KW TRANSFORMERS-K1/A TIMP. MOTORS 7 of OR1G. MOVLD MOTORS 76 OF ortla. BC SIGNS NO.. NO. TRANS. APPROVALS NQ. NO. LAMPV DATE INS O 'f E FOR KACH PSR IT• WIRING $1.00 CONDUIT FIXTURES 1.00 fl WIRING 3 �1J3 Ly'�y SUPPLAMENT RY FIXTURE§ to POWER TOTAL FEE ! —UTILITY CO. NOTIFIED —fo FINAL, r4! i .' yyffirmirm that cCM-8061-' COMPENSATION DECLARATION 76 663 i0/el APPLICATION FOR ELECTRICAL .PERMIT C affirm I have a -certificate of consent to self nsUro, a certificate of Workers' Compensation Insurance, COUWY OF LOS ANGLES- BUILDING A14D SAFETY or a certlfled copy thereof (Sec. 3800, Lob. C.) Polley No.—Company Certified copy Is hereby furnished; New Residential BldgsBRPooI T EACH NO. FEE Af0 kil N JOB DDRESS $ — f LOCALITY M Certified copy-Is filed with the county building Irtsf� 16 2-Family, Sq. R• L t C r _ /+�� tion departmenf. Multl-family Sq. Ft. Date Applicant CROSS St Residential Swimming Pools'`,. OWNER OR RM NAME114 OR.0/ C 9i C13ZTIF1(:ATE OF EXEMPTION FROM WORKERS' Outlets: ReLlght-1—Sw. L COMPENSATION INSURANCE (This socilon neRd rsbt be compteted if the work IrrootwFirst 2CF d by Total No_ FirstAddZonal CITY Tel. No.y�l the•perlrntt Is for one hundred dollars.($100)or less.) PLAN C1-iECx I certify that In the performance of the Work for which this CAtff permit Is Issued, I shall not employ any Ton In any manner so as to become sublect to the Worker Compensation Laws. Llghtlog Fixtures First 20 ADD9:M Additlonaf Total No. CITY 7p1. No� Date -Applicant Fixed Appliances Not Over,l HP PERMIT ICE TO APPLICANT: If, after making this Certlflcot6 of Exemption, you shoed become subject to the Workers' Rionge� Heater_D.W. Compensatlon 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 _ Fan Other— CITY - TqI. No. LICENSED CONTRACTORS DECLARATION OR _ I hereby affirm that I am Ilcensed under provision of Chapter 9 Dlsp. ___ Roam Air Cond. �UMMBgt Claw (commehcirq with Section 70010) of DIVJsIon 3 of the."Iness Power Apparatus 8 Large Appliances DISTRICT-NO. � BY and Profemloro Cone,and my license Is in full force and effect. Size 8 Type HP, KW, KVA or KVAR' License Number I Ic. Cla}s Up to 1 Ind. FINAL U W J OL Over I to 10 Incl. DATE ,2 Z VALIDA N O Contractor Date Over 10 to 50 Incl. G El -�� FIN - I am exempt under Sec: — Over 50 to 100 Inc. BY B.BP,G for this reason Over 100 Services, Swbd., MCC d PanelbPards Date: 0 -2�Amp. Under 600 V Signature 201 , I0Q0 Amp.-Urxier 600 V © Over 10010 Amp. or Over 600 V Exemption for Reg. Malnt. Elect. SINGLE FAMILY Temp. Power Pole 8 Appurtenances - HOME OWNER-BUILDER'DECLARATION affirm Sign with One Branch Clrtult I hereby arm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits Professions Code): I, as owner of the property, will do the work and the misc. Condults 8 Canductorf structure Is not Intended or offered for sale (Section Other(See Complete Fee Schedule)_ ► -2 179.O A 7044, Business and Ptofesslbns Code). CONSTRUCTION LENDING AGENCY #'o 0 0 0 0 2 1 hereby affirm that them Is a construction tending agency for the.performarlce of the work'for which this permit Is issued' PERMIT FEE (Sub-Total) ° ° 3 a 0 0 (Sec.3097,CIv. C.} PLAN CHECKING FEE _ 0 0 0 3$O.O ' Lender's Name PERMIT ISSUING FEE Q 04-03-8 5 Lender's Address I certify that I have read this application and state that thq TOTAL FEELID above Information Is correct. I agree to comply with all County ordinances and State laws re-gulatJng Electrical wiring, and 'hereby authorize representatives of this County to enter upon the above-mentioned property#of Inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of PafmntOF Date