HomeMy Public PortalAbout5626 GRACEWOOD AVE_Electrical__ 76A662-CE60610-59 APPLICATION FOR ELECTRIC PERMIT 4'
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEERBUILDING
SS
BUILDING AND SAFETY DIVISION ADDRE %fE
JOHN A. LAMBIE, COUNTY ENGINEER lei
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
PERMIT FEES CROSS ST.
OWNER ,�
1 T E M NUMBERI EACH FEE MAIL
OUTLETS: / �, $ f0 $ ADDRESS
LIGHTS RECEPT./, SW. -
LIGHTING FIXTURES 10 - .r� CITY TEL.NO. :/ - -
ELEC.RANGES CLO.DRYERS ELECTRICIAN
WATER HEATERS .50 ADDRESS
ELEC.SPACE HTRS. DISHWASHERS CITY TEL. NO.
GARBAGE DISPOSERS AUTO.- STATE
WASHERS STA.COOKING UNITS .25 LICENSE NO.
MOTORS: OVER INC. H.P. DISTRICT NO. GR_ UPI ZONE I PROCESSED BY
.25
1/2— 2 .50 INSPECTION RECORD
2- 5 1.00
5- 15 1.50
15- 50 2.50
50-200 5.00
SIGNS: NO.TRANS.
NO.LAMPS
SERVICE 0-600V 1.00
SERVICE OVER 600V 5.00
MISC.
WIRING PERMIT 1.00 ( (j
FIXTURE PERMIT 1.00
SUPPLEMENTARY PERMIT .50
TOTAL FEE $y
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
LANDITIRATILIETE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
LCOUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT
AL WIRING.
BY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR WIRING
AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
IA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
D RESIDENTIAL PROPERTY. POWER
RE --- r !; UTILITY CO.NOTIFIED
RMITTE �'
FI NA
®P VALIDATION ARTHUR C.VEIT,
/ CK, MO CASH SUPERVISING ELECTRICAL ENGINEER
1. nDEC -
s "c: L
I
'°"°"-°"-5 APPLICATION FOR ELECTRIC PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRMBV
JOHN A. LAMBIE, COUNTY ENGINE[R
CA81ATT D. GRIFFIN, SUrT OF 13UILDIM0 LOCALITY
FOR APPLICANT TO FILL IN NEAREST
QROaS ST.
PEM FSEs
I T [ Y HUMMER1 ILACH FE< OWNER K
OUTLITTSi j i MAIL
RtC[!rI'
LIGHTO Rw. ',10 ADDRESS ,y
LIGHTING FIXTURES .10 CITY
O f�
R1.C. RAHG[S CLO. DRYERS ti
s ELECTRICLAN
W A T[ R H EAT[R S •150 ADDRESS
m.-[C.8PAC[HTRS. DISHWASHQRS
Gww.aE DI6rOSQR1 wu-ro.-
CITY TEL.. NO.
STATS
WASHIRS XTA. COOKING UHm .215 U LICENSE NO.
MOTORSI ovxm IHO. H.F. DI QR P Z P
V.— 2 - 15o WSPECnON BECOBD
a— D 1.00
15— 115 — 1.150
Is— DO — 2.150
DO—200 — 15.00
81GNS1 NO. TRA".
NO.LAYrS
SERVICE 0-800V y 1.00 !
S[RVICE OVER 800V 15.00
MISC.
WIRING PERMIT 1.00 &V
FIXTUR¢PERMIT 1.00
DUPPL.SMENTARY PERMIT .150
TOTAL FEE ! AMOVALS
I HERIIY ACK NOWLKDQK THAT I HAV[ READ THIS APPLICATION DATX OiSrtCTOR•S SIGNATU RIL
AND
STATE THAT TKX ADOV[ 15 CORRECT AND AGREK TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCXD AND STAT= LAWS MMULAnma
RLKCTRICAL WIRfNa. WIRING — r
I HAY CERTIFY THAT I AY PNOFQILY Ria1STnum AND/OR
LICIIXSID7 AD RIGUIRIm SY LOS ANG�S COUNTY AND STATZ OF FIXTURES
CALIFORNIA OR THAT I AM THE L GA OWNER OF THI APOV[
D[SCRIEm RRSiDQITIAL POWER
SIGNATURE UTILITY CO.NOTIFIID
v A .,ARTHUR G ,fER,
A Noaws>tR uptvllrxaTwaAL SNGIN�R
-9
Z �
. - :yam
W _II.XXAPPLICATION FOR ELECTRIC PERMIT
)UMMES
DuArrum OF COUNTY m(Gmcm flBUILOING BUUXU(G�AyNDD SSAFETY DVMONcaz A G�INi.iav't cwTY 1 I
FORAPPU TOML.L.fN �� `
PEBMff
JTXM YMMOWNER
Oj j MAIL
u RkaaT. fw 10 j< A10DRIMIS
LIGI•R'INd FUCIh RRZ .10 -rrryN
0.
fur-RANafs mo.DItYK" ELECTRICIAN
WATER HfATf • 5
fur-XrAClK HTR/. MM-MA/}mH 'ADDRESS
UARawof DIS T
AUO.- CITY TEL.N
f WASHR" 1TA.C00KIRa UNIT/ STATE LJCM4BF-NO. 7
MOTORDi ovim rH H r l
0 — .TZS – _/ QADr Pon Irttr=anow
a\.ri
Vr— II .50
Y 5 1.00 INSPO IILC/HD
5 — 15 •1.150
15 — ISO 2.50
50— 2(>O 5.00
SIGNH� NO.TRAI,
H
NO.LAYrw
(SERVICE 0-600V 1.00
fH RVICE OVER 600V 5.00
MIHO. -
WIRINd PERMIT 1.00
P•LKTURE PERMIT 1.0b
HU PPL1m n-NTARY PERM rV 50
TOTAL F EE APP$OWUS
1 IiERkBT AC"OWLIDGE THAT I HAVE READ TAMIS AlIALl 0 13A IRSP CIOR'f EGRATURI
AND STATE THAT THE ABOVE If CORRECT AND AGREE TO COYPLT CONDUIT
WITH ALL COUNTT ORDINARCES AMD STATX LAWS GULATING
ELECTRICAL WIRING. WIRING
1 HERKBT CERTIFT AO OPHRLT 01 /OR
FI%TURHH
LICENSED AS REQUIRED T f AN K OF
CALIFORNIA 0RR T A THE LE F VE POWER
DES CRIBED REbI FERTj.
SIGNATURE UTILITY CO.NOT( I®
OF PERMI
FI -•!!
ATION �urfavuiuHaawL l�ouaaa.
Lt6695OR NOV 14 2A 1 .20 �
L -
_n-,sA.PPLICATION FOR ELECTRIC PERMIT
COMM CFL08xiMR=
Dm"mm bF coum ' MGM= BUILDING
BMp0W�IN�G, AND SAFETY D[ MON ADD
Cd�lr'1'�"G%%= LOCALITY
FOR A;jHD�CA 'TO�FrI11 QV
1 FEII�'t�F� XACH ?rKx OWNER
OIITL.lTHi f s MAIL
Lloam Mm. aw. .10 ADDRESS
LIGHTING FLX`YUm" .10QITYt
IIi4
RANG" 'ct.o.DRYIRI ELECTRICIAN
WATtR HCATXIt9 ADOR
IIi4 Ur"HTPM DUU4WASHLtI
GAFMAOE DljrOfQr CITY TEL.NO
STA.coopallo LfXr17 / 8 STATE .
atftiont OVIR INC. H P.
RiADY FGi Iltyr =om
— s 1!00 INSPECTION HE=ED
D — 1D 1.80
18 — 80 280
80— 200 8.00
SIGNSt *o'TRAX&
NO.LAW"
smzvlca o-aoov 1.00
SIUMCE OVER 600V 9.00
Misr—
WIRING PERMIT 1.00
FIXTURE PERMIT 1.00 '
SUPPLEMENTARY PERMIT .8O
TOTAL FEE s APPROVALS
1 HEREBT ACKNOWLEDGE ?HAT 1 HATS REP THIS APT CATIOX DATE INSPECTOR'!SIGRATURI
AND STATS THAT THE ABOVE IS CORRECT A►ID AGRKK TO COMPLT CONDUIT
WITH ALL COUHTT ORDINANCES AND STATE LAWS. REGULATIRG
ELECTRICAL WIRING. WIRING
I HEREBT CERTIFY I Al FRO I AXD/OR
LICENSED AS REQUIRED LOS AAGE ATY OF FIXTURES
CALIFORNIA OR THAT O THEI F E ABOVE POWER
DESCRIBED �EYTY./
SIGNATURE�AT UTILITY CO.NOTIFIED
OF PEHMI 'AAA ld
FINAL,
CASH 9UPnevli
awrrl
o LHd BLZrMC1AL RMWI4mt
au
M6 6 7 7 4 OR M18 2 A 1,25 �
DBS 5A ZSM SETS 7-47
DEPART 1ENT OF IIUIMING AND SAFETY' APPLIC.a1TION FOR I'EldliiTT
COUNTY OF LOS ANGELES ELECTRIC
M. J. FOX. HI FEN 1 R
z �" / DISTRICT NO. GROUP ZONE PERIVUT NO.
s NAME
ADDRESS
CITY 7 I f TEL NO. r RECEIVED BY READY FOR DATE!SS D
i FIRST INSPECTION
W COUNTY
CERT.NO. /C/ EXPIRES `J
APPLICANT FILL IN HEAVILY OUTLINED POR'T'ION ONLY
JOB
DESCRIPTION OF WORD. A
DDRESS. j �ppf
NUMBER OF OUTLETS ON CIRCUITS Y 71
C�
LOCATION BY ROOMS
LIGHT OUTLETS SW. PLUGS T.
CIRCUIT A B C D E F G HE r\
L
RESS
Y TEL.NO.
THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERrlFL6AT16 OFUALIFICATIQO
N..
- ELECTP.ICIAPI.
IAM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE
OWNER.
' CORRECTIONS
a
z
c
D
TOTAL
NO. OF OUTLETS $ '�� APPROVALS
I NO. OF FIXTURES OATE INSPECTOR'S NAME
NO. OF MOTORS H.P. $ CONDUIT l
NO. OF SIGNS TRANS. $ WIRING "
NO. OF RANGES OR HEATERS $ FIXTURES
rI
ISCELLANEOUS $ POWER
ERMIT FEE $ ..� UTILITY C.O.NOTIFIED 1,''
TOTAL FEE FINAL
20-W19
_ N(ORKFt I haveCOMPENSATION
oate of
7&&.M3 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT
� I hereby-crfflrm that I have a oertlfloate of consent to self Insure, 78AB63
or a'certlflcate of worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV.
copy thereof(Seo.3600 Lab. C.)
No. Company POR APPIJGANT TO FO_l.IM JOB
ADDRESSEl SID C PJ•'�I
CerM@d copy Is hereby hanfstted. New ReNdentiai Bldgs-S Pooh NO. EACH FEE
LOCALJTY
❑ CerfM1od copy Is fled with the county bulkflnp Inapection 1 a 2 family,Sq.FL = i— ( Q
depart—rL Mutt!-famfly Sq.FL CN ST. cl
Date Applicant Reeldentfal Swimming Pools MAP Boco<
058 l L+ P OI
CERTIFICATE OF E)CE.MPTION FROM WORKER& ARCEL
owNE31 (D
/•� 0 WVAE rn
COMPENSATION INSURANCE �� 117 /, _
(This section need not be oompleted If the work Involved by theTotel No. ) Additional ADDAEBS _51'2f
permit Is for one hundred dollars($100)or lass.)
I oerUfy that In the performance of the work for which this permit CITY I T u `(-, r, t TO'ND.
Is Issued, I shall not employ any person In any manner so as to PLAN CHECK
become subject to the Workers' Compensation Laws. Lighting fires First 20 APPUCANT
Total No. Additional
ADDRESS
Data Applicant % RESIDENTIAL APPLIANCES NOT OVER 3 HP.
NOTICE TO APPLICANT: If, after leaking this Certificate of CITY Tel.Na
Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP.
provision of the Labor Cod you must forthwith comply with ouch PERr�i
P }, Y P Y Power APP�s 8 t��APW APPf-G�T t�W+lJ P� IS�1.C Q r—
provisions or this permit shall be deemed revoked. Ia
LfCENSED CONTRACTORS DECLARATION Stz_e&_ype HP,KW,KVA,or iN ADDRESS
I hereby affirm that I am licensed under provisions of Chapter B Over 3 to 10 Ind. D
(commencing with Sectlon 7000) of Dlvlelon 3 of the Business and CTTY Tel-No-
ProfosCons Code,and my license Is In full force and effect. Over 10 to 60 Inc]. MENSE
OR Over 60 to 1010 1rid. REO.NUYBE R Close.
License Number Lb.Clase Over 100 DISTRICT N0. PQRF&SMBY O
erbe
Svs,Swbd.,MCC& (��
Contractor Date 0-399 Amp.under Boo V ere
El I am exempt under Seo. 4010-1000 Amp.Under 600 V VALIDATION V
Over 1000 Amp.or Over 600 V F�BY d
B.SP.C.for this reason BRANCGH CIRCUIT FEES
Date•. 16A,or 20A, 120V,UghtIN or Recept. Z
1 To 10 Branch Clroulb
11 To 40 Branch=
41 Or More Branch Clroutts t
El Exemption for Rep.Main-L Elect. 161 264 206V To 2T7V Br.Clrads -
r1
SINGLE FAMILY Temp.Power Pole&Appurtenances ;
HOME OWNER-BUILDER DECLARATION Sign wRh One Branch Circuit T.T
I hereby affirm that I am exempt from the Contractor's Llcanse Law I
for the following reason (Section 7031.6, Business and Profeselons Additional Sign Sign Brpnoh Clrcufte -- - � 143.10
Good{e):
I,as owner of the property,will do the work and the structure Mlec.Conduhe d Conductors _ --— i' I� f 7
Is not Intended or offered foF sale (Section 7044, Business Och
Other(See Compiete Fee Schedule) 'Poo. TOTAL 143 - 10
and Profeselona Code), {_�rtr
CONSTRUCTION LENDING AGENCYi�i l-r CK 143.10
1 hereby affirm that there Is a construction lending agency for the _
performance of the work for which this permit is Issued (Sec. 3087, PERMIT FEE (Sub-Total)
Civ.C.)
PLAN CHECKING FEE 0 V.Rf
Larders Name � LxJ�-OLI4PJ1 �I14I93
PERMIT 13SUING FEE -- - - 9713 1 Ali 8:14
Lenders Address
I oertfty that I have read this appllcaffon and under pehalty of pudury state TOTAL FEE
tbat the above Information h correct I agree to comply wtth all County v/D
ordlnanoee and State laws regulating ElooZttal wiring,and hereby authortre
representatives of tiro County to enter upon the abovetnerrtloned property
for hJWba0RQUrpD80a. SEE REVERBE FOR EXPLANATORY LANGUAGE
��•''�"�
aK nJFE P47Y= DATE