HomeMy Public PortalAbout10765 GRAND AVE_Electrical__ 76A663-CE806 8-62 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS 1074 121�'id1�
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
RECEPT,l2,' TOTAL NO. EACH FEE /
OUTLETS FIRST 20 ��$20 S }� _OWNER At
LIGHT MAIL
ADD'L l 10 ADDRESS 110'41�
SWITCH. � O —
VER 20 ` -.
TOTALCITY o7rlOLG C C TEL. NO. O SO
LIGHTING FIRST 20 `j .20 �'C
FIXTURES } ADD'L OVFR 20 70 ELECTRICIAN 94�lvli f��T o
RANGES CLO.DRYERS WTR.HTR.. 1.00 ADDRESS
GARB.DISP.` STA.COOK
CITY cS f TEL. NO. —7[7.3I
DISHWASH. AUTO.-WASH. STATE
SPACE HTRS. STA.APP.(I/s H.P.MAX.) / .50 LICENSE NO.
MOTORS: OVER NOT OVER H.P. DISTRICT NQ. G FUDU P OT NE PRS ED_B
O 1 1.00
1 3 1.50 INSPECTION RECORD
3 8 2.00 rr
i
8 15 2.50
15 50 3.00
50 100 5.00U/
NO.TRANS-
SIGNS: NO.LAMPS ,✓, ..G-41`__••, - ,} O
SERVICE 0.60OV-NOT OVER 200A 1.00
SERVICE 0.60OV-OVER 200 A. 2.00 N
SERVICE OVER 600V 5.00 ?
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE $
1HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPL CATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING /
.44
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
i
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. POWER
3 G
SIGNATURE � UTILITY CO.NOTIFIED _
OF PERMITTEE "9 »
FINAL
f VALARTHUR C. VETT
MO
CK MOCASH SUPERVISING ELECTRICAL ENGINEER
lcn
L jo4 4 0 5 JAN 14 2 < 9.40
I
L - --
SASSS_C Ee06.�1,70'"APPLICATION FOR ELECTRICAL PERMIT LJ
COUNTY OF LOS ANGELES O
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
COLEMANW. JQN INS u NTBUILDINGLOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
OUTLETS FEE OWNER
RECEPT. S MAIL
LIGHT TOTAL
FIRST 20 ADDRESS
CITY TEL. NO
SWITCH OVER 20 ip
PLAN CHECK ,
LIGHTING 1 TOTAL
l KIRST 20 � APPLICANT
FIXTURES .10 O
T OVER 20 ADDRESS
APPLI CES CITY TEL. NO.
PERMIT
RANGE__,DRYER_WTR. HTR._ APPLICANT
STA. COOK DISP. -F.A.U. ADDRESS
SPACE HTR, AIR COND. CITY TEL. N0.
CLOTHES WASH. DISHWASH. LICENSE NO. CUSS.
FAN OTHER 1A0 I HERESY ACKNOW L[DOE THAT I HA VIE READ THIS APPLICATION
AND STAT[ THAT THE ABOVE le CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND 2-TATE LAWS REGULATING
IND. HEATERS, ETC. HF. KW. KVA. EL[CTR CA WITH
IMS.
SIZE S TYPE OVER TO
IHERESY C[MT IFY THAT I AM PROPERLY REGISTERED AND/OR
0 — 1 Ipp L'C."KD AS R[OU IRED SY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER 0 rND INTEND TO �-
1 — 10 Spp RESIDE IN, THE V ESC D �IDAL PROPERTY. D..
SIGNATURE — U
10 — 80 6A0 OF PERMITTE
EO — 100 IO.GO O
DISIT R CR
OT NO AEe ZO [ PR !
100 — 600 15.00
N
SIGN, GAS SIGN AND ONE CIRCUIT 5.00 NOTES: Z
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1m
SERVI CENOT OVER 600 VOLTS OR 200AMP 5.00
APPROVALS DAT[ DiSr[CTOR d SKINATUNE
SERVICE OVER 600 VOLTS OR 200 AMP 10.00
TEMP.POWER POLE
TEMP.SERVICE,POLE, &APPURTENANCES 5.00
UNDERSLAB WORK
TEMP LIGHT OR RECEPT. SYSTEM 9.00
ROUGH CONDIUT
WIRING; Z
FIXTUR
POWER AUTHORISED
PERMIT FEE (SUB TOTAL) _
UTILITY CO. NOTIFIED
PLAN CHECK FEE
FINAL
PERMIT ISSUING FEE 8.00 JOSEPH C. R OHAN ,
TOTAL FEE -71 SUPERVISING Ei TRICAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION A
M.0. CASH
473� .APR 1 2 D 725N
SEE SACK OF APPLICATION FOR COMPLETE SCHEDULE
woRfmR'B COMPENSATION DECLARATION 7eerr°DPW(,2-�,) APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I have a certificate of oonsent to self Insure,
or a oertlncate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV.
copy there9l(Seg.3800 Lab. C.)
Pofloy wR APPUCANT TO Tai N uoe
No. Company A---S
Cerflfled copy Is hereby fumla e . New Reald tial Bldgs.S Pooh NO. EACH FEE LOCAL�II A.
❑ — = C h filed with the county buildlrq Inspection t d 2 fam0y,Sq.FL $
Mufti-family Sq.Ft — =STL
Date AppO nt Posakwntial Swill IN Pooh ASSEBgpR
YAP BOOT( PAGE PARCE
OR
2
CERTIFICATE OF EXEMPTION FROM WORKER$'t /p
COMPENSATION IN8URAN CE Orrtietx Reo /O �NNE
Flret fl AIAb
(This seotlon need not be completed H the work Involved by the Total No. Additional ADDREI c
Permit Is for one hundred dollars($108)or leas.)
I certify that In the performance of the work for which this permit CrIY Td Na
is Issued, I shall not employ any person In any manner so as to PLAN C*ECK
become aubjeot to the Workers'Compensation Jaws. Lighting Fbdures F9 rat 20 APPuc-&.NT
Total No. Addklonai ADDRESS
Dein Appllaent RE8IDENTIAL APPLLANCES NOT OVER 3 HP.
NOTICE TO APPLICANT: If, after making this Certificate of CfTY TOL-W.
Exemptlon,you should become subject to the Workers' Compensation OTHER APPLIANCE8 NOT OVER 3 HP.
provisions of the Labor Code, you must forthwith comply with such � r
provisions or this permft shall be deemed revoked. Power Apparatus&Large Appllanoe°
LKAa4SED CONTRACTORS DECLARATION Size h Type HP,KW,KVA,or KVAR ADDRESS
I hereby affirm that I am licensed under provisions of Chapter B Over 3 to 10 Ind.
(commencing with Section 7000) of Division 3 of the Business and CITY T�N0
Professions Code,and my license Is In full force and effect. Over 10 to 60 Ind. LKINSE OR
T Over 60 to 100 Ind. REO,NUMBER 0lOWL d
Over 100 Dt9TRIGT NO. BY S
Ltcena.Number Lb.Claus �D p
Servtcee,Swbd.,MCC 8 Panetboards Q [[
Contracror Data 0-396 Amp.under eco V DDATETE 0
❑ I am exempt under Seo. 400-1000 Amp.Under 600 VZW` vAuoAnor+ U
Over 1000 Amp.or Over 600 V FNA
B.BP.C.for this reasonBY
BRANCH CIRCUIT FEES
Date:
16A,or 20A,120V,LJghting or Reoept. Z
1 To 10 Branch Clroults
ftnaWre 11 To 40 Brash Ctraft
El
Or More&anch Ckntts 2Exemption for Req.Malnt Elect. 16A 20A,208V To 277V &.Cku is
SINGLE FAMILY Temp.Power Pae a Appurtenance. ANT.T
HOME OWNER-BUILDER DECLARATION SIS with One Brerah Cb-cult I hereby afflrtn that I am exempt from the Contractor's Lloense Law
05
for the following reason (Section 7031.6, Business and Professions A"donal SIgn Branch Clradts 1 ITEMS
Code): wl
I, as owner o.C,
of the property,will do the work and the structure Mlaonduttn&Conductors TOTAL 31-05
Is not Intended or offered for sale (Section 7044, Business Other(See Complete Fee Sohedule) , GECK 31.05
and Professions Code).
CONSTRUCTION LENDING AGENCY ilYiTilg �0m`■0
I hereby affirm that there Is a construction lending agency for the i Its
performanoe of the work for which this permit le Iasued (Sec. 3097, PERMIT FEE (Sub-Tot>� rry�y�r�1 f 111 7 1
Civ. C.) L.W1-M �J
PLAN CHEC1<1NG FEE 83 15 2 1 Ali 9:54
Lenders Name
- PERMIT ISSUING FEE
Lenders Address
I certify that I have read this epplbaiton and under penetty of purtury state TOTAL FEE
that the above Informarion Is oared. I agree to oompty wtth all County
ordnam cee and State laws regulating Electrical wiring,and hereby authortre 3 /�
a this mY ro enter upon the above-rnenrioned property
l SEE REVERSE FOR EXPLANATORY LANGUAGE
aP3WT uFtL DATE
` �y .V6ftERS'COMPENSAT10N DEGLARATIbN 76Aee3 10161
., 11 —, , hers a Dert>;� d h CE-a000 APPLICATION FOR ELECTRICAL. PERMIT
or of Vkfkars',,Compennatbn Ireurarxe% or a oerMW COUNTY OF LOS ANGELES 15UILDING AND SAFETY
r &)Py thereof(Sea 3800,Lab.C.)
Policy No.T' Corrparry FOR APPLI ANT. FILL.IN JOB Q
CorttW copy is hWeby furrg.shed. New Reeldential Bidpe.&Pods EACH NO. FEE
' S ,— 1JlY -
CWffW.COPY le filed with the county bu9dlpg hepectlon 1 d 2-FamFy,S4 Ft S LOCA
— •
NEAREST
departrnentMtA-farWy S¢Ft
CRDBS 9T."
Date Applicant ReelderrW Swbnming Pdois F1SM
NME
cERrFlcAc�oMPPENOF�TION FLAANmCE artiehr HaO�fL_Ll¢t,t L 8w.;
F1ret 20
(This aectign nMd not be oompkted a&ie work krtohF@d by-the Total•No. Addttional CITY Tei.No.
perfntt Is for one twndrod dollars($100)or I*M.)
I oertffy that in the performa6oe of the work icr'Mik)h ihb,pe MIt _
Is keels I shell not employ any Person In arty menngr $9 ea to
beoome1eub)ect to the Laws Llaft Ftxhree FM 20 ADDRESS
bete f Apploan� x` Jn_ �N No. bn Thi.No.
fNOTICE ff, .after �}��tNs Cert7ioeLa d Fbced Appiir+rioee Not Oyer 1 I PEF T
Exerrtptlal,you should bKom subject to�`r'"^°r°'C,ofnp9rtietbn F7anQeT Heater_ D.W. APPLK'►NT
provfalone of the Labor Code, you must fort*ffi.cenply with suoh Oven T Dryer_ VV.M ADDREgS
pmvwom br this parmtt shall be deemed rewked. 'Top F{UJ _ WJ-L _
( LJC�NSED CONTRACTORS DE -:,&:APON'. COY Tbl.Na
Food Fan Other_
I.hereby affirm that I am, lioWtie under proykalorts d Chapter 8 p� Room Alr.Cond. _ LICENSE 0rk C3.e�
(cpnihWi6ing.with Seodon 7006) of Dtvleon 3 of the Buelraw and
Profsesiore Code;.and my Ildwzio Is In tuil force'and effeoiPulver Apparatus Urge Dt8f1�CT No. -
. Stze.d Type HP,KW,ICDA,a k(N4A
tbenee.Number LJa>✓lam Up W I InQL _ FINAL
Over 1 to 10 Ind. DATE �- .
ContractDr Date -
❑ Grer 10 th601noE RNAL
I am exempt}aider'Seo. Over 60 in 100 I= . BY
B,SP;C, for this reason Over 100
Sgrvom Swbd,MCC S Parlelbowcle , -
- Dat 0-200 Amp.Under 800 V
Signature 201 -1000-Arflp.Under.600 V
Over 1000 Amp.,or Over 800 V
' Exemption for Rep.Maht F;leoL
SINGLE FAMILY Temp.Poker Pcie S Appxtsromm 2
HOME OWNER-BUILDER DEC1_ARATION SIQn with One Branch Cirbdt �./v�
t I hereby affirm that I am exempt from the Conic&d b Lbense LaW AMA
for the fob wlJV reason(Soodon 70$1.6, Buslneas end Prbfesalons A&ftiorie]Sign Branch Gircutts
Code): 3307 63.00
Mtaa Corlduttn a Conductors 1 ITEMS
I,as.owner,of the property,wIL do the work end the etruo4le I —.(gee ComPleSa Fee$aFredt�e) ,y�
Is
htanded cooftred for cele (Section 7044, Bueir,aee MAL 6:3.00
//..����//yy// rye0
CONSTRUCTION LENDING-AGENCY 4ffG4I� :' 63.0
I hereby aftf:m that there Is a corehvotlon lendlr>Q van y for the
perlormence of the work for which this,permft la baued(Sea 3087, PERMFF FEE (Sub-Total) MR .00
Lenders Mame RAN CHECKING EEE I.RA D-Mi 8/ 4/89
PERMIT ISSUING FEE 4$40 i At111I24 .
I Lender6 Address
r I certify that I have read thb appibathn and abate that the above Tom FSE -
hformation to correct I agree to oorn* with all County ordlr. o
r and State laws r&Xkdh G Eledroal wtrbV, and hereby authorize
Of thle County to enter upon the. above-me Tkne�
Irvepeotlorl purposes. SEE REVERSE FOR EXPLANATOfrf LkWUA13F
Signabir6 of Date