HomeMy Public PortalAbout10221 GREEN ST_Electrical__ 70A663 CEE06 ,,,7p APPLICATION FOR ELECTRICA PERMIT-
a COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
COLEMAN W. JISNKINs w LOCALITY _
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
OUTLETS NO. RACHI FEE
OWN15R
RECEPT._ MAI L
I,iOHT TOTAL
FIRST 20 25ADDRESS
CITY TEL. NO.
SWITCH OVER 20 10
PLAN CHEEK
TOTAL
LIGHTING 1 - FIRST 20 2B APPLICANT
F I XT U RES .,0
Jy
OVER 20 ADDRESS
APPLIANCES CITY TEL. NO.
PERMIT
RANGE DRYER_WTR. HTR. APPLICANT
STA. COOK DISP. F.A.U. ADORERS
SPACE HTR. AIR COND. CITY TEL. N0.
CLOTHES WASH. DISHWARH. LICENSE NO. CLA3S.
FAN OTHER 1.00 I HEREBY ACKNOWLEDGE THAT I HAVE READ THISAPPLICATION
AND STATE THAT THE ABOVE 1/ CORRECT AND ASREE TO COMPLY
MOTORS, TRANSFORMERS FLAT]N@
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND. HEATERS, ETC. HP. KW. RVA. ELECTRICAL WIRING.
SIZE B TYPE OVER TO
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
O — 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
1 - 10 Dpp RESIOK IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. O
s
10 - 'JO app SIGNATURE U
OF PERMITTEE
SO - 100 1OD0
DISTRI CT NO S O P C BY.
100 - 500 iS.00
CL
SIGN, GAR SIGN AND ONE CIRCUIT ILOO NOTES:
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.0
SERVICENOTOVER600 VOLTS OR 20OAMP 3.00
APPROVALS DATE VWXCIDWS SNSNATURK
SERVICEOVERBOOVOLT30R200AMP 10.00
TEMP.POWER POLE
TEMP SERVICE,POLE, ✓4 APPURTENANCES 5_00
UNDER3LAB WORK
TEMP LIGHT OR RECEPT. SYSTEM DAO
ROUGH CONDIUT
WIRIN
FIXTUR
POWER AUTHORIZED
PERMIT FEE (SUB TOTAL)
UTILITY CO. NOTIFIED
PLAN CHECK FEE
FINAL
16/at-
PERMIT ISSUING FEE SAO 0 V-vJOSEPH C. ROOMAN
TOTAL FEE ` 1
SUPERVISING ELECTRICAL ENGINE 1
PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDA 011 cK. M.D. _As
� 4 0 ..3 4;3JO20 2 0 6.00N. �
SEE BLACK OF APPLICATION FOR COMPLETE SCHEDULE
7/Aees-CL06 Is-- APPLICATION FOR ELECTRIC PERMIT 1
COUNTY OF LOS ANGEL E8
DEPARTMENT OF COUNTY ENGINEER BUILDING 2
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A.LAMBIE.Courrrr ENa1Nmt
CAfMrr D.QRI rrM&a-r oR NuE Km LOCALITY
FOR APPLICANT TO FML. EN NEST a/j•`'�
PEEMT FMS OWNER
ST-
IT E Y NUY■ El.C1i FIE
O ; ' MAIL
LIGH71 �. ,1O ADDREBD '7 '�
LIGHTS O FIXTURES if .10 prry
"o-AANGX5 CL9ELECTRICIAN ZZ
WATER HEATERS .50 ADDRESS
QiC./PACE HTR0. DISHWASHERS
CITY TEL NO.
GARBAGE DISPOSER/ AUTO.-
STATE
WASHERS STA.COOKING UNm .g5111CMUEE UQ.
MOTORS: ovER INC. H.P.
O— PROCESSED 9
y, Y 5 E
IA-, 2 .50 INSP=ON HWOBD
2— D 1.00
15— 15 1.50
Ta— DO 2.bQ
50-200 5.00
SIGND: NO.TRANS. f
NO.LAMP/ f/
SERVICE 0-800V 1.00 C
SERVICE OVER 500V 5.00 , /
'
MISC. I
WIRING PERMIT 1.60
F IXTIJ RE PERMIT 1.00
SUPPLEMENTARY PERMIT .50
TOTAL FEE APPHOVAM
I 'HERESY ACKNOWLMGE THAT I HAVE READ THIS PPLCATION DATE IN R'S■1 RI
AND STATE THAT THE MOVE Is COA
RRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY PRDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING.
1 HEREBY C".R.R-I'1FY THAT I AM PROPE7CI.Y REOI1Tptm AND/ortWIRING
LI CDLSED AS REQUIRED /Y LOS ANGEL-ES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 AY THE LEGAL OWNER OF THE MOVE
DESCRI■ED RXSIDEMIAL PROPXLTY, POWER
SIGNATURE UTILITY CO.NOTIFIED
OF PERM ITTE,�
m' ATION 6RTHUR C.
ax o CASH UPERVI 1Na CAL ENaIN[ilR
s06au"; .RM 2 A 1 .80
TEMPLE CIS
76A66;3--CE906 8-62 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER ulL�IN4
BUILDING AND SAFETY DIVISION Dltkil 11
JOHN A. LAM-BIE. CouNTr ENGINEKR
WILLIAM A-JENSX I,SUPT OF NUILDING LOCALITY
FOR APP
N rw Rt/T
CROSS ST.
n[cEFT. TOTAL$$
p FInDT 20 >t 10 $ OWNER =
GISHT 'L .160 MAIL
SWITCH 13 ov rt 20 .10 ADDR=M y� C
TOTAL CITY L. TN
.LIGHTING 15111 .10
gO.
FIXTURES ADD'L 10 ELECTRICIAN
ov n 20
RAIISES CLO.PRYPM w7R.I11TRS- 1.00 AIDI?
&ARS.DIl. STA.coat crry 72F
TmiL No.
DLSHWA1H. Mn-O,,WA►H. AT7[
rrAQ Pfi HT . [TA.AFF.(%H. MAX.) .50 L'CIQV<E N O.
YOTOFIS, ova Nor Ova Hr. IST CT N G E
0 1 1.00
t a 1.150 INSPECTION Rk6RD
a e :K.00
a 15 L6o
to 50 a.qo
50 1.00 5.00 8
•IGNjI NO.TRANS
NO.LAJWM
O
S=RVICa 0.600.V-NOT Ov0 100A 1.00
SatVlCJK 0-600V-0V=100 A. coo d
SERVICR,oVO4 600V 5.00
MIaC.
rmtMrT]=;JlNG MM 18.00
SUM-LjldKNtAj5Y P"MrT 18SUM0 rTX 1.00
TOTAL jrkK
LA)LD;STAME
WY ACKNOWLKD= 7HAT I HAY[ ISLAD THIS AJT 7'O °IAT[
TE THAT THE ASOY[ 1• COR1t,Cr AND ASIA TO COIpLYCONDO-RL'COUNTY ORDIHANCICS•AND STAT[ LAWS RKSULATINaCAL Wnu1H. WIRINGY CIEPMFY THAT 1 AN rRQraLY R[SISTSJl� AND/Olt
AS IS[QUIR>D SY LOS AN�EL[S COUNTY AND STATS:OF TIATURj�IIA Of THAT 1 All THS 1..[S.AI. OWMI/l OF TH[
m Manu pmAL FROrKw".UR.1 UTILITY N0T1RIHI
F1 NAL
VALIDAT ARTHUR C VIDT
CAL
CK VO CA11d aur[RVIIING �igINQR
3 2 D 420- V
. N _
a
76A6eS-C9e0e %-64 APPLICATIOW F TRIM PERMIT
COUNTY OF LOB ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DMBION DtliSs
JOHN A. LAMBIE, COUNTY ENGINEER
COLIMA* W. JENKINS, SUPT. OF BUILDING LOCALITY
NEAREST V�f
r
CROBS ST. L.1 1
RECEPT. TOTAL No
OUTLETS FIRST 20 •10 • OWNER
LIGHT I MAIL
SWITCH. OVER 20 .10 ADDR1<li ,
TOTAL
LIGHTING 1 r FIRST 20 .Z,O CITY Td NO.
FIXTURES Jj ADD'L 1O ELECTRICIAN
ov R 20
RANOIS CLL,DRYERS v rR.H'I'RE. I-Ool ADDRESS
SIAM DISP. STA.COOK
CITY - TmiL No.
DISHWASH. AUTO.-WASH. STATE
SrAC[HTRS. ETA.APP.I%H.P.MAX.) ,50 LICENSE NO.
MOTORS' ov>Q Nor OWN Hr. DI O. G EP EBBED Y
O 1 1.00 1 at
1 a 1.50 INSPECTION RECORD
a e 2.00 O
6 15 1.80 U
15 50 3.00 CieFO
Do 100 5.00 ['
o_
sfatlrl No u M. In
Z
0'V _
SERVICE O.50 -NGT ov>ot 100A 1.00
SERVICE O-BOOV-OVot 100 A. 1.00
SERVICE OVER 500V 5.00
MISC.
FK MIT IMUING Ffm 1.00
•UPPLKMKNTA[IY PERMIT IMUINQ FR 1.00
TOTAL FEE •
I MUMMY ACIONK WLMQE THAT I HAV[ READ TF11S Apprucknopt DATE
DMTLVM
AND STAT[ THAT TH11 ADOW 19 C01OIRCT AND AASIMM TO COMPLY CONDUYI'
WITH ALL -COUNTY ON
RDINACEO
S AND STATE LAWS RZOULATIN
El.[CTNICAL VrMN0. WIRING
1 HERESY.CERTIFY THAT I AM PROPERLY REGISTERED AND/OR pq XTU
LICENSED AS REQUIRED MY L01 AMO EL ES COUNTY AND STAT[ OF
CALIFORNIA OR THAT I AM TH[ LkSAL OWN[R OF, AND INTEND TO
RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL FROP[RT Y. POWER
SIGNATURE UTILITY cm,NOT1F1
OF PQRM
Fl NAL /
(DATION JOStPli G ROOHAN
' CK YQ GSASH SUPERVISING ELiCTR1CA1 a1GINEOt
J&13 1 9 3Q AM 2 9 2 D 4.4 0-
cv
I�
G _�
79"62
D&S-RA APPLICATION FOR ELECTRIC PERMIT 1
DrfMON OF BUELDING AND SAFETY
of Cott Enuln— A-ID
DING �J
COZY I IAS AII� 68DWM.J. FOX COUNTY NGINm?ciks"TiDI.6Ri"IN.aUT'T OF ouDDIMOI
uTY
OR_A� TO FILL IN NEAREST �^
v�$B�,a CR08a ffT.
.Nu ER EACH PER OWNER ,
LIGHT OUTLETe
MAIL
RECEPTACLES ADDRESS
WALL DW IT'CHS.D
ToTAL OuTLETs D t C ALJZ
ELEC.RANGES - 20 ELECTRICI N
ELEC.. HE.ATMRS 25 ADDRESS
KW EA CITY TEL NO.
•FIXTURES .DI-ICKNeff NO.
NUMBER OF LIGHT CIRCUITS - DISTRI NO. GROUR Z N ■[ABY FOR IIISFKCTIOII
NUMBER OF RZCEPTACLE CIRCUITS
MOTORS
NUMRut HORBEPOW@R FE[ INign
NM MVD. I HP ov" INS CA "
l __ly
•L[W .2D
2 .DO
2 B 1.00
D is 1.60
125 DO .2.250
bo 2CO 6.00
M I GC.
NO.SIGNS NO.TRANS.
SIGNS PG
FOR EACH PERMIT;
WIRING 1.00
F LXT U R EB 41.00
SUPPLEMENTARY .DO APPROVALS
TOTAL FEE t DATE INSPECTOR'S SIGNATURE
I HEREBY ACXXOWLE GE THAT--1 HAYS READ THIS APPL.ICA ION CONDUIT
AND 79TATE THAT THE AAggOYE IS CORRECT AND AGREE TO COMPLY
WITH ALL CgUNTY ORbINANCES AND STATY LAWS REGULATING WIRING
ELECTRICAL (RING.
I HEREBY CERTIFY THAT I Al PROPERLY REGISTERED AND/OR FLXTUREs
LICENSED AS REQUIRED BY LOB ANGELES COUNTY AND.-STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWIIEII THE ABOVE POWER
DESCRIBED IlCfID AL PROMTY,.
UTILITY CO.NOTIFIED
SIGNATURE
OF P[RMITTEE FINAL, �J
MnLLIAM J.FOX,COUNTY SNomms VALIDATION k C.VEIT,CHIQ ELKcT.INtrccTOR
}C0 8 1 1 4-, SEP 2 0 2 3 .9 5 '
• J
I hss8by a1t(trotasacoM a' '°a oDECLARATION aa,f ,n.�r,, 20-M
DP'""2 °'' APPLICATION FOR ELECTRICAL PERMIT Lf
or a oertffloatA of YVorkers Compensation Inaursnee, or a certified r C AUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV.
copthereoi(Sec. 3800 Lab.C.)
No. Company FOR ArPtLca,+T To at1 iNJOB
�oF.HB. / / GE s
Certmw copy Is hereby.tunawhed. New Reeldential Bldgs.of Pods NO. EACH FEE
— i : LOCALITY
ltnflied
❑ Cered b n
copy eed with the yI}d
buing Ina�ection 1 a 2 f.mUy,S4• FL — WAAEfFT 'f
department. Multi-fsmfy Sq.Pt. passe F. "l`�
Date Appncdnt RaeldenUsl9wlmminp Poole MAPBOOK
ICPAaE�T/ PAl F/�
GEtFmFATE OF EXEMPTION FROM WORKERS` Out} :Rec.A Light�Sw. S �
COMPENSATIOt4 INSURANCE Rrat 20 =NAVE
� ] � UAL
(This section need not be completed If the work Involved by the Total No O` Addttlonal ADOFtE8S �d11/ G� -5T
permtt)s for one hundred dollars({100)or less.)
I certify that In the periorr�ance of the work for which this permit CITY �` Td NW�
Is Issued, I shall not employ any person In any manner so as to PLAN CHECK
become subject to the Workers'CompenaMlon Laws. LlghtIng Rxturee Rrat 20 AI'PLIC WT
Total No.. Addf ionel ADDRESS
Die t RESIDENTIAL APPU NCES NOT OVER 3 HP.
NOIT
TFC� TO APPLICANT: If, after'making this Certificate of CITY TdL No.
Exemption,you should become aubject to the Worker' Compensation OTHER APPLIANCES NOT OVER 3 HP.
provisions of the Labor Code, you must forthwith comply with such APIT .
prov1sldn5 or this permit shall be deemed revoked. Pc r pis S�� ��
LICENSED CONTRACTORS DECLARATION Size a Type HP,KW,KVA,or KVAR ADDRESS
I'hereby a7flrm that I ant licensed under provisions of Chapter 9 Over 3 to 10 Ind.
(commencing with Section 7000) of Division 3 of the Business and CITY Tel.N0
Profesalons Code,and my license Is In full force and effect. Over 10 to 60 Ind. uCEtsIE OR
Over 50 to 100 Ind. �NUWBER a"` d
Over 100 DISTROCT N0. BY
LJcse O
enNumber LJc.Ctase �.Q/� U
• 8ervlcee,Swbd.,MCC 8 Panelboerds v �
Contractor Date 0-399 Amp.under 800 V DATE
O
F-1400-1000 Amp.Under 800 V f -� VALIDATQN V
I am exempt under Sea Over 1000 Amp.or Over 000V FNAL W
BY
d
BAP.C.for this reeaon BRANCH CIRCUIT FEES CEJ
Date: 15&or 20A,120V,L Ighting or Recept Z
1 To 10 Branch ClrouLU
ro 11 To 40 Branch Ctoub
41 Or More Branch Ciratfs
❑ Exemption for Reg.Maim E1ecC 16A,20A,20tiV To 277V Br.Ctraults
SINGLE FAMILY Temp. Power Pole S Appurtenances rri,!�
HOME OWNER�UILDER DECLARATION Sign with One Branch Clroutt rn' j■
I hereby afnrm that I am exempt from the Contractor's Llcenae Law ��
for the following reason (Section 7031,6, Business and Professions Additional Sign Branch Ctroults 3G3 90,
Code): T
I,ea owns#of the property,w111 do the work and the structure
Mleo.Conduit&a Conductors 1 I[E'k5
le not Intended or offered for sale (Section 7044, Business Other(See Compote Fee SOhedule) , TOTAL 90 . 75
and Professions Code).
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construcflon lending agency for the �l``�y 4�17CG�E
•��
performance of the work for which this permit la Issued (Seo.3097, PERMff FEE (Sub-TO* O
Civ. C.)
PLAN CHECKING FEE ( fit/ 3/
Lender's Name
PERMff ISSUING FEE � 9743 1 AM 8:32
Lenders Address
I certify that I have read this&pplbatki n and under penalty of pudury state TOTAL FEE Q,
Chad the above Infomlatlon Is correct I &gree to oompty with an Camty
ordnance&and Stets lave requlaling Elwt tcel wirlrq,and hereby aut:hortze
repmwYmttves of this County to eater upon the above mertt7oned ProP"
for Inepecom g SEE REVERSE FOR EXPLANATORY LANOUAOE
�� ��—/ 5
SK1NATLFE DATE