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HomeMy Public PortalAbout5547-49 HALLOWELL AVE_Electrical__ .76A663C- CE806B 12/75- -APPU M FOR EMMA PERM BUILD'IN ND SAFETY DIVISION FOR APPLICANT TO FILL IN _ JOB �; New Residential Bldgs. & Pools FEE EACH NO. ADDRESS 1 &2 Finaily Sq. Ft. $ — $ LOCALITY Multi-family Sq. Ft. — NEAREST t Residential Swimming Pools CROSS ST.OWNER OR ^ ') FIRM NAME - Outlets: Light, Switch & Receptacle MAI L ADDRESS First 20 Additional CITY r Tel. No. PLAN CHECK Lighting Fixtures APPLICANT First 20 - ADDRESS Additional CITY Tel. No. PERMIT Fixed Appliances Not Over 1 HP APPLICANT Range Heater_ D.W. ADDRESS Oven Dryer W.M. Top FAU W.H, CITY, Tel. No. r Hood Fan LICENSE OR CD REG. NUMBER Class. � Disp. A.C. � 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION I= AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING C..7 Size&Type HP;KW, KVA;or KVAR ELECTRICAL WIRING. w rn UpU to 1 Incl. z I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR Over'1 to 10 Incl. LICENSEDAS REQUIRED BY L05 ANGELES COUNTY AND STATE OF c CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE Over 10 to 50 Incl. DESCRIBED RESIDENTIAL PROPERTY. , Over 50 to }OO InCI. TRE 0 SIGNATURE Of ' Over 100 SIGNATUURE � DISTRICT NO. PROC SSED B Services O 0-200 Amp. Under 600 V 201 - 1000 Amp. Under 600 V APPROVALS' DATE INSPECTOR'S Over 1000 Amp.or Over 600 V SIGNATURE TEMP. POWER POLE Temp. Power Pole&Appurtenances UNDERSLAB WORK Sign with One Branch Circuit Additional Sign Branch Circuits ROUGH CONDUIT �o (Other) WIRING - 7'/--O—77 FIXTURES POWER AUTHORIZED PERMIT FEE (Sub-Total) UTILITY CO.NOTIFIED / _ PLAN CHECKING FEE (One-Fourth Permit Fee) FINAL 24177 '4�,91felvez- PERMIT ISSUING FEE0tf M TOTAL FEE NOTES ur �fWfl a r PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK.. G M.O. CASH 8 7-6 FEB 28 2 e. "~ 7.3 0 a:<, 76A663-CE806 10;74 APPUCAMN FOP, ELECTMCQL PEQN7 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER JOB �f BUILDING AND SAFETY DIVISION ADDRESS J LOCALITY NEAREST FOR APPLICANT TO 'FILL IN CROSS ST. OUTLETS N O. EACH FEE OWNER OR r .$ $ FIRM NAME RECEPT._ MAIL LIGHT TOTAL FIRST 20 25 ADDRES ���({ OVER 20 CIT TEL. N0� fV`y S V SWITCH .10 PLAN CHECK LIGHTING FIRST 20 25 APPLICANT TOTAL OVER 20 ADDRESS FIXTURES 1D " RESIDENTIAL.APPLIANCES CITY TEL. NO. PERMIT RANGE—DRYER ' WTR: HTR. APPLICAN STA..COOK' DI SP: F.A.U. _ ADDRESS /C/seJ �ZD SPACE HTR. AIR COND. CITY ('�l TEL.,NO.� .LICENS 0 CLOTHES WASH. DISHWASH. REG. NUMBER - CLASS -- D 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 _ - I HEREBY CERTIFY THAT I AM PROPER EGISTERED AND/OR 0 — 1 1.00 LICENSED AS REQUIRED BY LOS ANGELES OU P(TY AND STATE OF >.; CALIFORNIA OR THAT I •AM THE LEGAL 0 NER OF THE,'ABOVE 1 — 10 3.00 DESCRIBED RESIDE T L PROPERTY, '��/�I/gyp cU 10 — 50 5.00' PERMITE��;`--'y!//"l: /�.�, .O SIGNATURE }.., ` 50,— 100 10.00 U W DISTRICT NO. P SED BY a- 100,— 500 15.00 ` Z SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPE OR'S SIGNATURE TUBE, OR - MARQUEE ADD6TIONAL CIRCUITS 1.00 TEMP. POWER POLE' SERVICENOTOVER600VOLTS OR200AMP UNDERSLAB WORK SERVICEOVER600VOLTS OR.200AMP 10.00 -ROUGH CONDUIT TEMP SERVICE, POLE, &APPURTENANCES - 5.00 w WIRING TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL, Z_5=77. PERMIT FEE (SUB TOTAL) NOTES: PLAN CHECK-FEE PERMIT ISSUING FEE 3.00 6D TOTAL FEE OD -ot e PLAN CHECK VALIDATION CK,. M.O. CASH PERMIT ALIDATION CK. M.O. ASN-'' SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE �� WORKERS'COMPENSATION,DECLARATION 76A663 10/e1 //� (� �( � - CE-806G :•!P`�P UCA �OIl'Cl FOR ELEC II(' R�QA ..-PERM ff - rl hereby affirm 4haf I.have a certificate of consent to self insure, or a certific;Ate of V?5rkers"Compensationlnsurance,.or acertified COUNTY OF.LOS ANGELES '81JILDING AND:SAFETY :' copy there6(Sec.3800;La6. C.) .. Policy.No. Company OR AP F PLICANT TO;FILL IN 'JOB :Certified copy is hereby furnished. New Residential Bldgs.'&Pools OC 44 EACH NO: FEE, ADDRESS i�V � FJ 'Certified copy' is filed with the county building inspection . 1 &'2-Family,Sq.Ft. $ _ -- $ L ALITY� department. Multi=family Sq-Ft. :,.- - - NEAREST '- �- CROSS ST... •' : -`. Date Applicant; Residential Swimming Pools OWNER OR t IAM NAM CERTIFICATE OF EXEMPTION FROMWORKERS' S "''COMPENSATION INSURANCE' Outlets:Red LightuSw. ADDRESS' . Q� r ' 1 of O `(This section need not be`corimpleted if the work,involved by the First 20 i.. CITY Tel; ',Permit,is`for one hundred dollars($100)or less.), k: - Total No. Additional '1.•'certify that in the'performance-of the work for which this permit`: " PLAN CHECK is:issued;'Ishall•not employ any,person in any manner so as.to become subject to the Workers Compensation Laws Lighting Fixture First 20 ADDRESS. Total No. CITY Tel.No. Date Applicant Additional ti nal. NOTICE .TO,"APPLICANT:�If,` after making. fixed'Appliances Not'. ot Over'1 HP AEFMCA '.this Certificate, of Ran e Heater_ D.W. Exemption,you should become subject to the Workers'Compensation 9• NT provisions of.the Labor Code;-you must forthwith,comply with such Oven _ Dryer '_ W.M ADDRESS ;•'provisions or this permit shall be deemed;revoked.- Top —•FAIJ W:H. LICENSED.CONTRACTORSDECLARATION .'. ' Hood,•_"Fan _''Other_ • CITY - Tel No. 1.hereby affirm:that am licensed-under provisions of Chapter.9 a LICENSE OR ,•Dis Room-'Air Cond. ' MBER Class (commencing with,Section,7000)of._Division 3,.of the,Business and P REG..NU •_. Professions Code,and my license•is in full force and"effect: • 'Power Apparatus&,:Large Appliances DISTRICT'NO. PROCES D BY- Size& Type HP,KW KVA,:or KVAR- (� License Number Lic Class to 1 Incl. FINAL. -� U., , Contractor" V 'DATION' ' Up Over 1 to 10;Incl - DATE Date Over,10 to. FINA I-- „ •• Jam am exempt.under Sec. Over. Oto l00 Inc': . BY W B.&P.C.;for this reason Over 100„ Q. Services,SWbd.,MCC&Panelboards' D N. Date: 0`-200 Amp.Under 600 V Signature` „ ° . 201 - 16 0. Amp'.under duo d . 2 8 4 S4 A Over 1000 Amp:•Lor Over 600'V /j El Exemption for Reg Maiht.-Elect: #.o' 0,G ' �, c a. . , SINGLE FAMILY . Temp.Power Pole &'Appurtenances a c HOMEOWNER-BUILDER DECLARATION Sign with.One Branch;Circuit,+, a I^hereby affirm that 1 Am-exempt from the Contractor's License Law - O x for the following reason(Section 7031.5,Business and Professions` '. Sion,- "' o:-o o Code: a Additional Branch Circuits,% a.o " Misc.Conduits&.Conductors 3` I1 8.7 I as.owner of the property-will do the work and the structure Is not"intended or offered for sale (Section 7044, Business' Other(Se, omplete F ule) and Professions Code): Oth e C ee Sched (CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency,for'the .performance of the work for.which this,permit is issued(Seo.'3097,. PERMIT FEE (Sub-Total) Civ.cc,) PLAN CHECKING FEE -Lender's Name PERMIT ISSUING FEE Lender's Address I certify that I have read this application and state that the above TOTAL FEE' information is correct.1 agree to comply with all County ordinances and,State laws regulating Electrical wiring, and hereby authorize, representatives of this County:to enter,upon the above-mentioned prop. for inspection purposes. SEE-REVERSE FOR EXPLANATORY LANGUAGE., Signature 51 ermi Date . WORKERS-COMPENSATION that I have a-c ON DECLARATION 76A663 DPW 3/87 /�1PPUC n YMN FOR ELECT ICAL PERMY I hereby affirm that have_ a certificate of consent to self ;ceeo6� (� insure, or a.,certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS 1 -or aleflified copy thereof (Sec. 3800, Lab. C. Policy No,, y Company FOR APPLICANT TO FILL IN JOB ❑Certified co is hereby' furnished. EACH NO. FEE ADDRESS PY New Residential Bldgs. & Pools ElCertified copy is filed with the county building inspec- 1 & 2-Family, Sq. Ft. $ _ $ LOCALITY tion department. Multi-family Sq. Ft. NEAREST //l��/p� CROSS ST. , I vC� 11/7/— Residential Swimming Pools OWNER OR Date Applicant FIRM NAME 1y/Y CERTIFICATE OF EXEMPTION-FROM WORKERS' Outlets: Rec�Light Z Sw. MAIL COMPENSATION INSURANCE �; ADDRESS - (This section need not be completed if the work involved by. Total No.� First 20 Additional CITY Tel.'N the permit is for one hundred dollars ($100)or less:) PLAN CHECK I certify that in the performance of the work for which this APPLICANT permit is issued, I shall not employ any person in ny.mann so as to be ome subject to the Worker Co '� n ati a Lighting Fixtures First 20 ADDRESS Additional 7 Total No.� CITY Tel. No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE T, •APP ANT: If, of .making s Certificate of APPLICATION / a, / Exemption, you should become subject to the Workers' Range— Heater—D.W. — Compensation provisions of the Labor Code, you MUSjr 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— CIT ,f Tel. N LICENSED CONTRACTORS DECLARATIONDisp. _ Room Air'Cond. —- LICENSE OR Class/1071 / / I hereby affirm that I a'm licensed under provisions of Chapter 9 REG. NUMBER (commencing with Section 7000)of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO. _ PR ED BY a and Professions Code ,and my license is in full force and effect. Size &Type HP, KW, KVA, or KVAR �- P 0 License NumbQ4 Lic. Class Up to 1 Incl. FINAL U C is Over 1 to 10 Incl. DATE "(-?Z _/J .VALIDATION Contractor ' Date Over 10 to 50 Incl. 0 FINAL 17lam exempt under Sec. U Over 50 to 100 Inc. BY W B.&P.C. for this reason` Over 100 . O_ Services, Swbd.,.MCC& Ponelboards U) Date: Z 0-200 Amp. Under 600 V Signature r 201 - 1000 Amp. Under 600 V ❑ Over 1000 Amp. or Over 600 V Exemption for Reg. Maint. Elect. SINGLE FAMILY Temp. Power Pole &Appurtenances HOME OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit Low'for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits Professions Code): 71, Misc. Conduits&Conductors ❑ I, as owner of the property,, will do the'work and the - sT T:7M, c structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)— D -' Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of thework for which this permit is issued PERMIT FEE (Sub-Total) -_: ^;.?t' (Sec. 3097, Civ. C.). PLAN CHECKING FEE EG Lender's Name PERMIT ISSUING FEE Lender's Addressr: 1 F I certify that.1 have read'this application and state that the TOTAL FEE -= above information is correct. I agree to.comply with all County ordinances and State laws,regulating Electrical wiring, and hereby authorize representative f this County to enter upon the-above-mention pro rty r inspect&Pur;o es. SEE REVERSE FOR EXPLANATORY LANGUAGE S i"gnature m of erittee f I.te © WORKERS' COMPENSATION DECLARATION C -803 10/31 AI!PL��`>e AMOK FOR ELECT �, A PERNT CE-806G ��f �y L� I hereby affirm that I have a certificate of consent to self insure,. , or a cejtificate of Workers' Compensation Insurance, or a"certified COUNTY OF LOS ANGELES BUILDING AND.SAFETY copy ther`mof(Sec. 3800,Lab. C.) f7-' P❑olicy.No.` Company FOR APPLICANT TO FILL IN ,JOB Ce tifie-d co is hereby furnished. EACH NO. FEE' ADDRESS d copy Y New Residential Bldgs.& Pools � Certified 'copy is filed with the'county building inspection 1 & 2-Family, Sq.Ft. $ $ LOCALITY department. Multi-family Sq. Ft. — NEAREST CROSS'ST. Date Applicant Residential Swimming'Pools OWNER OR . FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec Light Sw. MAIL r9 COMPENSATION INSURANCE ADDRESS %'� (This section need not be-completed if,the work involved by the First 20 CITYTel.No.' permit is for one hundred'dollars($100)or less.) Total.No. Additional �.� I certify.that in the performarice.of the work for which this permit PLAN CHECK` APPLICANT is issued, I shall not employ any person in any manner.so as to become subject to the Workers',Compe tion L/ayes. Lighting Fixtures First 20 ADDRESS < Total No. Additional Date Applicant CITY - Tel.No. Fixed NOTICE TO APPLICANT:' If, after making, this Certificate of Appliances Not Over 1 HP. PERMITr J o' /`; C•,t 7 Exemption,you should become subject to the Workers'-Compensation Range_ Heater D.W. APPLCANT /J JJi provisions of the Labor Code, you must forthwith comply with such Oven Dryer W.M._ ADDRES ' provisions or this permit shall be deemed revoked Top FAU W.H. _ ` a LICENSED'.CONTRACTORS DECLARATION Hood Fan Other_ I hereby affirm that I am licensed under provisions of Chapter"9LICENSE OR �, C Disp. Room-Air Cond. Class. (commencing with Section 7000) of Division 3 of the Business and REG.NUMBER Professions Code,and my license is in-full force and effect. - - DISTRICT NO. E - PROCE ED BY Power Apparatus.& Large Appliances $ ®- ` Size & Type`Hf,KW,KVA, or KVAR t= � License Number _ �/ Lic.Class < -1C) Up"to 1-Inch FINAL �2 C Over 1,to 101nc1. DATE `{ p` v �� VALIDATION Contra r / fii �.l�/ afe �'3 ��/-�/ /, 0 Over 10 to 50.Incl. , ❑ I am exempt under Seo. Over 50 to 100 Inc. FINALBYr " W BAP.C, for this reason Over 100 LL Se i S,STUB.-M C& Panelboards F- Date: ., � o Z 0=2 Under 600 V Signature ­201=1'000 Amp'Under 600Y ❑ Over 1000 Amp.or Over 600 V Exemption for Reg,Maint.Elect. SINGLE'FAMILY Temp. Power Pole& Appurtenances HOME OWNER-BUILDER DECLARATION Sign with-One Branch Circuit I hereby affirm that I am exempt from the Cont'ractor's"License Law, r. T' for the following reason (Section 7031.5,'Business and Professions _ Additional Sign,Branch Circuits ri [ F k Code): ❑ Misc.-Conduits& Conductors • �! I,as owner of the property,will do the work and the structure _i 5 is not intended or offered for sale (Section 7044, Business ; Other(See Complete.Fee Schedule) ` and Professions Code)., TOTAL' 3 � � 00 CONSTRUCTION LENDING AGENCYCHECKG#I , I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued(Sec:3097; PERMIT FEE ) I F e C.). (Sub-Total i^'tIE`ii� f ij Ni PLAN CHECKING FEE -Lender's Name PERMIT ,?;7}i f'`1 PERMIT ISSUING FEE eo +=r;� Lender's Address !.w{ II I certify that I have'read this application and state that the above - TOTAL FEE �Q information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize representatives of this County o enter upon the above-mentioned . property nspection p po s SEE REVERSE FOR EXPLANATORY LANGUAGE Sitrbtt—reof Per tee" Date T WORKERS'COMPENSATION DECLARATION 20-Dole DPW 3/87 n 2p I� � I hereby affirm that I have a certificate of consent to self CE80 ��p�O�Q���� ��� 15L�LS��I1�T0 `VQL� ll-LSII�SIIVU� Il O insure, or a certificate of Workers"Compensation Insurance- COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certified copy,thereof (Sec. 3800, Lab..C.) f Policy No. _ Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH rNO. FEE ADDRE ❑Certified co is filed with the count building inspec- 1 &2'Famil S Ft. $ $ LOCALITY PY Y 9 . P Y. q� tion department. Multi-family Sq. Ft. / NEAREST CROSS ST. Residential Swimming Pools Dare Applicant' OWNER O OR FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw._ MAIL COMPENSATION INSURANCE ADDRESS First 20 (This section need not be completed if the work involved by Total No. CITY - Tel. No. the"permit is for one hundred 'dollars ($100)or less.) Additional PLAN CHECK I certify that in the performance of the work for which this APPLICANT permit is issued, I shall not employ any person in any manner Lighting Fixtures "First 20 ADDRESS so as to become subject to the Workers'Compensation Laws. • Additional - Total No. CITY Tel. No. Date_ ��- Applicant' Fixed Appliances Not Over 1 HIP PERMIT NOTICE TO APPLICANT:•.If, after' making' this Certificate of APPLICATION / Exemption, you should become subject 'to the Workers' Range— Heater—D.W. Compensation provisions of the Labor Code, you must forth- Oven Dryer W.M.— ADDRESS r, with ..comply with such provisions or this permit 'shall ,be Top FAU W.H. , deemed revoked. 19 Hood Fan —Other— �� C CIT I. No. / LICENSED CONTRACTORS DECLARATION LICENSE OR � I hereby'affirm that I am licensed undREG. NUMBER er provisions of Chapter 9 Disp. Room Air Cond. — Class. _ (commencing with Section 7000)of Division,3 of the Business Power Apparatus&,Large Appliances DISTRICT NO. P SSED BY >_ and Professions Code,and my license is in full force and effect. ry t1 Size &Type HP, KW, KVA, or KVAR ®d G�e� 11 Q License Number 31579 1 - Lic. Class l� /0 Up to 1 Incl. FINAL g U Contractor.��IVZ;3 696a4ate' 3 ~ZY-1' Over 1 to 10 Incl. DATE ;/S O/ VALIDATION ❑ Over 10 to 50 Incl. FINAL J I am exempt under Sec. Over 50 to 100 Inc. BY �/ W B.&P.C. for thi's reason Over 100 ���JJJ c• D Z Date: "' Services,.Swbd:,'MCC& Panelboards Z 0-200 Amp. Under 600 V — Signature 201 - 1000.Amp. Under 600 V ❑ Exemption for Reg. Maint..Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Temp. Power Pole &Appurtenances Sign with One Branch Circuit I hereby affirm 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): Misc. Conduits&.Conductors ❑ I, as owner of the property, will do the work and the _ _ = 1•� structure isnot intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ Business and Professions Code). D '[-`°N° 4.'_- 4 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a constructionlending agency for _ .•. _ ll the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) (� -I (Sec. 3097, Civ. C.). ` PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address w3Xj i A 1 i;i;y ` I certify that I have read this application and state that the TOTAL FEE above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby auth rize representatives of this County to enter upon the abo entione ro or inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date ©s