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HomeMy Public PortalAbout5566 HALLOWELL AVE_Electrical__ 768663-CE806 ,D,72 APPLICATION ELRTRICAL PERMIT . _ v_CONTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER JOB BUILDING AND SAFETY DIVISION ADDRESS '� [, LOCALITY NEAREST 0 FOR APPLICANT TO FILL IN CROSS ST, OUTLETS NO. EACH11 FEE OWNER OR $ Is FIRM NAME RECEPTJ MAIL FIRST 20 25 ADORES LIGHT TOTAL CITY TEL. N0. SWITCH OVER 20 10 PLAN CHECK LIGHTING TOTAL FIRST 20 25 APPLICANT FIXTURES OVER 20 ADDRESS .f0 RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT RANGE DRYERWTR. HTR. APPLICANT STA. COOK DISP. F.A.U. ADDRESS SPACE HTR. AIR COND. CITYTEL. NO. CLOTHES WASH. DISHWASH. LICENSE OR REG. NUMBER CLASS. FAN OTHER 1.00 ^ ,r1 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION V!/ 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 PROPERLY REGISTERED AND/OR 0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE d 1 - 10 3.00 DESCRIBED RESIDENTIAL PROPERTY. O - U 10 - 50 5.00 PERMITEESIGNATURE if� - CD O 1-- 50 - 100 10.00v DISTRICT NO. PlqrED BY LLJ 100 - 500 15.00 D ` f SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTOR'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE SERVICENOTOVER600VOLTS OR200AMP 3.00 UNDERSLAB WORK SERVICEOVER 600 VOLTS OR 200 AMP 10.00 ROUGH CONDUIT Ida TEMP SERVICE, POLE, &APPURTENANCES 5.00 .WIRING73 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 PE IT ALIDATION CK. M.0. CASH SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE I EE Ah-11L�° O 76A663-CE806 8-62 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER FR G BUILDING AND SAFETY DIVISION JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A.JENSEN, SUPT OF BUILDING - FOR APPLICANT TO FILL IN . RECEPT. TOTAL NO. EACH FEE . OUTLETS FIRST 20 $2O $ OWNER' LIGHT MAIL p�, yp ADD'L 10 ADDRESS SWITCH. I OVER 20 .-` LIGHTING TOTAL (FIRST 20 •20 CITY TEL. NO. FIXTURES } 1 I ADD'L fo ELECTRICIAN OVPR 20 417A Jd_4tCv, RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS GARB.DISP. STA.COOK / CITY mAr TEL.NO. DISHWASH. AUTO.-WASH. STATE rp SPACE HTRS. STA.APP.('/z H.P.MAX.) .50 LICENSE NO. Q b MOTORS: OVER NOT OVER H.P. DISTRICT NO. GROUP ZONE PR S BY O 1 1.00 1 3 1.so INSPECTION RECORD 3 8 2.00 *. ra 8 15 2.50 15 50 3.00 - �- -L — 7 a 50 100 5.00 0 SIGNS: NO.TRANS- , NO.LAMPS 0 O H SERVICE 0-60OV-NOT OVER 200A 1.00 - W SERVICE 0.60OV-OVER 200 A. 2.00 D' 0 SERVICE OVER 600V 5.00 z MISC. PERMIT ISSUING FEE 2.00 ®a SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE $ e v IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION 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 l6�k �-//o' lP ' /j•�;x � 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR + ' LICENSED A9 REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENT P OPERTY. a POWER p SIGNATURE UTILITY CO.NOTIFIED I ,P OF PERMITTEE FINAL ALIDATION ARTHUR C. VEIT CK MO CASH SUPERVISING ELECTRICAL ENGINEER 1"0403—t. SEP 1 9 204.5 Qr" I WORKERS'COMPENSATION DECLARATION . CE-806G (2-80) APPLICATION FOR ELECTRICAL PERMIT • CE-806 I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY insure, or a certificate of Workers'Compensation Insurance,or a cert• iedy o opy thereof(Sec. 3800, b.C.) FOR APPLICANT TO FILL IN JOB Poli ompany 1 EACH NO. FEE ADDRESS New Residential Bldgs.&Pools Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ — $ LOCALITY Multi-family Sq. Ft. — NEAREST Certified copy is filed with the county building inspection CROSS ST 'I d rtment. Residential Swimming Pools OWNER OR FIRM NAME Dat Applicant Outlets: Rec.—Light—Sw. ADDRESS First 20 CER IFICAT_0 OF EXEMP ON FROM WORKS, Total No. Additional CITY f Tel No. COMPENSATIO INSURANCE PLAN C �- (This section need not be completed if the work involved APPLICANT U by the permit .is for one hundred dollars ($100) or less.) Lighting Fixtures First 20, ADDRESS Total No. Additional 0 I certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No. (— permit is issued, I shall not employ any person in any manner PERMITV so as to become subject to the Workers' Compensation Laws. Range_ Heater_D.W. APPLICANT UJ Oven —,Dryer—W.M.— ADDR SS Date Applicant Top _ FAU W CITY P Tel No. , Hood — Fan Other_ ;7,7- NOTICE TO APPLICANT: If, after making this Certificate of Disp. — Room Air Cond.• LICE E OR Exemption, you should become -subject to the Workers' REG. NUMBER Class Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO. PROCESSED BY with comply with such provisions or this permit shall be deemed revoked. pp Size&Type HP,KW, KVA,or KVAR ✓-1 t _ I Upto�150 FINAL TE f VALIDATION WUL LICENSED CONTRACTORS DECLARATION , �E Over Incl. I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL IAL .9 (commencing with Section 7000) of Division 3 of the Busi- Over 100 BY ness and Professions Code, and my license is in full force and i effect. S rvices �" �' p, _r,,,�' a�i 7� /� 000 00F1er�6bII V� `7 License Number Lie. Class_G YJ f �. 201-1000 Amp. Under 600 V g/ • Contracto Date Over 1000 Amp.or Over 600 V ME OW R-BUILDER DE ARAT ON Temp. Power Pole&Appurtenances I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit License Law for the following reason (Section 7031S, Busi- Additional Sign Branch Circuits ness and Professions Code): Misc.Conduits&Conductors 2 . . 360.0 I; as owner of the property, will do the work and the Other (See Complete Fee Schedule)— structure is not intended or offered for sale (Section 0 0 0 3.6 0.0:v 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY a 1 2--'8:3 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is PERMIT FEE (Sub-Total) issued(Sec. 3097,Civ.C.)._ Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) Lender's Address PERMIT ISSUING FEE 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 authorize-representatives of this County to enter upon the above- eToned property for pection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE Signa ure Pe ittee D to r.., WOKERS'COMPENSATIONDECLARATION RCE-806G (2-80) APPLICATION FOR ELECTRICAL PERMIT.. CE-806y� I hereby affirm -that I have a certificate of consent to self COUNTY OF LOS ANGELES �"�7, BUILDING AND SAFETY 1uI insure, or a certificate of Workers'Compensation Insurance,or / a certified copy thereof(Sec. 3800,Lab.C.) FOR APPLICANT TO FILL IN ,JOB Policy No. Company New Residential Bldgs.&Pools EACH NO. FEE ADDRESS _571-!, ❑ Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ — $ LOCALITY Multi-family Sq. Ft. — NEAREST Certified copy is filed with the county building inspection❑ CROSS ST Residential Swimming Pools department. L[/,I- - d FO RM NA E v,t/ - _ Date Applicant Outlets: ReciLight_ Sw.� © MAIL I First 20 f ADDRESS �' r C &,4 CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY' - Ci7' el No. 1�/i//� �C COMPENSATION INSURANCE PLAN CHECK d (This section need not be completed if the work involved APPLICANT 0 by the permit is for one hundred dollars ($100) or less.) Lighting Fixtures First 20 U Additional ADDRESS Total No. cc I certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No. 0 permit is issued, I shall not employ any person in any manner PERMIT so as to become subject to the Workers' Compensation Laws. Range_ Heater_D.W. APPLICANT 7 -,L =/�7- W // l� Oven _ Dryer_W.M. ADDRESS J- ,,Ze0,.,C _lw� ate J'J 2 Applicant v' Top FAU _W.H. Hood Fan _Other_ CITYT��y� _ ei Tel No. J NOTICE TO APPLICANT: If, after making this Certificate of Disp. Room Air Cond._ LICENSE OR Exemption, you should become subject to the Workers REG. NUMBER Class Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO. PROCESSED BY �y with comply with such provisions or this permit shall be Size&Type HP,KW, KVA,or KVAR deemed revoked. '5�' Q� Up to 1 Incl. FINAL Over 1 to 10 Incl. DATE LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl. VALIDATION . I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL 9 (commencing with Section 7000 of Division 3 of the Busi- BY ( g ) Over 100 ness and Professions.Code, and my license is in full force and effect. Services License Number Lic.Class 0-200 Amp. Under 600 V 201-1000 Amp. Under 600 V Contractor Date Over 1000 Amp.or Over 600 V HOME OWNER-BUILDER DECLARATION Temp. Power Pole&Appurtenances I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit Additional Sign Branch Circuits License Law for the following reason (Section 7031.5, Busi- I ness and Professions Code): Misc.Conduits& Conductors 925 2 7 A I, as owner of the property, will do the work and the ) Other (See Complete Fee Schedule)— structure is not intended or offered for sale (Section }` 0 0 0 0 0 2 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY 2 0 o 1 1.50 9 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is PERMIT FEE (Sub-Total) ° ° ° 1 1,501 issued (Sec. 3097,Civ.C.). Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) 0 1.05-82 ender's Address PERMIT ISSUING FEE � Ag ertify that I have read this application and state that the TOTAL FEE ve information is correct.I agree to comply with all County ances and State laws regulating Electrical wiring, and authorize representatives of this County to enter upon 'e-mentioned property for inspection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE 3`, if J re of Permittee, Date