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Home My Public Portal About6047 HART AVE_Electrical__ COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY q� WILLIAM J. FOX, County Engineer FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. p ELECTRICIAN /- K EC7)?/(%-.SM® P � RECEIVED BY READY FOR DATE ISSUED ADDRESS � � ��'� �" �q � /FIRST INSPECTION CITY E L Kim,ru,{j TEL.NELFO-Wil'—dip COUNTY LICENSE NO. EXPIRES I.-341-4 BUILDING PERMIT FEES ADDRESS �/9® NUMBER EACH FEE LOCALITY _rV^I PL[Z C rr LIGHT OUTLETS NEAREST p� p RECEPTACLES CROSS ST. /p'� ,I l.��t'i�•� WALL SWITCHES OWNER —5/14A 1?T TOTAL OUTLETS SO $ 30 MAIL ELEC. RANGES 85 ADDRESS ELEC. HEATERS 25 � CITY TEL. NO. FIXTURES _ 5 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWERFEE ANGELES COUNTY LICENSE. OR I AM THE LEGAL OWNER NEW MvD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOYE. t " M5 " J L_ %2 s LE.. $ .25 SIGNATURE OF --- rJ %2 2 .50 PERMITTE 1 - 2 B 1.130 INSPECTfbN RECORD S is 1.50 15 50 2.50 50 200 5.00 _ 200 500 10.00 J 500 1 000 15.00 Q _Z OVER 1000 20.00 E7 M.G. SET/FREQ. CHANGER-HP Q' WELDERS: AC-KVA O GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF ORIG•) , MOVED MOTORS (75% OF ORIG.) MISC. SIGNS NO. NO.TRANS. APPROVALS NO. NO. LAMPS FOR EACH PERMIT? (�D,ATE> INSPECTOR'S NAME --- —^— CONDUIT _WIRING $1.013 ® /� t� — FIXTURES _$1.00 ®® WIRING �A--7 SUPPLEMENTARY .50 FIXTURES X ` /(3 gg POWER �y �.,! �// TOTAL FEE $ ,�Al�c�o UTILITY CO �V�A .NOTIFIED /� -�7/ii i '7 74 FINAL v /U v 7 vyr •,.. -_- 76A663 DBS.#SA 2-53 - WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) 76A663 LWPPL I11CA �®Y�I' FOR ELECTMAL PERM , ` �f I hereby affirm that I have a certificate of consent to self insure, or a certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec. 3800,Lab. C.) � cy No. Company d FOR APPLICANT TO FILL IN JOB q. - ADDRESS Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE $ $ LOCALITY El Certified copy is filed with the county building inspection 1 &2-Family,Sq.,Ft. NEAREST department. Multi-family Sq.Ft. - CROSS ST. Date Applicant Residential Swimming Pools ASSESSOR�� /S MAP BOOK PAGE PARCE CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER OR Y / COMPENSATION INSURANC.E Outlets:Rec._Light (/ e& Sw. FIRM NAME 71 � ( �� -Av,�` (This section need not be completed if the work involved by the First 20 MAIL ' r. ADDRESS -G permit is for one hundred dollars($100)or less.) Total No. Additional I certify that in the performance of the work for which this permit CITY Tel.No. J is issued, I shall not employ any person in any manner so as to PLAN become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANT K Total No. Additional ADDRESS Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: If, after making this Certificate of CITY Tel.No. Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code, you must forthwith comply with such PERMIT provisions or this permit shall'be deemed revoked. Power Apparatus&Large Appliances APPLICANT LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS hereby affirm that I am licensed under provisions of.Chapter 9 Over 3 to 10 Incl. (commencing with Section 7000) of Division 3 of the Business and CITY Tel.No. Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. Over 50 t0 100 Incl. LICENSEClass. REG.NUMBB ER (L Over 100 DISTRICT NO. SSED BY O License Number Lic.Class �� ' Services, b CC gggggg,,,,,,,,,,P n - Contractor Date /�� mp FINAL 0 V DATE O ❑ I am exempt under Sec. 400-1000 Amp. UUUUn er 600 V 2 f—7� VALIDATION W Over 1000 Amp.or Over 600 V FINAL W B.&P.C.for this reason BRANCH CIRCUIT FEES BY Date: 15A,or 20A, 120V,Lighting or Recept. Z 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits 2 Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits Al 4T a V SINGLE FAMILY Temp.Power Pole&Appurtenances ,., -, HOME OWNER-BUILDER DECLARATION ,j,y(J,j fi_L� fa6Q 1 hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit 1 he for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits 1 ITEMS Code): Misc.Conduits&Conductors CHECK 65 - 60 as owner of the property,will do the work and the structure 4�EGf� tr.�a to is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) .fl 4 O 60 and Professions Code). CHANGE 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 (Sec. 3097, PERMIT FEE (Sub-Total) 0000-0001 1/16/96 Civ.C.) PLAN CHECKING FEE 4271 1 AM 9*-41 Lender's Name PERMIT ISSUING FEE FC Lender's Address I certify that I have read this application and under penalty of purjury state TOTAL FEE that the 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-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE SPAT E OF PERMITTEE DATE ION WORKER'S I have a certificate of consent to 20-0019 DPW(12-91) APP CATMN F®� En ECTMICA PERMOT 76A663 1� u� l� LL PERMOT �J I he�by affirm'that 1 have a certificate of consent to self insure, or a certificate of Worker's Compensation Insurance. or a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS . - BUILDING AND SAFETY DIV. copy thereof(Sec.3800 Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOBIV ADDRESS �. �� Certified copy is hereby furnished.. New Residential Bldgs.&Pools NO. EACH FEE LOCALITY $ $Ft Sq. . m Certified copy is filed with the county building inspection 1 &2-Family, NEAREST o department. Multi-family Sq.Ft. CROSS ST. r • /�� !L' Date Applicant Residential Swimming Pools ASSESSORv PAGE MAP BOOK ! p 1 PARCELS!// J - WNER OR CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec. Light Sw. FlRM NAME COMPENSATION INSURANCE �,dtC� First 20 MAIL 00, (This section need not be completed if the work involved by the ADDRESS !'' permit is for one hundred dollars($100)or less.) Total No. Additional ;� �� I certify that in the performance of the work for which this permit CITY I��'J Tel. is issued, I shall not employ any person in-any manner so as to PLAN CHECK uuvv become subject to the Workers' Compensation Laws. Lighting Fixtures First 20 APPLICANT Total No. Additional ADDRESS Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: If, after making this Certificate of CITY Tel.No. Exemption,you should become subject to the,Workers' Compensation OTHER APPLIANCES NOT OVER 3 HP. rovisions of the Labor Code, ou must forthwith comply with such PERMIT provisions or this permit shall be deemed revoked. . p y p Y Power Apparatus&Large Appliances APPLICANT G�_0J A__) LICENSED CONTRACTORS DECLARATION" iz Type HP,KW,KVA,or KVAR ADDRESS I hereby affirm that I'am licensed 'under provisions of Chapter 9 gkcl, (commencing with Section 7000) of Division 3 of the Business and CITY Tel.No. Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. LICENSE OR Class. Over 50 t0 100 Incl. REG.NUMBER - a Over.100 DISTRICT NO. - Pl O SED BY .O License Number Lia Class fJ V Services,Swbd.,MCC&Panelboards �Scc 0-399 Am Under 600 V FINAL O CdntractDr Date p' DATE _ /� ❑ 400-1000 Amp.Under 600 V — v"1� VALIDATION V I am exempt under Sec. Over 1000 Amp.or Over 600 V FINALW B.&P.C.for this reason BRANCH CIRCUIT FEES BY- Date: Y-Date: 15A,.or 20A,-120V,Lighting or Recept. tJ Z 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits El - 41 Or More Branch Circuits Exemption.for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits 7 2 SINGLE FAMILY Temp.Power Pole&AppurtenancesJL HOME OWNER-BUILDER DECLARATION AC•C Ery°g I hereby affirm that I am exempt from the Contractor's License Law. Sign with One Branch Circuit f[t� 50.70 for the following reason (Section 7031.5, Business and Professions Additional.Sign Branch Circuits' 3303 ° Code: 1 ITEMS I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors 70 is not intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule) TOTAL �m ty and Professions Code). � �C;�t 50. 0 CONSTRUCTION LENDING AGENCY CHANGE .00 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 (Sub-Total) Civ. C.) 0400-0001 3/21/96 PLAN CHECKING FEE Lender's Name 5447 1 A�s 111041 PERMIT ISSUING FEE Lender's Address D1 certify that I have read this application and under penalty of purjury state TOTAL FEE that the 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-mentioned property for ins ection purpospf SEE REVERSE FOR EXPLANATORY LANGUAGE IGNATURE of PERMITTEE DA