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HomeMy Public PortalAbout6102 HART AVE_Electrical__ 76A663-C E80611-7,1 PER(�(��� COUNTY OF LO ANGELESANGELES uvq ' DEBUL DING AND SAFETY DIVISIONTMENT OF COUNTY BUILDING /op-_ A/1 KG? ADDRESS LOCALITY / ,/CNEARE / Tp FOR APPLICANT TO FILL IN CROSS HT. l/� /"�< l+i-40 OUTLETS N0, EACH FEE r � OWNER LfAA/VYCiL,.��. RECEPT. AIL $ $ ADDRESS 61/2 LIGHT__; TOTAL FIRST 20 .25, �1 CITY _ TEL. NO.®CB 1,1';b SWITCH OVER 20 1p ' PLAN CHECK FIRST 20 25 APPLICANT LIGHTING TOTAL OVER 20 ADDRESS FIXTURES .1U 1 1 RESIDENTIAL APPLIANCES CITY TEL. NO. RANGE DRY ERPERMITWTR. HTR._ APPLICANT � �� STA. COOK DI SP. F.A.U. ADDRESS. Sl*llkp SPACE HTR. AIR COND. CITY TEL. NO. CLOTHES WASH. �DISHWASH. LICENSE NO. CLASS. FAN OTHER 1.00 U 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 PROPERLY REGISTERED ANO/OR O - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF > CALIFORNIA OR THAT 1 AM.THE LEGAL OWNER OF, AND INTEND'TO 1 - 10 3.00 RESIDE IN, THE ABOVE DESCRIBED �.RRESID/ENT I AL'.PROPERTY. 0 SIGNATUR ./ 10 - 50 5.00 OF PERMITTEE ` O 50 100 10.00 ~ DISTRICTNO. CLASS PRO ESSED BY4 u Lu 100 - 500 15.00Z SIGN, GAS SIGN AND ONE CIRCUIT 5.00 NOTES: TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 SERVICEN_OTOVER600VOLTS OR200AMP / 3.00 D0 APPROVALS DATE INSPECTOR'S SIGNATURE SERVI CE OVER 600 VOLTS OR 200 AMP 10.00 TEMP.POWER POLE TEMP SERVICE,POLE, &APPURTENANCES 5.00 TEMP LIGHT OR RECEPT. SYSTEM 3.00 UNDERSLAB WORK, ROUGH CONDI UT WIRING FIXTURES T I PERMIT FEE (SUB TOTAL) UTILITY CO. NOTIFI PLAN CHECK FEE n PERMIT ISSUING FEE 3.00 FINAL TOTAL FEE PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. vvv M.O. CASH I ., 2 n 2 6:?3. AUG 7 2 0 1 5 .7 5 7 SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE .76AS(i,3C- CE806B 12/75 v_ & U LEEM FOR ELL7t:/UUUEA U EIJUMll BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN JOB / New Residential Bldgs.'&Pools EACH NO. FEE ADDRESS 0;2 4/. f,/,cllZ/ .4j/C 1 &2 Finaily Sq. Ft. $ — $ LOCALITY Multi-family Sq..Ft. — NEAREST n n Residential Swimming Pools CROSS ST.OWNER OR FIRM NAME - cV�7�I�L,/ Outlets: Light,Switch & Receptacle ADRESS ~ �� First 20 / _ Additibnal r CITY C.� Tel. No. ef,° �5797Z PLAN CHECK Lighting Fixtures APPLICANT First 20 ADDRESS Additional CITY Tel. No. IT Fixed Appliances Not Over 1 HP APPLICANT Range_ Heater ' D.W. ADDRESS /PJ2 /V, ��27 Oven Dryer dG W.M. Top ' FAU W.H. CITY Tel. No. > Hood fan f� LICENSE OR a Disp. A.C. al� 9^ REG. NUMBER Class: C I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION O AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY l.— Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING V V Size&Type HP, KW, KVA,or KVAR ELECTRICAL WIRING. a_ z Up to 1 Incl. HEREBY,CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR I Over 1 to 10 Incl. LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR. THAT 1 AM THE LEGAL OWNER OF THE ABOVE Over 10 to 50 Incl. I DESCRIBED RESIDENTIAL PR�OjP/EVERT/Y. �,le Over 50 to 100 Incl. PERMITEE Over 100 SIGNATURE Services DISTRICT NO. PROCESSED BY ' 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 UND'ERS'LAB WORK Sign with One Branch Circuit Additional Sign Branch Circuits ROUGH CONDUIT (Other) WIRING - - FIXTURES POWER AUTHORIZED PERMIT FEE (Sub-Total) UTILITY CO.NOTIFIED 0/ PLAN CHECKING FEE (One-Fourth Permit Feel FINAL t?'Z_X79 PERMIT ISSUING FEE 50 NOTES TOTALFEE PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK-. M.0. CASH 2 8 84�'GGT 5 2 ID18.2 0 �` r WORKERS' COMPENSATION DECLARATION :20-0019 DPW 3i87 /�1 I�I�p �� /tel��OO WV FOR �L�LS��I1���G�1L� I�LSI1�UVll�� I he!oby affirm that I have a certificate of consent to self" 'CE-806G, G�1ll–lf"LS G=�1 O insure, or a certificate o-f Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certified copy thereof (Sec. 3800, Lab. C.) / / //��7 Policy No. Company FOR APPLICANT TO FILL IN JOB ADDRESS (o��� �V� /7 Certified copy is hereby furnished. New Residential Bldgs. & Pools - EACH NO. FEE _ LOCALITY Certified copy is filed with the county building inspec- 1 & 2_Family, Sq. Ft. $ $ tion department. Multi-family Sq. Ft. — NEAREST CROSS ST. Residential Swimming t� Date Applicant Pools OWNER OR ^� �� FIRM NAME !J;/7�/ CERTIFICATE OF EXEMPTION FROM WORKERS' OutlMAIL ets: Rec Light Sw._ ��® COMPENSATION INSURANCE First 20 ADDRESS (This section need not be completed if the work involved by \ CITY Total No. Tel. No. the permit is for one hundred dollars ($100)or less.) Additional �/� / �,� ' 1j 1;;1 157.4 PLAI I certify that in the performance of the work for which this A PLIICANTK /T�`i permit is issued, I shall not employ any person in any manner _ so as to become subject to the Worker 'Co pensation Laws. Lighting Fixtures First 20 ADDRESS Additional Total No. CITYC Tel i Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT OZ Exemption, you should become subject to the,'-Workers' Range— Heater—D.W. — APPLICATION / Compensation provisions of the Labor Code, you must 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— CITY Tel. No. LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. Room Air Cond..— REG. NUMBER Class. (commencing with Section 7000)of Division 3 of the Business Power Apparatus & Large Appliances DISTRICT NO. PROCES BY >_ and Professions Code,and my license is in full force and effect. l f d Size &Type HP, KW, KVA', or KVAR (/ 0 License Number Lic. ClassU Up to 1 Incl. SINAL Contractor Date Over ] to 10 Incl. DATE , f � VALIDATION 0 Over 10 to 50 Incl. FIN v F I am exempt under Sec. Over 50 to 100 Inc. g W B.&P.C. for this reason Over 100 CL Date: Services, Swbd.;MCC 8 Panelboards Z 0- 200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V Exemption for Reg. Ma int. Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY Temp.Power Pole&Appurtenances 20761 A HOME OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit # e o o 0 0 2 Law for the'following'reason (Section 7031.5, Business and Additional Sign Branch Circuits Professions Code): e^o 2 5.5 0 I, as owner of the property, will do the work and the Misc..Conduits& Conductors 0 0'0 2 5.5 05 structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ D Business and Professions Code). 09,23'-88 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 PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address I certify that I have read this application and state that the TOTAL FEE o 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 thea ove- entioned property for inspection purposes. 9 SEE REVERSE FOR EXPLANATORY LANGUAGE G / .�f7 O a Signature of Permittee Date Os WORKERS'COMPENSATION DECLARATION 7E-806 10/81 !�1 fo P ice'. /tel���H IFOR ftp 12�5�i'fo���n � �fo�l2fo�11/T I hereby affirm that I have a certificate of consent to self CE-806G h11J'll'L� �G�1 11V lT ll� LS L;LS Il I1�I G�1 IT ISl1�I1Vll ll1. insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AICD SAFETY or certifieed�d��coopyyt�tvvh��ereof (Sec. 3800,pLyab. C.) �' /— yy,�� /- PIt�jCompany i� ��V YV f FOR APPLICANT.TO FILL IN JOB ADDRESS((/�V� /vim//G/ ❑ Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE — LOCALITY �+ Certified copy is filed with the county building inspec- 1 & 2-Family, Sq. Ft. $ — $ ion department. Multi-family Sq. Ft. ' 'NEAREST �����, 'Residential Swimming Pools CROSS ST. TT ,A— � Date �� OWNER OR � Applic FIRM NAME 6/�, w v v, CERTIFICATE OF EXEMPTION FROM WORKERS' � MAIL d Outlets: Rec Light Sw. c� COMPENSATION INSURANCE , � fZ1 ADDRESS (This ' d t be completed First 20 ( s secneenopeted if the work involved b Y Total No.'10 Additional CITY Tel. the permit is for one hundred dollars ($100)or less.) that in the'performance of the work for which this PLAN CHECK I certify P APPLICANT permit is issued, I shall not employ-any person in any manner so as to become subject to the Workers'.Compensation.Laws. Lighting Fixtures First 20 3 ADDRESS 721f-a Additional Total No. CITY Tel. No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT AA� NOTICE'TO APPLICANT: If, after making'this Certificate of APPLICANT . �� "�/` 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 with comply with such provisions or this permit shall be Top FAU /1 W.H. — © deemed revoked. Hood'_ Fan L Other_ CITY Q Tel. No LICENSED CONTRACTORS DECLARATION Sa:LICENSE OR 9 I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. REG. NUMBER /7 Class. (commencing with Section 7000) of Division 3 of the BusinessDISTRICT NO. PROCESSE BY and.Professions Code,and my license is in full force and effect. Power'Apparatus&Large Appliances q / Size &Type HP, KW, KVA, or KVAR' Q O License Numb O 77.3 Lic. Class_ FINAL to 1 Incl... FINAL u cc Over 1 to 10 Incl. DATE VALIDATION Contracto Ower 10 to 50 Incl. ❑ FINAL U 1 am exempt under Sec. Over 50 to 100 Inc. J BY � d B.&P:C. for this reason Over 100 Services, Swbd.;,MCCk nelboards D — Date: 0 -200 Amp. Und0 V Signature 201 - 1000 Amp: Un00 V ❑ Over 1000 Amp. or 600 V Exemption for Reg. Maint. Elect. -5 SINGLE FAMILY Temp. Power Pole &Appurtenances _ o o o 0 o.2 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License o o_ Low for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits 2 2 5 Professions Code): '.o'o a 2 4 5 0 ❑ I, as.owner of the property, will do the work:and the Misc. Conduits&Conductors' structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ D 09.21 —8 3 7044, Business and Professions Code). 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 PERMIT FEE (Sub-Total) Q? (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address I certify that I hav ead this application and state that the TOTAL FEE erc Y� above information-lis correct. I-agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby autho 1ze representatives of this County to enter upon the bove- ntioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE '/SigncRurj of Permittee Date