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HomeMy Public PortalAbout6203 HART AVE_Electrical__ Q pd� QED o N o o 11 4 76A663-CE606 9-66 PD O ��Q �n (�'���((��n �EGR COUNTY OF LOS ANGELES �f �L `� ~V I� �C UV❑ DEPARTMENT OF COUNTY ENGINEER BUILDING ��� BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. RECEPT, TOTAL NO. EACH FEE p/p �.�+-{• 1I OUTLETS FIRST 20 $.20 $ OWNER LIGHT T MAIL SWITCH ADD 10 ADDRESS OVER 20 TOTAL FIRST 20 .20 CITY TEL. NO. LIGHTING 1 FIXTURES �- FIXTURES 1 ADD'L 1O CONTRACTOR OVER 20 RANGES DRYERS WTR.HTRS. 1.00 ADDRESS jjae9& dL GARB.DISP. STA.COOK CITY e-,Ci DISHWASH. AUTO.-WASH. STA E SPACE HTRS. STA. APPL. ,50 LICENSE NO. (/ ZONE GROUP MOTORS: OVER NOT OVER H.P. DISTRICT NOE P CESSED BY O 1 1.00 ,_Q I 1 3 1.50 INSPECTION RECORD 3 a 2.00 8 Is 2.50 15 50 3.00 d s0 100 5.00 SIGNS: NO.TRANS NO.LAMPS O F- SERVICE 0.600V•NOT OVER 200A 1.00 W a SERVICE O•SOOV•OVER 200 A. 2.00 SERVICE OVER 600V 5.00 OTHER (SEE COMPLETE FEE SCHEDULE) PERMIT ISSUING FEE 2.00 Ob SUPPLEMENTARY PERMIT ISSUING FEE 1.00 APPROVALS DATE INSPECTOR'S SIGNATURE TOTAL FEE I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION UNDERS LAB WORK AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ROUGH CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING 1 HEREBY CERTIFY THAT I AM PROP LY REGISTERED DOR FIXTURES LICENSED AS REQUIRED BY LO .ANG ES COU ��'AN TE O CALIFORNIA OR THAT I AM H LEG OWNE OF. A TEND POWER RESIDE IN,THE ABOVE DE IBED ESIDE A PR TY. . SIGNATURE ILITY CO.NOTIFIED OF PERMITTEE a _. - ... ., FINAL VALIDATION JOSEPH C. ROOHAN MO CASH SUPERVISING ELECTRICAL ENGINEER CK its©.4 2 7. a 15• 2 D 2.2-Q WORKERS"COMPENSATION DECLARATION Y'' 76A663 10/£31 ��j�p ��a���®gip ��� 2p ��a� � /�p �j I hereby affirm that'( have•a certificate of consent toI'self insure, CE-ao6G' Ir LLQ C I1 Fl ELS l4� ICA PERINT or a certificate of Workers' Compensation Insurance, or ae,certifiedCOUNTY`OF;.LOS ANGELES.. `BUILDING AND SAFETY copy thereof( ec.',3 3 00 b. C.) � 2 c; Policy o "vim' '"Company'tifi �' ' FOR APPLICANT,TOFILLIN' - ,JOB ` ,p Certified copy-is hereby furnished. New Residential Bld s.& Poolsi,. EACH NO.• FEE,, ADDRESS f,,_ ® y . f g. _ Certified'copy is'-filed' 'with'the ,county owldmg lnsp66tion,� 1 &2-Family Sq.Ft — Edepartment" ;' Multi-family Sq.Ft. — NEARESCALT. �/'n / v' $ $ _ CROSS ST. Date G',•/r Applicant' ✓J�N Reaidential Swimming Pools OWNER OR a r CERTIFICATE= i 'FIRM.,NAME' G) OF.,EXEMPTION'FROM WORKERS n' ' r•" MAIL, s Outlets�Rec•— Light Sw. COMPENSATION INSURANCE �, pfJ =ADDRESS• . 11 First 20 (This section need,not be completed,if`the work involved�by the J CITY 7� Tel No ,. permit is.for one hundred,dcllars($,100)•or less) TotalNo Adddional. ' / '_ - _ ,•,: - q 'PLAN CHECK • ' ... :3 �� I,,certify,that',in the performance of thenich work.4or.wh ..this'permit ` is'issued,,l-shall not employ,any_,persohjn,any.manner,•so as to ' become subject.;,tothe„Workers Compensation_Laws Lighting.Fizturgs First 20 ADDRESS•' Total, .I %.l 1 - Ad • No: 'CITY ”" � Tel No: Date.. Applicant NOTICE' TO',APPLICANT: If; after' making' this Certificate of Fixed Appliances Not Over 1,HP „. PERMIT `r ' 1 b i "a,Exemption;you should. subjecY.to the,Workers'Compensation_,' Range_,'He ater_ D.W. APPLICANT' .. .., :. provisions of•'the;Labor Code ;you.must.,fo _witth'6 mply,.with such Oven Dryer _'-W.M ADDRESS rovisions or this ermit,shall be deemed.revoked. �! P .P Top FAU ,'' .W.H ��.. Y h•Y ..�,.�J r LICENSED,CONTRACTORS DECLARATION, / GIT Te kC• Hood Fan. Other_. +.I,hereby affirm that,l,amklioensed under provisions of Chapter.9` LICENSE OR Disp'� `Room,Air Condi, ! ":Class (9ohimencing'bode,-,a ,with'9eciion 7'000) of Division 3 of the:Business and 'Professions Code;and my license is m full force and effect, Power Apparatus& Large Appliances DISTRICT NO. O!SED BY Size.& Type HP;KW KVA or KVAR ` �fl -�/` :License.Number Licr Class'-*,- Up'to 1 Incl.. FINAL /.�•� DATE. .••� :Over,1 to 101nc ,R +:. • _. VALIDATION Contractor Date,. 1 ' „ Over'10 to 50 I cl O FINAL Q; am exempt under Sec. f -Over-50 to 100-Inc BYa B.&P.0 for this reason Over.,100 N - _ Date: S s ervices;Swbd MCC'& Paneltoard' - Z 0 - 200'Amp.Under'600 V V D Signature _ '201- 1000 Amp.Under 600 V S Exemption for Reg.Maint - _ Ov Elect. 1000 Amp.or Over.600 V SINGLE FAMILY Temp,Power Pole&Appurtenances HOME'OWNER-BUILDER'DECLARATION', a Sign with One Branch Circuit -' ACCTA I hereby affirm that I ani exempt from the Coritractor.'s License Law Additional S' ..Cr uits` u A.��.i for the;following reason(Section 7031:5, Business and Professions a a,7tiJ Sign,Brandi Circ Code) +� ilJ+,a�V . Misc Conduits&Conductors I,as'owner of the property,will do the work and-the struoture•. . 'Other See Complete'Fee Schedule); 1 ITEMS s not intended';or offered for sale (Section 7044,.Business-,,. , (. .,. y. .I��TttL` .ii.�l.D5 n f 0 and•ProfessionsCode): : s. .. It 1 RGL05 a 70 •` CONSTRUCTION LENDING•AGENCY I hereby affirm-'that there is a construction lending,agency, for the , CHANGE o a� p p ( ' 3097; '. PERMIT FEE' (Sub Total)'performance of the work for which this permit is issued Se Civ.C.). :'PLAN CHECKING FEE 000 -OQ01 5/9` Lender's.Name 11/'1.. D PERMIT.ISSUING FEE ��' 3341 1 r' 12=09 Lender's Address (..certify that I have read this application and state that the above TOTAL'FEE., 1-7 information i correct, I agree`to comply with all County ordinances and State, s regulating' EI ctrical wiring, and hereby authorize r, represent ves of t ' un to enter upon the above-mentioned property or inspe n p rp ses/'r/�� /. f ���Ys� SEE REVERSE FOR EXPLANATORY LANGUAGE. nature of Permitte to