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HomeMy Public PortalAbout4834 HELEO AVE_Electrical__ DOS S-A 5-46 APPLICATION FOR PL'PJiiY , ,AII EIFARTMENT OF BUILDING AND SAFETY COUNTS OF LOS ANGELES J: FOX.4CHJCF ENGINEER Q NAME ` 91�7 DISTRICT NO. GROUP ZONE i'ERMIT NO. ADDRESS "" � fRECEIVED BY READY FOR DATEISSUED U CITY ry 74 TEL.NO Tl FIRST INSPECTION W CERT.NO. aA�� EXPIRES APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY JOBr DESCRIPTION OF WORD ADDRESS/ • NUMBER:OF OUTLETS ON CIRCUITS LOCALITY �J LOCATION BY ROOMS NEAREST , LIGHT OUTLETS JSW. PLUGS FIxT CROSS ST. .;, L, CIRCUIT A B C D E F G H K NAME MAIL / ADDRESS O � CITY /Je TEL.NO. 1 AM THE - GAL POS$�SOR OF THE ABOVE„ I03 " ANGELES COUNTY CERT IFICTOF gUALIFICATI9N �C/// ELECTRICIAN. _ [^ a I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED Y f�/ '7 fi9 ABOVE OWNER. y CORREGFIO NS U P o� Q Z L9 C,! Q TOTAL- No. of ouTLETs APPROVALS NO. OF FIXTURESa= 'f $ �oV DATE INSPECTOR'S NAME NO. OF MOTORS MI. $ CONDUIT NO. OF SIGNS TRANS. $ WIRING NO. HEATERS $ 5 FIXTURES MISCELLANEOUS $ POWER �y PERMIT FEE $ J/r UTILITY CO.NOTIFIED TOTAL FEE S Iff) FINAL r a 76A668-CESOG 7-68 APP11 ICAT11®'Ipll FOR ELE TROC PERMIT g,� fey pq I II COUNTY OF LOS ANGELES I Cl II H�1 V� LL�1 11 L�11�1LLVll llll '�}Q 7i DEPARTMENT OF COUNTY ENGINEER d aB.o�RessG� �.3 Y" 4�s J .1� ,-6 /0 BUILDING AND SAFETY DIVISION JOHN A. LAMBIE, COUNTY ENGINEER CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY r �� FOR APPLICANT TO FILL 1N NEAREST y PERMIT FEES CROSS ST. 1 T E M NUMBERI EACH FEE 'OWNER c� '�Y 7r LJ '1• / �> �� ���� OUTLETS: / $ $ MAIL L�/. ' LIGHTS �RECEPT. :1 SW. / .10 �(,{' ADDRESS / Y' d - i - / - LIGHTING ,FIXTURES •10 CITY LIJke � e;7% TEL. NO. - c ELEC. RANGES CLO. DRYERS ELECTRICIAN WATER H EATERS .50 ADDRESS ELEC.SPACE HTRS. DISHWASHERS CITY TEL. NO. GARBAGE DISPOSERS AUTO.- STATE WASHERS STA. COOKING.UNITS .25 LICENSE NO. MOTORS: OVER INC. H.P. �@R�o.ry .n 4G •roq C,.4.a",a'i,]a; DISTRICT GROUP ZQN P Y O— 1/2 .25 lie— 2 .50 SPECTION RECORD 2— 5 1.00 5— 15 1.50 l IS— 5o 2.50 G P m 50—200 5.00 SIGNS: NO. TRANS. NO. LAMPS -- - SERVICE 0-600V 1.00 SERVICE OVER.600V 5.00 MISC. r ,. .WIRING PERMIT 1.00 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT '.50 TOTAL FEE is - 616 APPROVALS 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION 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 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE , DESCRIBED REBIID/Eyy�.wlrRR PERTY. 'N - POWER e SIGNATURE UTILITY CO.NOTIFIED 'e OF PERMITTEE IN FINAL VALIDA ARTHUR C. VEIT, CK MO CASH SUPERVISING ELECTRICAL ENGINEER Y. - I.03 1 9 4 n :S€P 2 8 2 A 3.6 0 WORKERS'COMPENSATION DECLARATION 76-663 ' CE-806G (2-80), �nLCiN FOR ELECTRICAL ECT ICAS PE T . 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 certified copy thereof(Sec. 3800, Lab.C.) 7:4 f /�f/N® /V S, FOR APPLICANT TO FILL IN JO'B Policy No / Company =` I ADDRESS • 7T�� New Residential Bldgs.&Pools EACH No. FEE Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ — $ LOCALITY LLCW TV 04 . Multi-family Sq: Ft. — NEAREST Certified copy is filed with the county building inspection CROSS ST department. Residential Swimming Pools OWNER OR ' /�q FIRM NAME DatzApplicant l�YOg���9 Outlets: Rec. Light—Sw. ® ADDRESS First 20 CERTIFICATE OF EXEMPTION FROM WORKERS' 'Total No. Additional CITY Tel Tel No. COMPENSATION INSURANCE } PLAN CHECK 11 (This section need not be completed if the work involved .. APPLICANT by the permit is for one hundred.dollars ($100) or less.) Lighting Fixtures First 20 ADDRESS V ' Total No. Additional I. certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No. Q permit is issued, I shall not employ any person in any manner PER r so as to become subject to the Workers' Compensation Laws. Range_ Heater_D.W. APPLICANT LG' W Oven _ Dryer'_W.M. ADDRESS ©! Cn Top _ FAU _W.H.._ Z Date Applicant, CITY Tel No. r Hood _ Fan . —Other 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 aS 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. Size&Type HP, KW, KVA,or KVAR Up to 1 Incl. FINAL Over 1 to 10 Incl. DATE LICENSED CONTRACTORS DECLARATION / VALIDATION Over 10 to 50 Incl 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- Over 100 BY ness and Professions.Code, and my license is in full force and effect. Services License Number Lic.Class— — 0 2 0 Am . 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 Sign with One Branch Circuit ° I hereby affirm that I am exempt from the Contractor's z 4 0 36 A License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits , ness and Professions Code): , ..# o'o 0 o o 2 Misc.Conduits&Conductors- EJ 1, as owner of the property, will do the work and the Other (See Complete Fee Schedule)— 2a° ° 28:5 0 . structure is not intended or offered for-sale (Section 7044, Business and Professions Code). 0 0 0 2 8 5 0 5 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a'construction lending agency. 10 9.'0'7--8 4 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 r hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE Sr ure of rmi D t