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HomeMy Public PortalAbout4903 HELEO AVE_Electrical__ 76A663-CE. 06-f0-56- (Tull P��`%dl',1TION 0 OR LSLECT�' C PERMT T IIILDING AND SAFETY DIVISION w' u Department of County Engineer # BUILDING f County of LOS Angeles ADDRESS JOHN A. LAMBIE.COUNTY ENGINEER 'p�f CASSATT D. GRIFFIN.SUPT OF BUILDING jr LOCALITY' Alf NEAREST C FOR APPLICANT TO FILL IN Ross PERIMIT FEES - - J nn OWNER A q; LIGHTS RECEPTACLES. QS SWITCHES R: NUMBER I T E M EACH FEE MAIL ADDRESS tJ, �1 Imo..,ls� 6•^ - _ TOTAL OUTLETS $ ,10 $ n q ,f{ (q( ELEC., RANGES, WATER HEATERS, CITY /Ofi X NO. CLOTHES DRYERS .50 ' ELEC. SPACE HEATERS, STAT-Y. COOK- ELECTRICIAN ING UNITS, GARBAGE DISPOSERS, ADDRESS AUTO WASHERS, DISHWASHER .25 LIGHTING FIXTURES •10 CITY TEL. NO. D MOTORS STATE LICENSE NO. HORSEPOWER H.P. OVERINC. DISTRICTNO. GROUPr ZONE READY FOR-INSPECTION e 1/2 &LESS_ 25 ' 5o s INSPECTION. RECORD 2 5 1.00 '5 15 1.50 15 50 2.50 50 200 5.00 ` k1MISC. _ I� € I NO.TRANS ! SIGNS NO.LAMPS c SERVICE O-600V 1.00 SERVICE OVER 600V 5.00 WIRING PERMIT 1.00 - FIXTURE'PERMIT 1.00 ? ''• SUPPLEMENTARY PERMIT .50 APPROVALS TOTAL-FEE DATE INSPECTOR'S SIGNATURE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION �. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING, . ELECTRICAL WIRING. WIRING - IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF >` ii CALIFORNIA OR. THAT 1 AM THE LEGAL OWNER OF THE ABOVE POWER DESCRIBED RESIDENTTIAII PROPERTY. - SIGNATURE 1� " UTILITY CO. NOTIFIED ryry /G OF PERM ITTEIX FINAL JOHN A. LAMBIE, VALIDAT ARTHUR C.VEIT, COUNTY ENGINEERcK Mo CA-sH SUPERVISING ELECTRICAL ENGINEER ® .2:3 629;. 'SEP 17 2 2.8 Q 0 e , 76A663•CE 06.10-56 APPLICATION FOR ELECTRIC PERMIT UILDING AND SAFETY DIVISION Department of County Engineer BUILDING County of Los Angeles ADDRESS JOHN A.-LAMBIE. COUNTY ENGINEER CASSATT D. GRIFFIN. SUPT OF BUILDING LOCALITY V. NEAREST FOR APPLICANT TO FILL IN CROSS T. PERMIT FEES OWNER.'y'3' \' LIGHTS RECEPTACLES ,SWITCHES -� NUMBER 1 T M EACH EE MAIL ° ADDRESS y TOTAL OUTLETS $ ,10 ,$ 769 Z,Q /.,r/•� J� .moi ELEC. RANGES, WATER HEATERS, - CITY f�" / .ff EL. NO,JVLN CLOTHES DRYERS 'SO ELECTRICI N (� ELEC: SPACE HEATERS, STAT'Y. COOK-. o- ING UNITS, GARBAGE DISPOSERS, ADDRESS - u :4 AUTO.. WASHERS, DISHWASHER .25 •LIGHTING FIXTURES, ,10 �r). CITY TEL. NO. MOTORS STATE LICENSE NO. HORSEPOWER p. a H.P. OVER INC. DISTRICT NO. GROUP ZON •^ EADY.EQR•INSPECTION +/2 &LESS .25 V) 1/2 2 .50 INSPECTION ORD 2 — s 1.00 "� 5 15 1.50 R 15 50 .2.50 /�< _Akrl -�C�"f�!. �'�� vr� _ 50 200 5.00 .YJt�„4t, misc. ,r SIGNS I NO.TRANS j. NO.LAMPS SERVICE O-600V 1.00 - C." 10 .> SERVICE OVER 600V 5.00 WIRING PERMIT 1.00 _1-4 e-6-4? FIXTURE PERMIT 1.00 ° O SUPPLEMENTARY PERMIT .50 I l APPROVALS TOTAL FEE $ 1'HEREBY ACKNOWLEDGE THAT.1 HAVE READ'THIS AP LICATION DATE INSPECTORS SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE 0 COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATINGs ELECTRICAL WIRING. WIRIN to _ I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR T.' FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF .. —. CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE POWER. DESCRIBED R;T,EN�TT A PROPERTY. I •, SIGNATU !� UTILITY CO. NOTIFIED OF PERM E FINAL JOHN A. LAMBIE. VA $Ti ARTHUR C.VETT, COUNTY ENGINEER CK m cAS SUPERVISING ELECTRICAL ENGINEER I 1471� AUG 22 2 4.80 0 WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) 76A663 ! udu lK1PPIL-J��fA��®IIV' FOR ELECTMICAL PE rRi NT - , u I hereby affirm that I have a certificate of consent to self insure, or a Sertificate 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 JOB' ,? ADDRESS 7 Ce}tified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE'. LOCALITY — [7•.• 'Certified copy is filed with the county building 1 &2-Family,Sq.Ft. $ $inspection _ NEAREST department. Multi-family Sq.Ft. CROSS ST. Date Applicant Residential Swimming Pools ASSESSOR \ 33 • p( PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' _ OWNER OR Outlets:Rec. Light Sw. FIRM NAME �� COMPENSATION INSURANCE First 20. �`5 F (This section need.not be completed if the work involved by the MAIL S D � Permlf fig for'one hundred dollars($100)or less.) Total.No. Additional I certify that in the performance of the work for which this permit CITY Eft _ G� TeL No.P100- is.issued, I shall not employ any person in any manner so as t0 PLAN CHECK ` become subject to«the Workers' Compensation Laws. Lighting Fixtures First 20 APPLICANT jU� Y Total No.� Additional ADDRESS t� a Date, Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP. t NG.T,ICE TO APPLICANT: If, after making this Certificate of CITY - G� 'Tel.Nody�^ = L Exemption,you should become subject to the Workers'Compensation' OTHER APIPUSNCES-�NOTIO •VER,3.,HP. .• •c.:_- - -, `-S - ,:-1`� ��,'.••�\ ...::'i\ provisions of the Labor Code, you must forthwith comply with SUCK APPLICANT PERMIT-_k,.i 'N Lr�Z provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances ✓LGS A Size&Type HP,KW,KVA,or KVAR ADDRESS S•, tiy': �' ' LICENSED CONTRACTORS DECLARATION YP - - .(•�9'O--• ,-�`'�'-F-�jG- .7'• ` ' I hereby affirm that`I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. / y (commencing with Section 7000) of Division3.of the Business and CITY /� (� T.I.N..�f�^ / Professions Code, and my license is in full force and effect. Over 10 to 50 Incl. LICENSEClass. CL Over 50 t0 100 Incl. REG.NUMBB ER a Over 100 DISTRICT NO. - ESSED BY Q License Number Lio.Class p 0 -Services,Swbd.,MCC&Panelboards �A a: 0-399 Am Under 600 V FINAL O Contractor Date p' DATE ❑ I am exempt under Sec. 400-1000 Amp, Under 600 V 6,2 43 VALIDATION V Over 1000 Amp.or Over 600 V FINAL LU B.&P.C.for this reason BRANCH CIRCUIT FEES BY Date: 15A,or 20A, 120V,Lighting or Recept... Z_ 1 To 10 Branch Circuits Signaturei t To 40 Branch Circuits ❑ 41 Or More Branch Circuits Exemption for.Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits SINGLE FAMILY Temp.-Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ' - I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits _� t Code): ❑ I,as owner of the property,will do the work and the structure Misc.'Conduits&Conductors .: is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) j' '= `_'`-°a °-� and Professions Code). D C CIF` `_ f _-7 CONSTRUCTION LENDING AGENCY r*,?.;_Y 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.) - -.a - r_ PLAN CHECKING.FEE. 1�---' °= - �: 3�J Lender's Name i i%=:`. -.31 PERMIT ISSUING FEE -' '= H M `_ `t Lender's Address 41 L7 I certify that I have read this application and under penalty of purjury state TOTAL FEE �T that the above information is correct. I agree to comply with all County ordinances and State laws regulating lectrical wiring,and hereby authorize representatives of this County a Pon the above-mentioned property for inspection purpose SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE OF PERMITTE DATE' - WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) ELECTRICAL��I� ������ 76n663 C LLLJJJ I hereby affirm that I have'a certificate of consent'to self insure, b`9��L�u���Q®� ®� 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.) r Policy-No. Company FOR APPLICANT TO FILL IN .. JOB 03 141; " t ADDRESS Certified copy is hereby furnished. New Residential Bldgs.&Pools ' NO. EACH FEE ,1 — $ $ LOCALITY C ©. ❑.. Certified co 'Is filed with the county,building inspection .I. 1 &2-Family,Sq. Ft. PY Y 9 P NEAREST department. Multi-family'Sq.Ft. CROSS ST. Date Applicant Residential Swimming Pools ASS SSOR . . 'PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER OR Outlets:Rec._Light Sw. FIRM NAME vA COMPENSATION INSURANCE ^ First 20 (This sectioAl 6 n,need not be completed if the work involved by the ADOREss' permit is'for one hundred`dollars($100)or less.) Total No. Additional ' I certify that in the performance'of the work for which this pe'rrni1.t . CITY Tel.No.' is issued, I shall.not employany person i'n any Manner'so'as to become subject,to the,Workers'Compensation Laws:,. Lighting Fixtures First 20 PLAN CHECK 9 9 APPLICANT Total No. Additional ADDRESS Date Y 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 con with such PERMIT Y comply APPLICANT provisions or'this permit shall be deemed revoked: Power Apparatus;&Large Appliances "�`�" ` Size&T e HP,KW,KVA,or•KVAR ADDRESS ' LICENSEDiCONTRACTORS:DECLARATION YP - . I hereby'affirm that I'am licensed.under,provisions of'Chapter 9 Over'3 to 101ncl. (commencing with Section 7000) of.Division 3 of the Business and CITY Tel.No. Professions Code; and my license is in full Over:10 to 50 Incl.force and effect. } LICENSE OR Class. IZ • Over 50 t0 1,00 Incl. REG.NUMBER O Over 100 DISTRICT NO. PROCESSED BY License Number Lic.Class p V Se ices,Swb .;MCC&Panelboar i d4 / FINAL Contractor Date • -399 A n er 0 DATE, _ H' ❑ I am exempt under Sea 400-1000 Amp.Under 600 V -.29—�, W' Over 1000 Am VALIDATION - p_-Or Over V _ ,FINAL B.&P.C.for this reason BY fn BRANCH CIRCUIT.FEES Date: 15A,or•20A, 120V,Lighting or Recept.. Z a" 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits EJ _ 41 Or More Branch Circuits Exemption(or Reg.Maint. Elect. 15A,20A,208V To 277V Lighting Br.Circuits SINGLE FAMILY Temp.Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that.I am exempt from the Contractor's License Law s i for the following reason.(Section 7031.5,'Business and Professions Additional Sign Branch Circuits Code): .. .. r ,� •r•s- ti `•�� I, as owner of the property, will do the,work and the structureMisc.Conduits&Conductors _ _50 is not intended or offered for'sale (Section 7044, Business Other(See.Complete Fee Schedule) and Professions Code). CONSTRUCTION LENDING AGENCY. I hereby affirm that there is a construction lending agency for the f e e performance of the work for.which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total) UL`=f'=w=`F`- _/95 Civ. C.) z� PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE- 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 la regulating Electrical wiring,and hereby authorize 'representatives of this unty to enter upon the above-mentioned property for inspection o SEE REVERSE.FOR EXPLANATORY LANGUAGE 1935 SIGNATURE OF E - DATE -