HomeMy Public PortalAbout8810 HERMOSA DR_Electrical__ ° °`°° APPLICATION FOR ELECTRICAL PERMIT 'I
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS 8810 East Hermosa
JOHN A.LAMBIE,COUNTY ENGINEER
WILLIAM A.JENSEN. SUP'TOF BUILDING LOCALITY Temple Cit
FORAPPLICANTTO FILLIN cRoss sT Muscatel and Ivar Avenue
PERMIT FEES OWNER
Dave Oakley
ITEM NUMBER EACH FEE MAIL
OUTLETS S S �— ADDRESS 8810 East Hermosa
LIGHTS RECEPT. SW. S.
AT, 7-8870
LIGHTING FIXTURES 1O CITY TEL NO
ELEC. RANGES CLO. DRYERS ELECTRICIAN
WATER HEATERS .50 ADDRESS
ELEC.SPACE HTRS. DISHWASHERS CITY TEL.NO.
nTj 8-
GARBAGE DISPOSERS AUTO.. STATE
LICENSE NO. 120129
WASHERS STA.COOKING UNITE .25
MoioRs: Oven Inc. H.P. DISTRICT NO. GR P Z N P E D B
o — %= 1/3 1 .25 25
V — 2 50 INSPECTION RECORD
2 — 5 1.00
d
5 — 15 1.50 0
U
15 — SO 2.50
C
SO 200 5.00 ~
U
w
SIGNS: NO TRANS. D.
NO. LAMPS z
Z_
SERVICE O.000V 1.00
SERVICE OVER 600V 5.00
MISC.
WIRING PERMIT 1.00
FIXTURE PERMIT 1.00
SUPPLEMENTARY PERMIT .50
TOTAL FEE s 3 45
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT
ELECTRICAL WIRING. WIRING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICOF
ENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AM THE LEGAL OW ER OF THE ABOVE
DE�RBffDBN61MLETT POWER
SIGNATURE 1Ull1�V OL �� UTILITY CO. NOTIFIED
OF PERMITTE •�
FINAL,
PV�LIDATiCIN ARTHURC.VEIT.
CK jInO CASH SUPERVISING ELECTRICAL ENGINEER
LPICo 8 0 7 JMq 30 2 A 3.4 5 m
76A606 DOS SA 11-E0 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY ��������
1 COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO ILS IN DISTRICT NO. GROUP ZONE PERMIT NO.
ELECTRICIAN �1.p_�APJ � ��✓ �� � I��
ADDRESS - � �� _ RECEIVED BY READY FOR FIRST INSPECTION DATEISSlrU\ESD'
COUNTY LICENSE NO. kZ W ,E%PIRES BUILDING (�/']-/D
PERMIT FEES v ADDRESS _pp,/,o /i=yam/
FEE v
NUMBER EACH LOCALITY
LIGHT OUTLETS r NEAREST
/4 CROSS ST.
RECEPTACLES I L/
WALL SWITCHES OWNER
IIyR TOTAL OUTLETS Y O Sc S MAIL L' �/ +
i ELEC. RANGES 25 ADDRESS
ELEC. HEATERS 25 CITY TEL. NO.
.L14 d FIXTURES 5 .'],�
1 1 HEREBY ACKNOWLEDGE THAT 1 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
NUNRHORSEPOWER FEE ANGELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER
ovER
NEw MVD. HP ER IMC.
EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
I/z s LESS $ .25 SIGNATURE OF '�l
IA2 .50 PERMITTEE
"J y
2 5 1.00 INSPECTION RECORD
S 15 1.50 /
15 50 2.50
so 200 5.00--
200
.oo200 500 10.00 _J
Soo 1000 15.00 Q
Z
OVER 1000 20.00 _ 0
M. G. SET/FRED. CHANGER-HP i ' � � O
WELDERS: AC-KVAN/
GENERATORS-KW � LI� G02 GL �`4'
TRANSFORMERS-KVA
TEMP. MOTORS (75%Of ORIG.) 1 /✓
MOVED MOTORS (75%OF OR.G.)
MISC. 1
SIGNS 1
NO. NO. TRANS. I I APPROVALS
NO. NO. LAMPS
DATE r INSPECTOR'S NAME
FOR EACH PERMIT: CONDUIT
WIRING $1.001
FIXTURES $1.00
SUPPLEMENTARY .50 FIXTURES
POWER
TOTAL FEE $� �� UTILITY CO. NOTIFIED
OO / ' FINAL
JORKERS' COMPENSATION DECLARATION XW'76A,ko W3/e7 APPLICATION FOR ELECTRICAL PERMIT 0
hhereh, affirm that I have a certificate of consent to self ci�ya
insure,'or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS
wr a certified copy thereof (Sec. 3800, Lab. C.)'
Policy No. 11 Company FOR APPLICANT TO FILL IN JOB O_C� J fflE�m0
Certified co is hereby furnished. EACH NO. FEE ADDRESS 60
PY Y New Residential Bldgs. 8 Pools �Q
Certified copy is filed with thecounty building inspec- 18 2-Family, Sq. Ft. $ — $ LOCALITY
tiog department, Multi-family Sq. Ft. — NEAREST t
{� CROSS ST. (`16LS C-�v
Date v Applicant V Residential Swimming Pools OWNER OR /�
FIRM NAME UrV (/rN ,4
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light 3 Sw. 3 IL
'A ICOMPENSATION INSURANCE First 20
-ADDRESS /,
(This section need not be completed i4 the work involved by Total No. Additional CITY .O r0Vt 04 (G7fTFy. No. lJJ'-(F
the permit is for one hundred dollars ($100)or less.) AN CHECK
I certify that in the performance of the work for which this PLAIN
HE
permit is issued, I shall not employ any person in any manner
NT
so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS
n�Q ---yyy///,,,��� // �I��
Additional
Date � �d Applican; �rW Total No.
CITY
NOTICE TO APPLICANT: If, after melon this Certificate o Fixed Appliances Not Over 1 HP PERMIT
Exemption, you should become subject to the Worker Range— Heoter—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 To — EAU W.H. —
deemed revoked. Hood — Fan —Other— CITY Tel. No.
LICENSED CONTRACTORS DECLARATION Disp. — Room Air Cond. C, LICENSE 0 Class.
(commencing with Section 7000)of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NOfr PROCESS BY >
and Professions Code, and m license is in full farce and effect. t1
U
License Number Lic. Class Size 8 Type HP, KW, KVA, or KVAR O
Up to 1 Incl. FINAL U
Over 1 to 10 Incl.
DATE — VA ATION
Contractor Dote Over 10 to 50 Incl. FI
I am exempt under Sec. Over 50 to 100 Inc. U
W
B.BP.C. for this reason Over 100 / �
Date:
Services, Swbd., MCC 8 Panelboards , Z
0-200 Amp. Under 600 V
Signature 201 - 1000 Amp. Under 600 V 05 2 9 A
a
Exemption for Req. Maint. Elect.
1000 Amp. or Over 600 V. # ° °,•.e ' 2
SINGLE FAMILY Temp. Power Pole 8 Appurtenances ,( .e e 3 3.0 0
HOME OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from thSign with One Branch Circuit
e Contractor's License e e e 3 3 0 0_
Law for the following reason (Section 7031.5, Business and Additional Sign Bmnch,Cirtuits 0
PrgOessions Code): O a 2 5 8 8
rpI, as owner of the property, will do the work and the Misc. Conduits 8 Conductors
structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ ,
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)
(Sec. 3097, Civ. C.), CA
PLAN CHECKING FEE
Lender's Name A
PERMIT ISSUING FEE G/
Lender's Address
I certify that I have read this application and slate that the I TOTAL FEE
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-menttiionneedd]"JAp''roperty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature o Permittee a
3/- Y
WOrmEth COMPENSATION DECLARATION CE-806 10/81 APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm'that I have a certificate of consent to self CE-8066
insure,or vicertificote of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY
or a certified copy thereof (Sec. 3800, Lab. C.
Policy No. - Company FOR APPLICANT TO FILL IN JOB
ADDRESS /r9pfr/n
Certified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE
❑ Certified copy is filed with the county building inspec- 18 2-Family, Sq. Ft.— $ — $ LOCALITY
tion department. Multi-family Sq. Ft. — 'NEAREST
Residential Swimming Pools CROSS ST.OWNER OR
Date Applicant
FIRM NAME C^
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec�Light_Sw._ 'MAIL
COMPENSATION INSURANCE First 20 ADDRESS
(This section need not be completed if the work involved by Total No CITY Tel. No.
the permit is for one hundred dollars ($100) or less.) Additional A 'e
PAN CHECK
I certify that in the performance of the work for which this APPLICANT
permit is issued, I shall not employ any person in on manner
so as to become subject to the Wo cer Cam a ti n Laws. Lighting Fixtures First 20 ADDRESS
Additional
S-_�G Total No. CITY Tel. No.
_
Date Applicant � + �- Fixed Appliances Not Over i HPPERMIT
NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT / Z: ,Z,:
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 Z ��69iC /iQ G
with comply with such provisions or this permit shall be Top FAU —W.H. —
deemed revoked. Hood Fan _Other_ CITY /,�� / T No 3�f 95%h
LICENSED CONTRACTORS DECLARATION LICENSE OR
I hereby affirm That I am licensed under provisions of Chapter 9 Disp. Room Air Cond. REG. NUMBER - Class. C�/O
(commencing with Section 7000) of Division 3 of the Business DISTRICT NO. P E ED BY
and Professions Code,and my license is in full force and effect. Power Apparatus 8 Large Appliances 5 D!l
Ll\5 / q S- Size 8 Type HP, KW, KVA, or KVAR' O
License Number J / I Lic Class C- LQ Up to 1 Incl.
FINAL V
Over I to 10 Ind. DATE -
Contract,-, VALIDATION Q
Date /7-S -W/
Over 10 to 50 Incl. FINPiL V
am exempt under Sec. Over 50 to 100 Inc. B m
B.BP.C, for this reasonOver 100 Z
Services, Swbd., MCC 8 Ponelboards
0 -200 Amp. Under 600 V
Signature 201 - 1000 Amp. Under 600 V
❑ Over 1000 Amp. or Over 600 V
Exemption for Reg. Maint. Elect.
SINGLE FAMILY Temp. Power Pole 8 Appurtenances
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit
I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits
Law for the following reason (Section 7031.5, Business and
Professions Code):
❑ I, as owner of the property, will do the work and the Mi.sc. Conduits 8 Conductors
structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ ,
7044, Business and Professions Code). 6 0 (59 Q
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for # • • o • • `2
the performance of the work for which this permit is issued PERMIT FEE - (Sub-Total)
(Sec. 3097,0v. C.). I es, 27.00
PLAN CHECKING FEE
Lender's Name • o o `2 7.0 0 FI
PERMIT ISSUING,FEE Q '
Lender's Address 1 205_86
1 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 s gulating Electrical wiring, and
i
eb th ize re onto ves of this County to enter upon
.6 o e e pro rt for inspection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature erm ittee Date