The URL can be used to link to this page

Home My Public Portal About5475 HILTON AVE_Electrical__ TGAE =�eOG.Tss APPLICATION FOR ELECTRIC PERMIT 1 BUILDING AND SAFETY DIVISION Department of County Engineer BUILDING County of Loa Angeles ADDRESS J 4/7 S JOHN A. LAMBIE. COUNTY ENGINEER CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN. NEAREST PERMIT FEES cRoss sr: NUMBER OWNE Q7.� LIGHT OUTLETS MAIL ADDRESS /-- RECEPTACLES WALL SWITCHES FEE CITY TEL. NO. TOTAL OUTLETS OUTLETS 0 54 $ ) ELECTRICIAN ELEC. RANGES 25 ADDRESS ELEC. HEATERS 25 CITY TEL, NO. KW EA STATE FIXTURES 5 LICENSE NO. MOTORS DISTRICT NO. GROU D ZON,tE READY sDB Ins PECTION NUMBER HORSEPOWER FEE NEW MVO, HP OVER INC. EACH V N LESS $ .25 1 INSPECTION RECORD If1 2 .50 1 I \ 2 5 1.00 h..� 5 15 1.50 Z-0- M-�,, 15 50 2.50 50 200 5.00 MISC. NO. SIGNS NO. TRANS. NO. SIGNS NO. LAMPS FOR EACH PERMIT' WIRING PERMIT $1.00 FIXTURE PERMIT S1.00 SUPPLEMENTARY .50 �( APPROVALS TOTAL FEE DATE INSPECTOR'S SIGNATURE I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION CONDUIT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING ELECTRICAL WIRING. FIXTURES I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES.000NTY AND STATE OF POWER CALIFORNIA OR THAT AM T E LEG OWNER OF THE ABOVE n DESCRIBED RESIDENT PROP TY. UTILITY CO.NOTIFIED 1 !' SIGNATURE i OF PERMITTE111 FINAL\ 4 I�Is�J / JOHN A. LAMBIE. v){I,jDp PGN ARTHUR C. VEIT, COUNTY ENGINEER %r`--/ SUPERVISING ELECTRICAL ENGINEER CK M OASH (AC7 5 1 4—� APR25 2 2.6 5 TfiafifiE1) OBE.EA IfisB APPLICATION FOR ELECTRIC PERMIT ' 1 DIVISION OF BUILDING AND SAFETY Depat enf Of County Engineer BUILDING < 5 CnMy Of Los Angeles ADDRESS lJ JOHN A. LAMB I E. COUNTY ENGINEER (_ CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY T `. .. FOR APPLICANT TO FILL IN NEAREST ��'`�/�� PERNIIT FEES CROSS ST. NUMBER OWNER ]FORINSPECTION LIGHT OUTLETS MAIL RECEPTACLES ADDRESS WALL SWITCHES FEE, CITY TEL. NOSTOTAL OUTLETS @ SR S ELECTRICIAN U U T HcELEG. RANGES 25 3 -JO .1 / /$RADDRESS ELEC. HEATERS 25 62" EACITY Sfj I/ �rH6iYi a TESTATE (FIXTURES 5 � LICENSE NO. /�� /dMOTORS FEEDISTRICT NO. GROUP ZApIE NUMBER HORSEPOWER 5 ^yl—, 1��N60f1E NEW MVO. HP OVER INc. EACH /z a LEER $ .25 •SO INSPECTION RECORD Y4 z .so IL c -N �w.t'r1VEPr kn z 5 1.00 5 15 50 2.50 •IOP T 50 2001 5.00 1 0.M. C, A EtT. tb e d — MISC. NO. SIGNS NO.TRANS. NO. SIGNS NO. LAMPS FOR EACH PERMIT: WIRING SLOO FIXTURES $1.00 SUPPLEMENTARY .50 APPROVALS TOTAL FEE ' I DATE INSPECTORS SIGNATURE 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AND STATE THAT THE ABOVE IS CORRECT AND AGRECONDUIT I\ WITH ALL COUNTY ORDINANCES AND STATE LAWS ELECTRICAL WIRING. WIRING \Q. LO ,r,1HEREBY CERTIFY THAT I AM PROPERLY REGISTFIXTURESLICENSED AS REQUIRED BY LOS ANGELES COUNTY A .CALIFORNIA OR THAT I A THE LEGAL OWNER OE POWER 1 DESCRIBED RESIDENTIAL ERTY. SIGNATURE VTILITY CO.NOTIFIE _q 51 OFPERMITTEE FINAL U JOHN A.LJ\MBIE.COUNTY ENGINEERy,I{LIDATION ARTHUR C.VEIT,CHIEF ELECT. INSPECTOR' .7 7 7 trr 1UV 2 M2 CASH 6-75 ID G m -� T L _GG WORKERS' COMPENSATION DECLARATION 720�196AW1 wsie> APPLICATION FOR ELECTRICAL PERMiT 13 v c�� h�aby affirm that have a certificate of consent to self CEpsm insure'or n✓ertificote of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certified copy thereof (Sec. 3800, Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB r� Certified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE ADDRESS) / d _ Certified copy is filed with the county building inspec- 18 2-Family, $q. Ft. $ — $ LOCALITYT in G/ tion department. Multi-family Sq. Ft. NEAREST Residential Swimming Pools CROSS ST. Dale Applicant t OWNER OR /) FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec_Light_SFirst v.w._ MAIL ADDRESS COMPENSATION INSURANCE (This section need not be completed if the work Involved by Total Nci Additional CITY Tel. N the permit is for one hundred dollars ($100) or less.) -• PIAN CHECK I certify that in the performance of the work for which this APPLICANT permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' mpe otion Lar . Lighting Fixtures First 20 ADDRESS Additional Da Applicant Via. _ A Total No. CITY Tel, No.NOTICE APPLICANT: If, after making this Certificate of Fixed Appliances Not Over I HP PERMIT APPLIC �O8 WIDE Exemption,n, you should become subject to the Workers' Range— Heater—D.W. — Compensation provisions of the labor Code, you must forth- I NG Oven _ Dryer —W.M.— ADDRCf with comply with such provisions or this permit shall be Top — FAU —W.H. — IRWIVDA deemed revoked. Hood — Fon —Other— CITY �s CA 8�7�e1. No. 0272997 LICENSED CONTRACTORS DECLARATION LICENSE O Disp. Room Air Cond. REG. NUMBER Class. d I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NO. / PROCES BY >_ and Professions Code,and my license is in full force and effect. // O. q / Size 8 Type HP, KW, KVA, or KVAR c ✓ o 0 License Number �l.T tic. Classc a o Up to 1 Incl. FINAL U Controcto�� — Dotet�..S��/ Over 1 to 101ncL DATE V D ION 0 ❑ Over 10 to 50 Incl. H FINAL U 1 am exempt under Sec. Over 50 to 100 Inc. BY LU B.SP.C. for this reason Over 100 p_ Services, Swbd., MCC 8 Ponelboards Date: 0- 200 Amp. Under 600V��I»��'ppppyTI'4 Signature 201 - 1000 Amp. Under 600 V1 fU OOver 1000 Amp, or Over 600 V Exemption for Reg. Maint. Elect. SINGLE FAMILY Temp. Power Pole &Appurtenances ;20303A HOME OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuito 2 Low for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits Professions Code): I °'O 3250 ❑ I, as owner of the property, will do the work and the Misc. Conduits 8 Conductors a Other ( P See Complete Fee Schedule)— u 3 2 5 0 ® o,e structure is not intended or offered for sale(Section 7044, Business and Professions Code). o,1 2 a..-S a 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 A PERMIT ISSUING FEE v Lender's Address r—D 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 hereby authorize representatives of this County to enter upon the above-mentioned pr perty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE e ®s Signature of Permittee Date