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Home My Public Portal About5938 IVAR AVE_Electrical__ 768663-CE80610/72 APPLICATION FOR ELECTRICAL PER COUNTY OF LOS ANGELES ,. DEPARTMENT OF COUNTY ENGINEER 0 JOB BUILDING AND SAFETY DIVISION ADDRESS " 08 v( . A LOCALITY NEAREST - _ FOR APPLICANT TO FILL IN CROSS ST. OUTLETS NO. EACH FEE OWNER OR FIRM NAME RECEPT._ S $ MAIL FIRST 20Gy ADDRES LIGHT _� TOTAL 25 ✓ 1-3 CITY ' �® - TEL. NO ., SWITCH 1-3 OVER 20 .10 PLAN CHECK LIGHTING TOL FIRST 20 25 APPLICANT 1 )j OVER 20 ADDRESS FIXTURES .10 RESIDENTIAL APPLIANCES R L. NO. PERMIT RANGE DRYER_WTR. HTR._ APPLICANT STA. COOK DISP. F.A.U. ADDRESS SPACE HTR. AIR COND. CITY TEL. NO. CLOTHES WASH. • DISHWASH. LICENSE OR CLASS. REG. NUMBER FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR O - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAI I AM THE LEGAL OWNER OF THE ABOVE } 1 - 10 3.00 DESCRY ED RESIDENTIAL PROPER Y. d n O PERMITEE 10 - 50 5.00 SIGNATURE CD 50 - 100 10.00 DISTRICT NO. PROCES ED BY W 100 - 500 15.00 GO SIGN, GAS SIGNAND ONE CIRCUIT 5.00 APPROVALS DATE INSPECT. SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE SERVICENOTOVER600VOLTS OR200AMP 3.00 UNDERSLAB WORK SERVICEOVER 600 VOLTS OR 200AMP 10.00 ROUGH CONDUIT TEMPSERVICE,POLE, &APPURTENANCES 5.00 WIRING ,� 921,7 TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL PERMIT FEE (SUB TOTAL) NOTES: - PLAN CHECK FEE ++�� PERMIT ISSUING FEE 3.00 J TOTAL FEE (� PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIONCK. M.0. CASH a 9 o ti jUL 18 2 0 7.0 0 SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE / ~-WORKERS' C®MPENSATION DECLARATION CE-806G 10/8 1 APPLICATION FOR ELECTRICAL PERMIT that I h certificate of consent-to self'"insure, I herPby.affirs' Compensation Insurance, or a certified ; COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certif`;a e`kO,Lab.C.) cope Company FOR APPLICANT TO FILL IN JOB * �❑ Certified copy,is herebyfurnished. EACH NO. FEE ADDRESS New Residential Bldgs.& Pools Certified copy is tiled withthecounty building inspection 1 & 2-Family,Sq.Ft. $ — $ LOCALITY depart ent. Multi-family Sq. Ft. — NEAREST !2� Residential Swimming Pools CROSS ST. r Date Applicant OWNER OR ,X1 FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec� 9—Light Sw. MAIL COMPENSATION INSURANCE i 90 ��i ADDRESS (This section need not be completed if the work involved by the First 20 CITY �J Tel.No. permit is for one hundred dollars($100)or less.) Total No. Additional ` ciL I certify that in the performance of the work for which this permit ALAN CHECK is issued, I shall not employ any person in any manner so as to APPLICANT become subject to the Workers'Compensation Laws, Lighting Fixtures First 20 ADDRESS Additional Total No.� CITY Tel.No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT + NOTICE TO APPLICANT: If, after making .this Certificate of /� Exemption,you should become subject to the Workers'Compensation Range_ Heater_ D.W. APPLICANT provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer W.M._ ` ADDRESS provisions or this permit shall be deemed revoked. Top — FA W.H. _ G 7 J LICENSED CONTRACTORS DECLARATION Hood — Fan Other_ CITY Tel.No. I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. LICENSE OR Class. (commencing with Section 7000) of Division 3 of the Business and REG.NUMBER Professions Code,and my license is in full force and effect. Power Apparatus& Large Appliances DISTRICT NO. Q PROCESSED BY } Size& Type HP,KW,KVA,or KVAR License Number Lic.Class �-` Up to 1 Incl. FINAL U n fI Over 1 to 101nc1. DATE ;r, / VALIDATION �. Contractor ��-Create ! Over 10 to 50 Incl. "i f ❑ I am exempt under Sec. Over 50 to 100 Inc. FINAL Lr V BY (., LLI B.&P.C.for this reason Over 100 CL Services, Swbd.,MCC& Panelboards J N Date: 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 Pale& Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law f for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits F `-`PIF Code) 3307 C:7 Misc.Conduits& Conductors i _;�: ❑ I,as owner of the property,will do the work and the structure i ��j_,IL is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) _ and Professions Code). ® T I ITA 5 ' - 60 CONSTRUCTION LENDING AGENCY57.6l_ 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) �T :.'HANGS c�;!` Civ.C.). PLAN CHECKING FEE Lender's Name / I,sUl 31- I SiE lu/i 7 r�{ PERMIT ISSUING FEE �r sem. Lender's Address ,i4c 1 j= I certify that I have read this application and state that the above TOTAL FEE f information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize repreentatives of this County to enter upon the above-mentioned pr pert for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Sign br(3-oT Permit e Da e WORKERS'COMPENSATION DECLARATION 76A663 10/81 APPLICATION �PPp IC ATION FOR ELECTRICAL p ECTRIC A L PERMIT I hereby affirm that I have a certificate of consent to self insure, CE-806G i'1 L /�11 L fl /1 I� �V� or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof (Sec.3800,Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB (�/ ❑ CertifVd co is hereby furnished. EACH NO. FEE ADDRESS V PY Y New Residential Bldgs.& Pools ❑ w A- 1 & 2-Family,Sq.Ft. $ — $ LOCALITY Je' Certified copy is filed with the.county building inspection CH i department. Multi-family Sq.Ft. NEAREST CROSS ST. Residential Swimming Pools 1 Date Applicant OWNER OR NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec Light — Sw. — MAIL COMPENSATION INSURANCE ADDRESS. (This section need not be completed if the work involved by the First 20 permit is for one hundred dollars ($100)or less.) Total No. Additional iEtCITY Tel.No. - 62 ' I certify that in the performance of the work for which this permit APPLICANT K is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS • Additional t CITY Tel.No. Total No.Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT Exemption,you should become subject to the Workers'Compensation Range_ Heater_ D.W. _ APPLICANT provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer _ W.M._ ADDRESS provisions or this permit shall be deemed revoked. Top — FAU _ W.H. CITY Tel.No. LICENSED CONTRACTORS DECLARATION Hood — Fan Other_ I hereby affirm that I am licensed under provisions of Chapter 9 LICENSE OR (commencing with Section 7000) of Division 3 of the Business and Disp. — Room Air Cond. REG.NUMBER Class. Professions Code,and my license is in full force and effect. Power Apparatus& Large Appliances DISTRICT NO. �y P ED'BY Size& Type HP,KW,KVA,or KVAR Od 0 License Number Lic.Class Up to 1 Incl. FINAL U Over 1 to 10 Incl. DATE VALIDATION Contractor Date Over 10 to 50❑ Incl. U FINAL I in exempt under Sec. Over 50 to 100 Inc. BY 1 B.&P.C.for this reason Over 100 C/1 Services,Swbd.,MCC& Panelboards Z Date: 0- 200 Amp.Under 600 V Signature 201 - 1000 Amp.Under 600 V ❑ Exemption for Reg.Maint.Elect. Over 1000 Amp.or Over 600 V SINGLE FAMILY Temp.Power Pole& Appurtenances f HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit i I hereby affirm that I am exempt from the Contractor's License Law X, for the following reason(Section 7031.5,Business and Professions Additional Sign Branch Circuits I sL•:E x 8 Code): 3307 33_ic;,L Misc.Conduits & Conductors L�pl 1,as owner of the property,will do the work and the structure 1 is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) and Professions Code). ® I i_I T AL -3 3 m 0 0 CONSTRUCTION LENDING AGENCY •._.Hy`„CK ,I_II I hereby affirm that there is a construction lending agency for the _ P ( PERMIT FEE (Sub-Total) r I �Rk performance of the work for which this permit is issued Sec.3097, �••• tai ,E�I.1 Civ. C.). PLAN CHECKING FEE Lender's Name i_Ijl11 —ilfl �!' 1E'°>j PERMIT ISSUING FEE Lender's Address i B Iv 51-1cQ I certify that I have read this application and state that the above TOTAL FEE 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 property for' pection purpos . ' SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permit Date WORKERS'COMPENSATION DECLARATION CE-663 10/81 APPLICATION �PPg I^/TION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self insure, CE-806G /'"'1 L i,//�"11 !V FOR ELECTRICAL �V� or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec. 3800,Lab.C.) Policy No. Company FOR APPLICANT TO FILL IN JOB • 'p/ Certifii,d copy is hereby furnished. New Residential Bldgs.& Pools EACH NO. FEE ADDRESS V ❑ LOCALITY Certified copy is filed with the.county building inspection 1 & 2-Family,Sq.Ft. $ — $ e department. Multi-family Sq.Ft. — NEAREST CROSS ST. Date Applicant Residential Swimming Pools OWNER OR i FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec— Light Sw. MAIL COMPENSATION INSURANCE ADDRESS This section need not tie completedFirst 20 ( if the work involved b Y the Total No. Additional CITY � � Tel. i , permit is for one hundred dollars($100)or less.) I certify that in the performance of the work for which this permit PLAN CHECK APPLICANT is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS Additional Total No. CITY Tel.No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of Exemption,you should become subject to the Workers'Compensation Range_ Heater_ D.W. _ APPLICANT provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer _ W.M._ ADDRESS provisions or this permit shall be deemed revoked. Top — FAU _ W.H. _ LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other_ CITY Tel.No. I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. LICENSE OR (commencing with Section 7000) of Division 3 of the Business and REG.NUMBER Class. Professions Code,and my license is in full force and effect. DISTRICT NO. P ED BY Power Apparatus& Large Appliances Size& Type HP,KW,KVA,or KVAR 0� License Number Lic.Class Up to 1 Incl. FINAL / g U Over 1 to 10 Incl. DATE ?'/ — VALIDATION 0 Contractor Date Over 10 to 50 Incl. 17— ❑ FINALt//r"/ I am exempt under Sec. Over 50 to 100 Inc. gy W Over 100 a BAP.C.for this reason Cq Services,Swbd.,MCC& Panelboards ® Z Date: 0-200 Amp.Under 600 V Signature 201 - 1000 Amp.Under 600 V ❑ Exemption for Reg.Maint.Elect. Over 1000 Amp.or Over 600 V 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 ;_; g for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits Code): 33 017 3 e0 I,as owner of the property,will do the work and the structure Misc.Conduits& Conductors I T,— is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) " ' and Professions Code). too. _`I_I(AL yam,m 010 CONSTRUCTION LENDING AGENCY E_•iZ�U 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) ( AI i'� iANIGIv ,{, f Civ.C.). PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE .,iIJlU{D—i !"(J I 2 Lender's Address 5559n �'_`` I certify that I have read this application and state that the above TOTAL FEE , . AN Z a 1 S 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 property for' pection,purpos SEE REVERSE FOR EXPLANATORY LANGUAGE M dA Signature of Permit Date