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Home My Public Portal About6112 IVAR AVE_Electrical__ 76A6637CE.806 10,72, APPLE CSA-r o 'WQ E'LEC Qd PERM .... _ ��. COUNTY OF LOS ANGELES ' I - DEPARTMENT-OF COUNTY ENGINEER JOB BUILDING"AND'SAFETY DIVISION ADDRESS• v� pt LOCALITY .I FOR APPLICANT TO FILL IN•' NEAREST - CROSS ST, OUTLETS NO. EACH FEE OWNER OR 11 �y ph $ $- FIRM NAME L Q'. t,, „ RECEPT,,_ MAI L1� - FIRST 20 ADDRES ,`�, � t �V LIGHT TOTAL 25 r OVER 20 .CITY �• .TEL. NO..• - - &W TCH_ _ .10, PLAN C ECK ..LIGHTING • FIRST 20 .25 APPLICANT 'TOTAL _ -- r "OVER'20 .10 ADDRESS FIXTURES "-� " �'' RESIDEN TIAL'APPLIANCES CITY TEL. No. RANGE DRYER WTR. HTR._ PERMIT - .APPLICANT. STA. COOK DI SP. F.A.U, ADDRESS SPACE HTR.' AIR COND. - CITY 'TEL. NOOR . CLOTHES WASH. DISHWASH. EG.LICENSE NUMBER• REG. "CLASS. R FAN OTHER 1.00I 'HEHE81' ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE. ABOVE 1S CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS 'RATING WITH ALL �'C OUNTY ORDINANCES AND STATE LAWS REGULATING ' -IND. HEATERS, ETC. HP. KW. KV . ELECTRICAL WIRING. SIZE & TYPE OVER. TO I i • I HEREBAD THAT I 'AM PROPERLY REGISTERED A'ND/OR' O — 1 - X00 _ LICENSED ED BY LOS ANGELES TY AND STATE OF CALIFORNIAI' AM.THE L GAL 0 OF THE ABOVE 1 — 1O 3.00 D@G GR IREDTIAL PROP R �. CD PERMITEE U .10'— 50 5.00' SIGNATUR SO — 100 1000 � DISTRICT.NO. 0 SSED BY W 100 - 500 15.00 �' � � _z SIGN, GAS ,SIGNAND ONE CIRCUIT 5.00: .. ,` _A'PPRov,ALs 'DATE INSPE oR'S SIGNATURE TUBE, OR - MARQUEE ADDITIONAL-CIRCUITS •.1.00- TEMP. POWER POLE SERVI'CENOTOVER 600VOLTS OR200AMP 3.00 UNDERSLAB WORK SERVICE OVER 600VOLTS OR200AMP 10.00• ROUGH CONDUIT. TEMP'SERVICIE, POLE, &APPURTENANCES . 5.00 WIRING" „ 7. 20 / - TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES •POWER NUTHORI"ZED UTILITY CO. NOTIFIED L I. FINAL r PERMIT FEE - (SUB TOTAL) NOTES: PLAN CHECK FEE'. PERMIT ISSUING FEE 3.00 7> d - TOTAL FEE PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK'. . \o. CASH du1'l 17 :2. 6.00. SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE / ' 76A663A-CE806A 4/72 APPMCAM ` OR ELLS 'MUC/r L PERUV U COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING / ( n ' �, BUILDING AND SAFETY DIVISION ADDRESS lO 'V —TV LOCALITY nj_ NEAREST FOR APPLICANT TO FILL IN CROSS ST. ,9— OUTLETS NO. EACH FEE , $ $ OWNER yLFk5to Al-Ax) 9A ruSSO114 RECEPT._ MAIL rJ' LIGHT TOTAL FIRST 20 ADDRESS 61 ^ CITYlk L? EL. NO. j of SWITCH OVER 20 PLAN CHECK LIGHTING .� FIRST 20 APPLICANT 1 TOTAL FIXTURES OVER 20 ADDRESS RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT RANGE DRYER WTR. HTR._ APPLICANT STA. COOK DISP. F.A.U. ADDRESS SPACE HTR. AIR COND. CITY TEL. NO. CLOTHES WASH. - OISHWASH. LICENSE NO. NF CLASS. FAN OTHERI HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION �. AND STATE THAT THE ABOVE IS CO RRECT'AND AGREE TO COMPLY C 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� 0 - 1 LICENSED AS RED IRED BY LOS ANGELES COUNTY AND STATE OF („7 CALIFORNIA OR THAT I .M THE LEGAL OWNER OF, AND INTEND TO LV RESIDE IN, THE O EJESCPED L111NTIAL PROPERTY. �1 - 10 N 10 - 50 SIGNATURE OF PERMITTEE '� 50 - 100 DISTRICT NO. CLASS 20NEPROC SED BY 100 - 500 SIGN, GAS SIGN AND ONE CIRCUIT - NOTES: 7 TUBE, OR MARQUEE ADDITIONAL CIRCUITS " SERVICENOTOVER600VOLTS OR200AMP " APPROVALS DATE INSPECTOR'S SIGNATURE SERVI CE OVER 600 VOLTS OR 200 AMP TEMP.POWER POLE TEMP SERVICE,POLE,&APPURTENANCES UNDERSLAB WORK TEMP LIGHT OR RECEIPT. SYSTEM ROUGH CONDIUT WIRING FIXTURES POWER AUTHORIZED PERMIT FEE (SUB TOTAL) UTILITY CO. NOTIFIED PLAN CHECK FEE FINAL q PERMIT ISSUING FEE -As 0 TOTAL FEE PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION M.O. CASH yWm that I have a COMPENSATION of c nsent ON CE-806G 10 /81 APIl—Lam, CAMON FOR ELECTMICAL� PE RNT f Hereby affirm that I have a certificate of consent to self insure, ,,.or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy (�reof(Sec.3800,Lab. C.) Polic)�.No. Company FOR APPLICANT TO FILL IN JOB trlr vCs Q ' 0"'Certified copy is hereby furnished. New Residential Bldgs.& Pools EACH NO. FEE ADDRESS Certified copy is filed with the county building inspection 1 & 2-Family,Sq.Ft. $ — $ LOCALITY e department. Multi-family Sq.Ft. — NEAREST CROSS ST. Date Applicant Residential Swimming Pools OWNER OR Y/J FIRM NAME lr rn T� CERTIFICATE OF EXEMPTION FROM WORKERS' � MAIL Outlets:Rec Light t 2 ADDRESS COMPENSATION INSURANCE � D �� i S i;�`�'Gt n a v� This section need not be completed.if the work involved b the v First 20 ? ( y Total No. �/ Additional . CITY HECK G� py�� Tel.No. 9.7-9 too—/ permit is for one hundred dollars($100)or less.) , 1 certifythat in the performance,of the work for which this permit PLAN CHECK P - 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 Total No. Additional / 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 OtherCITY Tel.No. _ I hereby affirm that I am licensed under provisions of Chapter 9LICENSE 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. DISTRICT NO. PR 6SED eY Power Apparatus& Large Appliances a Size& Type HP,'KW,KVA,or KVAR 0 License Number Lic.Class Up to 1 Incl. FINAL U Over 1 to 10 Incl. DATE Contractor Date VALIDATION O ❑ Over 10.to 50 Incl. FINAL F" I am exempt under Sec. Over 50 to 100 Inc. BY W B.&P.C.for this reason Over 100 cf) to Services, Swbd.,MCC& Panelboards 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 Pole& Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit y I hereby affirm that I am exempt from the Contractor's License Lawr•f" for the following reason (Section 703 1.5,Business and Professions Additional Sign Branch Circuits =, n e 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) I T ENO and Professions Code). 1 1_)1 AL 34 . 90 CONSTRUCTION LENDING AGENCY CINEECK 74.Wk 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_1"�MN('l= ,t�1= Civ.C.). PLAN.CHECKING FEE Lender's Name ;;[� ;_(jlj; ? '4s PERMIT ISSUING FEE Lender's Address 43.56 1 !-M :;5 1 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 toe ter upon the above-mentioned property for inspection pur SEE_ REVERSE FOR EXPLANATORY LANGUAGE 12 - 7— !(� Signature of Permittee Date