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HomeMy Public PortalAbout6231 IVAR AVE_Electrical__ DBS SA 11-46 AA11�TWC1 TIOFAT FOR ABEj` DEPARTMENT OF BUILDING AND S dAC>�II18iJLS\�A 1V 11 lYlia Y COUNTY OF LOS ANGELES ELECTRIC WM. J. FOX CHIEF ENGINEER NAME ' DISTRICT IVO. GROUP ZONE PERMIT NO. ADDRESS �j RECEIVED BY READY FOR DATE ISSUED CITY TEL.NO. FIRST INSPECTION .Wj COUNTY '� W CERT.NO. EXPIRES ife }' �� APPLICANT PILI. IN HEAVILY OUTLINED PORTION ONLY DESCRIPTION OF WORK. ADDRESS GZ 5 Y.�T V 11 R /9 V/ NUMBER OF OUTLETS ON CIRCUITS LOCALITY LOCATION BY ROOMS NEAREST LIGHT OUTLETS JSW. PLUGS FIXT CROSS ST. .CIRCUIT A B C D E F ' G H NAME _ f7 ,-t r' MAIL - iCr 3 ADDRESS �'I Tst�71y:r " eft e' O CITY TEL.NO r? I ♦ s_ f � `,1 I AM THE' LEGAL -POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION.. - ELECTRICIAN. ® AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE .Cr"JG ,✓ l.r,. rc . OWNER. VJ®llMCTIONS ' J Q Z_ L7 O TOTAL �l NO. OF OUTLETS 'J $ !(e APPROVALS NO. OF FIXTURES $ DATE INSPEE6OR'S NAME NO. OF MOTORS H.P. $ CONDUIT /ni NO. OF SIGNS TRANS. $ WIRING �y�2 [NO. OF RANGES OR HEATERS $ FIXTURES MISCELLANEOUS $ .ems POWER 4 PERMIT FEE $ ,?d UTILITY CO.NOTIFIEDc� TOTAL FEE -? f;—FINAL rvv l - COUNTY OF LOS ANGELES APPLICATIOIN FOR PERMIT DEPARTMENT.OF COUNTY ENGINEER - DnnSIOIN OF BUILDING &SAFETY ' F6 WILLIAM J..FOX; COUNTY ENGINEER FOR APPLICANT TO FILL: IN DISTRICT NO. GROUP (ZONE PERMIT NO. ELECTRICIIAN/�C 5'�C—,V 16 � �/ -I v 1 //—a !� �f 4f ADDRESS �) / y /_ �S /,J:Al is RECEIVED BY READY FOR DATE ISSUED n B FIRST INSPECTION A CITY ,"�D/ �Y /��C TEL. -NO. �.�� '(�" �r 6 --Gt"F �PLICENNpSAEpNTOO. (tom (n©!.. EXPIRES BUILDING Praa<u�aa8 FEE... ADDRESS (Q "- NUMBER EACH FEE LOCALITY ��1.>r LIGHT OUTLETS NEAREST , RECEPTACLES CROSS ST. WALL SWITCHES [• ` �[/.// �s. " OWNER (� / r� c-z,�- TOTAL OUTLETS 5C $ IrMAIL ELEC. RANGES • 25 ADDRESS ELEC. HEATERS 25 FIXTURES - 5 ® CITY -TEL. NO. MISC. 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS NUMBER OF LIGHT CIRCUITS APPLICATION AND STATE THAT THE ABOVE- IS CORRECT 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 - NUMBER HORSEPOWER. FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER NEW MVD. HP OVER INC. EACH OF THE.RESIDENTIAI,i PROPERTY D CRIBED ABOVE. . I/a&LESS $ '.25 !/ //, /)/► . SIGNATURE OF ��•, J l 2 .50 PERMITTE 0 z s 1.00 ' INSPECTION RECORD 5 15 1.50 15 50 2.50 ` 50' 200 5.00 200 500 10.00 .J 500- . 1000 15.00 Z OVER 1000 20.00' z M.G. SET/FREQ. CHANGER-HP WELDERS:'AC-KVA• 0• GENERATORS -KW TRANSFORMERS-KVA TEMP.'MOTORS (75% OF ORIG.) MOVED MOTORS (75% OF ORIG.) MISC: • SIGNS 11 NO. NO. TRANS. NO. NO. LAMPS APPRO�TALS FOR EACH PERMIT: DATE INSPECTOR'S NAME WIRING' $1.00 CONDUIT FIXTURES $1.00 "WIRING SUPPLEMENTARY .50 FIXTURES POWER , TOTAL FEE' $ _ UTILITY CO. NOTIFIED �r+—1,6— F ,6 - FINAL I t d 76A 669 DBS# ,6A. 4-52 - I i PUNT ..WORKERS'�COM2EiiSATICSN DECLARATION CE 806G (2-80)A U"L ICA 11 �OIIN FOR ISL EC II IntU ALSs v I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY - insure, or a certificate of Workers'Compensation Insurance,or '/ a certified copy thereof(Sec. 3800,Lab. C..) IAI/V 0. '`�� � �i FOR APPLICANT TO FILL IN JOB ApDRESS 2--? 1 Policy No. Com any ^o'l�C. l��`^l/ • ✓ New Residential Bldgs.&•Pools EACH NO. FEE C •fied co is hereby furnished. $ — $ LOCALITY, "^ PY � Y 1 &2-FamiLy,Sq. Ft.- ✓� -. � J Multi-family Sq. Ft. NEAREST Certified copy is filed with the county building inspection CROSS ST /l dep rtment. Residential Swimming Pools OWNER OR l�,, ,f !L— FIRM NAME t S l�r- Dat� 9t A licant2C;A�tA K� � � C MAIL PP Outlets: Rec.—Light First ADDRESS e._ ' First 20 CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY Tel No. COMPENSATION INSURANCE i PLAN CHECK d (This section need not be completed,if'the work involved APPLICANT. O by the permit is for one hundred dollars (5100) or less.) Lighting Fixtures First 20 ADDRESS U Additional Total No. I certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No. permit is issued, I shall-not employ any person in any manner PERMIT. so as to become subject to the Workers' Compensation Laws. . Range_ Heater_D.W. APPLICANT �Q C.At 'A ��+G G B <<-- LU Oven Dryer_W.M. ADDRESS, ( `t-Z- S ! '/-V(�J J y xDate Applicant Y Top _ FAU _W.H.. � Z ' \\ Hood — Fan _Other_ CITY �� �� Tel No.�-� NOTICE TO APPLICANT: If, after making this Certificate of Disp. _ Room Air Cond._ LICENSE OR Exemption, you should become subject. to the Workers' REG. NUMBER32 96 Class Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO. PRO CE SED BY with comply with such provisions or this 'permit shall be deemed revoked. Size&Type HP,KW, KVA,or.KVAR (/ Sc� Up to 1 1 ncl. FINAL _ LICENSED CONTRACTORS DECLARATION Over 1 to 10 Incl. DATE VALIDATION Over 10 to 50 Incl. I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL BY 9 (commencing with Section 7000)of Division 3 of the Busi- Over 100 ness and Professions.Code, and my license is in full force and effect: Services / a r)p ( 0-200 Amp. Under 600 V License Number 32 p Lic.Class G'1 201-1000 Amp. Under 600 V Contractorw A ot.0 eg!�f e<Date Over 1000 Amp.or Over 600 V i HOME OWNER-BUILDER DECLARATION Temp.Power Pole&Appurtenances I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit License Law foi• the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits ness and Professions Code): Misc.Conduits&Conductors 2 O 1.6 4 A, I, as owner of the property, will the work and the Other (See Complete Fee Schedule)= . structure is not intended or offered for sale (Section #•o,o,0 0`0 2 7044, Business and Professions Code); . , CONSTRUCTION LENDING AGENCY Z o' T9,5 5 0 I hereby affirm that there is.a construction lending agency for the performance of the work for which this permit is PERMIT FEE (Sub-Total) o 0'0 1 9,506 issued (Sec. 3097,Civ.C.). � SU Lender's Name PLAN CHECKING FEE (One-Fourth Permit Feel0 ] _8;1 Lender's Address PERMIT ISSUING FEE I certify that I,have read this application and state that the TOTAL FEE S(� 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 property for inspection purposes..' SEE'REVERSE FOR EXPLANATORY LANGUAGE } Signature o ermittee Dat WORKEiCS'COMPENSAT40N DECi ARATION CE 806G (2-80) APPHC/aMN FOR ELECTMCQL PERNT I hereby affirm that I have a certificateof consent.to self COUNTY OF LOS ANGELES BUILDING AND SAFETY insure, or a certificate of Workers'Compensation Insurance,or c e r ' opy//thre f(Sec. 3800,Lab.C. `\_.// ,( p y FOR APPLICANT TO FILL IN JOB o cy o. �aG om an EACH NO. FEE ADORE NJ New Residential Bldgs.&Pools Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ _ $ LOCALIT Multi-family Sq. Ft. — NEAREST Certified copy is filed with the county bui g inspection D CROSS ST d, ent. Residential Swimming Pools OWNER OR FIRM NAME a plicant Outlets: Rec.—Light—Sw. MAIL First 20 ADDSS CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CIT Tel No. COMPENSATION INSURANCE } PLAN CHEC CL (This section need .not be completed if the work involved APPLICANT p Fixtures First 20 ADDRESS U by the permit is for one hundred dollars ($100) ori less.) LigAdditional. 0C Total No. I certify that, in the`performance of the work for which this Fixed.Appliances Not Over 1 HP CITY Tel No. 0 permit is issued, 1;shall not employ any person in any manner PERMIT () so as to become subject to the Workers' Compensation Laws. Range_ Heater_D.W. APPLICA T WiL . Oven Dryer_W.M. ADDRES W Date Applicant Top _ FAU _W. Z H. Hood --Fan —Other_ CIT NOTICE TO APPLICANT: If, after making this Certificate'of Dis LICENSE OR p. _ Room Air Cond-_ Exemption, you should' become subject to the Workers' ' REG. NUMBER ass Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO. P C SED BY with comply with such provisions or this permit shall be deemed revoked. Size&Type HP,KW, KVA,or KVAR / �'• Up to 1 Incl. FINAL Over 1 to 10 Incl. DATE f �/ LICENSED CONTRACTORS DECLARATION //� VALIDATI N - Over 10 to 50 Incl. I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL 9 (commencing with Section•7000) of Division 3 of the Busi- Over 100 BY .ness and Professions.Code, and my license is in full force and. effect. Services License N ber ic.Class 0-200'Amp: Under 600 V — 201-1000 Amp. Under 600 V v Contract r Date Over 1000 Amp.or Over 600 V HOME OWNER-BUILDER DECLARATION Temp.Power Pole&Appurtenances Sign with One Branch Circuit I hereby affirm'that I am exempt from the.Contractor's Additional Sign Branch Circuits z`5 4 9 R License Law for the following reason (Section 7031.5, Busi- ness and Professions Code): # 0 0 0 0 .0 2 Misc.Conduits&Conductors I, as owner of the property, will do the work_and the Other(See Complete Fee Schedule)— 2 ° - 32,0 0 structure is not intended or offered for 'sale (Section 7044, Business and Professions Code). 0.0 0 32 0 0 M CONSTRUCTION LENDING AGENCY ! i I hereby'affirm that there is a construction lending agency for the performance of the work for which this permit is PERMIT FEE, (Sub-Total) 0.5,2 issued(Sec. 3097,Civ.`C.). Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) Lender's Address PERMIT'ISSUING FEE I certify that I have read this application and state that the TOTAL FEE G� 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 property for-inspection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE 6 � 1 Signature o ermittee ate