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HomeMy Public PortalAbout4846 KAUFFMAN AVE_Electrical__ COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY WILLIAM J. FOX, County Engineer FOR AP LICANT TO FILL IN DISTRICT NO. GR//OUP I ZONE QPEERrMIITtNNO. A-1 /►-l V `� ELECTRICIAN U RECEIVED BY READY FOR DATE ISSUED ADDRESS C.ctr FIRST INSPECTION c_ 1_3 CITY 1/�� TEL NO., _ //// y , /� V —V COUNTY LICENSE. NO. Z e EXPIRES , , Q1��(. BUILDING 1 �j PERMIT FEES ADDRESS J p.(r /J�,l.-0—fA FEE NUMBER EACH LOCALITY LIGHT OUTLETS � NEAREST RECEPTACLES CROSB ST. WALL SWITCHES OWNER TOTAL OUTLETS n Sc YZ3 MAIL r ELEC. RANGES 83 ADDRESS ELEC. HEATERS 25 CITY � TEL. NO. FIXTURES ! 5 •A I 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 I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER NEw MVD. HP OVER INC. EACH S�� OF THE RESIDENTIAL P OPERTY DE9 B "D AB VE. %2 LEse $ .25G�c� SIGNATURE OF _ I/2 2 .50 PERMITTE 2 Is 1.00 INSPECTION RECORD _ s is 1.50 15 So 2.50 —�- -_ SO 200 5.00 - P�✓Y.0 {1, ;7'wG lo C..)"�L£�'�' 200 Soo 10.00 500 1 000 15.00 ` Z OVER 1000 20.00 M.G. SET/FREQ. CHANGER-HP .L ^—oO M WELDERS:AC-KVA .� ❑ GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF OR113.) MOVED MOTORS (75% OF 61416.) _ MISC. SIGNS NO. NO.TRANS. NO. NO. LAMPS APPROVALS FOR EACH PERMIT: DATE INSPECTOR'S NAME WIRING $1.00 ? 04f) CONDUIT J FIXTURES $1.00 yWIRING SUPPLEMENTARY ,50 FIXTURES POWER TOTAL FEE s UTILITY CO. NOTIFIED FINAL �✓ 76A663 DBS$ 5A 4-52 COUNTY OF LOS ANGELES APMICATION FOR PERMIT Department of County Engineer di DIVISION OF BUILDING & SAFETY WILLIAM J. FOX, County En9lneer FOR.APf�LICANT TO FILL IN DISTRICT NO. GROUP ZONE �PERMIT NO, LN" EECTRICIA � '/ , � � 44 ;/ � / RECEIVED BY READY FOR DATE ISSUED ADDRESS ,S - �—�.L �`��•'—L /'y/,A FIRST INSPECTION < CITY ��•• TEL.NO./ ���77 t l N/////C�/��- / l De _ J✓� COUNTY LICENSE-NO. L: EXPIRES i - C.: BUILDING ADDRESS PERMIT FEES C7/ NUMBER EACH FEE LOCALITY LIGHT OUTLETS NEAREST CROSS ST. RECEPTACLES WALL SWITCHES OWNER TOTAL OUTLETS Sc B MAIL / ELEC. RANGES 2s— ADDRESS ELEC. HEATERS 25 _ CITY TEL. NO. FIXTURES B I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE 18 CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWERFEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER NEEww MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. f %2 6 LESS $ .25 SIGNATURE OF-./''�-e� _ '/2 2 .50 PERMITTEE 2 s 1.00 INSPECTION RECORD S is 1.50 is so 2.50 50 200 5.00 200 500 10.00 J 1000 15.00 Z OVER 1000 20.00 _ (' M.G. SET/FREQ. CHANGER-HP IY WELDERS:AC-KVA O GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% or DRIB-) MOVED MOTORS (75% OF ORIG.) MISC. SIGNS NO. NO.TRANS. APPROVALS NO. NO. LAMPS DATE% INSPECTORIS NAME FOR EACH PERMIT: CONDUIT WIRING $1.00 / . s �e FIXTURES $1:00 WIRING SUPPLEMENTARY ,50 E FIXTURES ``` POWER TOTAL FEE 1 �v UTILITY CO. NOTIFIED FINAL + e•� ����Y��J � 76A663 DEIS#SA 2-S3 l WORKERS'COMPENSATION DECLARATION 76A669oPwaia7 APPUC�QIMN FOR Q ELECT AL PERMY I hereby gffirm that I have a certificate of consent to self CEA8o6G insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or.b certified copy thereof (Sec. 3800, Lab. C.) Poli.W No. Company FOR APPLICANT TO FILL IN JOB ❑Certified copy.is hereby furnished.' New Residential Bldgs. & Pools EACH NO. FEE ADDRESS ❑Certified copy is filed with the county building inspec- 1 & 2-Family, Sq. Ft. $ — $ LOCALITY l l e Cis tion department. Multi-family Sq. Ft. NEAREST CROSS ST. Residential Swimming Pools Date Applicant OWNER OR FIRM NAME QM CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: RecLight2o Sw MAIL 9 'COMPENSATION INSURANCE First 20 / © � O ADDRESS //llyy (This section need not be completed if the work involved by .Total No. Additional 1 O CITY e�xn Ie Tel. No.(11 . the permit is for one hundred dollars ($100)or less.) I certifythat in the performance- the work for which this PLAN CHECK P rs APPLICANT permit is issued, I shall not.employ any person in any manner so as to become subject to the-Workers'* Workers'Compensation'Laws. Lighting Fixtures First 20 + C ADDRESS Addition al D Total No.� CITY ,Tel. No. Date Applicant Fixed Appliances Not Over 1 HP_ PERMIT NOTICE TO APPLICANT: If, after making this Certificate of +, APPLICATION Exemption, you should become subject to the Workers' Range— Heater D.W. Compensation provisions of the Labor Code, ybru must forth- Oven — Dryer W.M. d �Z 0 ADDRESS . with comply with such .provisions or this'permit shall be Top FAU W.H. v O0644 deemed revoked. Hood '� Fan Other— CITY Tel. No. LICENSED CONTRACTORS DECLARATION Dis LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 p' Room Air Cond. — REG. NUMBER Class. (commencing with Section 7000)of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO. PROCESSED BY >_ and Professions Code,and my license is in full force and effect. r e 12- Size Size &Type P, KW, KVA, or KVAR � �d rly����� 0 License Number Lic. Class Up to 1 Inc]. 0 FINAL U Over, 1 to 10 Inc 1. DATE �� �/ VALIDATION cr Contractor Date Over 10 to 50 Incl. I❑ 0 I am exempt under Sec. Over 50 to 100 Inc. FINAL g ~ v LIJ � B.&P.C. for this reason Over 100 CL DZ Services, Swbd.,-MCC & Ponelboords /, U Z 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 HOME OWNER-BUILDER DECLARATION Temp. Power Pole&Appurtenances 1 hereby affirm that.l am exempt from the Contractor's License Sign with One Branch Circuit Branch Circuits Sign '-' ' Law for the following reason (Section 7031.5, Business grid Additionalg al i� Professions Code): '91,, as owner of the property,.will do the work and the Misc..Conduits&Conductors structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ Business and Professions Code). D (O"FAL 12 1 8L 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) ���' `_•i"�1��'GEE ,!11-I 97 (Sec. 30 , Civ. C.). PLAN CHECKING FEE /2 Lender's Name / ✓ 0 fcr.11_I-00-101 1•/1-61"90 PERMIT ISSUING FEE '` Lender's Address 1 {�_ 2 I certify that I have read this application and state that the TOTAL FEE `L i 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 � go SF6nature of Permitt ' Date. ©s