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Home My Public Portal About5954 KAUFFMAN AVE_Electrical__ COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY WILLIAM J. FOX, County Engineer FOR APPLICANT TO FILL IN DISTRICT NO. 13R13UP I ZONE PERMIT NO. ELECTRICIAN e;?A 77/75-e 7W 1 Ci ADDRE89 9 �. �� RECEIVED,;3Y READY FOR DATE ISSUED FIRST INSPECTION CITY � RI TEL. NO.#9f I �Z/ COUNTY LICENSE NO. -L7 EXPIRES 9UILDINO �1 y,� PERMIT FEES ADDRESB , _QQy� A &qC!„ A FEE NUMBER EACH LOCALITY C.�LIGHT OUTLETS OUTLETS NEAREST RECEPTACLES 0 CROSS ST. //'',, WALL SWITCHES - OWNER (/VQ M AGS TOTAL OUTLETS 5c 19 D MAIL sl L�� ,(�� r� � / ELEC. RANGES - 25 —ADDRESS /J//1� �/�Ei1_(�/��'! ELEC. HEATERS 25 CITY 9�' �OA TEL. NO. FIXTURES 5 I HEREBY ACKNOWLEDGe THAT I 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 I CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWERFEE ANGELES' COUNTY LICENSE, OR i AM THE LEGAL OWNER NEWMvo. HP OVER INC. EACH OF THE RESIDENTS ESCRIBE%ABOVE. '12 6 LESS $ .25 SIGNATURE OF 1�2 2 .50 PERMITTEE ——--A-- 2 Is 1.013 INSPECTIO ECORD 5 13 1.50 is 50 2.50 _ so 200 5.00 _ 2130 Soo 10.00 500 1000 15.00 Q _Z OVER 1000 20.00 ES M.G. BET/FREQ. CHANGER-HP WELDERS:AC-KVA O GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF ORIG.) MOVED MOTORS (75% OF ORIG.) MISC. SIGNS NO. NO.TRANS. APPROVALS NO. NO. LAMPS — — FOR EACH PERMIT: DATE INSPECTOR'S NAME WIRING - $1.D0 v V CONDUIT FIXTURES $1.00 WIRING SUPPLEMENTARY ,50 FIXTURES POWER TOTAL FEE $ �.� UTILITY CO.NOTIFIED FINAL 76A663 DBS#5A 4-52 r .76A66rCE806 1.66 APPLICATION FOR ELECTRIC PERMIT COUNTY OF LOS ANGELES I DEgQARTKENT OF COUNTY ENGINEER Q �� BUILDING AND SAFETY DIVISION B UILDING ^� i JOHN A. LAMBIE. COUNTY ENGINEER �^I�^ s _ r COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING ` ` V� L ,l \e FOR APPLICANT TO FILL IN / NO. EACH FEE RECEPT._ - $ $ OWNER • tN. 1 d1A� ADD AtLt , LIGHT TOTAL FIRST 20 20 ADDRESS � SWITCH_ OVER 20 10 CITY C TEL. NO- PLAN CHECK LIGHTING �T07ALrFIRST 20 20 APPLI-CANT FIXTURES VER 20 10 ADDRESS , RANGE—DRYER—WT.R.HTR. CITY TEL. NO. STA.COOK_DISP. F.A.U.— CONTRACTORcd-uS@L1104't112.0 c>1IN,"( 61 S SPACE HTR. AIR COND.—ADDRESS Lo'= CLOTHES.WASH DISHWASH. CITY TEL. NO. FAN_OTHEIR 1 00 LICENSE: NZ _O CLASS. cib _MOTORS,TRA NS FORMERS RATING _ - - IND HEATERS, ETC HP. KW. KVA I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION SIZE & TYPE OVER TO AND STATE THAT THE ABOVEJS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND •STATE LAWS REGULATING ELECTRICAL WIRING. 0-. -_ .1 1 00 - - _ _ I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 10• 3 00 LICENSED AS REQUIRED BY•LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL'OWNER OF, AND INTEND TO 10 — 50 5 00 RESIDE IN, THE ABOV DESCRIPED RE NTI L PROPERTY. O 50 - 100 10 00 OF PERMITTEE j V OF PERMITTEE ��..7777��ffff /�- !ll�� ad 100 - soo 15 00 DISZ.RICT N - GROUP ZON 'PROLES ED B G SIGN,GAS S TUBE, OR IGN AND ONE CIRCUIT 3 00 W / MARQUEE ADDITIONAL CIRCUITS 1 00 NOTES: < (/C� Z SERVICE NOT OVER 600 VOLTS OR 200 AMP ' 2 00 SERVICE OVER 600 VOLTS OR 200 AMP - 5 00 TEMP SERVICE, POLE, & APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE S.erk ul c P is 100A c� , 1 ea /� TEMP. POWER POLE - n� R caua U-NDERSLAB WORK ROUGH CONDUIT PERMIT FEE (SUB TOTAL) WIRI NG • • FIXTURES " PLAN CHECK FEE (50% PERMIT FEE) a� POWER AUTHORIZED PERMIT, ISSUING FEE 2 00 42 UTI LITYCO.NOTIFIED SUPPLEMENTARY PERMIT ISSUI NG FEE .1 00 FINAL 10114-A-1 TOTAL FEE JOSEPH C. ROOHAN SUPERVISING ELECTRICAL ENGINEER PLAN CHECK VALIDATION cK, M 0 CASH i. PERMIT VALIDATION `CK M O 'CASH SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE ' N 768663-CE80610,72 APPLICATION FOR ELECTRICAL PE IT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER JOB ,!BUIL ING AND SAFETY DIVISION ADORE LOCALITY S NEAREST FOR APPLICANT TO FILL IN CROSS ST. w OUTLETS NO. EACH FEE OWNER OR FIRM NAME RECEPT.� $ $ MAIL LIGHT TOTAL FIRST 20 26 / C� ADDRESS J CITY TEL. NO. SWITCH_ OVER 20 10 PLAN CHECK LIGHTING FIRST 20 25 O Q APPLICANT TOTAL OVER 20 ADDRESS FIXTURES 10 RESIDENTIAL APPLIANCES clTv T L. N0. PERMIT RANGE DRYER_WTR. HTR. APPLICA STA. COOK DISP. F.A.U. ADDRESS L.^ SPACE HTR. AIR COND. CITY i TIES NO.- CLOTHES WASH. 01SHWASH. LICENSE OR CLASS. (� REG. NUMBER FAN OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING W ITH 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 REGIS TERED,AND/OR 0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THA M THE LEGAL OWNER OF THE ABOVE d 1 - 1O 300 DESCRIBED REST T L PROP Y V PERMITEE 10 - 50 500 SIGNATOR O C, 50 - 100 1000 v DISTRICT NO. PR SSED BY - LLJ SIGN, GAS=SGN A1 00 - 500 1500 '57 0 V Z NO ONE CIRCUIT 5.00 APPROVALS DATE INSPECTOR'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 TEMP. POWER POLE SERVICE NOTOVER 600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK t SERVICEOVER600 VOLTS OR 200AMP 1000 ROUGH CONDUIT TEMP SERVICE,POLE, &APPURTENANCES 500 WIRING i TEMP LIGHT OR RECEPT. SYSTEM 300 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL (J / PERMIT FEE (SUB TOTAL) 2, NOTES: C PLAN CHECK FEE n PERMIT ISSUING FEE 300 {.1 TOTAL FEE YL i PLAN CHECK VALIDATION CK. M O CASH PERMI ALIDATION CK. M 0. CASH t SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE { �. 2 V 4 673 AU '2 2 a D 8.2 5 tl ' I l 76A 663-CE806 3-69 APPLICATION FOR ELECTRI AL, PER COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEERBUILDING �gf ' BUILDING AND SAFETY DIVISION ADDRESS L J JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W, JENKINS, SUPERINTENDENT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN - CROSS ST. NO. EACH FEE, $ $ OWNER r-- RECEIPT. MAIL - LIGHT TOTAL FIRST 20 .20 ADDRESS SWITCH - CITY TEL.NO. OVER 20 •10 PLAN CHECK , LIGHTING TOTAL FIRST 20 ,20 APPLICANT FIXTURES OVER 20 .10 ADDRESS , RANGE_DRYER_WTR. HTR. CITY TEL.NO. - STA. COOK DISP. F.A.U. CONTRACTOR SPACE HTR. AIR COND. ADDRESS - _ .•� ,- CLOTHES WASH._DISHWASH. CITY �(J . �Uy..�.`p` TE L.NO. 33 '�'Z'y3� FAN-OTHER 1.00 LICENSE NO. CLASS. �ZS MOTORS,TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT.1 HAVE READ THIS APPLICATION , IND. HEATERS, ETC. HP. KW. KVA. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. - — — - _ s • 0 — 1 1.00 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 'LICENSED AS REQUIRED BY LOS ANGELES COUNTY, AND STATEOF 1 — 10 3.00 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND,TO_ 0— RESIDE IN, THE ABOVE D SCRIBED R TIAL PROPERTY. O 10 - 50' 5.00 V SIGNATURE - 50 - 100 10.00 ,OF PERMITTEE .Q 1- 100 — 500 15.00 DISTRICT N/RJ GRQUPZONE ,PROC Y U CL SIGN,GAS SIGN AND ONE CIRCUIT 3.00 `� Z TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 V SERVICE OVER 600 VOLTS OR 200 AMP 5.00 TEMP SERVICE, POLE', &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE- TEMP. POWER POLE UNDERSLAB WORK ROUGH CONDUIT , WIRING PERMIT FEE (SUB TOTAL) FIXTURES POWER AUTHORIZED PLAN CHECK FEE (50% PERMIT FEE) - PERMIT ISSUING FEE 2.00 G 6 UTILITY CO.NOTIFIED ' SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL - TOTAL FEE JOSEP C. ROOHAN . �- SUPERVISING El FrrTRLCAL,ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION L. . M.O. CASH 7, kGV-17 2 D 4.2,0- � SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE 75A663-CE806 ,/�0. APPLICATION FOR EL CTRL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING Q BUILDING AND SAFETY ,DIVISION ADDRESS- 5S ',5 JOHN A. LAMBIE, COUNTY ENGINEER LOCALITY r COLEMAN W. JENKINSr SUPERINTENDENT OF BUILDING NEAREST FOR APPLICANT TO FILL IN CROSS ST, de. OUTLETS NO EACH FEE *'{^ q RECEPT. $ $ MANLR / , �� Ili'S rIK, 3.1 FIRST 20 /, 20 ADDRESS LIGHT TOTAL , CITY TEL. NO:— SWITCH_ OVER 20 10 a PLAN CHEC - LIGHTING FIRST 20 20 APPLICANT E , TOTAL OVER 20 ADDRESS FIXTURES' 10 _ APPLIANCES CITY TEL. N0. PERMIT RANGE DRYERWTR. HTR. APPLICANT I O t STA. COOK DI SP. F.A.U. - ADDRESS j ,(L -b((c(a SPACE HTR: AIR COND, _ o, - CITY - -.�_ TEL. N0. CLOTHES WASH. DISHWASH. LICENSE NO. CLASS. FAN OTHER 100 1 HEREBY ACKNOW LEDGE T HAT 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 0 - 1 100 LICENSED AS- REQUIRED BY LOS ANGELES COUNTY•AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO 1 - 10 300 RESIDE N', THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. SIGNATURE ` r a- •101- 50 500 OF PERMITTEE' .W40 0 50 - 100 1000 DISTRICTNO CLASS IGZ ZONE R CESS ED 100 - 500 15 00 ��OCA.., O SIGN, GAS SIGN AND ONE CIRCUIT 300 NOTES: W d TUBE, OR _ N MARQUEE ADDITIONAL CIRCUITS 100 - ?- SERVI CENOT OVER 600 VOLTS OR 200 AMP 200 - APPROVALS .DATE INSPECTOR'S SIGNATURE SERVICEOVER600VOLTS OR200AMP 500 TEMP.POWER POLE TEMP SERVICE, POLE, &AP,PURTENANCES 300 , TEMP LIGHT OR RECEPT: SYSTEM 300 UNDERSLAB WORK ROUGH CONDI UT WIRING FIXTURES PERMIT FEE (SUB TOTAL). POWER AUTHORIZED PLAN CHECK FEE (50% PERMIT FEE)• - _ UTILITY CO. NOTIFIED ' PERMIT ISSUING FEE 200 S ` FINAL �� O SUPPLEMENTARY PERMIT ISSUING FE 0 J69EPH C. ROOHAN TOTAL FEE / SUPERVISING ELECTRICAL ENGINEER, PLAN CHEC VALIDATION —�' CK,- , 1 'CASH PERMIT VALIDATION cK M O. LASH � J �(�o�i��d�? •`. SDA 7' o 4. 5 NGV1 7 2'-D- .001• SEE BACK OF APPLICATION-FOF••C'O LL1'.?1. 9" 1E•'"` 4 j A APPLICATION FOR EL"I �L_,P�RMIT� - 76A663-CE806 1-68 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE; COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY NEAREST 'FOR APPLICANT TO FILL IN CROSS ST. NO. EACH FEE RECEPT. $ $ OWNER I' .yl/J MAIL LIGHT TOTAL FIRST 20 f 20 20 ADDRESS - SWIT_CH OVER 20 10 CITY TEL. NO: / PLAN CHECK LIGHTING �TOTALFIRST-20 20 APPLICANT FIXTURES OVER 20 10 AADDRESS ' RANGE-0RYER WTR.HTR. CITY TEL. NO STA.COOK_DISP. F.A.U. COiaTRACrOR E SPACE HTR. AIR COND. ,ADDRESS W C.LOT-HES WASH._DISHWASH._ - - -- - - CITY - TEL. NO% FANOTHER - 1 .00 LICENSE ISO. 76 1 L CLASS. MOTORS,TRANSFORMERS RATING IND HEATERS, ETC HP. KW. KVA I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION SIZE & TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL'COUNTY ORDINANCES AND STATE- LAWS REGULATING _ _ _ELECTRICAL WIRING. _ .� -•0--.- 1 - 1 00 - -- '-- I HEREBY CERTIFY THAT I AM PROPERLY' REGISTERED AND/OR 1 - 10 3 00 LICENSED 'AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT,I A HE LEGA OWNER OF, AND INTEND TO 06 10 - 50 5 00 JRESIDE IN, THE V D SCRIP D R N7IAL PROPERTY O GNATURE' V 50 – 100 10 00 F PERMITT 100 – 500 15 00 DISTRICT NO. OUP ZONE PROCESSED_B�i_ V TUBE,GOR AS SIGN AND ONE CIRCUIT 3 00 r / t ,7— Lu a MARQUEE N ADDITIONAL CIRCUITS 1 00 NOTES: l.' _ Z_ SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00 -• - J SERVICE OVER 600 VOLTS OR 200 AMP. 5.00 TEMP SERVICE,,P.OLE, & APPURTENANCES 3 00 APPROVALS DATE INSPECTOR'S SIGNATURE I TEMP. POWER POLE UNDERSLAB WORK / ROUGH CONDUIT, PERMIT FEE (SUB TOTAL) WIRING FIXTURES - PLAN CHECK FEE (50% PERMIT FEE) POWER-AUTHORIZED' ' PERMIT ISSUING FEE 2 00 �0 UTILITY CO.NOTIFIED SUPPLEMENTARY PERMIT ISSUING FEE 1 00 FINAL TOTAL FEE ' JOSEPH C. ROOHAN SUPERVISING ELECT ICAL ENGINEER PLAN CHECK VALIDATION CK M 0 CASH t PERMIT VALIDATION, cK M.0 CASH tALo -74- NOV 4.20,1 EE BACK•OF APPLICATION FOR COMPLETE FEE SCHEDULE I _ 7GA663-CES06-6-57 APPLICATION FOR ELECTRIC PE,RMITI COUNTY OF LOS ANGELES / DEPARTMENT OF COUNTY ENGINEER gDDRESING S J BUILDING AND SAFETY DIVISION JOHN A.LAMBIE,COUNTY ENGINEER CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY NEAREST / FOR APPLICANT TO FILL IN CRSS sT. PERMIT FEES OWNE LIGHTS RECEPTACLES SWITCHES , NUMBER I T E M EACH FEE MAIL , TOTAL OUTLETS � .10 S ADDRESS ELEC. RANGES, WATER HEATERS, CITY TEL.NO. O CLOTHES DRYERS •50 ELECTRICIAN ��-f' ELEC. SPACE HEATERS, STAT-Y. COOK. ING UNITS, GARBAGE DISPOSERS, ADDRES I I AUTO WASHERS, DISHWASHER .255' ` 1 LIGHTING FIXTURES .10 CITY tw�D/1 TEL.NO IJ STATE =MOTORS.""-- L_�- -- - - LICENSE-NO. - 66� ---- -`-- - HoasEPowERDISTRICT H. OVER INC. NO. GROUP ZONEREADY FOR INSPECTION -. +/II @ LESS .215 +i2 — 2 50 INSPECTION RECORD 2 5 1.00 5 15 1.50 15 - SO 250 , SO - 200 5.00 MI I SIGNS NO.TRANS NO.LAMPS SERVICE O-600V 1.00 SERVICE OVER 600V 5.00 WIRING PERMIT 1.00 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .50 TOTAL FEE yI APPROVALS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING /• ELECTRICAL WIRING. WIRING 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE POWER DESCRIBED RESIDENTIAL/ PR,PERTY. SIGNATURE UTILITY CO.NOTIFIED /,]]�� OF PERMITTE - FINAL Z - 111,teb O JOHN A.ENGINEER E, VALIDATi� ARTHUR C.VETT, + COUNTY ENGINEER ( i SUPERVISING ELECTRICAL ENGINEER• CK MO CASH • .J CO 5 1 7 6 DEC 17 2 1 .2 5 M WORKERS'COMPENSATION DECLARATION -663 10/81APPLICATION FOR ELECTRICAL PERMIT C I hereby affirm that I have a certificate of consent to self insure, CE-806G 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.W C P 1 1 2-1 Eompany-G 11.P_e PerOr FOR APPLICANT TO FILL IN JOB ❑ Certified copy is hereby furnished. EACH NO. FEE ADDRESS 5954 Kauffman S t/. New Residential Bldgs. & Pools LOCALITYem 1e City Certified copy is filed with the county building inspection 2-Family, Sq.Ft. p$ — $ T 1 & department. Multi-family Sq.Ft. — NEAREST CROSS ST. Residential Swimming Pools OWNER OR Date Applicant FIRM NAME T. C. W.o m e n s Club CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL COMPENSATION INSURANCE Outlets:,Rec— Light — Sw. ADDRESS 5954 Kauffman S t . (This section need not be completedthe First 20 if the work involved b y Total No. Additional CITY Temple City Tel.No. 287-2716 permit is for one hundred dollars ($100) or less.) PLAN CHECK I certify that in the performance of the work for which this permit 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 T NOTICE TO APPLICANT: If, after making this Certificate of PERMITAPPLIC O ri n O Y Air Exemption,you should become subject to the Workers'Compensation Range_ Heater_ D.W. provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer _ W.M.. ADDRESS 4931 N. E n c i n i t a Ave . provisions or this permit shall be deemed revoked. Top _ FAU i W.H. Q CITY Tel.No. LICENSED CONTRACTORS DECLARATION Hood — Fan A— Other_ Temp 1 e city t 2 8 6-315 7 I hereby affirm that I am licensed under provisions of Chapter 9 LICENSE OR' 4 0 3 7 3 5 S C 2 0 Disp. — Room Air Cond. 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 A DISTRICT NO. - PROC SED BY C 3 8 pparatus& Large Appliances Size& wo Type HP, KW,KVA,or KVARv� License Number4 0 3 7 3 5 Lic. Class S C 2 0/C 3 8 g Q Up-to 1 Incl DATE � I Over 1 to 10 Incl. DATE VALIDATION 0 ContractoW a Y n e 9 . C O n n o Zate 4/30/93 Over 10 to 50 Incl. V El FINAL t I am exempt under Sec. Over 50 to 100 Inc. BY ('//-,L�3y ,y,/ 1.1B.&P.C.for this reason Over 100 G�`"•` N 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 a I hereby affirm that I am exempt from the Contractor's License Law H?w? 1 .7 for the following reason(Section 7031.5, Business and Professions Additional Sign Branch Circuits ' »90 Code): 33J0r� _) ❑ Misc.Conduits & Conductors a^ �•i= -� Ej-(€ I,as owner of the property,will do the work and the structure is not intended or offered for sale (Section 7044, Business Other (See Complete Fee Schedule) ® 3 and Professions Code). ;CI T AL 9 - $00 CONSTRUCTION LENDING AGENCY C a E_IK' _ 0__ I hereby affirm that there is a construction lending agency for thett99 "" performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total) 4•t '�L �`IL3 Civ.C.)." PLAN CHECKING FEEto �; �, ; }f Lender's Name 01 t1 jf —UU 11 7r�c t: '�, PERMIT ISSUING FEE Lender's Address I certify that I have read this application and state that the above TOTAL FEE `9 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 prMperoectionpurposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee to WORKERS',COMPENSATION DECLARATION, CE-806G (2-80) APPLICATION FOR ELECTRICAL PERMIT ' - CE-806 I hereby affirm that'I have a certificate.of consent to self COUNTY OF LOSANGELES _ BUILDING AND SAFETY insure, or a certificate of Workers'Compensation Insurance,or L �'�, �� 1 'T a certified copy thereof(Sec. 3800,Lab. C.) FOR APPLICANT TO FILL IN JOB Policy No. Company New Residential Bldgs.&Pool s EACH NO. FEE ADDRESS Certified copy is-hereby furnished. 1 &2-Family,Sq. Ft: $ — $I "LOCALITY �l ' — NEAREST SFt.Certified copy.is filed with the county building inspection ROSSST- department.'' Resideritial'Swimming Pools OWNER OR * , -FIRM NAME Date Applicant Outlets Rec_Light Sw AMAIL DDRESS. CERTIFICATE OF EXEMPTION FROM WORKERS' + First 20 Total No. Additional CITY- Tel No. - }� COMPENSATION INSURANCE PLAN CHECK - APPLICANT 0 (This section need not be 'completed 'if-the.work involved Lighten FixturesFirst 20 - .01 by the permit is for one hundred dollars ($100)'or less.) g • - 'ADDRESS Additional Total No. 0 I certify that:in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY T o. U permit is issued, I shall not employ any person in any manner ` PERMIT W so•as to become subject"to the Workers' C mpensafion Laws. Range_ Heater_D.W. APPLICANT x 1111 _G-� - - _ .w. - - - -- -�. - - Z Oven Dryer_ —a- M.. _ ADDRESS - Date '�7-: Plicant -Top FAU +L W:H.. C -•; c I' CIT 1 - _Tel N Hood _ Fan Other_ 7 .NOTICE APPLICANT:•If,'after making this Certificate of Disp. _ Room-Air Cond.�i T � � \' �` � LICE OR Exemption, you should become -subject to the Workers' REG.NUMBER C7� Class ( b Compensation provisions of the Labor Code, youf'must forth- Power Apparatus& Large Appliances DISTRICT NO. PROC S BY with comply with,such provisions or,this .permit shall be- deemeel`evoked. : yp , K Size&Te HP, KVAR _ Up to 1•Intl. - FINAL LICENSED CONTRACTORS DECLARATION Over'1 to 10 Incl. ` DATE2 VALIDATION. Over 10 to 50 Incl. I .� I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc.' FINAL Y• 9 (commencing with Section 7000)of Division 3 of the Busi- Over 100 B ness and Professions Code, and my_ license is in full'force and effect. Services 0-200 Amp. Under 600 V 'License Number Lic.Class 201'-1000 Amp. Under 600N w i Contractor Llete Over,1000 Amp.or Over 600 V 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 for the following,reason (Section 7031.5, Busi- Additional Sign Branch Circuits X914 O R 4 A ness and Professions Code):' Misc.Conduits&Conductors `#�o,o 10. o o,2` ❑ 1, as owner of the property,•will do the work and the O (See Complete Fee Schedule)— structure-'is not intended or offered for sale (Section e rlo'oto 0 0 0,0•g. 7044, Business and Professions Code). •� 2_� —82 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency y for the performance of the work for which this permit is issued (Sec. 3097,Civ-.C.). PERMIT FEE (Sub-Total) Lender's,Nam PLAN CHECKING FEE (One-Fourth Permit Fee) Lender's Address PERMIT ISSUING_FEE •I certify that I have read this application and state'that th'e .. 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 I the ab tinned p rty for" pection purposes. SEE REVERS -FOR EXPLANATORY LANGUAGE Sign ure of Permittee., Date o �_