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Home My Public Portal About6118 KAUFFMAN AVE_Electrical__ 76AS63 DBS SA•7-S1 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND.SAFETY . COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. ® v fes ELECTRICIAN RECEIVED BY READY FOR DATE ISSUED ADDRESS _ FIRST INSPECTION 2 CITY TEL NO. ' ' 9�? COUNTY LICENSE NO. EXPIRES BUILDING ADDRESS PERMIT FEES _ FEE LOCALITY ./ NUMBER EACH LIGHT OUTLETS NEAREST CROSS ST. //azkadz RECEPTACLES ' 1 WALL SWITCHES T OWNER TOTAL OUTLETS I SC Zd MAIL ( C`� ✓ ' ELEC. RANGES 25 S. ADDRESS 1 ELEC. HEATERS 25 CITY ` TEL. NO. 737A FIXTURES _..� 5 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS MISC. _APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS ------ - Iz- 'g 6'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 HORSEPOWERFEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER NEW MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. I/2 6 LESS $ .25 -.SIGNATURE OFQ I/2 a .50 PERMITTEEr =- a B 1.00 INSPECTION RECORD 5 15 1.50 1 S 50 2.50 50 200 5.00 _ 200 SOD 10.00 J 500 1 000 15.00 Z OVER 1 000 20.00 ��••,, L �/ `�0 ,Q�r M.G. SET/FREQ. CHAN_GER-HP �/ -Q�✓�--� ��/�""�.," 'D WELDERS: AC-KVA ` .E TF e� /�!,/1t4. J��, O GENERATORS - KWTRANSFORMERS - KVA _ r TEMP. MOTORS (75% OF ORIG.) ', 17 AO / /��ff MOVED MOTORB (75% OF ORIG.) AOT 7�� f/1 n I* /, SIGNS t7Q0e,e'01?E19-x,Erz Za 6 &11lys- NO.TRANS. APPROVALSGND 2 oartsr's NO. NO. LAMPS FOR EACH PERMIT: DATE INSPECTOR'S NAME WIRING $1,00 CONDUIT FIXTURES $1.00 WIRING SUPPLEMENTARY ,50 FIXTURES '2. ',S �® POWER TOTAL FEE �� ........ � , UTILITY CO.NOTIFIED 2��5 I FINAL ' WORKERS'CON ATION DECLARATION 76A663 1081 APPLICATION FOR ELECTRICAL PERMIT her�i}y offitm that I have of certifica fe of consent to self CE-8066 ";flsur'e, oda certificate of WorkersiCoff4 ewsation Insurance, COUNTY OF LOS ANGELES "BUILDING-AND SAFETY or a certified copy thereof (&,3c 300, La C ) Policy No • Compa y �_ FOR APPLICANT TO FILL IN JOB Certified co is hereby furnished- EACH NO FEE ADDRESS PY Y - �•v New Residential Bldgs. 8 Pools F-1 — LOCALITY `p 01 Certified copy is filed'with the county building inspec- 1 & 2-Family, Sq. Ft $ — § Tion department \ Multi-family Sq Ft. NEAREST •h CROSS ST Residential Swimming Pools OWNER OR Date Applicant, Y FIRM NAME i // CERTIFICATE OF EXEMPTION FROM WORKERS' -• Outlets: Rec�Light •-Sw(� MAIL COMPENSATION INSURANCE., First 20 tS ADDRESS (This section need not be completed If the work involved by Total NoAdditional CITY• Tel. No the permit is for one hundred dollars ($100)or less.) PLAN CHECK I certify that in the performance of the work for which this APPLICANT permit 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. APPLICANT ° t Exemption, you should become subject'to the Workers' Range_ Heater_D.W. — Compensation provisions of the Labor Code, you must forth- Oven _ Dryer — W M — ADDRESS , l with comply with such provisions or this permit shall be Top — FAU —W.H — 7 deemed revoked. Hood Fan _ Other— CITY XCU�� Tel. No �-_ � LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp — Room Air Cond REG. NUMBER Class (commencing with Section 7000) of Division 3 of the Business DISTRICT NO PRO SED BY and Professions Code,and myW11cse is in full force and effect. Power Apparatus&-Large AppliancesSize & Type HP, KW, KVA, or KVARLicense Numbe 20Lic Class__ Up to 1 Incl FINAL V �rQ. Over 1 to 10 Incl DATE J 77 �� V ATION 0 Contractor Date Over 10 to 50 Incl. !/[� �IN H ❑ I am exempt under Sec Over 50 to 100 Inc. J Over 100 B&P.0 for this reason Services, Swbd., MCC& Ponelboards D — 0 -200 Amp Under 600 V Stgnatu 201 - 1000 Amp Under 600 V ;2 7 4 p, ❑ Over 1000 Amp. or Over 600 Vo Exemption for Reg. Maint Elect # 0 0 0 SINGLE FAMILY Temp. Power Pole&Appurtenances' HOME OWNER-BUILDER DECLARATION 7.5 Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits. 0 1'0 0 77 5= • Law for the following reason (Section 7031 5, Business and , � Professions Code)- ❑ 1, as owner of the property, will do the work and the Misc. Conduits & Conductors X7,•1 .01187 structureis not intended or offered for sale (Section Other (See Complete Fee Schedule)_ 110111.7044, Business and Professions Code) CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for r ;9 7 4 7.'3 A the performance of the work for which this permit is issued PERMIT FEE - (Sub-Total) (Sec 3097, Civ. C ). # o'e o • • 2 PLAN CHECKING FEE Lender's Name I i• ° 2 7.7 5 PERMIT ISSUING FEE Lender's Address o.• e 5 I certify that I have read this application and state that the TOTAL FEE 2 7.7 5 above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and / r 0 7. 1 5-87 hihereby authorize representative of this County to enter upon e -m bone r fo m ct n p poses � f O�Qf • SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) 76A663 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self insure, or a certlficatO of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof,(Sec.,3800 Lab .C.) y1 Policy No ry Company - FOR APPLICANT TO FILL IN AB ADDRESS .4;5�.//y //.. ❑ Certified co is hereby furnished NO EACH FEE �! PY' Y New Residential Bldgs &Pools CALITY 1 &2-Family,Sq Ft $ _ $ )+ ❑,, ,Certified copy,is filed with the-county budding inspection. _ _ NEAREST department. Multi-family Sq:Ft CROSS ST i - Date •''• " '- Applicant Residential Swimming Pools ASSESSOR PAGE PARCEL CERTIFICATE OF EXEMPTION FROM,WORKERS' NER OR Outlets Rec —Light Sw : ,FRM NAME COMPENSATION INSURANCE First 20 AIL (This section need'not fie completed if the work'involved by the ':;. J ADDRESS �p/� '`"- ,• ai•• Total No Additional permlt'i's for,one hundied•dollars($10o)or'less_.� I certify that in'the perfo?mance ofthe4work for;which this permit. is Issued, I-shall not employ any person.in,any manner,s0 as t0 PLAN CHECK r r becom_ a subject to the Workers'Compensation Laws. ' Lighting Fixtures First 20 APPLICANT Total No. Additional ADDRESS Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP rNOTICE"TO APPLICANT, If, after making this Certificate-ofCITY Tel,No Exemption„you should become subject to the Workers;Compensation OTHER APPLIANCES NOT OVER 3 HP provisions of,tlie-Labor Code, ou'm-ust forthwith con with such PERMIT` P Y comply Power Apparatus&Large Appliances APPLICANT provisioris or this permit shall be deemed revoked. ” L'ICENSED CONTRACTORS DECLARATION Size&Type HP,KW,,KVA,or KV AR ADDRESS I hereby affirm that l am licensed under provisiohs of Chapter 9 Over 3 to 10 Incl (commencing with Section 7000) of Division,3,of the Business and CITY Tel No Professions Code, and my license is in full force Over 10 to 50 Incl and effect - LICENSE OR } Class Over 50 to 100 Incl REG NUMBER • O War 100 DISTRICT NO PROCESSED BY' License.Number Lic.Class Q V Se rSwbd.,D1C '8�Pa Iba �I 0. ��C/ FINAL10 Contractor Date 0-3 - mp Un er 60 DATE H 400-1000 Amp. Under 600 V y LU I am exempt under Secy 1 / '�� VALIDATION Over 1000 Amp or Over 600 V' FINAL _ a B.&P C.for this-reasonBY Z BRANCH CIRCUIT FEES Date: 15A,or 20A,120V,Lighting or Recept.' ,' 1 To 10 Branch Circuits Signature, 11 To 40 Branch Cucwts 41 Or More Branch Circuits ❑ Ezemption'for-Reg.,Maiht Elect' 15A,20A,208V To 277V Lighting Br Circuits } SINGLE FAMILY Temp Power, Appurtenances Pole&AtCCTa HOME OWNER-BUILDER DECLARATION - `' 'Ir Sign with One Branch Circuit - - ---- - ,- _ a 1 fiereby affirm ihat'l am exempt from the Contractor's License"Law 7 `� �.�. - ,,for the following reason (Section'7031 5, Business and Professions Additional Sign Branch Circuits tt I Code) t I'VE 1 S. ` Misc.Conducts&Conductors "` "� —o 1, as owner of the property, will do the work and the structure TOTAL 63-- 45 i&not intended or offered for sale (Section 7044, Business Other(See-Complete Fee Schedule) i t and Professions Code) ®. ... r,il�l.i• A1.45 -fr ` CONSTRUCTION LENDING AGENCY CHANGE ff-fNGE s1_��( 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) Civ.C) PLAN CHECKING FEE T - _ I� _ a"�'I� dd Lender's Name 123 1 1 Alths 8'.46 PERMIT ISSUING FEE Lender's Address ~' I certify that I have read this application and under penalty of perjury state TOTAL FEE that the 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 up in the above-mentioned property NA fofr In tion rposes SEE iREVERSE FOR EXPLANATORY LANGUAGE , SIO RE OF�R EE DATE �� C!" / / - - -