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Home My Public Portal About6210 KAUFFMAN AVE_Electrical__ COUNTY OF LOS ANGELES . APPLICATION FOR PERMIT DEPARTMENT OF.COUNTY ENGINEER DIVISION OF BUILDING & SAFETY ELECTRIC 1 WILLIAM 1. FOX, COUNTY ENGINEER FOR APPLICANT TO-FILL IN DISTRICT' NO. GROUP ZONE PERMIsT. NO. ELECTRIC[ �AfN q / � f 7. 47 ADDRESS pz s / RECEIVED BY READY FOR DATE ISSUED W TEL. NO. rr2l1 W� FIRST INSPECTION CITY ffrr'' COUNTY LICENSE NO. .-,d� EXPIRE9 �' �_L! gU1LDINar �Q PERFEES• ADDRESS 1 NUMBER EACH FEE • LOCALITY LIGHT OUTLETS NEAREST RECEPTACLES CROSS ST, �-�¢� WALL'SWITCHES _ OWNER aC .TOTAL OUTLETS 5c $ MAIL ELEC. RANGES 25 - ADDRESS - ELEC. HEATERS - 25 ' FIXTURES 5 CITY TEL. NO. MISC. I HEREBY ACKNOWLEDGE THAT I 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 CIRCU ITS AND STATE LAWS REGULATING ELECTRICAL WIRING. .MOTORS I CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR I AM THE_LEGAL OWNER NEW MVD. HP. OVER INC. EACH w OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. _ 1/2&LESS $ .25 SIGNATURE I/s 2 - .50 PERMI7TE 2 •s 1.00 i s INSPECTION RECORD ' s 1.So- Is 50 2:50 -50' 200 5.00 - 200 500 10.00 J 500• 1000 15.00 Z OVER IGOO 20.00 M.G.•SET/FREQ. CHANGER-HP - WELDERS: AC-KVA _ 0 GENERATORS -KW. ' TRANSFORMERS-KVA - - - TEMP. MOTORS (75%,OF ORIG.) 1 MOVED'MOTORS (75% OF ORIG.) ' MISC., ' SIGNS NO. NO.'TRANS. - NO. - NO. LAMPSAPPROVALS FOR EACH PERMIT: DATE INSPECTOR'S NAME _ WIRING $1.00 CONDUIT FIXTURES $1.00 0 WIRING 6 ! Z L�- SUPPLEMENTARY - •5O' FIXTURES �7 M ac POWER UTILITY CO, NOTIFIED TOTAL FEE' $ 003 FINAL. �A .rte X94 76A663 DBS# OA. 4-02 ' ' WORKERS' COMPENSATION DECLARATION 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby-affirm thatCE-806G I have a certificate of consent to self CE-8066 .insure,lur a certtficat� of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thgreof (Sec. 3800, Lab C.) Policy No Company FOR APPLICANT TO FILL IN' JOB Ceftified copy is hereby furnished New Residential Bldgs. & Pools EACH NO FEE ADDRESS 110, �'t 1��1Z"1 yr Certified copy is filed with the county building inspec- 1 & 2-Family, Sq. Ft $ — $ LOCALITY -tion'department '• Multi-family Sq Ft NEAREST CROSS ST Residential Swimming Pools OWNER OR Date Applicant FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' � J_ MAIL &V IA INSURANCE Outlets Rec Li ht Sw.• r g � ADDRESS b;,to, /V• ��Q,IA `1'LQ'''1 � � This section need not be completed if the work involved b First 20 ( p Y Total No = Additional ..'Sb CITY �" Tel. No. the permit is for one hundred dollars ($100)or less.) I certif that in the performance of the work for which this PLAN CHECK Y P APPLICANT permit is issued, 1 shall not employ any person iri any manner so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS .jtad^W4 Total-No Additional CITY Tel. No 1 Date Applicant l�Lr Fixed Appliances Not'Over 1 HIP PERMIT NOTICE TO APPLICANT- If; after, making this Certificate of APPLICANT Exemption, you should become subject to the Workers' Range_ Heater_D.W. — Compensation provisions of.the'Labar Code, you must forth- Oven _ Dryer — W.M.— ADDRESS with comply with.such provisions or this permit shall be Top FAU —W.H'_ lop deem6d ' — deemed revoked. Hood Fan _Other_ CITY Tel. No. LICENSED CONTRACTORS DECLARATION 3•Jv 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. OCE ED BY a' and Professions Code,and my license is'in full force and effect. Power Apparatus& Large Appliances �)Q . , O Size &Type HP, KW, KVA, or KVAR' �- t/v C) License Number Lic. Class Up to 1 Incl FINAL n= Contractor Date Over to 101nc1. DATE�� I VALIDAT � Over 10 to 50 Incl. FI61 L�ii I am exempt under Sec.- Over 50 to 100 Inc, BY fl U) B.&P.C. for this reason Over 100 f Z Date Services, Swbd., MCC& Panelboards 0 -200 Amp. Under 600 V l goo' 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 I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits Law for the following reason (Section 7031 5, Business and Professions Code) (� �BtJ I, as owner of the property, will do the work dnd the Mrsc. Conduits &Conductors structure is not intended or offered for sale (Section Other (See.Complete Fee Schedule)_ 7044, Business and-Professions Code). ►' S8 2 2 A CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for #-o o o ,o 2 the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) (Sec. 3097, Civ C ). i o e 350 ' PLAN"CHECKING FEE Lender's Name o,o o 5 0 z PERMIT ISSUING FEE d Lender's Address •') Q 2 9 t$6 j certify that I have read this application and state that the 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 the bove-m rationed property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Ott ignature of Permittee Date.