HomeMy Public PortalAbout9241 KENNERLY ST_Electrical__ 76A663^06S SA 11-50 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 N.G.
ELECTRICIAN R F Walton 5 2799-/7
RECEIVED BY READY FOR DATE ISSUED
ADDRESS 5134 Ne Acacia Ste FIRST INSPECTION
CITY San Gabe TEL NO. AT 68583
COUNTY LICENSE NO. 1104 EXPIRES BUILDING
PERMIT FEES ADDRESS 9241 Kennerly St.
NUMBER EACH FEE LOCALITY Temple City
LIGHT OUTLETS NEAREST
CROSS ST.
RECEPTACLES
WALL SWITCHES OWNER Be E. Turner
TOTAL OUTLETS 5c MAIL
ELEC. RANGES 25 ADDRESS
ELEC. HEATERS 23 CITY TEL. NO.
FIXTURES 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 1 POSSESS THE ABOVE VALID LOS
NUMBER HORSEPOWERANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
FEE
NEW MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROEPLTY DESCRIBED ABOVE.
I/2 & LESS $ .23 SIGNATURE OF
%2 2 .50 PERMITTE ��2��Ao
2 5 1.00 INSPECTION RECORD
s is 1.50
is so 2.SO
so 200 5.00 _
200 Boo 10.00 J
5013 1 000 15.130 Z
OVER 1000 20.00 L7
M.Q. SET/FREQ. CHANGER-HP Q,'
WELDERS: AC-KVA
GENERATORS - KW
TRANSFORMERS - KVA
TEMP. MOTORS (75% OF ORIO.)
MOVED MOTORS (75% OF DRIG.)
MISC.
SIGNS
NO. NO.TRANS.
APPROVALS
NO. NO. LAMPS
FOR EACH PERMIT: DATE INSPECTOR'S NAME
WIRING $1.00 (10 CONDUIT ,,//
FIXTURES $1.00 WIRING l.Y,f.Oeoe /,.L2-16'2—
SUPPLEMENTARY
.]ySUPPLEMENTARY ,50 FIXTURES
POWER
TOTAL FEE $ UTILITY CO. NOTIFIED / / La'✓ i
FINAL
WORKERS'COMPENSATIONDECLARATION E-806G-(2-80)
CE-806G-(2-80)
APPLICATION FOR ELECTRICAL PERMIT
CE-806 ,
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.)
FOR APPLICANT TO FILL IN ,JOB
Policy No. Company EACH NO ' FEE ADDRESS Z
❑ New Residential Bldgs.&Pools
Certified copy is hereby furnished. 1 8i 2-Family,Sq. Ft. $ $ LOCALITY
❑ Multi-family Sq. Ft. — NEAREST
Certified copy is filed with the county building inspection CROSS ST
department. Residential Swimming Pools
n' FIRM NAME
Date Applicant Outlets Rec',ILight Sw.� 12 ADDRESS
First 20y.
CERTIFICATE OF EXEMPTION FROM WORKERS' Total No'..�A Additional CITY Tel No.
COMPENSATION INSURANCEa
^ PLANCAN �– O
(This section need not be completed if-the work involved Lighting Fixtures First 20 ADDRESS �� U
by the permit is for one hundred dollars ($100) or less.), Additional
Total No. O
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 U 0
LU
so has to become-subject-to th W rrs' Com on Laws. Range_ Heater_D.W. APPLICAN a
Oven _ Dryer_W.M. ADDRESS N
_ i Z
Dat plicant Top _ AU _W.H.. CITY Tel No.
`Hood _ Fan _Other
NOTICE TO APPLICANT: If, after making this.Certificateof Disp. — Room Air Cond.— LICENSE OR
Exemption, you should become subject to the Workers' REG N U M B E Class.
Compensation provisions of the Labor Code, you must•forth- Power Apparatus& Large Appliances DISTRICT NO. PROCESSED BY
with comply with such provisions or this permit shall be Size&Type'HP,KW, KVA,or KVAR
deemed'revoked. O'
Up to 1 Incl: a,2 -
FINAL
Over 1 to 10 Incl. DATE
LICENSED CONTRACTORS DECLARATION
Over 10 to 50 Incl VALIDATION
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
License Nu Lic.Class v 0-200 Amp. Under 600 V'
201-1000 Amp. Under 600 V
Contracto DateOver 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
ness and Professions Code): -2'59 Q 3.A
Misc.Conduits&Conductors W0'0no 0 0 2
❑ I, as owner of the property, will do the work and the
Other,(See Complete Fee Schedule►— - "
structure is' not intended or offered for sale (Section 2.010 4 O Il} 0
7044,Business and Professions Code).
CONSTRUCTION LENDING AGENCY
I hereby;affirm that there 'is-a construction lending agency o 0 o.(G Q :�r
for the performance'of the work for which this permit is PERMIT FEE (Sub-Total), p
issued (Sec. 3097,Civ.C.). ' U 27'.-8 2
Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee)
Lender's Address PERMIT ISSUING FEE )
I ce hat I have read this application and state that the TOTAL FEE
"infoationect. I agree to comply with all'County
ws regulating Electrical,wiring, and
ntatives of this County to enter uponperty for inspection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
Wgnature of Permittee Date