HomeMy Public PortalAbout9430 KENNERLY ST_Electrical__ D.B.S.SA 251A.BETS 10-47 MPLICATION••�.}�O IPERWr
.�DEP�T'li'IENT ®F B��G S1�S�aa�JxxLE`moat.A a� IC
EOX.._ WL Nff OF LOS ANGELES
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x DISTRI l NO. GROUP I ZONE PERMIT NO.
NAME ��// • i
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RECE717
READY FOR -DATE-ISSUE
W CITY TEL.NO. FIRST INSPECTION
A COUNTY
to CERT.NO. �� EXPQRES
a� �®
APPLICANT FII.n�.WORK
HEEIVii.Y OU tNEID PO�t'i'Y®N ONLYJOB
.
DE.SCRE a O OF WORK ADDRESS
NUMBER OF OUTLETS ON CIRCUITS LOCALITY
LOCATION BY ROOMS NEAREST
LIGHT OUTLETS 18W. PLUGS FOOT CROSS ST.
CIRCUIT A B C D E F G H lz m NAME ��it/ d
7 G 7 MAIL
3 ADDRESS
O
CITY TEL.NO.
1 AM THE LEGAL POSSESSOR OF THE-ABOVE' LOS
ANGFIEG COUNTY CERTIFI TE OF QUALIFICATION..
ELECTRICIAN.
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE
OWNER.
CA) CIONS
J
Q
Z
R
O-
TOTAL
NO. OF OUTLETS 0 S APPROVALS
NO. OF FIXTURES DATE INSPECTOR'6-NAME
NO. OF MOTORS H.P. $ CONDUIT
NO. OF SIGNS - TRANS. E WIRING
NO. OF RANGES OR HEATERS FIXTURES
M1201ANEOUS !g POWER
PERMIT FEE UTILITY CO.NOTIFIED
TOTAL FEE
COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
DEPARTMENT OF COUNTY ENGINEER E L E C T It I C
• DIVISION OF BUILDING & SAFETYIA •
WILLIAM . FOX, COUNTY ENGINEER
FOR APPLICANT TO FILL IN D13TRICT NO. GROUP ZONE PERMIT NO..
ELECTRICIAN. O�i� 'Al T �— 5 -C.
ADDRESS RECEIVED BY READY FOR DATE ISSUED
CITY TEL. N"z-- .s y _ FIRST INSPECTION
_ 2-1 1-5�-
COUNTY LICENSE NO. a EXPIRES✓d^ C ,S BUILDING
PERNIIT FEES ADDRESS
` ,r✓ 0-G
FEE
NUMBER EACH LOCALITY
'LIGHT OUTLETS
NEAREST
RECEPTACLES S T
WALL SWITCHES _
OWNER
TOTAL OUTLETS Q 5. '$ G 6
MAIL
ELEC. RANGES - 25' ADDRESS
ELEC. HEATERS j 25 -
FIXTURES 5 CITY TEL. NO.
MISC'. I HEREBY ACKNOWLEDGE THAT 1 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 CIRCUIT Y- AND STATE LAWS REGULATING ELECTRICAL WIRING.
MOTORS I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
NUMBER HORSEPOWER FEE + ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
New MvD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
1/2 a LESS $ .25
SIGNATURE OF
1/2 2 .50 PERMITTEE
2 s 1.00 INSPECTION RECORD
s -15 1.56
15 50 2.50
s0 1 200 5.00
20b' 500 10.00 J
500 1000 15.00 Q
' Z
OVER 1000 20.00
M.G. SET/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.
NO NO. LAMPS APPROVALS
FOR EACH PERMITi DATE INSPECTOR'S NAME
WIRING $1.00 oo' CONDUIT
FIXTURES $1.00 O'U WIRING 'Y- !IA-/ &ZA—,,.-
SUPPLEMENTARY ;50 FIXTURES
POWER
TOTAL FEE $ 2 UTILITY CO. NOTIFIED
d
FINAL
7GA 663 DBS# 8A; 4-65 '
WORKERS'COMPENSATIONDECLARATION CE8616G (2-80) APPLICATION FOR ELECTRICAL PERMIT
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 OB
Policy,No. Company EACH NO. FEE ADDRESS
New Residential Bldgs.&Pools
Certified copy is hereby furnished. 1 &2-Family,Sq. Ft: $ — $ LOCALITY r-�
Multi-family Sq. Ft. — EAREST
Certified copy is filed with the county building inspection ROSS ST
department'. Residential Swimming Pools WNER OR
FIRM NAME' 'r
Date— Applicant Outlets. Rec._Light Sw.20 AMAIL
DDRESS
I CERTIFICATE OF EXEMPTION FROM WORKERS' First
' Total No AdditioonalOAN
� Tei N _
COMPENSATION INSURANCE ;HEC Ki CL
(This section need not be completed if the work involved - APPLICANT 0
by the permit is for one hundred dollars '($100),or less.) Lighting Fixtures First 20 ADDRESS
Additional
Total No.
F-
I certify that in the performance of the work for which this CITY Tel No.
Fixed Appliances Not Over 1 HP F-
permit is issued, I shall not employ any person in any manner ( PERMIT U
so as to become•sub ect to the Workers' Compensation Laws. Ran e- Heater D.W.
W
J — APPLICANT
P 9 p,
Oven _ Dryer_W.M. ADDRESS to
Date Applicant Top _ FAU _W.H. '°
Z
Hood _ Fan _Other_ CITY Tel No
NOTICE TO APPLICANT If, after making this Certificate of Disp. Room Air'Cond.� r LICENSE OR
Exemption, you should become subject to the Workers' REG.NUMBER Class'
Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO. PROC ED BY
with comply with such provisions or this permit shall be
deemed revoked. Size&Type HP,KW, KVA,or KVAR O
Up to 1 Incl. 1
Over 1 to 10 Incl. DATEL
LICENSED CONTRACTORS DECLARATION I[� — — -VALIDATION
Over 10 to 50 Incl.
I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL
9 (commencing with Section 7000) of Division 3 of the Busi-- Over 100 BY
ness and Professions Code, and my license is in full force and r/
effect. Services
0-200 Amp. Under 600 V
License Number Lic.Class
- 201-1000 Amp. Under 600 V -
Contractor 'Date 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 2 51 3.9 A
License Law for the following reason (Sectiori 7031.5, Busi- Additional Sign Branch Circuits
ness and Professions Code):. I I #'0 0 0 0 0 2
Misc.Conduits& Conductors
I, as owner of the property; will do the work and the Other (See Complete Fee Schedule)— 2,0;o 29.50
structure is not intended or•offered for sale (Section .
7044, Business and Professions Code). _
CONSTRUCTION•LENDING AGENCY ° ° .2 9.5 0 c�
I hereby affirm that there is a construction lending agency f
for the. performance of the work for which this, permit is �y7,•2 3;
PERMIT FEE (Sub-Total) 8 2
issued (Sec. 3097,Civ.C.).
Lender's Name • PLAN CHECKING FEE (One-Fourth Permit'Fee)
Lender's Address PERMIT ISSUING FEE
I 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 abov ed grope for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Permittee Date j'