HomeMy Public PortalAbout9167, 9167 1/2 LAS TUNAS DR_Electrical__ DOS-5A 3-SS APPLICATION FOR ELECTRIC PERMIT 1i
DMSION OF BUILDING AND SAFETY
Deportment of County Engineer
County of Los Angeles FLkD
ING
WM.J. FOX. COUNTY ENGINEER ESSCASSAT-T D.GRIFFIN. SUPT OF BUILDINGLITY
FOR APPLICANT TO FILL IN• NEAREST
PERMIT FEES cRoss ST.
NUMBER EACH FEE n 1
OWNER L I C C So if
LIGHT OUTLETS
RECEPTACLES MAIL // �; / A,f •�L<j/1�/¢.rJ' /"�
ADDRESS //
WALL SWITCHES
TOTALOUTLETS _ 5¢ $ CITYf+TEL NO _
ELEC RANGES 25 ELECTRICIAN 0/26
_ELEC HEATERS 25 ADDRESS
KW EA CITY 4/-1y 4-0 e TEL NO.5
FIXTURES 5 LICENSE NO
NUMBER OF LIGHT CIRCUITS - DISTRICT NO. GROUP NE I READY FOR INSPECTION
NUMBER OF RECEPTACLE CIRCUITS I S16A/
MOTORS lS� vvv
NUMBER HORSEPOWER FEE INSPECTION RECORD
NEW MVD HP I OVER I INC I EACH
I/2&LESS $ 25
1/Z 2 50
2 5 1 00
5 15 1 50
15 50 2 50
50 200 500
MISC.
NO.SIGNS NO TRANS
NO SIGNS NO LAMPS
FOR EACH PERMIT
WIRING $100 V'ti
FIXTURES $1 00
SUPPLEMENTARY 50 APPROVALS
ALS
TOTAL FEE S Z DATE INSPECTOR'S SIGNATURE
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CONDUIT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY c
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING 1 t7
ELECTRICAL WIRING.
1HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE POWER
DESCRIBED RESIDENTIAL PROPERTY.
SIGNATURE r UTILITY CO NOTIFIED
OF PERMITTEE W FINAL
WILLIAM J. FOX. COUNTY ENGI R VALIDATION A.C.VEIT.CHIEF ELECT. INSPECTOR
0455, SEP 21 2 2.00 n
76A663C- CE8068 1=,75 APPLICATION R ELEC RICAL PERMIT
BUILDING AND SAFETY DIVISION// j+�
FOR APPLICANT TO FILL IN JOB V-7 Z \S N
FResidential Bldgs & Pools EACH NO FEE ADDRESS ,
Sq Ft $ - $ LOCALITY RE r_rY
q Ft CROSS ST `6(
esidential Swimming Pools OWNER OR •� `
FIRM NAME
Outlets Light, Switch& Receptacle MAI L
First 20 ADDRESS 4nAAA010i QAu o
Additional CITY Tel No J
PLAN
Lighting Fixtures APPLICANTK a
First 20 ADDRESS
Additional
CITY Tel No
PERMIT
Fixed Appliances Not Over 1 HP APPLICANT VSA- 19-l`LC ~Ill
Range Heater_ D W 99655— / A,,� -rum
pks
Oven Dryer W M ADDRESS G� '�77
Top FAU WH CITY �� Tel No D&7-07 >-
Hood Fan REG NUMBER 3� ��B Class e-10 o�
Disp. A C. �
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION 0
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY U
Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING W
Size&Type HP, KW, KVA,or KVAR ELECTRICAL WIRING,
vi
Up to 1 Incl Z
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND(4R
Over 1 to 10 Incl LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
C CALIFORNIA OR THAT 1 AM THE LEGA WNER OF THE ABOVE
Over 10 to 60 Incl. DESCRIBED RE IAL PTY
Over 50 to 100 Incl. PERMITEE
Over 100 SIGNATURE
D
ISTRICT NO ��C D BY
Services 0CY �
0-200 Amp Under 600 V 6 201 - 1000 Amp Under 600 V PPROVALS D E INSPECTOR'S
Over 1000 Amp or Over 600 VSIGNATURE
OWER POLE
Temp Power Pole&Appurtenances LAB WORK
Sign with One Branch Circuit
Additio I SignBranc Qircuits CONDUIT
Other) `�
AUTHORIZED
PERMIT FEE (Sub-Total) C_O NOTIFIED
PLAN CHECKING FEE (One-Fourth Permit Fee) FINAL 3 �7
PERMIT ISSUING FEE
TOTAL FEE N, NOTES
�sr.t-4a. rr-t r+ r��r.�raAp,If_A'�P(� I 0 V
EeK-V*Lff)Ai10N--CK-----t71 6 CASH PERMIT VALIDAITICK M O CASH
FOLICY HOLDER: �-��'''��� 9 8 0��Af� 9. 2 n 9.0 0 '&"-tc;
POLICY I WABER:
D.B.B.SA 25M SETS 10-47 PP ICATION FOR P
DEPARTMENT OF BUILDING AND SAFL�Y APPLICATION+�+4 �� a��
COUNTY OF LOS ANGELES
WM. J. FO CHIEF ENGINEER
Q NAME DISTRIC O. GROUP ZONE PERMIT
� �--y17
��.. ADDRESS
WU CITY nn TEL.NO RECEI BY FIRST IN CATE ISSUED
CERT.NO. O� EXPIRES A
APPLICANT FILL IN HEAVILY OUTLINED PORTION OM x
JOB
DESCRIPTION OF WOE -ADDRESS
NUMBER OR OUTLETS ON CIRCUITS LOCALITY ;-v&4 oid AL Cx*tv
LOCATION BY ROOMS
NEAREST -
LIGHT OUTLETS JSW. PLUGS FOtT CROSS ST
CIRCUIT A B C D I E IT G H It NAME S
ZMAIL
3 ADDRESS
O
CITY TEL.NO.
1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGF,LES COUNTY CERTIFICAT OF UAL ICA ION..
ELECTRICIAN.
I AM THE LEGAL OWNER F THE PROP
F,fiTY DESCRIBED
ABOVE
OWNER.
41p oNs
f '44F
- 4.4,
Q
E7
ii
O
TOTAL Z'
NO. OF OUTLETS 2- $ APPROVALS
NO. OF FIXTURES $ DATE INSPECTOR'S NAME
NO. OF MOTORS H.P. $ CONDUIT
NO. OF SIGNS TRANS. $ WIRING
NO. OF RANGES OR HEATERS $ FIXTURES
` .
MISCELLANEOUS $ POWER
PERMIT FEE $ UTILITY CO.NOTIFIED �.,--
TOTAL FFA FINA d 0
76A663 DBS 5A 11-50 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES ELECTRI1
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FI IN DISTRIr NO. GROUP ZONE PERMIT NO.
ELECTRICIAN \ 1N
c—i K—e�6/M
_ /� RECEIVE BY READY FOR DATE ISSUED
ADDRESS t� �{,.�.. !J �D FIRST INSPECTION
CITY Q, G'+I+7 TEL. NO �i
COUNTY LICENSE NO. EXPIRES BUILDING 17
I I / �,. J
PERMIT FEES ADDRESS b .Sl,
NUMBER EACH FEE LOCALITY v
LIGHT OUTLETS S NEAREST
CROSS ST. `
RECEPTACLES
WALL SWITCHES OWNER
TOTAL OUTLETS 5c $ MAIL /
ELEC. RANGES 25 ADDRESS
ELEC. HEATERS 25 CITY• • TEL. NO.-�
FIXTURES 5 1 HEREBY ACKNOWLEDTHAT 1 HAVE READ THIS
MISC APPLICATION AND STATE "THAT THE ABOVE IS CORRECT
NUMBER OF LIGHT CIRCUITS / �S 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 HORSEPOWER ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
FEE OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
NEW MVD. HP OVER I INC. EACH
1/2 &LESS $ .25 SIGNATURE OF x, + Q
1/2 2 .50 PERMITTE w�
2 5 1.00 INSPECTION RECORD
5 15 1.50
15 50 2.50
so 200 5.00
200 500 10.00
500 1000 15 00 Q
Z_
OVER 1000 20 00 (�
M. G. SET/FREQ. CHANGER-HP
0
WELDERS AC-KVA
GENERATORS-KW
TRANSFORMERS-KVA _
TEMP. MOTORS (75%OF ORIG.)
MOVED MOTORS (75%OFORIG.)
MISC
SIGNS
NO. NO. TRANS. APPROVALS
NO NO LAMPS
DATE INSPECTOR'S NAME
FOR EACH PERMIT-
CONDUIT � _
WIRING $1 00
WIRING / i w� 1017'( ►1.
FIXTURES $1 00 v 6 ,, 14 �r�q jy•
SUPPLEMENTARY .50 FIXTURES �iW WI
POWER
TOTAL FEE $ 33,S UTILITY CO. NOTIFIED
rr
® FINAL
1 `
7SA663 DBS SA 11-49 APPLICATION FOR PERMIT
s DEPARTMENT OF BUILDING AND SAFETY ELECTRIC
� COUNTY OF LOS ANGELES
SWILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO.
�} ELECTRICIAN
RECEI711,
'B READY FOR DATE 16SUED
ADDRESS /"'= FIRST INSPECTION ^/
_ �v a
CITY TEL. NO. ! 7yBUILDINGjr /�/"
COUNTY LICENSE N EXPIRES ADDRESS i Lr
/ +
PERMIT FEES
FEE
NUMBER GUTLFTS EACH LOCALITY
LIGHT Be $ NEAREST
CROSS ST.
RECEPTACLES 5
FIXTURES 5 OWNER
WALL SWITCHES 5 I MAIL Q �y
ELEC. RANGES 25 I ADDRESS a
ELEC. HEATERS 25 CITY TEL. NO.
MISC I HEREBY VCKNOWLEDGE HAT I HAVE READ THIS
NUMBER OF CIRCUITS INSTALLED:
TOTAL APPLICATION AND STATE THAT THE ABOVE IS CORRECT
LIGHTS RECEPTACLES AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
MOTORS AND STATE LAWS REGULATING ELECTRICAL WIRING.
NUMBER HORSEPOWERFEE 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
NEW MVD. HP OVER INC. EACH In ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
_ r
I/2 s
LESS $ .25 OF THE RESIDENTIAL,: RI;PEPTY DESCRIBED ABOVE.
ZX
V2 2 .50 SIGNATURE OF ^ ,
PERMITTEE
2 5 1.00 1
d
5 1 s l.so INSPECTION RECORD
is so 2.50
so 200 5.001
200 Soo 10.00 _
Soo 1000 15.00 J
OVER 1000 20.00 Z
M.G. SET/FREQ. CHANGER-HP LIr
WELDERS' AC-KVA
GENERATORS - KW O
TRANSFORMERS - KVA
TEMP. MOTORS (75% OF ORIG.)
MOVED MOTORS (75% DF ORIG.)
MISC.
SIGNS
TYPE: �� N0.TRANS. /
TYPE: NO. LAMPS
APPROVALS
FOR EACH PERMIT: DATE INSPECTOR'S NAME
WIRING $1.00 CONDUIT
FIXTURES $1.00 WIRING
SUPPLEMENTARY .50 FIXTURES
POWER
TOTAL FEE $ �/" V UTILITY CO. NOTIFIED
FINAL �ij —� .tr✓'�
WORKER'S'COMPENSATION DECLARATION
CE-806G (2-80) APPLICAT-ION FOR ELECTRICAL PERMIT
CE-606
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.) - I 1
192-71-3080-2 Ins♦ Co• FOR APPLICANT TO FILL IN JOB
Policy No Company EACH NO FEE ADDRESS
of the West New Residential Bldgs &Pools
❑ ,Certified copy is hereby furnished. 1 &2-Family,Sq Ft $ — $ LOCALITY Temple City
' ® Multi-family Sq Ft — NEAREST
Certified copy'ls filed with the county building inspection CROSS ST
department Residential Swimming Pools OWNER OR ,
11-6-81 Edwards Electric FIRM NAME `
Date Applicant Outlets Rec_Light Sw MAIL
i
First 20 ADDRESS :
CERTIFICATE OF EXEMPTION FROM WORKERS' Total No Additional CITY Tel No
COMPENSATION INSURANCE PLAN CHECK a
(This section need not be completed if the work involved A APPLICANT
by the permit, is for one hundred dollars ($100) or less.) Lighting Fixtures First 20 ADDRESS
Additional
I certify that in the performance of the work for which this Total No CITY Tel No
j _ Fixed Appliances Not Over 1 HP U
perm'ite:s-issued; I-shall not employ any person on any manner PERMIT
so as to become subject to the Workers' Compensation Laws.- Range_ Heater_D.W APPLICANT' Edwards Electric d
Oven _ Dryer_W M__ ADDRESS a _ N
FAU _W.H -
•Date � - Applicant Top _
Hood Fan _Other_ CITY Arcadia Tel No 447-5096
NOTICE TO APPLICANT If, after making this Certificate of Disp _. Room Air Cond._ 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 PROCESSED BY
with comply with such provisions or this permit shall be Size&Type HP,KW, KVA,or KVAR
deemed revoked �Q
Up to 1 Incl.
Over 1 to 10 Incl DA EL
LICENSED CONTRACTORS DECLARATION 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 l
ness and Professions Code; and my license is in full force and t
effect Services
257191 C-10 0-200 Amp. Under 600 V
License Number Lic.Class
Edwards Elect Ju 1982 201-1000 Amp Under 0 V
Ed
Contractor ��� � Over 1000 Amp.or Over
600 V
HOME OWNER-BUILDER DECLARATION Temp Power Pole&Appurtenances 1
I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit
Ljcense Law for the following reason (Section 7031 5, Busi- Additional Sign Branch Circuits 24 7 7 A
ness and Professions Code)
Misc.Conduits&Conductors
❑ I, as owner of the property, will do the work and these 2
Other(See Complete Fee Schedule)— ,
structure is not intended or offered for sale (Section
7044, Business and Professions Code).
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency 0
/for the performance of the work for which this permit is PERMIT FEE (Sub-Total)
issued (Sec 3097,Civ C)
Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee)
Lender's Address PERMIT ISSUING FEE /
' V
I certify that I have read this application and state that the TOTAL FEE IVO 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 above-mentioned property forinspectionpurposes SEE REVERSE FOR EXPLANATORIY LANGUAGE
4-6-81
Signature of Permittee Date