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Home My Public Portal About9828 LEMON AVE_Electrical__ 76A663 DBS SA 11-60 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES L CT- I C 1 WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DIST RI O. GROUP ZONE PERMIT NO. ELEC TRICIPAN I L'S / !f� G(JJ�Berl• ADDRESS- y 1/ 5 L cL I s�•'t 1(� J� (/ I RECEIVED BY FIRST IN PECTION DY FOR DATEISSUED CITY ��({ C,-P yn��jfl,�g,�. TEL NO R(S ( 0. �—/�� r/� COUNTY LICEN 'IJd�( EXPIRES BUILDING (✓� (� / �•-�"') ) PERMIT FEES ADDRESS /\ n{ , / / ,,/I) ' % V� FEE }�f'/� NUMBER EACH � ,E NEARST LOCALITY !� E LIGHT OUTLETS q CROSS ST. RECEPTACLES A0 ESn r7p ' WALL SWITCHES i WNER TOTAL OUTLETS _Sc' $ y MAIL x/� ELEC. RANGES 25 ADDRESS '/ U /I« \ ✓"V[ ELEC HEATERS 25 CITY ti 5 TEL. NO. FIXTURES I HEREBY ACKNOWLEDGE THAT 1 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 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER NEW MVD. HP OVER I NC. FEE Eac1+ OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. I / 1/2 &LESS $ .25 SIGNATURE OF 1/2 2 .50 PERMITTEE_�� 2 s 1 00 -INSPECTION RECORD 5 15 1 5o 15 50 2 50 50 200 5,00 200 500 10.00 Soo 1000 15 00 _ Z OVER 1000 20 00 (� M G SET/FREQ CHANGER-HP WELDERS, AC-KVA GENERATORS-KW , TRANSFORMERS-KVA TEMP MOTORS (75%OF ORIG.) MOVED MOTORS (75%OF ORIG.) MISC SIGNS NO. NO. TRANS. APPROVALS_ NO NO LAMPS • DATE INSPECTOR'S NAME FOR EACH PERMIT WIRING $1 00 I CONDUIT FIXTURES $1 00 I WIRING SUPPLEMENTARY 50 1 - FIXTURES , POWER TOTAL'FEE $ UTILITY CO. NOTIFIED ® FINAL 4/4�Z- r� 4. WORKERS' COMPENSATION DECLARATION to/Bt APPLICATION FOR ELECTRICAL PERMIT I hereby,`affirm that I have a certificate of consent to self CE-806G ,.S_I`sure or,a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec 3800, Lab C ) P61 cy No Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished New Residential Bldgs & Pools EACH NO FEE ADDRESS Certified copy is filed with the county building inspec- 1 & 2-Family, Sq Ft $ _ $ LOCALI tion department Multi-family Sq Ft 'NEAREST Residential Swimming Pools CROSS ST OWNER Date Applicant // FIRM NA !� CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec-l—LightLSw AMAIL DDRESS COMPENSATION INSURANCE LLLL First 20 (This section need not be completed if the work involved by Total No Additional CITY Tel the permit is for one hundred dollars ($100)or less.) that in the performance of the work for which this PLA HE K I certify p APPLICANT permit is issued, I shall not employ any person in any manner so ZIC tbecom sublect,to the W ers'Compensation Laws Lighting Fixtures First 20 ADDRESS Total No AdditionalCITY Tel No DaApplic t Fixed Appliances Not Over 1 HP PERMIT NTO APPLICANT If, fte making this Cert ficate ofAPPLICANT Exon, 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 with comply with -such provisions or this permit shall be Top _ FAU —W H — CITY Tel No deemed revoked Hood _ Fan _ Other_ 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 Power Apparatus& Large Appliances DISTRICT NO �` PROCE BY >_ and Professions Code,and my license is in full force and effect OY d Size &Type HP, KW, KVA, or KVAR O License Number Lic' Class Up to 1 Incl FINAL / u Over 1 to 10 Incl DATE Qr[ VALIDATION Q H Contractor Date Over 10 to 50 Incl ((// FINAL U I am exempt under Sec Over 50 to 100 Inc BY, CL B &P C for this reason Over 100 'Z Date Services, Swbd , MCC & Panelboards ► z2562A — 0 -200Amp Under 600V Signature 201 - 1000 Amp Under 600 V Over 1000 Amp or Over 600 V # o 0 0 0 0 2 ❑', ,Exemption for Reg Maint Elect - SINGLE FAMILY Temp Power Pole &Appurtenances o -,1 27 5 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit o o 0 12755 1 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 Q ],2 9—18 5 Professions Code) I, as owner of the property, will do the work and the Misc Conduits'&Conductors structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ , 7044, Business and Professions Code) CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued PERMIT FEE _ (Sub-Total) (Sec 3097, Civ C ) PLAWCHECKING FEE Lender's Name -y� PERMIT ISSUING FEE, V S-0 Lender's Address I certify that I have read this application and state that the TOTAL FEE 7 above-information is correct I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby auth r,ze representatives of this County to enter upon th above- tioned pro erty f r inspection purpos s SEE REVERSE FOR EXPLANATORY LANGUAGE ignature 31 rermitfee Da e WORKERS'COMPENSATION DECLARATION CE-806G (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 JOB Policy No Company EACH' NO FEE ADDRESS 0 New Residential Bidgs &Pools a ❑ Certified copy is hereby furnished. 1 &2-Family,Sq. Ft $ —• $ LOCAL[ OIL le, Multi-family Sq Ft — NEAREST ❑ Certified copy is filed with the county building,inspection CROSS ST Residential Swimming Pools department OWNER OR ' f / _ FIRM NAME Date Applicant Outlets Rec Light Sw MAI L First 2-('-'-- 61 ADDRESS CERTIFICATE OF EXEMPTION FROM WORKERS' Total N�a Additional v CITY Tel No COMPENSATION INSURANCE41 } PLAN CHECK Cl. APPLICANT V (This section need not be completed ,if the work involved by the,permit is for one hundred dollars ($100) or less.) Lighting Fixtures First 20 ADDRESS Additional Total No I certify that in.the performance of the work for which this Fixed Applidnces Not Over 1 HP CITY Tel No permit is issued, I shall not employ any person in any manner PERMITU so as to become subject to the Workers' Compensation Laws' Range_ Heater_D W APPLICANT / a Oven Dryer_W M._ ADDRESS N Z Date Applicant Top FAU _W H _ CITY Tel No Hood i Fan _Other_ �l ? NOTICE TO APPLICANT If, after makmg this Certificate of Disp. Room Air Cond.— .�V C: 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. P OC SED BY with comply with such provisions or this permit shall be Size&Type HP, KW, KVA,or KVAR p deemed revoked (J -Up to 1 Incl .. FINAL _ Over 1 to 10 Incl. DATE LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl VALIDA ON I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 InFINAL -c BY -2133,4,A 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 ' #'o o'0 0 0 2 effect Services , License NumbeLac Class 0-200 Amp. Under 600 V 2 0 - 2.260 r 201-1000 Amp Under 600 V , Contractor Date Over 1000 Amp or Over 600 V o o o 2.2 6 0_J, HOME OWNER-BUILDER DECLARATION Temp. Power Pole&Appurtenances .O 7 1 8,-80 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) � Misc Conduits&Conductors `el I, as owner of the property,' will do the work and the Other (See Complete Fee Scheduler structure is not intended or offered for sale (Section :2 1 33,3 A 7,044, Business and Professions Code). CONSTRUCTION LENDING AGENCY '0 0 0 0 0 1 hereby, affirm that there is a construction lending agency for the performance of,the work for which this permit is PERMIT FEE (Sub-Total) 2 o to 1,11)0 issued (Sec 3097,Civ C) f� Lender's,Name PLAN CHECKING FEE (One-Fourth Permit Fee) V o 0 2 0,'17 '. Lender's Address' PERMIT ISSUING FEE 7 9 / 177, 1 8-80 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 aaz hereby authorize representatives of this County to enter upon If the a e-mentio perty for inspectio/pp oses SEE REVERSE FOR EXPLANATORY LANGUAGE Sign ture o ermt tee D e a - t - t WORKERS'COMPENSATION DECLARATION 76A663 CE-806G (2-80) APPLICATION FOR' ELECTRICAL PERMIT- , I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES �j GBUILDING 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 ADDRESS New Residential Bldgs &-Pools • EACH NO FEE Q Certified copy is hereby furnished 1 &2-Family,Sq Ft $ — $ LOCALIT Multi-family Sq Ft — NEAREST Certified copy is filed with the county building inspection CROSS ST department Residential Swimming Pools OWNER OR FIRM NAME ib i Date Applicant Outlets Rec—Light_ Sw MAIL I First 20 CERTIFICATE OFaEXEMPTION FROM WORKERS' Total No Additional CITY Tel N!, - COMPENSATION INSURANCE PLA HECd ' APPLICANT O' (This section need not be completed if>the work involved Lighting Fixtures First 20 U by the permit is,for one hundred 'dollars ($100)'or-less.) A D D R ESS Total'No Additional ' O I certify that In the performance of the woilc for which thisFixed Appliances Not Over 1 HP - CITY Tel No f permit is issued, I shall not employ any person in any-mannerPERMIT W so as to become,sublect to the Workers' Compensation Laws Range_ Heater_D W. APPLICANT �' O. Oven _Dryer_W M. ADDRESS Date Applicant ; Top _•FAU _WH Hood _ Fan _Other— CITY r Tel No NOTICE TO APPLICANT If, afier 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 PROCE ED BY with comply with such provisions or this permit shall be Size&Type HP,KW, KVor KVAR ^ deemed revoked A, Up to 1 Incl. FINAL Over 1 to 10 Incl. DATE�• //� 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. BY AL 7� 9 (commencing with Section 7000) of,Division 3 of the Busi- Over 100 �r ness and Professions Code, and?my license is m full force and' effect. Services License Number Lw"Class 0-200 Amp Under 600 V �d • .r, . 201-1000 Amp,Under 600 V Contractor`' Date Over 1000 Amp or Ovef 600 V HOME OWNER-BUILDER DECLARATION Temp Power Pole&Appurtenances e 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, Bust- Additional Sign.Branch Circuits 1 1. 2 A ness and Professions Code) # o o'0 0 0 2 Misc Conduits&Conductors _ I, as owner of the property, will do the work and the Other (See Complete Fee Scheduler structure is not intended or offered for`said'(Section 2'° ° 1,,9,'5-0 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY °-° ° 1 9.50 F', I hereby affirm that there Ss a construction lending agency " for the performance of the work for which this permit is PERMIT FEE (Sub-Total) ' (� V7 0-8t=,$0 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 ` 6 above information is correct I agree to comply with all County ordinances and State laws regulating-Electrical wiring, and hereby authorize represe fives of this County to enter upon t e abo >�entione`d pe ty for inspection purpose SEE REVERSE FOR EXPLANATORY LANGUAGE Sig atur o Permrtte Date