HomeMy Public PortalAbout10216 LIVE OAK AVE_Electrical__ 7SA663 DBS 5A 3-50 - APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY�
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOR�AP'PlLICAyT TO FILIZ IN DISTRICT NO. GROUP ZONE PERMIT NO.
ELECTRICIA �X A A —3—~ / �_/ ea."-05
ADDRESS �� / , RECEIVED BY READY FOR DA E 1 ED
ln-MFIRST INSPECTION -� �� /�/
CITY TEL.NO. N /
COUNTY LICENSE NO. /l& EXPIRES ABUILDING
DDRESS
PERMIT FEES
FEE
NUMBER EACH LOCALITY
7
LIGHT OUTLETS � NEAREST
/1
RECEPTACLES CROSS ST.
WALL SWITCHES 115 OWNER
TOTAL OUTLETS SC $ MAIL
ELEC. RANGES 25 ADDRESS
ELEC. HEATERS 25 CITY TEL NO.
FIXTURES 5
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
MISC. A
``_ APPLICATION AND STATE THAT THE ABOVE IS CORRECT
J
NUMBER OF LIGHT CIRCUITS 3 AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING.
MOTORS I CERTIFY THAT 1 POSSESS THEEABOVE VALID LOB
NUMBER HORSEPOWER ANGELES COUNTY LICENSE, OR 1 AM/THE LEGAL OWNER
NEW Mw. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESSCRIBED ABOVE.
%2 A LESS $ .25 SIGNATURE OF
I2 2 .50 PERMITTEE
2 s 1.00 'INSPECTION RECORD
s 15 1.50
15 50 2.50
50 200 6.00
200 500 10.00 J
500 1000 15.00 Z
OVER IOOO 20.00
M.G. SET/FRED. CHANGER-HP Q'
WELDERS:AC-KVA O
GENERATORS - KW
TRANSFORMERS - KVA
TEMP. MOTORS (75% OF ORIG•)
MOVED MOTORS (75% OF ORIG.)
MISC.
SIGNS
NO. NO.TRANS. APPROVALS
NO. NO. LAMPS _
FOR EACH PERMIT: DATi INSPECTOR'S NAME
WIRING $1.00 119 10 CONDUIT I /
FIXTURES $1.00 WIRING / i1.,,., 0 4/
SUPPLEMENTARY ,50 FIXTURES d v� 'CL `,�I7•t►'>•.
POWER
TOTAL FEE >a ® UTILITY CO.NOTIFIED _
FINAL �-
WORKERS'COMPENSATION DECLARATION CE-806 10/81 g�PP KATION'F®R FLEATRIAL , PERMIT
CE-806G ,- � Q-91r" IL IIV� 'ts IL PERMIT
?: _ - •
I rm that•I have a certificate of consent to self Insure,
oI a icate ofWorkers'.Compensation,lnsuranc'e, or,a certified',' r 'COUNTY OF LOS ANGELES 'BUILDING AND SAFETY,.' f
copy thereof(Sec 3800.Lab C-)
_
Policy No 230735-'-,Company Pfac i.f,i c Nat i ona 1 I• S`. FOR,APPLICANT.TO FILL IN ":' ' JOB ,�•' '
' • ,ADDRESS' •��! 1' _
Certified copy,is hereby furnished- New Residential Bldgs'& Pools ., EACH' NO- FEE `
1 & 2-Family,Sq Ft $ $ LOCALITYtt-
Certified'copy'is file6•with'the co nt `buildi ! ''inspection a
? department'' Multi family,Sq Ft — ;NEAREST
77
CROSS,ST
Date 4. Applicant' Residentiaf,Swimmmg Pools
•; OWNER OR I
K n
- ', -, - kl'`•''=a: •" ,` »_ Y ,FIRM NAME
.• 'CERTIFICATE.OF EXEMPTION FROM KERS' ' '`r e! t -' 'MAIL
Outlets Rec'— Light — Sw 4
COMPENSATION INSURANC , r 'b ADDRESS JVI
" First 20
(This section need not be,completed If the work Involved by the CITY
Q permit Is for orie•hundred,dollars($,1P0),or less) Total No M Addrtional _54.
I certify that in the`performance of•the.work"for which this permit PLAN CHECK.
I i APPLICANT
Is Issued, I`shalloot%employ'anw,person uo.any mariner, so as to
f LI hhn Fixtures " First 20 ADDRESS'
become subject.,to;the Workers Compensation,Laws 9 ,9 ,
Additional„ v*., s _
Total No CITY; _ -Tel No
Date "Apphcanb F ;Fixed Appliances Not Over,1.HP, PERMIT.
NOTICE TO ,APPLICANT•;If,"after- making this'Certificate of' + t APPLICANT_ ,.G•, &'�S• E'1 ec tr i c-
Exemption,you should become subject to the,Workers'Compensation -. Range_ Heater_ D W ,
provisions of,the Labor,Code;nyou`must forthwith comply,with such Oven,� r _ W M ADDRESS,531 r S: At 1 a nt 1 C B 1 V d: . ' '
provisions orsthis permit shall be deemed revoked ', Top' FAU WH-- r CITY Monterey Pdr;k Tel.'N13 17
LICENSED,CONTRACTORS DECLARATION Hood — Fan' Other _
I hereby affirm that�l,am,licensed under provisions„of•Chapter 9 d Dis Room Air Cond '_', LICENSE OR,' - RO 7 C_1'Q
(commencing with Section•7000)'_
of Division 3 of the;Business and p u REG NUMBER 2`I V05/ Class"
Professions,Code,and my license is in full force and effect ' ` - ,•" DISTRICT NO _ PROCESSED Y �'
Power-Apparatus&'Large Appliances
r tiSize,& Type HP,KW,KVA,or KVAR' v` + vq ' O
License Number -2'48057- Lic Clas's G 1 0 r FINAL m, U
C Up to•1 Incl
OVer 1'to 101ncl, DATE %p
�Cont�actor «&--S. 1"P r l bate J ((JJ VALIDATION.- Q
❑ Over 10 to 50 Incl FIN ~
I`am exempt under Sec Over.50 to 100 Inc• t " ;+ U
B :ct,•ar
Over 100
B&P C for this reasori CA
„ y Services,Swbd,MCC,&'Panelboards .'
bate- 0-200 Amp,Under 600 V, V
Signature ki,, 1000 Amp Undei°800,V, `.�°a
Over 1000 Amp or Over 600 V, -
Exemption for Reg Mamt Elect
�. SINGLE FAMILY =Temp:Power,Pole•& Appurtenances
HOMEOWNER-BUILDER DECLARATION Sign with One Branch Circuit
I hereby affirm that I am exempt from the Contractor's License Law v
fo'r the following reason (Section,7031 5,Business and Professions Additional Sign Branch Circuits ACCT.i`•"
Code)
❑ , Misc Conduits&Conductors t 1-1-TEM
I,as owner of'&property,will do the work and the•structure rP ~
( Other•(See Complete Fee Schedule) a ; ',',;.' �o 00
_ ,Is not Intended or offered for sale Section 7044,'Busmes§ _
and Professions Code) -i �,` �.• r}p �y
MCK
CONSTRUCTION LENDING AGENCY "L7cSJLt
a. :-
I-hereby'affirm'that there is,a'construction tending agency_ for the :"•
performance of the woek'for which this permit Is,issued(Sec 3097,
PERMIT-FEE "'• (Sufi-Total)'
}
Civ C) I f k3+
'PLAN CHECKING FEE - �O00—Q�11' 6/28/89
Lender's Name 1��2t1
PERMIT ISSUING FEE ;1 - 4234-
Lender's Address GAA
I-certify that'l have read this application,and state that the above- TOTAL FEE_ .,
information is correct I agree to comply with all County ordinances t
and State la s regulating Electrica wrong, and hereby authonze
representativ, of is County.to
er•upon t above-mentioned ;
property for sp t n purposes r -° SEE REVERSE FOR EXPLANATORY LANGUAGE
r�
a4gapilk,ejf er rttee D to G 9 ;