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HomeMy Public PortalAbout9232 LIVE OAK AVE_Electrical__ 76A663CE-806(6/78) APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN JOB C ADORES vL„/� New Residential Bldgs:&Pools EACH NO. FEE 1 &2-Family,.Sq. Ft. $ .025 — Is LOCALITY / Multi-family Sq. Ft. ..02 NEAREST Residential SwimmingPools 25.00 — CROSS ST. OWNER OR FIRM NAME Outlets: Rec Light Sw. MAIL First 20 50 ADDRESS , Total No. Additional .30 CITY Tel. No. PLAN CHE APPLICANT Lighting Fixtures First 20 .50 ADDRESS Additional .30 Total No. CITY I. Fixed Appliances Not Over 1 HP P IT ,per Range_Heater_ D.W. _ vV Oven—Dryer_ W.M. ADD li�4e_ Top _FAU — W.H._ CITY � i Tel. No. Hood_Fan _Other_ LICENSE OR Disp._Room Air Cond. 2'50 REG.NUMBER / CI ss. — 555 IHEREBY HAT I HAVE READ THIS APPUCA Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO Size&Type HP, KW, KVA,or KVAR COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRIC a Up to 1 Incl. 2.50 0 I/ASR IFY T IAM RO RLY REGISTERED AND/OR Over 1 to 10 Incl. 5.00 LICENSUIRE LOS A G S COUNTY AND STATE OF 12.50 CALIFOIAM THE L OWNER OF THE ABOVEOver 10 to 50 Incl. Qo 29 Over 50 to 100 Inc. 25.00 DESCRINTI �ROPERTOver 100 40.00 PERMIT /® �Fi�SIGNA (/ � Services DISTRICT NO. a P SE BY 0-200 Amp.Under 600 V 12.50 �' 4 — --� 201-1000 Amp. Under 600 V 25.00 Over 1000 Amp.or Over 600 V 50.00 'O` j Temp. Power Pole&Appurtenances 10.00 `J / la � � y �f Sign with One Branch Circuit 10.00 / Additional Sign Branch Circuits 2'00 INSPECTION > INFORMATION Misc.Conduits&Conductors 10.00 ON REVERSE s Other(See Complete Fee Schedule) SIDE v Q1 2 2 2 A Z a J 0. 9 0 0 0 O o 2 i I -] PERMIT FEE (Sub-Total) 2 A o ,3200 Z PLAN CHECKING FEE (One-Fourth Permit Feel p x - 32005 y r PERMIT ISSUING FEE $7.00 �/ c 1.08-78 J TOTAL FEE INSPECTION FINALED W date: ��� /a Q By ©s WORKEPSdit I have a CION DECLARATION CE-806 10/81 APPLICATION FOR ELECTRICAL PERMIT J here♦Jy'dffirm'thcit ( have a certificate of consent to self CE-806G Snsare, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certifie I cc0py therreeo�,fff (Sec. 3800, L b C.) Policy No. O` D Company �d FOR APPLICANT TO FILL IN JOB �' r �L� ❑ Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS — G r ❑ Certified copy is filed with the cou y building i pec- 1 & 2-Family, Sq. Ft. $ $ LOCALITY _ tion department. Multi-family Sq. Ft. — 'NEAREST CROSS ST. Residential Swimming Pools Date 3 — Applican OWNER OR _ FIRM NAME d.4V CA PC.,-ro CER IFICATE OF EXEMPTION FROM WOR KE Outlets: Rec�Li ht � MAIL 3 g �Sw. COMPENSATION INSURANCE 20 ADDRESS (This section need not be completed if the work involved by First Total No. Additional CITY the permit is For one hundred dollars ($100)or less.) �, L4 Tel. No.fj PLAN CHEC I certify that in the performance of the work for which this APPLICANT permit is issued, I shall not employ any person in any manner 2 so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ✓ ADDRESS Total No. J Additional CITYTel. No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT `` rl"�C"fi ' � ,, NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT W4Z/�J71�r � CC/k• Exemption, 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 ,9 with comply with such provisions or this permit shall be Top _ FAU —W.H. — deemed revoked. Hood Fan _Other_ CITY Tel. No. LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provision's 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. `� PRO S D BY and Professions Code,and my license is in full force and effect. i Size & Type HP, KW, KVA, or KVAR' License Number 3Q ZU 7— Lic. Class Up to 1 Incl. U FINAL ��-� 3 1 Over 1 to 10 Incl. DATE fd 2 VALIDATION Contractor Date _ / Over 10 to 50 Incl. FINAL a ❑ I am exempt under Sec. Over 50 to 100 Inc. BY n, � B.&P.C. for this reason Over 100 T Date: Services, Swbd., MCC & Panelboards ► 0 -200 Amp. Under 600 V 2`1 7 2.8 A Signature 201 - 1000 Amp. Under 600 V ❑ Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V # 0o o o o 2 4 o o 3 6,0 Q SINGLE FAMILY Temp. Power Pole& Appurtenances U HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 0 0�0 3 6. 0 QFI I 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 3 2 -$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.). PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address I certify that I have read this application and state that the TOTAL FEE t above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize representatives f this County to enter upon throve-m ntioned pr erty inspection purpose /✓! SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of mitt D e WORKERS' CI have cerci DECLARATION CE-806 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby affirrrl that I have a certificate of consent to self CE-806G insure, or a certificate of•Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec. 3800, Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS Ae 1 & 2-Family, S Ft. $ — $ LOCALITY 4 Certified copy is filed with the county building inspec- Y, q ` tion department. Multi-family Sq. Ft. — NEAREST CROSS ST. Date Applicant Residential Swimming Pools OWNER OR ��j y FIRM NAME G. CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec2zbghY��SwR MAIL COMPENSATION INSURANCE First 20 d ADORES W (This section need not be completed if the work involved by Total No. — CITY Tel. No. the permit is for one hundred dollars ($100)or less.) Additional ✓Z that in the performance of the work for which this PLAN CHECK I certify P APPLICANT permit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compenscltjon Laws. Lighting Fixtures First 20 ADDRESS _ Total No. Z 7 Additional 1 CITY Tel. No. Date ` G Applica Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after ming this Ce ificate of APPLICANT Exemption, you should become subject to the Workers' Range_ Heater D_w' Compensation provisions of the Labor Code, you must forth- Oven _ Dryer W.M.T ADDRESS leq with comply with such provisions or this permit shall be Top _ FAU W.H. — deemed revoked. CITY Tel. No. Hood LICENSED CONTRACTORS DECLARATION _ Fan _Other— LICENSED Room Air Cond. LICENSE Class. I hereby affirm that I am licensed under provisions of Chapter 9 . . REG. NUMBER (commencing with Section 7000) of Division 3 of the Business DISTRICT NO. PR S BY and Professions Code, and my license is in full force and effect. Power Apparatus& Large Appliances (� O, Size 8 Type HP, KW, KVA, or KVAR' (J<J (� License Number Lic. Class Up to 1 Incl. FINAL Over 1 to 10 Inc!. DATE pt�Z(Q % -VALIDATION � Contractor Date Over 10 to 50 Incl. 0 FINAL I'l ❑ I am exempt under Sec. Over 50 to 100 Inc. BY p., B.&P.C. for this reason Over 100 Z Date: Services, Swbd., MCC& Ponelboords ► 0 -200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V ❑ Over 1000 Amp. or Over 600 V Exemption for Reg. Maint. Elect. SINGLE FAMILY Temp. Power Pole & Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I 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 Prof ssions Code): I, as owner of the property, will do the work and the Misc. Conduits& Conductors 9 5 9 2.7 A structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ ► 7044, Business and Professions Code). # 0 0 0 0 0 2 CONSTRUCTION LENDING AGENCY I a - 9225 1 hereby affirm that there is a construction lending agency for o 0 0 9 2 2 5.5) the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). 1. 13-86 PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address 7i 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 thebove-mentione operty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE gn re ofPermittee/ Date