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HomeMy Public PortalAbout9932 LIVE OAK AVE_Electrical__ 76A663 DBS SA 11-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES I WILLIAM J. FOX, CHIEF ENGINEER FOR P LICANT T� L IN , DISTRICT NO. GROUP ZONE PERMIT NO. / � 327x2 ELECTRICIANS � • RECEIVED BY READY FOR DATE ISSUED ADDRESS FIRST INSPECTION CITY H ✓ TEL. NO. 19,AMP COUNTY LICENSE NI EX IRES UILDING PERMIT FEES ADDRESS �1 FEE NUMBER EACH; LOCALITY LIGHT OUTLETS NEAREST / ♦ I ' ` CROSS ST. RECEPTACLES .� R WALL SWITCHES •{ OWNER yL'"Lf•/�'V TOTAL OUTLETS 5c $ 118'(0 MAIL ELEC RANGES 25 ADDRESS A ELEC HEATERS 25 2 CITY L✓ 'J EL. NO. FIXTURES 5 1 HEREBY ACKNOWLEDGE THAT I 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 HORSEPOWERANGELES COUNTY LICENSE, OR 1 M THE LEGAL OWNER FEE NEW MVD. HP I OVER NC. EACH OF THE RESIDENTIAL OROPERTY •ESCRI'BED ABOVE. I 1/2 a LESS $ 25 SIGNATURE OF /2 2 .50 PERMITTE 2 5 1.00 INSPECTION RECORD 5 15 1.50 15 50 2.50 50 200 1 5 00 200 Boo 10 oo J 500 1000 1s 00 Q Z_ OVER 1000 20 00 (� M G SET/FREQ. CHANGER-HP O 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 DATje INSPECTOR'S NAME FOR EACH PERMIT CONDUIT WIRING $1.00 I/� WIRING FIXTURES $1 00 �I SUPPLEMENTARY 50 FIXTURES POWER TOTAL FEE $ DSS UTILITY CO NOTIFIEDG�c �- G✓ti 3�2 b © FINAL r �✓' WORKERS'COMPENSATION DECLARATION CE-806G (2-80) APPLICATION FOR ELECTRICAL PERMIT - CE-806 I hereby affirm that I have a certificate' of consent to'self COUNTY OF LOS ANGELES BUILDING AND SAFETY msure,.or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec 3800,Lab C) FOR APPLICANT TO FILL IN JOB I, Policy No Company EACH NO FEE ADDRESS r' ' New Residential Bldgs &.Pools Certified copy is hereby furnished 1 &2-Family,Sq Ft $ — $ LOCALITY ([S (t r Multi-family Sq Ft — NEAREST copy is filed with the,county building inspectiori Residential Swimming Pools CROSS ST Certified department OWNER OK- FIRM - . H FIRM NAME A/ Date Applicant Outlets Rec—Light_Sw MAI L First 20 ADDRES 3 !dl` da Ave CERTIFICATE OF EXEMPTION FROM WORKERS' Total No Additional CITY P(( Tel No f437-0,614 } COMPENSATION INSURANCE PLAN CHECK 06, APPLICANT-. O ' (This section need not be completed if the work involved U by the permit is for •one hundred dollars ($100) or less.) Lighting Fixtures First 20 ADDRESS Total No Additional O I certify that'm the performance of the,work'for which thisCITY' Tel No ermit is issued, I'shall not'emto Fixed Appliances Not Over 1 HP p p y'any person m"any manner PERMIT so as to become subject to-the-Workers' Compensation LAws -Range_ Heater_D W ' , APPLICANT W W CL Oven Dryer_W MU)ADDRESS Top FAU W.H 0 _ Date Applicant CITY Tel Hood Fan —Other_ , NOTICE TO APPLICANT -If, after making this Certificate of 'Dlsp- Room Air Cond. LICENSE OR - Exemption, you should become subject to, the Workers' REG NUMBER Class Compensation provisions of tie Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO P C D BY with comply with such provisions or this permit shall be -Size&Type HP,KW;KVA,or K-VAR a� deemed revoked 6 ; Up to'1 Incl ' FINAL Over 1 to 10 Incl DATE LICENSED CONTRACTORS DECLARATION f r VALIDATION • - Over 10 to 50 Incl • I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc BV AL 9 (commencing with Section 7000) of,Division 3 of the Busi- nessand Professions Code, and my license is in full force and ` vvv effect Services-, d 1 License Number Lic Class 0-200 Amp•Under 600 V ; 201-1000 Amp. Under 600'V. Contractor I'Date Over 1000 Amp 'or-Over 600 V i HOME OWNER-BUILDER DECLARATION Temp Power Pole&Appurtenances 0'8 9 A I he eby affirm that I am exempt from the Contractor's Sign with One Branch Circuit Lic se Law for the following reason (Section 7031 5, Busi-, Additional Sign Branch Circuits #,0.0 0 0 0 2 nes and Professions Code) Misc Conduits 8i Conductors 2 o,o L1 9,5 0 I, as owner of the property, will do the work and the Other (See Complete Fee Schedule)— structure.is not intended or offered for sale, (Section o:o'o 1 9,506 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY ) 0,6,2,5'-8 1 I hereby affirm that there is a construction lending agency 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 I certify that I have read this application and state-that the TOTAL FEE above information is correct.I ;ee to comply with all County or and State s re ating Electrical wiring, and reb au horize s t of this County to enter upon \ the ove- o o for inspectio rposes SEE REVERSE FOR EXPLANATORY LANGUAGE n ire o ermittee Date '