HomeMy Public PortalAbout6415 LIVIA AVE_Electrical__ DBS 5-A 6-46 - . MPLI.ATIO17 FOR PERM
DEPARTMENT of F LOS AN AND sAF ��.,��:��1�:
COUNTY ®� Los ANGELES '
WM. J. FOX CHIEF ENGINEER
a NAME_ DISTRICT NO. GROUP ZONE PERMIT NO.
ADDRESS
C % RECEIVED BY READY FOR DATE ISSUED
CITY TE f]._ FIRST INSPECTION
J COUNTY
w CERT.NO. EXPIRES
APPLICANT FILL IN HEAVILY OUTLINED POR'T'ION ONLY
JOB
DESCRIPTION OF WORD ADDRESS A u M
y. w
NUMBER OF OUTLETS ON CIRCUITS LOCALITY / /'�7 L.� 'A
J T �� �J LC
LOCATION BY ROOMS ,NEAREST /
,
LIGHT OUTLETS JSW. PLUGS FIXT 'CROSS ST. ,aP9 AIJ I`4 A:'A!
CIRCUIT A B C D E F G H w NAME PA 1 APS ,? cd S Yn
Aeo- q -
/ Z MA_IL '7 1 6
3 ADDRE,,,,SS 1 .��� .d 1 LJ!�� � ��
1 O CITY pr ,YJJ/.n
1 AM THE LEGAL. POSSESSOR OF THE ABOd.AN
ANGELES COUNTY CERTIFICATE OF QUALIFICAT
ELECTRIC
i I AM THE LXGAL OWNER OF THE PROPERTY DE
,ABOVEOW
CORRECTIONS
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LNO.
OUTLETS $ APPROVALS
FIXTURES $ DATE INSPECTOR'S NAME
MOTORS H.P. $ CONDUIT
SIGNS TRANS. $ WIRING
RANGES OR HEATERS $ FIXTURES
LANEOUS $ ) POWER
I
PERMIT FEE $ l r UTILITY CO.NOTIFIED i/
TOTAL FEE IU_'Q FINAL
DBS 5-A 12-4-4 "rY.1CATIO FOR YlGOYlY
DEPARTMENT OF BUILDING AND SAFETY ELEC"IrL IC
COUNTY OF LOS ANGELES
WM. J. FOX CHIEF ENGINEER
NAME B. DISTRICT NO. GROUP ZONE PERMIT NO.
ADDRESS
FF
1 R$ EIVED BY READY FOR ll DATE ISSUED
CITY K L.NO. / FIRST INSPECTION �.� �� �
COUNTY C U (
CERT.NO. EXPIRES
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
JOB DESCRIPTION OF WOVE; ADDRESS ' / !J I IFi
NUMBER OF OUTLETS ON CIRCUITS LOCALITY
LOCATION BY ROOMS
NEAREST p ` p
LIGHT OUTLETS SW. PLUGS FIXT CROSS ST /1' e AY/ y
CIRCUIT A B C D E F G H NAME 1 IQ 0
Z MAIL
ADDRESS O G GI AP.
O CITY R)°AG 2, TEL.NO. 7
1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE OF QUALIFICATION..
i ELECTRICIAN.
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE
0 I
/ d OWNER.
CORRECTIONS
J
Q
Z_
L7
O
TOTAL
NO. OF OUTLETS $ rA APPROVALS
NO. OF FIXTURES A $ C/ DATE INSPECTOR'S NAME
NO. OF MOTORS H.P. $ CONDUIT
NO. OF SIGNS TRANS. $ WIRING ,
NO. OF RANGES OR HEATERS $ FIXTURES
MISCELLANEOUS $ 1 POWER
PERMIT FEE �y �� $ _UTILITYCO.NOTIFIED i. . 1` n P
TOTAL FEE !� FINAL
D ��PPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES ELECTRIC
WM. J. FOX CHIEF ENGINEER
Q NAME r DISTRICTZ
NO. GROUP ONE PERMIT NO.
U ADDRESS
W CITYQ� T RECEIVED BY READY FOR DATE ISSUED
/[ FIRST INSPECTION
J COUNTY
W CERT.NO. EXPIRES
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
JOB
DESCRIPTION OF WORK ADDRESS
NUMBER OF OUTLETS ON CIRCUITS LOCALITY J fi
LOCATION BY ROOMS
NEAREST p
LIGHT OUTLETS SW. PLUGS FlXT CROSS ST !i
CIRCUIT' A B C D E F G IH w NAME �I IALd
A 1� 9�/ _
2 M IL
ADDRESS / J A A 1,, e
3
CITY 6 A/?,, eTEL.No./ 3 -IK-'X,�)
I AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE OF QUALIFICATION..
ELECTRICIAN.
1 AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE 44
v v OWNER.
CORRECTIONS
ti
J
Q
Z
TOTAL
NO. OF OUTLETS / $ APPROVALS
NO. OF FIXTURES $ DATE INSPECTOR'S NAME
NO. OF MOTORS H.P. $ CONDUIT
NO. OF SIGNS TRANS. $ WIRING
NO. OF RANGES O EATERS (� $ FIXTURES
MISCELLANEOUS S $ POWER
PERMIT FEE / $ UTILITY CO.NOTIFIED
TOTAL FE Q (j FINAL l a
76A663-CE806 8-62 APPLICATION 'FOR ELECTRICAL PERMIT
- COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING d
BUILDING AND SAFETY DIVISION ADDRESS I Vi'u cTtlE
JOHN A. LAMBIE. COUNTY ENGINEER rd-
�}}� pp
WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY rd--",0 � �j�� � � AIo
NEAREST
FOR APPLICANT TO FILL IN CROSS ST. �O
RECEPT TOTALNO EACH FEE
OUTLETS FIRST 20_/0 $2O $ OWNER
LIGHT ® ADo'L .1O MAIL
ADDRESS
H
SWITC1 0 OVER 2O
LIGHTING I TOTAL F1RST20 .20 CITY /r `. //' TEL NO Q��p /I
FIXTURES 1IS -6— ADD'L 10
ELECTRICIAN e'l -
OV R 20 - _p
RANGES CLO DRYERS WTR.HTRS. 1.00 ADDRESS
GARB.DISP. STA.COOK
CITY, TEL NO.
DISHWASH AUTO.-WASH STATE
SPACE HTRS STA.APP.(v,H.P.MAX.) ,50 LICENSE NO.
MOTORS OVER NOT OVER . H P. DISTRICT137 P Z PR FjD Y
_0y I0 1 100
1 3 150 INSPECTION RECORD
3 8 2.00
8 is 2.50
15 50 300
O_
50 100 5,00 0
SIGNS NO.TRANS
NO LAMPS O
SERVICE 0.60OV-NOT OVER 200A too tL
CL
SERVICE 0.60OV-OVER 200 A. 200 Z
SERVICE OVER 600V 5.00
MISC.
PERMIT ISSUING FEE 200
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE $
IH
ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSP S SIGNATURE
AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING,
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL EOWaNEROFHE AB VE
DESCRIBED RESIDENTI R ERTY POWER
SIGNATURE UTILITY CO.NOTIFIED 1/7
OF PERMITTEE
FINAL ✓
VAIIDATl9 ARTHUR V
SUPE
' CK M�CASH SUPERVISING ELECTRICAL ENGINEER
LACO 0 ,3 8 7Q SEP19 2 0 5.0 OM
l�,l� I� 2 I1 2/� /� I� 1 `
WORKERS'-GOMPENSATION DECLARATION 76A663 10/81 Gl P OP C /�5'1 �ON FOR EL E C��n MCAD FI.2f[D1� OT
I h y affirm that I have a certificate of consent to self CE-8066 G�1[f"I�L� `a�G�1 N Ili 111 U fSlIl@9kl
in ai atertificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES Ir �( BUILDING AND SAFETY 1
or a certified copy Thereof (Sec 3800, Lab C /
Policy No ` Compan FOR APPLICANT TO FILL IN JOB
Certified co is here urnished EACH NO FEE ADDRESS
PY New Residential Bldgs & Pools .
' —
�- Certified co s filed with the•counTy building m 1 & 2-Familspec- Y. Sq Ft $ $ LOCALITY C,—
tion de ment Multi-family Sci Ft NEAREST
CROSS ST.
Residential Swimming Pools OWNER OR ,
Dat Applicant
FIRM NAMEAZ
CERTIFICATE-OF EXEMPTION FROM WORKERS" MAIL
COMPENSATION INSURANCE Outlets Rec Light Sw_ ADDRESS '
Tis section need not be completed if the woik involved b
First 20
( htip Y Total No – CITY ( Tel No
the permit is for one hundred dollars($100)or less.) Additional << '
� PLAN CHECK
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
so as to-become subject To the Workers'Compensation Laws Lighting Fixtures First 20 ADDRESS
Total No Additional
f( CITY Tel No
Date Z''V pplIcant ""y 1 Fixed Appliances Not Over 1 HP PERMIT
NOJCY TO APPLI ANT If, after making this Certificate of APPLICANT J
ExerrVtion, you should become subject to the Woikers' 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 —
deemed revoked Hood Fan _Other_ CITY , Tel No
LICENSED CONTRACTORS DECLARATION LICENSE OR +7
I hereby affirm that I am licensed under provisions of Chapter 9 Disp — Room Air Cond REG NUMBER J(� L Class 1
(commencing with Section 7000) of Division 3 of the,Busmess DISTRICT NO PROCESS BY
and Professions Code,and my
license is in full force and effect Power Apparatus&Large Appliances (� •, 0.
0.
Size &Type HP, KW, KVA, or KVAR �ir�() Q
License NumbecT2 'j 6J CV 1 D--Lic Class --��yy--�� Up to 1 Incl FINAL - V
� lr Over 1 to 10 Incl DATE �� VALIDATION Q
Contractor , Date ((// Over 10 to 50 Incl
OFIN U
I am exempt under Sec Over 50 to 100 Inc FBy W
B&P C for this reason / Over 100 Z
'Services, Swbd , MCC & Panelboards D ' —•
ate 0 -200 Amp,Under 600 V
Signature 201'- 1000 Amp Under 600 V
Over 1000 Amp or Over 600 V
Exemption for Reg Mai Elect $'2 1,'b A
SING FAMILY Temp Power Pole.&Appurtenances ' {o i o t o o 10•2
HOME OWNER UILDER DECLARATION Sign with One Branch Circuit
I hereby affirm that I a2/exempt from the Contractor's License Additional Sign Branch Circuits,, 2 o ro'3 2 rj d
Law/7044, usiness
ollow n reason (Section 7031 5, Business and
Profde)
Misc Conduits&Conductorsn
n r of the property, will do the work and the 0 2'8-'84
is not intended or offered for sale (Section Other (See Complete Fee Schedule)—
usiness and Professions Code)CONSTRUCTION LENDING AGENCYI hethat there is a construction lending agency for
the nce of the work for which this permit is issued PERMIT FEE (Sub-Total)(Se , iv C�)
PLAN CHECKING FEE
ender's Name
PERMIT ISSUING FEE p V
Lender's Address
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 represe totives of this County to enter upon
the —fveent;ioZcl pert for inspection_purposes
SEE REVERSE FOR EXPLANATORY LANGUAGE
Z.�
Signature of Permittee Dale