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HomeMy Public PortalAbout6436 LIVIA AVE_Electrical__ 76A663-CE80610-6I APPLICATION FOR ELECTRICA PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEERBUILDISNG / BUILDING AND SAFETY DIVISION ADDRES 6 JOHN A. LAMBIE, COUNTY ENGINEER T WILLIAM A.JENSEN, SUPT OF BUILDING LOCALITY CI NEAREST FOR APPLICANT TO FILL IN CROSS ST. I T E M NO. EACH FEE OUTLETS: (FIRST 20) $.20 $ .� OWNER _�DBl� C�AE,�ESEIL/ LI. RECEPT. SW. MAIL OUTLETS: (ADD'L UNITS) .10 ADDRESS IA S7 LIGHTS RECEPT. SW. T LIGHTING FIXTURES: (FIRST 20) .20 CITY / TEL. NO. LIGHTING FIXTURES: (ADDITIONAL) .10 ELECTRICIAN //G RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS/42e):? Ala- GARB.DISP. STA.COOK / CITY ,Q Q410 TEL. NO DISHWASH. AUTO.-WASH. STATE / SPACE HTRS. STA.APP.(l/.H.P.MAX.) .SO LICENSE NO. 16¢3 AO MOTORS: OVER NOT OVER H.P. DIS15ICT NO. GROUP ONE PSSED BY O 1 Z 1.00 1 s ,� ,'Z 1.50 /�Q INSPECTION RECORD r - - - - CL 3 8 2.00 O 8 15 2.50 ----- --- - - — V 15 50 3.00 ----- - -- -- ---- ------- 50 100 5.00j _ d SIGNS: NO.TRANS. N NO.LAMPS z SERVICE 0-600V-NOT OVER 200A A 1.00 SERVICE 0.600V-OVER 200 A. 2.00 SERVICE OVER 600V 5.00 MISC. PERMIT ISSUING FEE 2.00 SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE $ IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING - ELECTRICAL WIRING. WIRING 1 HEREBY CERTIFY THAT AM PROPERLY REGISTERED A � R LICENSED AS REQUIRED B OS fNOGELES COUNTY AND S E F FIXTURES CALIFORNIA OR THAT I LEGAL OWNER O T A VE DESCRIBED RES NTIAL PERTY. POWER SIGNAT / UTILITY CO.NOTIFIED OF PER TTEE a r _ FINAL 1 (DATION ARTHUR C. VEIT t)' O CASH SUPERVISING ELECTRICAL ENGINEER V;l,o 4 8 1 y: GC71 3 D J WORKERS' COMPENSATION DECLARATION `76A663 oPw3 e7 APPUCAMN FOR ELECYPHICAd PERNT I Hereby affirm that I have a certificate of consent to self CE°�G nsur'e,or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS 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 4-3 4e LviCts FCertified copy is filed with the county building inspec- 1 & 2-Family, Sci Ft $ — $ LOCALITY �{J tion department Multi-family Sci Ft — NEAREST r Residential Swimming PoolsCROSS ST Date Applicant OWNER OR ✓J /1 / FIRM CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec Lr ht b Sw q MAIL ��" NAME G.C✓t l.i COMPENSATION INSURANCE g r /b 4Q ADDRESS -3 -1 V f G( First 20 0 (PnL �Q )^ r7 (This section need not be completed if the work involved by Total No Z Additional CITY Tel No the permit-is for one hundred dollars ($100)or less.) I certify that in the performance of the work for which this PLAN CHECKAPPLICANT 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 Additional Total No CITY Tel No Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO-APPLICANT If, after making this Certificate of APPLICATION 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 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 Disp — Room Air Cond — REG NUMBER Class I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000)of-Division'31 of the Business Power Apparatus&Large Appliances DISTRICT NO PROCESSED BY >_ and Professions Code,and my license is in full force and effect 5 t1 Size &Type HP, KW, KVA, or KVAR -- � "�` O License Number Lrc Class Up to 1 Incl IINALI.,4n U Over 1 to 10 Incl DATE Contractor Date I/ V CIDATION 0 El Over 10 to 50 Incl FINAL O I am exempt under Sec Over 50 to 100 Inc BY U W B&P C for this reason Over 100 d D Services, Swbd , MCC& Panelboards Z Date Z 0-200 Amp Under 600 V Signature 201 - 1000 Amp Under 600 V F] Exemption for Reg Maint Elect Over 1000 Amp or Over 600 V SINGLE FAMILY i I)EM'-' Temp Power Pole &Appurtenances HOME OWNER-BUILDER DECLARATION � i 1 —�•� �• 1 hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit 1 COAL 3 a - 30 Law for the_following reason Section 7031 5, Business and Additional Sign Branch Circuits 'yrSC; 9 ( t_•Ht•i'i Professions Code) r dirt nl It I, as owner of the property, will do the work and the, Misc Conduits&Conductors r r" GE structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ D Business and Professions Code) CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for t1 i fi int the performance of the work for which this.permit is issued PERMIT FEE (Sub-Total) Q (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 Jo{�gL� above information is correct I agree to comply with all County ordinances and State jaws regulating Electrical wiring, and hereby authorize representatives of this County to enter upon the above- ntioned roperty for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Sign t e P ittee Date i i `. WORKERS'COMPENSATION DECLARATION zo-ooeDPW aia7 n ������y��Onn ��� ���������� ������ O I hereby'-affirm that I have a certificate of consent to self CEA ( (J �f n re, ora certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS "or certifit?d copy ther@of(Sec 3800, Lab C ) Polity No Company FOR APPLICANT TO FILL IN JOB / / / ? /� 4 FICertified copy is hereby furnished New Residential'Bldgs & Pools EACH NO FEE ADDRESS b L �� vE ( C, Certified copy is filed with the county building inspec- 1 & 2-Family, Sq Ft $ — $ LOCALITY fion department Multi-family Sq NEAREST Ft CROSS ST LoiV Ute/ r Residential Swimming Pools OWNER T Date Applicant T /� I • ` FIRM NAME W(/ / � C �V CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec�bght 2- Sw MAIL ✓ COMPENSATION INSURANCE First 20, U ADDRESS (This section need not be completed if the work involved by CITY Tel No the permit is for one hundred dollars ($100)or less.) Total No Additional that in the performance of the work for which this PLAN CHECK I certify P APPLICANT 619w/^/• T, Cy/(l 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 ,0 ADDRESS s 19B✓ Additional Date Applicant Total No CITY Tel No �-{J31�� NOTICE TO APPLICANT If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT Exemption, you should become subject to the Workers' Range— Heater—D W APPLICATION n Compensation provisions of the Labor Code, you must forth- Oven — Dryer —W M — ADDRESS 5,f"f / �t tI with comply with such provisions or this permit shall be Top — FAU —W H — deemed revoked Hood — Fan —Other— CITY Tel No r LICENSED CONTRACTORS DECLARATION LICENSE OR Disp — Room Air Cond — REG NUMBER Class I hereby affirm that I am licensed under provisions of Chapter 9 ' (commencing with Section 7000)of Division 3 of the Business Power Apparatus & Large Appliances DISTRICT NO P ESSED BY >- and Professions Code,and my license is in full force and effect YP C �-�� d Size &Type HP, KW, KVA, or KVAR �/�=-2-��� Q License Number Lic Class Up to 1 Incl FINAL U Over 1 to 10 Incl DATE VALIDATION IM Contractor Date ElOver 10 to 50 Incl FINAL [[ O I am exempt under SecOver 50 to 100 Inc BY U W B&P C for this reason Over 100 k�> CL Services, Swbd , MCC& Panelboards D Z U) Date - 0-200 Amp Under 600 V Signature 201 - 1000 Amp Under 600 V Exemption for Reg Maint Elect Over 1000 Amp or Over 600 V SINGLE FAMILY Temp Power Pole &Appurtenances HOME OWNER-BUILDER DECLARATION I hereby affirm that Im oexempt from the Contractor's License Sign with One Branch Circuit h3r:_ T=as Law for the following reason (Section 7031 5, Business and Additional Sign Branch Circuits I_ ProPfessions Code) -l7 I, as owner of the property, will do the work and the Misc Conduits & Conductors I ! ErG structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ D TOTAL I i�� 10 Business and Professions Code) 0 CONSTRUCTION LENDING AGENCY �•HLi- t =1f I hereby affirm that there is a construction lending agency for C;Hfrt1`]E the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) 80 (Sec 3097, Civ C ) PLAN CHECKING FEE i 3f s-€it ilj Lender's Name ;� � ''s :i PERMIT ISSUING FEE Lender's Address ri {°= 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 f 1A%/,�i0/Z Jt77X)M"✓ hereby authorize representatives of this County to-enter upon _ 1 the above-mentioned property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Signre of ermittee Dat ` ©s