Loading...
HomeMy Public PortalAbout5312 LOMA AVE_Electrical__ 76A663-CE806 10/72nn PP)I C n IMN R ELECT M /�,\/rl L PERNT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER , JOB BUILDING AND SAFETY DIVISION ADDRESS LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST OUTLETS NO EACH Ill FEE OWNER OR $ 5 FIRM NAME RECEPT MAIL FIRST 20 25 ADDRESS LIGHT- TOT L CITY TEL NO Q SWITCH OVER 20 10 PLAN CHECK LIGHTING TOTAL FIRST 20 25 APPLICANT FIXTURES , OVER 20 ADDRESS � RESIDENTIAL APPLIANCES CITY L. NO PERMIT RANGE DRYER_WTR HTR APPLICANT STA COOK DISP F A U ADDRESS SPACE HTR. AIR COND CITY TEL NO CLOTHES WASH DISHWASH LICENSE OR CLASS. REG. NUMBER FAN OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AN STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING W ITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND HEATERS, ETC HP KW KVA ELECTRICAL WIRING SIZE & TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 - 1 100 LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AN STATE OF CALIFORNIA OR THAI I AM THE LEGAL 0 NER OF HE ABOVE a 1 - 10 300 DESCRIPED RESIDIAL PROPERTY U 10 - 50 500 PERMITEESIGNATURE O F- 50 - 100 1000 v DISTRICT NO ROCES ED BY W d 1 00 - 500 1500 \ Z i SIGN, GAS SIGN AND ONE CIRCUIT 500 1 APPROVALS DATE INSPE--K SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 TEMP. POWER POLE SERVICE NOTOVER600VOLTS OR200AMP 300 UNDERSLAB WORK SERVICEOVER 600 VOLTS OR 200AMP 1000 ROUGH CONDUIT TEMPSERVICE,POLE, &APPURTENANCES 500 WIRING ,�o -7N TEMP LIGHT OR RECEPT, SYSTEM 300 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED T- a FINAL PERMIT FEE (SUB TOTAL) NOTES PLAN CHECK FEE PERMIT ISSUING FEE 300 66 TOTAL FEE PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK M 0 CASH 9.0 Q otIo SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE �6A663-CE806 10/74 APPUCAMN FOR ELEC�CAL PERWr COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER EADDRESS BUILDING AND SAFETY DIVISION TYNEAREFOR APPLICANT TO FILL IN ST OUTLETS no EACH FEE O N NAME RECEPT.� MAIL $ $ ADDRESS / AlLIGHT IO TOTAL FIRST 20 J �`` CITY Tt _ TEL NO ISWITCHA2_ 11L OVER 20 �TO �• PLAN CHECK LIGHTING TOTAL FIRST 20 / a APPLICANT FIXTURES Ll OVER 20 / 54 ADDRESS RESIDENTIAL APPLIANCES clrY TEL No PERMIT, RANGE DRYER WTR. HTR APPLICANT STA COOK DISP F.A U ADDRESS / SPACE HTR. AIR COND. CITY r - TEL. NO.,AZ` CLOTHES WASH. f�DISHWASH LICENSE IC NNUMBER CLASS. FAN OTHER 100 D 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND HEATERS, ETC HP KW KVA ELECTRICAL WIRING SIZE,& TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTER AND/OR 0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AN STATE OF CALIFORNIA OR THAI I AM THE LEGAL OW ER O HE ABOVE C- 1 - 10 300 DESCRIBED RESIDENTIAL PROPERTY , V PERMITEE 10 - 50 500 SIGNATURE CD _ U 50 - 100 1000 DISTRICT N0. OC ED BY cn � JC✓ 100 — 500 1500 (QJ Z SIGN, GAS SIGN AND ONE CIRCUIT 500 APPROVALS D INSPECTOR'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 TEMP. POWER POLE SERVICE NOTOVER 600 VOLTS OR 200 AMP 300 UNDERSLAB WORK SERVICE OVER 600 VOLTSOR200AMP 1000 ROUGH CONDUIT TEMP SERVICE,POLE, &APPURTENANCES 500 WIRING TEMP LIGHT OR RECEPT. SYSTEM 300 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL �-•► //�-'" LPERMIT (SUB TOTAL) NOTES FEE UING FEE 30E PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION cK M 0 CASH 3 1 kPP 1 Q 2 0.0 5 SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 7GA663-CESOG 10-62 A PPCr5N1�FR�LECTR�r'� PERNii COUNTY OF LOS ANGELES _ DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A JENSEN, SUPT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN cRoss ST. 0.4 I I/1 RECEPT �.� TOTAL NO. EACH FEE ' OUTLETS FIRST 20 $20 $ _ OWNER l7 L/ G O S 7' CO LIGHT S d MAIL /� SWITCH / � OVER 20 .L .f0 /)o ADDRESS /� Zpr V9LL6 �Q✓✓n LIGHTING TOTAL FIRST 20 ,20 CITY V�N ��Q�1/�1. TEL NO.,k?" I�O FIXTURES OVER 20 .10 ELECTRICIAN VCd/Q CONS*l CO RANGES CLO DRYERS WTR HTRS. 1.00 ADDRESS .-2 A-- YgAAE 13 JC✓/J GARB DISP. STA COOK .y CITY 'q/V CsQ/a/?/.E( TEL.NO. e< �t' ✓f O DISHWASH AUTO.-WASH STATE /J SPACE HTRS J STA APP.('A H.P.MAX.) ,50 Z+• LICENSE NO �•/ / ' MOTORS OVER NOT OVER H P. DISTRIoC,`TNO. GROUP ZO E PR CESS D BY O 1 1.00 0 15-1 C/ 1 3 150 INSPECTION RECORD d 3 s 2.00 O B 15 2.50 u� n WGC 15 50 3 00 L� O 50 100 Soo SIGNS NO TRANS NO.LAMPS SERVICE 0.600V-NOT OVER 200A 1.00 SERVICE 0.60OV-OVER 200 A. 2.00 SERVICE OVER 600V 5.00 MISC PERMIT ISSUING FEE 200 SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY r CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING '' WIRINGr ^''" 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR s LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES /I CALIFORNIA OR THAT E LEGAL OWNER OF THE ABOVE }! DESCRIBED RSIDENTI P ERTY.EA POWER SIGNATURE UTILITY CO.NOTIFIED OF PERMI - - FINAL I LIDATION ARTHUR C. VEIT MO CASH SUPERVISING ELECTRICAL ENGINEER CK _ 8 1 -3 4APR20 2 D 1 6.80- ulJo1 WORKER S'COMPENSATION DECLARATIbN 76A663 - n PP �ICAMN FO ,[gyp ECTMA PER(, , T • C15-806G (2-80) !r"B If'Lb lL, II CI I!- IIS ISLE L� UGII Il ,I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES t C/ BUILDING AND SAFETY insure, or a certificate of Workers'Compensation Insurance,or p.certified copy thereof(Svc 3800, Lab C) FOR APPLICANT TO FILL IN JOB / A Policy No Company New Residential Bldgs &Pools EACH NO FEE ADDRESS 5;-31Z_ , C rtified copy is hereby furnished 1 &2-Family,Sq Ft $ — $ LOCALITY Multi-family Sq Ft NEAREST ©!G Certified copy is filed with the county building inspection CROSS ST department' Residential Swimming Pools OWNER OR �+ /� ; ^ FIRM NAME 51-r-V T Date C ry Applicant �ysl C7- �� Outlets Rec,�Light fes-. Sw � � X70 �/ gDDRESS First 20 CERTIFICATE OF EXEMPTION FROM WORKERS' Total No Additional �a (� COMPENSATION INSURANCE CITY Tel No a- PLAN CHECK 0 APPLICANT (This section need not be completed if the work involved sd 00 U by the permit is for one hundred dollars ($100) or less.) Lighting Fixtures First ` � Total No �^' Additional g„_ ADDRESS •� LIC I certify that in the performance of the work for,which this Fixed Appliances Not Over 1 HP CITY Tel No U permit Is issued, I shall not employ any-person in any manner I PERMIT so as to become subject to the Workers' Compensation Laws Range_ HeaterLL_D W APPLICANT S/ j°� � a Oven _ Dryer_W M ADDRESS ^� to Date Applicant Top _ FAU _WH ` �t F ?� C Z Hood Fan _Other_ CITY C�`j�/l�✓� Tel No f67Gtr3( / NOTICE TO APPLICANT 'If, after making this Certificate of Disp. _ Room Air Cond._ ILICENSE OR `7 ZZG Exemption, you should become subject to the Workers' REG NUMBER! Class Compensation provisions of the Labor Code, you must forth- Power Apparatus& Large,Appliances DISTRICT NO r PROCgtSSED e with comply with such provisions or this permit shall be Size&Type HP,KW, KVA,or KVAR deemed revoked. l7 000 ' Up to 1 Incl • FINAL LICENSED CONTRACTORS DECLARATION Over 1 to 10 Incl DATE r VALIDATION Over 10 to 50 Ind I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc FINAL B� 9 (commencing with Section 7000) of Division 3 of the Busi- Over 100 BY ness and Professions Code, and my license is in full force and _effect Services License Number LC Lic Class %.- 0-200 Amp Under 600 V p 201-1000 Amp Under 600 V Contractor&Sin OA,, D✓te � D � - Over 1000 Amp or Over 600 V HOME OWNER-BUILDER DECLARATION Temp Power Pole&Appurtenances I hereby affirm that II am exempt from the Contractor's Sign with One Branch Circuit License Law for the following reason (Section 7031 5, Busi- Additional Sign Branch Circuits ness and Professions Code) Misc Conduits& Conductors 1, 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 7044, Business and Professions Code). 20;1 6 2 A CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency # 0 0 0 0 0 2 for the performance of the work for which this permit is PERMIT FEE - (Sub-Total) Q issued(Sec 3097,Civ C) 2,0 0.1 4,0 0 Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) Lender's Address o:o'0 1 4,000 PERMIT ISSUING FEE d0 • 0 f>. 1 1 -8 1 I certify that I have read this application and state that the TOTAL FEE �v above information is correct.I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize-zet7esentatLves of this County to enter upon the above- I d pr y for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE , l//V r Signatu?""',rrTittee Date