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HomeMy Public PortalAbout5314 LOMA AVE_Electrical__ ' 7.6A663-CE806 10/72 QppUCQMN FOP, ELECTMAd PUNY - COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER JOB BUILDING AND SAFETY DIVISION ADDRESS 4 �oM S( LOCALITY NEAREST ` �j FOR APPLICANT TO FILL IN CROSS ST �J Ul OUTLETS No EACH FEE OWNER OR $ Is FIRM NAME RECEPT MAIL ` -- ..— FIRST 20 -2- ADDRESS 1 1�,0 rl LIGHT TOTAL 25 CITY �� TEL _ SWITCH OVER 20 10 PLAN CHECK LIGHTING TOTAL FIRST 20 25 APPLICANT OVER 20ADDRESS r FIXTURES tp RESIDENTIAL APPLIANCES CITY TEL NO PERMIT RANGE DRYERWTR HTR APPLICANT eC_-_ STA COOK DISP F A U ADDRESS SPACE HTR AIR COND _ Cl T7 TEL NO -�� CLOTHES WASH DISHWASH LICENSE OR 1 1 REG. NUMBER I CLASS FAN OTHER 100 0 1 HEHEBI 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 1 AM PROPERLY REGISTERED ANO/OR 0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNT AND STATE OF CALIFORNIA OR T l I AM THE LEGA OWN R F THE ABOVE 1 - 10 300 DESCRIF.ED REST L PROPER Y pr„ > O PERMITEE U 10 - 50 5001 j SIGNATOR AA 0 GC O 50 - 100 1000 v DISTRICT NO. PROC SSED BY 1y 100 — 500 15 00 O GO SKVA=�� IGN, GAS SIGN AND ONE CIRCUIT 500 APPROVALS DATE INSPECTOR'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 TEMP. POWER POLE SERVICENOTOVER600VOLTS OR200AMP 300 ©p UNDERSLAB WORK SERVICEOVER600VOLTS OR20OAMP 1000 ROUGH CONDUIT i TEMPSERVICE,POLE, &APPURTENANCES 500 WIRING i TEMP LIGHT OR RECEPT SYSTEM 300 FIXTURES l.1 J[� ��G1c�• ,,wj POWER AUTHORIZED t� _UTILITY CO. NOTIFIED r FINAL PERMIT FEE (SUB TOTAL) NOTES PLAN CHECK FEE PERMIT ISSUING FEE 300 ©Q TOTAL FEE '7 PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION- CK M 0 CASH SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 76A663-CE-806(11 /78) Ge51fl'l!'L cklrm Il On �LECTMC'ALs Mwr, COUNTY OF'LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO PILL-IN JOB ' New'Res,d'n_f,al Bldgs,&Pools --EACH • NO FEE ADDRESS $ 025 — $ LOCALITY �- 1 &2-_Family,Sq'Ftl Multi family Sq Ff = 02 — - NEAREST a • -� 25 00- CROSS ST Resid'ential;Swimming,P6ols OWNER OR • --- ? FIRM NAME Outlets ,Rec_r_Light—/—, Sv, �Z-_ _ MAIL First 20 50 t ADDRESS i r ✓ Total No ••. gdditional 30 CITY• T,el,No e , PLA CHECK APPLICANT._ Lighting Fixtures First'20 50 ADDRESS Total NoJ Additional 30. CITY Tel'No —, Fixed Appliances Not Over,-1 HP_ PERMIT -- Range—Heater—'D W APPLICANT ADDRESS- Oven - —Dryer_W M_. Top _FAL) — W H CITY r Tel No,,• Hood=Fan Other_ LICENSE OR Disp —Room Air Cond 2 50' REG NUMBER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP LICA Power Apparatus&'Large Appliances - TION AND STATE THAT THE.ABOVE IS CORRECT AND AGREE TO S¢e&'T COMPLY' WITH ALL'COUNTY`ORDINANCES AND-STATE-`LAWS •0- ype HP,•KW,,KVA, or KV,AR = 0. REGULATING ELECTRICAL WIRING - .., 01 Up to 1'Incl 2 50 -I HEREBY CERTIFY-THAT-I'AM;PROPERLY'REGISTERED AND%OR .v Over 1 to-10 Incl 5 00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY'AND'STATE OF Over,10 to 50 Incl 1250, CALIFORNIA•OR,THAT I AM THE _LEGAL.OWNER OF,THE ABC)VE _ 25 00 •DESCRIBED RESID PROPERTY Over 50 to 100 Inc 4000 PERMIT EE 'Over'l 00• SIGNATURE g Services--• ,• - DISTRICT NO -- P, ESSE Y' " 0-200 Amp Under 600 V 12 50 08 201--1000-Amp-Under 600 V 25 00 Over 1000 Amp or Over 600 V 5000 Z QJ O Temp Power Pole&Appurtenances 1.0 00 Sign with One Branch Circuit 1000 " J Additional Sign Branch'Grcuits' 200 INSPECTION 0 00 >. 1 •i INFORMATION• ; - M{sc Conduits&Conductors W Other(See Complete Fee Schedule) ON REVERSE' "u " SIDE, ;z a �670,3A # 0.0 c, O 2 .. _ '' 2'0 PERMIT FEE (Sub-Total) 2 0 0 ' PLAN CHECKING FEE '(One-Fourth Permit Fee). O J 00 0;1 200U ,PERMIT ISSUING FEE ., . _ ,$7 00 ,• - -. .1 �.- o O 7 9 J TOTAL FEE a • O� > INSPECTION FINALED nc p.�q • r p ENO/, W dote f q 0 �l 1 By 9�0 WORKERS'COMPENSATION DECLARATION CE 806G (2-80) APPUCAT6®iltl FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY- insure, or a certificate of Workers'Compensation Insurance,or ` a certified copy thereof(Sec 3800,Lab C,) FOR APPLICANT TO FILL IN SOB Policy No Company EACH NO FEE ADDRESS �f� N i-OMA ^-V E7 New Residential Bldgs &Pools Certified copy is hereby furnished/e/_JJ 1 &2-Family,Sq. Ft $ — $ LOCALITY (✓N PL I'[ If - IAREST Multi-family Sq. Ft WE COWNER ORertified copy 6 filed with the county building inspection, Residential Swimming Pools CROSS ST de artment `Lp IvVI�I>bvW 13 Q �1O`('G1� 21��'b Date Applicant' g O� uFIRM NAME Recd?Light 3 Sw �� ADDRESS g .�3 l N. LC�!'1 A J\ E. First 20 CERTIFICATE OF EXEMPTION FROM WORKERS' Total No 1 7 Additional CITY TE:f1 FL-13 c1Ty Tel No 241 -`til I } COMPENSATION INSURANCE PLAN CHECK a (This section need not be completed if the'work involved , APPLICANT r�l�?'SCJ1.�] i3V 11-Crx 1Z S O y p ( ) ) Lighting Fixtures First 20 ADDRESS T� INV IF, � b the permit is for one hundred dollars $100 or less. 3 tii,'~�p �• T�1.OS Total No Additional I certify that in the performance of the work for which thisFixed Appliances Not Over 1 HP CITY GL.�NWr101^ Tel No U permit is issued, I shall not employ any person in any-manner PERMIT so as to become subject to the Workers' Compensation Laws Range_Heater—D W. APPLICANT �,� 17N OW. Oven _ Dryer_W M' ADDRESS t) Z Date Applicant' Top _ FAU _WH. -- Hood _ Fan _Other_ CITY Tel No NOTICE TO APPLICANT If, after making this Certificate,of Disp _ Room Air Cond.— LICENSE OR 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 PROC B with comply with such provisions or this pbrmit shall be . Size&Type HP,KW, KVA,or KVAR deemed revoked. v Up to 1 Incl. FINAL Over 1 to 10 Incl. LICENSED CONTRACTORS DECLARATIONDATE VALIDATION Over 10 to 50 Incl I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc FINAL 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 21 p F L>!;� Lic Class / g . 1 0-200 Amp Under 600 V �iNwZ\.•► BViL�il3 I- �' 201-1000 Amp. Under 600 V f g ��✓ Contractor Date Over 1000 Amp or Over 600 V HOME OWNER-BUILDER DECLARATION Temp Power Pole& Appurtenances /� �/1 0 3 5 8 A I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit f `�� . License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits #,o':o o;o'o 2 ness and Professions Code) O 6 2 to o 1 17,0 0, - 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 o o,o 1 7.0 0 51 7044, Business and Professions Code) CONSTRUCTION LENDING AGENCY Q 71 .5—8 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 agree to comply with all County ordinances and State laws. regulating Electrical wiring, and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE /Z/ii Cad v.7 l�L1.�iL.S 13� . " �'- Signature of Permittee Date WORKERS'COMPENSATION DECLARATION 76A663CE-806 10/61 APP C pMON FOR Ep ECTMICA • P(�RMIT I hereby affirm:hat,•I have-.a cert�Lte of consent to self insure, CE-806G IJ—L� P'4 tl�1 L� lL IG tl �HII or a,cerriificate of Workers' Compensation Insurance, or a certified, COUNTY OF LOS ANGELES BUILDING AND SAFETY -copy thereof(Sec 3800,Lab C) a Policy No Company FOR APPLICANT TO FILL IN JOB 77 //�� ❑ Certified copy is hereby furnished New Residential Bldgs & Pools PCH., NO FEE ADDRESS SJ/ vv7 A A✓� ❑ -1 & 2-Family,Sq Ft $ LOCALITY L� /e . IC/ Certified copy is filed with the county budding'inspectiondepartment Multi-family Sq Ft NEARESTCROSS STDate Applicant' Residential Swimming PoolsOWNER OR 2 S ,FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL Outlets Rec tight — Sw ADDRESS- L YYJ 19 COMPENSATION INSURANCE � O• S � _r (This section need not be completed if the work involved by the First 20 permit is for one hundred dollars ($100)or less) / CITY,•— Tel No � • Total No Additional e['Yl ,,• PLAN CHECK I certify that m the performance of the,work for which this permit APPLICANT epIL0Q 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 ' / (J J•�G Additional Date Gro P 9' Applicant C .� i � �3s..vnyy Total No CITY Tel No �^-�- T—� Fixed Appliances Not Over 1 HP PERMIT making , NOTICE TO APPLICANT If, after ming this Cerhflcate of Exemption,you should become subject to the Workers'Compensation Range_ Heater_'D W APPLICANT provisions of the Labor Code, you must forthwith`comply with such Oven Dryer _ W M ADDRESS" provisions or this permit shall be deemed revoked Top FAU WH LICENSED CONTRACTORS DECLARATION CITY Tel No - Hood Fan � Other I hereby affirm that I am licensed under provisions of Chapter 9 O nd LICENSE OR •(commencing with Section 7000)'of Division 3 of'the'Business and Disp Room Air CoREG NUMBER Class Professions Code,and my license is in full force and effect- DISTRRgLLLCCCT NO ESSED Y , Power Apparatus& Large Appliances I �•• a Size& Type HP,KW,KVA,or KVAR J/ 0 License Number Lic'Class' Up to 1•Incl - FINAL U Over 1 to 10 Incl DAT , VALIDATION 0 Contractor Date Over 10 to 50 Incl - U ❑ FINAL I am exempt under Sec Over 50 to 100 Inc _ FI W B&PC for this reason Over 100 - Cn Services,Swbd,MCC& Panelboards ; Y Date 0- 200 Amp Under 600 V D �. 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 i, 2 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit �/••/�•�• I hereby affirm that I am exempt from the Contractors License Law ACCT, 1, for the following reason(Section 7031 5, Business and Professions Additional Sign Branch Circuds .y �C Code e .7JV7 TCS 6�n(J' Misc Conduits& Conductors -1 ITEMS• „ ' I,as owner of the property,will do the work and the,structure• is not'intended or offered for sale (Section 7044, Business -Other(See Complete Fee Schedule) and Professions Code) D { ' ' //+TOT//yyL 28 o 75 CONSTRUCTION LENDING AGENCY LRGM ,'' 28°75 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued(Sec 3097, PERMIT FEE (Sub-Total) °� Civ C) t PLAN,CHECKING FEE 1 9/26/85 .Lender's Name ' PERMIT ISSUING FEE 0000-Mpq Lender.'s Address _ �rw I r"12e0 I'certify that I have read this application and state that the above TOTAL FEE' 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 the above-mentioned - IN roperty for inspection purposes ' SEE REVERSE FOR EXPLANATORY LANGUAGE Signat re 01 Permittee Date WORKERS'COMPENSATIONDECLARAI;ION CE-806 APPLICATION FOR ELECTRICAL PERMIT I heyeby affirm that I have a certificate of consent to self COUNTY OF"LOS ANGELES BUILDING AND SAFETY insure, or a certificate of Workers'Compensation Insurance,or a-certified cfpy theregf(Sec 3800,Lab C.) I ' , Z 5)' FOR,APPLICANT TO FILL IN JOB' / Policy No �- CompanyST � EACH NO FEE -ADDRESS New Residential Bldgs &Pools ❑ Certified copy is hereby furnished 1 &2-Family,Sq Ft $ $ LOCALITY C G� 1/0� Multi-family Sq NEAREST Ft CROSS ST EJ LGv� Certified copy is filed with the county building inspectionResidential Swimming Pools department' � OWNER OR // p FIRM NAME Date g�'�D Applicant�E/5,7-0,;, � Outlets Rec�Li ht� S. a l �° MAIL ' 9' Hirst 20 iS o ADDRESS 3io Y/7- CERTIFICATE OF EXEMPTION FROM WORKERS' Total No — Additional CITY Tel No-' e7 �Si'O COMPENSATION INSURANCE a PLAN CHECK , APPLICANT 0 J6 section need not be completed,if the work involved " by the permit is for one hundred ,dollars ($100) or less.) Lighting Fixtures First 20 ADDRESS Additional cc Total No4— I certify that in the'performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No permit is issued, I shall not employ any person in,any mannerPERMIT � —~ V so as to become 'subject to the Workers' Compensation Laws Range_ Heater_D W. APPLICANT tJJ/7 40 e) A a ' Oven Dryer_•W Mco ADDRESS �� :�� CA: .�jV Z ,Date• Applicant Top FAU _W H Hood Fan' _Other— CITY Tel No NOTICE TO APPLICANT If, after'makmg this Certificate of Disp _ Room Air Cond,_' LICEN EOR Exemption, you should become subject 'to the Workers' REG NUMBER 7 lass 13 Compensation provisions-of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO PROCESSED BY with comply with such provisions or this permit shall be Size&Type HP,KW, KVA,or KVAR deemed revoked. Up to 1 Incl r Over 1.to 10 Incl FINALDATE LICENSED CONTRACTORS DECLARATION Over•10 to 50 Incl VALIDATION = --- I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc FINAL 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 NumberQ Z y �, 0-200 Amp Under,600 V ,T 7 Lilass `l�j / ,�� 201-1000 Amp Under 600 V Contractod f!✓r57��'/ �K�n Date Over 1000 Amp or Over 600 V HOME OWNER-BUILDER DECLARATION Temp. Power'Pole&Appurtenances Sign with One Branch Circuit I hereby affirm that I am exempt from,the Contractor's Additional Sign Branch Circuits 2 0'6'6,,9 A License Law for the following reason (Section 7031 5,•Busi- ness and Professions Code) - o Ko 0 , _ Misc.Conduits&Conductors f# 0 j0 0 2 ❑ I, as owner of the property, will do the work and the Other"(See Complete-Fee Schedule)— - 2 0'0.l structure is not intended or offered for sale (Section 7044, Business and Professions Code) _ CONSTRUCTION LENDING AGENCY oro"o Q 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) 0 a o 7—� 1 issued (Sec 3097,Civ C.) Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) Lender's Address PERMIT ISSUING FEE w J 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 wirmg, and hereby authonz9 repr ntatives of this County to enter upon the above-menti o ty for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE ignature rmittee Date WORKERS' COMPENSATION DECLARATION CE-806 10181 n nnp �CAIMN FOR ftp f2�1�(b7��/� (j (�f2f�I1 57 • .;–hereby 2�rfirm that I' have a certificate of consent to self CE-8066 G"�llT II"[� Il lf- lIK I�L�LS ll Ili B�11S I!"L511�I117U Il insure, or a certificate 6f Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY Jr a certffred copy thereof ($ec 3800, Lab C ) Policy No Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished" New Residential Bldgs 8 Pools EACH NO FEE ADDRESS ❑ 1 & 2-Famil S Ft $ — $ LOCALITY Certified copy is filed with the county building mspec- Y- q tion department Multi-family Sq Ft NEAREST CROSS ST Residential Swimming Pools OWNER OR Date Applicant FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL V N _ COMPENSATION INSURANCE• Outlets RecLight5w First 20 ADDRESS S � (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 /f!y PLAN CHECK I certify that,in the performance of the work for which this APPLICANT S�i►Z - ' permit is issued, I shall not employ any person in any manner so as to be/or)(e subject to the Workers' ensation Laws Lighting Fixtures First 20 ADDRESS Total No _ Additional CITY Tel No / Date pplica Fixed Appliances Not Over 1 HP PERMIT NOTIC TO APPLICANT If, aft aking ertificate of Range Heater_D W APPLICANT /y Exemption, you should beco subje o the Workers' 9 Compensation provisions of t 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 J_ Fan _Other_ CITY Tel No LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp Room Air Cond REG NUMBER Class (commencing with Section 7000) of Division 3 of the Business DISTRICT NO PROCES Q and Professions Code,and my license is in full force and effect Power Apparatus 8 Large Appliances �l O Size 8 Type HP, KW, KVA, or KVAR �L`� U License Number Lic Class Up to 1 Incl FINAL d' Over 1 to 10'lncl DATE //S i VALIDATION � Contractor Date Over 10 to 50 Incl FINAL (/V W ❑ I am exempt under Sec Over 50 to 100 Inc BY f Q. 100 B 8P C for this reason Over z Date Services, Swbd , MCC 8 Ponelboards D '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 94 3 9.3 A SINGLE FAMILY Temp Power Pole &Appurtenances # 0 0'0 ? o 2 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License ' o - 3000 Law for the following reason (Section 7031 5, Business and Additional Sign Branch Circuits Professions Code) 0 010 3 a 010 6 ❑ 1, as owner of the property, will do the work and the Misc Conduits 8 Conductors 0 4.0 8 8 6 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 6 Lender's Address �D 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 theabov boned ropert for inspe ion rposes SEE REVERSE FOR EXPLANATORY LANGUAGE gnatwe Pe tee Date