The URL can be used to link to this page

Home My Public Portal About5417 LOMA AVE_Electrical__ COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer M. DIVISION OF BUILDING & SAFETY WILLIAM J. FOX, County Engineer ELOECO ma FOR APPLICANT TO FILL IN DISTRICT NO. GROUPI ZONE P PERMIT�O. ELECTRICIAN i '' 1r.' A — C/9 RECEIVED BY READY FOR DATE ISSUED ADDRESH -• ' 7 -r !�i. ,�J��,� FIRST INSPECTION CITY :��^'+�CI � ' i'. INTEL'{ANO. �� v✓1 ""✓ V� S COUNTY LICENSE NO. I/ EXPIRES �o—,�A ' 9(�3 BUILDING Ij 7 /V d PERMIT FEES ADDRESS _ NUMBER EACH FEE LOCALITY`_ _LIGHT OUTLETS NEAREST RECEPTACLES ?i CROSS ST. WALL SWITCHES OWNER — �dG�/yca�,';C� __ TOTAL OUTLETS SO $ /O MAIL ELEC. RANGES 25 ADDRESS _ ELEC. HEATERS 25 CITY TEL NO. FIXTURES B I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS MISC. 1APPLICATION AND STATE THAT THE ABOVE 19 CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWERFEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER NEw MVD. HP OVER INC• EACH OF THE RESIDENTIAL P_ROPERT%Y�D7ESRBED ABOVE. I/2 a I-Ess $ .25 SIGNATURE OF �� I/2 2 .50 PERMITTEE - v 2 15 1.00 INSPECTION RECORD 5 15 1.50 15 50 2.50 50 200 5.00 200 500 10.00 E J 500 1000 15.00 Q OVER 1000 20.00 L Q M.G. SET/FREQ. CHANGER-HP C WELDERS:AC-KVA O GENERATORS - KIN TRANSFORMERS - KVA ' TEMP. MOTORS (75% OF ORIG•) _ MOVED MOTORS (75% OF ORIG.) MISC. SIGNS NO. NO.TRANS. NO. NO.LAMPS -T7 — APPROVALS FOR EACH PERMIT: DATE INSPECTOR'S NAME WIRING $1.00 DO CONDUIT FIXTURES $1.00 WIRING SUPPLEMENTARY .50 FIXTURES POWER TOTAL FEE $ `® UTILITY CO.NOTIFIED FINAL 76A663 DBS#5A 4-52 COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY ELECTRIC WILLIAM J. FOX, County Engineer FOR APPLICANT TO FILL IN DISTRICT NO. GROUPI ZONE PERMIT NO. ELECTRICIAN SVHi I 5-H ELECTRIC ;73 r 7ter l- RECEIVED BY READY FOR DATE ISSUED ADDRESS B230 RAVERDALE DR. FIRST INSPECTION CITY -fl3Q�'�-Sjig Far&lr,:D_CALIF. -/,D J� COUNTY LICENSE NO. 1)'F1 EXPIRES 00— BUILDING 'J �q PERMIT FEES ADDRESS (3 °� 1/ Al Aod NUMBER EACH FEE LOCALITY / LIGHT OUTLETS 9 NEAREST RECEPTACLES CROSS STa, ('-" 01,011 WALL SWITCHES _ OWNER v FLOC G 't ri TOTAL OUTLETS If 5C MAIL �J ELEC. RANGES 25 ADDRESS ELEC. HEATERS 26 CITY bs'� TEL. NO. FIXTURES —� B y 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS MISC. p APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS / S AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT 1 POSSE98 THE ABOVE VALID LOS NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER NEW MVO- HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. ! �/J Vz a LESS $ 25 0 SIGNATURE OF I/2 2 .50 PERMITTEE- 2 ERMITTEE 2 B 1.00 INSPECTION RECORD s is 1.50 s 15 so 2.50 so zoo 5.130 �� 4� ��>r• �1�csutiO ' "°' . _ 200 SO0 10.00 J 500 1000 _15.00 Q Z OVER 1000 20.00 L7 M.G. SET/FREQ. CHANGER-HP 7z WELDERS:AC-KVA 0 GENERATORS - KW _ TRANSFORMERS - KVA TEMP. MOTORS (7S% OF ORIG-) MOVED MOTORS (75% OF BRIG.) MISC. SIGNS NO. NO.TRANS. w APPROVALS NO. NO. LAMPS FOR EACH PERMIT: DATE INSPECTOR'S NAME WIRING $1.00 as CONDUIT e FIXTURES $1.00 WIRING SUPPLEMENTARY .50 FIXTURES POWER Ile TOTAL FEE UTILITY CO.NOTIFIED / _ - FINAL ��/�'�✓ A 76A663 DBS##5A 4-52 s� 1 WORKERS'COMPENSATION DECLARATION CE-863 10/81 APPLICATION FOR ELECTRICAL PERMIT 11�e'' bV affirm that I have a certificate of consent to self insure, CE-806G or,.acertificate of Workers' Compensation Insurance,'or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy,thereof(Sec. 3800,Lab.C,) P01471-'- Company FOR APPLICANT TO FILL IN JOB ❑ '� ADDRESS - V Certified copy is-hereby furnished. New Residential Bldgs.& Pools EACH NO. FEE ) 1 & 2-Family,S Ft. $ — $ LOCALITY `TEM LE Z El Certified copy is filed with the county building inspection y q department. Multi-family Sq.Ft. — NEAREST i CROSS ST. L Residential Swimming Pools OWNER OR Date Applicant 16 FIRM NAME �( CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec Light Sw,410 MAIL COMPENSATION INSURANCE ADDRESS (This section need'not be completed if the work involved.by the First 20 permit is for one hundred dollars($100) or less.) Total N Additional CITY Tel.No. I certify that in the performance of the work for which this permit PLAN CHECK APPLICANT is issued, I shall not employ any person in any manner so as to become subj ct to the Workers'Compensationaw . Lighting Fixtures First 20 ADDRESS L' r Additional a� Total No._ �" CITY Tel.No. Date Applicant Fixed Appliances Not Over 1 HP NOTICE TO APPLICANT: If, aft r making 'INW Certificate of PERMIT Exemption,you should become subje, to the Workers'Compensation Range Heater_ D.W. L APPLICANT provisions of the Labor Code, you must forthwitti comply with such Oven Dryer _ W.M._ ADDRESS provisions or this permit shall be deemed revoked. Top FAU _ W.H. CITY Tel.No. LICENSED CONTRACTORS DECLARATION Hood Fan Other_ I hereby affirm that I am licensed under provisions of Chapter 9 Disp. Room Air Cond. • / LICENSE OR Class. (commencing with Section 7000) of Division'3 of the Business and REG.NUMBER Professions Code,and my license is in full force and effect. DISTRICT NO. Power Apparatus& Large Appliances Size& Type HP,KW,KVA,or KVAR F O License Number Lic.Class Up to 1 Incl FINAL n U Over 1 to 10 Incl. DATE t I O VALIDATION Contractor Date VVV ❑ Over 10 to 50 Inc[. FINAL 1-- I am exempt under Sec. Over 50 to 100 Inc. gY 0 B.&P.C.for this reason Over 100 Services,Swbd.,MCC& Panelboards Date: 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. SINGLE FAMILY Temp.Power Pole& Appurtenances -••••• 2 HOME OWNER-BUILDER DECLARATION Sign with One Branch CircuitAG�•Tat I hereby affirm that I am exempt from the Contractor's License Law for the followingSection 7031.5, Business and Professions Additional Sign Branch Circuits reason ( 3307 18 a`C► Code): I,as owner of the property,will do the work and the structure Misc.Conduits & Conductors 1 ITEMS _ d-1, is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) r ► TOTAL 8.3®50 and Professions Code). HECK U q�t�' yy CONSTRUCTION LENDING AGENCY GHEtY� v3a�!V I hereby affirm that there is a construction lending agency for the CHANGE .011 performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total) Civ.C.). PLAN CHECKING FEE_ OOM-0001 9/25M Lender's Name • PERMIT ISSUING FEE .5y77 1 AMID i 16 Lender's Address I certify that I have read this application and state that the above TOTAL FEE 93 information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize representatives this County to enter upon the above-mentioned ;pro4perfo,rMlecl. purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE -25 S" ature of'PbrrfTittee Date