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Home My Public Portal About5631 LOMA AVE_Electrical__ 76A663 WS 5A 7-51 APPLICATION FOR PERMIT -DEPARTMENT OF BUILDING AND.SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER AIMECTIRIC DISTRICT NO. GR P 'ZONEPERMIT 7 FOR APPLICANT TO FILL IN �' ,.O ELECTRICIAN >. -- RECEIVED BY READY FOR DATE ISSUED ADDRESS ¢ 4A, Wv-�-r� 'f FIRST INSPECTION CITY y� TEL No. -F 6� � ''7 COUNTY LICENSE NO. � r EXPIRES BUILDING Lam'/ 3CCC;;��.. I 'fit PERMIT FEES ADDRESS 17 GO FEE_ NUMBER EACH LOCALITY LIGHT OUTLETS NEAREST CROSS ST. RECEPTACLES c �®. WALL SWITCHES OWNER TOTAL.OUTLETS 5c1 MAIL - ELEC. RANGES 25 + ADDRESS ,ELEC. HEATERS 25 S. %i CITY TEL. NO. FIXTURES - 5 •t 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS MISE ' APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS ifAND AGREE TO COMPLY .WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWERFEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER NEw MVD. HP OVER INC. SACH OF THE.-RESIDENTIAL A ROPERTY PESCRIBED ABOVE. 6 LED !$ .25 SIGNATURE OF44jpv&_� A 2 .50 PERMITTEE a - _ le69 z Is 1.00 INSRECTION RECORD 5 L6 1.50 1S BO '2.50 // '50 mC 15.00 _ '200 1010 S 1.00 Soo 1 COO 1.5.00 . } z OVER 1 000 20.00 ,r]e �-� - - - M.G. SET/FREQ. CHAA1DEER-HP 1 :57/2-.-/- - / - WELOERB:AC-KVA GENERATORS '- KW TRANSFORMERS - KVA TEMP. MOTORS (7S% cr owa.) MOVED MOTORS (73% or ORIa.) - M ISC. SIGNS NO. NO.TRANS. _ NO.. NO.LAMPS. - APPROVALS _ FOR EACH PERMIT: DATE INSPECTOR'® AME WIRING $1.00 CONDUIT �p - ��t. .+� 1•G4trva�G�+•t.t s, �� FIXTURED $1.00 WIRING '(yC u__ SUPPLKMELiTARY ,50 - FIXTURES POWER TOTAL FEE $� � UTILITY CO. NOTIFIED -.FINAL ✓ ®_LG(1�••� / :/ 9s. y . 76S-5A_3-515AL-I�-CTT I-ON FOR ELECTRIC LECqIC ERMIp �? �1`'�•��, - � DIVISION OF BUILDING, AND SAFETY Department of County Engineer County of Los Angeles BuILmNG /�— WM.J. FOX, COUNTY ENGINEER ADDRESS 50 CASSATT D. GRIFFIN, SUPT Oe BUILDING LOCALITY FOR APPLICANT TO FILL IN " NEAREST PERMIT FEES CROSS ST. N UMBER.. EACH FEE, s / OWNER Ad LIGHT OUTLETS - - -A- MAIL RECEPTACLES - : .ADDRESS WALL SWITCHES - TOTAL OUTLETS 3 5¢'. S ',CITY' / TEL. NO. ELEC. RANGES 25 ELECTRICIANh / �I+ A wy O ELEC. HEATERS - •25 ADDRESS AJ�//-�j KW EA CITY % g7_65 � /� � TEL 'NCa4l )f / FIXTURES .5 - ® LICENSE NO. 7_ O 5 6 .NUMBER OF LIGHT CIRCO ITS.' - DISTRIC NO. GROUP I ZO(!E� I READY,FOR INSPECTION NU:MBER.OF'RECEPTACLE CIRCUITS MOTORS NUMBER HORSEPOWER INSPECTION RECOM FEE NEW, MVD:: (_HP OVER I INC. I. EACH - - 1/j'&LESS S .25. 172 2 .5O .,2_ 5 ..1.00 5 15 1.50 15 50 2.50 - `50 .200 5.00 MISC. NO.SIGNS NO.TRANS: - - ' ..NO.SIGNS NO. LAMPS, _ FOR EACH PERMIT: _ WIRING FIXTURES -51.00 lee - Said SUPPLEMENTARY i50_ APPRICNALS - TOTAL FEE I S .-i.7-V DATE - '.INSPECTOR'S SIGNATURE, 1 HEREBY ACKNOWLEDGE-THAT 1 HAVE READTHIS APPLICATION. . CONDUIT ' AND STATE THAT THE�ABOVE ISCORRECT AND AGREE,TO COMPLY WITH ALL COUNTY ORDINANCE.S AND STATE LAWS REGULATING. WIRING ELECTRICAL WIRING. I HEREBY CERTIFY THAT, I AM.PROPERLY REGISTERED-,AND/OR, FIXTURES " LICENSED AS REQUIRED BY LOS _ANGELES OUNTY AND STATE OF - CALIFORNIA OR THAT H LEGA WNER' OF THE-ABOVE POWER i DESCRIBED RESIDENT! P OPE T SIGNATURE .UTILITYCO.NOTIFIED ,`t. L` t✓ ""'"""'�` OF PERMITTEE - FINAL ' WILLIAM J. FOX, COUNTY ENGINEER VALIDATION A. C.VEIT,CHIEF ELECT:INSPECTOR , � I t -0:7711 41 DEC 250, in WORKER'S COMPENSATION DECLARATION 76A669 DPW 9/89 APPLICATION FOR-ELECTRICAL PERMIT 76A663 �V� I hereby affirm that I have a certificate of consent to self insure, 'or a certificate of Worker's Compensation.Insurance, or a certified COUNTY OF LOS ANGELES DEPT.OF!PUBLIC WORKS BUILDING-AND SAFETY DIV. copy thereof;(Seca 3800 Lab.,C.) <a r Policy No. Company - FOR APPLICANT TO FILL IN J JOB J" M, _:j-', i ADDRESS .. .. Certified copy is hereby furnished. New Residential Bldgs.&Pools k EACH NO .'.__FEE LOCALITY , 01, 'Certified copy is filed with Vthe'county bruilding•inspection:nz,', 1 &'2-Family,Sq.Ft. $ — $ . department.. _ Multi-family Sq.Ft. — CROSS ST. . �. Residential Swimming Pools `ASSESSOR Date Applicant ° MAP BOOK } cJ�7 PAGE �® PARCEU / CERTIFICATE OF EXEMPTION FROM WORKERS �O ,y- FIRM OR Outlets:Rec. Light SW. � FIRM NAME ' COMPENSATION INSURANCE - /" First 20 Total No. Additional (This section need not be completed if the work,involved by the MAIL Q� �_ - - -- ADDRESS t permit Is fo' one hundred.dollars($T00)or less.) I certify that in the performance of the work for which'this permit u--- __ CITY .� �. Tel.No. is issued, I shall not employ any person in any manner so as to A PLANfcI9ECK becomesubjec to the.Workers' Cc pe ion Laws Lighting Fixtures First 20 �+ - APPLICANT Total No: Additional ' • +,� ADDRESS Da Applicant q5 0R 20A,120V BRANCH CIRCUITS- NOTICE TO:APPLICANT: If,,after making this` ertlficate of CITY Tel.No. Exemption,..you,should become subject.to,the Workers',Compensation 1 TO 10 INCLUSIVE EACH rovlslons of the Labor Code,.you must forthwith comply with,such 11 TO 40 INCLUSIVE-EACH- PERMIT, ) P Y P Y - - APPLICANT provisions dr this permit shall be deemed revoked. 41 OR MORE BRANCH CIRCUITS EACH 'LICENSED CONTRACTORS DECLARATION _ ADDRESS �C � J TING EACH CL I hereby affirm' that I am licensed 'under provisions of Chapter 9 ! (,,,1 (commencing with Section 7000) of Division-3 of the Business-and 15 OR 20A,208V'TO 277V LIGH CITY ��( T" No.�(�S 2 T Professions Code,and my license is in full force and effect. RESIDENTIAL APPLIANCES UP TO 3HP LICENSE OR / C Class. Power Apparatus&Large Appliances REG.NUMBER J 0 t Size&Type HP,KW„KVA,or KVAR_ DISTRICT NO. P��[D BY i. ass License Number V13 1Z ts-7 Llc.CI Up-to 31ncl: [/,� '• Over 3 to 10 Ind. FINAL Contractod /jUfG ate _- - - _ -- _. . _ _ . DATE Cl) 1� Over 10 to 50 Incl. D Z ❑ I am exempt under Sec. Over 50 to 100 Incl. (. �` !'' VALIDATION _. L- - B.&P.C.for this reason —' Over 100 ' ` BY Services Swbd.,MCC&Panel rd _ _.. 7 0-200 Amp.Under 600 _ Signature _201-1000 Amp..Under-_600 V. ❑ _ Over 1000 Amp.dr Over 600 V Exemption for Reg.Maint.Elect. _ SINGLE FAMILY Temp.Power Pole&Appurtenances wr 8 r HOME OWNER-BUILDER DECLARATION — - I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit c for the following reason (Section 7031.5, Business and Professions - _Additional Sign Branch Circuits �� Code): I, as owner of the property, will do the work and the structure Misc.-Conduits&Conductors 'G ❑ 1 333”' is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) - and Professions-Code). TIJT1. 1 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the r eia performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE. , _. `(Sub-Total) Civ. c.) �} nn PLAN CHECKING FEE * ,i' �• V1 9� 4/7i Lender's Name _- O 9: 1 PERMIT ISSUING FEE Lender's Address I certify that I have read this application and state that the above TOTAL FEE D information is correct. ,I agree to comply with all County ordinances - and State laws regulating Electrical wiring, and hereby authorize . rep s ntatives this ty to enter upon the Ove-mentioned p p ty ctio ur ses ` SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE OF APPLIC NT OR I tGENT ATE - - '