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Home My Public Portal About6228 LOMA AVE_Electrical__ COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY (� WILLIAM J. FOX, County Engineer FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRICIAN ADDRESS p 2.f' P l ECEIVBD HY FIRSTpDY FOR INSPECTION DATE ISSUED � / v CITY V TEL NO. J— COUNTY LICENSE NO. EXPIRES BUILDING SS PERMIT FEES ADDRE v fI NUMBER EACH FEE LOCALITY LIGHT OUTLETS NEAREST v ✓ V RECEPTACLES CROSS ST. WALL SWITCHES I OWNER TOTAL OUTLETS 5C $ MAIL ELEC. RANGES 25 ADDRESS AJ �J Jy'�'1�- ELEC. HEATERS 26 / v'l `' � f / 4-7 A (� Z, CITY �"�/!� TEL NO. /��///777 s FIXTURES S v �y< < '—'- 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE IH CORRECT NUMBER OF LIGHT CIRCUITB AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWN REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE. OR I AM THE LEGAL OWNER NEW MVD. t•IP OVER INC. EACH OF THE RESIDENTIAL PROPERTYi DEBCRIBED ABOVE. 1017 V2 s LESS $ .25 SIGNATURE 0,246, r v V2 2 .50 PERMITTEE _ a / Y 2 s 1.00 INSPECTION RECORD 5 15 1.50 is so 2.SO 50 200 5.00 200; 500 10.00 J 500 1000 15.00 Q Z OVER 1000 20.00 0 MOVED MOTORS (75% or GRIM.) a M.G. BET/FREQ. CHANGER-HP O WELDERS: AC-KVA GENERATORS - KW TRANSFORMERB - KVA MISC. SIGNS NO. NO.TRANS. NO. NO. LAMPS APPROVALS FOR EACH PERMIT: DATE INSPECTOR'S NAME WIRING $1,00 CONDUIT !FIXTURES $1.00 WIRING SUPPLEMENTARY ,50 FIXTURES j POWER TOTAL FEE $ ' UTILITY CO. NOTIFIED 1A FINAL ru sip Cyl 76A663 D95#5A Cd b 12-53 089 EA 25M 9ET9 1-48 'r PPLI/r�►pme N FOR n47if1tW ' DEPAR 11ldIGN II (W BUHAD ` AM v 1`9 Es"'Lv L9EA i'll�riv.JiR� rI�Cl�ii� COUNTY OF LOS ANGELES f, J. P HIEF 6E a ___ ` DISTRICT NO. GROUP ZONE PERMIT NO. � � l 4 ADD n ewe J CITY ` (� TEL.NO. RECEIVED BY READY FOR DATE I UED COUNTY (�/�/ FIRST INSPECTION / L CERT.NO ,//t4 EXPI V APPLICANT FILL IN EEAVILY OUTLINED PORTION ONLY DESCRIPTION OF WORK ADDRESS �� - �� "7. ,*;t— NUMBER OF OUTLETS ON CaRCU1TS LOCALITY / /vl S6-_ L LOCATION BY ROOMS . p NEAREST LIGHT OUTLETS 9W. PLUGS rmT C fi CIRCUIT A C D E F G I-L 0: NAME 0 ,S. /< Z MAIL ,x ADDRESS od �• JV r t,/+ 11 i CITY %t1 `� �• TELL No. J�9 �. 92 A i 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE'OF, QUALIFICATION.. _ ELECTRICIAN. I AM THS r r�OWNER OF TH9=PROPERTY'DESCRIBED' ABOVE OWNER. COR RECTIONSJ nWci Q 1— cvi «l G° r^P^-3a e Z CI !Y_ O NO. OF'OUTLETe $ APPROVALS NO. OF FIXTURES DATE INSPECTOR'S NAME NO. OF MOTORS H.P. S CONDUIT �� r NO. OF S1GN8 TRANS. S WIRING NO. OF ANaES OPR HEATERS $ J FIXTURES F/I I $ POWER PERMIT FEE $ Y V UTILITY CO.NOTIFIED TO FEE FINAL 76A663-CE806 10-62 [x1111 Il UC(r11M8 V FOR ISLL5MMrALll ERNIl , COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND-SAFETY DIVISION ADDRESS i / r JOHN A. LAMBIE, COUNTY ENGINEER- WILLIAM A. JENSEN, SUPT OF BUILDING + LOCALITY t;�- NEAREST FOR APPLICANT TO FILL INcRoss ST. ; f �✓ RECEPT. TOTAL NO EACH FEE r� OUTLET_S FIRST 20 $20 $ S ��•� OWNER LIGHT / 4 C1 MAIL 9 �l SWITCH / y OVER 10 .10 ADDRE TOTAL /'i CITY TEL NO. LIGHTING FIRST 20 20 LJ FIXTURES f ADD•L 10 ELECTRICI N , OVER 20 rn RANGES CLO DRYERS WTR.HTRS 1.00 ADDRESS GARB DISP. STA COOK CITY EL NO �J J DISHWASH AUTO.-WASH STATE SPACE HTRS STA.APP (%H.P.MAX.) -.50 LICENSE NO y - MOTORS' OVER NOT OVER H P DISTRICT GjrPj V)4 R C DB O 1 1.00Ir 1 3 1.50 INSPECTION RECORD 3 B 2.00 a B 15 2.50 Ov 15 50 300, pw 50 100 500 o NO.TRANS G. SIGNS:. NO LAMPS H Z SERVICE 0.60OV-NOT OVER 200A 1.00 SERVICE 0.60OV-OVER 200 A 2.00 SERVICE OVER 60OV, 500 MISC. PERMIT ISSUING FEE 2.00 SUPPLEMENTARY PERMIT ISSUING FEE 1100 TOTAL FEE $ � IH 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 r ELECTRICAL WIRING - WIRING 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED A9 REQUIRED BY OS ANGELES COUNTY AND FATE OF I FIXTURES CALIFORNIA OR THAT 1 THE LEGAL WNE F ABOVE DESCRIBED RESIDENTIAL POWER I( OF PERMITTEE I UTILITY CO.NOTIFIED �} FINAL LIDATION ARTHUR C. VEIT CK MO CASH SUPERVISING ELECTRICAL ENGINEER 0874 OCT 1 2 D 3.40cu - , f) WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) \i w►s®T by afflrrli that I have a certificate of consent to self Insure, 76A663 APPLICATION FOR ELECTRICAL PERMIT u 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`(Sec 3800 Lab C) ; Policy NO Company FOR APPLICANT TO FILL IN JOB ADDRESS "44W 2 ❑'" Certified copy is hereby furnished New Residential Bldgs &Pools NO EACH FEE _ ❑ _ $ $ LOCALITY . Certified copy Is filed with the county building Inspection 1&2-Family,Sq Ft department Multi-family Sq Ft CROSS s7 Date Applicant - Residential Swimming Pools ASSESSOR MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec -Light_/__S. OWNER OR COMPENSATION INSURANCE FIRM NAME First 20 (This MAIL section need not be completed if the work involved by the Total No � Additional ADDRESS permit is for one hundied dollars($100)or less-) I certify that in the performance of the work for which th rmit CITY Tel No is issued, I shall not employ any person in any a ne s as to PLAN CHECK become subj t to the Workers' Compen t n L s Lighting Fixtures First 20 APPLICANT r Total No Additional ADDRESS u{ Date Applica RESIDENTIAL APPLIANCES NOT OVER 3 HP ^� NOTIC ,TO AP LIC NT If, at er making this Cer ificate of CI G Tel No Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP �^ provisions of the Labor Code, you must forthwith comply with such PERMIT �, /d provisions or this permit shall be deemed revoked Power Apparatus&Large Appliances APPLICANT CA l �, LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADORE 5 R1� I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl (commencing with Section 7000) of Division 3 of the Business and CITY Tel Nod Professions Code,and my license is In full force and effect Over 10 to 50 Incl J O Over 50 to 100 Incl LICENSE B REG NUMBER Class f�''VV a License NumberOver 100 DISTRICT NO ESSED BY 0 Llc Class p cc.�� 1q1] 1 •�"/i//�� Services,Swbd,MCC&PanelboardsFINAL , t� Contract or-� a 1 n� L f •Date 0-393 Amp Under 600 V DATE ❑' 400-1000 Amp Under 600 V VALIDATION W I am exempt under Sec Over 1000 Amp or Over 600 V, FINAL d B&P C for this reason - BRANCH CIRCUIT FEES BY Date 15A,or 20A,120V,Lighting or Recept Z_ - 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits Exemption for Reg 'Maint Elect 15A,20A,208V To 277V Lighting Br Circuits a SINGLE FAMILY Temp Power Pole&Appurtenances 7F, HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ''133 _ �n a 't I hereby affirm that 1 am exempt from the Contractor's License Law ii t-a for the following reason (Section 7031 5, Business and Professions Additional Sign Branch Circuits i 1 I Gi[(" Code) T f TrIL 42, 75 Conduits&Conductors I, as owner of the property,will do the work and the structure Misc �t is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) D �,HE K 'I 8.7 5 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 (Sec 3097, PERMIT FEE (Sub-Total) a Civ C) PLAN CHECKING FEE 6-17 i i AM 10:-S7 Lender's Name ` ' PERMIT ISSUING FEE (may00 , Lender's Address I certify that I have read this application and under penalty of purjury state TOTAL FEE 0 that the above Information is correct I agree to comply with all County ;ordinances I Electrical wiring,and hereby authorize nter upon the above-mentioned property SEE REVERSE FOR EXPLANATORY LANGUAGE DA