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HomeMy Public PortalAbout6420 LOMA AVE_Electrical__ i 76A663 CE-80616/78) APPLICATION FOR- ELECTRICAL- PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN ADDRESS FApplionces sidential Bldgs &Pools ✓ EACH NO FEE -Family,Scl Ft $ 025 — $ LOCALITY Multi-familySclFt 02 — NEAREST T� O " ential Swimming Pools 25 00 CROSS ST /U OWNER M ,�oo4 �GZ FIRM NAME Rec—.-Light Sw MAIL / — First 20 50 D ADDRESS � r/YI No - Additional 30 CITY T'� G Tel No��1 Q/4 PLAN CHECK APPLICANT Fixtures First 20 50 ADDRESS Additional 30 No CITY Tel No plionces Not Over 1 HP PERMIT-e_Heater_D W APPLICANT_Dryer_ WM— ADDRESS Top _FAU — WH -_ CITY7—, Tel No7A�� Hood_Fan _Other_ LICENSE OR Disp —Room Air Cond 2 S0 REG NUMBER Class I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO Size&Type HP, KW, KVA,or KVAR COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS yp 2 50 REGULATING ELECTRICAL WIRING Up to 1 Incl I HEREBY CERTIFY-THAT I AM PROPERLY REGISTERED AND/OR O Over 1 to 10 Incl 5 00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF in Over 10 to 50 Incl 12 50 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE , Over 50 to 100 Inc 25 00 DESCRIBED RESIDENTIAL PROPERTY Over 100 _40 00_ PERMITEE , SIGNATURE � Services 12 50 DISTRICT NO PROCESSED BY 0-200 Amp Under 600 V 25 00 � q�w� A 201-1000 Amp Under 600 V � G4 p'2,Over 1000 Amp or Over 600 V 5000 Z �f o ^jrt`J Temp Power Pole&Appurtenances 10 00 Q Sign with One Branch Circuit 10 00 C Additional Sign Branch Circuits j .200 INSPECTION > 9k4� INFORMATION cYi Misc Conduits&Conductors 1000 ON REVERSE x Other(See Complete Fee Schedule) :9$IDE v 1 5 a 8 A Q # o o o a o 2 J d 2Q - 2Q60 PERMIT FEE (Sub-Total)' 1 - o o o20,5 0 6 Z PLAN CHECKING FEE (One-Fourth Permit Fee) O + 201-78 1 C PERMIT ISSUING FEE $7 00 7 � Q TOTAL FEE > INSPECTION FINALED W -date .�Z —t —"4,O By ..^ �,�• ©s . _ (. TEMPLEC& 1S Di 76A663-CE806 8-62 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING D BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER t WILLIAM A JENSEN, SUPT OF BUILDING LOCALITY 'NEAREST FOR APPLICANT TO FILL IN CROSS ST. RECEPT /Z TOTAL NO EACH FEE OUTLETS FIRST 20 n $2O $ a OWNER LIGHT V MAIL ADD'LSWITCH VERAD W 1O ADDRESS OVER 2O TOTAL CITY TEL N LIGHTING FIRST 20I .20 FIXTURES AOD'L 10 ELECTRICIAN AA L OV R 20 2 RANGES CLO.DRYERS WTR HTRS 1.00 ADDRESS GARB.D19P. STA.COOK _ CITY DISHWASH. ��jj -AUTO.-WASH STATE SPACE HTR9 .J STA.APP.(yz H.P.MAX ) .50 LICENSE NO ni MOTORSi OVER NOT OVER HP. ,DISTRICT N OUP TNTP D O 1 1.00 1 s 150 /� INShE ION RECORD 3 8 200 8 15� 2.50 iS 50 300, SO 100 s 00 `CJ�ie�`�� 0./y�i$ ��,•�'Q' l/ 6/�/'�N7- A 'O SIGNS- NO.TRANS 1 G v f NO.LAMPS O SERVICE 0.600V-NOT OVER 200A 1.00 W SERVICE 0.60OV-OVER 200 A. X2.00 D' N SERVICE OVER 600V 5.00 z MISC. PERMIT ISSUING FEE 2 00 SUPPLEMENTARY PERMIT ISSUING FEE 1100 TOTAL FEE $ LWIBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATI N APPROVALS , DATE INSPECTOR'S SIGNATURE TE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT ! L COUNTY ORDINANCES AND STATE LAWS REGULATINGAL WIRING WIRINGBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR AS REQUIRED BY LOS ANGELES COUNTY AND STATE OP FIXTURES16IA OR THA 1 AM THE LEGAL N R OF THE ABOVE D RESIDE POWER �jfPERMSIGNATURE d UTILITY CO.NOTIFIED /✓,[(/ 'L6�'y�T�,,��pp • VALIDAT� ARTHUR C. VETT CK MO CASH SUPERVISING ELECTRICAL ENGINEER Ltlil o 2 6 8 2 w AUG 17 2 D 8.901- a DES-5A 11.85 6'"gll II ��CA 11 MN FOR ELECTMC PERYVII� 11 BB-5A DIVISION OF BUILDING AND SAFETY _ _ - Depax out Of County Engineer BUILDING County Of I.OS Angeles ADDRESS 2-4 JOHN A. LAMBIE COUNTY ENGINEER f CASSATT D. GRIFFIN. SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST PERIWIT•FEES c OSS ST. /✓ NUMBER OWNER LIGHT OUTLETS MAIL RECEPTACLES ADDRESS WALL SWITCHES FEE CITY TEL. NO. TOTAL OUTLETS ® 50 $ ELECTRICIAN I(�r ELEC. RANGES 25 ADDRESS ELEC. HEATERS 25 CITY TEL.NO. KM/FA STATE FIXTURES 5 LICENSE NO. r.• a a MOTORS DISTRICT NO. GR P ZONE READY FOR INSPECTION NUMBER HORSEPOWER FEE I I �+—( NEW MVD. HP OVER INC. EACH INSPECTION RECORD Jh&LESS $ .25 - if1 2 .50 2 5 1.00 S 15 1.50 15 50 2.50 SO 200 5.00 M ISC. 1 � NO.SIGNS NO.TRANS. NO.SIGNS NO. LAMPS FOR EACH PERMIT: WIRING $1.00 ho LRES $1.00 D MENTARY .50 APPROVALS TOTAL FEE I- t $ DATE INSPECTOR'S SIG ATURE REBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION �•.r ANDATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT ALL COUNTY ORDINANCES AND STATE LAWS REGULATINGICAL WIRING. WIRING REBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES ED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF RNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE POWER BED RESIDENTI PR PE UTILITY CO.NOTIFIEDTURE ERMITTEE �`'� ^` FINAL 151 JOHN A.LAMBIE.COUNTY ENGINEER VALIDATION ARTHUR C.VEIT.CHIEF ELECT. INSPECTOR CK MO CASH JW07737 JUL 5 2 2.50 WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) APPUCATION FOR ELECT ICAL PERK , 76A663 f he�elby 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(Sec A3800 Lab C) fed / /� Policy No •- /y 9/ahy'03 v -0c ie e FOR APPLICANT TO FILL IN JOB ^ ,p ,`�• ❑ - ADDRESS !T CIE Certified copy is hereby furnished New Residential Bldgs &Pools NO $ EACH $ FEE LOCALITY r E M till, v Certified co s filed with the count buildinginspection 1 &2-Family,Sq Ft departure tpy y p Multi-family Sq Ft CROSNEAREST �+ Qi , C t2 g�21 ejA/ r'rf7 y Residential Swimming Pools ASSES ST GQ DateSSOR Applicant MAP BOOK - PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER OR COMPENSATION INSURANCE Outlets Rec —Light Sw �rJ FIRM NAME. �0"AT I-( A�1 GKE (This section need not be completed If the work Involved by the 11- First 20 MAIL permit Is for one hundred dollars($100)or less) Mp Total No Additional ADDRESS 4 2 LCUM A A vE 1 certify that In'the performance of the work for which this permit CITY f E, I! t:� e/Ir rel No 2 g4 r ,6 is Issued, I shall not employ any person In any manner so as to PLAN CHECK become subject to the Workers' Compensation Laws Lighting Fixtures First 20 APPLICANT Total No Additional ADDRESS Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP NOTICE TO APPLICANT If, after making this Certificate of CITY Tel No Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP provisions of the Labor Code, you must forthwith comply with such APPLICANT G H A�C.� S Sft15 d/'f7f �/s" provisions or this permit shall be deemed revoked IT Power Apparatus&Large Appliances LICENSED CONTRACTORS DECLARATION Size&Type HP,KW, V or KVAR ADDRESS 1$S E 5 A TA e-C A IZA I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Ov to'101ncl CITY ��G�q p�A Tel No JC� r 77 g' Professions Code,and my license Is In full force and effect Over 10 to 50 Incl �. LICENSE OR Class C 21' O Over 50 t0 100 Incl REG NUMBER 67 9 ©74 tr 20 Over 100 DISTRICT NO C SED BY License Number G // Llc Class V jG C M E e_MA^/f G 4 C_ 96 Services,Swbd,MCC&Panelboards O Cc 0-399 Amp Under 600 V FINAL O Contractor Date DATE F- ❑ I am exempt under Sec 400-1000 Amp Under 600 V .Q W v VALIDATION Over 1000 Amp or Over 600.V FINALQ. B&P C for this reason BRANCH CIRCUIT FEES BY Date 15A,or 20A,120V,Lighti�V OR Z 1'0rTch Clrcwts 57 O '? Signature 11 To 40 Branch Circuits ❑ _ 41 Or More Branch Circuits }••nr s Exemption for Reg Maint Elect 15A,20A,208V To 277V Lighting Br Circuits SINGLE FAMILY Temp Power Pole&Appurtenances ' 67.80 HOME OWNER-BUILDER DECLARATIONSlgn with One Branch Circuit i TTC7MQ I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031 5, Business and Professions Additional Sign Branch Circuits rt'rTm A7 -SO Code) a p�1 ❑ �,�u7r•y 67.80 I, as owner of the property,will do the work and the structure Misc Conduits&Conductors Is not Intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) ® rt1e1R!!C nV0 and Professions Code) ; nrtnrl_ CONSTRUCTION LENDING AGENCY fltln� RI29/91 I hereby affirm that there Is a construction lending agency for the 9-'23 performance of the work for which this permit is issued (Sec 3097, PERMIT FEE (Sub-Total) O Civ C) PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE o Lender's Address I certify that I have read this application and under penalty of purjury state TOTAL FEE Q�,0 o that the above information Is correct I agree to comply with all County ordinances and State laws regulating Electrical wiring,and hereby authorize repres try of this County to enter upon the above-mentioned property for I pec pu oses SEE REVERSE FOR EXPLANATORY LANGUAGE SI NAT OF PERMITT E DATE