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Home My Public Portal About6462 LOMA AVE_Electrical__ 76A6B8_CE80612-58 APPLICATION FOR ELECTRIC PERMIT ],• COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BtTLD I B y �' . BUILDING AND SAFETY DIVISION Al G"swd JOHN A.LAMBIE.COUNTY ENGINEER ,tom CASSATT D.GRIFFIN.SUP'T.GF BUILDING LOCALITY FOR APPLICANT TO FILL-IN NEAREST . ,•� CROSS ST. ��'/vd=CSO✓' PERMIT FEES OWNER fir v.5 ITEM - NUMBERI EACH FEE OUTLETS: s MAIL ' LI G HTS BRRECE PT.F SW. •10 ��'1 ADDRESS LIGHTING FIXTURES .10 f a CITY TEL.NO. ELEC.RANGES CLO.DRYERS ELECTRICIANwJC- WATER HEATERS .50 ADDRESS X31-7 l�ave�el�a'a�e_ iQr� ELEC.SPACE HTRS. DISHWASHERS _ J C- .CITY �d..�e Gd./04 .0' TEL.NO. /'`d�t GARBAGE DISPOSERS AUTO.- ' STATE P l y WASHERS .STA.COOKING UNITS .25 LICENSE NO. MOTORS: OVER INC. H.P. DISTRICT NO. IGROUP ZQNEI Z&m Y 0— 1/2 .25 � 1/2— 2 .50 INSPECTION RECORD 2— 5 1.00 5— 15 1.50 15— 50 2.50 50-200 •5.00 SIGNS: NO.TRANS. NO.LAMPS SERVICE 0-600V 1.00 SERVICE OVER 600V 5.00 misc. WIRING PERMIT 1.00 foo FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .50 TOTAL FEE S .y o20 APPROVALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING .CONDUIT >`9 ELECTRICAL WIRING. - K_ I HEREBY CERTIFY THAT I PROPERLY REGISTERED ANWIRING OR r / � LICENSED' AS REQUIRED BY LOSS ANGELES COUNTY AND STATE OF FIXTURES j CALIFORNIA OR THAT A TH LEG L OW ER F THE ABOVE DESCRIBED RESIDE NTI PR PE Y. J�/Q POWER SIGNATURE �rin -,' �' UTILITY CO.NOTIFIED ✓r/� OF PERMITTEE """"'""".•{'«... ��''� FINAL - `1-7 6 ®FATION ARTHUR C. VETT, SUPERVISING ELECTRICAL ENGINEER CK MO CASH 5 9 9 2 iIAY 1 2 A 4.20 K �. WORKERS'COMPENSATION DECLARATION CE 806G (2-80) APPLICATION FOR, ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self COUNTY OF LOS'ANGELES I ING AN SAFETY insure, or a certificate of Workers'Compensation Insurance,or, ol,&- a certified copy thereof(Sec. 3800,Lab ) • FOR APPLICANT TO FILL IN _ Mpg Policy No. Company EACH NO. FEE ADDRESS Gd2 New Residential Bldgs.&Pools Certified copy is hereby furnished. 1 &2-Family,Sq.,Ft. $ $ LOCALITY, Multi-family Sq. Ft. — NEAREST Certified copy is filed with the.county buil ng nspection CROSS ST depar ment. Residential Swimming Pools OWNER OR FIRM NAME Date. jr Applicant Outlets: Rec._Light_ Sw. MAIL First 20 ADDRESS— CERTIFICATE OF EXE M ION FROM WORKER Total No. Additional CITYTel No. COMPENSATION INSURANCE } PLAN CHECK p -xe 0 APPLICANT (This sectionneed not be completed if the work involved V by the permit is for one hundred dollars ( Additional or less.) Lighting Fixtures First onal ADDRESS - Total No. O I certify that in the performance of the work for which this Fixed Appliances-Not Over 1 HP CITY Tel No. I– I 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 d Oven _ Dryer_W.M. ADDRESS /D Ce N Top _ FAU'_W.H.. Z Date Applicant - Hood _ Fan- _Other— CIT Tel No, *,?, NOTICE TO APPLICANT: If, after making this Certificate of Disp. Room Air Co LICENSE 0 Exemption , you should become subject to the Workers' REG. NUM ER Class C– v Compensation provisions of the Labor Code, you must forth- Powe/4p"a,af.i Carge epplianc�s� 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. FINAL Over 1 to 10 Incl. DATE V o /``�,�,.°� L LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl. C VALIDATION• . � FINAL i I•hereby affirm that I am licensed under provisions of Chapter Over,50 to 100 Inc. BY er, 9 (commencing with Section 7000) of Division 3 of the Busi- Over 100 ness and Professions Code, and my license is in full force and effect. Services License Numb Lic. Class C 16 0-200 Amp. Under 600 V 201-1000 Amp. Under 600 V Contractor ate Over,1000 Amp.or Over 600 V HOME 1. NER-BUILDER ECLARATION Temp. Power Pole&Appurtenances I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit License Law for the following reason (Section 7031.5, Busi- ness and Professions Code): 3.317.7 t Misc.Conduits&Conductors I, as owner of the property, will do the work and the Other (See Complete Fee Schedule)— #'o 0 0, o o 2 structure is not intended or offered for sale (Section 7044, Business and Professions Code). 2 0 o 1 (0 0 CONSTRUCTION LENDING AGENCY'. I herebyaffirm that there is a construction lending agency ° ° ° II,0 0 _ U. for the performance of the work for which this permit is PERMIT FEE (Sub-Total) issued•(Sec. 3097,Civ.C.). 7 05-83 ' 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 represe tives of this County to enter upon the above- entioned p pe y for inspection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE S ature of Permittee. Dat WORKERS'COMPENSATIONDECLARATION 76A663 APPLICATION FOR ELECTRICAL PERMIT. CE-806G (2-80) I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES' BUILDING AND SAFETY ins'tvre, or.a certificate of Workers'Compensation Insurance,or a certified co y thereof(Sec. 3800, C.� FOR APPLICANT TO FILL IN JOB Policy No. ompany ADDRESS AA New Residential Bldgs.&Pools EACH NO. FEE Certified copy'is hereby furnished. 1 &2 Family,Sq. Ft. $ — $ LOCALITY —4Z .. — NEAREST 1 Y Certified`copy.is filed'with the county building inspect' Multi-family Sq. Ft. CROSS ST ' epartment. Residential Swimming Pools OWNER OR (� FIRM NAME t Date r"Cpplicant Ae Iff Outlets: Rec.—Light—Sw. MAIL . First 20 ADDRESS CERTIFICATE OF EXEMPT/ION FROM WORKERS' Total No. Additional CITY . 1—Itl PL,— Tel No` V } COMPENSATION INSURANCE PLAN CHECK tL APPLICANT (This section need not be completed if the work iolved: nv Li by the permit is for one hundred dollars ($100) or less.) ghting Fixtures First 20 ADDRESS cr Additional 1 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 W so as to become subject to the Workers' Compensation-Laws. Range_ Heater_D.W. APPLICANT tl Oven _ Dryer_W.M. ADDRESS' �� s��. 2 Date Applicant Top FAUW.H.,_ ,y � Hood Fan _Other_ CITY 60 C, ' Tel No. NOTICE TO APPLICANT: If, after makingthis Certificate.of LICENSE OR ff� ) p Exemption, Disp.,._ Room Air Cond. . REG. NUMBER V v 0 Class p you should' become subject to the Workers' Compensation provisions of the Labor Code, you must forth- Power.Apparatus& Large Appliances DISTRICT NO. P SSED BY with comply with such provisions or this 'permit shall be Size&Type HP,KW, KV A,or KVAR deemed revoked. �/e �U 8 Up to 1 Incl. FINAL Over 1 to 10 Incl. DATE 1-6 .— '� VALIDATION. LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl. I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL r By 9 (commencing with Section 70.00) of Division 3 of the Busi- Over 100 ness and Professions.Code, an'd my license is in full force and p F� p effect. e=Services owl SiW41C % 0-200 Amp. Under 60,0.V 0 117 License NumbeW_VR c. Class 201-1000 Amp. Under 600 V Contractorate ' '� Over 1000 Amp..or Over 600 V HOM WDECLARATION Temp.Power Pole&Appurtenances I 'hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits ness and Professions Code): Misc.Conduits& Conductors I, 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 7044; Business and Professions Code). o CONSTRUCTION LENDING AGENCY 2,35 5,0 A I hereby affirm that there is a construction lending agency P-0.0,0 o 2 for the performance of the work for which this permit is PERMIT FEE'•, (Sub-Total) 2 --024,5 0 issued (Sec. 3097,Civ.C.). Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) 0 0'•o 2[h 5 0 5 Lender's Address PERMIT ISSUING FEE d ,1229-80 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 ent ed property for insp tion purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE nature of Permittee ate