HomeMy Public PortalAbout8760 LONGDEN AVE_Electrical__ 76A663 DBS SA 11-SO APPLICATION FOR PERMIT
DEPARTMENT OF*BUILDING AND SAFETY
COUNTY OF LOS ANGELES T V
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO.
4` I ► IPoo
ELECTRICIAN.//t //� _A
�'•+ ^ RECEIVED BY READY FOR DATE.ISSUED
ADDRESS G //_ f, � A FIRST INNSSPPECTION
CITY TEL. NO.
COUNTY LICENSE NO. EXPIRES BUILDANG
DDRESS
PERMIT FEES
V r
NUMBER EACH FEE LOCALITY -
LIGHT OUTLETS NEAREST
CROSS ST.
RECEPTACLES __ a -� •*-�
WALL SWITCHES OWNER. ;/>-_'-.;)
TOTAL OUTLETS Sc $ - MAIL ��1 ���/
ELEC. RANGES 25 ADDRESS
ELEC. HEATERS 25
CITY i_•.3,,.s -%i: /_!'t�dM/,.r 14NO.
FIXTURES 5
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
MISC. APPLICATION AND STATE THAT THE ABOVE ISCORRECT
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 I POSSESS THE ABOVE .VALID LOS
ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
NUMBER HORSEPOWER
FEE I OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
NEW MVD. HP OVER INC. EACH
1/2&LESS $ .25. SIGNATURE OF. �/ C /
1/2 2 50 PERMITTE eC (((//
2 5 1.00 INSPECTION RECORD
5 15 1.50 —�
15 50 2.50
50 200 5.00
200 Boo 10.001 n 82
�
Soo 1000 15.00 - Q
OVER 1000 20.00 `_ v
M. G. SET/FRED. CHANGER-HP
WELDERS: AC-KVA
GENERATORS-KW Y
TRANSFORMERS-KVA
TEMP. MOTORS (75%OF ORIG.)
MOVED MOTORS (75%OF ORic.) j
MISC. e5v
SIGNS
NO. NO..TRANS. I APPROVALSNO. NO. LAMPS
DATE /y I/N}SPECTOR'S NAME
FOR EACH PERMIT: CONDUIT
WIRING $1.00.
WIRING
FIXTURES $1.00
SUPPLEMENTARY .50 FIXTURES
POWER .i
TOTAL FEE I.$ ( UTILITY CO. NOTIFIED ('J// "7'�y
G - � FINAL I U � 1� •'A
DeDEPARTMENT
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HDEPAIIB'I�'IENH O BU11IIi11�HiVTP AND SAFETY ������� �d8 i{ICi
COUNTY OF LOS ANGELES ELECTRIC
WM. J. FOX CHIEF ENGINEER
a NAME DISTRICT NO. GROUP ZONE PERMIT NO.
600' ADDRESS )) � e/ � ele,b 3
U CITY G � O71 RECEIVED BX. READY FOR DATE ISSUED
T L
FIRST INSPECTION
A COUNTY
W CERT.NO. EXPIRES
APPLICANT FILL IN HEAVILY OUTLINE® PORTION ONLYJOB
,
DESCRIPTION OF WORK ADDRESS
NUMBER OF OUTLETS ON CIRCUITS LOCALITY' �� _e01�V`��
LOCATION BY ROOMS NEAREST p C�
LIGHT OUTLETS SW. PLUGS FIXT CROSS ST. / GSA\a
CIRCUIT A B C D E F G H 0! NAME 15'lz 9AI C
-- Z MAIL p
_ 3 ADDRESS.
O
CITY. TEL.NO.
I AM THE LEGAL POSSESSOROF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE OF QUALIFICATION..
ELECTRICIAN.
IAM THE LEGAL OWNER OF THE PROPERTY DESCRI1IB[[[���yyyppp
O
ABVE- -";�
° OWNER.
CORRECTIONS
J
— Q
Z_
L9
!Y
O
TOTAL
NO: OF OUTLETS $ �v. APPROVALS
NO. OF FIXTURES $ DATE INS�PECTOR'S NAME
NO. OF MOTORS H.P. $ CONDUIT LA� !/Q(! l l�
NO. OF SIGNS TRANS. $ WIRING
NO. OF RANGES OR HEATERS $ FIXTURES
MISCELLANEOUS $ POWER
PERMIT FEE /S O A> $ / U UTILITY CO.NOTIFIED �'
TOTAL FEE /'' i./ 0 FINAL _��
WORKERS'COMPENSATION DECLARATION CE-806 10/81 APPUC ATMH FOR ELEC���° CAL PERN7
I hereby affirm that I have a certificate of consent to self CE-8066
insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES �.� BUILDING AND SAFETYora certified copy thereof (Sec. 3800, Lab. C.)
Policy No. Company FOR APPLICANT TO FILL IN JOB
❑ Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS Q 67.-^ S
❑ 1 & 2-Family, S Ft. $ — $ LOCALITY
Certified copy is filed with the county building inspec- Y, q
tion department. Multi-family Sq. Ft. — NEAREST
CROSS ST.
Date Applicant Residential Swimming Pools OWNER OR //may� Q
FIRM NAME ld f VTJe
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Li ht Sw._ MAIL
COMPENSATION INSURANCE g ADDRESS 6- C-,
NGS
s section not completed if the work involved b First 20
(Thitin need t bom p Y Total No. Additional CITY Tel. No.
the permit is for one hundred dollars ($100)or less.)
I certifythat in the performance of the work for which this PLAN CHECK
P APPLICANT
permit is issued; I shall not employ an personjin an a�ner
.so as to'become subject to the o s'Com en i ws. Lighting Fixtures First 20 ADDRESS
^ Additional
Total No. CITY Tel. No.
Date Applicant J Fixed Appliances Not Over 1 HP PERMIT
NOTICE TO APPL CANT: If, afte making this Certificate of APPLICANT
Exemption, you should beco "e subjectto the Workers' Range_ Heater—D.W. J
Compensation provisions.of the Labor Code,.you must forth- Oven _ Dryer — W.M.— ADDRESS G
with comply with such provisions or this permit shall be Top — FAU —W.H.
deemed revoked. y
Hood CITY r Tel. No.X 14
�
r
LICENSED CONTRACTORS DECLARATION _ Fan _ Other_ LICENSE OR
I hereby affirm that I am licensed under provisions of Chapter 9 Disp. _ Room Air Cond. REG. NUMBER Class.
(commencing with Section 7000) of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO. PROCED S BY., >_
and Professions Code, and my license is in full force and effect. S-v0.
Size &Type HP, KW, KVA, or KVAR'
License Number Lic. Class Up to 1 Incl. FINAL
Over 1 to 10 Incl: DATE ] VALIDATION 0
Contractor Date Over 10 to 50 Incl. FINAL I �
❑ 11 am exempt under Sec. Over 50 to 100 Inc. BY y' r� LU
Lf �.
B.&P.C. for this reason Over 100 rA
Services, Swbd., MCC& Panelboards D
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
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit3 .5 3 7 A
I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits o 0
Law for the following reason (Section 7031.5, Business and # . 0 0 o'2
Professions Code):
❑ Misc. Conduits&Conductors 2 ° o 2 a..5 Q '
I, as owner of the property, will do the work and the
structure is.not intended or offered for sale (Section Other (See Complete Fee Schedule)_ oto .0 2 5.57044, Business and Professions Code). D' ' b 1
CONSTRUCTION LENDING AGENCY o8_.1 6-84
1 hereby affirm that there is a construction lending agency for
the performance of the work for which this permit is issued PERMIT FEE (Sub-Total)
(Sec. 3097, Civ.'C.)..
PLAN CHECKING FEE
Lender's Name42
PERMIT ISSUING FEE. LA
Lender's Address
I certify that 1. have read this.application and state that the TOTAL FEE
above information is correct. I agree to comply with all County
ordin nces and State laws re luting Electrical wiring, and
r y utboriz repres ti e of this County,to enter upon
th m� conedro rt f r inspection purpos
SEE REVERSE FOR EXPLANATORY LANGUAGE
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/Signature of Pe flee Date