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Home My Public Portal About9464 LEMON AVE_Electrical__ I 76A663 DBS SA 3-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES i WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTR17�.- GROUP ZONE PERMIT NO. ELECTRICI N • 6�(�s .411 I �� 1-/0 -6 RE EIVED BY READY FOR DATE ISSUED ADDRESS Al. FIRST INSPECTION CITY TEL.NO.o ,p') ALI_3 COUNTY LICENSE NO EXPIRESlie-201, BUILDIG 00 DDREBB PERMIT FEES NUMBER EACH FEE, LOCALITY LIGHT OUTLETS NEAREST CROSS ST. RECEPTACLES may} WALL SWITCHES OWNER Y TOTAL OUTLETS 5c $ MAIL ELEC. RANGES 25 ADDRESS ELEC. HEATERS 25 CITY TEL. NO. ' FIXTURES 5 ' 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER ANGELES COUNTY LICENSE, OR I AM HE LEGAL OWNER FEE EACH OF THE RESIDENTIAL PROPERTY DE RIBED ABOV NEW MVD. HP OVER INC. ,,AA V a LESS $ .25 BIGNATUREI Jq E %2 2 .50 PE R M I TTTTTT�CCCCCEEEE 2 5 1.00 INSPECTION RECORD 5 15 1.50 15 SO 2.50 50 200 5.00 200 500 10.00 J 500 1Ooo 15.00 Z OVER 1000 20.00 M.G. SET/FREQ. CHANGER-HP - Q' WELDERS:AC-KVA O GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF ORIG.) MOVED MOTORS (75% OF ORIG.) 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 POWER TOTAL FEE 91 4-UTILITYCO.NOTIFIED J � � FINAL 76A663C- CE806EI1=/75 , APPLICATION FOR ELECT CAL PERMIT L BUILDING SAFETY DIV ON FOR APPLICANT TO FILL IN ,JOB 7Residential Bldgs & Pools EACH NO FEE ADDRESS Sq Ft $ — $ LOCALITYq Ft. — NEAREST CROSS ST Residential Swimming Pools OWNER OR QQ FIRM NAME G, Outlets Light, Switch& Receptacle MAI L First 20 ADDRESS Additional CITY- - ;IN PLAN CH CK APPLICANT Lighting Fixtures First 20 ADDRESS Additional CITY PERMIT I n Fixed Appliances Not Over 1 HP APPLICANT ,(// Aol Range_ Heater_ D.W ADDRES Oven Dryer W M Top FAU W.H CITY r 0 Hood FanLICEOR 5_1REG NNUM SE ERgv?- Class E.31Dlsp. AC z 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION O AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY V Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING LL.I Size&Type HP, KW, KVA,or KVAR ELECTRICAL WIRING I:)- C'")cn Up to 1 Incl I HEREBY CERTIFY T I AM PROPERLY REGISTERED AND/OR Over 1 to 10 Incl LICENSED AS REOU IRE B LOS ANGEL OU NTv7— STATE OFCALIFORNIAR THA I M THE LE L WNE ABOVE Over 10 to 50 Incl. DESCRIBED RESIDE PROPERTY Over 50 to 100 Incl PERMITEE VA Over 100 SIGNATURE Services DISTRICT NO (ROCESSE BY 0-200 Amp Under 600 V Z/ 4SIA 201 - 1000 Amp Under 600 V INSPE OR'S APPROVALS DATE SIGNATURE Over 1000 Amp.or Over 600 V TEMP POWER POLE Temp Power Pole&Appurtenances UNDERSLAB WORK Sign with One Branch Circuit Additional Sign Branch Circuits ROUGH CONDUIT (Other) WIRING FIXTURES POWER AUTHORIZED PERMIT FEE (Sub-Total) UTILITY CO NOTIFIED PLAN CHECKING FEE 1 (One-Fourth Permit Fee) FINAL PERMIT ISSUING FEE TOTALFEE NOTES >P-L=Aih6EHECASH PERMIT VALIDATION CK MO CASH POLICY HOLDER; � �-., 9 1 1 r—MAR 6 2 a 1� 5.0 0 A'_4j POLICY NUMBER: WORKERS' COMPENSATION DECLARATION 20-0019 DPW 3/87 APPLICATION FOR ELECTRICAL PERMIT O 663 I hereby affirm that I have a certificate of consent toeself CE-806G insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certifI'b/d c''o ''CCyj'thherreof (Sec 380:1� Policy No 319yol Company FOR APPLICANT TO FILL IN JOB // Certified copy is hereby furnished w 7-/-9� NeResidential Bldgs & Pools EACH NO FEE ADDRESS ❑Certified copy is filed,with the county building mspec- 1 & 2-Family, Sol Ft $ — $ LOCALITY hon department Multi-family Sol Ft — NEAREST Residential Swimming Pools CROSS STOWNER OR Date Applicant b _ S FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec Li ht�Sw ti MAIL COMPENSATION INSURANCE g6 �8 ADDRESS" First 20 (This section need not be completed if the work involved by Total No 69 Additional CITY Tel No the permit is for one hundred dollars ($100)or less.) PLAN CHECK I certify that in the performance of the work for which this APPLICANT permit is issued, I shall not employ any person in any manner p (� so as to become subject to the Workers'Compensation Laws Lighting Fixtures First 20 46 �a ADDRESS Additional �- Total No CITY Tel No Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT If, after making this Certificate of I APPLICATION Exemption, you should become subject to the Workers' Range— Heater_D W - Compensation provisions of the Labor Code, you must forth- Oven — Dryer W M — ADDRESS with comply with such provisions or this permit shall be Top FAU J-W H — deemed revoked CITY Te o 9,6323 (� LICENSED CONTRACTORS DECLARATION Hood Fan —Other— Ll I p OU LICENSE OR 1 hereby affirm that I am licensed under provisions of Chapter 9 Disp Room Air CanalLICE NUMBER s73 3 Class r✓ �() (commencing with Section 7000)of Division 3 of the Business Power Apparatus & Large Appliances DISTRICT NO •' PRO SSED BY and Professions Code, and my license is in full force and effect G_ Size &Type HP, KW, KVA, or KVAR �� ..J Q License Nu�mbjer� Td Lic Class Up to 1 Incl FINAL U Contract6i �� -�-� Over 1 to 10 Incl Q DATE VALIDATION ❑ Over 10 to 50 Incl FINAL I am e empt under Sec Over 50 to 100 Inc BY W B&P C for this reason Over 100 d r ® Z • Date Services, Swbd , MCC 8 Panelboards /�j � Z 0- 200 Amp Under 600 V O - -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 Circuit 1 hereby affirm that I am exempt from the Contractor's License ,_q i o Z Law for the following reason (Section 7031 5, Business and Additional Sign Branch Circuits Ir Professions Code) F-11, as owner of the property; will do the work and the Misc Conduits 8 Conductors structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ T0 .f Business and Professions Code) ® _ �i_ 126 m 60 CONSTRUCTION LENDING AGENCY HE'-V [ I herebyaffirm that there is a construction lending a enc for i ° _ g 9 Y. ht9i�il oI,_! the performance of the work'for which this permit is issued PERMIT FEE (Sub-Total) V , (Sec 3097, Civ C ) PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address 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-mentioned property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE O Signature of Permittee Date :