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Home My Public Portal About9516 LEMON AVE_Electrical__ DBS SA 25M BETH 2-47 APPLICATION PP IC A►mION FOR E17R� NOrr - - MPARTMENT OF 'BUILDING � SA �-ELECT IIa. rl�.C31YElY .COUNTY OF LOS ANGELES - /} =, ' wM. J. FOX CHIEF ENGINEER1!. F(jRj) A AME DISTRICT NO. GROUP ZONE PERMIT NO. DDRESRECEIVED BY READY FOR DATEISSUEDTY TEL.NO. FIRST INSPECTIONOUNTY ERT.NO. EXPIRES �P CANT FILL. IN HEAVILY OUTLINED PORTION'opiLy JOB DESCRIPTION OF -WORK r ADDRESS NUMBER OF OUTLETS ON CIRCUITS _ LOCALITY LOCATION BY ROOMS NEAREST •LIGHT OUTLETS SW. PLUGS FTXT CROSS ST. J - CIRCUIT A -B C I D .E F G JH IYNAME i .r Z MAIL }r ADDRESS ; O CITY TEL.NO. I AM THE LEGAL POSE SSOR'OF ^E ABOVq LOS ANGELES COUNTY CER FICA OF�AFIFICATION.. _ELECCIAN. e AM THE;TLrsar OWNER aF TH6 PROPERTY DESCRIBED ABOvF. OWNER. COl$.I$.ECTIONS W _U J a A ❑ TOTAL` NO. OF OUTLETS $ APPROVALS NO. OF FIXTURES $ DATE INSPECTOR'S NAME NO. OF MOTORS -H'.P. $ CONDUIT NO, OF SIGNS TRANS. $ _ WIRING NO. OF RANGES O HEATERS $ FIXTURES MISCELLANEOU $ POWER - PERMIT FEE $ UTILITY CO.NOTIFIED TOTAL FEE 41M FINAL, WORKER5'COMPENSATION DECLARATION CE-806(3 (2-80) APPLICATION FOR' ELECTRICAL PERMIT I hereby affirm that I have a certificate, of consent to selfCOUNTY OF LOS ANGELES ING AND SAFETY insure, or a certificate of Workers'Compensation Insurance,or ( / ,a certified copy thereof(Sec 3800, Lab C) 1 Policy No Company /l FOR APPLICANT TO FILL IN JOB �L ^ I J) Residential esidential Bldgs &Pools EACH NO FEE ADDRESS J L' Certified copy is hereby furnished 1 &2-Family,Sq Ft $ — $ LOCALITY' Certified T ❑ is Sq Ft NEAREST y� copy filed with the county building inspection CROSS ST Residential esidential Swimming Pools OWNER OR FIRM NAME Date Applicant ) Outlets Ree_Light_ Sw MAIL /n 0 ADDRESS First 20 J y CERTIFICATE OF EXEMPTION FROM WORKERS' Total No Additional CITY C i Tel No��p— 3C>3 } COMPENSATION INSURANCE PLAN CHECK n (This section need not be completed if the work involved APPLICANT L) by the permit is for one hundred dollars ($100) or less.)' Lighting Fixtures- First 20 ADDRESS Total No Additional O I certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP-_ CITY Tel No HP-- permit is issued, I shall not employ any person in any manner PERMITU so as to become subject to the Workers' Co nsation Laws Range_ Heater_D W. APPLICANT�•� ✓Z W Oven Dryer_W M ADDRESS Date I Applicant Top ' _ FAU —WH. Z pP Hood Fan —Other CITY T�� LAE j el Nop?$'�~�p NOTICE TO APPLICANT If, after making this Certificate of Disp Room Air Cond. ' LICENSE OR Exemption, you should become subject to the Workers' - — REG NUMBER R 3 Class Compensation provisions of the Labor!Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO PROCESSED BY with comply with such provisions or this permit shall be deemed revoked. Size&Type HP, KW, KVA,or KVAR Up to 1 Incl 19 Over 1 to 10 Incl FINAL - - LICENSED CONTRACTORS DECLARATION DATE �, VALIDATION Over 10 to 50 Incl I hereby,affirm that I am licensed under provisions of,Chapter" Over 50 to 100 Inc FINAL 9 (commencing with,Section 7000) of Division 3 of the Busi- Over 100 BY ness and Professions Code, and my license is in full force and effect. Ser 1�- 30 200 Amp Under 600 V License Number �0/ /Lie.Class. Z201-1000 Amp Under 600 V- Contractor Date _ `f / Over 1000 Amp or Over 600 V OME OWNER-BUILDER DECLARATION Temp Power Pole&,Appurtenances - n'O 4 „'A 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 1 _ U ° u 0,0 ness and Professions Code) i J Misc Conduits&Conductors ° ° 5,•� r' 1, as owner of-the property, will do the work and the Other (See Complete Fee Schedule)— d.° ° r = structure is not intended or offered for sale (Section 2r'�d c 7044, Business and Professions Code) ' �,1•� CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for 'which this permit is PERMIT FEE (Sub-Total) I� issued (Sec 3097,Civ C) 1a , L Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) Lender's Address 1. PERMIT ISSUING FEE O I certify that I have read this application and state that the TOTAL FEE S�( above information is correct I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authori repr ntat�for his County to enter upon the a e- e e opertpection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE atur of ermittee Date 'I 6R 'ERS'COMPEhJSATION bECLARATION CE-806 1081 APPLICATION, FOR ELECTRICAL PERMIT '� -here' ia�t Affirm that I have a certificate of consent to self CE-8066 nsure,-or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELESBUILDING AND SAFETY or a certified copy thereof (Sec 3800, Lab C ) - f �j- Policy No Company FOR APPLICANT TO FILL IN JOB i' ✓� '< �1 ,v Certified copy is hereby furnished New Residential BldgsADDRESS& Pools EACH NO FEE J S _ Certified copy is filed with the county building m 1 & 2-FamilY spec- . q Ft $ $ LOCALITY tion department Multi-family Sq Ft CROSS NEARESTT/ Residential Swimming Pools OWNER OR ,� ' C Date Applicant g FIRM NAMEAJ CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Re Li ht V3 Sw If L�f_ MAIL COMPENSATION INSURANCE ADDRESS /�► - /� iv (This section need riot be completed if the work involved by Total No__� AddiFirst tional 1S V CITY ; �_; Tel Ng,�� 31� 3r the permit is for one hundred dollars ($100)or less.) _ �� p /1 I certify that m the performance of the PLAN CHECK work for which this APPLICANT �l �L',� J� � permit is issued, I shall not employ any person in an manner so as to be co a subject to the Workers'Comp ion'Laws Lighting Fixtures First 20 ADDRESS�j /`� 3 �j�` Total No Additional CITY T`,G Tel Ng. 8'lo•'(r 7 Date pplIcant Fixed Appliances Not Over 1 HP PERMIT _. NOTICE T PLICANT If, after akmg this Certificate of APPLICANT -� - �T�2 OIL' S� 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 —W H-— deemed revoked Hood Fan _ Other— CITY Tel No LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp — Room Air Cond, REG NUMBER -17&t 3 V Class 13+' (commencing with Section 7000) of Division 3 of the Business DISTRICT NO PROC yCL E BY and Professions Code,and m license is in full force and effect Power Apparatus& Large Appliances /'t Size &Type HP, KW, KVA, or KVAR � V O License Number / 3/ Lic Class �3 I Up to 1 Incl FINAL V Contractor / Date 3 y Over 1 to 10 Incl DATE VALIDAT N 0 E:1Over 10 to 50 Incl FINAL ~ I am xempt under Sec Over 50 to 100 Inc BY d B &P C for this reason Over 100 Z Date Services, Swbd , MCC & Panelboards ► — 0 -200 Amp Under 600 V n n Signature 201 - 1000 Amp Under 600 V 1/VII Exemption for Reg Maint Eject Over 1000 Amp•or Over 600 V SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Temp Power Pole 8 Appurtenances 1 5 p Sign with One Branch Circuit # o o o,o-a 2 I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits ` Law for the following reason (Section 7031 5, Business and � o 0 4 2 5 0 Professions Code) I, as owner of the property, will do the work and the Misc Conduits&Conductors J o a o 4 2 5 0 x structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ , 1204-84 7044, Business 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 PERMIT FEE (Sub-Total) (Sec 3097, Civ C ) 32 k PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address O 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 Sta 9 laws regulating Electrical wiring, and hereby author a presentative of this County to enter upon the aba -me t,ned property fo inspection pur�oosses SEE REVERSE FOR EXPLANATORY LANGUAGE L Sig ture f ermi tee Date'