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Home My Public Portal About9412 LOWER AZUSA RD_Electrical__ 76AA9-CE806;8=6' APPLICATION FOR ELECT ICAL PLFtMIT i COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. NO. EACH FEE $ $ OWNER Tr OlU RECEIPT. MAIL LIGHT TOTAL FIRST 20 ,20 ADDRESS SWITCH OVER 20 ,10 CITY TEL.N0. PLAN CHECK LIGHTING TOTAL RST 20 ,20 APPLICANT FIXTURES 1-��Ov"ER 20 ,10 ADDRESS RANGE_DRYER_WTR. HTR. CITY TEL.NO.. STA. COOK_DISP._F.A.U. CONTRACTOR Alzelle 61 A t' SPACE HTR. AIR COND. ADDRESS C CLOTHES WASH._DISHWASH. CITYxJ TEL.NO. FAN_OTHER 1.00 LICENSE N0. s CLASS. MOTORS,TRANSFORMERS RATING VV 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION IND. HEATERS, ETC. HP. KW. KVA. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. 0 - 1 1.00 1 HEREBY CERTIFY THAT I AM PROP LY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGE UNTY AND STATE OF I - 10 3.00 CALIFORNIA OR THAT IHE EGAL OF, AND INTEND O RESIDE IN, THE ABOVE E RI D RE NTI L ROPERTY. / 10 - 50 5.00IL SIGNATURE � 50 - 100 t0A0 OF PERMITTEE 0 100 - 500 15.00 DIST RI T NO. GROUPAZO PR C t n u SIGN GAS SIGN AND ONE CIRCUIT 3.00 E `� 1 1 u TUB?, OR L MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES: SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 SERVICE OVER 600 VOLTS OR 200 AMP 5.00 TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP. POWER POLE UNDERSLAB WORK ROUGH CONDUIT WIRING PERMIT FEE (SUB TOTAL) FIXTURES PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED PERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED ,+ SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL JOSEPH C. ROOHAN TOTAL FEE IVJV , SUPERVISING ELECTRICAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH q PERMIT VALIDATION CK. M.O. CASH 4 per 6 0-ME nuG 2 0 2 D 5.0 0 SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE 76A663 DBS SA 3-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF EN13114EER Em L IS CFO,or'R I Co FOR APPLICANT TO FILL IN DIST7 NO. GROUP ZONE PERMIT NII. ELECTRICIAN / 1-00,/ RECEIVED BY READY FOR DATE ISSUED ADDRESS ��/✓'.? i• /_ -FIRST INSPECTION CITY �/ i• " +° TEL.NO.;r i COUNTY LICENSE NO. i—=r� " EXPIRES BUILDINB,F• PERMIT FEESS` ADDRESS L NUMBER EACH FEE LOCALITY LIGHT OUTLETS NEAREST ° CROSS ST. RECEPTACLES -71 WALL SWITCHES i OWNER TOTAL OUTLETS Be 0 MAIL CLEC. RANGES 85 ADDRESS ELEC. HEATERS 25 CITY TEL NO. FIXTURES _�_ 5 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WIT14 ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOB NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER NEW MVD. HP OVER I IND. EACH of THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. !/a s LESS $ .25 SIGNATURE OF YR 2 .BO PERMITTEE 2 B 1.131 INSPECTION RECORD 5 16 1.50 113 So 2.50 / BO 200 5.00 / /✓f'./J /!% .!t./ ./Ta RC 2013 Boo 10.00J Boo 1000 15.00 2-0 A OVER 1000 20.00r� L7 M.G. HET/FREM. CHANGER-HP WELDERS'AC-KVA v O GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF CRIB.) MOVED MOTORS (79% OF ams.) MISC. SIGNS NO. NO.TRANS. APPROVALS NQ. NO.LAMPS DATE INBPECTORIB NAME FOR EACH PERMIT: WIRING $1.00 % CONDUIT FIXTURES $1.00 WIRING SUPPLEMENTARY .50 FIXTURES �( POWER TOTAL FEE $ 3 1 UTILITY CO.NOTIFIED FINAL ie ~ 76A663 CBB 5A- a`-80 -- APPLICATION FOR PERMIT DEPARTMENT OF.BUILDIIITG AND-SAFETY 'COUNTY OF LOS ANGELESELECTKI WILLIAM J. FOX, CHIEF ENGINEER ' ' FOR APPLICANT TO FILL IN DIST RI NO. GROUP ZONE ,_PERMIT ND. .ELECTRICIAN 77-7_7 '••.T7,74 r- RECEIVED,BY READY FOR DATE ISSUED ADDRESS .Y.41 -?f ry 4� FIRST INSPECTION �� /: ' CITY '' ,/✓+/l�di//rZ.II' TEL NO.-r 7 4,/.r5-I P P -COUNTY LICENSE NO. 'f�i�' EXPIRES BUILDING •ADDRESS .6b�'1'r1 PERMIT FESS NR UMBEEACH FEE LOCALITY ' J !; :.s•_y .6r•d �c d:7: LIGHT OUTLETS. j4p NEAREST RECEPTACLES CRI358 ST..'`�,. I�n WALL- SWITCHES OWNER /� Icy TOTAL OUTLETS•- 6c .A MAIL ;+K '• ' ' ELEC. ,RANGES 25 ADDRESS ,ELEC. HEATERS 85 CITY TEL N`13. FIXTURES 5 I HEREBY ACKNOWLEDGE THAT 1 HAVE•READ•,THIS MISC. APPLICATION AND STATE THAT THE ABOVE IS,CORRECT NUMBER CF LIGHT'CIRCUITS AND AGREE •T,O• COMPLY W.IT14 ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE,CIRCUITS A_ND STATE.AND WIRING. MOTORS I CERTIFY THAT 1 POSSESS THE_ABOVE VALID- LOS NUMBER, HORSEPOWER FEE ANGELES COUNTY LICENSE, 13R .1 AM THE LEGAL OWNER NEW MVD. HP OVEia ;NO. EACH' OF THE RESIDENTIAL'PROPERTY DESCRIBED.ABOVE. , & lees S .85' SIGNATURE DR• rr- � �/t 8 .613 PERMITTED a " B 1.013 -INSPECTION RECORD , 5 15- 1.50 .15 50 8.50 3 5 hp 6O 8013 5.00 101f p/ ', 8013 6130 10.DO - 5013 1000• 15.013 ' y Z $ ..�. f • OVER 1 OOO 80.00 - _ M.S.,BET/FREq. CHANGER-HP - 0!9.24f WELDERS•AC-KVA O GENERATORS - KW' TRANSFORMERS --KHA• - TEMP. MOTORS (75% of CRIB.) J MOVED MOTORS (75%u DF OR-Ra •MISC: ? SIGNS NO. NP.TRANS. Lill NQ. NQ.LAMPS' APPROVALS -DAT INSPECTOR'S NAME - 'FOR-EACH�PERMIT;' � - , , WIRING 4 101.00 CONDUIT FIXTURES '' >$1.OD WIRING f; - /e-• �Co C7 SUPPLEMENTARY .613 FIXTURES' POWER ' . TOTAL FEE S °J? j) UTILITY Co.NOTIFIED / FINAL � � y } OOY■7Y OF 1.0■ A■L1ELE■ APPLZCA67= FOS PSBMr HILUM L F03L OmmW WINN, ELECTRIC 1 FCR APPLICANT TC FILL IN DI■MICT NO. ■ROUP ZON■ R NIL �s- I kc LLJXCJK Ii ANGERED Ar FIS NI lr�OT10N OITY N jMMMLUONIL 1 ■u1LO1N■ PER= F AOOREO FEi I NUM■0 EAON L u■HT OUTLET■ N10101 R■OIRTAOLO 07 9111011111mr. MALL■I TONE■ C*VNER TOTAL OLT1 LEE N MAIL ■LII. RAN■0 ! ADDRESS XLER. HEATED 0 OITY TRIM NO. l771T11110 ■ 1 NEWSY AOENOMIWD■E THAT 1 HAVE NEAR IN MIS APPLIOATION ANO MATE THAT THE A■OIR 1■ OMMWf NYM■E■OF u■HT OINOurm ANO M■ TO OOMPLY MRN ALL OOIINTY OmINAN00 RUNNER OF NmwrAOLi OINOYIm AND ■TATE LADD 1■OIuLATIN■ O.EOTRIOAL MIRIN■. mcnmm 1 OENTIFY THAT 1 PO THE A■OVE VAUO LO■ Na HO FEE AN■oi■ ■OIIIRY UUZMM OR 1 AM THE Li■AL OIILREN NEW MYN. •HP Emma I Im T OF THE N01or PROPORII OLNMRI■m mom LRRI .!■ NIr1ATYNE OF .■O P� 1.mmopEc7mBBC= 1N 116011 ' No N.m • e 1O.m � J f LM Z orae 1® RILM e M O C 0 R M or M M ■R ■1■N■ NIL NO.TNANL �v�$ FOR EARN FROM TI MEL mum_ 110 —qmmu- 11111.11101 N■ ,..• •...+ TWAL I= ■ UTI rim, FINAL +. t`sVORKER'S COMPENSATION DECLARATION 00 DPW_' I I hereby affirmAhat I have a certificate of consent to self Insure, APPLICATION FOR ELECTRICAL PERMIT or certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec.3800 Lab.C.) Policy No. Company } FOR APPLICANT TO FILL IN UB SS 4 a I I M AZ-4%A Certified copy is hereby furnished. I CA New Residential Bldgs.&Pools EACH NO. FEE i $ —Is LOCALI ru.. ❑ Certified copy is filed with the county building,inspection i 1&2-Family,Sq.Ft. NEAREST �y�y�� Gt �/ department: Multi-family Sq.Ft. CROSS ST: W/i�•• " t J�U Date Applicant Residential Swimming Pools ASSESSOR gS•7 PAGEPARCEL MAP BOOK CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec. Light�Sw. OWNER OR I f'V" 6 COMPENSATION INSURANCE ) FIRM NAME First 20 MAIL. �. 74/1 (This section need not be completed if the work involved by the ` Total No. Additional ADDRESS permit is for one hundred dollars($100)or less.) I certify that in the performance of the work for which this permit l CITY Tel.N(g d�e13 Is issued, I shall not employ any person in any manner so as.to gpL become subject to the Workers'Compensation Laws. r Lighting Fixtures j First 20 pICANTK Total No. Additionalpv ADDRESS y/2 Ln4 Date Applicant , ^� ,��,G NOTICE TO APPLICANT: If, after making this Certificate o15 OR 20A120V BRANCH CIRCUITS .f CITY--MWJZC41��i IM Tel.No. 3SD- Exemption,'you should become subject to the.Workers'Compensation 1 TO 10 INCLUSIVE EACH 07 9 PERMIT ��r. �y�a �� provisions of the Labor Code,you must forthwith comply with such 11 TO 40 INCLUSIVE EACH APPLICANT •"'v� /-�"�'rl�M provisions or this permit shall be deemed revoked. 41 OR MORE BRANCH CIRCUITS EACH LICENSED CONTRACTORS DECLARATION ADDRESS��IZ O 1 hereby affirm that I am licensed under provisions of Chapter 9 150 R 20A,208V TO 277V LIGHTING EACHIL o (commencing with Section 7000)of Division 3 of the Business and CITY L r 9n�Tel.N. ��>3�." U Professions Code,and my license is in full force and effect. RESIDENTIAL APPLIANCES UP.TO SHP LICENSEOR .� Power Apparatus&Large Appliances REO.NUMBER Claes. O License Number Lic.Class Size&Type HP,KW,KVA,or KVAR DISTRICT NO. �j PROCESS B I— ' Up to 3 Incl. S v W Over 3 to 10 Incl. FINAL a' Contractor Date DATEco ❑ Over 10 to 50 Incl. % I am exempt under Sec. Over 50 to 100 Incl. VALIDATION Over 100 FINAL B.&P:C.for this reason BY Services,Swbd.,MCC&Panelboards 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 Circuit 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 �''� T'�`+ rj-' 9 ( 9 ;).��I� 3 1-SLI Co e): 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) ONO. (j `"xk ;'�i � and Professions Code). - SHL. .,,�_.. c 20 w•I,_., 1. CONSTRUCTION LENDING AGENCY ' 1Iw s•�s: ,� I I hereby affirm that there is a construction lending agency for the t,•!"It NGE a!l._ performance of the work for which this permit is Issued(Sec.3097, PERMIT FEE (Sub-Total) Civ.C.) PLAN CHECKING FEE C 3l r3 G i�1 is,/�.�7�iii Lender's Name �,.,s� 9:5'_:o s�: PERMIT ISSUING FEE Z ;tf j '1 ill4' ;,,._._ Lender's Address I certify that I have read this application and state that the above TOTAL FEE 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 ',[g\ property for Inspection purpose SEE REVERSE FOR EXPLANATORY LANGUAGE `SIGNATURE OF APPLICANT OR AGE ,