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Home My Public Portal About9547 LOWER AZUSA RD_Electrical__ I t P 1 1 1 1 1 =j j1 DFSCREMON OF WORK NUMBERCIRCUITS �l?Arip-vLOCATION BY ROOMS 7- ■■■■■■■■■■■■■■ CBS SA 7-51 APPLICATION FOR PERMIT ""IDEP'ARTMENT OF BUILDING AND SAFETY �� COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRIFO. GROUP ZONE PERMIT NO. ELECTRICIAN L(7.? 7 RECE VED BY READY FOR DATE 19SUED ADDRESS FIRST INSPECTION CITY Ly Z TEL. NO bmr� ^A I COUNTY LICENSE NO. EXPIRES BUILDING —ADDRESS PERMIT FEESy. NUMBER EACH FEE LOCALITY Q yti� e LIGHT OUTLETS NEAREST CROSS BT RECEPTACLES I WALL SWITCHES OWNER _ TOTAL OUTLETS SC !p MAIL ELEC RANGES 26 ADDREHB S V' V V ELEC HEATERS 25 CITY TEL NO. FIXTURES 6 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS MISC APPLICATION AND 13TATE THAT THE ABOVE IB CORRECT NUMBER OF LIGHT CIRCUITS l AND AGREE TO COMPLY WITH 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 ANGELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER FEE NEW MVO HPI avec INC EACH OF THE RESIDENTIAL PROPER DESCRIBED ABOVE %2 6 L.B. 15 25 SIGNATURE OF %2 2 50 PERMITTE _- 2 e 100 SPECTION RECORD 5 15 1 50 15 50 250 511 2110 5 00 200 BOO 1000 JQ 500 1000 1500 Z OVER 10013 20 DO 19 M G SET/FRE4 CHANGER-HP Fr ,WELDERS AC-KVA O GENERATORS - KW TRANSFORMERS - KVA TEMP MOTORS (75% of ORIS) MOVED MOTORS (75% OF GRIM) MISC SIGNS NO NO TRANS. APPROVALS NO NO LAMPS DATE INSPECTOR'S NAME FDR EACH PERMIT. WIRING $1.00 1 6 0 CONDUIT _ FIXTURES $100 WIRING SUPPLEMENTARY ,gp FIXTURES POWER TOTAL FEE 4 UTILITY CO NOTIFIED FINAL 76)Mp,PB%,aA 11-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY �� COUNTY OFF LOSLOS ANGELES WILLIAM J FOX, CHIEF ENGINEER ti z4w ROUP ZONE PERMIT NO FOR APPLICANT TO FILL IN ELECTRICIAN �L'v ly -2 CRECEI D BY READY FOR DATE ISSUED ADDRESS fS�rl` FIRST INSPECTION ✓� I' / CITY TEL NO 5 COUNTY LICENSE NO --.—Es UILDING PERMIT FEES ADDRE68 FEE NUMBER EACH LOCALI LIGHT OUTLETS S NEAREST CR08S ST RECEPTACLES WALL SWITCHES OWNER TOTAL OUTLETS Sc MAIL r ELEC RANGES 2E ADDRESS �J ELEC HEATERS 25 CITY TEL NO FIXTURES S 1 HEREBY ACKNO LEDGfi THAT 1 HAVB (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 14ND STATE LAWS REGULATING ELECTRICAL WIRING MOTORS 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWERANGELES COUNTY LICENSE. OR I AM THE LEGAL OWNER FfiE New Mv0 HP OVER INC BACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. IA a Less 28 12 SIGNATURE OF A 1/2 2 50 ' PERMITTEE!��22 r �� 2 s 1 00 INSPECTION RECORD 5 15 1 50 is so 2 50 5o 2010 5.00-- 200 00200 500 10 00 500 1000 1500 Q Z OVER 1000 20010 (� M G SET/FREQ CHANGER-HP WELDERS AC-KVA O GENERATORS-KW TRANSFORMERS-KVA TEMP MOTORS 75%OF ORIG MOVED MOTORS ( Y.OF'PRIG MISC AV SIGNS NO NO TRANS APPROVALS NO NO MP8 DATE INSPECTOR'S NAME FOR EACH PERMIT WIRING !61 00 • V CONDUIT FIXTURES $1 00 WIRING SUPPLEMENTARY 50 FIXTURES POWER TOTAL FEE f UTILITY CO NOTIFIED , FINAL 1T WORKERS'COMPENSATION DECLARATION CES 1081 APPLICATION FOR ELECTRICAL PERMIT I hereby affirr��that I have a certificate of consent to self insure, or a certi#icate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY, or a certified copy thereof (Sec 3800, ab C ) S' , r Policy No ;3 , an�/ i FOR APPLICANT TO FILL IN JOB ertified copy is hereby furnished New'Residential Bldgs & Pools EACH NO FEE ADDRESS owe.t &xos v ertified copy is filed with the county building inspec- 1 & 2-Family, Sq Ft $ — $ LOCALITY do a tment � Multi-family Sq FT — NEAREST 9 11ST1 a Residential Swimming Pools OWNER OR CROSS ST Date Applicant Jess$ Sek�G S FIRM NAME CERTIFICATE OF EXEMPTIO FROM WORKERS' Outlets Rec4_1 Lighta% Sw MAIL .L V s pJ COMPENSATION INSURANCE - First 20 ADDRESS a w et lam. (This section need not be completed if the work Involved by Total No Additional CITY lie Yin jl"i 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 so as to become subject to the Workers'Compensation Laws Lighting Fixtures First 20 ADDRESS Total No 2� Additional CITY Tel No Date Applicant Fixed Appliances Not Over 1 HP PERMIT /� NOTICE TO APPLICANT If, after making this Certificate of APPLICANT O S • l , 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 !i r 4 h eA with comply with such provisions or this permit shall be Top — FAU —W H _ t deemed revoked Hood _ Fan _Other_ CIN DV / Na 117 Tel No „ate LICENSED CONTRACTORS DECLARATION Dis _ Room Air Cond LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 p REG NUMBER jj- Class (commencing with Section 7000) of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO ED BY and Professions Code,and my license is in full force and effect C v r �[ Size&Type HP, KW, KVA, or KVAR `/r CLO License Number L,cc Class Up to 1 Incl FINAL tJ ,,,,��`� 7 d Over 1 to 10lncl DATE /� /� pC Contractor domr.ate 8� /� VALIDATION 0 ❑ Over 10 to 50 Incl FINAL I am exempt under Sec Over 50 to 100 Inc BY ( W Over 100 B&P C for this reason Ovey Services, Swbd , MCC& Ponelboards Pool Date 0 -200 Amp Under 600 V Signature 201 - 1000 Amp Under 600 V ❑ Exemption for Reg Maint Elect Over 1000 Amp or Over 600 V 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 Additional Sign Branch Circuits Law for the following reason (Section 7031 5, Business and Professions Code) ❑ I as owner of the property, will do the work and the Misc Conduits&Conductors structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ , 7044, Business and Professions Code) CONSTRUCTION LENDING AGENCY 546,oa I hereby affirm that there is a construction lending agency for # • • • • • 2 the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) (Sec 3097, Civ C ) I • PLAN CHECKING FEE • 1 7,25 Lender's Name • • •.1 7,25c" PERMIT ISSUING FEE 0 Lender's Address 0 9. 18-86 1 certify that I have read this application and state that the TOTAL FEE '1j 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 t e bove-mentionee l property for inspect of pur oses � Q O� SEE REVERSE FOR EXPLANATORY LANGUAGE Si iturePerrrytV6 / Date