The URL can be used to link to this page

Home My Public Portal About9931 LOWER AZUSA RD_Electrical__ DBS S-A I2-44 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY ELECTRIC � COUNTY OF LOS ANGELES WM J. FOX CHIEF ENGINEER _ NAME / DISTRIPT NO. GROUP ZONE. PERMIT NO. U ADDRESS �., ..✓+p ( S'O � }�. U CITY TEL.NO. ..��' EI BY FIRST IN INSPECTION DA ISSUEDr Id WCOUNTY CERT.NO. 1/ EXPIRES ~ APPLICANT FILL IN HEAVILY OUTLINED PORTIONJOB Y DESCRIPTION OF WORK ADDRESS y ~✓ �` NUMBER OF OUTLETS ON CIRCUITS LOCALITY LOCATION BY ROOMS LIGHT OUTLETS SW. PLUGS FI][T CROSS 91.� �j CIRCUIT A B C D E F IG JH W NAME Z MAIL 3 ADDRESS O CITY TEL.NO. 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION.. ELECTRICIAN. I AM THE LEGAL OWNER OF THE lPljOPF=Y ESCRIBED ABOVE x OWNER. CORRECTIONS J — Q Z E O TOTA NO. OF OUTLETS $ . APPROVALS NO. OF FIXTURE'S $ DATE INSPECTOR'S NAME NO. OF MOTORS H.P. $ CONDUIT NO. OF SIGNS TRANS. $ WIRING a NO. OF RANGES OR HEATERS $ FIXTURES MISCELLANEOUS $ POWER PERMIT FEE $ • 3 UTILITY CO.NOTIFIED FI AL TOTAL FEE 4 a i F 084,V-A 6-46 DEPARTMENT OF BU"ING AND SAFETY APMCATWN FOR PERMIT L COUNTY OF LOS E ANGLES X CHIEF G EER' ELECTRIC NAME DISMgK NO. GROUP I ZOO/NE PERMIT NO. U ADDRESS 1141/ / / 8 READY FOR DATE ISSUED ,l CITY TEL NO. r FIRST INSPECTION COUNTY �r -41 m CERT NO EXPIRES --'Q APPLICANT FILL IN HEAVMY OUTLINED PORTION ONLY JOB IDESCREMON OF WORK JFITCROSS RES6 NUMBER OF OUTLETS ON CIRCUITS ALITY LOCATION BY ROOMS REST LIGHT OUTLETS SW PLUGS ST CIRCUIT A B C D E R G HNAME MAIL ESqjADDR CITY TEL NO. 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANG&LEB COUNTY CERTIFICATE OF QUALIFICATION. ELECTRICIAN. I AM THE LXQAL OWNER OF THE PR P FTY D68C UBED ABOVE owNER. CORRFMONS x J Z_ O NO. OF OUTLETS- ffi APPROVA'IS NO. OF FIXTURES DATE INSPECTOR'S NAME NO. OF MOTORS H P. ` CONDUIT NO OF 810N8 TRANS. WIRING NO OF RANGES OR HEATERS FIXTURES MISCELLANEOUS ffi / POWER PERMIT FEE ffi V UTILITYCO NOTIFIED r WORKERS'COMPENSATION DECLARATION CE 80BG ��81 APPLICATION FOR ELECTRICAL PERMIT (hereby affirm that I have a certificate of consent to self insure, "fl or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sea 3800 Lab C) c Policy No parry / FOR APPLICANT TO FILL IN JOB ADDRESS 7�1- ❑ 2 C4 Certified copy is hereby furnished New Residential Bldgs &Pools EACH NO FEE Certified copy is filed Hnth the county budding inspection 1 &2-Family,Sq Ft $ _ $ LOCALITY C EAREST de ru Multi-family Sq Ft NCROSS ST Date 1♦FlJ� Applicant Residential Swimming Pools OWNER OR FIRM NAME CERTIFICATE OF EXEMPTION FR M WORKERS Outlets Rec—Light _Sw MAIL COMPENSATION INSURANCE ADDRESS (This section need not be completed d the work Involved by the First 20 CITY Tel NoTotal No Additional permit Is for one hundred dollars($100)or less) I certify that in the performance of the work for which this permit FLAN CHECK APRJCANT 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 Additional CITY Tel No Date Applicant Fixed Appliances Not Over 1 HP NOTICE TO APPLICANT If, after making this Certificate of AAPPLIJCANT `EU6G Exemption,you should become subject to the Workers'Compensation Range_ Heater_ DW _ provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer_ W M — ADDRESS t Z provisions or this permit shall be deemed revoked Top _ FAU _ WH CITY („ bAL Tel No LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other_ I hereby affirm that I am licensed under provisions of Chapter 9 LICENSE OR (commencing with Section 7000)of Division 3 of the Business and Disp _ Room Pur Coed REG NUMBER -SJ a Class Professions Code,and my license is in full force and effect Power Apparatus&Large Appi-ices DISTRICT NO :)EIM Sure&Type HP,KW,KVA,or KVAR ✓i License Number Lx Class —( D Up to 1 Incl FINAL _ �{ Contractor �" to Over 1 to 10 Incl DATE "/ VALIDATION C -Over 10 to 50 Incl / ❑ 1 am xempt under Sec Over 50 to 100 Inc BY BAP C for this reason Over 100 l/V N Services,Swbd,MCC&Panelboards ► Z Date 0-200 Amp Under 600 V Signature 201 - 1000 Amp Under 600 V ❑ Exemption for Reg MaOver 1000 Amp or Over 600 V mt 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 Law for the following reason(Section 70315,Business and Professions Additional Sign Branch Circuits ACCT,&T s code) 3307 124.1 ❑ 1,as owner of the property,will do the work and the structure Misc Conduits&Conductors 1 IM is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) _ ► rTG W and Professions Cade) TOTAL 124. 15 CONSTRUCTION LENDING AGENCY IDE`i K 124.15 1 hereby affirm that there is a construction lending agency for the rruw�t performance of the work for which this permit is issued(Sec 3097, PERMIT FEE (Sub-Total) •� Civ C) PLAN CHECKING FEE Lenders Name J3 0000—MOI 8/13/90 PERMIT ISSUING FEE Lender s Address /C 2363 1 AM10:46 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 wrong, and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection uses SEE REVERSE FOR EXPLANATORY LANGUAGE ) Sigriveof Permittee Date WORKERS'COMPENSATION DECLARATION CE 806G ��81 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that 1 have a certificate of consent to self insure, or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy.thereof(Sec 3800 Lab C) 'fl Policy Nob ��AkZ- FOR APPLICANT TO FILL IN JOB ADDRESS �..�1/W`iley' 7K. ❑ Certified copy is hereby furnished New Residential Bldgs &Pools EACH NO FEE — LOCALITY Q �Certfied copy is fled with the county building &2-Family.Sq Ft $ $ lding inspection _ NEAREST Cl department Multi-family Sq Ft CROSS Residential Synmming Pools OWNER OR Date licant FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec—Light—Sw MAIL COMPENSATION INSURANCE I ADDRESS (This section need not be completed tf the work Involved by the First 20 permit Is for one hundred dollars($100)or less) Total No Additional CITY Tel No I certify that in the performance of the work for which this permit PLAN CHECK APPLICANT 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 Additional CITY Tel No Date Applicant Fixed Appliances Not Over 1 HP NOTICE TO APPLICANT If, after PP��M king this Certificate of ERUPERMIT Exemption,you should become subject to the Workers'Compensation Range— Heater— DW — provisions of the Labor Code,you must forthwith comply with such Oven — Dryer— W M — ADDRESS d provisions or this permit shall be deemed revoked Top — FAU — W H — CITY �� Tel No Z-c� LICENSED CONTRACTORS DECLARATION Hood — Fan — Other— t-� I hereby affirm that I am licensed under provisions of Chapter 9 Disp — Room Air Cond LICENSE OR BER �J s (7 (commencing with Section 7000) of Division 3 of the Business and REG Professions Code,and my license is in full force and effect Power Apparatus&Large Appliances DISTRICT NO ED BY KIS- � Size&Type HP,KW,KVA,or KVAR ✓. ox , License Number d Lic Class f '�{j�� .( Up to 1 Incl FINAL y Contractor Date ` D Over 1 to 10 Incl DATE' VALIDATION Over 10 to 50 Incl 1 ❑ I am exempt under Sec Over 50 to 100 Inc y� B&P C for this reason Over 100 v N Services,Swbd,MCC&Panelboards , Z Date 0-200 Amp Under 600 V Signature 201 - 1000 Amp Under 600 V El Exemption 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 2 1 hereby affirm that I am exempt from the Contractor's License Law Additional Sign Branch Circuits ACCT. T the following reason(Section 70315,Business and Professions Code) �n E] 1,as owner of the property,will do the work and the structure Misc Conduits&Conductors +7.W7 31.L�[) is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) — ► 1 ITM and Professions Code) TOTAL 31.00 CONSTRUCTION LENDING AGENCY �/ rt0 I hereby affirm that there is a construction lending agency for the MILK 31.0 performance of the work for which this permit is issued(Sec 3097, PERMIT FEE (Sub-Total) Civ C) owa .00 PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE -0001 8/13/90 Lender's Address V 1 certify that I have read this application and state that the above TOTAL FEE 2371 1 AMid:57 information is correct 1 agree to comply with all County ordinances and State laws regulafing Electrical wrong, and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection pu s SEE REVERSE FOR EXPLANATORY LANGUAGE Signature rmdtee Date