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76A563 DBB SA :3-50APPLICATION FOR PERMIT
t DEPARTMENT OF BUILDING AND SAFET -
COUNTY OF LOS ANGELES S� ELEVE Au
WILLIAM J. FOX, CHIEF ENGINEER
/ F APPLICANT/TO FILL IN DISTRICT NO. GROUP ZONE
ELECTRICIAPERMIT NO.
N /1�� �� ���2 m /
� Q 4-n RECEIVED BY READY FOR DATE IBBI�ED
ADIDRESB
� ' FIRST INSPECTION /
CITY TEL.NO. (/
COUNTY LICENSE NO. CJ'//f X EXPIRES BUILDING
ADDRESS
PERMIT FEES
FEE !/ (�
' NUMBER. EACH .LOCALITY .E _ l 1JJJllI�
LIGHT OUTLETS NEAREST v
- '
RECEPTACLESCROSS ST.
• PL`/�
WALL SWITCHES � .OWNER
TOTAL OUTLETSSc $ Cp * vj_ - v
MAIL V
ELEC. RANGES 25 ADDRESS
ELEC. HEATERS 25 CITY TEL.' NO.
FIXTURES 3
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
MISC. . APPLICATION AND STATE THAT THE ABOVE 18 CORRECT
NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORMI'NANCES
NUMBER OF RECEPTACLE CIRCUITS ' AND STATE LAWS REGULATING ELECTRICAL WIRING.
MOTORS I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
NUMBER HORSEPOWERANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
FEE OF THE RESIDENT AL PROPERTY, DESCRIBED ABOVE.
NEW MVD. HP � OVER INC. EACH � [/
Y 1/2 s LEBB $ .25 SIGNATURE OF
%2 2 .50 PERMITTED -
2 5 1.130 VINSPECTION RECORD
D
5 15 1.50
15 50 2.50
50 200 5.00
200 S00 10.00 J
500 1000 15.00 Z
OVER- 1000 20.00 Q
M.G. SET/FREQ. CHANGER-HP
WELDERS:'AC-KVA 13
GENERATORS - KW
- -=
—TRANSFORMERS-=-KVA-- --' —"- -
TEMP. MOTORS (75% DF ORIG•) -
MOVED MOTORS (75% DF ORIG.)
MISC.
SIGNS
' h
NO. NO.TRANS.
No. NO. LAMPS - APPROVALS
FOR EACH PERMIT: DATE INSPECTOR'S NAME
WIRING $1.D0 Q CONDUIT
FIXTURES $1.00 , WIRING ! "/_-7-7,'
r
SUPPLEMENTARY .50 FIXTURES '
POWER
TOTAL FEE UTILITY CO.NOTIFIED
FINAL _ V v
U UJB
7GA663
DBS-SA 3-55 APPLICATI
DIVISION OF BUILDING ANb SAFETY
Depcsrtment of County Engineer
County of Los Angeles BUILDING.
`- - - '. ' ADDRE - ..
WM.J. FOX, COUNTY ENGINEER - - "
CASSATT D. GRIFFIN,SUPT OF BUILDING '.
LOCALITY
FOR APPLICANT TO FILL,IN NEAREST ~
PERMIT FEES: CROSS ST,
- NUMBER H.EAC -FEE - -
OWNER V,
LIGHT OUT
�- - _
RECEPTACLES J 'MAIi,
ADDRESS •
WALL SW ITCHES, -
TOTAL OUTLETS 9¢ $ GITY A TELrNO.
ELEC:RANGES; 25 ELECTRICIAN
_ELEC. HEATERS I 25, - ADDRESS
KW EA" L.J.tl I _ CITY " TENO 040
0:N r '
FIXTURES • I 5 LICENSE NO.
NUMBER OF LIGH T'CIRCUITS "
DISTRICT-NO. GROUP ZO,fyE I READY FOR INSPECTION
NUMBER OF-RECEPTACLE CIRCUITS -
MOTORS {!
NUMBER HORSEPOWER: FEE INSPECTION RECORD
NEW' MVD. HP OVER I INC. I EACH" '
1/2&"LESS S .25I -
1/2 2 , .50
1 2 '.5., -1.00 -.
5 15 . '1.50
I. 15 x-50 2.50 - -
.. - 50 200. ...- :5.00.
.I
MISC.' - - - -
NO.SIGNS NO.TRANS
N0.'�SIGNS � NO.LAMPS - _,IJfI, - •
FOREACH PERMIT:
WIRING 'S1.00 - d
FIXTURES 51.00
SUPPLEMENTARY .50 APPROVALS -
TOTAL FEE 797.- I --DATE'` INSPECTCR'S"S IGNATURE-
A I 'HEREBY ACKNOWLEDGE'T,HAT`I '.HAVE READ THIS'APPLICATION CONDUIT }
ND STATE. THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ��((
WITH ALL COUNTY ORDINANCES AND STATE .LAWS ,REGULATING WIRING '-S V'S v`` )p,-,> }�✓b$Y'
ELECTRICAL WIRING'.
I HEREBY. CERTIFY THAT,I AM PROPERLY .REGISTERED, AND/OR FIXTURES
LICENSED:'AS REQUIRED,BY LOS:ANGELES COUNTY-AND_ STATE OF;
CALIFORNIA OR THI A THE 1EGAL:.'OWNER' THE.ABOVE POWER.:
DESCRIBED RESIDENTLL PR PERTY. '
S - \ -
SIGNATUREUTILITY CO'.NOTIFIED
:" - � - •
Cy
OF PERMITZ
TEE FINAL b �3
WILLIAM J. FOX. .OUNTY ENGINEER " •- VALIDATION,, - -A.-C.VEIT,CHIEF-.ELECT.INSPECTOR
. 07.2•:8 5t-l. nus30 '2 . 1 .5 5
76A663-CE806 12-65 APPLICATION FOR ELECTRIC L PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING S
BUILDING AND SAFETY DIVISION ADDRESS %M a
JOHN A. LAMBIE„COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING, LOCALITY
NEAREST •
FOR APPLICANT TO FILL IN CROSS ST. Gri
R ECEPT. TOTAL No. EACH FEE -
11 OUTLETS,FIRST 20 $.20 $ OWNER wwe
LIGHT T MAIL
SWITCH ADD'L'- 10' ADDRESS _
OVER 20 I
TOTAL FIRST 201 (? .20 CITY TEL. NO.
LIGHTING 1 FIXTURES -
FIXTURES, J( ADD'L �7 CONTRACTOR
OVER 20 1/ .10
RANGES DRYERS WTR.HTRS. 1.00 ADDRESS '
GARB.DISP: STA:COOK - - -
_ CITY TEL.NO.
DISHWASH. AUTO."WASH. STATE
SPACE HTRS. STA. APPL. .50 LICENSE NO.
MOTORS: OVER NOT OVER H.P. DIST�LCT N GR ZO moss
ED.B
O T• 1.00 �. O
1 3 1.50 ”INSPECTION R RD - °-
O
3 '8 2.00 V
ix
8 15 2.50 Q
0
15 50 3.00 U
W
CL
50 100 5.00 Z
SIGNS: NO.TRANS
NO.LAMPS
SERVICE 0.600V-NOT OVER 200A 1.00
SERVICE 0-60OV-OVER 200 A. 2.00
SERVICE OVER 600V 5.00
OTHER (SEE COMPLETE FEE SCHEDULE)
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING.FEE 1.00 - APPROVALS. - DATE INSPECTOR'S SIGNATURE
TOTAL FEE' $
--1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS PPLIC TION UNDE RS LAB WORK
A
AND STATE.THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ROUGH CONDUIT -
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING /�
ELECTRICAL WIRING.. WIRING :./ '�
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS.REQUIRED BY LOS ANGELES COUNTY AND STATE OF.
CALIFORNIA OR THAT.] AM THE LEGAL OWN AND.INTEND TO
RESIDE IN,THE AS D REST RTY. POWER -
SIGNATURE UTILITY CO.NOTIFIED
OF PERM[TT - �+T
NAL ~
VALIDATION JOSEPH:C. ROOHAN
CK MO ASH SUPERVISING ELECTRICAL ENGINEER
1 .5. 2 3_3 .. DST 1,1 2 D .8 0~
affirm 1S'COMPENSATION DECLARATION 76A663 '`10/81 APPLICATION
j� /��T E
1. WORKER /`119 �'er/`11101�1 FO.it ELECTRICAL PERMIT:
hat I 'have a certificate of consent to self CE-806G
insure, or a certificate of'Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY
e: or a certified co�y thereof(S c80c0)b�Lab. C.)
P 'cy.N.0paln��-�'�" �LI�+'•
-FOR APPLICANT TO FILL IN JOB \ �
Certified copy is.hereby furnished.' New Residential Bldgs. & Pools
EACH NO. FEE ADDRESS C
l & 2-Fbmil, '$ Ft. $ — $ LOCALITY '
Certified copy is'filed with the'county building inspec- r Y q —
tion department r 1 Multi-family Sq.'Ft.
Residential Swimming Pools
'NEAREST
CROSS ST:' t
Date- APPlicant
. . OWNER O
CERTIFICATE OF EXEMPTION FROM WORKERS' g ` 'F`^IAIL
Outlets: Ree' Li ht Sw
COMPENSATION;INSURANCE ": „ [ "' 7 ADDRESS,rE
This Section heed not be,com`leted'if'the'work involved b First 20
( P. Y Total No CITY Tel. No
the permit"is^for one hundred dollars($100)or less:)- Add Tional
I certify that in,.the performance of the work for which this A PNCANTK HIP 'C
permit is issued;_I shall not employ any person in any'manner -
so as to become'sublect to•the Workers •CompensationLaws. Lighting Fixtures' First 20 - ADDRES
Additional
Total Total No.I ( CITY' �'� -'Tel': No.
Date Applicant
Fixed Appliances Not Over 1 HP PERMIT';
NOTICE'TO APPLICANT: If, after.:making. this Certificate of APPLICANT
Exemption; you 'should• become •subie-ct to the Woi-kers' Range. Heater.D.W.
Compensation provisions`of the Labor Code, you must forth- Oven _ Dryer — W.M. ADDRESS Mw
QZ,( Q,
with, comply with such-.provisions or this permij shall-be Top FAU —W.H. —
deemed revoked.. Hood Fan Other CITY el. No: ll/- 7 ,
'loLICENSED CONTRACTORS DECLARATION, LICENSE NUOq
MBER SE
I hereby affirm that I am licensed under provisions,of.Chapter 9 . Dispr-._ REG.Room-Air Cond. 6 Class.
(commencing with Section 7000) of Division 3 of.the.Business DISTRICT NO - PROCESSI>D_ Y
and Professions Code, CL
and my license is in full force'_and effect. Power Apparatus & Large Appliances /
Size &Type HP, KW, KVA, or KVAR'
License Number'/v Lic.,Class Up to 1,Incl FINAL
Over—1 to;10'Incl. DATE ��` VAL. ATION Y 0
Contractl Da / r
❑ Over 10 to 50 Incl. FINA
I q`'exemp u�er Seca Over 50 to,100 Inc. BY Z/Z
w.
B.&P.C. for this reason Over 100 Nal
Services; Swbd.,'MCC&Panelboards
Z
Date: 0 -200 Amp. Under 600 V
Signature a 201 -1000 Amp. Under 600 V - 2
' Over 1000 Amp: or Over 600
'Exemption for Reg. Moint. Elect:-
SINGLE FAMILY Tem -Power Pole.&Appurtenances
HOME OWNER'-BUILDER DECLARATION P-
Sign with One Branch Circuit Q
f hereby-affirm that'I am exempt from the Contractor's.License 69 a2 A
Law'for-the following reason (Section 7031.5, Business and Additional'Sign Branch Circuits
Professions Code): . ' '• o.o 2
Misc. Conduits&Conducfois
I; as owner.of the property,.will do the;work and the
structure is not 'intended or offered for sale (Section Other (See:Complete Fee Schedule)_ 3'
7044, Business and Professions Code).
55
CONSTRUCTION LENDING AGENCY
l hereby affirm that there is a construction lending agency for.
the- erformance of the work for-which--this ermit-is issued: (`:`-- — - - -- - - -- -
p P PERMIT FEE'— - --(S'ub'-Total)' "
(Sec.�3097,'Civ. C )
PLAN CHECKING FEE
Lender's Name' �
-PERMIT ISSUING FEE-
Lender's Address
1,certify that I have read this application and,state that-the TOTAL FEE,
above informaiion.is correct. I agree to comply with all County
or 'nances and State laws regulating Electrical wiring, and '
he Guth rize•representatiJes of thi's County to enter upon e
t a ve-merty for inspection purposes. L'
�/ - ---SEE-REVERSE FOR EXPLANATORY LANGUAGE
nature o ,ermittee - '.Date - - -