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HomeMy Public PortalAbout10141 LYNROSE ST_Electrical__ 7SA563 DB9 SA 3-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY �Rm� COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER ! DISTRICT'NO. GROUPJZONE PERMIT NO. FOR APPPLLI CANT TO FILL IN ELECTRICIAN-: til A RECEIVED BY READY FOR DATE ISSUED ADDRESS �.Kll� O �-n FIRST INSPECTIONS CITY TEL NO. v �� COUNTY LICENSE NO. A/9 f,p EXPIRES ' BUILDING PERMIT FEES ADDRESS NUMBER EACH FEE LOCALITY LIGHT OUTLETS NEAREST CROSS ST. U RECEPTACLES D WALL SWITCHES OWNER (J TOTAL OUTLETS 5c MAIL V ELEC. RANGES 25 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 76 AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWERi ANGELES COUNTY LICENSE. OR ( AM THE LEGAL OWNER NEW Mvo. HP OVER INC. EACH OF THE RESIDENTIAAL PROPERTY ESCRIBED�ABCVVE. V2 a LESS .25 SIGNATURE Oro I/2 2 .50 PERMITTEE-/ _ 2 5 1.00 d/INSPECTION RECQRD 5 is 1.50 is 50 2.50 50 200 5.00 200 500 10.00 J 500 1000 15.00 Z OVER 1000 20.00 Q M.G. BET/FREQ. CHANGER-HP R' WELDERS:AC-KVA D GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF CRIG.) MOVED MOTORS (75% OF DRIG.) MISC. SIGNS F7 NO. NO.TRANS. NO. NO LAMPS APPROVALS FOR EACH PERMIT: DATE INSPECTOR'S NAME WIRING $1.00 ® CONDUIT FIXTURES ;1.00 WIRING SUPPLEMENTARY .50 FIXTURES POWER TOTAL FEE UTILITY CO.NOTIFIED FINAL /v 76A663-CE606 B-62 APPLICATIO FOR ELS ICAI COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND,SAFETY DIVISION ADDRESS G� JOHN A. E, COUNTY ENGINEER ADEN WILLIAM A JENSEN, SUPT OF BUILDING LOCALITY IIimlNEAREST J e t o Q q/ FOR APPLICANT TO FILL IN cRoss sT. L P({./7 ill RECEPT TOTAL NO. EACH FEE )�"16 OUTLETS FIRST 20 $20 $ OWNER LIGHT MAIL SWITCH ADWL10 ADDRESS OVER 20 bb LIGHTING TOTAL F1RS7 20 .20 CITY — C TEL.NO FIXTURES AD .10 ELECTRICIAN �.-. OV R 20 /.� RANGELO DR R WTR HTRS. 1.00 ADDRESS �e�� 11� (� GARB.DISP STA.COOK CITY V /7 C TEL NO. ~—L DISHWASH. AUTO.-WASH STATE SPACE HTRS. STA._APP.(1/.H P.MAX ) .50 LICENSE NO MOTORS OVER NOT OVER HP. 'DISTRICT NO. GROUP • 7N7 PRO E ED BY 0 1 1.00 [ I l 1 3' 1.50 /n 1! INSPECTION RECORD - 3 8 2.00 8 15 250 �c r V � 'p 15 SO 300 50 100 500 SIGNS. NO TRANS Y_ I" D" NO LAMPS O SERVICE 0-600V-NOT OVER 200A 1.00 SERVICE 0.600V•OveR 200 A. 2.00 ` ���� 1 �� � •� +l�f�'d/ d Z SERVICE OVER 600V 500 t Je MISC r ((///4"4' .F�'n�-'' s+'D.3�,.d,•C?+�' wq .�.�1 '�'fe s PERMIT ISSUING FEE 200 Q SUPPLEMENTAgY PERMIT ISSUING FEE 100 TOTAL FEE $ p 1 HEREBY ACKNOWLEDGE THAT i HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING 7 ELECTRICAL WIRING WIRING I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR JFC LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF _FIXTURES ALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RES)DENTI PROPERTY. POWER .01 SIGNATURE UTILITY CO NOTIFIED OF PERMITTE FINAL - (� �LI AR`TH`UR C. VETT r CK MOO CAS CASH SUPERVISING ELECTRICAL ENGINEER L,tUCJ ("' Jljfiil 2 i^ n. 76A663-C E806 i tom/70 /tpPPMCAT�®I�ry Ika©I�y ELI}I{ U���//AL Rr � {I COUNTY•OF LOS ANGELES V FOR LS�1 uv UVU Ll LLLJJJ DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITYNEAl q� d /V��J FOR APPLICANT TO FILL IN CROSS NEAREST, lC.. �..`'�/! OUTLETS NO EACH FEE OWNER � Y > -MAIL r CIA k 5 RECEPT $ is ADDRESS./o l k all res�� FIRST 20 �J _ LIGHT_ TOTAL - _ J 25� t � CITY TEL NO Y SWITCH1_ -3— OVER 20 10 PLAN CHECK , LIGHTING FIRST 20 25 APPLICANT ' TOTAL ' )(l 10 FIXTURES OVER 20, ADDRESS 1. APPLIANCES CITY TEL. NO. PERMIT - RANGE DRYER^WTR HTR APPLICANT 9—r STA COOK DISPF A U ADDRESS, SPACE HTR _AIR CON CITY - TEL NO. CLOTHES WASH DISHWASH y LICENSE NO CLASS. FAN A OTHER '{ 100 11 V 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION SJ AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS' RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ' IND HEATERS, ETC HP KW KVA ELECTRICAL WIRING. SIZE & TYPE OVER TO ' HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO 1 - 1O - 300 JRESIDE IN, T ABOVE DE C IB RESI ENTIAL PROPERT O SIGNATURE U 10 - 50 500 OF PERMITTEE 50 - 100 1000 DISTRICT NO CLA95 ONE P SE O 1 00 — 500 1500 f L w O_ ,SIGN, GAS=SIGN ONE CIRCUIT 500 NOTES: z Z TUBE, OR MARQUEE ADDITIONAL CIRCUITS 100 ' SERVICENOTOVER60OVOLTSOR20OAMP 300 APPROVALS DATE INSPECTOR'S SIGNATURE SERVI CE OVER 600 VOLTS OR 200 AM P 1000 TEMP.POWER POLE � - 'TEMP SERVICE,POLE, &APPURTENANCES 500 UNDERSLAS WORK TEMP LIGHT OR RECEPT. SYSTEM 300 ROUGH CONDIUT I r WIRING FIXTURES POWER AUTHORIZED PERMIT FEE (SUB TOTAL) - UTILITY CO. NOTIFIED PLAN CHECK FEE , FINAL PERMIT ISSUING FEE 300 6:67J SE H C. ROOHAN TOTAL FEE SUPE V SING ELECTRICAL ENGINEER, - PLAN CHECK VALIDATION cK M o , cASH PERMIT VA ON DCK M o CASH to mAf 2 7t �J- SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE WORKERS'COMPENSATIONDECLARATION CE-806G (2-80) APPLICATION FOR ELECTRICAL PERMIT CE-806 I h:reby affirm that I have a certificatefof consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY insure, or a certificate of Workers'Compensation Insurance,or a certified-copy thereof(Sec 3800,Lab C), FOR APPLICANT TO FILL IN Policy No Company JOgADDRESS New Residential Bldgs &Pools EACH' NO FEE Certified copy is hereby furnished. 1 &2-Family,Sq Ft $ — $ LOCALITY 6 Certified co y g p Multi-family Sq Ft NEAREST copy is filed with the count building inspection CROSS ST i department Residential Swimming Pool OWNER OR t7 FIRM NAME Date Applicant Outlets Rec_Light Sw MAIL First 20 ADDRESS / 20SE, CERTIFICATE OF EXEMPTION FROM WORKERS' Total No Additional CITY Tel No COMPENSATION INSURANCE PLAN CHECK d (This section need not be completed if the work involved xt F ng Fixtures LightiFirst 20 APPLICANT 0 Eby the permit is for, one hundred dollars ($100) or less.) ADDRESS Additional _ cc Total No 0 I,certify,that in the'performance of the work for which this CITY Tel No Fixed Appliances Not Over 1 HP permit is issued, I shall not em any person in any manner PERMIT W so as to b come'sublect to th Wor ers' Compensation Laws Range_ Heater_D W APPLICANT ���— a Oven Dryer_W M. ADDRESS to Z Date �3 Applicant Top FAU _W H CITY. Tel No Hood _ Fan _Other NOTICE TO APPLICANT If,after making this ertificate of Disp Robm Air Cond._ LICENSE OR Exemption, you should become subject to the Workers' REG NUMBER 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 r _ - Up to 1 Incl Over 1 to 10 Incl caer FINAL LICENSED CONTRACTORS DECLARATION DATE / VALI DATION • 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 Services 0-200 Amp Under 600 V License Number` Lic Class 201-1000 Amp. Under 600 V Contractor Date Over 1000 Amp or Over 600 V HOME OWNER-BUILDER DECLARATION Temp Power•Pole&Appurtenances I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit ' 20 7 G 9 A License Law for the following reason (Section 7031 5, Busi- Additional Sign Branch Circuits ness and Professions Code) #to o.o'o 10 2 Misc Conduits&Conductors I, as owner of the property, will do the work and the Other (See Complete Fee Schedule)— 2 o c,1 70 Q structure is not intended or offered for sale (Section 7044, Business and Professions Code) o'0'0 1 7.0 0 CONSTRUCTION LENDING AGENCY „ y ,• I hereby affirm that'there is a construction lending agency V 0 13— 3_8 1, for the performance of the work for which this permit is PERMIT FEE (Sub-Total) issued(Sec 3097,Civ C) Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) Lender's Address PERMIT ISSUING-FEE 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 State laws regulating Electrical wiring, and eel e— hereb horize representatives of this County to enter upon the Ove- boned property for inspection purp ses SEE REVERSE FOR EXPLANATORY LANGUAGE � Signature of Permittee Date ION WORKERS'COMPENSATION DECLARATd6)N f$�f�p � 2000teoPw3iez � CAI �®r\n FOR LSL�15���� y,AL�, llf�Rt�IT I hereby affirm that I-hove'a IONw EC of cosent to self CE806G nsure, or a.4ert,ficate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS dor a certified copy thereof (Sec 3800, Lab C ) PTolicy.No Company FOR APPLICANT TO FILL IN r JOB ❑Certified copy is hereby furnished New Residential Bldgs & Pools EACH NO FEE ADDRESS Certified copy is filed with the county building inspec- 1 & 2-Family, ScFt $ — $ LOCALITY' �C.1611 r ❑tion-department Multi-family Sq Ft CROSS (f es Date Applicant Residential Swimming Pools OWNER OR FIRM N �y1 CERTIFICATE OF EXEMPTION FROM WORKERS' AME l r u /C. COMPENSATION INSURANCE Outlets Rec�LightSw—Z.—.. I� ADDRESS '(This section need not be completed if the work involved bFirst 20 y Total No Additional CITY Tel No the permit is for one hundred dollors($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'ony person in any manner Lighting Fixtures First-20 ADDRESS -so as to become subject to the Workers'Compensation Laws Additional ' • Total No � CITY - Tel No Date Applicant NOTICE TO APPLICANT If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT APPLICATION Exemption, you should become subject to the Workers' Range_ Heater—D W Compensation provisions of the Labor Code, you must forth- _ Oven Dryer —I—W M — ADDRESS with comply with such provisions"or this permit shall be Top, FAU J—W H — deemed revoked . CITY Tel No' LICENSED CONTRACTORS DECLARATION Hood — Fan —,Other Disp — Room Air Cond LICENSE OR Class I hereby affirm that I am licensed under provisions of Chapter 9 REG NUMBER- (commencing with Section 7000)of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO PR SSED BY >- and Professions Code,and my license is in full force and effect '` d Size &Type HP, KW, KVA, or KVAR Q 1 License Number� �� L,c Class Q Up to 1 Incl FINAL V /f1;/3.fDg//#,GT�lO FLS' - -Over 1 to 10 Incl DATE+ VALIDATION Cr 'Contractor- Date' / „r�n, ❑ Over 10 to 50 Incl FINAL ��// v I am exempt under Sec Over 50 to 100 Inc BY �Vh W B &P C for this reason Over 100 1 d Date Services, Swbd„ MCC& Panelboards Jay Z 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 FAMILYv 2 HOME OWNER-BUILDER DECLARATION Temp Power Pole &Appurtenances I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit }f:�T. Law for the following reason (Section 7031 5, Business and Additional Sign Branch•Circuits 8 _307 49.513 Professions Code) 1.�� J Ell, as owner of the property, will do the work and the ' Mist .Conduits & Conductors - structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ ' TOTAL 49 .50 Business and Professions Code) �' CONSTRUCTION LENDING AGENCY 'ASH 49.50 1 hereby affirm that there is a construction lending agency for t;� ,f�l I the performance of the work for which this permit is issued ' PERMIT.FEE (Sub-Total) (Sec 3097, Civ C ) ' PLAN CHECKING FEE rF�, Q Lender's Nome —tJ�rv1 12/11/8, PERMIT ISSUING FEE 507412 1 AM10.*27 Lender's Address 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 State laws regulating Electrical wiring, and hereby authorize representatives of this County to enter upon the ab e mentioned roperty r inspection purpose t SEE REVERSE FOR EXPLANATORY LANGUAGE ignature of Pertnittee Di6te Os WORK4RS' COMPENSATIOlJ DECLARATION -20-0019 DPW 3/87 ���n �ra n��®I1 V [FOR LS�LS Vfl�ll�l��/rV Lb �LS U�IUVU�� I hereby affirm-that I have,a ce�'tificate of consent to self CE"� LL lCA insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certified copy thereof (Sec 3800, Lab C ) Policy No Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished New Residential Bldgs & Pools EACH NO FEE ADDRESS O� — ~O NEAREST Certified copy is filed with the county building inspec- 1 8 2-Family, Sq $ $Ft LOCALITY u tion department Multi-family Sq Ft CROSS ST r Residential Swimming Pools Date Applicant OWNER OR ma�yy,, , ��. e ��ppG��r�- �, FIRM NAME /ry CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec Light Sw_ ` MAIL COMPENSATION INSURANCE First 20 ADDRESS (This section need not be completed if the work involved by CITY el No the permit is for one hundred dollars ($100)or less.) Total No Additional ' 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 Lighting Fixtures First 20 ADDRESS so as to become subject to the Workers'Compensation Laws g g , Total No CITY Tel No Date Applicant Additional Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT If, after making this Certificate of APPLICATION 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 Disp — Room Air Cond — REG NUMBER Class I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT O P O SS D BY f2 I d and Professions Code,and my license is in full force and effect V Size &Type HP, KW, KVA, or KVAR U I License Numbery Lic Class � Up to 1 Incl FINAL° WU �,�, A� /� Over 1 to 10 Incl DATE Ir VALIDATION 0 Contractor ate a Over 10 to 50 Incl FINALft F- I I am exempt under Sec Over 50 to 100 Inc BY U 'W B&P C for this reason Over 100 Ne . dService MCC & Panelboords _ C ZZ Date 0-200 A ' Under 600 V Signature 201 - 000 Amp Under 600 V QOver 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 it�i_(4a I hereby affirm that I am exempt from the Contractor's License _ Law for the following reason (Section 7031 5, Business and Additional Sign Branch Circuits 5407 Professions Code) Ii�� T E I, as owner of the property, will do the work and the Misc Conduits 8 Conductors i structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ TO_AL 31 - 00 Business and Professions Code) "i_�r "7;.1311 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction'lending agency for CHANGE the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) (Sec 3097, Civ C ) PLAN CHECKING FEE 0000—J)1311 2/ 71/5'0 Lender's Name PERMIT ISSUING FEE 13 Q W-23 1 ACI :21 Lender's Address TOTAL FEE ,, J 06 , I certify that I have read this application and state that the above information is correct I agree to comply with all County ordinances and State jaws regulating Electrical wiring, and hereby out a representatives this County to enter upon the a7;0V-mboned p rty f nspection pur ase SEE REVERSE FOR EXPLANATORY LANGUAGE Sig ture of PermPe to ? ©s