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HomeMy Public PortalAbout10146 LYNROSE ST_Electrical__ 7SA&S3 Des 5A 3-517 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING ARID SAFETY COUNTY OF LOS ANGELES /� $ b WILLIAM J. FOX, CHIEF ENGINEER �r �1 i3(�Fl�m�KC91 a FOAPPLICjrTTO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRICIAN RECEIVp BY READY FOR DAT ISSUED ADDRESS G � TEL NO.- FIRST INSPECTION CITY _,f u J , / d F COUNTY LICENSE NO. /0 R EXPIRES �_ BUILDING S/�/ ADORES PERMIt FEES NUMBER EACH FEE LOCALITY: LIGHT OUTLETS P NEAREST v f RECEPTACLES CROSS ST. // ,� /j/ ' WALL SWITCHES /3 9q .OWNER t 4sJ(1A,:� TOTAL OUTLETS T Sc $ pC,.� MAIL ✓ V ELEC. RANGES 2S ADDRESS ELEC. HEATERS 25 �` `CITY TEL. NO. FIXTURES gi I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDJNANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT '1 POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR I AM-THE LE1:3AL OWNER NEw MVD. HP OVER INC. EACH s� OF THE RESIDENTIAL PROPERTY D,Ep/JS(CRIBED ABOVE. 1 %2 & LESS $ .25 cdC SIGNATURE OF Via` q 1/2 2 .50 PERMITTEIC 2 5 1.00 GINSPECTION RECORD 5 15 1.50 is 50 2.50 50 200 5.00 200 500 10.00 J 500 1000 15.00 - < OVER 1000 20.00 0 M.G. SET/FREQ. CHANGER-HP WELDERS: AC-KVA O GENERATORS - KW - TRANSFORMERS - KVA TEMP. MOTORS (75% OF DRID.) MOVED MOTORS (75% OF ORIS.) MISC. SIGNS NO. NO.TRANS. APPROVALS NO. NO. LAMPS FOR EACH PERMIT: ATE INSPECTOR'S NAME WIRING $1.00 ! G CONDUIT i FIXTURES $1.00 l B WIRING n' SUPPLEMENTARY .50 FIXTURES POWER TOTAL FEE $Ls Sly UTILITY CO.NOTIFIED a / FINAL 1 r) V 76A6$3-CES06 10-62 apndcumN Om an-TmC AL �m6v�i dv . COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING i- BUILDING AND SAFETY DIVISION ADDRESS ✓�/ c� �4//f�®�i� JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY 0 NEAREST FOR APPLICANT TO FILL IN CROSS ST. RECEPT. j TOTAL NO. EACH FEE/ , OUTLETS FIRST 20 $20 $l OWNER LIGHT 4- MAIL SWITCH. ADD'L ADDRESS OVER ZO .fO CITY TEL. NO. LIGHTING TOTAL� FIRST 20 G .20 ! �}' FIXTURES t ADD'L , / OVER 20 .10 ELECTRICIAN RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS ®� GARB.DISP. STA.COOK CITY TEL. N0. DISHWASH. AUTO.-WASH. STATE /� a //' SPACE HTRS. STA.APP.(+/i H.P.MAX.) ,50 LICENSE NO. `s cu (� MOTORS: OVER NOT OVER H.P. DISTR CT NO. ZONE P OCESSED BY O f 1.00 42, r . 1 3 1.50 1 SPECTION RECORD 3 8 2.00 d 8 is 2.50 O V 15 50 3.00 tea / 50 100 5.00 pv. SIGNS: NO.TRANS. C1 NO.LAMPS H z SERVICE 0.00OV-Nor OVER 200A 1.00 SERVICE 0-60OV-OVER 200 A. 2.00 - SERVICE OVER 600V 5.00 MISC. PERMIT ISSUING FEE 2.00 SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE $ 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 ELECTRICAL WIRING. WIRING -7W' -(� W L C��LI_Cl'ml-,i 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT 1 AM THE LEGAL O R OF THE ABOVE DESCRIBED RES IDENTI PROPERTY. POWER I- _1 SIGNATURE UTILITY CO.NOTIFIED � OF PERMITTEE FINAL i.r� 3� �941411`b7s,Q�d' - LIDATION ARTHUR C. VETT ! C .; MO CASH SUPERVISING ELECTRICAL ENGINEER U11 0823 JUL 2 2 D 7.0.0N WORKERS'COMPENSATION DECLARATION CE-806G (2-80) A1!'I!'MCAMN FOR EL EC ll PUCAL PLSRNU I. I hereby affirm that I have a certificate of consent to self' COUNTY OF LOS ANGELESBUILDING AND SAFETY insure, or a certificate of Workers'Compensation.Insurance,or 69-, ., T- a certified copy thereof(Sec. 3800,Lab.C.) / Policy No. CompaFOR APPLICANT TO FILL IN 16 S T JOB / / �/Q�S )4�� K ny New Residential Bldgs.&Pools EACH NO. FEE ADDRESS D Certified copy is hereby furnished. 1 &2-FamilY. q•S Ft. $ — Is LOCALITY A Certified copy is filed with the'county Multi-family Sq. Ft. Nbuilding inspection CROEREST SS ST L A/Ras department. Residential Swimming Pools OWNER OR �J p FIRM NAME ��J1I�Q AD r��AWLO V Date Applicant Outlets: Rec. Lightl Sw .2 _ S� �Q MAIL 1<3 CERTIFICATE OF.EXEMPTION FROM WORKERS' Total No. _ Additional CITY Tel No.S74 96' COMPENSATION INSURANCE } PLAN CHECKAy RQ,�L© U o (This section need not be completed if the work, involved SU APPLICANT U by the permit is for one hundred dollars Fixtures First 20 s ($100) dr less.) Additional ADDRESS CC Total No. S '4 O I certify that in the performance of the work for'which this CITY Tel No. permit is issued, I shall not employ* Fixed Appliances Not Over 1 HP l- p p y'any person in any manner PERMIT ^ U so as to become subject to the Workers' Compensation Laws. Range_ Heater_D.W. APPLICANT A4 ° �T ROJI�-e �' 0. ' Oven Dryer_•W.M._ ADDRESSZ /Date e � d Applicant - Top FAU —W.H..— S 14-Y+�(}� Hood Fan 0.—Other CITY Tel No. NOTICE TO APPLICANT: If, after <kmg this Certificate of �, 1 S LICENSE OR Exemption, Disp. _ Room Air Cond-_ p ,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. PROCE SED BY with comply with such provisions or this permit shall be Size&Type HP,KW, KVA,or KVAR deemed revoked. l����S Up to 1 Incl'. 3 FINAL Over 1 to 10 Incl. DATE LICENSED CONTRACTORS DECLARATION DATE //io7 —ell VALIDATION Over 10 to 50 Incl. /( �ilrJ I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL 9 (commencing wBYith Section 7000) of Division 3 of the Busi- Over 100 .� ness and Professions-.Code, and my license is in,full force and effect. Services 0-200 Amp. Under 600 V License Number Lia 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 91 .3 4,3 A' Y ,I License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits ness and Professions Code): # o.0 o 0 o2 Misc.Conduits& Conductors I, as owner of the property, will do the work and the Other(See Complete Fee Schedule)— 0,0 1 3 50- structure is not intended or offered for sale (Section 1 'S O Ur 7044,Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency o9.2 5,—81 for the performance of the work for which this permit is issued (Sec. 3097,Civ.C.). PERMIT FEE (Sub-Total), S()' Lender's Name • PLAN CHECKING FEE (One-Fourth Permit Feel - - Lender's Address PERMIT ISSUING FEE I certify that I have read this application and,state that the TOTAL FEE 3 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 above-mentioned property for inspection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE Si atu a of Per ittee Dat