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Home My Public Portal About5024 MCCLINTOCK AVE_Electrical__ 7OW66's-.g:r%A 11-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY ELECTRIC. COUNTY OF LOS ANGELES WILLIAM J. FOX. CHIEF ENGINEER FOR APPLICANT TO F,�LYIN ELECTRICIAN /f DISTRICT NO. GROUP ZONE PERMIT NO I LY �- ADDRESSRECEIVED BY READY FOR FIRST INSPECTION DAATE(ISSUED �J CITY (y TE IPNO. COUNTY LICENSE NO. /PIRES v! BUILDINGADDRESS d !e v/i--/, ��r PERMIT FEES v FEE NUMBER I EACH LOCALITY LIGHT OUTLETS 111— CROSS ST. �J RECEPTACLES F WALL SWITCHES TOTAL OUTLETS 1 SC. S MAIL ELEC. RANGES F 2S ADDRESS ELEC. HEATERS ' 25 CITY TEL. NO. FIXTURES S 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 ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER I ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER FEE OF THE RESIDENTIA RO RTY DESCRIBED ABOVE. NEW MVD. HP OVER INC. EACH fJ I 9 LESS S .25 SIGNATURE OF ! .0' � I / 1/2 2 .50 PERMITTEE lloo .l` 2 s 1.00 INSPECTION RECORD s 1s 1.50 ' Is so 2.50 so 200 s oo 200 500 10.00 �-�i✓,O<_ J Soo 1000 15.00 Z OVER 1000 20.00 3 M. G. SET/FREQ. CHANGER-HP 1z WELDERS:AC-KVA 0 GENERATORS-KW TRANSFORMERS-KVA TEMP. MOTORS (75%OF omr..) MOVED MOTORS (75%OFORIG.) MISC. SIGNS NO. NO.TRANS. I APPROVALS NO. NO. LAMPS DATE INSPECTOR'S NAME FOR EACH PERMIT.• WIRING $1.00 Q Q CONDUIT FIXTURES $1.00 Q WIRING SUPPLEMENTARY .50 FIXTURES (y POWER TOTAL FEE $ X (� UTILITY CO. NOTIFIED ® O FINAL L ION • WORKER'S I have certificate of consent to 7766A6°t�DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT .I hereby affirm that I have a certificate of consent to self Insure, or a certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec.3800 Lab,C.) Policy No. Company FOR APPLICANT TO FILL IN JOB IA.0 /J ADDRESS !°4 L Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE LOCALITY `� O ❑ Certified copy is filed with the county building inspection 1&2-Family,Sq.Ft. $ $ _ NEAREST department. Multi-family Sq.Ft. CROSS ST. Datil Applicant Residential Swimming Pools ASSSOR J MAP BOOK PAGED6� PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Ree. Light Sw. a OWNER OR COMPENSATION INSURANCE � �j FIRM NAME (This section need not be completed if the work Involved by the qq 22 First 20 YJ MAIL pp permit is for one hundred dollars($100)or less.) Total No.� Additional •a-fl ADDRESS ,C. ( I certify that in the performance of the work for which this permit CITY 1p Tel.No. M4(04 Is issued, I shall not employ any person in any manner so as to PLAN CHECK' become subject to the Workers'Compensation Laws. Lighting Fixtures/3 First 20 APPLICANT Total No. Additional ADDRESS Date' Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: If, after making this Certificate of CITY Tel.No. Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code,,you must forthwith comply with such PERMIT p Y p y Appliances APPLICANTe A s&Lar at r Apparatus gpp provisioris or this permit shall be deemed revoked. Powe - - LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS I Hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. (commencing with Section 7000)of Division 3 of the Business and CITY Tel.No. Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. LICENSE.OR Class. Over 50 t0 100 Incl. REG.NUMBER a• License Number Lic.Class Over 100 DISTRICT NO. P SED BY V - Services,Swbd.,MCC&Panelboardsg L Contractor Date 0-399 Amp.Under 600 V. DATE FINAL /,!"J ❑ 400-1000 Amp.Under 600 V G M / VALIDATION V I am exempt under Sec. W Over 1000 Amp.or Over 800 V FINAL BAP.C.for this reason BRANCH CIRCUIT FEES BY co Date: 15A,or 20A,120V,Lighting or Recept. Z 1.To 10 Branch Circuits Signature 11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits Exemption for Reg.Maint.Elect. 15A,20A,208V To 217V Lighting Br:Circuits SINGLE FAMILY Temp.Power Pole&Appurtenances f{T g HOME OWNER-BUILDER DECLARATION �r='I =A with One Branch Circuit n I-hereby affirm that I am exempt from the Contractor's License Law Sign -•;(�— +.:;;, x for the following reason(Section 7031.5, Business and Professions Additional Sign Branch Circuits Code); \e) a -. i duts&Conductors I,as owner of the property,will do the Work and the structure Misc.Conf 4�$ o.�,�' is not Intended or offered for sale.(Section 7044, Business ' Other(See Complete Fee Schedule) TOTAL and Professions Code). , CHECK 9y.o 40 CONSTRUCTION LENDING AGENCY :CHANGE. ,�;0 I hereby.affirm that there is a construction lending agency for the performance of the work for which this permit,is issued(Sec. 3097, PERMIT FEE (Sub-Total) Civ.C.) PLAN CHECKING FEE 0.000-03,011 1.2I29�`` Lender's Name. "� PERMIT ISSUING;FEE O� '� �O F'� Ip��'" Lender's Address I certify that I have read this application and under penalty of purjury state I TOTAL FEE Aloe that the above information is correct: I agree to comply with all County ordinances and State laws regulating Electrical wiring,and hereby authorize Mntatives of this County to abler upon the above-mentioned property action purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE (A Ift AA 71 SIG TU F PERMITTEE .--WORKER'S COMPENSATION DECLARATION 20.0018 DPW(12-91)76A663 APPLICATION FOR ELECTRICAL PERMIT ' I.heteby44WA that Fhave a certificate of consent to self insure, or a certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS-ANGELES, DEPT.`OF PU&LIC WORKS BUILDING AND SAFETY DIV. copy thireof,(Gec.3800 Lab.C.) Policy No. Company FOR APPLICANT TO FILL IN JOB ADDRESS Certified copy is hereby furnished. New Residential Bldgs.&Pools NO.1 EACH FEE LOCALITY � I�i,� Certified copy is filed with the county building inspection 1&2-Family,Sq.Ft. NEAREST / ,J department. Multi-family Sq.Ft. CROSS ST: (rV K Date Applicant Residential Swimming Pools ASSESSOR a� MAP BOOK �� PAGE(90.S PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec.l(��_Light Sw. p� FlpM NAME s COMPENSATION INSURANCE ,p O n �� First 20 MAIL (This section need not be completed if the work Involved by the Total No. .�— Additional ADDRESS permit Is for one.hundred dollars($100)or less.) I certify that In the performance of the work for which this permit CITY (,e Tel. Is issued, I shall not employ any person in any manner so as to PLAN CHECK become subject to th.e Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANT Total No. Additional dw ADDRESS Date Applicant. RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE,TO APPLICANT: If, after making this Certificate of CITY Tel.No. Exeteption,.you should become subject to the Workers'Compensation.. OTHER APPLIANCES NOT OVER 3 HP.-, provisions of the Labor Code, you must forthwith comply with such PERMIT' provisions or this permit shall be deemed revoked. �P/°�wer Apparatus&Large Appliances APPLICANT ILA/✓ LICENSED CONTRACTORS DECLARATION. alESize&Type HP,.KKWW;I/y/ or VA R' ADDRESS I hereby affirm that I am licensed under provisions of Chapter 9 bv§r 3 to 10 Incl. (commencing with Section 7000)of Division 3 of the Business and CITY Tel.No. Professions Code,and.my license is In full force and effect. Over 10 to 50 Incl. 'Over 50 to 100 Incl. REGNNUMOBER Class• Q. Over 100 DISTRICT NO. P O SED BY 0 License Number Lic.Class �7r U Services,.SW d„ C &:Panelb ards d-399 Amp.Under 600 V FINAL 0 Contractor. Date DATE V F1400-1000 Amp.Under 600.V �- VALIDATION I am exempt under Sec:. W Over 1000 Amp.or Over 600 V FINAL IL B.&P.C.for this reason BRANCH CIRCUIT FEES BY t0 Date: ISA,or 2 20V,Lighting or Recept. Z Signature "9P 1 To 10 Branch Circuits g 11 To 40 Branch Circuits AU e a ❑ Exemption for Reg.Maint.Elect. 15A,20A,208V To 277VOLighting Branch 3303 107.40 SINGLE FAMILY Temp.Power Pole Appurtenances I N &. ENS HOME OWNER-BUILDER DECLARATION Sign With.One Branch Circuit TOTAL 1107 m I hereby affirm that I am exempt from the Contractor's License Law 40 for the following reason(Section 7031.5, Business and Professions Additional Sign Branch Circuits rECK _ �[IMisc.Conduits&Conductors I,as owner of the property,will do the work and the structure CHANGE e 011 Is not Intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule) ► and Professions Code). i � Y ��` CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending.agency for the / 062213 An ;,;4 performance of the work'for which this permit is.Issued-(Sec.3097, PERMIT FEE (Sub-Total) Civ.C.) ^e 5'a nd Ira yam, PLAN CHECKING FEE Lender's N e. 'OV4 a'y �r U rrZ PERMIT ISSUING FEE Lender's Addreas I certify that I have.feed.this application and under penalty of purjuy s ate TOTAL FEE /Q that the 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 action iurposes. SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE.OF PERMITTEE -DATE ON 20-0019 .. WORKER'S have a certificate of consentDECLARATION self insure 76A663 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT (4WW, -� 11 L.hereby elflr that-I have a or a certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV.- copy thereof(Sec.3800 Lab.C.) POIICy No. Company FOR APPLICANT TO FILL IN JOB d'Y ♦� r" r'r �/`� — ❑ Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. $EACH $ FEE LOCALITY ❑ Certified copy is filed with the county building.Inspection 1&2-Family,Sq.Ft. NEAREST n _ department. Multi-family Sq.Ft. GRoss ST. Date Applicant Residential Swimming Pools ASSESSDOK �. /�7 PaoEwJ PARCEL V 77 O CERTIFICATE.OF EXEMPTION FROM WORKERS' Outlets:Rec._Light SW. NAME COMPENSATION INSURANCE First 20 MAIL (This section need,not be completed If the work Involvedby the ADDRESS Total No. Additional SS' � permit is for one hundred dollars(5100)or less.) � .! 1 certify that.in the performance of the work for which this permit CITY is Issued, I shall not employ any person in any manner so as to PLAN.CHECK become subject to the Workers'Compensation:Laws. Lighting Fixtures First 20 _ APPLICANT Total No. Additional ADDRESS Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: If, after making this Certificate of CITY' Tet. Exemption,you should'become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code,you must forthwith comply with such PERMIT provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances APPLICANT LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS I hereby"affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. (commencing with Section 7000) of Division 3 of the Business and CITY Tel.No.. Professions Code,and m license Is do full force and effect. Over 10 to 50 Incl. } y LICENSE OR Clens d Over 50 to 100 Incl. REG.NUMPpR Over 100 DISTRICT NO: P SED BY V License Number Lic.Class /� f Services,Swbd.,MCC&Panelboards V d4 Contractor Date 0-399 Amp.Under 600 V FAN / Q ❑ 400-1 000 Amp.'Under 600 V t9 4 b - VALIDATION V I am exempt under Sec. Over 1000 Amp.or Over 600 V FINAL; fl B.&P.C.for this reason BRANCH CIRCUIT FEES BY Cl) Date: A A A,or 20A,120V,Lighting or Recept. aaid 1 To 10 Branch Circuits A/1 V Signature 11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits 2 a: SINGLE FAMILY Temp.Power Pole&Appurtenances -•� a HOME OWNER-BUILDER DECLARATION' Sign with One Branch Circuit ACCT. ,. I hereby affirm that I am exempt from the Contractor's License Law -�, t i for the following reason(Section 7031.5, Business and Professions Additional Sign Branch Circuits ,.30,75 59e�. I ITEMS 1,as owner of the property,will do the work and the structure Misc..Conduits&Conductors Is not intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule) TOTAL � ' and:Professions Code). , • CHECK 9-9.4 CONSTRUCTION LENDING AGENCY r, AN., o[f[@ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total). 3/3 Civ.C.) PLAN CHECKING FEE Lender's No ` .PERMIT ISSUING FEE2473 1 AM 9'-13 Lender's Address "v '" 1•certify that I have read this application and under penalty of purjury state TOTAL:FEE --- that the above information is correct. I agree to comply with all County 1 ordinances and State laws regulating Electrical wiring,and hereby authorize representatives of this County to enter upon the above-mentioned property f n action purpose SEE REVERSE FOR EXPLANATORY LANGUAGE DATE SIG ITT SIGNATURE OF PERMEE, '