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Home My Public Portal About5332-5334-5836-5338 MCCULLOCH AVE_Electrical__ 78A883 C6 806R 10/77 n APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEERJOB G' - BUILDINd AND SAFETY DIVISION i4DDRE5$ + FOR APPLICANTTO FILL IN LOCALITY 3' New Residential Bldgs.&Pools EACH NO. 7FEE. NEAREST 1 &2-Family,Sq.Ft. /3 $ :025 — $ may, CROSS ST. OWNER OR Multi-family Sq.Ft. 02 — FIRM NAME Q Residential Swimming Pools 25.00 AA�RESS L� Outlets:Rec Light Swp—? CITY °� �yQ�, Tel.No s... f First 20 •50 1 CHECK Total No.4Q41— Additional .30 1 APPLICANT ADDRESS,3(/ Lighting Fixtures First 20 .50 CITYel.No. Additional .30 PERMIT Total No. APPLICANT Fixed Appliances Not Over 1 HP ADDRESS �. Range_Heater_D.W.— CITYTel.No. tr Oven—Dryer—W.M. r� LICENSE OR � �r-� Top —FAU W.H.— REG.NUMBER (pal(,t Class. Hood FanOther- I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE Disp. X Room Air Cond. 2'50 THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDIN- ANCES AND STATE LAWS REGULATING ELECTRICALWIRING. Power Apparatus&Large Appliances Size&Type HP,KW,KVA,or KVAR I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM Up to 1 Incl. 2.50 THE LEGAL OWNER OF THE ABOVE'DESCRIBEDRESIDENTIALPROPERTY. Over 1 to 10 Incl. 5.00 v Over 10 to 50 Incl. 12.50 PERMITTEE Over 50 to 100 Inc. 25.00 SIGNATURE - Over 100 40.00 DISTRICT NO. SED BY Services 0.200 Amp.Under 600 V 12.50 I ECTOR'S 201-1000 Amp.Under 600 V 25.00 APPROVALS DATE IGNATURE Over 1000 Amp.or Over 600 V 50.00 TEMP.POWER POLE Tem Power Pole&A 10.00 fFIXTURES RSLAB WORK Temp. Appurtenances Sign with One Branch Circuit C/ 10.00 H CONDUIT Additional Sign Branch Circuits 2'00 G ��Zd Misc.Conduits&Conductors 10.00 Other(See Complete Fee Schedule), R AUTHORIZED 4q VALY CO.NOTIFIED PERMIT FEE [Sub=Total) NOTES PLAN CHECKING FEE IOne-Fourth Permit Fee) PERMIT ISSUING FEE $7.00 TOTAL FEE , 3 PLAN CHECK VQGDfiffC IM PLtNSA"® CASH PERMIT VALIDATION CK. M.O. CASH _ 7 o tiri�l€t zo a- 5 9.8 3 &--d HOLDER: 'AS Vi.I yltl Glte ORCOMPL/ 9-3 oh• :'.•_vy r-�� _� 76A tE/7S ��LIyAT10'k FOlVEECTRICAL P RMIT - AP C BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN JOB /n� ppyyo� New Residential Bldgs.&Pools EACH NO. FEE ADDRESS 3 U. . !/1 C(xL1G 1 &2 F.maily Sq. Ft. $ — $ LOCALITY L(,'' .C, Multi-family Sq.Ft. NEAR CROSST. ; 1 Residential Swimming Pools OWNER OR u m A_ FIRM NAME !T Outlets: Light,Switch&Receptacle MAIL /''J First 20 ADDRESS G vlr Additibnal CITY Tel- Nn- PLAN el. No.PLAN CHECK APPLICANT Lighting Fixtures First 20 `ADDRESS Additional CITY Tel.No. PERMIT Fixed Appliances Not Over 1 HP APPLICANT AC,, f Range_ Heater_ D.W. Oven Dryer _ W.M. _ ADDRESS , (9 9AM Top FAU — W.H. _ CIT ,. M Tel.No. 06 Hood Fan LICENSE OR REG. NUMBERC'7'1)tkq6 Class. Disp. A.C. CZA '1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THISAPPLICATION AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY CD Power Apparatus&Large Ap lances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING I.... Size&Type HP,KW,KVA,or KVAR ELECTRICAL WIRING. Up to 1 Incl. I HEREBY CERTIFY AT'1 AM PROPE Y REGISTERED ANO/OR to Over 1 to 10 Incl. LICENSED AS REGUIR BY LOS ANOBLES LINTY AND TATE OP 1 AM THE LEG WNER OP E ABOVE Over 10 to.50 Incl. DESCRIBED RESIDE TI P Over 50 to 100 Incl. Over 100 SIGNATURE DISTRICT NO. PROCESSED BY Services 0-200 Amp. Under 600 V 201.-1000 Amp.Under 600 V APPROVALS DATE INSPECTOR'S Over 1000 Amp.or Over 600 V SIGNATURE TEMP.POWER POLE Temp.Power Pole&Appurtenances UNDERSLAB WORK Sign with One Branch Circuit Additional Sign Branch Circuits ROUGH CONDUIT (Other) WIRING FIXTURES A 10 Tz r n POWER AUTHORIZED PERMIT FEE (Sub-Total) UTILITY CO.NOTIFIED PLAN CHECKING FEE (One-Fourth Permit Fee) ` FINAL 2 -.1 200 PERMIT ISSUING FEE TOTAL FEE I /"(A NOTES o 0 0 1 7,a n i / Lim 1 z .. 17n PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. NL0. CASH �-7 �� -3"77 76A � IE��g APPLICA I N FOR ELECTRI AL PERMIT AY B LDIN AND SAF TY DIVISIO POR APPLICANT TO FILL IN JOB EE ADDRESS.CH New Residential Bldgs.&Pools EANO. F �� 1 &2 Finaily Sq. Ft. $ — $ LOCALITY Multi-family Sq. Ft. — NEAREST d✓1 CROSS ST. GSC_ Residential Swimming Pools OWNER OR AA FIRM.NAME d A11MR . Outlets: Light,Switch&Receptacle MAI L AD'DRES First 20 Additional CITY -1 Tel. No, r PLAN CHECK Lighting Fixtures. APPLICANT First 20 ADDRESS Additional CITY A Tel.No. Fixed Appliances Not Over 1 HP APPLICANT ` L Range_ Heater_ D.W. ADDRESS Oven Dryer _ W.M. Top _. FAU _ W.H. CITY el. No. Hood FanLICE SE OR O ATWREG. NUMBER Class. Disp. .— A.C. I HEREBY ACKNOWLEDGE THAT 1 HAVE READ.THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLI/ 0 Power Apparatus&Large App nces WITH: ALL COUNTY ORDINANCES AND STATE LAWS REGULATING 1 ELECTRICAL WIRING. Size&Type HP, KW,KVA,or KVAR W Up to 1 Incl. 1 HEREBY.CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR Z Over 1 to 10 Incl. LICENSED AS REQUIRED BY LO GELE UNTY AND STATE OF CALIFORNIA OR THAT I. AM AR LEGAL VER OF THE ABOV Over 10 to 50 Incl. DESCRIBED RESIDENTIAL PR ERTY. Over 50 to 100 Incl. - PERMEE Over 100 SIGNA Services DISTRICT NO. OCES ED B 0-200 Amp. Under 600 Vcog 201 -1000 Amp. Under 600 V APPROVALS DATE IN NATURE CTORE Over 1000 Amp.or Over 600 V TEMP.POWER POLE Temp.PoWer Pole&Appurtenances UNDE.RSLAB WORK Sign with One Branch Circuit Additional Sign Branch Circuits ROUGH CONDUIT (Other) WIRING FIXTURES POWER AUTHORIZED PERMIT FEE (Sub-Total). UTI LITY CO.NOTIFIED c D D D PLAN CHECKING FEE (One-Fourth Permit Fee) FINAL ;14f 11 PERMIT ISSUING FEE NOTES �� Q 2 TOTAL FEE PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M!6 CASH 7 �3S IBA883 CE eoeR ,o,» c APPLICATION FO ELECT ICAL PERMIT .: COUNTY Olz LOS.ANGELES DEPARTMENT OF COUNTY ENGINEERJOB ° BU�LDINGAND SAFETY DIVISION ADDRESS. Z FOR APPLICANTTO FILL IN LOCALITY New Residential Bldgs.&Pools EACH NO. FEE CROSS ST. d`'arTs°� 1 &2-Family,Sq.Ft. $ '025 — $ OWNER OR Multi-family Sq.Ft. .02 — FIRM NAME Residential Swimming Pools `` 25.00 ADDRESS C�� Outlets:Rec Light;LSw.Az? CITY Tel.No. First 20 .50 1 PLAN CHECK Total No. Additional .30 APPLICANT ADDRESS Lighting Fixtures First 20 .50 CITY Tel.No, Additional :30 PERMIT �� Total.No. APPLICANT I—I . Fixed Appliances Not Over 1 HP ADDRESS.3 , Ir&Z�Ve Range_Heater_D.W._ CITY - 'O ?Tel.No Oven_Dryer_W.M. LICENSE OR Top —FAU —W.H. REG.NUMBER 3 1 Class. Hood_Fan _Other I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE Disp. — Room Air Cond. 2.50 THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY'ORDIN• ANCE5 AND STATE LAWS REGULATING ELECTRICAL WIRING. Power Apparatus&Large Appliances Size&Type HP,KW,KVA,or KVAR I HEREBY CERTIFYTHAT.I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM Up to 1 Incl. 2.50 THE LEGAL OWNEROFTHEABOVEDESCRIBEDRESIDENTIALPROPERTY. C Over 1 to 10 Incl. 5.00 c7 Over 10 to 50 Incl. 12.50 PERMITTEE Q Over 50 to 100 Inc. 25.00 SIGNATURE '`–� Over 100 40.00 DISTRICT NO. P SED BY ti Services ' Do 0-200 Amp.Under 600 V 12.50 I ECTOR'S 201-1000 Amp.Under 600 V 25.00 APP VALS DATE SIGNATURE Over 1000 Amp.or Over 600 V 50.00 TEMP. OW R POLE ,j 2D Zg UNDERSLAB WORK Temp.Power Pole&Appurtenances 10.00 Q Sign with One Branch Circuit 10.00 ROUGH CONDUIT 2.00 WIRING Additional Sign Branch Circuits Misc.Conduits&Conductors 10.00 FIXTURES Other(See Complete Fee Schedule! POWER AUTHORIZED UTILITY CO.NOTIFIED Of FINAL PERMIT FEE (Sub-Total) NOTES PLAN CHECKING FEE (One-Fourth Permit Feel PERMIT ISSUING FEE $7.00 TOTAL FEE "MM624MOMPENSAYMON CASH PERMIT VALIDATION CK'. M.O. CASH POLICYHOLDER: s ' 7; 3 6 90—'MAR 20 2 D• ' 70.95A zd DULEW SV VLetrff6WGf[.FOR�COMPLETE/ !N C V , r WORKERS'COMPENSATIONDECLARATIONAPPLICATION FOR ELECTRICAL PERMIT 'CCE-806E-806G (2.80) I hereby affirm that I have a certificate of consent to self I COUNTY OF LOS ANGELES BUILDING AND SAFETY insure,or a certificate of Workers'Compensation Insurance,or e a certified copy thereof(Sec.3800,Lab.C.) 5? / o13 '� FOR APPLICANT TO FILL IN JOB Policy No. Company—:;-- EACH NO. FEE ADDRESS �3 New Residential Bldgs.&Pools Certified copy is hereby furnished. ��/r� 1 &2-Family,Sq. Ft. $ — $ LOCALITY Certified copy is filed with the county building inspection Multi-family Sq. Ft. NEAREST Residential Swimming Pools CROSS ST e department. OWNER OR ¢ . FIRM NAME Date LI _VPApplicant <<' Outlets: Rec.^Light Sw. MAIL First 20 ADDHESS 1Old 5N. i CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY Tel No J03 d COMPENSATION INSURANCE PLAN CHET U (This section need not be completed if the work involved APPLICANT Fixtures First 20 Fi hting x by the permit is for one hundred dollars ($100) or less.) LigAdditional ADDRESS Cr I certify that in the performance of the work for which this Total No. CIT Tel No,2�s'_ permit is issued, I shall not employ an person in an manner Fixed Appliances Not Over 1 HP U P P Y Y P Y PERMIT uJ so as to become subject to the Workers'Compensation Laws. Range_Heater D.W. APPLICANT /7- C tl Oven — Dryer ACW.M._ ADDRESSS'4) � Date Applicant Top _ FAU _W.H.._ S1S'`Z� Hood —Fan —Other ITY Tel No. NOTICE TO APPLICANT: If, after making this Certificate of Disp. _ Room Air Cond— / LICENSE 0RJV 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. PR SED with comply with such provisions or this permit shall be � deemed revoked. Size&Type HP,KW,KVA,or KVAR V Up to 1 Incl, v Over 1 to 10 Incl. ATFL LICENSED CONTRACTORS DECLARATION �- VALIDATION 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 f 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 Sign with One Branch Circuit ° r. I hereby affirm that I am exempt from the Contractor's Additional Sign Branch Circuits License Law for the following reason (Section 7031.5, Busi- ness and Professions Code): Misc.Conduits&Conductors •' :- � �• = ' I, as owner of the property, will do the work and the Other(See Complete Fee Schedule)— structure is not intended or offered for sale (Section 7044,Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency 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 hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE slot - //-! kz , Signature of Permittee Date