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Home My Public Portal About5412 A & B MCCULLOCH AVE_Electrical__ DES 6-A. 5-46 ,APPLICATION FOR PERWr DEPARTMENT OF BIJIGDING AND SAFE'L'Y . , COUNTY OF LOS ANGELES ELECTRIC 'm WM. J. FOX CHIEF ENGINEER z DISTRICT NO- GROUP ZONE PERMIT NO. NAMIy'. 4^DDRESS yg U CITY rT.ELLrNO. R ��6 BY FIRST E INSPECTION ADY FOR DATE ISSUED 111 /� pA W RT.NO. EXCOUNTY PIRES; tG4Ff-4�y gl/ / APPLICANT FILL IN HEAVILY btjTLEVp PORTION ONLY JOB DESCRIPTION OF WORK- - ADDRESS - NUMBER'OF OUTLETS ON CIRCUITS LOCAEI rf ��, �+' ' i, LOCATION BY ROOMS NEAREST LIGHT OUTLETS SW. PLUGS FIXT CROSS ST. CIRCUIT A I B C D. E F IG lH E NAME ZMAILfr 3 ADDRESS O t CITY 1 AM THELEGA�,�IP ISSESSOR OF THE ABOVE LOS ANGKLCII COUNiY CERTIFICATE OF QUALIFICATION.- - ELECTRICIAN. I AM THE LtQAL OWNOF THE PROPFAM DESCRIBED ABOVE ✓� � G�'��'��+t/^ �� x - CORRECTIONS" J - - a z n - o TOTAL NO. OF OUTLETS y $ APPROVALS NO. OF FIXTURES $ DATE INSPECTOR'S NAME NO. OF MOTORS H.P. $ - CONDUIT NO. OF SIGNS TRANS. $ WIRING NO. OF RANGES OR HEATERS S FIXTURES / MISCELLANEOUS $ yy POWER PERMIT FEE $ / � ! UTILITY CO.NOTIFIED_ ? TOTAL FEE ✓J r.�f L3 FINAL `- `� �' ev e oeS BA X$M BETS 2-47 APPLICATION FOR PE DEPARTMENT OF RUM DING AND SAFM _ "+g �1 coUI�I'1'Y OF LOS ANGELES A'LEC IC WM. J. FOX CHIEF ENGINEER Zzz 'NAME DIST ]SJI'NO. GROUP ZONE PERMIT NO U ADDRESS CITY TEL.NO RIVED BY READY FOR DATE ISSUED FIRST INSPECTION COUNTY ' J�j s Z— W CERT.NO. EXPIRES APPLICANT FILL IN HEAMY OUTLINE PORTION ONLY JOB DESCRIPTION OF WORK ADDRESS NUMBER OF OUTLETS ON CIRCUITS T LOCALITY LOCATION BY ROOMS NEAREST LIGHT OUTLETS SW. PLUGS FOIT CROSS ST. - F'QLG LGJ •�/ CIRCUIT' A B. C D 1 E F G I'I N NAME !r e1 'V.4_s Wyr MAIL f 6 � ADDRESS� / ! O SITY64--.0" ac a 1, TEL.NCC01 f R ! 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ( ANGELES COUNTY CERTIFICATE OF QUALIFICATION.. ', �Ij!� ELECTRICIAN. `( 1 AM THE LEQAL OWNER OF THE PROPERTY DESCRIBED ABOY61 r�'• � �.,` OWNER. C® MONS - Q Z_ O O a ToTaL - - NO. OF OUTLETS ri. APPROVAL'S- NO. OF FIXTURES DATE INSPECTOR'S NAME NO. OF MOTORS H.P. CONDUIT [NO. OF SIGNS TRANS. WIRING NO. OF RANGES OR HEATERS FIXTURES M ISCELLANEOU POWER PERMIT FEE / D UTILITY CO.NOTIFIED I grerraw eer elwel_ Ilt ",_ i1 rd" �'®`► • �• ��,��t ,��, !�' � l�� ,j/G 4"• (art��`.� !1l ,i �LL.'��'.y �..f;_J COUNTY OF LOS ARGELU Y NUUMM ASD ems: ELECTRIC i WILLUIN i FOX. OHIIOr Mmwm= FOR APPLICANT TO FILL IN Diffm0T NO. mmoup mNX P�lff tom. my 11CADY rm DATE rMFI� AM l7M 11lmn arry TEL.Ma � v,�r!- Z- pE'9M't FEBa Ma ITAOFI 1� LIMHT OIrrLZTE MSA1M W I AC Ls ej VAM..MrrrroHs ` -t �. TOTAL OuTLFLr■ Mo wy ELML MAMMA FLLM. HZATA Orgy .ZA,rwn� • Iid .S' JZ M 1A te! THAT 1 HAIR 1=Ap TIM ~rm APPLtHM AMD MTATE THAT THIC AMCMM 0 mumOR um"OIM rm AMD AFMFM= TO 0MdMV WrrH ALL OMWM OMDIIFAIMMN Z/ MUTAFZ>! OR NEUE"AOLi OIM4IITM Alm MTWM LANM IMCM ILATINM a"'rM"�" MIRMMl MOTORH I OaTUT THAT I TOO TM AMCW VALm LM ANN== DOIMITY L MM% DM 1 AN TM LMAI. Mm uv% HP oral CW TIM MCOME TVA . PMCPCWM DFOsI■M MUM ` i MBMKAT s EW ■ is I-= MD O ■IM" NO. M0.TM APPROVALS NM r M KAON 'o1NnY TOTAL FQ R1MAL v I-,%3 -•a7 v f+wrw. �• 76.0663-GEBO6 10/76 APPLICAT N F REL ' RICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER pDDRESS BUILDING AND SAFETY DIVISION Cvl D �• LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. CE 7 OUTLETS N0. EACH FEE FOWNER OR IRM NAME 88 i QV} RECEPT._ 5 MAIL T c G G LIGHT TOTAL FIRST 20 �g OVER 20 CITY �E C TEL. NO. -,� SWITCH_ PLAN CHECK LIGHTINGl FIRST 20 APPLICANT I TOTAL FIXTURES OVER 20 /-.!re ADDRESS RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT RANGE DRYER_WTR. HTR. APPLICANT SAM STA. COOK DISP. F.A.U. ADDRESS SPACE HTR. AIR COND. )CITY TEL. NO. CLOTHES WASH. DISHWASH. )+REG.NUMBER CLASS. FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION 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 • I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/Op 0 - 1 1.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA ORTHAI' I AM THE LEGAL OWNER THE ABOVE 1 - 1O 3.00 DESCRIBED RESIDENTIAL PROPERTY. p C7 PERMIT EELo 10 - 50 5.00 SIGNATURE O F- 50 - 100 10.00 yVj DISTRICT NO.�r- OCE ED BY Rp„ 100 - 500 15.00 ` Z SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTOR' SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE SERVI CENOT OVER 600 VOLTS OR 200 AMP 3.00 ® UNDERSLAB WORK SERVICE OVER 600 VOLTS OR200,AMP 10.00 ROUGH CONDUIT TEMPSERVICE,POLE,&APPURTENANCES 5.00 WIRING TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES POWER AUTHORIZED 'I UTILITY CO. NOTIFIEDy FINAL PERMIT FEE (SUB TOTAL) y o NOTES; �. PLAN CHECK FEE PERMIT ISSUING FEE TOTAL FEE 0O PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.0. CASH SEE,BACK OF APPLICATION FOR COMPLETE SCHEDULE ' V x. �V RKERS'.COMPENSATION DECLARATION CE-806 APPLICATION FOR ELECTRICAL_ERMIT CE-806G (2.80) I hereby affirm that I have a certificate of consent to self, COUNTY OF LOS ANGELE UI WING AND SAFETY insure,or a certificate of Workers'Compensation Insurance,or I "fl a certified copy thereof(Sec.3800,Lab.C.) Policy No. Company FOR APPLICANT TO FILL IN JOB New Residential Bldgs.&Pools EACH NO. FEE ADDR g ' uy, ❑ Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ — $ LOCALITY e C(r ❑ Certified copy is filed with the count building Multi-family Sq.Ft. — NEAREST Ji Y g inspection Residential Swimming Pools department. FIRM NAME .o Date Applicant Outlets:Rec._LightSw. 'MAIL First 20 ADDRESS b"41(it,- CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY e. Tel No. L. 3 678" COMPENSATION INSURANCE 'PLAN CHECK CL (This .section need not be completed if the work involved Lighting Fixtures First 20 ADDRESS:APPLICANT V by the permit is for one hundred dollars ($100) or less.) Additional Total No. I certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No. 0 permit is Issued, I shall not employ any person in any manner PERMIT W so as to become subject to the Workers' Compensation Laws. Range_Heater D.W. _ APPLICANT d Oven _ Dryer_W.M._ ADDRESS N Date <1_ Applicant `� —� Top _ FAU _W.H.,_ Z '— Z Hood _ Fan _Other— CITY Tel No. NOTICE TO APPLICANT: If, after making this Certificate of Disp. _Room Air Condom 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. P D BY with comply with such provisions or this permit shall be 0/002 'deemed revoked. ""-•� Size&Type HP,KW,KVA,or KVAR Up to 1 Incl. r �� FINAL LICENSED CONTRACTORS DECLARATION Over 1 to 10 Incl. DATE VALIDATION Over 10 to 50 Incl. I hereby affirm that I'am licensed under provisions of Chapter Over 50 to 100 Inc. AL 41 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 License Number Lic.Class 0-200 Amp.Under 600 V 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 License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits 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 5 !' I hereby affirm that there is a construction lending agency for the performance of the work for which this permit isPERMIT FEE (Sub-Total) �' 0 `- U issued(Sec.3097,Civ.C.). '� Lender's Name 1 PLAN CHECKING FEE (One-Fourth Permit Fee) 2 c c i C)( Lender's Address PERMIT ISSUING FEE o r: n I certify that I have read this application and state that the TOTAL FEE 17 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 Signature of Permittee Date , WORKERS'COMPENSATION DECLARATION APPLICATION FOR ELECTRICAL PERMIT CE-806 - -' CE-806G (2-BO) I hereby affirm that I have a certificate of 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 JOB / .Policy No. Company EACH NO. FEE ADDREsaf I N /I76'_'L/,txA New idential Bldgs. Poo ri Certified copy is hereby furnished. 1 8 2 amily,Sq. F U $ $ .S LOCALITY —�iO p �t_ Multi-family Sq. Ft. ` — NEAREST Certified copy is filed with the county building inspection CROSS ST _ department. Residential Swimming Pools OWNER OR FIRM NAME �S,r✓eI /2xa Date Applicant Outlets: Rec.—Light—First ADDRESS? � C�t1�49, �rJ First 20 CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY ` Tel No. !'l�j C COMPENSATION INSURANCE PLAN CHECK p. (This section need not be completed if the work involved APPLICANT p Lighting Fixtures First by the permit is for one hundred dollars ($100) or less.) io ADDRESS M Total No. Additional I certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP' CITY Tel No. O permit is issued, I shall not employ any person in any manner PERMIT (� so as to become subjbct to the Workers'Compensation Laws. Range_Heater D.W._ APPLICAN e.N- U W /Y )fin Oven _ Dryer_W.M._ ADDRESS U �C7g-7-7�o Date d� Applicantl ,i� {� ?�� Top _ FAU —W.H. _ _ Hood _ Fan _Other_ CITY Tel No. NOT CE O APPLICANT: If, after making this Certificate of Disp. _Room Air Cond` LICENSE OR r Exemption, you should become subject to the Workers' REG.NUMBERJtr Class C 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 i,� Up to 1 Incl. V FINAL, ' LICENSED CONTRACTORS DECLARATION Over 1 to 10 Incl. DATE`'' : — 7' r VALIDATION Over 10 to 50 Incl. 6hereby 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 License Numbe0 1 L Lic.Class (] 0-200 Amp.Under 600 V n pr 201-1000 Amp.Under 600 V Contractor M(_ikI fi ELI VDate Over 1000 Amp.or Over 600 V S j y'O HOME OWNER-BUILDER DECLARATION Temp.Power Pole&Appurtenances I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits ness and Professions Code): El Misc.Conduits&Conductors I, as owner of the property, will do the work and the Other(See Complete Fee Schedule)— r)1, 9 n structure is not intended or offered for sale (Section 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY { u n o u c , 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, ar � �J? �p�✓ � V Lender's Name p7, /� PLAN CHECKING FEE (One-Fourth Permit Fee) Lender's Address%�A fll�/��Ce�� /�/�Ya PERMIT ISSUING PEE ;�o /►,errQ �q q/7 7 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 e above-mentioned property for inspection purposes. SEE-REVERSE FOR EXPLANATORY LANGUAGE ') ft��.,to, , A�_ rQ Sign re of Permittee Dat