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Home My Public Portal About5530 MCCULLOCH AVE_Electrical__ coIr OF LOS AXX - APPT.I�CATIOR FOR PST mmuwmCOUNTY Egan= nnlum OF Han.=a sAMM ELECTRIC 1 + WbT.UM L FOE.COUNTY IIHIMMI FOR APPLICANT TO FILL IN SOT N0. ORL ZONE PERMIT NO. ELECTRICIAN 5 IA -1 6 i ADDRfM _ ` RECEIVED READIr'POR 'R IMUED FI191T 11MPECTION cITY f' COU E IBUUBMING PST FSS NUY■ol mnc1l FQ LIGHT OUTLRiti NEAREST RECEPTACLES v WALL SWITCHES I OWN ER TOTAL OUTLETS ms EIEC. RANGES : ASD u' S c �-t• --s EIEC. HEATEIMI 20 9T I FIXTURES s2 e4 TEL, Dim 144 1 Hm=4fAcK=wuu& THAT I NAvc amaD THIS NUMBER OF LIGHT CIRCUITS APPLICATION AND sTATs THAT THE ABOVE MI COIMIUM AND AGREE TO COIIPLT WITH ALL COUNTY ORDINMMIM NUMB OF RECEPTACLi AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I 1 CERTIFY THAT 1 1O 110 THE ABOVE VALID LIOII Nulostl HORSES 101 EDE "MOM COUNTY LICENSE, OR 1 AM THE LEGAL CWHISH Mm MYo. HP ovoi I lam sAa1 OF THE RESIDENTIAL PIMP DESCRIBED AMOVII. MIMUM 9 .25 'siGNATURs OP • fl .80 PEIIY L s s s 1.00 � 8� m 1m 1.00 in ISO 11.90 EsO am 9.00 • f-• c / Soo moo 10.00 J moo 1000 18.00 Z OVER 1000 AO OO p M.G. nzr FRE=. CHANGER•HP 0' WEIEIERs. AC-XVA GENERATOM-KW TRANePORMESS-IMA TEMP. MOTORS 7 oR Me.) MOVED MOTORS 7 or ma. misc. BIONS NO. NO.TRANS. El I APPWVM O N MIT DA'L'E INSPECT01Ps NAME WIRING 1, CONDUIT FIXTURp sf.00 O WIRING y �I� �i. s ENT p FIXTURES e. • POW n TOTAL FRE s / s UTILITY 00. NOTIFIED _ VGA 114111 =a sA. *OR 1 WORKERS'COMPENSATION DECLARATION 10.0019 DPW 3/07 APPLICATION FOR ELECTRICAL PERMIT O 1 hereby affirm that I have a certificate of:consent to self .CE 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. EACH NO. FEE ADDRESS 2> � New Residential Bldgs. &-Pools _ Certified copy is filed with the county building inspec- 1 8.2-:Family, $ LOCALITYFamily,Sq.'Ft. - tion department. Multi-family Sq, Ft. -- NEARESTJ r- CROSS Residential Swimming Pools OWN R O Date Applicant FIRM'NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec tght�Sw.4 MAIL COMPENSATION INSURANCE ADDRESS First 20 (This section.need not be completed if the work involved byCITY Tel. 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 W rk Com sation Laws. g g Additional Date Applicant Total No. CITY Tel. No. NOTICE TO APPLI NT: If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT Exemption, you should become subject to the Workers' . Range— Heater—D.W. — APPLICATION 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 I hereby affirm that I am licensed under provisions of Chapter 9' REG. NUMBER Disp. _ Room Air Cond. _ Class. (commencing with Section 7000)of Division.3 of the Business Power Apparatus&Large Appliances DISTRICT NO. PR E ED BY >_ and Professions Code,and my license is in full force and effect. U Size&Type HP, KW, KVA, or KVAR License Number Lic. Class Up to 1 Incl. I FINAL rac Conttor bate Over 1 to 10 Incl. DATE VALIDATION O 0 ❑ Over 10 to 50 Incl. � ' UFINAL I am exempt under Sec. Over 50 to 100 Inc. BY 0 100 s 4 • LIU B.BP.C. for this reason_ - Over N Services,Swbd.,MCC&Panelboords Z Date: 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 FAMILY Temp. Power Pole&Appurtenances ' HOME OWNER-BUILDER DECLARATION I herebyaffirm that I am exempt from the Contract'or's License Sign with One Brandi Circuit f p Additional Sign Branch Circuits Law for the following reason (Section 7031.5, Business and 9 Professi Code): -o-6-1 I, as owner of the property, will do the work and the Misc. Conduits 8 Conductors structure is not intended or offered for sale(Section 7044, Other(See Complete Fee Schedule)_ Business and Professions Code). - ® ?!L lh- 16e0 r-• Q CONSTRUCTION LENDING AGENCY I y. j�.:r.• ie_i1j I hereby affirm that there is a construction lending agency for the.performance of the work for which this permit is issued PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name 4if r � PERMIT ISSUING FEE Lender's AddressitLf.];" 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 t hereby outhoriz representatives of this ounty to enter upon the abov me ned propert for Ins ction purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE S1t atureffif mittee Date ®' { WOF'CERS'Gi 01 ENSATION DECLARATION 1: 7aA663. 10t81 F LIGATION FOR ELECTRICAL PERMIT iy w.• I hereb .flff(rm that f have a certificate of count to self'inCE-868G sure,] 4 a certificate of Workers' Compensation Insurance,or a certified; COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec.3800,Lab.C.) • ;, Policy No. Company FOR APPLICANT TO FILL IN JOB ADDRES s 7 ' �i ' 0 Certified copy.is hereby furnished, New Residential Bldgs.&,Pools EACH NO. FEE LOCALITY y . $ — $ ' 4 'Certified copy is-filed with the county building inspeetionl 1 &2-Family,Sq.Ft r . department. 1 'Multi-family Sq.Ft. .. NEAREST { CROSS ST Residential Swimming Pools Date Applicant i OWNER OR FIRM.NAME LL CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL Outlets:Rec_Light.—Sw.— COMPENSATION INSURANCE' ADDRESS8 7 4 L f ZI1. -' (This section need not be completed If the work Involved by the Fret 20 No. Additional Total Nl CITYI.No. permit is'for one hundred dollars.($100)'or less.) _. I certify that in the performance of the work for which this permit; PL CH CK is issued, I shall not employ any person.in any manner so as to PLICANT become subject to'the Workers'Compensation Laws. Lighting Fixtures First 20 .ADDRESS Additional Total No. CITY Tel.No. Date " Applicant _Fixed Appliances Not Over 1 HPPERMIT _ NOTICE TO APPLICANT: If, after. making this Certificate of Exemption,you should become subject to the'Workers'Compensation Range_ Heater D.W. APPLICANT provisions of the Labor Code,ybu must forthwith comply with'such, Oven _ Dryer_ W.M._ ADDRESP,7,.9,42[� J y. . f� provisions or this permit shall be deemed revoked. Top _ FAU _ W.H. _ r LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other_ CITY, . Tel.No . .f.J`'�-�(� I hereby affirm that I am licensed under provisions of Chapter 9 LIC (commencing with Section 7000)of Division 3 of the Business and Disp. — Room Air Cond. REG.NUMBER Class Professions Code,and my license is in full force and effect.. DISTRICT NO. PROCESSED BY - Power Apparatus&Large Appliances Size&Type HP,KIN,KVA,or KVAR License Number Lic.Class Up to 1 Incl. FINAL �+ Over 1 to 10 Incl, DATE Contractor Date Over 10 to 50 Incl. , V DATION, • , FINAL f am exempt under Sec;. Over 50 to 100 Inc. gy W BAP.C.for this reason Over 100 y Services,Swb&,"MCC&Panelboa Z Date: 0-200 Amp.Under 600 V 0 . 9 Q Signature I 201 - 1000'Amp.Under 600 V Over 1000 Amp.or Over 600 V Exemption for Reg.Mafnt.,Elect. ;2T9Q7A SINGLE FAMILY Temp.Power Pole&Appurtenances HOME OWNER=BUILDER DECLARATION. 0 0 0 0 0 hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit 2 Additional Sign Branch Circuits o - 2550 fbr the�l(owing reason.(Section 7031.5,Business and Professions •� Code. _ }� O U 6 C.7 " Misc.Conduits.&Conductors 2 5'S 0 I,as owner of the property,will do the work and.the structure 'is not intended or offered for sale.(Section 7044,.Business ' Other(See Com I e F, Schedule) , 09. 1 4"8 7 -and Professions Code). �� 'T�' CONSTRUCTION LENDING AGENCY 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). I PLAN CHECKING FEE Lender's Name I; PERMIT ISSUING FEE Lender's Address I certify that I have read this application and state that the above TOTAL.FEE informationis correct.I agree to comply with all County ordinances and State laws regulating Electrical wiling, and hereby authorize representatives of this County to enter upon the above-menti ed property for ins e n purposes. [/�`'y, SEE REVERSE FOR EXPLANATORY LANGUAGE /L l� I ' ignatu. f Permittee D V. �ENSAfION DECLARATIONI CE-806 ,q,Bl APPLICATION FOR ELECTRICAL PERMIT I [eby,affirmi'tivat'I have.a certificate of consent to self CE-806G i �QF a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec. 3800, Lab. C.) Policy No.. Company FOR APPLICANT TO FILL IN JOB Certified co is hereby furnished. EACH NO. FEE ADDRESS i L/1 copy y New Residential Bldgs. &Pools Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. $ — $ L.CAU CC tion department. Multi-family Sq. Ft. — NEAREST r-r Residential Swimming Pools CROSS ST. Date Applicant. OWNER Or FIRM NAME Low CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Lfght J_Sw.L ' COMPENSATION INSURANCE First 20 ADDRESS V (This section need not be completed if the work involved by Total No. Additional CITY Tel. No. S -the permit is for one hundred dollars($100)or less.) PLAN CHECK I certify that in the performance of the work for which this APPLICANT permit is issued, I shall not loy a y person in any manner, so bec a Sublett Wor r 'Compensation Laws Lighting Fixtures First 20 ADDRESS Total No. Additional a CITY I o. A Fixed Appliances Not Over 1 HP PERMIT TIC TO PLICANT: If, after making this Certificate APPLICANT xem ion, 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. CONTRACTORS DECLARATION LICENSE OR 'I hereby affirm that I am licensed under provisions of Chapter 9 Disp. Room Air Cond. REG.NUMBER Class. (commencing with Section 7000) of Division 3 of the Business Power.A DISTRICT IyO. PROCESSE Y pparatus 8 Large Appliances �JC� >_ and Professions Code,and my license is in full force and effect. ,, � Size&Type HP, KW, KVA, or KVAR- O License Number Lit. Class Up to 1 Incl. FINAL V • Over 1 to 10 Incl. DATE VALI ATION99 Contractor Date Over 10 to 50 Incl. I. 0 ❑ FINAL I am exempt under Sec. Over 50 to 100 Inc.. :Py � B.&P.C.,for this reason Over 100 Date: Services,Swbd., MCC&Panelboards 0 -200 Amp. Under 600 V Signature 201 -9060 Amp. Under 600 V Over 1000 Amp. or Over 600 V ( 0 7 8 Q 2 A Exemption for Reg. Maint.Elect: SINGLE FAMILY Temp. Power Pole&Appurtenances #-o o 0 o 0,2 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit o•o 12010 hereby affirm that I,am exempt from the Contractor's License Additional Sign Branch Circuits Law for the following reason (Section 7031.5, Business and o o'o Z,Q;Q Professions Code): �I; as owner of the property, will do the work and the Misc. Conduits&Conductors 0 a-5 1 i-87 tructure is not intended or offered for sale (Section Other(See Complete Fee Schedule)- 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 issued PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE !O S 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 authorizer pr sentatives of this County to ter up n th b enti property for inspecti n ses, �� a SEE REVERSE FOR EXPLANATORY LANGUAGE U dr Sigricituri 6T Perr - ee Dat