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Home My Public Portal About5536 MCCULLOCH AVE_Electrical__ i IA4.8.084044.80 APPLICATION FO ELECTRIC L PERMIT COUNTY OF LOS ANGELES �. DEPARTMENT OF COUNTY ENGINEERING BUILDING AND SAFETY DIVISION ADDRESS ip a JOIN A.LAMBIE.COUNTY ENGINEER WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY C- FOR APPLICANT TO FILL IN CROs-ST. ` PERMIT FEES OWNER ITEM NUMBER EACH FEE MAIL OUTLS OADDRESS. LIGHTET D LIGHTING FIXTURES .10 CITY EL.NO ELEC.RANGES CLO.DRYERS ELECTRICIAN . CO WATER HEATERS .BO ADDRESS - C - ELEC.SPACE HTRS. DISHWASHER S� CITY I TEL.NO. GARBAGE DISPOSERS �eµur.• STATE 17 WASHgMa STA.COOKING UNITS ` ,2$ Z� LICENSE NO. MOTORS. OVER ' INC. H.P. ID�ISTRIV NO. P Z N P OCESSED BY O — 1/2 .2$ V ' d y, — 2 .150 INSPECTION RECORD 2 — $ 1.00 d Lso V is — so 2.50 D:O so — 200 6.00 ti r NO TRANS. a SIGNS: NO.LAMPS Z SERVICE O.600V 1.00 SERVICE OVER 600V $.00 MISC. a WIRING PERMIT 1.00 00 FIXTURE PERMIT 1.00 D SUPPLEMENTARY PERMIT .50. TOTAL FEE S �y I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ' APPROVALS DATE INSPE OR.'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ; CONDUIT ..l WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT I AM. THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTI PROPERTY. POWER SIGNATURE � UTILITY CO.NOTIFIED OF PERMITTE FINA IDATION A HUR C.VETT, MO CASH SUPERVISING ELECTRICAL ENGINEER Ll x,3 9 3 9 - ; • 4dCOMPENSATION DECLARATION ! E 80BG APPLICATION FOR ELECTRICAL PERMIT 1081 �I hereby $ffir. that that S I have a certificate of consent to self insure, C for 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 EACH FEE Certified copy is filed with the county building inspection ADDRESS [' ❑ Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. _ ❑ 1 &2-Family,Sq.Ft. $ — $ LOCALI department. Multi-family Sq.Ft. NEAREST CROSS ST. Date Applicant Residential Swimming Pools OWNER O e FIRM NAME c� CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Ree—Light—Sw.— MAIL COMPENSATION INSURANCE ADDRESS 007 _4 (This section need not be completed if the work involved by the First 20 Total No. Additional CITY el.No. permit is for one hundred dollars($100)or less.) 14 I certify that in the performance of the work for which this permit. APPLICANT is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS Total No. Additional CITY Tel.No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT twv v Exemption,you should become subject to the Workers'Compensation Range_ Heater_ D.W. provisions of the Labor Code,you must forthwith comply with such Oven _ Dryer_ W.M._ ADDRESS d provisions or this permit shall be deemed revoked. Top _ FAU _ W.H. CITY �— el.No. LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other_ I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. LICE Class (commencing with Section 7000)of Division 3 of the Business and REG.NUMBER Professions Code,and my license is in full force and effect. Power Apparatus&Large Appliances DISTRICT NO. PROCESS Y Size&Type HP,KW,KVA,or KVAR t V License Number Lie.Class Up to Vincl. FINAL Over 1 to 10 Incl. DATE -0 Contractor Date VALIDATION ,., O ❑ � ver 10 to 50 Incl. Rn IN am exempt under Sec. Over 50 to 100 Inc. BY W IL B.&P.C.for this reason Over 100 E3 8 19.3 A ri) Services,Swbd.,MCC&Panelboards Z Date: 0-200 Amp.Under 600 V # 0 0 0 0 0 2 Signature 201 - 1000 Amp.,Under 600 V Over 1000 Amp.or Over 600 V f o - 2550 ElExemption for Reg.Maint.Elect. 0 - - 2-5505 SINGLE FAMILY Temp.Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I o,26-87 I hereby affirm that I am exempt from the Contractor's License Law Additional Sign Branch Circuits for the following reason(Section 7031.5,Business and Professions CCoI ode)); SLI,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 chedule) , and Professions Code). CONSTRUCTION LENDING AGENCY 11 Z20 1 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 Lender's Name PERMIT ISSUING FEE Lender's Address I certify that I have read this application and state that the above TOTAL FEE information is correct.I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize representatives of this County t enter upon the above-mentioned proper nspection pur SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date WORKERS'GOIV1PfiNSATION DECLARATION CE- M 10/81 APPLIC A IOIV FOR ELECTRICAL PERMIT k•,,herebyrt#brm"that I have'a certificate of consent to self CE-BO6G /'9 `insere, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS NGELES BUILDING ANDS FETY .or a certified copy thereof(Sec. 3800, Lab. C.) A. Policy No. Company FOR APPLICANT TO ILL IN JOB Certified copy is hereby furnished. ACH NO. FEE ADDRESS !i New Residential Bldgs. &Pools _ $ L'OC,�LI YG r ❑ Certified copy is filed with the county building inspec- 1 &2-Family, Sq, Ft. 71 tion department. Multi-family Sq. — NEAREST CROSS ST. Residential Swimming ing Pools OWNER OR Date Applicant / FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light ` Sw. ADDRESS MAIL c. COMPENSATION INSURANCE First 20 �1 (This section need not be completed if the work involved by CITY Tel. Noor�s-S' Total No the Permit is for one hundred dollars(;.100).or'less.) : Additional that in the erfornionce.of the work for which this PLAN CHECK I certify P APPLICANT permit is issued, I shall not employ,any person in any manner so as tclebecome subject to the rs'Compensation Laws. Lighting Fixtures First 20 ADDRESS 1 d I Total No. Additional CITY Te ppli n ✓' �"�"' Fixed Appliances Not Over 1 HP PERMIT TICE' T APPLICANT: If, after making this Certificate o APPLICANT empti n, you should become subject to the Workers' Range_ Heater—D.W. ompensation 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. — CITY Tel. No. IT deemed revoked. Hood _ Fan _Other_ LICENSED 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 Apparatus&Lare ADISTRICT NO. PROCESSED Y >_ and Professions Code,and,my license is in.full force and effect. gppliances c \yIL Size&Type HP, KW, KVA, or,KVAR' 6 License Number Lic. ClassFINAL V Up to 1 Incl. Over 1 to 10 Incl. 11 '! .DATE VA' -TION Contractor Date Over 10 to 50 Incl. FIN U ❑ I am exempt under Sec. Over 50 to 100 Inc. B W At 116 B.&P.C. for this reason Over 100 "" A 7 8 3 5A Services, Swbd., MCC&Ponelboards Date: 0 -200 Amp.Under 600 V #'0 0 0 0 0 2 Signature 201 - 1000 Amp..Under'600 V f,( 0 -.1200 Over 1000 Amp. or Over 600 V ' ❑ Exemption for Reg. Maint. Elect. 0 0'0 1 2 0 0 5 SINGLE FAMILY Temp. Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 09.03.-87 I 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 Professions Code.):. P as owner of the property, .will do the work and.the Misc. Conduits&Conductors structure 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 Lender's Address J1 I Certify that I have read'this application and state that the TOTAL FEE r(f above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authoriz . e sen tatIves of this County to a ter up n ' thea me o ed prop.ty f r inspec on purp es. < _ SEE REVERSE.FOR EXPLANATORY LANGUAGE Signchurg of Perini ee Dat