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HomeMy Public PortalAbout5660 MCCULLOCH AVE_Electrical__ OBS 5A 15M SETS 1-48 V - i L7 MC A��RAX FOR - aDEPPARTMNT .OF BUUMM. AM SAFETY �1CrLa�t�liVl�r�1''�l1� _ �1 COUNTx OF LOS ANGELES ZL��,CJL Y`�Idi W _ CHIEF' 1. _ Z NAME � `,,� •!1� DISTRICT NO. P ZONE - PERMIT NO. E U. ADD /� � � v, 1 'RECEIVED.my READY FOR DATE ISSUED NU CITY. �/ O. _ FIRST INSPECTION CERT.NRES ` ar APU CANT FILA IN HEAVIUY OUTLINED P01MON ONLY _ DESCRIPTION OF WOE = ADDRESS NUMBER OF OUTLETS ON CIRCUITS LOCALITY A_ b.sXlr LOCATION•BY ROOMS. • NEAREST LIGHT-OUTLETS.. SW. PLUGS FiXT C ST.-_ ',� CIRCUIT A B C D E F .C3- �•I o'. NAM[: 7-4 Z MAIL 'I y.� '�,•/} y ADDRESS •• -JJ {_efa�.�.l •L y O CITY �!i7IS�b/ EL�NO: _ 1 AM TA$ 'LEGAL POSSESSOR , THE ABOVE LOS _ ANGELES COUNTY Ct�FICATA OF QUALIFICATION.. • - �.` ELECTRICIAN.' I AM TRIG OF TAE" RO ESCRIBED • ABOV6 f OWNER. IS No OF OUTLETS a.- ffi © 'APPROVALS NO. OF FIXTURES. ffi DATE INSPECTOR'S NAME NO. OF MOTORS = H.P. ffi CONDUIT - NO. OF SIGNS TRANS. ffi WIRING NO. OF RANGE OR HEATERS ffi FIXTURES ANEOUS. I POWER 1 • PERMIT FEE ffi. oZ- UTILITY.CO.NOT.1 1 DL ;tOl. FINALI !� i/� 4. WORKERS'COMPENSATION DECLARATION 76A663. 10%81 APPLICATION FOR ELECTRICAL PERMIT .1I'4ie.rjt)�',affi m,tha't r1 have a certificate of consent to self, CE-806G insure, or a certificateof Workers'Compensation insurance,, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof(Sec. 3800, Lab. C.) ,I Policy No. Company FOR APPLICANT TO FILL IN JOB ir Certified copy is hereby furnished. + New Residential Bldgs. &Pools EACH NO. FEE ADDRESS ❑ $ — s LOCALITY Certified copy is filed with the county building inspec- 1 �&2-Family, Sq. Ft. tion department. Mulfi-family Sq. Ft. — NEAREST Residential Swimming Pools CROSS ST. Date Applicant OWNER OR �. CERTIFICATE OF EXEMPTION FROM WORKERS' /J ` FIRM NAME I / Outlets: Rec�Light�Sw._L_ MAIL COMPENSATION INSURANCE ADDRESS (This section need not be completed if the work involved by First 20 CITY Tel. No. 7(�0 Total No. the permit is for one hundred dollars(;100)or less;.) Additional PLAN CHECK S'7 �9y7 I certify that in the performance of the work for which this APPLICANT 7 permit is issued, I shall not employ any person in-any manner so as to become subject to the Workers'Compgnsation Laws. Lighting Fixtures First 20 ADDRESS ' Total NO. Additional CITY T Date ZG-�'. pplicant � r+ NOTICE TO APPLICANT: If, after making this Certificat f Fixed Appliances Not Over 1 HP PERMIT 9 APPLICANT Exemption, you should become subject to the Wo rs' 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. — CITY Tel. No. deemed revoked. Hood _ Fan Other— LICENSED.CONTRACTORS DECLARATION LICENSE OR I hereby affirm that 1.am licensed under provisions of Chapter 9 Disp. Room Air Cond. REG. NUMBER Class. (commencing with Section 7000)of Division 3 of the Business DISTRICT NOPROCES Y Power Apparatus 8 Large Appliances IL and Professions Code;and my license is'in full f . forte and effect. � IL �. Size&Type HP, KW, KVA, or KVAR' License Number Lic. dlgs Up to 1 Incl.' FINAL 29 Contractor Date Over 1 to 10 Incl. DATE � � � VA ATION Over 10 to 50 Incl. FINA I am exempt under Sec. Over 50 To 100'Inc.. BY � B.&P.C. for thiq reason Over 100 Date: Services, Swbd., MCC&Panelboards -2841.2A 0 -200 Amp. Under 600 V Signature 201 -1000 Amp. Under 600 V # o .0 0 0�0 2 Over 1000 Amp. or Over 600 V o o'1 7(],Q ❑' Exemption for Reg. Maint. Elect. SINGLE FAMILY 0 0 0 1 7,Q 0= Temp. Power Pole&Appurtenances � HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits 11'2 Q_ 7 Law for the following reason (Section 7031.5, Business and Professions Code): ❑ I, 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) 46 (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name j PERMIT ISSUING FEE 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 authorize representatives of this County to enter upon the above-m ntioned property for inspection purposes. �/ SEE REVERSE FOR EXPLANATORY LANGUAGE K e 49 �'TiO—,P, Signature of Permittee Date