HomeMy Public PortalAbout5928 MUSCATEL AVE_Electrical__ GAGG9-C69CG.;D.BG APPLICATION FOR, ELECTRIC PERMIT 1
BUILDING AND SAFETY DIVISION ,,..{{
Deparhaent of County Engineer ADN G
D EISS d`.A �VWJ/L�•I.t it
County of Los Angeles
JOHN A.LAMBIE.COUNTY ENGINEER
CASSATT D.GRIFFIN.SUPIT OF BUILDING LOCALITY
112111111111111 1 NEAREST
FOR APPLICANT TO FILL-IN CROSS
PERMIT FEES OWNER c
LIGHTS RECEPTACLES O SWITCHES
Lf
NUMBER ITEM EACH FEE MAIL- P
ADDRESS
(� TOTAL OUTLETS. $ ,10 $ D O
ELEC. RANGES, WATER HEATERS, CITY TEL.NO.
CLOTHES DRYERS .50 /
ELEC. SPACE HEATERS, STAT-Y. COOK. ELECTRICIAN ' I
IN 6 UNITS, GARBAGE DISPOSERS, a ADDRESS 0 q '/ iR►� yYL+i✓1^•+• D'���
AUTO WASHERS, DISHWASHER .25 /� �, � �� �®
LIGHTING FIXTURES •10 (p CITY a-&IV-v ✓1'I/- TEL.NO.
MORONS
STATE `0
.LICENSE NO.
HORSEPOWER
H.P. OVER INC. DISTRICT NO. I GROUP. ZONE I READY FOR INSPECTION
A Be LESS .25 I toz
...
z so INSPECTION RECORD
2 5 1.00
1.50 '/ - /AI J fir/ l-" F"pAo
III - ISO 2.50 F�JQ S L/P �/�G6; le,J T 19 V /�
50 — 200 5.00
MISC. ,.�'G _ CAI 014 A/ D JCS
f T 4=ra 0 u
av'v77 282- V4- Aeem�2
SIGNS- NO.TRANS
NC.LAMPS
SERVICE O-GOOV 1.00
SERVICE OVER GOOV 5.00
WIRING PERMIT 1.00 /fes
FIXTURE PERMIT 1.00 / _0
SUPPLEMENTARY PERMIT .50 APPROVALS
TOTAL FEE S ";- DATE INSPECTOR'S SIGNATURE
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING gg
ELECTRICAL WIRING. WIRING :JI'
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE POWER
DESCRIBED RESIDENT, PROPERTY. ,r '` I
SIGNATURE /� �• �! /l-�'1s.to 1- UTILITY CO.NOTIFIED
OF PERMITTEE' FINAL Z is .+d
IOHN A.LAMBIE. VALIDATION ARTHUR C.VEIT.
IOUNTY ENGINEER cK NO CASH SUPEILVIa1NG ELECTRICAL ENGINEER
.�0 o 4. 5 =, JUL 1. 7 5.8 5
Wm that I have a COMPENSATION of consent ON 78-806 10/81 APPLICATION FOR ELECTRICAL PERMIT
CE-806G �1 1� /"i itl
hereby affirm that I have a certificate of consent to self insure,
or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY
copy thaleof(Sec.3800,Lab.C.)
Policy No. Company FOR APPLICANT TO FILL IN JOB
❑ Certified copy is hereby furnished. New Residential Bldgs.&Pools EACH NO. FEE ADDRESS
❑ 1 & 2-Family,Sq.Ft. $ _ $ LOCALITY
Certified copy is filed with the county building inspection NEAREST
department. Multi-family Sq.Ft. CROSS ST.
Date Applicant Residential Swimming Pools OWNER OR
FIRM NAME
CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL
COMPENSATION INSURANCE Outlets:Rec—Light—Sw.—
� ADDRESS
(This section need not be completed if the work involved by the First 20
permit is for one hundred dollars($100)or less.) Total No. Additional CITY, Tel.
CHECKPLAN
I certify that in the performance of the work for which this permit APPLICANT
is issued, I shall not employ any pers i7tvy manner so as to
become su 'ect to the Workers'Com {ion aws. Lighting Fixtures First 20 ADDRESS
Additional
/L Total No. CITY Tel.No.
Date Q� r�APPIic Fixed Appliances Not Over 1 HP
NOTICE O APPLICANT: If, aft aking this Ce ificate of PERMIT
APPLICANT U Irmo,
Exemption,you should become subject to the Workers'Cd pensation Range_ Heater_ D.W. ✓
provisions of the Labor Code,you must forthwith comply with such Oven _ Dryer W.M._ r ADDRESS29
provisions or this permit shall be deemed revoked. Top — FAU T W.H. SO CITY Tel.No. �-`L�
LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other— AhA %
I hereby affirm that I am licensed under provisions of Chapter 9LICENSE OR
(commencing with Section 7000)of Division 3 of the Business and Disp. — Room Air Cond. REG.NUMBER 1,7 Clas .
Professions Code,and my license is in full force and effect. Power Apparatus&Large Appliances DISTRICT NO. PR E SED BY
&
Size ype HP,KW,KVA,or KVAR � �`�r• J O
License Number 0� U fCJ Lic.Class p Up to 1 Incl. FINAL Q
Over 1 to 10 Incl. DATE 410 aX_ _L_1_DATI0N Q
Contractor Over 10 to 50 Incl.
❑ FINAL �
I am exempt and Sec. Over 50 to 100 Inc, BY Vv 0.
B.&P.C.for this reason Over 100 N
Services, 66-8 boardsp pop. z
Date:
' � - 0 .Under 800 V d �
Signature 201 - 1000
Over 1000 Amp.or Over 600 V
E] Exemption for Reg.Maint.Elect.
SINGLE FAMILY 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 Law Additional Sign Branch Circuits
for the following reason(Section 7031.5,Business and Professions
Code)'.
El1,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 Schedule)
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(Sec.3097, PERMIT FEE (Sub Total) 66" 1p
Civ.C.).
PLAN CHECKING FEE
Lender's Name /
PERMIT ISSUING FEE ; J
Lender's Address
I certify that I have read this application and state that the above TOTAL FEE eV7 d,
information is correct.I agree to comply with all County ordinances
and State laws regulating Electrical wiring, and hereby authorize
repres ves of is County to enter upon the above-mentioned
Proper y fo ins c Ion purpos
as.
- 4
/q3SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Permittee Date?