HomeMy Public PortalAbout6030 MUSCATEL AVE_Electrical__ �`
76A66V.3-CE806 11/70Y;APPLICATION FOR ELECTRICAL PERMIT
t. COUNTY-OF.LO•S ANGELES
DEPARTMENT.OF COUNTY ENGINEER F
BUILDING AND SAFETY DIVISION 3p �� tts4-, 5COLEMAN W. JENKINS SUPERINTENDENT OF BUILDING i .
FOR APPLICANT TO FILL IIV �.
OUTLETS N0. EACH FEE
nn OWNER t S
RECEPT. V 5 $ y MAIL ` ,�^
LIGHT, TTA FIRST 20 � � .25 V ADDRESS 6 a tJ. 0 t L i
cy CITY TEL. NO. f -0
SWITCH OVER 20 10 5L
PLAN CHECK
LIGHTING FIRST 20 .25 A-r� APPLICANT
} TOTAL V
FIXTURES OVER 20 10 A cp ADDRESS
PLIANCES• CITY TEL. NO.
PERMIT /1� ^ZJ />�0 .
RANGE DRYERjO —WTR. HTR. APPLICANT �,J rT/� (V
STA. COOK-2—DISP.-j—F.A.U.-j— ADDRESS &p 2 , 114&c yr- /-EZ
SPACE HTR. :5 COND. CITY • C , TEL. N0. -QDz
CLOTHES WASH. DISHWASH.-j— LICENSE NO. CLASS.
FANOTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION 13,
131 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
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 — 1 1.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO O}.
1 — 10 9.00 RESIDE IN, THE AB E ESCRIB RESIDENTIAL PROPERTY. O
SIGNATURE- ` V
10 - 50 5.00 OF PERMITTEE__ Iy
50 — 100 10.00 DISTRICTNO. 'CLASS ZON PR C E Y O
100 - 500 15.00 ILU
L
SIGN, GAS � 1n
SIGN AND ONE CIRCUIT 5.00 NOTES:/�%-71 O,k, /' Q rz n SOAl ?
TUBE, OR _
MARQUEE ADDITIONAL CIRCUITS 1.00 �� ski"' 11 0+
SERVICENOTOVER 600 VOLTS OR 200 AMP 3.00 L �r � ,
APPROVALS DATE INSPECTOR'S SIGNATURE
SERVICEOVER 600 VOLTS OR 200AMP 10.00
TEMP.POWER POLE
TEMP SERVICE,POLE,&APPURTENANCES 5.00
TEMP LIGHT OR RECEPT. SYSTEM 3.00 UNDERSLAB WORK
ROUGH CONDIUT
WIRING /
FIXTUREESr.v
POWER AUTHORIZED
PERMIT FEE (SUB TOTAL)
UTILITY CO. NOTIFIED
PLAN CHECK FEE
FINAL
PERMIT ISSUING FEE 3.00 " JOSEPH C. ROOHAN
TOTAL FEE 00 SUPERVISING ELECT ICAL ENGINEER,
PLAN CHECK VALIDATION CK. -M.G. CASH PERMIT VALIDATION CK. O. CASH
�r�0 2.9 .3 11 W-1 2 0 2. D' 3 6.Q.0
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 1
WORKERS'COMPENSATION DECLARATION !I CE 806G 10/81 APPLICATION FOR ELECTRICAL PERMIT
I fIY"aff�rt�r that I have a certificate of consent to self insure,
00 a cerilH-ate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY
copy thereof(Sec.3800,Lab.C.)
Policy No:-2 r 9 91-1 5 7Company R PTLLb-Lir I n d e m n'1 t FOR APPLICANT TO FILL IN JOB
❑ j EACH NO. FEE ADDRESS 6 0 30 Muscatel
Certified copy is hereby furnished. New Residential Bldgs.&Pools
® •Certified copy is flie with th co u";ng inspecti 1 &2-Family,Sq.Ft. $ _ $ LOCALITY San Gabriel
.
department / Multi-family Sq.Ft. NEAREST
n A4 CROSS'S,.Hermosa
Date '�,-rr?�-r_ Appc i Residential Swimming Pools OWNER OR
FIRM NAME D a l e R e i b e r
CERTIFICATE OF EX P N FROM W I RS' MAIL
COMPEN N INSURANC Outlets:Rec—Light_SW.— ADDRESS20. 3 0 M u s c a t e 1
(This section need not be com leted If the work Involved by'the First ion
p Total No. Additional. CITY S a n Gabriel Tel•"O. 4 4 0-211
permit is for one hundred dollars($100)or less.)
I certify that in the performance of the work for which this.permit pppCANT"
.Is.issued,.['shall not,.employ any person•in any manner so as to
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 APPLICANT B r a n t: 'H t Pit A/C Inc .
Exemptions 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 1 3 5 0. East Las . Tunas D r'.
provisions,or this permit shall be deemed.revoked. - 'Top FAU _ .H. — CITY
LICENSED CONTRACTORS DECLARATION ,I Hood — Fan — 0.ther— San Gabriel 'Tel.Not 8 6-1141
I Hereby affirm that I am licensed under;provisions.of Chapter 9
LICENSE OR
(commencing with'Section 7000)of Division.3 of the Business and'
Disp. — Room Air Cond. — REG:NUMBER 2 217 51 Cis• C-20
.
Professions Code,and my license is in full force and effect. power Apparatus&Large Appliances DISTRICT NO. PROCE
Size&Type HP,KW,KVA,or KVAR, ��a S
Licen a Nu 22-1751. Lim Class.&--20-2 0 ,, Up to 1 Incl. FINAL
�,.
Contr Date 7/.22%91 �—Over 1 to 10 Incl. ATE VALIDATION• U
Over 10 to.50 Incl. FINAL
I m exempt unde c. Over'50 to 100 Inc. BY 'I
LI
for this reason Over 100 y
Services,Swbd:,MCC&Panelboards Z
I Date: I 0 200 Amp.Under 600V
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 !. Sign with One Branch Circuit i
I hereby affirm that I am exempt from the Contractor's License Law Additional Sign Branch Circuits l= r•'• °v
for the following reason(Section 7031.5,Business and Professions
Code.): +"C I:j-
❑ I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors TEN
is not intended or offered for sale-(Section 7044, Business Other(See Complete Fee Schedule) _ ,
1}}AL
and Professions Code). } �° a
pr4 r•.e , .43 01"
CONSTRUCTION LENDING AGENCY CNEClz
I hereby affirm that there is a construction lending agency for,theto air CHANCE
[ACE
performance of the work for which thispermit is issued(Sec.309.7, PERMIT FEE (Sub Total) - t'JJ
Civ..C.).
Lender's Name
PLAN CHECKING-FEE _ 000+�-1:(GC 3 �;. '��•9-i
r, v!
PERMIT.I.SSUINGFEE 13 . 0 456 1 AM V]
Lender's Addresa
.1 certify that I have read this application and state:that the above TOTAL FEE $2 0.0#2-&i1=5
information is correct.I agree to comply with all County ordinances '
t an laws regulating Electrical wiring, and: hereby.authorize
re resen tive t ounty•to enter upon the above-mentioned i
P er ns to urposes. 1 SEE REVERSE FOR EXPLANATORY LANGUAGE '
7/:22/91
Sig re of Permittee Date