HomeMy Public PortalAbout6246 MUSCATEL AVE_Electrical__ -76A663-CESO6 9-64 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE. COUNTY ENGINEER
COLEMAN W. JENKINS, SUPT. OF BUILDING LOCALITY 6—C,12 PI I e.
NEAREST
FOR_APPLICANT TO FILL IN cRoss ST. 3�
REC SPT. TOTAL N EACH FEE
LIGHT OUTLETS! FIRST 20 $2O ® OWNER �, u t—
MAIL
ADO'L 1O ADDRESS G r L
SWITCH. OVER 20 /' a
LIGHTING TOTAL 1 F1Rsr 20 .20 CI C% / TEL.NO. C
19
FIXTURES La__ OV ADD'L .10 ?ELECTRICIAN
R ZO
RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS t/E/y
GARB.DISP. STA.COOK
CITY TEL.NO.
DISHWASH. AUTO.-WASH. STATE
SPACE HTRS. STA.APP.(Va H.P.MAX.) .50
LICENSE NO.
MOTORS& OVER NOT OVER H.P. DISTRICT O. I G P P E
O 1 1.00
1 8 1.50 INSPECTION R CORD
s S 2.00 - , V
8 is 2.50
s
1s 50 8.00
O
f-
s0 100 5.00 V
W
SIGNS& NO.TRANS. d
NO.LAMPS h
Z
SERVICE 0-600V-NoT OVER 200A 1.00
SERVICE 0.60OV-OVER 200 A. 2.00
SERVICE OVER 600V 5.00
MISC.
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY CONDUIT ♦ / ,�
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
LIHEREBY.CERTIFY THAT 1 AM PROPERLY REGISTERED ANO/OR FIXTURES
CENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. POWER
SIGNATURE UTILITY CO.NOTIFIED - i
OF PERMITTEE 11'
FINAL rcf
A DATION JOSEPH C. ROOHAN
CK O CASH SUPERVISING ELECTRICAL ENGINES
Ao 0 1 3 1 w MAR 2 2 A 6.3 Or,
WORKERS'COMPENSATIONDECLARATION ICEASO6G (2-80) APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I have a certificate of'consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY
insure,or a certificate of Workers'Compensation Insurance,or r
a certified copy thereof(Sec.3800,Lab.C.) 71
Policy No. JOB
Company FOR APPLICANT TO FILL IN I A DRESS
New Residential Bldgs.&Pools EACH NO. FEE
Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ — $ C r \
y is filed with the count p Multi-family Sq. Ft. — NEAREST
Certified co
p y building inspection CROSS ST
department. Residential Swimming Pools OWNER M
FIRM NAME 07HS I
Date Applicant Outlets: Rec.—Light Sw.� I 6 MAIL
CERTIFICATE OF EXEMPTION FROM WORKERS' First 20 �� ADDRESS S/e Z_Total No. Additional CITY Tel No.�g'��
COMPENSATION INSURANCE
PLAN CHECK �
(This section need not be completed. if the work involved APPLICANT sf4h7 V
by the permit.is for one huLighting Fixtures First 20
ndred dollars ($100) or less.) ADDRESS W
Total No. Additional 0
I certify that in the performance of the work for which this CITY Tel No. U
permit is issued, I shall not employ an person in an manner Fixed Appliances Not Over 1 HP
P P Y P Y � � _ PERMIT '
so as to become subject to the Workers'Compensation Laws. Range_Heater D.W._ APPLICANT SiV"7 d.
N
Oven _ Dryer_W.M._ ADDRESS Z
c Top _ FAU _W.H.
Date �—/—d 1 Applicant. �"-"` CITY Tel No. m
Hood _ Fan _Other_
NOTICE.TO APPLICANT: If, after making this Certificate of Disp.. _Room Air Condom LICENSE OR
Exemption, you should become subject to the Workers' REG.NUMBER Class
Compensation provisions of the•Labor Code,you must forth- Power Apparatus&Large Appliances DISTRICT NO. PROCE SED BY
with comply with such provisions or this permit shall be Size&Type HP,KW,KVA,or KVAR / t
deemed'revoked.
Up to 1 Incl.
FINAL
LICENSED CONTRACTORS DECLARATION' Over 1 to 10 Incl. DATE �• �' VALIDATION
Over 10 to 50 Incl.
I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL i
9 .(commencing with Section 7000)of Division 3 of the Busi- Over 100 BY t ��
ness and Professions.Code, and my license is in full force and
effect. Services
License Number Lic.Class 0-200 Amp.Under 600 V
201-1000 Amp..Under 600 V
Contractor Date Over 1000 Amp.or Over 600 V '
HOME OWNER-BUILDER DECLARA'I;ION Temp.Power Pole&Appurtenances
I hereby affirm that I am Sign with One Branch.Circuit exempt from the Contractor's. Additional Sign Branch Circuits •
License Law for the following reason (Section 7031.5, Busi-
ness and Professions Code):
Misc.Conduits&Conductors Ell, as owner of the property, will do the work and the Other(See Complete Fee-Schedule)—
structure is not intended or offered for sale (Section -c 1 Q 0 5 A
7044,Business and Professions Code).
CONSTRUCTION LENDING AGENCY ,
I hereby affirm that there'is a construction lending agency o 0 o b o 2
for the performance of the work for which this permit is pEFiMIT FEE (Sub-Total) ) o .0 1 Q 9(, a
issued(Sec.3097,"Civ.C.). ,
Lender's Name PLAN CHECKING'FEE (One-Fourth Permit Fee) '0''0 0 10,9(j F
Lender's Address PERMIT ISSUING.FEE 0 9. C 1 -8,1
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 I
hereby authorize representatives of this County to enter upon
the above-mentioned property for inspection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE
Signature of Permittee Date i i ,