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HomeMy Public PortalAbout6013 OAK AVE_Electrical__ ill 7GA663C CBBO61318/75 APPLICATION FOR ELECTRICAL PERMIT BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN JOB New Residential Bldgs &Pools EACH NO FEE ADDRESS 1 &2 Finaily Sq Ft $ — $ LOCALITY Multi family Sq Ft CROSS ST Residential Swimming Pools OWNER ORT FIRM NAME Outlets Light Switch&Receptacle VC MAI L First 20 ADDRESS Additional CITY Tpl No PLAN CHECK fighting Fixtures APPLICANT First 20 ADDRESS Additional CITY Tel No PERMIT !C y ed Appliances Not Ov r 1 HP � � APPLICANTA!w LL ange_ Heater r D W _ Oven Dryer _ W M ADDRESS Top _ FAU _ WH CITY Tel No �- sp REG AC_ Fan / NNUM DER Class — D c�a sp � i< 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION Power{A rates&Large Appliances AND STATE THAT THE ABOVE 19 CORRECT AND AOR!! TO COMPLY pPa rg pP WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING uJ Size&Type HP KW KVA or KVAR ELECTR CAL W RING C. it CO) Up to 1 Incl 1 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR Over 1 to 10 Incl / LICENSED AS REOU RED BY LOS ANGELES COUNTY AND STATE OF \ CALIFORNIA OR THAT 1 M THE LEGAL OWNBR O TH6 ABOVE P Over 10 to 50 incl DESCRIBED RBSIDENTIA ROPERTV Over 50 to 100 Incl PERMITEE Over 100 SIGNATURE If DISTRICT NO PROCESSED BY Services r! 0 200 Amp Under 600 V 201 1000 Amp Under 600 V APPROVALS DATE (SIGNATURE Over 1000 Amp or Over 600 V TEMP POWER POLE Temp Power Pole&Appurtenances UNDERSLAB WORK Sign with One Branch Circuit Additional Sign Branch Circuits ROUGH CONDUIT Tf (Other) WIRING 3/i FIXTURES POWER AUTHORIZED PERMIT FEE (Sub Total) j TILITY CO NOTIFIED PLAN CHECKING FEE (One Fourth Permit Fee) INAL PERMIT ISSUING FEE OTESTOTALFEE PLAN CHECK VALIDATION CK MO CASH PERMIT VALIDATION CK MO CASH 9 8 5 SEP 22 2 V 0 2 12 © hub t * 76A66S DBS SA 11 60 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES ELECTRIC 1 WILLIAM J FOX CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO GROUP ZONE PERMIT NO ELECTRICIAN RECEIVED BY READY FOR DATB I88UBD ADDRESS FIRST INSPECTION CITY TEL NO COUNTY LICENSE NO RES BUILDING PERMIT WS FBfi ADDRESS 6 NUMBER I EACH LOCALITY LIGHT OUTLETS NEAREST RECEPTACLES CROSS ST WALL SWITCHES OWNER d TOTAL OUTLETS SC MAILyy ELEC RANGES 28 ADDRESS WIQI.790 ELEC HEATERS 1 28 CITY TEL NO T FIXTURES S I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS MISC APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING MOTORS 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWERANGELES COUNTY LICENSE OR I AM THE LEGAL OWNER FEE NEW MYD HP OVER INC EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. 1 a 1.E66 S 28 SIGNATURE OF 1 1 2 SO PERMITTE opr 2 s 100 INSPECTION RECORD S 18 1 SO IS SO 2 SO BO 200 S OO — � 20SOo 10 00 y� d Soo 1000 1S o0 Z OVER 1000 20 00 G_ M G SET FREQ CHANGER HP 0: O WELDERS AC KVA GENERATORS KW TRANSFORMERS KVA TEMP MOTORS (78%OF ORIG MOVED MOTORS (75OF ORIS LSC Rms A 0 400T 1 ,Pon it 7 xgc SIGNS NO NO TRANSAPPROVALS % O N LAMPS DATE INSPECTORS NAME FOR EACH PERMIT r r� CONDUIT O WIRING $1 00 FIXTURES $1 00 WIRING SUPPLEMENTARY So FIXTURES POWER TOTAL FEE s/ UTILITYCO NOTIFIED L rV 4M/5T6iE r +� 2 FINAL I L" WORKERS COMPENSATION DECLARATION 76A663 (2 80) APPLICATION FOR ELECTRICAL PERMIT d' z n CECE-�806G 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 a certified copy thereof 3800 Lab C q, to BS�r�(�Q� ��/7 � FOR APPLICANT TO FILL IN fpg Policy N �F/ Company `�`/" ADDRESS New Residential Bldgs &Pools EACH NO FEE Certified copy is hereby furnished 1 &2 Family Scl Ft $ — $ LOCALITY e t REST I iXtertified copy is filed with the county builds nspection Multifamily Sq Ft CROSS ST le t r Residential Swimming Pools OWNER M n FIRM NA Dat Applicant Outlets Rec_Light Sw MAIL First 20 ADDRE CERTIFICATE OF EXE TION M WORKERS Total No Additional CIT el No COMPENSATION INSURANCE ' PLAN HE Kip RO APPLICANT V (This section need not be completed if the work involved Lighting Fixtures First 20 by the permit n for one hundred dollars ($100) or less) Total No Additional ADDRESS - O Fixed 1 certify that in the performance of the work for which this Fd Appliances Not Over 1 HP CITY Tel No permit is issued I shall not employ any person in any manner PERMIT 11 so as to become subject to the Workers Compensation Laws Range_Heater D W APPLICANT N Oven — Dryer_W M ADDRESS LtrCh Ti 1AZ Date Applicant _ Top _ FAU _W H Hood —Fan _Other_ CITY Tel No NOTICE TO APPLICANT If after making this Certificate of Disp _Room Air Cond_ ILICENSE OR Exemption you should become subject to the Workers REG NUMBE lzggcll�_"�4 Compensation provisions of the Labor Code you must forth Power Apparatus&Large Appliances DISTRICT Ns, PR BY with comply with such I provisions or this permit shall be Size Type HP=tol r KVAR deemed revoked • Ul FINAL Incl DATE 6 -11 � �� VALIDATION LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc FINAL 11 9 (commencing with Section 7000)of Division 3 of the Busi Over 100 BY � ness and Professions Code and my license as in full force and effect Services 's. �r J4q 0 200 Amp Under 600 V ` License Numbe Q �^ is Cless '�=— 201 1000 Amp Under 600 V alContractor v Date Over 1000 Amp or Over 600 V { HOME OWNER BUILDER DECLARATION Temp Power Pole&Appurtenances I hereby affirm that 1 am exempt from the Contractors Sign with One Branch Circuit License Law for the following reason (Section 7031 5 Buss Additional Sign Branch Circuits ness and Professions Code) i N ors I as owner of the property will do the work and the Mise CSee Complete & ete Fe Schedule)— structure ch / structure is not intended or offered for sale (Section Other(See Complete Fee Schedule►— a 7044 Business and Professions Code) CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency 9 3 8 6 4 A _ for the performance of the work for which this permit is PERMITTEE (Sub Total) issued(Sec 3097 Civ C) _ # •f• • • • 2 Lender a Name PLAN CHECKING FEE (One Fourth Permit Fee) 2 •i• 1 15 0 Lender a Address PERMIT ISSUING FEE ' • •-• 1 1 505 1 certify that I have read this application and state that the TOTAL FEE i above information is correct I agree to comply with all County 06 0 4—8 2 ordinances and State laws regulating Electrical wiring and C hereby authorize representatives of this County to enter upon th bove mentioned prope t or inspection purpos SEE REVERSE FOR EXPLANATORY LANGUAGE atur o Permittee D e r ( • i W2KERS Ci,1MPEhGSATION DECLARATION 76A663 10/81 CE 8%G APPLICATION FOR ELECTRICAL PERMIT I heroly affinn that I have a certificate of consent to self insure or a certificate of Workers Compensation Insurance COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec 3800 Lab C ) Policy No Company FOR APPLICANT TO FILL IN JOB //qq a Certified copy is hereby furnished New Residential BldgsOA &Pools EACH NO FEE ADDRESS AVQ, ❑ Certified copy is filed with the county building inspec 1 &2 Family Sq Ft $ — $ LOCALITY 8i//60- tion department Multifamily Sq Ft — NEAREST Date Applicant Residential Swimming Pools CROSS ST OWNER OR ,v Q f CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec • Light /J�. Sw FMAIL IRM NAME B/17 COMPENSATION INSURANCE ADDRESS (001.3 A Ade. (This section need not be completed if the work involved by /b First 20 Total No the permit is for one hundred dollars(:100)or less) Additional CITY C, Tel No PLAN CHECK I certify that in the performance of the work for which this APPLICANT permit is issued I shall not employ any person in any manner so as to b cam subject to the Workers Compensation Laws Lighting Fixtures First 20 ADDRESS .�f Total No Additional Date-� �'� opphcan / CITY Fixed Appliances Not Over 1 HP PERMIT yy Tel No , NOTICE TO APPLICANT If after making this Ce icate of APPLICANT yf►S eC�s✓� file /yC Exemption you should become subject to the Workers Range_ Heater_D W Compensation provisions of the Labor Code you must forth Oven _Dryer _W M ADDRESS.X80/pt Al &"a It with comply with such provisions or this permit shall beTo _ deemed revoked p _ FAU _W H CIN cw el No LICENSED CONTRACTORS DECLARATION Hood Fan _Other Vt Rh JQ o gyA�Jv Drsp Room Air Cond LICENSE OR 399 Class C-)0 (commencing with Section 7000)of Division 3 of the Business power Apparatus 8 Large Appliances DISTRICT NO PR BY d and Professions Code and my license is in full force and effect O Size&Type HP KW KVA or KVAR 0 License Nu be I., Class "� ///O Up to 1 Incl FINAL DATEO Contractor to �v Over 1 to 10 Incl VALI TION F- 1:1 Over 10 to 50 Incl FINAL Ltl I am exempt under Sec Over 50 to 100 Inc BY h B&P C for this reason Over 100 ' Z Date Services Swbd MCC&Ponelboards ► 14000, 0 200 Amp Under 600 V Signature 201 1000 Amp Under 600 V ❑ Over 1000 Amp or Over 600 V Exemption for Reg Maint Elect SINGLE FAMILY Temp Power Pole 8 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 for the following reason (Section 7031 5 Business and Professions Code) ❑ I as owner of the property will do the work and the M'sc Conduits&Conductors structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)_ ► 7044 Business and Professions Code) { 3 4 7 2 3 A CONSTRUCTION LENDING AGENCY # • • e • • 2 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) • •3 6 5 0 (Sec 3097 Civ C ) Lender s Name • PLAN CHECKING FEE • 936505 Lender s Address PERMIT ISSUING FEE O 5 2 8 a 8 6 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 t bove me honroperty for inspection urp ses • , SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date