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HomeMy Public PortalAbout6036 OAK AVE_Electrical__ 76A668 DBS BA 11-50 APPLICATION FOR PERMIT \ DEPARTMENT OF BUILDING AND SAFETY ELECTRIC 1 COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMIT NO. ELECTRICIAN �n aem .g^ �` "9 ADDRESS . RECEIVED BY FIRST IN READY FOR DISSUED TE CITY d TEL. NO. G� COUNTY LICENSE NO. 1� EXPIRES BUILDING rj n PERMIT FEES ADDRESS .J FEE NUMBER EACH LOCALITY LIGHT OUTLETS NEAREST CROSS ST. RECEPTACLES 7 WALL SWITCHES OWNER TOTAL OUTLETS BC $ MAIL ELEC. RANGES 25 ADDRESS ELEC. HEATERS 25 CITY C "' tKL. NO. r' FIXTURES 5 J/ 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 I CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWERANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER FEE NEW MVD. HP OVER INC. EACH P OF THE RESIDENTIAL OPERTY DESCRIBED ABOVE. 1/2 a LEss $ .25 SIGNATURE OF I/2 2 .50 PERMITTE 2 s 1.00 INSPECTION RECORD 5 1s 1.50 1s so 2.50 s0 200 5.00 /�.�7 200 Boo 10.00 a r �Ge • 'v A/l / Boo 1000 15.00 V r C� Z OVER 1000 20.00 M. G. SET/FREQ. CHANGER-HP WELDERS:AC-KVA P ,�= Ly 6Wb�0 GENERATORS-KW 1? n — SrP6Y TRANSFORMERS-KVA Flo '� TEMP. MOTORS (75%OF ORIG.) / MOVED MOTORS (75%OF ORIG.) � �► Y 64i MISC. SIGNS NO. NO.TRANS. I ,APPROVALS NO. NO. LAMPS FOR EACH PERMIT: DATE INSPECTOR'S NAME CONDUIT WIRING $1.00 FIXTURES $1.00 o WIRING SUPPLEMENTARY .50 FIXTURES POWER TOTAL FEE $ �S UTILITY CO. NOTIFIED 1/►n. ® (!! FINAL Vv V W0111 1�ORKER S'COMPENSATION DECLARATION CE-806 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 a certified copy thereof(Sec:.3800,Lab.C.) FOR APPLICANT TO FILL IN ' b�`-Wr O�� Policy No. Company ADAD DRESS �/(3. J u"6'` New Residential Bldgs.&Pools EACH NO. FEE Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ — $ LOCALITY ❑ Multi-family Sq. Ft.• — NEAREST Certified copy is filed with the county building inspection CROSS ST department. Residential Swimming Pools OWNER OR , FIRM NAME Date Applicant Outlets: Rec4Light� Sw. GQ le /, MAIL First 20 F '�' ADDRESS 6WV_ e. CERTIFICATE OF EXEMPTION FROM WORKERS' Total No.LL_ Additional CITYT /jOLj6 C/ Tel No. COMPENSATION INSURANCE PLAN CHECK a (T}iis section need not be completed if the work involved . ��� ��APPLICANT O by the permit is for one hundred dollars ($100). or less.) Lighting Fixtures First 20 ADDRESS. V Total No.—..? Additional W I certify that iii the.performance of the work,for which this Fixed Appliances Not Over 1 HP CITY Tel No. permit is issued, I shall not employ any person in any ma PERMIT so as to become subject to the Workers'Compensat• n ws:• Range_Heater_D.W._ APPLICANT 22 � G��l71�G W Oven _ Dryer_W.M._ ADDRESS �t3 99"COf��� .Q co) DO Z ApplicaA �`,.� Top _FAU _W.H.._ Z D Hood Fan —Other CITY G/T Tel No�cv r/7cI NOTICE TO APPLICANT: If,,a er making this Certificate of Disp. _Room Air Cond— LICENSE OR /D Exemption, you should become subject to the Workers' REG.NUMBER •.31i Class �/ Compensation provisions of the Labor Code, you must forth- Power Apparatus&Large Appliances DISTRICT NO. PROCESSED BY with comply with such provisions or this permit shall be deemed•revoked. Size&Type HP,KW,KVA,or KVAR Up to 1. Incl. Over 1 to 10 Incl. FINAL LICENSED CONTRACTORS DECLARATION DATE s®Y �s VALIDATION Over 10 to 50 Incl.' K I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL 9 (commencing with Section 7000)of Division 3 of the Busi- Over 100 BY ness and Professions.Code, and my license is in full force and �r effect. `!7 Services ' © La •� License Numbe 3u Lic.'Class e/ v 0-200 Amp..Under 600 V 201-1000 Amp.Under 600 V ContractorL� Date d t Over 1000 Amp.or Over 600 V HOME OWNER-BUILDER DECLARATION Temp.Power Pole&Appurtenances I hereby affirm that I am exempt from the Contractor's Sign with One Branch Mcuit License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits ness and Professions Code):. i- I, as owner of the property, will do the work and the Other(See Complete Fee Schedule►— Conduits&Conductors structure is not intended' or offered for sale (Section Other 7044,Business and Professions Code). CONSTRUCTION LENDING AGENCY C 5 4 9,7 A I hereby affirm that there is a construction lending agency # o'o o o 0 2 for the performance of the work for which this permit is PERMIT FEE (Sub-Total) issued(Sec..3097,Civ.C.). 2 0 ,0 3 1.9 0 Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) 31,90 Lender's Address PERMIT ISSUING FEE .� 1 certify that I have read this application and state that the TOTAL FEE above information is correct.I agree to comply with all County ordina e. and State laws regulating�Electr' 'ng, and h authorize representativ f this Co ty to enter upon ove-me tinned roper or inspect purposes. SEE`REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date WORKERS'COMPENSATION DECLARATIOIU _ 76A669,.10 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a .certificate of consent to self CE-8066 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. Fri Certified co is hereby furnished. EACH PNO. FEE ADDRESS PY Y' New Residential Bldgs. &Pools ❑ g g LOCALITY Certified copy is filedyvith.the county building inspec- 1 &2-Family, Sq. Ft. 2 L tion department. . - Multi-family Sq. Ft. NEAREST Residential Swimming Pools CROSS ST. yy ``,, Date Applicant FlWNER OR RM NAMErlem l~ CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL +- . Outlets: Rec Light Sw._ �`�`v " COMPENSATION INSURANCE ADDRESS ��'� �/G/ � tThis section need not be completed If the work involved b First ti o, he permit Is for one hundred dollars($100)or less.) )/ Total No. Additional CITY C fes ®G�'�� Tel. No '- PLAN CHECK I certify that in the performance of the work for which this APPLICANT permit is Issued,.I shall not emplWanyson in any man er so as to become subject to the p�ensation La�ni . Lighting Fixtures First 20 ADDRESS © Additional 7 �,�^ Total No. CITY Tel. No. Date -12 Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after mamg this Qn0ficate of APPLICANT Exemption, you should become suitiect t the Workers' Range_ Heater_D.W. Compensation provisions of the Labor Code, you must forth- Oven —Dryer —W.M.— ADDRESS2,j j f with comply with such provisions or this permit shall be Top _ FAU _W.H. — deemed revoked. Hood _Fan _Other_ CITY g(:— Tel. IVo. LICENSEDa CONTRACTORS DECLARATION 'LICENSE OR l' 1 hereby affirm that I am licensed under provisions of Chapter 9 Disp. _ Room Air Cond. — REG. NUMBER— Class 1d (commencing with Section 7000)of Division.3 of the Business power Apparatus&.Large Appliances DISTRICT NO. / PROCESSED BY and Professions Code,and my license is in full force and effect. .90 Size&Type HP, KW, KVA;or KVAR' y.•. License Number 3,2e 2S 2I / Lit.-Class ` Q FINAL Up to 1' Incl. - �►� I Over 1 to 10 Incl. DATE �� VALIDATION. Contractor Date �' Over 10 to 50 Incl. FINAL V ❑ I am exempt under Sec. Over 50 to 100 Inc. BY LU BAP:C.,for this reason Over 100 Date: ' Services, Swbd., MCC&Ponelboards , ' 0 -200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V ']!�O 1 Over 1000 Amp. or Over 600 V' / ❑ Exemption for Reg. Maint. Elect. SINGLE FAMILY Temp. Power Pole&Appurtenances _ HOME OWNER-BUILDER DECLARATION j Sign with One Branch Circuit 51 1,4 F I hereby affirm that I am exempt from the Contractor's License SignAddiwith nen r ach Circuits Law for the following reason (Section 7031.5, Business and c �.� i' 0 0.0.0.0.2 Professions Code): Ui ❑ I, as owner of the property, will do the work and the MIi. Conduits&Conductors L;o c 2 5 E C structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)— , „ „ n r x 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY C 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) (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender'sName U PERMIT ISSUING FEE Lender's Address I certify that I have read this application and sf -that the TOTAL FEE '/sI above information is correct. I agree to OtV with all County i ordinances and State laws regula. g Electrical wiring, and hereb uthorize represent fives. f this County to enter upon the v -m ted p erty fo inspection purposes. �. SEE REVERSE FOR EXPLANATORY LANGUAGE /./• - Signature of Permitt /Fir// Date WORKERS'COMPENSATION DECLARATION s• 7.6A663 I hereby affirm that I have a certificate of consent to self �:E-806G• 4&i. APPLICATION FOR ELECTRICAL PERMIT ' 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 Certified copy is hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE ADDRESS 4 t7 ❑ 1 &2-Family, S Ft. $ — $ LOCALITY Certified copy is filed with the county building inspec- Y� q• tion department. Multi-family Sq. Ft. NEAREST — Residential Swimming Pools CROSS ST. Date Applicant OWNER OR FIRM NAME I. ;fee_ ff CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Recy Light�Sw.Z' ADDRESS f MAIL COMPENSATION INSURANCE First 20 (This section need not be completed if the work involved by Total No. Additional CITY Tel. . the permit is for one hundred dollars($100)or less.) that in the performance of the work for which this PLAN CHECK I certify P APPLICANT permit is issued,'I shall not employ any person in any manner so as to become subje toWorkers'. m ensation Laws. Lighting Fixtures First 20 ADDRESS s�« V Total No. Additional v CITY Tel. No. Dat p;111' n fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making thi ertificate of APPLICANT Exemption, you should become subject t the Workers' Range_ Heater_D.W. — Co.mpensation 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.li. — deemed revoked. CITY Tel. No. LICENSED CONTRACTORS DECLARATION Hood _ Fan _Other_ Disp. _ Room Air Cond. LICENSE Class. I hereby affirm that I am licensed under provisions of Chapter 9 REG.NUMBER (commencing with Section 7000)of Division 3 of the BusinessPower Apparatus&Large Appliances DISTRICT NO. PROCESSED BY and Professions Code,and my-license is in full force and effect. �-- � � Size&Type HP, KW,.KVA, or KVAR• / O License Number Lic: Class U Up to 1 Incl. FINAL � .- �f_�Q Contractor paw Over 1 to 10 Incl. DATE 'F VALIDATION 09 Over 10 to 50 Incl. V FINAL ❑ I am exempt under Sec. Over 50 to 100 Inc. BY B.&P.C. for this reason Over 100 Date:. Services,.Swbd., MCC&Ponelboards: 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&Appurtenances ' r'�• 11 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 Law for the following reason (Section 7031.5, Business.and ' Professions Code): > s_ j ❑ Misc. Conduits&Conductors I, as owner of the property, will do the work and the •� '� r -' structure is not intended or offered for sale (Section Other'(See Complete Fee Schedule)_ , 7044, Business and Professions Code). C CONSTRUCTION LENDING AGENCY Ihereby affirm that there is a Construction lending agency for the performance of the work.for which this.permit is issued PERMIT FEE (Sub-Total) / (Sec. 3097, Civ. C.). PLAN CHECKING FEE. Lender's Name 1 PERMIT ISSUING FEE Lender's Addressl I certify.that I have read this application and state that the TOTAL FEE above iformation 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 entioned prop rty.for'inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE too of Signature .ermittee Date i I .