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HomeMy Public PortalAbout6135 OAK AVE_Electrical__ - 4 BA889xE�B08(8/781++ APPLICATION FOWEL.ECTRICAL PERMIT" - - ,� 1 COUNTY OF LOS ANGELES- BUILDING AND SAFETY , FOR APPLICANT TQ FILL.IN JOB EACH NO. FEE ADDRESS 'New Residential Bldgs.&Pools , 025 - $ LOCALITY G00, 1 &2-Family,Sq.Ft. Multi-family Sq.,Ft. .02 — NEAREST' ' - Resid25.00 CROSS ST.6nti61 Swimming Pools OWNER OR - '� FIRM NAME." . Outlets:Rec� _Z LightSw.a �, -MAIL".'. First.20 ,50 .SO ADDRESS. /e;$ p/:,. Total.No. Additional .30 -(titY- ` • - r Tel.No, G3315W _ PLAN EGK APPLICANT - - Lighting Fiicfures First 20 50 O ADDRESS.- Q Additional 30 Total No._SL, CITY '`- Tel.No. Fixed Appliances Not Over 1 HP-- PERMIT +. APPLICANT Range=.Heater_D.W. Oven—Dryer_W.M. ADDRESS - Top _FAU —W:H._ CITY Tel..No. Hood_Fan- _Other_ 2:50 n JPQ LICENSE.OR Disp._Room Air Cond. �l REG:NUMBER' i Class. I'HEREBY ACKNOWLEDGE THAT I HAVE READ-THIS-APPLI-CA• Power Apparatus&Large Appliances TION AND STATE THAT;THEABOVE IS.CORRECT,AND AGREE TO Size&Type HP,KW,.KVA,or KVAR•, ,. COMPLY' WITH ALL .COUNTY ORDINI4NCES' AND STATE LAWS yp_ REGULATING ELECTRICAL WIRING..' ' `bp to.. Incl. _2.50 0 _ - I HEREBY'GERTIFY THAT I AM PROPERLY REGISTERED AND/OR Over•1 to'10 Incl. 5.00 D ©.O LICENSED AS REQUIRED BY.LOS ANGELES COUNTY AND STATE OF Over 10 to 50 Incl. 12.50 • CALIFORNIA OR THAT I Am'THE LEGAL OWNER:OF THE ABOVE. DESCRIBEDAESIDENTIAL P. PERTY.. Over 50 to-100 Inc. 25.00,. �z , . 40:00 - PERMITEE . Cher 100 SIGNATURE Services DISTRICT NO. PRO .SSED Y 0-200 Amp.Under 600.V 12.50 - 201.1000 Amp.Under 600 V -25.00: 0 - - Over 1000 Amp.or Over 600 V 50.00. Z -Temp.Power Pole.&Appurtenances 10:00 Sign with One Branch Circuit 10.00 Additional Sign Branch Circuits x'00 INSPECTION u Misc.Conduits&Conductors - io.00 INFORMATION-ON-REVERSE s Other(See-Complete Fee Schedule) SIDE .W r \. V b'c PERMIT FEE 1Sub-Tofall PLAN CHECKING-FEE (One-Fourth..Permit Feel •O ,.PERMIT ISSUING FEE ••'$7:00 7 TOTAL FEEQ �'. INSPECTION FINALED W ' date: By WORKERS'that COMPENSATION DECLARATION r .CE-806 10/81 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 cer f'LLed co y thereof.(Sec. 3600, Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB �` ❑ , Certified co is hereby furnished. EACH NO. FEE ADDRESS 1 p PY Y New Residential Bldgs. &Pools ❑ 1 &2-Family, S Ft. $ _ $ LOCALITY Certified copy is filed with the county building inspec- Y' q' 'NEAREST � tion department. Multi-family Sq. Ft. CROSS ST. C47.-1,6 Residential Swimming Pools OWNER OR Date""' App Iican FIRM NAME /C,kGc/cQ CERTIFICATE OF EXEMPTION OiFOM WOR ERS' Outlets: Rec Ught�Sw. I Total NoL COMPENSATION INSURANCE DDRESS (This section need not be completed if the work involved by First tCITY Tel. N the permit Is for one hundred dollars($100)or less.) . Additional , o. 3 I certify that in the performance of the work for which this PLAN CHECK permit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. Lighting Fixture First 20 ADDRESS Total No. t� Additional CITY Tel. No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT 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 r ADDRESS with comply with such provisions or this permit shall be Top _ FAU W.H. — deemed revoked.. Hood _ Fan _Other_ CITY Tel. No. LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. _ Room Air Cond. REG.NUMBER Class. (commencing with Section 7000)of Division 3 of the Business DISTRICT NO. PROCESSED BY and Professions Code,and my license is in full force and effect. Power Apparatus&Large Appliances Size&Type HP, KW, KVA, or KVAR' License Number `� �' �� Lic. Class Up to 1 inclFINAL . Over i to 10 Incl. DATE �`7,� � VALIDATION 09 Contractor ��� Date Over 10 to 50 Incl. FINAL U ❑ I am exempt under Sec. Over 50 to 100 Inc. BY Ul B.&P.C. for this reason Over 100 Date. Services, Swbd., MCC&Panelbpards 0 -200 Amo. 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 V7 6.C A HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit „ I hereby affirm that I am exempt from the Contractor's LicenseAdditional Sign Branch Circuits 0 0 C Law for the following reason (Section 7031.5, Business and Professions Code): o o 6 J•! u ❑ I, as owner of th.e.property, will do the work and the Misc. Conduits 8 Conductors 7 1 structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)_ o c 0 ( � 7 5 7044, Business 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 PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). PLAN CHECKING FEE �} ,Lender's Name PERMIT ISSUING FEE Lender's Address 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 the above-mentioned property for inspection purposes. _ SEE REVERSE FOR EXPLANATORY LANGUAGE s­— Signature Per ee Date