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Home My Public Portal About6616 OAK AVE_Electrical__ 7BA663-CE806 11/70 APPLICATION FOR •ELECTRI �iPERMIT.COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING r PI,JILDING AND SAFETY DIVISION ADDRESS CCRIEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY f NEAREST FOR APPLICANT TO FILL IN CROSS ST. OUTLETS NO. EACH FEE w S S OWNER RECEPT._ MAIL ADDRESS Laf2 LIGHT TOTAL FIRST 20 ,P5 �i SWITCH_ OVER 20 10 CITY TEL. NO. PLAN CHECK LIGHTING TOTAL FIRST 20 .P5 APPLICANT FIXTURES •10 OVER 20 ADDRESS APPLIANCES CITY TEL. NO. PERMIT lC� RANGE DRYER_WTR. HTR. APPLICANT 14 STA. COOK DISP. F.A.U. ADDRESS Fee" SPACE HTR. AIR COND. CITY �LC TEL. N0. A?(/7 CLOTHES WASH. DISHWASH. LICENSE N0. ' B Q 7 CLASS.C-/O FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION 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 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 - 1 1.00 LICENSED AS REOU IRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO }_ 1 - 10 3.00 RESIDE IN, THE OVE DESCRIBED ESIDENTIAL PROPERTY. CL • O 10 - 50 5.00 SIGNATURE V OF PERMITT 50 - 100 10.00 0 DISTRICT NO. CLASS ZONE PROC SSE BY (- 100 - S00 15.00 a SIGN, GAS ` N SIGN AND ONE CIRCUIT 5.00 NOTES: , `7 � Z TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 SERVI CENOTOVER 600 VOLTS OR 100 AMP 3.00 ��j APPROVALS DATE INSPECTOR'S SIGNATURE SERVI CEOVER 600 VOLTS OR 200 AMP 10.00 TEMP.POWER POLE TEMP SERVICE,POLE,&APPURTENANCES 5.00 UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM 3.00 ROUGH CONDIUT WIRING FIXTURES PERMIT FEE (SUB TOTAL) POWER AUTHORIZED UTILITY CO. NOTIFIED PLAN CHECK FEE FINAL PERMIT ISSUING FEE 9.00 JOSEPH C. ROOHAN TOTAL FEE SUPERVISING ELE L ENGINEER PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION CK. M.O. CASH L;Abo g ? ,6 N AM 3 2 D 6.0 0 N 6 SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE WORg that I have a certificate DECLARATION 76AW DPW 3/87 APPLICATION FOR ELECTRICAL PERMIT 0 I herEby �ffirrrj that I have a certificate of consent to self CEAttoac insure, or a certificate of Worked Compensation Insurance, I COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certified copy therer6ff(Sec. 3800, Lab. C.) i Policy N ,Y/ 6-_ kompany, �c Fah I FOR APPLICANT TO FILL IN JOB �� fy'�• Ce•tified co is hereby furnished. EACH NO. FEE ADDRESS v V PY Y New Residential Bldgs. &Pools Certified copy is filed with the county buildin _- � 1 &2-Family, Sq. Ft. LOCALITY $ — $ �6lj /� L' • tion department. I Multi-family Sq. Ft. — CROSS ST. NEAREST +� Residential Swimming Pools OWNER OR //pp Date ApplicanT� f FIRM NAME CERTIFICATE OF EXEMPTION FROM WO RS' I Outlets: Rea{`7 Light ID SIL .41 COMPENSATION INSURANCE I ADDRESS (This section need not be completed if the work Involved by i First CITY Tel. No. the permit is for one hundred dollars($100)or less.) Total No. Additional I PLAN CHECK I certify that in the performance of the work for which this i APPLICANT permit is issued, I shall not employ any person in any manner i Lighting Fixtures First 20 I ADDRESS so as to become subject to the Workers'Compensation Laws. i Additional Date Applicant � Total No. CITY Tel. No. NOTICE TO APPLICANT: If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT n Exemption, you should become subject to the Workers' Range— Heater—D.W. — APPLICATION �yl Compensation provisions of the Labor Code, you must forth- Oven — Dryer —W.M.— ADDRESS S' s < a with comply with such provisions or this permit shall be Top — FAU —W.H. — s deemed revoked. CITY /,,� Tel. No. GLS Hood — Fan —Other_ '�� LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. _ Room Air Cond. — Class REG. NUMBER (commencing with Section 7000)of Division 3 of the Business I Power Apparatus&Large Appliances DISTRICT NO. PRO BY �- and Professions Code,and my license is in full force and effect. i d �1 �� Size&Type HP, KW, KVA, or KVAR • O License Number Lic. Class-e---f-6 Up to 1 Incl. FINAL j U DATE 0 �3 ,t(_ 0 (_ 'r9-/ l Over 1 to 10 Incl. / V ATION U Contractor add-.0 sz.-Date Over 10 to 50 Incl. F- I am exempt under Sec. Over 50 to 100 Inc. BY 1 U B.&P.C. for this reason j Over 100 Services, Swbd., MCC&Ponelboards ! , Date. 0-200 Amp. Under 600 V — Signature 201 - 1000 Amp. Under 600 V Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY Temp. Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit c 0 0 2 3 A Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits Professions Code): X 0 0 0 0 0 2 Misc. Conduits&Conductors as owner of the property, will do the work and the s Other( P See Complete Fee Schedule)_ ® I' ° - 4000 structure is not intended or offered for sale(Section 7044, I Business and Professions Code). 0 0 0 4 0,0 0 20: CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for 0629-88 the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). i PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address TOTAL FEE I certify that I have read this application and state that the 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-me ' ep erty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature o • rmittee Date