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Home My Public Portal About9105 OLEMA ST_Electrical__ WORKERS'COMPENSATION DECLARATION 76Aeea ioiel r��r•. nI�pp //�� II��pp I ehele'by.affirm that I have.a.certificate of consent to self insure, bE-606G AIS li✓LSO Cl,'�TE O N FO R E LE CTR]CAL PERMIT 6r a.certificate of Workers',:C.ompensation Insurance,.or a certified ' COUNTY OF LOS ANGELES � BUILDING AND SAFETY copy.thereof.(Sec.$800;Lab.'C.) Policy No. Company FOR APPLICANT TO FILL IN JOB ❑ Certified•copy is.hereby furnished. New Residential Bldgs.&Pools' EACH NO. FEE ADDRESS (s ' 1 & 2-Fam'il S Ft. $ — $ LOCALITY ' ❑ Certified copy is .filed with the. county building inspection. y q _ departmerit. Multi-family.Sq.Ft. NEAREST CROSS ST, Date Applicant _ Residential Swimming Pools OWNER OR FIRM NAME " CERTIFICATE OF EXENIPTION'FROIvI WORKERS` Outlets:Rec�Light Sw. OI MAILPl COMPENSATION INSURANCE Firet 20 Q ADDRESS �Q . . `9ZR d O .. (This section.need not be completed if.the work Involved by the CITY V.No. permit is for one hundred dollars,($100)or Less.) Total No. Additional. �� PLAN CHECK I certify. that.in.the,performance of the work for which-this permit APPLICANT , ,is:issued,'I'shall•not employ any person in any manner so as. to become subject.to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS Additional.: Total No._� CITY V.No.: ' Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE• TO .APPLICANT: It; -after making this Certificate of. APPLICANT Exemptiorf,.you should become subject.to the Workers'•C.ompensation Range_ Heater_ D.W. _ provisions of'the Labor Code,you must,forthwith comply'With such. Oven Dryer— W.M._. ADDRESS provisions,or this permit shall be deemed revoked. Top• FAU W.H. LICENSED CONTRACTORS DECLARATION Hood_ Ean- OtherCITY _ _ , 1'hereby affirm that I am licensed,uhder provisions of Chapter 9LICENSE OR. Disp: — Room Air Cond, .�Clasm (commencing With Section 7000)of Division 3-of the Business and REG:NUMBER, Professions Code',and my license is in:'full force and effect. DISTRICT NO. PFtWESSED BY ' Q . Powe - - - • ,. U 4 r Apparatus&Large:Appliances � Size. IZVA,. &Type HP,KW or KVAR License Number -. Lic.Class 1.Inbl.. FINAL.'' •' -- Up:to,. Over i;to 10.Incl. DATE VALIDATION'' Contractor Date Over 10 to 50 Incl,. . FINAL ❑ I.am exempt under,$ec. Over 50ito 1001nc.. BY Over`1.00 -BAP.C.for this reason Se M C'.&PanelbAa s ' rvioes,'Swbd., •C rd .Z� 6-200 ,600 Vmp•. " Signature. 201 - 1000 Amp.Under 600'V Over 1000:Pimp.or Over 6.06 V ❑ Exemption for Reg.Maint.,Elect. ; SINGLEFAMILY Temp,Power Pole&Appurtenances HOME OWNER=BUILDER:DECLARATION Sign.with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Lawr-;� •,s. for tyle following reason.(Section 7031.5;Business.and Professions Additional Sign.Branch Circuits , _ rrs,•I=.s godel- ' Misc:.Conduits&Conductors , I,as owner of the '6pert. ,will do the work and the structure i is not intended or offered for sale(Section 7044; Business ;Other(See Complete Fee Schedule) acid-Professions.Code). �" TOTAL AL ;3;3 @,2=5 CONSTRUCTION LENDING AGENCY ��.i I here affirm that:there is a construction.lending agency for the performance.. of the work for which We permit is issued.(Sec:309.7, F' '� CIV.C.).. �PERMIT FEE t , (Sub Total) �•��"•- ( i PLAN CHECKING FEE Lender's Namei 1 i 9 PERMIT`ISSUING FEE _ Lende'r's Address: 1 certify that.1 have read',this application'and state that the:abo �� TOTAL FEE' 3 y �(-' `°s information is correct.I agree to comply With all County ordinances and State laws regulating. Electrical wiring; and hereby authorize representatives ofthis.County to enter upon:the above-mentioned , pro erty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE ignatu of Pe-kit _1_7 Date '76A663 DBS 6A 7751 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY-i. COUNTY OF LOS ANGELES ELECTRIC WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMIT NO. ELECTRICIANS_AL2s'1-&-, A. / t ^y �� J RECEIVED BY FIRSREADY INSPECTION DATE ISSUED ADDRESS )`--' O / r`:G 1•:.��"f�r.�". CITY G� TEL.NO�nn ~ �� COUNTY LIOENSE NO. d EXPIRESJA.-C ' BUILDADDRE1N. 88 - PERMIT FEES . NUMBER EACH FEE _LOCALITY iL.1/►Y�"J^! L%�"7 LIGHT OUTLETS, NEAREST • RECEPTACLES CROSS ST. ...sl. R I�•4.f}�.i WALL SWITCHES OWNER TOTAL OUTLETS I 5O 7d , MAIL ELEC. RANGES. > ,yg ADDRESS •�.... ELEC. HEATERS 25 CITY �J[ tier lam"% TEL NO. FIXTURES 5 1 HEREBY ACKNOWLEDGE THAT I 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 1 POBSESS THE ABOVE VALID LOS NUMBER P HORSEPOWER _ ANGELES COUNTY LICENBE,'OR 1 AM THE LEGAL OWNER NEW MVD. HOVER IND. EACH OF THE RESIDENTIAL PROPERTY DESCRt.BED ABOVE. I/s s LE66 $ .25 -SIGNATURE OF „ I/s 2 .50 PERMITTE 2 5 1.00 •INSPECTION RECORD 5 15 1.50 15 50 2.50 50 200 5.00 •+/"fr} 200 500 10.00 zh< ^lllr/+�/el Q 500 1000 15.00 OVER 1000 20.00r�/� �� J �j M.O. H1.f ET/FREQ. CHANGER-HP ' A) jOy• //��P 91 WELDERS:AC-KVA 77LE eig 7,Atsv? O GENERATORS - KW Uxt•-r./�F _?dA;•.1,&6 TRANSFORMERS = KVA ` 11 IAI TEMP. MOTORS .(75% OF ORIG.) �) "-IJ f 1- 'r I W. flo MOVED MOTORS•(75% of ORIa.) MISC. SIGNS NO. NO.TRANS. . _ APPROVALS NO. NO.LAMPS FOR EACH PERMIT: DATE- INBPECTOR-S NAME WIRING '$1.00. CONDUIT ff FIXTURES $1.00 WIRINS Uhl, l, FIXTURES � 4yi SUPPLEMENTARY .50 - C Q POWER TOTAL FEE !8 " UTILITY CO.•NOTIFIED FINAL 8A886 GE-60818/78) APPLICATI FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANTTO FILL IN JOB �+ New Residential Bldgs.&Pools EACH NO. FEE. ADDRESS 1 &2-Family,Sq.Ft. $ .025 — $ LOCALITY "�- Multi-family Sq.Ft. .02 — NEAREST CROSS ST. L! V /�- Residential Swimming Pools 25.00 OWNER OR 3 FIRM NAME ^2 t S A U O_c CCA Outlets.:Rec�Light sl_Sw. MAIL First 20 •50 ADDRESS S J�' O':e:' 4 Total No. Additional .30 CITY r(- h P C F C 1 r y Tel.No. PLAN CHECK APPLICANT Lighting Fixtures First 20 •50 ADDRESS Additional .30. Total No. CITY Tel.No. Fixed Appliances Not Over 1 HP PERMIT 7 APPLICANT 1^-J o ` t K ti A 1211 G Range_Heater_D.W._ Oven—Dryer_W.M. ADDRESS 9'!'2. ! I ).�+ C_ r>tcN Top _FAU _W.H._ CITY 76 M p L N C-1 71( Tel.No. z S 7113 Hood_Fan —Other_ LICENSE OR Disp._Room Air Cond. _ 2.50 REG:NUMBER 7 Class. 13 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA• Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO Size&Type HP,KW,KVA,or KVAR COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS 2.50 REGULATING ELECTRICAL WIRING. Up to 1 Incl. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR Over 1 to.10 Incl. 5.00 _ 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 Over 50 to 100 Inc. 25,00 DESCRIBED RESIDENTIAL PROPERTY. Over 100 40.00 PERMITEE SIGNATURE Services 12 50 DISTRICT NO. SED BY 0-200 Amp.Under 600 V 201.1000 Amp. Under 600 V 25.00 v` 08 Over 1000 Amp.or Over 600 V 50.00 Z O Temp.Power Pole&Appurtenances 10.00 'Sign with One Branch Circuit 10.00 Additional Sign Branch Circuits 2.00 INSPECTION > INFORMATION u Misc.Conduits&Conductors 10.00 ON REVERSE z Other(See Complete Fee Schedule) SIDE Z -9 0 7 1.2 A g # 0000o2 !PERMIT FEE (Sub-Totall 2 0 0 1 250 PLAN CHECKING FEE (One-Fourth Permit Fee) p o 0 0 1 2 5 0 PERMIT ISSUING FEE $7.00 "' c. I, Q 1 1 -78 TOTAL FEE �, > INSPECTION FINALED date: f�� ) U By 6 ®s r6A663 CE 806(11 /78) ;APPLICATION'FOR ELECTRICAL PERMIT COUNTY.OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT`rO FILL IN. J New Residential Bldgs.&Pools EACH NO: - FEE A DRESS U V. •. 1 &2-Family,Sq.Ft:. $ •.025 — $ LOCALITY » Multi-family Sq.Ft. .02 — NEAREST - Residentiol Swi min 'Pools 25.00 CROSS'ST. p 9 OWNER OR- FIRM NAME Outlets:Rec . Light • Sw.: MAIL.. _. First 20 •50. ADDRESS V Total No. Additional .30 CITU, • No. : PLAN CHECK APPLICANT_. - Lighting Fixtures First 20 •50 ADDRESS 'Additional .30 -- - Total No. CITY Tel.No. Fixed Appliances Not Over I HP PERMIT Range—Heater—D.W._ APPLICANT q'DDRESS '- - Oven_Dyer_W.M. /. Top _FAU —W.H._ CITY T.el,No.. - 37 .Hood—Fan _Other_ ` Disp._Room Air Cond. 2.50 REG.NUMBER Glass. — a a 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPL.ICA-. Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO Size&T COMPLY. WITH ALL'COUNTY ORDINANCES'AND-STATE LAWS ype HP,KW,KVA,orKVAR 2 50 REGULATING ELECTRICAL WIRING. Up to 1'In8l. 1-HER€BY-CERTIFYTHAT'I AM'PROPERLY REGISTERED'AND/OR V Over 1 to 10 Incl. 5.00 ,LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF cc Over 1:0 to-50 Incl: 12.5.0 CALIFORNIA OR,THAT I.AM THE LEGAL_OWNER OF ?HE.ABOVE .00. DESCRIBED RESIDE IAL PROPERTY. 25 Over 50 to 100 Inc. 25.00 PERMIT.EE Over 100 SIGNATURE'_jf y Services = DISTRICT NO. V VROCESSE "B1G: Z 0-200 Amp.Under 600 V 1.2.50 1 201.1.000 Amp. Under 600 V 25:00 ;-- L5; 6. Ovgr 1000 Amp.or Over'600 V• 50.00' y .' Z C Temp.Power Pole&Appurtenances' 10.00 - Q Sign with One Branch Circuit 10.00_ o Additional.Sign Branch Circuits.' 2'00 INSPECTION. >, INFORMATION o:oo_ Misc.Conduits&Conductors ON REVERSE s Other(See Complete Fee Schedule] SIDE u 5 �857,8A 000002 PERMIT FEE, :].Sub=Total! ! 2 0.0 19,50 Z PLAN CHECKING FEE (One-Fourth Permit Feelr A o 0 0 9,Fj b U PERMIT ISSUING FEE ; $7.00 0 1.1 4 0, TOTAL FEE > INSPECTION FINALED W date: � /��O By � ®s