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Home My Public Portal About9144 OLEMA ST_Electrical__ IAESB-CESOS 10-60 APPLICATION FOR ELECTRICAL PERMIT - 1 COUNTY OF LOS ANGELES DEPARMENT OF COUNTY ENGINEER VAB UILDING 'BUILDING AND SAFETY DIVISION DDREss44JOHN A.LAMBIE. COUNTY ENGINEERWILLIAM A.JENSEN.SUPT OF BUILDING OCALITYEAREST 4 FOR APPLICANT TO FILL IN CROSS ST. PERMIT FEES OWNER I T E M NUMBER EACH I FEE MAIL OUTLETS- $ s ADDRESS LIGHTS RECEPT. SW. .10 CITY TEL. NO. LIGHTING FIXTURES .10 0 Gum RANGES CLO.DRYERS ELECTRICIAN WATER HEATERS .50 ADDRESS ELEC.SPACE HTRS. DISHWASHERS CITY TEL NO. GARBAGE DISPOSERS AUTO.- - STATE , WASHERS STA.COOKING UNITS .25. LICENSE NO. MOTORS: OVER INC. H.P. DISTRICT O. GRO NE P D B 0— 1/s .25 va— 2 .5d INSPECTION E ORD .1 2— s 1.00 ,/ la 7 - '�'Y. &.r GI•' ) (�t ' O s- 15 1.50 1s— so 2.so - O SO— 200 5.00 c. SIGNS; NO TRANS. ssyr� NO.LAMPS /.c. SERVICE 0-600V 1.00. SERVICE OVER 600V 5.00 MISC. WIRING PERMIT 1.00 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .50 TOTAL FEE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS AI DATE 1 I IN/SPSCTOR'S'SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT / q _ ✓ ..s ��;�� WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING J., (,. / ELECTRICAL WIRING. WIRING ) 17l/i rn r �If 1✓•`J'"r 1HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THA AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RE SIDEN A ROPERTY. POWER SIGNATURE UTILITY CO.NOTIFIED OF FERMITTE tt r FINAL A•!1/1 V / fjf�f�Y�"f VALIDAT AR fiuR C.vEtr/' OxSUPWRVISING ELECTRICAL ENGINEER:0 g 0 8 MAR 91 2 0 3.0 0 � - r Lt-- M(It-fc,, QI tf LJ 76A663-CEBOG 11-71 APPLICATION FOR EdECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS LOCALITY ,� v NEAREST FOR APPLICANT TO FILL IN CROSS ST. OUTLETS NO. EACH FEE $ $ MAIL RECEPT._ ADDRESS SS /�T L�� LIGHT TOTAL FIRST 20 25 . SWITCH_ OVER 20 10 CITY ��L� TEL. N0,7p7-1,3'71 PLAN CHECK LIGHTINGTOTAL FIRST 20 .25 I APPLICANT 'FIXTURES OVER 20 - 10 ' ADDRESS RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT RANGE DRYERtWTR. HTR. APPLICANT STA. COOK DISP. F.A.U. i ADDRESS, SPACE HTR. AIR COND. CITY TEL. NO. CLOTHES WASH. DISHWASH. LICENSE NO. CLASS. FAN OTHER 1.001 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. KYA. i ELECTRICAL WIRING. SIZE & TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED A-ND/OR O - 1 1.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY-AND STATE OF d CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF, AND INTEND TO 1 - 10 3.00 RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. Q r U SIGNATURE 10 - 50 5.00 OF PERMITTEE e0&41ele_it_) i✓ O So 100 10.00 1"' DISTRICT NO. CLASS ZONE E ED BY W 100 - 600 15.00 G.07R a Z SIGN, GAS SIGN AND ONE CIRCUIT 5.00 NOTES: TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 SERVI CENOT OVER 600 VOLTS OR 200 AMP 3.00 QQ SERVICEOVER60OVOLTSOR200AMP 10.00 I APPROVALS DATE INSPECTOR'S SIGNATURE TEMP.POWER POLE TEMP SERVICE,POLE,&APPURTENANCES 5.00 UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM 3.00 ROUGH CONDIUT WIRING FIXTURES PERPOWER AUTHORIZED MIT FEE (SUB TOTAL) -. UTILITY CO. NOTIFIED PLAN CHECK FEE FINAL PERMIT ISSUING FEE 3.00 3.QCT TOTAL FEE -3 PLAN CHECK VALIDATION CK. M.O. 0 PERMIT IDATION . CK. M:O. D-1. 2 D 7.0 O~ a SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE WORKER'SCOMPENSATION DECLARATION 7SA663 DPW(12.91) APPLICATION FOR ELECTRICAL PERMIT I fiereb�►'affirm thatthat Ihave a certificate of consent to self insure, or a certificate o�Worker's Compensation Insurance, or.a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec..3800 Lab;C.) .. `Policy NO. Company - .FOR':APPLICANJOB NO. TO FILL ADDRESS Certified co is hereby furnished. NO. FJ1CH FEE PY Y New Residential Bldgs.&Pools _ $ $ LOCALITY ❑ Certified copy is filed with.the county building inspection 1 &2 Family,Sq.Ft. - _ NEAREST department. Multi-family Sq.Ft, CROSS ST. Date Applicant Residential Swimming Pools ASSESSOR - MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM'WORKERS' OWNER OR COMPENSATION INSURANCE Outlets:Rec._Light Sw, FIRM.NAME =f First 20 (This'section need not be completed If the work Involved by the MAIL Total No. Additional 1ADDREss �� • permit is for one.hundred dollars($100)or less.) I certify that in the performance of the work for which this permit ..Cl el.14? is issued,.I shall not employ any person in:any manner so as to PLAN CHECK become.subject to the:Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANT Total'No. Additional 1ADDRESS Date ,ApplicantRESIDENTIAL.APPLIANCES NOT . NOTICE TO APPLICANT: If, after making this Certificate of iCITY Tel.No. Exemption,you should.become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HPER 3•HP. provisions of:the Labor Code,you must forthwith comply with-such - - (APPLICANT provisions or this permit shall be deemed.revoked. Power Apparatus&Large Appliances LICENSED.CONTRACTORS DECLARATION' Size&Type HP,KW,KVA,or KVAR I ADDRESS 1 hereby affirm that I.'am'licensed under provisions of Chapter 9. Over 3 to 10 I'ncl. ' a (commencing with Section 7000)of Division 3,of the Business and- CITY Tel.No. Professions.Code,.and my license is In full force and'effect. Over 10 to 50 Incl. } C Over 50 to 100 Incl. LICENSE OR Class. , REG.NUMBER O Over 100 DISTRICT NO. ESSED BY License Number Lic.Class Q V - Services,Swbd.,MCC&Panelboards; Contractor Date 0:999 Amp.:Under 600 V DAA / ❑ 400-10 00 Amp.Under'600 V 2'r � VALIDATION V I am exempt under Sec:. a Over 1000 Amp,dr.Over 600 V FINAL B.&P.C.for this reasonBRANCH CIRCUIT FEES' BY /• a) Date: 15A,.or 20A;120V,Lighting or Recept:: 1 To:10 Branch Circuits Y Signature 11 To 40 Branch Circuits ,l, 41 Or More Branch.Circuits #•• . e ❑ Exemption for Reg.Mlaint.Elect. 15A,20A,208V76 2 M. Lighting Br.Circuits 4 I a SINGLE FAMILY Temp.Power Pole.&Appurtenances ,-'rf}f I�. HOME OWNER -BUILDER DECLARATION 61A5 with One Branch Circuit �•�t 1A5 I hereby affirm that I am exempt from the Contractor':s License'Law for the following reason(Section 7031.5,.Business and Professions Additional Sign Branch Circuits � ��.C[.1`t Code): TO I AL 6:1 . 61 ❑ i,as owner of the property,will do the.work and the structure Misc:Conduits ` ""&Conductors HECK ' is not intended.or offered for sale(Section 7044, Business . Other(See Complete Fee Schedule) and•'Professions Code). I CCH( CONSTRUCTION LE.ND.ING.AGENCY I Hereby.aff.irm that there is a construction leriding.agency for the i t' performance of the-work for which this permit is issued(Sec. 3097, ' PERMIT FEE (Sub-Total) Af 26 0900—f0•x,01 11/ 4/?.0 Civ:C.) i� 0 X7 6,(1,3-. PLAN CHECKING.FEE' Lender's Name = PERMIT ISSUING FEE p2(p Lender's.Address - I'certify`thaf l have'read this application and under penalty of purjurystate. TOTAL FEE 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 16 enter upon the above-mentioned property' or inspection purposes. SEE REVERSE:FOR EXPLANATORY LANGUAGE IGNATURE OF PERMITTEE DATE.