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Home My Public Portal About9421 OLEMA ST_Electrical__ 76A663-CES0611/70 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING �7 BUILDING AND SAFETY DIVISION ADDRESS 7 COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. OUTLETS NO. EACH FEE OWNER RECEPj S S MAIL ��//[[JJ�_ FIRST 20 �� .P5 � ADDRESS LIGHT TOTAL CITY TEL. N0. SWITCH OVER 20 3 10 PLAN CHECK LIGHTING TOTAL FIRST 20 .25 '7 APPLICANT FIXTURES OVER 20 .10 ADDRESS APPLIANCES CITY TEL. N0. PERMIT /�-y RANGE DRYER_WTR. HTR. APPLICANT (�O STA. COOK DISP. F.A.U. ADDRESS f�% d (_ SPACE HTR.. AIR CON D. CITY 60 fy � TEL. NO.. � ) k CLOTHES/W_/�SH.' DISHWASH.; LICENSE N0. ,�c� �� CLASS. 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 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 - 1 1.001 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO d 1 - 1O 3.00 RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. CL 10 - 50 5.00 SIGNATURE V OF PERMITTEE 50 - 100 10.00 DISTRICTN CLASS ZONELU CL PR CESS Y V 100 - S00 15.00 150 SIGN, GAS SIGN AND ONE CIRCUIT 5.00 NOTES: h Z TUBE, OR I - MARQUEE ADDITIONAL CIRCUITS 1.00 SERVI CENOTOVER 606 VOLTS OR 200 AMP 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE SERVI CEOVER 600 VOLTS OR 200AMP 10.00 TEMP.POWER POLE TEMP SERVICE,POLE,&APPURTENANCES 5.00 TEMP LIGHT OR RECEPT. SYSTEM 3.00 UNDERSLAB WORK ROUGH CONDIUT WIRING FIXTURE1S POWER AUTHORIZED PERMIT FEE (SUB TOTAL) UTILITY CO. NOTIFIED PLAN CHECK FEE r FINAL � 3 PERMIT ISSUING FEE 3.00 " 1. JOSEkPA r4OOHAN TOTAL FEE _311SUPERVISI EyECTRICAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALI CK. M.0. CASH R0770 30'27 2 0 22.15x SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 768663-CE80610/72 APPLICATION OR ELORICAL PERMIT COUNTY OF LOS ANGELES , DEPARTMENT OF COUNTY ENGINEER ADDRESS 9421 C1ema St. BUILDING AND SAFETY DIVISION LOCALITY Terinle City. . NEAREST FOR APPLICANT TO FILL IN CROSS ST. OUTLETS NO. EACH FEE77 OWNER OR PtFoley Foley $ $ FIRM NAME RECEPT._ MAIL ADDRESS as ►OU LIGHT TOTAL FIRST 20 2,. 25 CITY TEL. NO2L5-5346 SWITCH-L ;k- OVER 20 .10 PLAN CHECK FIRST 20 23 APPLICANT LIGHTING TOTAL FIXTURES OVER 20 101 1 ADDRESS RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT RANGE DRYER_WTR. HTR. APPLICANT Anthony Pools STA. COOK DISP. F.A.U. ADDRESS 5371 E. Firestone SPACE HTR. AIR COND. CITY South Gate TEL. NOE v 0,-2 05 7 CLOTHES WASH.-DI SHWASH. REG NNUMBER79 CLASS.C-� 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 1 AM PROPERLY REGISTERED AND/OR r ✓ 0 - 1 i,p0 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CAL FORNIA OR THAI I AM THE LEGAL OWNER OF THE ABOVE } 1 - 10 3.00 DESCRIBED RESIDENTIAL PROPERTY. C PERMITEE v 10 - 50 5.00 SIGNATURE 50 - 100 1000 DISTRICT N0. SED Vf LLJ 100 - 500 15.001 1 SIGN, GAS SIGN TUBE, A AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECWIfSSIGNATURE MARQUEE ADDITIONAL CIRCUITS IAO TEMP. POWER POLE SERVI CENOT OVER 600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK SERVICEOVER 600 VOLTS OR 200AMP 10.00 ROUGH CONDUIT TEMPSERVICE,POLE,&APPURTENANCES 5.00 WIRING TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL PERMIT FEE (SUB TOTAL) °, NOTES; PLAN CHECK FEE PERMIT ISSUING FEE 3.00 0d TOTAL FEE PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH 0 4 AL 12 4.75 ,6,- SEE .75e,sSEE BACK OF APPLICATION FOR COMPLETE SCHEDULE , WORKERS'COMPENSATION DECLARATION I 20;0019 DPW 3/87 APPLICATION FOR ELECTRICAL PERMIT I:I�Y ty affirM that 1 have a certificate of consent to self CE-806r. Q insure, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES DEPT..OF PUBLIC WORKS ,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 9 a ^' Certified co is filed with the count building inspec- 1 &2-Family, S Ft. $ — $ LOCALITY PY Y 9 � P y' q' tion department. Multi-family Sq. Ft. — NEAREST Residential Swimming Pools CROSS ST.NER OR 11�h1 Date Applicant - ''11 // ((]] FWM NAME DPcV�„ G'e" ', CERTIFICATE OF EXEMPTION FROM WORKERS' �Ught3JC_Sw.3 MAIL. COMPENSATION INSURANCE. Outlets: Rec ADDRESS (This section need not be completed if the work Involved by First CITY Tel. No. the permit Is for one hundred dollars($100)or less.) Total No. Additional L� PLAN CHECK I certify that in the performance of the work for which this SrVNObW a. APPLICANT permit.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 0 AA 0 ADDRESS Additional Date Applicant Total No. is .CITY Tel. No. Fixed Appliances Not Over NOTICE TO APPLICANT: If, after making this Certificate of '1 HP PERMIT Exemption, you should become subject to the Workers' Range— Heater—D.W. — APPLICATION Compensation provisions of the.Labor Code,,you must forth- Oven — Dryer —W.M.— ADDRESS with comply with such provisions or this permit shrill be Top = FAU —W.H. — deemed revoked. ( ..Hood — Fan —Other— CITY Tel. No. LICENSED CONTRACTORS DECLARATION LICENSE OR — _ I hereby affirm that lam licensed under provisions of Chapter 9 Disp. Room Air Cond. REG. NUMBER Class. (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. d Size&Type HP, KW, KVA, or KVAR U License Number.. . Lic. Class Up to 1 .Incl. FINAL cr Date Over 1 to.10 Incl. DATE �° L VALIDATION Contractor ❑ Over 10 to.50 Incl. 0 I am exempt under Sec. h Over 50 to 100 Inc. FINAL U BY ,, 0 LU B.&P.C, for this reason I Over 100 1' a Z Services, Swbd., MCC&Ponelboards Z Date: 0-200 Amp. Under 600 V Signature. . .. I 201 - 1000 Amp..Under 600 V 'Exemption for Reg. Maint. Elect. I Over 1000 Amp. or Over 600 V M. SINGLE FAMILY Temp. Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign I hereby affirm that I am.exempt fromSi with One Branch Circuit.the Contractor's License g -��l- i••;r'Lts Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits ___ Professions Code): I J. •�;�{�� 10 Misc. Conduits&Conductors -� I, as owner of the property, will do-the work and the 11:jy structure is not intended or offered for sale(Section 7044, Other(See Complete Fee Schedule)_ Business and Professions Code): - CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for ' l Y'll`1i i'. -fI E the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) (Sec..3097, Civ. C.). PLAN CHECKING FEE t'( 1="-t_l�'T! z`25 92 Lender's Name PERMIT ISSUING FEE I.}'' ii+'•.x 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 DMID 6 P.2.-•zJ' Si natu a of Permitt a Dat ®s l� r,� w IN" . ASG _ '