HomeMy Public PortalAbout9478 OLEMA ST_Electrical__ 76A663CE-806`(11/78) APPLICATION FOR ELECTRICAL •PERM_ IT.
COUNTY OF LOS ANGELES BUILDING AND 1SAFETY
FOR APPLICANT TO FILL IN . .JOB
New Residential Bldg's.&Pools EACH NO. - FEE ADDRESS. .
1 &2-Family,Sq.Ft. S .025 — $ LOCALITY
Multi•familySq.Ft. 02 — NEAREST
Residential Swimming Pools 25.0.0ROSS'ST.
OWNER.OR-- -=
FIRM NAME t/!—
Outlets:Rec Light. Sw, MAIL _.
:First 20 .•50 ADDRESS'
- Total No. - Additional .30 CITY Tel.No_--'. _
PLAN CHECK
APPLICANT.. _ ..
Lighting Fixtures Fitst 20 •50 ADDRESS
Additional
Total No. CITY 'Tel.No.
Fixed Appliances Not Over 1.W PERMIT �r -
Range_Heater._D.W._ '
APPLICANT
Oven_Dryer_.WA.— ADDRESS
Top —FA.0 _.-W.H._ CITY
Hood_Fan _.Other_
2.50 LICENSE OR
Disp.,_Room Air Cond'. REG.NUMBER/.rj.�O. .� - Class,._
I HEREBY ACKNOWLEDGE.THAT I HAVE.READ THIS APPLICAa.
Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND.AGREE.TO
COMPLY WITH AL'L.'•000NTY ORDINANCES ,AIVD'STATE-LAWS
Size&'T
ype HP;KW,K.VA,or KVAR 2.50 REGULATING ELECTRICAL WIRING.
T_ „Up to 1 In I HEREBY CERTIFYTHAT`I AM-PROPERLY"REGISTERED ANDYOR r--%)
Over 1 to 10 Incl., 5.00 LICENSED AS REQUIRED BY LOS-ANGELES COUNTY AND STATE OF.
Over 10 to'S0 Incl. 1-2'.50 - CALIEORNIA O T I AM THE LEGAL.OVyJJER,QF 1H-f.ABOVE
25..00 DESCRIBED R ENT .L'FROPERTY:
40:00 PERMIT EE
Over 100 SIGNAT
Over,30 tor 100 Inc: UR . Vr ✓ y�j
ServicesDISTRICT. PR SED Z
0-200 Art;p.Under 600 V' 12.50 ✓ 0
'
. 201.1000 Artlp;'Under25.00
600 V
Over 1000"Amp:dr Over 660 V 50.40C000p
O
Teinp.•.Power Pole&.Appurtenances 1.0.0.0
Sign with One Branch.Circuit, 10.00
Additional Sign Branch Circuits 2.00 INSPECTION
Misc.Conduits&ConductorsINFORMATION u `t
t o;oa' W
Other(See Complefe Fee.Schedblel- ON REVERSE" u
_SIDE Z
g 751.4 f'
'({ 000.007
PERMIT FEE (Sub-Total)
PLAN CHECKING FEE (One•Fourth Permit Feel O
'. .0 0 0.O2cocot
PERMIT ISSUING FEE $7.00 .o
a 1CI.31 -79
TOTAL FEE >
INSPECTION EINALED
d
date: Byi, es
r•
' CE_806`'1 78' APPLICATION FOR° ELECTRICAL PERMIT
COUNTY OF LOS.ANGELES BUILDING AND SAFETY
FOWAPPLICANTTO FILL IN JOB
New Residential Bldgs,&Pools :--EACH NO. 'FEE ADDRESS
1 &2=Family,Sq.Ft.. $' ' .025 — $ , LOCALITY
Multi-family Sq.Ft. .02 — NEAREST
Residential.Swimmitlg Pools 25.00 CROSS ST. OAK OLC' M
OWNER OR
FIRM NAME + TQ Air aN
Outlets:Rec�Light Sw. MAIL
First 20' •.50 M.ADDRESS—8• ? `dr. OLE.HA 5_5- '
..Total No. Additional• 30 CITY „.C: Tel.,No. _
PLAN CHECK,
APPLICANT _
Lighting.Fixtures :First 20• {.50 ADDRESS
Additional .30
Total.No. CITY Tel.No.
Fixeb Appliances Nbt.Over 1 HP PERMIT -
APPLICANT
•Range_Heater_D.W._ ADDRESS
Oven—Dryer_W.M.—. 3 2Aw .
'Top _FAU —W..H._ CITY ,C_ TeI.,No_X47-13 i- „
.Hood_Fan _Ofher_ LICENSE OR
.Disp._Room Air Cond.. 2'5Q REG..NUMBER 343r-till; Class,g'-
I HEREBY ACKNOWLEDGE THAT I.HAVE.READ TIJIS APPLICA,
Power'Apparatus&Large,Applionces TION AND STATE THAT-THE ABOVE.IS.CORRECT AND AGREE TO
Size&T COMPLY WITH ALL, COUNT`! ORDINANCES AND STATE LAWS'
Upp tto 1
ype.HP, K ncl KVAR 2'50 REGULATING'ELECTRICAL WIRING. 6
o . Incl. . •I HEREBY CERTIFY THAT I AM'PROPERL'.Y REGISTERED AND/OR U
Over 1 to 10 Incl. 5.00 LICENSED AS REQUIRED_BY LOS-ANGELES COUNTY AND STATE OF
Over 10 to 50 Ind. 12.50 CALIFORNIA OR THAT'1 AM THE LEGAL.OyVtJER OF THE ABQYF 0
'25.00 DESCRIBED RESID AL PROP Y.
Over 50 to 100 Inc.
40.00 •PERMITEE
Over 100 SIGNATURE ark
ServicpsF?ISTR.ICr : PROCESSED-BY
0-200 Aymp.Under,600 V 1:2.50
201-1000 Amp.Under 600 V 25.00 •••
Over.1000.Amp.or Over 600 V -'50.00 Z
O
Yemp.Power Pole&Appurtenances 10-00' - Q.
Sign with One Branch Circuit '10,00 C 7 7 n 6 A
Additional Sign Branch Circuits 2'00 INSPECTION- > ft 0 0 0 0 0 1
INFORMATION. u
Misc.Conduits&Conductors 10..00 ON REVERSE z 2 a o'o 7.50
Ot er(See Complete Fee•Schedule) v
SIDE .
A L Q 0 0 0 0 5 0C
11. 1 -79
PERMIT FEE (Sub-Tofal)
PLAN CHECKING FEE: (One-Fourth Permit Feel O
PERMIT ISSUING FEE : $7.00 .• . o
TOTAL FEE >
INSPECTION FINALED ode
W
date: By: •/f•�2��2:�
v [ a ®s
76A663kEBO6 12/7.4 C- , r
APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER JOB ,
BUILDING AND SAFETY DIVISION ADDRESS
FOR ACC_LjE.&ML_T2FILL IN LOCALITY �` C
New Residential Bldgs& Pools EACH NO. FEE NEAREST
1 & 2-Family,.Sq. Ft. $ .025 — $ CROSS ST.
Multi-family Sq. Ft. •02 — OWPf NOioIRE O1
Residential Swimming Pools 20.00 MAIL Voi
ADDRESS
Outlets: Light,Switch & Receptacle CITY c Tel.No.
First 20 •50 PLAN CHECK
Additional .30 APPLICANT
Q ADDRESS
(Lighting Fixtures ,
First 20 .50 CITY Tel.No.
Additional 30 - PERMIT
APPLICANT
,Fixed Appliances Not Over 1 HP ADDRESS
Range_HeaterD.W._ N till CITY Tel..No.
Oven_'D�yer_W.IVI._ LICENSE OR
Top_ FAU _W.H._ REG.NUMBER Class.
Hood_ Fan ___
Disp-A.C. 2.00 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WIT H
ITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
Power Apparatus& Large Appliances ELECTRICAL WIRING.
Size&Type HP,KW, KVA,or KVA.R 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES .COUNTY AND STATE OF
Up to 1 Incl. 2.00 CALIFORNIA OR THAI I AM THE LEGAL OWNER OF THE ABOVE
Over 1 t0 10 InCI.
5.00 DESCRIpED RESIOILNTIAL P PERTY.
Over 10 to 5,0 Incl. 10.00 PERMITEE
SIGNATURE
Over 50 to 100 Incl. .20.00 41A
Over 100 30.00 DISTRIC E e PR ED Y
I5;
Services U
0- 200 Amp. Under 600'V 12.50 INSPECTOR'S g6
201.1000 Amp. Under 600 V 25.00 APPROVALS DAT VZ SIGNATURE y
Over 1000 Amp. or Over 600 V 50.00 TEMP.POWER POLE
Temp. Power Pole&Appurtenances 10.00 1UNDERSLABWORK
Sign with One Branch Circuit 10.00 ROUGH CONDUIT -�7G-
Additional Sign Branch Circuits 2.00 WIRING
(Other)
FIXTURES
POWER AUTHORIZED
UTILITY CO.NOTIFIED
FINAL
PERMIT. FEE (SubTotal) NOTES
PLAN CHECKING FEE (One-Fourth Permit Fee)
PERMIT ISSUING FEE $6.00
TOTAL FEE laO
PLAN CHECK VALIDATION CK. M.O. -CAS PERMIT VgAt IDATIO CK. MO. CASH
' JJ rrllFIR
y[
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
'°"°°'-`C°°° '°''°
APPLICATION FO LTRIGi�CL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER JOB 2JX Z
BUILDING AND SAFETY DIVISION aooRESS
LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
CUT ET S N0. EACH PEE OWNER OR
FIRM NAM
RECEPT. $ S MAIL ,
LIGHT TOTAL
FIRST 20 d ADDRESS
CITY TEL. N0. d
SWITCH_ OVER 20 10 PLAN CHECK
LIGHTING TOTAL FIRST 20 .25APPLICANT
FIXTURES OVER 20 10 ADDRESS
RESIDENTIAL APPLIANCES CITY TEL.
PERMIT
RANGE DRYER_WTR. HTR. APPLICANT
STA. COOK DISP. F.A.U. ADDRESS N
SPACE HTR. AIR COND. CITY TEL. NO.
CLOTHES WASH. DISHWASH. LICENSE OR
REG. NUMBER CLASS.
FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 19 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 fi TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR
0 - 1 1.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF }
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
1 - 10 9.00 DESCRIBED REST NTIAL PROPERTY.
10 - SO 9.00 PERMITEE
SIGNATURE o
50 - 100 10.00 DISTRICT NO. PROCE ED BY a
100 - 500 19.00 Q CO)Z
SIGN, GAS
TUBE, OR SIGN AND ONE CIRCUIT 8.00 APPROVALS DATE INSPEC SSIONATURE
MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE
SERVI CENOTOVER 600 VOLTS OR 200 AMP' 3.00 UNDERSLAB WORK
SERVICE OVER 600 VOLTS OR 200 AMP 10.00 ROUGH CONDUIT
TEMP SERVICE,POLE,&APPURTENANCES 9.00 WIRING 1 2
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
TOTAL FEE `
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.0. CA H
4 4 6ca-'nFC 225 2 D 6.10 0ld
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
WORKERS'coMPENSAZION DECLARATION of PoeIG ,o/B, APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm teat I have a certificate of 6on9ent to self'tnsure,
or a certificatb of Workers' Compensation Insurance,or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY
copy.thereof(Sec.3800,Lab.C.)
a
Policy No. •- Company FOR APPLICANT TO FILL IN JOB
❑ ADDRESS
ertified copy Is hereby furnished. New Residential Bldgs.&Pools EACH NO. FEE
1 &2-Family,Sq.Ft. $ — 4-- K-
PLAN
LOCALITY
Certified copy is filed with the county building inspectio NEAREST
depar ent. Multi-family Sq.Ft. CROSS ST.
Date—Pr
Applicant 7 Residential Swimming Pools OWNER OR J
Q� FIRM NAME go ! c'
RTIFICATE OF EXEMP I FROM WORKERS' it � MAIL r
COM EN SURANGE Outlets:Rec Light Sw. sopm
First 20 DDRES$
(This section need not be completed If the work involved by the t CITY Tel.No.
permit is for one hundred dollars($100)or less.) Total No. lU 1 Additional
I certify that in the performance of the work for which this permit CHECK
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 CITY Tel.No.
Total No.
Date Applicant
NOTICE TO APPLICANT: If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMITAPPLICANT
Exemption,you should become subject to the Workers'Compensation Range— Heater— D.W. —
provisions of the Labor Code,you must forthwith comply with such Oven — Dryer— W.M.— ADDRESS o l�
provisions or this permit shall be deemed revoked. Top — FAU _
LICENSED CONTRACTORS DECLARATION - Hood — Fen Other_' CITY �ie45C—e Tel.No.
I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. y_ LICENSE OR tr
(commencing with Section 7000)of Division 3 of the Business and REG.NUMBER Q/ 7 Class.
Power Apparatus&Large Appliance3 PR SS
Professions Code,and my license is in full force and effect. DISTRICT NO.. ED
ff1� , a
License NumberT/�7D /�7 Lic.Class Size&Type HP,KW,KVA,or KVAR a U
Up to 1 Incl. FINAL
Over 1 to 10 Incl. DATEVALIDATION� � )_4 —1100, Q
Contractor ���� � Date % FINAL
�" Over 10 to 50 Incl. F�
❑ 1 am exempt.under Sec. Over 50 to 100 Inc. BY W
BAP.C.for this reason Over 100 Cn
Dat Services,S.wbd.,MCC&Panelboards�21 • ► ' Z
Arr+p.Under 600 V
Signature 201 - 1000 Amp.Under 600 V
❑ Over 1000 Amp.or Over 600 V
Exemptionf eg.Maint.Elect.
SINGLE FAMILY Temp.Power Pole&Appurtenances
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit a
I hereby affirm that I am exempt from the Contractor's License Law Additional Sign Branch Circuits for the following reason(Section 7031.5,Business and Professions _
Code): 07 79.80
❑ 1,as owner of theroper Misc.Conduits&Conductors 1 ITEMS
p ty,will do the work and the structure Fee Schedule Complete See
is not intended or offered for sale (Section 7044, Business Other( p )
and Professions Code). Polo. TOTAL 79.80
CONSTRUCTION LENDING AGENCY j CHECK 79.81
I hereby affirm that there is a construction lending agency for the
� � �
performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total) 000
Civ.C:).
PLAN CHECKING FEE 9 O 0
Lender's Name 00011-0001 4/779[(
PERMIT ISSUING FEE 074"" 1 �� 8022-
Lender's Address
I certify that I have read this application and state that the above 'TOTAL FEE c
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 i pecti purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
Sign of mi ee� Date