HomeMy Public PortalAbout10232 OLIVE ST_Electrical__ 7BA$G; I�eD�46s APPLICATION FOR ELECTRICAL P MIT
.~COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY _
NEAREST
FOR APPLICANT TO FILL IN CROSS ST. .
NO. EAC FEE
RECEPT._
$ s OWNER vz f: L'
MAIL
LIGHT TOTAL FIRST 20 .20 �� ADDRESS //t� � .
SWITCH, `� OVER 20 .10 CITY C)L( 4F C� TEL. NO. "� I
PLAN CHECK
LIGHTING
�.TOTAL FIRST 20 20 �� APPLICANT
FIXTURES OVER 20 .10 ADDRESS
RANGE—DRYER—WTR.HTR._ CITY TEL. NO.
STA.COOK_DISP.—F.A.U._ •CONTRACTOR
SPACE HTR. AIR COND. ADDRESS
CLOTHES WASH._DISHW.ASH._ CITY TEL. NO.
FAN—OTHER i.-Ool LICENSE IJO. CLASS.
MOTORS,TRANSFORMERS RATING
IND. HEATERS, ETC. HP. KW. KVA. 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
SIZE & TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
1.00 ELECTRICAL WIRING. '
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
1 - 10 1 3.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM:THE LEGAL OWNER OF TEND TO
10 - 50 5.00 RESIDE IN, T DESCRIBED AEI TIAL P PERTY.
50 - 100 10.00 SIGNATURE' J/ 0
OF PERMIT E Ld s V
100 - 500 15.00
DIS IC O. GROUP N� PROCESSED Y o
TUBE, OR SIGN AND ONE CIRCUIT 3.00 SIGN,GAS [ V
W
MARQUEE ADDITIONAL CIRCUITS 1.00 NOT S• nj
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00
v O Z
SERVICE OVER 600 VOLTS OR 200 AMP 5.00zda or_
&
TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DARE INSPECTOR'S SIGNATURE \"
9/1
TEMP. POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
PERMIT FEE (SUB TOTAL) rFIXTURES
PLAN CHECK FEE (50% PERMIT FEE) THORIZED
PERMIT ISSUING FEE 2.00 00O.NOTIFIEDSUPPLEMENTARY PERMIT ISSUING FEE 1.00 VEX 90%0�
TOTAL FEE ,� JOSEPH C. ROOHAN
SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. rises
ca
IEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
c u�
76A683-CEL0610/76 APPLICATIO FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
+' ,bEPARTMENT OF COUNTY ENGINEER JOB
BUILDING AND SAFETY DIVISION ADDRESS
LOCALITY >�
NEAREST
FOR APPLICANT TO FILL IN CROSS ST 17114, �+
OUTLETS NO. EACH FEE OWNER OR
FIRM NAM
RECEP S $ MAIL
FIRST 20 25 ADDRESS
LIGHT TOTAL
SWITCH OVER 20 10 r
CITY TEL. NO. {�
PLAN CHECK
LIGHTING FIRST 20 .25 APPLICANT
000,TOTAL
FIXTURES OVER 20 10 ADDRESS
RESIDENTIAL APPLIANCES CITY TEL. NO.
RANGE�` O DRYER�WTR. HTR. �� PERMIT '
APPLICANT
STA. COOK W0 DISP.flip F.A.U.WD ADDRESS a rR f
SPACE HTR AIR COND. CITY 1 f C'r TEL. NO.fj 9-636
CLOTHES WASH. " DISHWASH. LICENSE OR
REG. NUMBER CLASS.
FAN WV OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT 1 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
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 — 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA THAT 1 AM THE LEGAL OWNER OF THE ABbVE
1 — 10 3.00 DESCRIBED E DENT AL PR TY. p
V
10 - 50 5.00 PERMITEE
SIGNATOR CD
F-�
50 - 100 10.00 8
DISTRICT NO. _ SED BY LLI
Ci..
100 - 500 15.00 ItZ
SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPE R'S SIGNATURE
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE
SERVICENOT OVER 600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK
SERVICEOVER 600VOLTS OR200AMP 10.00 ROUGH CONDUIT
TEMPSERVICE,POLE, &APPURTENANCES 5.00 WIRING
TEMP LIGHT OR RECEPT, SYSTEM 3.00 FIXTURES
POWER AUTHORIZED
UTILITY CO. NOTIFIED n
FINAL 6-3-77
PERMIT FEE (SUB TOTAL) NOTES:
PLAN CHECK FEE
PERMIT ISSUING FEE 3.001 zfb—D
TOTAL FEE
PLAN CHECK VALIDATION eK. m. CASH PERMIT VALIDATION cK. M.O. CASK i
4.7 6 tiN-0V —26 2 D 1 8.8 0 AL*
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
76ABBS DBS SA I1-60 APPLICATION FOR PERNIIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES ELECTRIC 1
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMIT NO.
ELECTRICIAN cc
R CEIVED BY READY FOR DATE ISSUED
ADDRESS L� FIRST INSPECTION
CITY w TEL NO. 9
COUNTY LICENSE NO. b EXPIRES. ADDRESS 623
6� (
PERMIT FEES
FEE
NUMBER EACH LOCALITY
LIGHT OUTLETS NEAREST
CROSS S'1. °�hC
RECEPTACLES
WALL SWITCHES OWNER
TOTAL OUTLETS Sc 5 1p MAIL
ELEC. RANGES 25 ADDRESS
ELEC. HEATERS 25 CITY TEL. NO.
i
FIXTURES 5 I 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 POSSESS THE ABOVE VALID LOS
NUMBER HORSEPOWERANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
FEE OF THE RESIDENTIAL PROPER -DESCRIBED ABOVE.
NEW MVD. HP OVER INC. EACH �f
I/2 6 LESS 5 .25 SIGNATURE OF,
I/2 2 .50 PERMITTEE
2 s 1.00 INSPECTION RECORD
5 1s 1.50
15 50 2.50
50 200 5 00
200 500 10.00 J
SOO 1000 15.00 Z
OVER 1000 20.00
M. G. SET/FREQ. CHANGER-HP (�
WELDERS:AC-KVA
GENERATORS-KW
TRANSFORMERS-KVA
TEMP. MOTORS (75%OF ORIG.)
MOVED MOTORS (75%OFORIG.)
MISC.
SIGNS
NO. NO.TRANS. I- I APPROVALS
NO. NO. LAMPS
FOR EACH PERMIT:
DATE INSPECTOR'S NAME
WIRING $1.00 l tr/C CONDUIT
FIXTURES $1.00 WIRING 2+ `1 3 -tiZ v-411
SUPPLEMENTARY .50 FIXTURES
�y
POWER.
TOTAL FEE 5 t 0 UTILITYCO. NOTIFIED
® FINAL
WORKERS'COMPENSATION DECLARATION 76A663 10481
I herqb affirm that :1 have 6 certificate of consent to self I CE-80613 APPLICATION FOR .ELECTRICAL PERMIT
.Y
insure�iror a certtfficate of Workers'Compensation Insurance, I, COUNTY OF LOS'ANGELES BUILDING AND SAFETY
r..1'certified copy thereof.(Sec. 3800, Lab. C:)
Policy No: Company i, 'FOR APPLICANT.TO PILL IN JOB /v� 7%j Is-
Certified'copy is hereby furnished. New Residential'Bldgs, &Pools
EACH NO. FEE ADDRESS 1C�2- 2 V I.
❑ Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. .... $ — $ -LO
CALITY•r,Cyr QL;� ;CiTY.
tion departmNEARESTent. Multi-family Sq. Ft. GROSS ST.
Date A licant Residential Swimming Pools -•� OWNER OR
Pp I• p5Q FIRM NAME ifo"N lir
CERTIFICATE OF EXEMPTION.FROM WORKERS' I' Outlets:Re..cj_LIght�.S ._ MAIL ,
COMPENSATION INSURANCE DDR . : • � . f la`
- F First 20
ESS '
This section need not'be.0ompleted If the.work involved by CITY
( Total.No. Additional L Tel.'No. � -�(p�(eJ
the permit.is for.one hundred dollars($100)or less..) PLAN CHECK
I certify that in the performance of the.work forwhich this -APPLICANT
permit is issued, I shall not employ any person in any manner I'
so as to become subject to the. rkers.'Compe. tion Laws. Lighting Fixtures Firpt 20 -ADDRESS
Additional
Date�5'��-" licant '
� r
Total No. Add CITY Tel No
PP- i t Over 1 :HP
Fixed Appliances No PERMIT
NOTICE. TO APPLICANT: If, after, making. this Certificate of
Exemption, you should 'become subject to the Workers' F Range_.Heoterv_D.W. APPLICANT '
Compensation.prol.isions of the Labor Code, you must forth- Oven _Dryer' —W.M.— ADDRESS
with comply with such .provisions 'or this: permit .shall beI• Top _ FAU —W.H.._ CITY Tel. No: '
deemed.revoked. Good — Fan _Other_,
LICENSED CONTRACTORS DECLARATIONLICENSE OR
I hereby affirm that l am.licensed under provisions of,Chapter 9 I Disp _ Room Air Cond. REG.NUMBER ��D" Cass.
(commencing with Section 7000).of Division 8'of the Business DISTRICT NO: 5 PROLES DIBIr•
and Professions: y
Code;and m. license is'In full force and effect. Power Apparatus&Large Appliances' a _
! Q Size&Type HP, kW, KVA,or KVAR.' d�
License Nu ber ddb i Lic. Class FINAL
Up#0 1 Incl.
a. r Over 1..to 10'Incl. DATE � ad
Date cSV i�-'92� � VALIDATION O
Contracto Over 10 to 50 Inc.I. FINAL
❑ I.am.exempt under Sec. Over 50 to 100 Inc. BY L
j ~
B.&P.C. for this reason I Over 1.00 PA
Services; SWbd., MCC&Panel.boards
Date; 0 -.2 p. Under 600'V
Signature. . I 2 10 1.000 Amp. Under 600 V
El 'Exemption.
1000 Amp. or Over 600 V'
Exemption.for Reg. Maint.'Elect.
SI.NGLE'FAMILY r
-HOMETemp. Power Pole&Appurtenances
OWNER-BUILDER DECLARATION
Sign with One Branch Circuit _
I hereby affirm that I'am exempt from the Contractor's License Additional Sign Branch Circuits
Law for the following reason (Section 7031.5, Business and i
Professions Code):. c o c o a
❑ M`isc. Conduits&Conductors
I, as owner t
.of' he property,: will do the work and the -
structure is not intended or offered for sale (Secttoh Other(See Complete Fee Schedule)_
7044, Business and Professions Code).
CONSTRUCTION LENDING AGENCY I < r,
r
I hereby-affirm that there is.a construction.lending agency for f' c• ) _n
the performance of.the work for which this permit.-is issued PERMIT FEE (Sub Total)
(Sec..300, Civ. C.).
PLAN'CHECKING FEE
Lender's Name I ,
PERMIT ISSUING FEE
Lender's Address
I certify that I have read this application and.state that the TOTAL FEE �� �d
above information is correct. I agree to comply with all County
ordinances and State -laws regulating Electrical wiring, and
hereby. outhorize representatives of this County to enter upon ,
he above-.mention property for inspection.purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Permittee Date