HomeMy Public PortalAbout10406 OLIVE ST_Electrical__ 717-- %e—, 4 cr
76A663_-j806-!jjuMAPPLICOF LOS ATEON FOR LECTRICAL PERMIT
_ DEPARTMENT BUIL NG AND SAFETY YDIVISIONER BUILDING 10 0 olive
ADDRESS V
JOHN A. LAMBIE, COUNTY ENGINEER LOCALITY Temple Cit
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING
Mi NEAREST
FOR APPLICANT TO FILL IN CROSS ST. Hal faX
OUTLETS NO. EACH FEE
OWNER
FRECEPT._CL- $ $ pLlyod
pDRESSSamT TOTAL FIRST 20 14 3 502 14 OVER 2010CITY TEL. N0.44$�2795
_ PLAN CHECK
LIGHTING l FIRST 20 3 75 APPLICANT
)} TOTAL
OVER 20 ADDRESS
FIXTURES ,� •10
APPLIANCES CITY TEL. N0.
PERMIT TT,,
RANGE DRYER_WTR. HTR. APPLICANTyJarr Electric
STA. COOK DISP. F.A.U. ADDRESS15834 Workman St
SPACE HTR. AIR COND.X _ 1 1 00 CITY La Puente TEL. No. 1$
CLOTHES WASH. DISHWASH. LICENSE NO.250843 CLASS. 0�10
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 I AM PROPER Y REGISTERED AND/OR
0 - 1 1.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM T E LEGAL 0 ER OF, AND INTEND TO
1 - 1O 9.00 RESIDE IN, THE ABOVE ES ICED ESIDENTIAL PROPERTY.
G.
SIGNATURE 0
10 - 50 5.00 OF PERMIT (J
50 - 100 10.00
DISTRICTNO. CLASS GROG IZOPI100 - 500 15.00J1/'r'
W
SIGN, GASSIGN AND ONE CIRCUIT 3.00 NOTES: h
TUBE, OR Z
MARQUEE ADDITIONAL CIRCUITS 1.00
SERVI CENOTOVER 600 VOLTS OR 200 AMP 00
APPROVALS DATE INSPECTOR'S SIGNATURE
SERVI CE OVER 600 VOLTS OR 200 AMP 5.00
TEMP.POWER POLE
TEMP SERVICE,POLE,&APPURTENANCES 3.00
UNDERSLAB WORK
TEMP LIGHT OR RECEPT. SYSTEM 3.00
ROUGH CONDIUT
WIRING �` L
PERMIT FEE (SUB TOTAL) d 2 FIXTURES
O POWER AUTHORIZED
PLAN CHECK FEE (50% PERMIT FEE)
UTILITY CO. NOTIFIED
PERMIT ISSUING FEE 00
3 . FINAL � 7 3
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
JOSEPH C. ROOHAN
TOTAL FEE 1125 SUPERVISING ELECIB4AL ENGINEER.
PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION CK. M.0. CASH
&0 7 4 3 5 N AUS 10 2 D 11.25-
SEE
1.25NSEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
76A669-CE806 6,69 APPLICATION FO A�ELECTRIC PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS. o��® /L✓ a
JOHN A. LAMBIE, COUNTY,ENGINEER
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY / 0
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
RECEPT. TOTAL NO. EACH FEE
OUTLETS FIRST 20 8 2O 8 OWNER
LIGHT MAIL
ADD'L .10 ADDRESS
SWITCH. OVER 20
TOTAL ADD' CITY TEL.NO.
LIGHTING FIOVER 2O
RST .20
FIXTURES .10 ELECTRICIAN Q 'EAa
RANGES CLO.DRYERS WTR.HTRB. 1.00 ADDRESS
GARB.DISP. STA.COOK I B
CITY TEL.NO.
DIBHWASH. AUTO.-WASH. STATE
SPACE HTRB. BTA.APP'.(Ya X.P.MAX.) .50
LICENSE NO.
MOTORS,. OVER NOT OVER H.P. DISTRI T NO. G OUP N P C SEED BY
O 1 1.00
1 5 1.so INSPECTION RECORD
s 8 2.00 C.Z _d s.
CL
S I B 12.sol 0
n n0
Is s0 5.00 O
so 100 5.00
U
r I..;+'A' y I A U.1
SIGNS
NO.TRANS. `� - `" G.
NO.LAMPS Z
SERVICE 0.600V-Nor OVER 200A 1.00 t"`AA
SERVICE O.600V-OVER 200 A. 12.00
SERVICE OVER 600V 5.0.0
MISC.
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE
1HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'881GNATURE
AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY CONDUIT.
WITH ALL•COUNTY ORDINANCES•AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERLb AND/OR
LICENSED AB REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AM THE LEGAL OWNER F THE ABOVE a
DESCRIBED
SIGNATUREeIDBN IA PROP UTILIPOWTY CO.NOTIFIEDtel-
OF PERMITT lij r
FINAL O
' 0
CKIDATION ARTHUR C. VETT -
MC CASH SUPERVISING ELECTRICAL ENGINEER
Lhlo4 3. 5 0 SEP 29 2 D 3.20-
V
Y -
011
76A663-CE806 8-62 ' APPLICATION FO.R ' 'k-T ICAL kaT
� .
. COUNTY_-OF,LOS ANGELES'
.DEPARTMENT:OF COUNTY ENGINEER F
BUILDING AND,SAFETY DIVISION -JOHN A. LAMBIE. COUNTY ENGINEER
WILLIAM A.JENSEN;=SUP•T OF BUILDING TYFOR APPLICANT TO FILL IN ST.•.
RECEPT,� TOTAL NO. EACH FEE
OUTLETS" FIRST 20 $20 OWNER'
LIGHT o MAIL
SWITCH. ADO�L .1G ADDRESS'
OVER 20
TOTAL /�' CITY • TEL.N4
LIGHT.IN'G 1+ F1R5T2.0 .20" v -
FIXTURES I ADO'L 1O ELECTRICIA
11 .. OV R 20 ..
RANGES CLO.DRYERS WTR.HTRS.. 1.00 -
' ADDRE$S� •� .I�
-GARS.DISP. ".STA.COOK -
' EIRY � TEL.NO.
DISHWASH.• AUTO.-WASH. �: _ -,STATE,
SPACE HTRS. BTA.APP.(ys N:P.MAX.) .80 LIC.ENSE.NO. 7.
7 .
MOTORS: OVER NOT OVER M.P. ,:DISTRICT NO. I GROUP ZONE PROCESSED. BY
O 1 1..00 '
1, 5 1.80. 1,�' I�/NSPEC�TI�O•N�,R�EC�ORD / :?
5 S 2.00 Ila l Q mit. / lTd/' iy Yr^6i1 .'✓Z�fC J,
A '
B 1.5 2.80
18. _ SO 5.00
O
50 100' 8.00 ..f J(11�r. `
SIGNS: NO.TRANS. - J'/• -
NO:LAMPS a
SERVICE O.•600V.NOT OVER 200A '1.00 Lu
SERVICE 0.600V•OvER 200 A. 2:00 y
SERVICE OVER•6COV 5.00 ?
MISC.
PERMIT ISSUING FEE: 2.00
SUPPLEMENTAIRY PERMIT ISSUING FEE 11.00 J
TOTAL FEE a
HEREBY ACKNOWLEDGE THAT I HAVE'READ THIS APPLICATION- APPROVALS. DATE INSPECTOR'S SIGNATURE
AND ESTATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT - P f A 1;
WITH ALL.-COUNTY ORDINANCES AND, STATE LAWS REGULATING
ELECTRICAL WIRING. - M `Jc
WIRING fD,r:4�lsr`
I HER®Y CERT THAT.-1 AM PROPERLY RE'ISTERED AND/OR � 1 (1 / Ar
LICENSED A8 R, UI D BY LOS ANGELES:COU Y'•AND STATE OF FIXTURES' YAM
A. `
CALIFORNIA OR THA I• AM THE LKGALJ6W9 O THE ABOVE - -
DESCRIBED RESI N AL-P OPERTY. -POWER
l SIGNATURE-" UTILITY.CO.NOTIFIED` 7'idZ®7fJ'Q
OF PERMITT FINAL6/A /
LIDATION ARTHUR'C. VEIT
CK MO CABFI` SUPERVISING ELECTRICAL ENGINEER
i.tll,o 5;.4 0 G �AY 2 9 2 D 15.00 -.1
• •� '-r ' .� ' . - • ,( >:: :gyp /
i
WORKERS'COMPENSATION DECLARATION CE 80 G 10/81 APPLICATION FOR ELECTRICAL PERMIT
I hgreby affirm that I have a certificate of consent to self
insure, or a certificate of Workers'Compempl.lion Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY
wiro,
ed copy]Jtherereof(Sec. 3800, Lob. C.)
7/I/ Company �l/l� D� �/ FOR APPLICANT TO FILL IN JOB /
❑ Certified copy is hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE ADDRESS
Certified copy is filed with the county building inspec- I &2-Family, Sq. Ft. $ — $ LOCALITY NEAREST
tion department. Multi-family Sq. Ft. CROSS ST.
WIMg, AgoResidential Swimming Pools OWNER OR
Applicant FIRM NAME n 1A
CERTIFICATE OF EXEMPTION FRO WORKERS' Outlets: Rec Light Sw._ MAIL
COMPENSATION INSURANCE ADDRESS
This section need not be completed if the work involved b First 20
the
the Is for one hundred dollars($100)or less.) Y Total No. Additional CITY ep Tel. No.
PLAN CHECK
1 certify that in the performance of the work for which this 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 ADDRESS
Total No. Additional CITY Tel. No.
Date Applicant Fixed Appliances Not Over 1 HP PERMIT
NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT t
Exemption, you should become subject to the Workers' Range_ Heater—D.W. _
Compensation provisions of the Labor Code, you must forth- Oven —Dryer _W.M. ADDRESS
with comply with such provisions or this permit shall be Top _ FAU —W.H. —
deemed revoked. Hood _ Fan _Other— CITY Tel. No.L���'
LICENSED CONTRACTORS DECLARATIONLICENSE OR
I hereby affirm that I am licensed under provisions of Chapter 9 Disp. _ Room Air Cond. REG.NUMBER Q Class.
(commencing with Section 7000)of Division 3 of the Business DISTRICT NO. PRO ED BY per.
and Professions Code,and my license is in fullforce and eff t. Power Apparatus&Large Appliances O
Size&Type HP, KW, KVA, or KVAR
License Number,((!� Lic. C)"ass – Up to 1 Incl. FINAL fr
& ft �qoL Over 1 to 10 Incl. DATE ) I VALIDATION
Contractor FINAL W
Over 10 to 50 Incl.
X)d
❑ W
Ik (n
I am exempt under Sec. Over 50 to 100 Inc. BY i Q.'
Over 100
B.&P.C. for this reason Z'
Date: Services, Swbd., MCC&Panelboards
0 -200 Amp. Under 600 V
Signature 201 - 1000 Amp. Under 600 V
❑ Exemption for Reg. Maint. Elect. Over 1.000 Amp. or Over 600 V
SINGLE FAMILY Temp. Power Pole&Appurtenances y
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ACCP E
I hereby affirm that I am exempt from the Contractor's License °a
Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits L �7 22.DO Professions Code):
F-1 1, as owner of the property, will do the work and the Misc. Conduits&Conductors NEMS
structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)— ► TOTAL 22.010
7044, Business and Professions Code).
CONSTRUCTION LENDING AGENCYECK ?°�
I hereby affirm that there is a construction lending agency for CHFIk4GE .011
the performance of the work for which this permit is issued PERMIT FEE (Sub-Total)
(Sec. 3097, Civ. C.).
PLAN CHECKING FEE jIGOO-0001 9/27/050
Lender's Name
PERMIT ISSUING FEE , 3044 1 AM 9:16
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 iza
ordinances and State laws regulating Electrical wiring, and
hereby authorize repre ntotives of this County to enter upon
the ove-mentione ert for inspecti purpas SEE REVERSE FOR EXPLANATORY LANGUAGE
r�
Signature of Permittee Da