HomeMy Public PortalAbout10409 OLIVE ST_Electrical__ FGA663-CESOB.7 APPLICATION FOR ELECTRIC PERMIT
BO i!6G AND SAFETY DIVISION
Department of County Engineer BUILDING w
County of LDs Angeles ADDRES8 D D ef
JOHN A.LAM131E. COUNTY ENGINEER
CASSATT D.GRIFFIN.SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST. _
PERM FEES
[NUMBER OWNERLIGHT OUTLETS MAIL
ADDRESS
RECEPTACLES
WALL SWITCHES FEE CITY TEL.NO.
TOTAL OUTLETS 0 5¢ $ ELECTRICIAN
ELEC.RANGES 25 ADDRESS
ELEC.HEATERS 25CITY TEL.NO.
KW EA STATE
FIXTURES 5 LICENSE NO.
MOTORS DISTRICT NO. GRQUP ZONE READY FOR INSPECTION
NUMBER HORSEPOWER FEE _ I I /
NEW MVD. HP OVER INC. EACH
&LESS $ .25 INSPECTION RECORD
lh 2 .50
2 5 1.00
5 15 1.50
15 50 2.50
50 200 5.00
MI
NO.SIGNS NO.TRANS. ;
NO.SIGNS NO.LAMPS
FOR EACH PERMIT:
WIRING PERMIT $1.00 4'O
FIXTURE PERMIT $1.00
SUPPLEMENTARY .50 APPROVALS
TOTAL FEE DATE INSPECTORS SIGNATURE
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CONDUIT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING
ELECTRICAL WIRING.
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF POWER
CALIFORNIA OR THAT I AM THE EG NER OF THE ABOVE
DESCRIBED RESIDENTIA OP UTILITY CO.NOTIFIED
SIGNATURE OF PERM TTE FINAL - 7 7. y J ?/! !'L:! ..�
IOUN A.LGINEER .IDATION ARTHUR C.VETT.
BOUNTY ENGINEER �j SUPERVISING ELECTRICAL ENGINEER
CK MO CASH
;_�
FSACO.CE608.•10.55 APPLICATION FOR ELECTRIC PERMIT 1
BUILDING,AND SAFETY DMSION
Deportment of County Engineer BUILDING r
County of LOS Angeles ADDRESS
JOHN A.LAMBIE, COUNTY ENGINEER
CASSATT D. GRIFFIN.SUP'T OF BUILDING LOCALITY t 40
NEAREST
7LLIGHTS
OR APPLICANT TO FILL IN CROSS T
PERMIT FEES
OWNER
RECEPTACLES SWITCHES
1 T E M EACH FEE MAIL
ADDRESS
OUTLETS $ ,10 S �'
ELEC. RANGES, WATER HEATERS, CITY NO'
CLOTHES DRYERS .50
ELEC. SPACE HEATERS,'STAT•Y. COOK- ELECTRICIAN r '�
INS. UNITS, GARBAGE DISPOSERSK ADDRES S
QQQ AUTO WASHERS, DISHWASHER :25
LIGHTING FIXTURES 10CITY TEL.NO
MOTORS STATE
LICENSE NO. fP
HORSEPOWER
H.P: OVER INC. DISTRIC O. GR ZONE. READY FOR INSPECTION
Va&LESS .25 t4- /
14 - 2 . .50 7`JO INSPECTION RECORD
2 S 1.00
5 /'.0f15 1.50 "➢� .f. �/- ///I
1S 50 2.50 4" /Y
50 200 5.00
MIBC.
SIGNS I NO.TRANS
NO.LAMPS
SERVICE O-GOOV 1.00
SERVICE OVER 500V 5.00
WIRING PERMIT 1.00 d
FIXTURE PERMIT 1.00 Q 0
SUPPLEMENTARY PERMIT 50
TOTAL FEE 8 APPROVALS '
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP CATION DATE INSPECTOR'S SIGNATU
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
:�L_
ELECTRICAL WIRING. WIRING 7-'1/ (/LC
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES o
LICENSED AS REQUIRED BY LOS 6AGELES COUNTY AND STATE OF
CALIFORNIA OR THA T L OWNER OF THE ABOVI POWER
DESCRIBED RES,
S16NATURB UTILITY CO.NOTIFIED_ /0/'+
OF PERMITTE / y:y
FINAL 6.�wLd+.�
IOHN A.._LAMBIE. VALIDATION ARTHUR C.VETT.
.OYNTY NGINEER CK No CASH SUPERVISING ELECTRICAL ENGINEER
76A66C-CE#806 5.61
APPLICATION FOR ELECTRICAL PE IT
COUNTY OF LOS ANGELES
DEPARMENT OF COUNTY ENGINEER BUILDING /
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
PERMIT FEES OWNER
1 T E M NUMBER EACH FEE MAIL
OUTLET S S ADDRESS
LIGHTS RECEPT. SW. .1O D CITY , NOIg .
LIGHTING FIXTURES 10 D
ELEC.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. Z 3
MOTORS: OVER INC. H.P. DISTRICT N G Z NE/ P
O— '/Z .25 J I
1/a— 2 450 INSPECTION RECORD
2— 5 1.00 �.
S— 15 1.50 V
Is— 50 2.50 OG
SO— 200 5.00 U
SIGNS: NO TRANS. H
NO.LAMPS
..e
SERVICE 0-60OV 1.00
SERVICE OVER 600V 5.00
MISC. �.
WIRING PERMIT 1.00
FIXTURE PERMIT 1.00 ov
SUPPLEMENTARY PERMIT 50
TOTAL FEE S
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION - APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. G
WIRING J m ) 10JJr'
I
HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF x: FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED REBID EN OPERTY. ;' POWER
SIGNATURE fi' UTILITY CO.NOTIFIED
OF PERMITTEE ` FINAL /6 '�te- 7•' 1
VALIDATI ARTHUR C. VEIT
CK Mo cash SUPERVISING ELECTRICAL ENGINEER
1- 6 U 3 .75
5 t
. J
V N.r 'COMPENSATION DECLARATION j, 76-683 10/81 APPLICATION FOR ELECTRICAL PERMIT
hereby aff'irrri zt 1 have a certificate of consent to self insure, {. CE-806C3
or a cVificate of Workers' Compensation Insurance, or a.certified COUNTY OF LOS ANGELES BUILDING AND SAFETY
copy thereof.(Sec.3800,Lab.C.) ! I
Policy No. Company FOR APPLICANT TO FILL IN JOB r
❑ Certified copy is hereby furnished: EACH NO. FEE ADDRESS
� New Residential Bldgs.&Pools
❑ 1 &2-Family,Sq.Ft. $ — $ LOCALITY
Certified .copy is -filed with the county building inspection _
department. Multi-family Sq.Ft. NEAREST
CROSS
Date Applicant j Residential Swimming Pools OWNER OR
I e FIRM NAME
` CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rao Light—Sw._ MAIL
COMPENSATION INSURANCE ADDRESS
(This section need not be completed if the.work involved Eby the First 20
permit Is for one hundred dollars($100)or less.) „
Total No. Additional CITY Tel,.No.
I certify that in the performance of the work for which this,.permit PLANra
HECK
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
Total No. CITY Tel.No.
Date. 37dApplica k I Fixed Appliances Not Over 1 HP
NOT T APPLICANT: If, after making this Certificate Of PERMIT
Exemption,you should become subject to the Workers'Compensation. Range_ Heater_ D.W. APPLICA.
provisions,of the Labor Code,you must forthwith comply with such Oven _ Dryer_ W.M._ ADDRESS -r
provisions or this permit shall be deemed-revoked. Top _ FAU _ W.H. _
LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other_' '. CITY Tel.N
1 hereby affirm that I am Licensed under provisions of Chapter .9.. Disp. — Room Air`Cond. LICENSE OR s,
(commencing with Section 700Q)of Division 3 of the Business andr. REG.NUMBER ,�
Professions Code,and my license is in.full force and effect. ! DISTRICT NO. PROC SSE
� Power Apparatus&Large Appliances '
p� Size&Type HP,KW,KVA,or KVAR O
License Numbe�yf7 �2 -Licc.Class C.��IG� Up to 1 Incl. FINAL
Over 1'to 10 Incl. DATE &11h�,
VALIDATION GContrac}� �-""TDateOver 10 to 50 Incl.
FINAL �j
❑ I am exempt under Sec: b Over 50 to 100 Inc.
BY
B.&P.C.for this reason Over 100 f . vTT N
Services,Swbd.;MCC&Panelboards
Date: 0 200 Amp.Under 600'V
Signature ' / %' 201 - 1000 Amp.Under 600 V
f' Over 1000 Amp:or-Over 600 V r
❑ Exemption for Reg.Majnt.Elect 2
SINGLE AMILY Temp.Power Pole&Appurtenances ;( °v
HOME OWNER- ,ILDER DECLARATION Sign with One Branch Circuit
I hereby affirm that I am mpt from the-Contractor's License Law. '73 7 �:'
for-the following reason action 7031.5,Business and Professions Additional Sign Branch Circuits J'i
Code): 1 ITEMS
❑ e Misc.Conduits&.Conductors TOTAL' 40 m 0C)
I,as owns f the property,Will do the work and the structure l
is not 1 nded or offered for sale (Section 7044,:Business Other(See Complete Fee Schedule)
and P essions Code). ® '+HECK �rq°QO
CONSTRUCTION LENDING AGENCY # I CHANGE
I hereby affilm that there is a construction lending agency for the i
perform nce of the work for which this permit is issued.(Sec.3097, PERMIT FEE p (Sub-Total)
Civ,C.). 0 4�—fl1301 4/ 4/90
• PLAN CHECKING FEE I
Lender's.Name � E
9896 1 AM 7°411
PERMIT ISSUING FEE
Lender's Address
I certify that.I,have read this application and state that.the abode TOTAL'FEE
information Is correct.I agree to comply with all County ordinances
and State laws regulating Electrical wiring, and hereby authorize.
representativei of this County to enter upon the above-mentioned
property or�� CL mapsction pd-� %T�/\/ SEE REVERSE FOR EXPLANATORY LANGUAGE ,
C 9 / V
Signature of Permittee Date