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HomeMy Public PortalAbout10569 OLIVE ST_Electrical__ r6A663F- ES 613 12/75 O FOR ELECTRICALPERMIT APPLICATION0 BUILDI AND SAFETY D, SION FOR APPLICANT TO FILL IN JOB ADDRESS /)©7�+ O ;° / •e, q.., �e EACH NO. FEE . `� 6 New Residential Bldgs.&Pools 1 &2 Finaily Sq. Ft. $ — $ LOCALITY 4-M Multi-family Sq.Ft. — NEAREST Residential Swimming Pools CROSS ST. OW OR �• FIRM NAME y L.It Odtlets: Light,Switch&ReceptacleMAI L i First 20 b ADDRESS 0, 4161. vo FrFlWe- It /Q`IGN/d)7/— Additibnal CITY 4�a. T.I. No'. PLAN CHECK iLighting Fixtures A APPLICANT First 20 ADDRESS Additional CITY Tel. No. WK Fixed Appliances Not Over 1 HP APPLICANTCT7/,?uAP" k`7t�M Range_ Heater_ D.W. _ t Oven _ Dryer _ W.M. _ ADDRESS- 4Q O O/taft Yr p/QGG Top _ FAU _ W.H. _ CITY Gfjpre/y M7 Tel. No. 7 !b >- Hood Fan ^, LICENSE G NUMBECD R y`Z �3�� Class: dpya Disp. A.C. 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION Q AND STATE THAT THE ABOVE IS CORRECT AND ACRES TO COMPLY V Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES A-NO STATE LAWS REGULATING W Size&Type HP,KW,KVA,or KVAR /p /� ELECTRICAL WIRING, y (/ Up to 1 Incl. I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR Over 1 to 10 Incl. 1O-V LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE Over 10 to 50 Incl. DESCRIBED RESIDE TI PROPERTY. Over 50 to 100 Incl. PERMITEE Over 100 SIGNATU Services DISTRI T SSED BY 0-200 Amp. Under 600 V 52 201 -1000 Amp. Under 600 V APPROVALS DATE IN CTO 'S Over 1.000 Amp.or Over 600 V SIGNATURE TEMP.POWER POLE Temp.Power Pole&Appurtenances UNDERSLAB WORK Sign with One Branch Circuit Additional Sign Branch Circuits ROUGH CONDUIT (Other) WIRING FIXTURES POWER AUTHORIZED PERMIT FEE (Sub-Total) UTILITY CO.NOTIFIED PLAN CHECKING FEE (One-Fourth Permit Fee) A/-6-J*D FINAL PERMIT ISSUING FEE NOTES - TOTAL FEE PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH ' - 2 .9 tifi9AY 16 2 @ 1 .8 0 a YCI- 7SA663-CES06 8-62 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES ` DEPARTMENT OF COUNTY ENGINEER BUILDINGR. - LIGHT BUILDING AND SAFETY DIVISION ADDRESSJOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A.JENSEN,SUP'T OF BUILDING LOCAL]NEARESTFOR APPLICANT TO FILL IN CROSS ST.RECEPT. TOTAL NO. EACH FEE OUTLETS FIRST 20 $2O $ OWNER MAIL _ SWITCH. OVER 20 .10 ADDRESS 07 LIGHTING CITYA IL TEL.N 1 TOTAL FIRST .20 FIXTURES 1 ,10 ELECTRICIAN C� R OVvgR 2O 2 BANG S CLO.DRYERS WTR.HTRS. 1.00 ADDRESS SII p�•7 • /�// ARB.DI8P STA.GOOK CITY y8 X.P.MAR.1 TEL.NO. DISHWASH. AUTO.-WASH. STATE / Imo" C/r, SPACE HTRB. BTA.APP.( `j'. .50 LICENSE NO. a 2- i/ MOTORS, OVER NOT OVER P. DISTRI T GROUP Z NE PR E BY O 1 1.00 1 3 1.50 INSPECTION RECORD s s 2.00 8 Is 2.50 f s 50 3.00 a so 100 5.00 0 SIGNS? NO.TRANS. NO.LAMPS [�0 SERVICE 0.500V-NOT OVER 200A 1.00 W o_ SERVICE 0-600V-OVER 200 A. 2.00 rA SERVICE OVER 600V 5.00 ? MISC. PERMIT ISSUING FEE 2.00 SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE $ 1 HEREBY ACKNOWLEDGE THAT 1 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 0 ELECTRICAL WIRING. WIRING I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR ' LICENSED A8 REQUIRED Y LOS ANGELE COUNTY A STATE OF FIXTURES CALIFORNI t AM TH G. NER Op? ABOVE DESCRIBED RESIDE 1 L ROPE POWER SIGNATURE 8 UTILITY CO.NOTIFIED OF PERMITTE W5t FINAL e,V�LIDATION ARTHUR C. VEIT UCK MO CASH SUPERVISING ELECTRICAL ENGINEER Lltl,o 5 6 9 0:G FEB 18 2 B 3.0 0 GA668-CEBOS 10-62 APPLICATION FOR I E LECTR.ICA PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEERfAD NG BUILDING AND SAFETY DIVISION SS j JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A.JENSEN,SUPT OF BUILDING ITY Q ST FOR APPLICANT TO FILL IN CR sT. RECEPT. TOTAL NO. EACH FEE d OUTLETS FIRST 2O � s8 20 111 R LIGHT 6 SWITCH. OVERADD,20 .10SSLIGHTING lTOTAL FIRST 20 .20 TEL.NO.FIXTURES I _I ADD'L 1O TRI AN 11 OVER 20 , RANGES CLO.DRYERB WTR.HTRB. 1.00 ADDRESS GARB.DISP. STA.COOK CITYEL.NO. DI8HWA8H. AUTO.-WASH. STATE ^7 SPACE HTRB. STA.APP.(y=N.P.MAX.) .50 LICENSE, O. MOTORS: OVER NOT OVER H.P. DIST I2CT G P ZONE 171Z=Y O 1 1.00 1 8 1.50 INSPECTION RECORD a is 2.50 /' "�✓ �... V 15 So 8.00 ' • (% O s0 100 5.00 r SIGNSt NO.TRANS. / "'• ✓ �`` y NO.LAMPS / SERVICE 0-600V-NOT ovER 200A 1.00 SERVICE O.600V•OVER 200 A. 2.00 SERVICE OVER 600V 5.00 MISC. PERMIT ISSUING FEE 2.00 SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APP CATION 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. WIRING 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR - _LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT I AM THE LEGA OWNER F TH AB E •v , DESCRIBED RESIDENTIAL P POWER SIGNATURE IUTILITY CO.NOTIFIED T • d_ OF PERMITTEE s / f• �.e..�• e-� -% LIDATION ARTHUR C. VEIT MO CASH SUPERVISING ELECTRICAL ENGINEER C. U.L03 4 3 812 DEC i2 2 D 4.00- q 'WORKERS"COMPENSATION DECLARATION 76-683 ,0/8, APPLICATION FOR ELECTRICAL PERMIT r t �• 'CE-806G I F�ereb)f,affirnk that I have a certificate of consent to self insurer ° Iu' or a certificate of Workers'Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY ropy;hereof(Sec.3800,Lab:C.) policy No. . Company FOR APPLICANT TOTILL IN- JOB❑ EACH NO. FEE ADDRESS Al�/! fm 5T- Certified copy is hereby furnished. New Residential Bldgs.&Pools ..-� ❑ 1 &2-Family,Sq.Ft. $ _ .$ LOCALITY Certified copy is filed with the county building inspection NEAREST department. Multi-family Sq.Ft. CROSS ST. Residential Swimming Pools OWNER OR -^ Date Applicant FIRM NAMEi CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:. oP`vZ ' MAIL • COMPENSATION INSURANCE Re Light Sw.L- �o .ADDRESS �(,Z,. (This section need not be completed if the work involved by the First 20 oc permit is for one hundred dollars($100)or less.) ' Total No.—A— Additional CITY S Tel.No. I.certify that in the performance of the work for which•this permit PLAN CHECK is'issued,.I shall not employ any person in-any manner so as to APPLICANT + become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 Q. ADDRESS Additional s• .g Total No. � CITY Tei.No. X Date Applicant NOTICE. TO APPLICANT: If, after m in thi Certific of Fixed Appliances Not Over 1 HP } PERMIT g _ '_ Exemption, Range Heater D.W. APPLICANT you should become subject to the Workers'Compensation i provisions of the Labor Code,you must forthwith comply with.such Oven Dryer_ W.M._ ADDRESS provisions or this permit shall,be deemed revoked. :Top FA.0 _. W.H. _ CITY-' :+ Tel.No: LICENSED CONTRACTORS.DECLARATION Hood — Fan _ .Other_ I hereby affirm that: I am licensed under provisions of Chapter 9LICENSE OR IDisp. — Room Air Cond. REG.NUMBER Class. (commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. Po"r Apparatus&Large-Appliances DISTRICT NO. 1 PROCESS BY ;Size&Type HP,KW,KVA,or KVAR v r License Number Lic.Class Up to 1 Incl. FINAL)� ' Over 1 to•10lncl: DATE. VALIDATION - Contractor Date. Over 10 to 50 Incl. U FINAL C� ❑• I'am exempt under Sec. I Over 50 to 100 Inc. BY W .Over 100 �- BAP.C.for this.reason l to Services,Swbd.,MCC&Panelboards Date: 0-200 Amp.Under 600 V Signature 201 - 1000 Amp.Under 600 V ❑ Over 1000 Amp.or Over 600 V L , Exemption for Reg.Maint.Elect: SINGLE FAMILY Temp.Power Pole&Appurtenances .HOME OWNER-BUILDER.DECLARATION Sign with One,Branch.Circuit ' 41 I hereby affirm that I am exempt from the Contractor's License Law for the following reason(Section 7031.5,Business and Professions Additional Sign Branch'Circuits y g Code): 6 8,a Gf to ., Mise:Conduits&Conductors TOTAL❑ •I,as owner of the property,will do'the work and the structure ' 40,:,S2 is not intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule) _ IC CHCK and Professions Code). r �' 40.50 CONSTRUCTION.LENDING AGENCY u I hereby affirm that there is a construction lending agency for the Performance of the work for which this permit is issued(See.3087, PERMIT FEE (Sub Total) PLAN CHECKING FEE tender's Name PERMIT ISSUING FEE. Lender's Address I certify that I.have read this application-and state that the above TOT/IL FEE S 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 - elg:y Sig atu f-PermitteyDate I, - :• ' .WORKERS'COMPENSATION DECLARATION ,7SAe63 10/81 APPLICATION FOR ELECTRICAL PERMIT,. I hereby affirm that I have a certificate of consent to self insure, PCE-8o8G or a certificate of Workers'Compensation Insurance, or a certified I COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec.3800,Lab.C.) ^I ' 0 No. Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished. EACH NO. FEE DDRESS New Residential Bldgs.&Pools A ❑ t. $ _ $ LOCALITY Certified copy is filed with the. county building inspection 1 &2-Family,Sq.F department. Multi-family.Sq.Ft. NEAREST A' CROSS ST.. /�✓Z %� Date Applicant Residential Swimming Feols OWNER OR FlRM NAME 145p ZAsv . 6 ,&e,,ao• ? CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL COMPENSATION INSURANCE Outlets:Rec—Light—Sw.—: ADDRESS lax?, '9 0 1/L. S (This section need not be completed If the work involved by the First 20 permit is for one hundred dollars($100)or less.) Total No. Additional PLAN CITY Tel.'No. I certify that in the performance of the work for which this permit 'APPLICANT CHECK' Is issued, I shall not employ any person in any manner so as to 1 become subject to the Workers'Compensat' n Laws. Lighting Fixtures First 20 -ADDRESS ,�/� Total No. , Additional CITY Tel.No. Date i o Applicant — Fixed Appliances Not Over'1 HP PERMIT NOTICE TO APPLICANT: If,: after making this Certificate of APPLICANT 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 provisions or this permit shall be deemed revoked. Top _ FAU _ W.H. CITY .Tel.No. LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other_ I hereby affirm that I. am licensed under provisions of Chapter 9LICENSLICENSE OR. Disp. - Room Air Cond. REG. UMBER Class. (commencing with Section 7000)of Division 3.of the Business and Professions Code,and.my license is in full force:and effect. Eo BY Power Apparatus&Large Appliances DISTRICT NO.: ..•�• t Size&Type HP,KW,KVA,or.KVAR 0 License Number Lic.Class Up to 1 Incl. FINAL. V Over 1 to 1.0 Incl. DA � VALIDATION Contractor Date Over 10 to 50 Incl. U FINAL ❑ I am exempt under Sec. Over 50 to 100 Inc. BY {yl ( 0. I B&P.C.for this reason, Over 100 v N l Services,Swbd.,MCC&Panelboards / NON.Date: 0-200 Amp.Under 600 V ( e3 Signature 201 - 1000 Amp.Under 600 V x Over 1000 Amp.or Over 600 V ❑ Exemption for Reg.Maint.Elect. 3307 'SINGLE FAMILY Temp.Power Pole&Appurtenances 02 HOME OWNER-BUILDER DECLARATION Sign with One:Branch Circuit ��! 7 I hereby-affirm that I am exempt from the Contractor's License Law a for the following reasonAdditional Sign.Branch Circuits t+ G ..(Section 7031.5,Business and Professions 2 ITE I Code): TOTAL °� Misc.Conduits&Conductors L`_1 I,as owner of the property,will do the work and the structure Other(See Complete Fee Schedule) _ DI I is not intended or offered for sale (Section 7044, Business I and Professions Code). poll. ( I AN r1fF i CONSTRUCTION LENDING AGENCY 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) Civ.C.). PLAN CHECKING FEE Lender's Name I PERMIT ISSUING FEE Lender's Address I I certify that I have read. this application and state.that the.above TOTAL FEE information is correct.I agree to comply with.all County ordinances I ' a and State laws. regulating Electrical wiring, and hereby authorize representatives of this County to enter upon the above-mentioned ;I property for Inspection purposes. t' SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee D to WORKER'SCOMPENSATION DECLARATION I 20.0019 DPW(12.91) I her ebyi ffirm that I have a certificate of consent to self insure, 76A663. APPLICATION FOR ELECTRICAL PERMIT MS a certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof'(Sec.3800 Lab.C. Ir Policy No. Company FOR APPLICANT TO FILL IN I JOB n 1 ADDRESS DS O /✓-e �J ❑ Certified copy Is hereby furnished. I FNewesidential Bldgs.&Pools NO. EACH FEE LOCALITY&2-Family,Sq.Ft. _ $ $ / Certified copy Is filed with the county building inspection I NEAREST department. Multi-family Sq.Ft. CROSS ST, Date Applicant Residential Swimming Pools MAP BOOK PAGE PARCEL t� CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec. !Light � Sw._!4__ OWNER OR NAME. COMPENSATION INSURANCE _ 1. ,j o This section need not be com leted If the work Involved b the .r, First 20 MAIL 1 ( P y Total No.le� Additional ADDRESS permit Is for one hundred dollars($100)or less.) I certify that in the performance of the Work for which this perm t ( CITY C rel.No. is issued, I shall not employ any person in any manner so as t . PLAN;CHECK become subject to the Workers"Compensation Laws. Lighting Fixtures First 20 APPLICANT Total No. Additional I ADDRESS ' Date Applicantl NOTICE TO, APPLICANT: If; after making this Certificate olf RESIDENTIAL APPLIANCES NOT OVER 3 HP. •I CITY Tel.No. ' Exemption,you should become subject to the Workers'Compensatio p1 OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code,you must forthwith comply with sucFl PERMIT p p y Power Apparatus&Large Appliances � APPLICANT provisions or this permit shall be deemed revoked. ;I I LICENSED CONTRACTORS DECLARATION II Size&Type HP,KW;KVA;or KVAR 1 ADDRESS I hereby affirm that 1 am licensed under provisions of Chapter 9 Over 3 to 10 Incl. (commencing with Section 7000)of Division 3 of the Business and CITY Tel.No. II Over 10 to 50 Incl. Professions Code,and my license Is in full force and effect. � LICENSE OR � Over 50 to 100 Ind. I REG.NUMBER Class. d Over 100 I DISTRICT NO. P C SED BY V License Number Lic.Class Services,Swbd:,MCC&Panelboards � 0-399 Amp.Under 600 V FINAL O Contractor Date I I DATE ` I— ❑ 400-1000 Amp.Under 600 V I V r 1 V I am exempt under Sec.. VALIDATION LL1 Over 1000 Amp.or Over 600 V ' a B.&P.C.for this reason FINAL CIRCUIT FEES I BY CO. I Date: i 15A,or 20A,120V,Lighting or Recept. i _ 1 To 10 Branch Circuits Signature ,I 11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits Exemption for Reg.Maint.Elect.. i 15A,20A;208V To.277V Lighting Br.Circuits: I + M SINGLE FAMILY Temp.Power Pole&Appurtenances. t HOME OWNER-BUILDER DECLARATION I I s I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit KCTo4 for the following reason(Section 7031.5, Business and Professions Additional Sign Branch Circuits3303. 57.11,10 I�®Ji I,as owner of the property,will do the work and the structur; Misc..Conduits&Conductors � I ITEMS is not intended or offered for sale(Section 7044, Busines Other(See Complete Fee Schedule) , TOTAL 57.00 and Professions Code):. _ CONSTRUCTION LENDING AGENCY I CHECK, `� j I hereby affirm that there is a construction lending agency for the i; CHANGE ,til] performance of the work for Which this permit Is issued(Sea. .309 7, PERMIT FEE (Sub-Total) Civ.C.) PLAN CHECKING FEE Lender's Name / I � ���0001 �� � ? PERMIT ISSUING FEE (p +� °1 Lender's Address I 76 I certify that I have read this application and under penalty of purjury stat. TOTAL FEE 1372 that the above information is correct. I.agree to comply with all Count ordinances and State laws regulating Electrical wiring,and hereby authorize representatives of this County to enter upon the above-mentioned propert for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE sieNATURE OFPERMITTEE DATE