HomeMy Public PortalAbout10643 OLIVE ST_Electrical__ CITY,
IAGSS-CESCS 10-61 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER F
LDING
BUILDING AND SAFETY DIVISION ADDRESS."m .8 �.
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A.JENSEN,SUPT OF BUILDING ALITY
REST
FOR APPLICANT TO FILL IN SS ST. _
I T E M NO. EACH FEE -
oUTLE'1S (FIRST 20) 3 '$ $ OWNER'
LIGHTS RECEPT. SW. •2O O MAIL - -- --
OUTLETS: (ADD'L UNITS) 1O ADDRESS
LIGHTS RECEPT. SW. ,
LIGHTING FIXTURES. (FIRST 20) tPO CIT ++ TEL.NO.
LIGHTING FIXTURES: (ADDITIONAL) .10 ELECTRICIAN Co s�f�
RANGES CLO.DRYERS WTR:HTRS. 1.00 ADDRES, V��•
GARB.DISP. STA.COOK Cl TEL.NO. O
DISHWASH. AUTO.-WASH. STATE / O j
SPACE HTRS. STA.APP.(Va'H:P.MAX.)' .50 LICENSE NO. 10 /
MOTORS: OVER NOT OVER H.P. DISICT NO. GROUP Z NE PR ESSED Y
O 1 1:00 -
1 5 1.50 INSPEC .1 15ECO.RD
S 8 2.00 a
8' 15 .2.50 U
1550 5.00 ahs 1 Aw"." .r4rr !/ _
s0 100 1 jr,.00 ► f�/` �.. I'/#-. •�'� f/
I fir' Ir" /a D.
SIGNS: NO.TRANS.
NO.LAMPS
i' .rte✓i r .
SERVICE 0.000V-NOT OVER 200A 1.00 1 rY•G.' °3-4 4`t�:t'�1 I/'n" -
SERVICE 0-600V-OVER 200 A. 2.00 `_. �}- e`
V- i'' °G'Gs' 2:�• /_,w'A<3 •&
SERVICE OVER 600V 5.00.
N 21t.
misc. v
PERMIT ISSUING FEE 2.00duo
SUPPLEMENTARY jPERMIT 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 n
ELECTRICAL WIRING. WIRING �✓/ Y
I HEREBY CERTIFY THAT 1 AM PROPERLY. REGISTERED AND/OR
LICENSED AS REQUIRED 13Y LOS ANGELES COUNTY AND'STATE OF FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIOENTI ROPERTY. POWER _
SIGNATURE • UTILITY CO.NOTIFIED
OF PERM[TTE FINAL
OLIDATION ARTHUR C. VETT r
KMO CASH SUPERVISING ELECTRICAL ENGINEER
- Li Uo 8124(- DEC 7 2:p 4.20-
�.
F `TcMPLGet�'.
16AS63-CES06 6-62 APPLICATION FOR ELECTRICAL PERMrT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS: C�
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A.JENSEN,SUP'T OF BUILDING LOCALIT ode
1 -
NEAREST Ll
FOR APPLICANT TO FILL IN CROSS ST. L /u-0'v i.6 A w�
RECEPT. TOTAL NO. EACH FEE
OUTLETS FIRST 20 ffi 2O ffi OWNER
LIGHT MAIL g
ADO'L 10 ADDSEB C.
SWITCH. OVER 20
CI TEL.NO. '� Q
LIGHTING TOTAL l FIRST 20 .20
FIXTURES 1 ADO'L �p ELECTRICIAN
OV9R 20
RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRES .:r o
GARB.DISPJ,-'O' STA.COOK
CITY TEL.NO. O O
DISHWASH. AUTO.-WASH. STATE G/
81-ACE HTRS. BTA.APP (V=X.P.MAX.) .50 LICENSE.NO. Q
MOTORSs OVER NOT OVER H.P. DISTRICT NO. GROUP ZONE PROCESSED BY
0 1 .1.00 08 A - f eleD10
1 3 1.so INSPECTION RECORD.
s a 2.00
a to 2.50
15 so 3.00 a
so 100 5.00 0
SIGNSs NO.TRANS. cc
NO.LAMPS Q
SERVICE 0.600V-NOT OVER 200A 1.00 Lli
b
SERVICE 0.600V-OVER 200 A. 2.00 N
SERVICE OVER 600V 5.00 ?
MISC.
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE ffi
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INWRCTOR'B 610MATURE -
AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY CONDUIT / a
WITH ALL-COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY L06 ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL ROPERTY. POWER
SIGNATURE UTILITY CO.NOTIFIED
OF PERMITTEE FINAL /lY�n J �'r%sv _%`s ✓�
�LI ARTHUR C. VETT
- C MOO CAS CASH SUPERVISING ELECTRICAL ENGINEER
L jUo 4 2 5 G'ia' i:Ay 3 2 D 2.5 0
'°"°°'`e °°°R,°''' APPLICATION F R ELk7RICAL PERMIT
,1Ol7NTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER JOB / t
j BUILDING AND SAFETY DIVISION ADDRESS V
3 OU
FOR APPLICANT TO FILL IN LOCALITY LI
New Residential Bldgs.&Pools EACH NO. FEE NEAREST
$ —
1 &2-Family,Sq.Ft. 4 025 $ CROSS ST.
OWNER OR
Multi-family Sq.Ft. 02 — FIRM.NAME
Residential Swimming Pools 25.00 DDRESS L (�
Outlets:Rec��LightvSw.-7-- CITY Tel'.No.
First 20 •50 PLAN.CHE K
Total No. Additional .30 APPLICANT
ADDRESS
Lighting Fixtures First 20 .50 CIfiY Tel.No.
Additional .30 PERMIT
Total NO. �_ APPLICANT
Fixed Appliances Not Over 1 HP 'ADDRESS
Range_Heater_D.W. CITY
Oven—Dryer�W.M.J� LICENSE OR
Top —FAU —W.H._ REG.NUMBER Class.
Hood_Fan _Other- I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE
Disp. _Room Air Cond. .2.50 THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDIN-
ANCES AND STATE LAWS REGULATING ELECTRICAL WIRING.
Power Apparatus&Large Appliances
Size&Type HP,KW,KVA,or KVAR I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM
Up to 1 Incl. 2.50 THE LEGAL OWNER OF THE ABCRIBED RESIDENT PROPERTY: C
Over 1 to 101ncl. 5.00
Over 10 to 50 Incl. 12.50 PERMITTEE c
Over 50 to 100 Inc. 25.00 SIGNATURE. b
Over 100 40.00 DISTRICT NO. P ESS BY H
Services
200 Amp Under'600 V 12.50 APPROVALS ISIGNATURE
NSPECTOR'S201-1000 Amp.Under 600 V 25.00
Over 1000 Amp.or Over 600 V 50.00 TEMP.POWER POLE
Temp.Power Pole&Appurtenances ,
10.00 UNDERSLAB WORK
Sign with One Branch Circuit 10.00 ROUGH CONDUIT
2.00 WIRING
Additional Sign Branch Circuits
Misc.Conduits&Conductors 10.00 FIXTURES
Other(See Complete Fee Schedule! POWER AUTHORIZED �f
UTILITY CO.NOTIFIED
FIAL
PERMIT FEE (Sub-Total! NOTES
PLAN CHECKING FEE (One-Fourth Permit Feel
PERMIPISSUING FEE $7.00 7
TOTAL FEE L3
PLAN CHECK VALIDATION CK. M.O. CASH gEVALIDATION CK: M.O. CASH
.' R:�N 0 3 8.5 a
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE )r
WORKERS'COMPENSATION DECLARATION 1 76AB83 10181
h'fiereby 1Ilfirm' that I have a certificate of consent to self insure, CE-806.131 ARPUCATION FOR ELECTRICAL PERMIT
oP a certificate of Workers'Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY
copy thereof(Sec.3800,Lab.C.)
Policy No. Companl FOR APPLICANT TO FILL IN JOB �/
❑ EACH NO. FEE ADDRESS (�
Certified copy is hereby fyrnlshed. New Residential Bldgs.&Pools
❑ FilSFt
1 &2-Family, q. . $ — $ LOCALITY
Certified copy is filed'with the county building inspection
department. Multi-family Sq.Ft. NEAREST
CROSS ST:
Date Applicant Residential Swimming Pools OWNER OR
FIRM NAME
CERTIFICATE OF EXEMPTION FROM WORKERS' Rec Light Sw. y�_ MAIL.
J
COMPENSATION INSURANCE Outlets: / ADDRESS. e
(This section need not be completed If the work Involved by theFirst 20
permit is for one hundred dollars($100)or less.) Total No. Addi4tional CITY C , Tel.No.
I certify that in the performance of'the work for which this permit PLAN CHECK
is issued,.) shall riotemploy any person in any manner so as to APPLICANT' ,
become subject to the Workers'Compensation:Laws. Lighting Fixtures First 20 ADDRESS
Additional
1 Total No.�'� CITY Tel No.
Date Applicant Fixed Appliances Not Over 1 HP. ,
NOTICE TO,APPLICANT: If, after making this Certificate ofPERMIT
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. _
,
., LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other_ CITY Tel..-No.
I hereby affirm,that I am,licensed under provisions, of Chapter 9 LICENSE OR
(commencing,with Section 7000)of Division 3 of the Business and Disp. — Room Air Cond. REG.NUMBER Class'
Professions Code,and.my license is in full force and effect. DISTRICT No. PROCESSED BY
Power Apparatus&Large Appliances _
License Number —Lir-Class
Size&Type HP,KW,KVA,or KVAR �O n
Up to'1'Inc]. FINAL
Over 1 to 10 Incl. DATE v VALIDATION �.
Contractor Date Over 10 to 50 Iricl. FINAL
❑ I am exempt under Sec. Over 50'to 100 Inc.
BY
W
BAP.C.for this reason Over 1.00 NI
'Services,Swbd.,MCC&Panelboards Z
Date: 0-200 Amp.Under 600 V
Signature 20.1 1000 Amp.Under 600 V
Over 1000 Amp.or Over 800 V
❑ Exemption for Reg.Maint.Elect.
SINGLE FAMILY Temri,Power Pole&Appurtenances ,
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit _
I hereby affirm that I am exempt'from the Contractor's License taw Additional Sign Branch Circuits
for the following reason.(Section 7031.5,Business and Professions
Come): 329'17
I,as owner of the property,wMisc.Conduits&Conductors
is
do the work and the structure
is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) _
and Professions.Code). ►, H
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) '� Etr:'3� _'-'
Civ.C.).
PLAN CHECKING FEE
i1LLIJ.�Vv'1�.,1 lir' F�r"i=.
Lender's Name PERMIT ISSUING FEE
Lender's Address Joe'.
I certify that I have read this.application and state that the above TOTAL FEE; �Q
information is correct.I.agree•to comply with all County ordinances
and State laws regulating Electrical wiring, and hereby authorize
representatives of his County toe r upon the above-mentioned
propert for l e ion purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
$lg ure o Permittee ttat -14e ,