HomeMy Public PortalAbout9070 OLIVE ST_Electrical__ 76A688-CE606-I1-WAP.PLICATiON FOR•'E•LECTRIC PERMIT 1`
COUNTY OF LOS XMELES
DEPARTMENT OF COUNTY ENGINEER BUILDIN �' ,Grlr I
BUILDING AND SAFETY DIVISIONDhESS
*Rf11L*4 tp
CAILTT D. GENF90S t o! 111 9 LOCALITY
NEAREST r
FOR APPLICANT TO FILL IN CROSS ST.
PERM FEES
ITEM NUMBER EACH FEE OWNER
'
OUTLETS $ $ MAIL
LIGHTS RECEPT. SW. fl .1O ADDRESS
LIGHTING FIXTURES 1 .10 CITY TEL.NO.
ELEC.RANGES 'CLO.DRYERS ELECTRICIAN
WATER HEATERS .50 ,,,_/•
ELEC.SPACE HTRS. DISHWASHERS ADDRESS - A'(61� • !'�. C.•t C i`P
GARBAGE DISPOSERS AUTO.- CITYGer% ll:n?y�TEL.NO. A
WASHERS STA.COOKING UNITS .28 ATE
LICENSE NO . .L7 0-/ O�
MOTORS: OVER INC. H.P.
o— 1/2 .28 DIS R C O. IGROUPIZONE READY FOR INSPECTION
jqoo
1/2 — 2 .50
2 - 5 1.00 MSPSCTION RECORD
a — Is 1.50
is — SO 2.80
50— 200 8.00
SIGNS: NO.TRANS.
NO.LAMPS
SERVICE 0-000V 1.00
SERVICE OVER GOOV 8.00
MISC.
WIRING PERMIT 1.00
FIXTURE PERMIT 1.00
SUPPLEMENTARY PERMIT .50'
TOTAL FEE g APPROVALS
I HEREBY ACKNOWLEDGE THAT I HAVE READ 'THIS A C ON DATE INSP.ECTOR'SSIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE T0. COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS• REGULATING
ELECTRICAL WIRING. WIRING /Y✓ -/
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR x.
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE POWER
DESCRIBED RESIDENTIAL PRQPERTY. J
SIGNATURE /_ UTILITY CO.NOTIFIED
OF PERMITTEt FINAL y C r
f VAUDATO S) ARTHUR C.VEIT.
CK NO• cASH
SUPERVISING ELECTRICAL NEER
� 2 7 6 7 0 JUL 14 'i' 2 A 6 2.3 0 �°
WORKER'SCOM�ENsaTI.ON DECLARATION 76A6s3 DPW(12-91.1 APPLICATION FOR ELECTRICAL PERMIT IJ
heFeby,,.�fffrm;tli.tt•I have a certificate of consent to self insure.,
or a cei !cafe of Wbrker's.Compensation. Insurance,or a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY'DIV:
copy thereof(Sec.3800 Lab.C.)
�1 /�. FOR APPLICANT TO FILL IN JOp 3f
Z-9-2 LLL P Y � [— � - ADDRESS
(!
Poli: No: Com an
Cerfified'copy'is hereby'furnished. New Residential Bldgs.&PoolsFEE LOCALITY �r
' -. 1.&2-Faniil..Sq.Ft.� NO - -
EACH,
Certified.copy is filed.with the county building inspection y q NEAREST
department. Multifamily Sq.Ft: CRoss.sT. IZA
Date Applic..ant Residential Swimming Pools ASSESSOR
MAP BOOK . ?� PAGE G�iJ:(p PARCEL O"�'7
CERTIFICATE OF EXEM..F FROM WO AS' Z
Outlets:Rec. I ht Sw.. OWNER OR
COMPENSATION INSURANCE g First 20 FIRM NAME --
This section need riot be:com leted if the w.otk Involved b the ' p� 1. '
�O
(. P ... Y may. %O't'�' ADDRESS - -
permit is for.one hundred'dollars.($100)or less.)
Total No. Additional :. - - Q D -
I.bertify that in the performance of the work for which this permit CITY I.No.
is issued, I shall not employ any'person:in any manner so as to V0 D PLAN CHE K
becom.e,subject to the Workers'Compensation Laws. Lighting Fixtur First 20 APPLICANT
Total No Additional
DDRESS
Date. Applicant RESIDENTIAL APPLIANCES NOT..OVEFt 8 FIR. d.
NOTICE,TO.APP.LICANT: If, ,after Making- this-Certi.ficate of CITY Te.I:No..
Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HIS.
rovisions of the Labor Code,you must forthwith comply with such PERMIT
P Y. . P Y - - APPLICANTA 1U6,
provisions or this pe rmit;shall'-:be deemed.revoked. Power Apparatus&Large Appliances
LICENSED CONTRACTORS DECLARATION Size&.Type HP,KW,.KVA;or KVAR. ADDR-
v ESS
I hereby affirm that i. Ain licensed under provisions.bf Chapter 8 Q _� Over 3 to 10 Incl: + -
(commencing with.Section 7000)of:Division 3 of the Business and n Ci1Y � Tel.No. Z
Over 10 to 50 Incl.
Professions Code...and my license is in full force and effect. LICENSE OR
Over.50 to 100 Incl:- REG..NUMBER Class.+ .-: �� O
L - Over TOO DISTRICT NO. gg �.ROCESSED BY .V
X.
License.Nurnber Lic.Class A . ..
rvices,S M C&P elboards � 0
FINAL
Contractor, Date „ 3..8 mp.Under 600'V DATE / I-
400-1000 Amp.Under 600 V
❑ exempt.. er.Sec, VALIDATION LU
Over 1000 Amp.p Over 600 V FINAL C p.
B.&R:C.for this reason BY co
BRANCH CIRCUIT FEES•
Date: 15A,or 20A,120V,Lighting or Race pt. —
1 To 10 Branch Circuits
Signature 11 To 40 Branch Circuits41 Or Or Mofe:Branch Circuits
Exemptibn for Reg.Maint.Elect. 15A,MA,208V To 2M.Lighting Br.Circuits 2
SINGLE FAMILY Temp.Power Pole.&Appurtenances ACCT i
s
HOME OWNER-BUILDER DECLARATION
I hereby'affirm that•I am exempt from the Contractor's-License Law Sign with One Branch Circuit ..301.-, r� o
for the following reason (Section•7037:5, Business and Professions Additional Sign Branch Circuits '� '
Code): i TTEMS,.
❑ I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors
Is not intended or,offered for sale(Section 7044, Business Other(See Complete Fee Schedule) C
TOT
.and Professions Code). , �`}[��� 19�'n`6,5
CONSTRUCTION LENDING AGENCY CHANGE. POO
I hereby affirm that there is a construction.lending agency for the j Q
performance of the work for which this permit is Issued.(Sec. 3007, PERMIT FEE (Sub-Total) /•�✓
Civ,C.)
PLAN CHECKING FEE 0000-00011 7/16/T3
Lender's Name58
PERMIT ISSUING FEE 0939 �' AM10--58
Lender's Address /
I certify that I have,read.this application Viand under penalty of:purjury state TOTAL FEE
that the above 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
81 RE OF PERMrrr DATE