Loading...
HomeMy Public PortalAbout9216 OLIVE ST_Electrical__ D55 5--A5-45APMCATION FOR IPERR1 VECMTMNTOY ]MUMBQNG MD SAL COUNTY ®IF LOS MGMES ELECTRIC IMM. J. FOX CHIEF ENGINEE=R a NAME DIS`TRIC�NO. GROUP ZONE PERIIAIT NO. 0 ADDRESS !'�� / e 1' Y RECEIVED BY READY FOR DATE.ISSUED CITY C TEL.NO. FIRST INSPECTION .1 COUNTY R C`l ,"" el?N CERT.NO. / EXPIRES APPLYCANT FILL IN HEAVILY OUTLMD PORTION ONLY JOB IDESCREMON OF WORD ADDRESS /e NUMBER OF OUTLETS ON CIRCUITS LOCALITY Ali LOCATION BY ROOMS NEAREST LIGHT OUTLETS 1SW. PLUGS FIILT CROSS ST. l1/ CIRCUIT A B C D E F G H E NAMEA/k,"i 1'J} Z MAIL! 3 ADDRESS fl/.-.�phml .. �i ° CITY 7r ��i kA `i II TEL.NO.4/Y/-_y ` (` 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANG COUNTY CERTIFICATE OF QUALIFICATION.. ELECTRICIAN. I OA$'THIO LECIAL OWNER OF THE PROPERTY DESCRIBED AB q OWNER. ' COBREMONS J Q Z_ R R D TOTAL ,NO. OF OUTLETS $ APPROVALS 1 NO. OF FIXTURES $ DATE INSPECTOR'S NAME s NO. OF MOTORS H.P. $ CONDUIT NO. OF SIGNS TRANS. $ WIRING f ! V R I-,-$ NO. OF RANGES OR HEATERS FIXTURES M.ISCELLANEOUS $ POWER PERMIT FEE $ '�f ti UTILITY CO.NOTIFIED TOTAL FEE �� `-�� FINAL DS S-A12-43 25M DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PEIiM1T COUNTY OF LOS ANGELES ELECTRIC j WM. J. FOX CHIEF ENGINEER NAME DISTRICT NO. GROUP ZONE, PERMIT NO. U ADDRESS n/►� / - ��" ry y 1 ,I BY CITY J f /FIO. � V� FIRST INSPECTION DATE ISSUED COUNTY CERT.NO. EXPIRES APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLYJOB DESCRIPTION OF WORK ADDRESS NUMBER OR OUTLETS ON CIRCUITSf/1fl•4J1� � LOCALITY LOCATION BY ROOMS NEAREST LIGHT OUTLETS SW. PLUGS Fl , CROSS T. / �?•M s \- t'I CIRCUIT A 113 C 10 1 E Fr. H m NAME q G�►.,ivyt.piL:I %;.L-9''•! J 3 MAIL AD RES3 I I Q ���-�� i /�.J� ��r�(J� 3 O CITY . �ie 11.4-,;? L al-!tl LTEL.NO./11.0 .-!a!& 1 AM THE LEGAL 'POSSESSOR OF THE ABOVE LOS ANGELES COUNT?V CERTIFICATE/OF QUALIFICATION.. t• 6L6CTRIGAN. ABO IK �j 913 MM PROPERM DESCRIBED r OWNER. CORRECTIONS J Q _Z m E O TOTAL S `� NO. OF OUTLETS f APPROVALS NO. OF FIXTURES S DATE INSPECTOR'S NAME NO. OF MOTORS H.P. S CONDUIT NO. OF SIGNS TRANS. I WIRING NO. OF RANGES OR HEATERS S FIXTURES MISCELLANEOUS / S POWER PERMIT FEE /.1 S { F. UTILITY CO.NOTIFIED TOTAL FEE �� FINAL 2 APPLICATION FOR ELECTRICAL PERMIT WORKERS'COMPENSATION DECLARATION 76A663 10/81 L` t''heip affirm that I have a ce"cate-of 6onsent to self insure; CE-806G or a certificate of Works V' Compensation Insurance,or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY_ copy therdbf(Sec.3806, Policy No. Company FOR APPLICANT TO FILL IN JOB DDRESS f r ❑ Certified copy is hereby furnished. New Residential Bldgs.&Pools EACH NO. FEE. $ _. $ LOCALITY o Certified copy is filed with the county building inspection NEAREST&2-Family,Sq.Ft. _ departme Multi-family Sq.Ft. NEAREST CROSS ST Date Applicant14 Residential Swimming PooJI& OWNER OR FIRM NAME' CERTIIACATE OF EXEMPTIO ROM WORKERS' Outlets:Rec L Light—Sw. MAIL COMPENSATION INSURANCE ADDRESS 01 Z (This section need not be completed if the work Involved by the First 20 permit Is for one hundred dollars($100)of less.) Total No. Additional CITY Tel.No. I certifythat'in the performance of the work for Which this permit PLAN CHECK P P -APPLICANT is issued, I shall not employ any person in any manner so as to become.subject to the Workers'Compensation Laws. I Lighting Fixtures. First 20 S ADDRESS Additional Date Applicant Total No. CITY Tel.No. NOTICE TO' APPLICANT: If, after making this Certificate of Fixed Appliances Not Over 1-HP PERMIT' Exemption,you should become subject to the Workers'Compensation, Range_ Heater_ D.W. APPLICANT provisions of the Labor Code,you must forthwith comply with such Oven Dryer_ W.M. ADDRESS— a 0. provisions.or this permit shall be.deemed revoked. Top FAU _ W.H. 1 CITYJ&_,&_ Tel:.N0.2" LICENSED CONTRACTORS DECLARATION Hood _ Fan Other- 1 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 ''�f .�; 7 Class: Professions Code,and my license is in full force and effect. DISTRICT NO, PROCESS , BY Power Apparatus&Large Appliances � � !' Size&Type HP,KW,KVA,or KVAR O SO( !cerise Num r Z�r; 7(:/ LIC.Class _ Up to 1 Incl. FINAL "' Over 1 to 10lncl. DATE. VA I ATION p ntrecto S' Date Over 10 to 50 Incl. T— CF=A I am Oempt under Sec. Over 50 to 100 Inc: FI W BAP.C:for this reason Over 100 N Services,Swbd.,MCC.&Panelboards Z Date: 0-200 Amp.Under 600 V •Signature 201 - 1000 Amp.Under 600 V Over 1000 Amp.or Over 600 V 8 7 6 3 A Exemption for Reg.Maint.Elect. SINGLE FAMILY Temp.Power Pole&Appurtenances o 0 0 0 0 2 HOME OWNER-BUILDER DECLARATION. Sign with One Branch Circuit. ereby affirm that I am exempt from the Contractor's License Law• I 0 6 1 9 0 0 r the following reason(Section 7031,5,Business and Professions Additional Sign Branch Circuits 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) _ 0 1: 1. 3­8 8 and Professions Code). , CONSTRUCTION LENDING.AGENCY hereby affirm that there is a'construct'ion 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 - . • PERMIT ISSUING FEE Q Lender's Address q 1 I certify that I have rea this application:and state that the above TOTAL FEE' r information is corre gree to comply with all County ordinances and State laws �I mg Electrical wiring, and hereby authorize. representatives f County to enter upon the above-mentioned Pro arty for' p. ' n.purposes. SEE REVERSE'FOR EXPLANATORY LANGUAGE' Signature o rmittee �. J 'PJWORKERS'COMPENSATION DECLARATION 78-8061 10/81 APPLICATION FOR ELECTRICAL PERMIT CE-806G I�ierepK.affirm that I.,hava a_c�rtlficate•pf consent to self insure, or!a certificate of Workers' Compensation Insurance, or a certified i COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec.3800,Lab.C.) Policy No. Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished. ' New Residential Bldgs.8 Pools I EACH NO. FEE ADDRESS S — ❑• Certified copy is filed with the county building inspection 1 &2-Family, q•Ft. $ $ LOCALITY— ,- department. Multi-family Sq.Ft: NEAREST Multi-family CROSS ST lll? Date Applicant Residential Swimming Pools OWNER OR �� / FIRM•NAME ' � 11 CERTIFICATE.OF EXEMPTION FROM WORKERS' MAIL •COMPENSATION INSURANCE Outl ts:Rao—Light t 2 — LUSADDRESS' ' 1 (This•section.need not be completed if the work Involved by the J First 20 permit is for one hundred dollars($100)or less.) T tai No. Additional CITY �� Tei.No.a I bertify'that in the APPLICANT performance of the work for which this permit PLAN CHECK is,issued; f 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._L_ CITY" Tel.No. � Date ��–� Applicant Fixed Appliances Not Over 1 HP PERMIT ! NOTICE TO .APPLICANT: If; r making this Certificate of Exemption,you should becomesubject to the Workers:Compensation .Range_ Heater_ D.W. _ APPLICANT 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. _, 1 1 CITY, 'Tel,No. ;. l ICENSED-CONTRACTORS DECLARATION ood _ Fa Otha TE �- I hereby affirm that I am licensed under provisions of Chapter 9 p sp. d+�n _ � LICENSE OR (commencing with Section 7000)of.Division 3 of the Business and � oom it ion . Class. I REG.,NUMBER Professions Code,and(ny license is in full force and effect. Power Apparatus&Large Appliances DISTRICT N.O. PROCESS(D BY Size&Type HP,KW,KVA,or KVAR (� p License Number Lic.ClassUp to I Incl. FINAL, Over 1 to 10 Incl. DATE' (� Contractor DateOver 10 to 50 Incl. FINAL 0 V IDATION 0 Elam exempt under Sec. ;i Over 50 to 100 Inc. BY 8 i BAP.C.for this;reason Over 100 N Seiv ces,Swbd.,MCC&Panelboards Z Date. 0-200 Amp.Under 600 V Signature 2101 - 1000 Amp.Under 800 V ' •Over 1000 Amp.or Over 600 V ❑ Exemption for Reg.Maint.Elect. ;.9 3'7.'1 A SINGLE FAMILY Temp.Power Pole.&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One,Brandi Circuit # 0 0 0 0 0 2 1 hereby affirm that I am exempt from the•Contractor's License Law for the following reason(Section 7031.5,Business and Professions. 1 Add i Tonal Sign Branch Circuits 0 1 625 Code): Mi.. Conduits&Conductors o 0 01 62576 I,as owner of the property,will do the work and the structure j is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) _ 1 and Professions Code). i 011101.1 4.12 x 8 8 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, PERUT FEE (Sub Total) Civ.C.). PLAN CHECKING FEE Lender's Name D i PER OIT ISSUING FEE Lender's Address I certify that I have read this application and state that the above TOTRL FEE ,a� I 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 purpo es. SEE REVERSE FOR EXPLANATORY LANGUAGE Si a ure 61Permitted Date WORKER'S COMPENSATION DECLARATION 2D.0019,DPW(12-91) AppLICATION FOR ELECTRICAL PERMIT 1 hereby affirm that (°'have a certificate of consent to self Insure, 76A663 or 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:) PoliLrNo. Company FOR APPLICANT TO FILL IN JOB of ADDRESS ❑ Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE LOCALITY 1 &2-Family,Sq.Ft. _ $ $ Certified copy is filed with the county building inspection NEAREST department. Multi-family Sq.Ft. CROSS ST. Date Applicant Residential Swimming Pools ASSESSOR MAP BOOK PAGE PAR CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec�Light sw: OWNER OR ME COMPENSATION INSURANCE First 20 D FIRM NAME Jecia (This section need not be completed if the work Involved by the ADDRESS permit Is for one hundred dollars($100)or less.) Total No. Additional' I certify that in the performance of the work for which this permit CITY Tel.No: Is issued, I shall not employ any person in any manner so as to • ro PLAN CHECK /� become subject to the.Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANT 'A. Total No. Additional 94 ADDRESS S Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP, NOTICE TO APPLICANT: If,• after making this Certificate of CITY Tel.No. Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. 04 provisions of the Labor Code;you must forthwith comply with such PERMIT provisions or this permit.shall'be deemed revoked. Power Apparatus&Large Appliances APPLICANT LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS I hereby affirm that I'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. Professions Code,.and my license is in full force and effect. Over 10 to 50 Incl. LICENSE OR Class. (l Over 50 to 100 InCI. REG.NUMBER Over 100 DISTRICT.NO. PROCESSED BY O License Number Lic.Class. U Services,Swbd.,MCC&Pa.n�elboards cc Contractor Date 0-399 Ame1'600 V 6 DATE O ❑ 400-1000 Amp.Under 600 V VALIDATION qj ' W I am exempt under Sec. Over,1000 Amp.or Over 600 V FINAL. IL B.&P.C.for this reason BRANCH CIRCUIT FEES BY co Date: 15A,or 20A,120V,Lighting or Recept. Z 1 TO 10 Branch.Circuits Signature 11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits 2 SINGLE FAMILY Temp.Power Pole&Appurtenances HOMEOWNER-BUILDER DECLARATION Sign with Orie Branch Circuit ACCT. I hereby affirm that I am exempt from the Contractor's License Law for the following reason(Section 7031.5, Business and Professions Additibnal:Sign Branch Circuits 209.07 Code): 1W1,as owner of the property,will do the.work and the structure Misc.Conduits&Conductors 1 ITEMS is.not intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule) TOTAL .209.07 and Professions Code). , CHECK 209-137 a ' 411GR.� .��9 s 137 CONSTRUCTION LENDING AGENCY CHANGE .0EI 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 -011 11/13/92 Lender's Name2 PERMIT ISSUING FEE 6472 1 Ali 81- 4 Lender's Address I.certify that I have read this application and 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 th" County to a er upon the above-mentioned property if9r inspect i n ph s. SEE REVERSE FOR EXPLANATORY LANGUAGE ' a ATURE OF RMDTEE D E '