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HomeMy Public PortalAbout9503 OLIVE ST_Electrical__ _� c;c col 76A663=CE80611-71 APPLICATION F ELECT AL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER B UILDING BUILDING AND SAFETY DIVISION a U 5 TYd!l �t FOR APPLICANT TO FILL IN EA RE NEARET. d C ORtve P OUTLETS NO. EACH I FEE 'w OWNE V MAIL ©� tV RECEPT._ $ $ ADDRESS • �0 Q L; ei .5' LIGHT TOTAL FIRST 20 25 A OVER 20 CIT Q li w EL. NO.,h Q SWITCH_ .10 PLAN CHE LIGHTING l TOTAL FIRST 20 .25 APPLICANT )} OVER FIXTURES 10 20 ADDRESS RESIDENTIAL APPLIANCES CITY EL. NO. PERMIT RANGE DRYER_WTR. HTR. APPLICANT STA. COOK DISP. F.A.U. ADDRESS SPACE HTR. AIR COND. CITY TEL. NO. CLOTHES WASH. DISHWASH. LICENSE NO. CLASS. FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR O - 1 1.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF a CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO - 1O 3.00 RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. V SIGNATURE 10 - 50 5.00 OF PERMITT 50 - 100 10.00 F" DISTRICT NO. CLASS PROC SED Y W 100 - 500 15.00 �� N SIGN, GAS SIGN AND ONE CIRCUIT 5.00 NOTES: ? TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 SERVICENOTOVER 600VOLTS OR200AMP 3.00 Sao SERVICEOVER 600 VOLTS OR 200AMP 10.00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP.POWER POLE TEMP SERVICE,POLE,&APPURTENANCES 5.00 TEMP LIGHT OR RECEPT. SYSTEM 3.00 UNDERSLAB WORK ROUGH CONDIUT WIRING Z -.24- ;k FIXTURES POWER AUTHORIZED PERMIT FEE (SUB TOTAL) UTILITY CO. NOTIFIED /.31 s� �7 -/t®/lsyerr'3/ PLAN CHECK FEE FINAL / G)l/,,� I/ ��9 9 d 7 _Z,U*nJ PERMIT ISSUING FEE 3.00 310'o TOTAL FEE ©d 1 PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VA I IIAATION � M.O. :C.:.0 nj`,� 1 4 273 JUN 1 D \\��6.0 ON v .SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE V / ' 76A683+CE806 _71 APPLICATION FOR ELECTRICAL PERMIT - r'I111L.1111111 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS t 47 LOCALITY NEAREST r FOR APPLICANT TO FILL IN CROSS ST. l® � Q G OUTLETS N0, EACH FEE OWNER . J�Iv �F N RECEPT. $ $ 'MAIL DDRESS' /� ©� 0 L S LIGHT TOT FIRST 20 ,29 OVER 20 CITY d TEL. N0. SWITCH_ .10 PLAN CHECK LIGHTING 1 TOTAL FIRST 20 .25 APPLICANT )} OVER 20 ADDRESS FIXTURES IO RESIDENTIAL APPLIANCES CITY TEL. NO. PERMIT RANGE DRYER_WTR. HTR. APPLICANT STA. COOK DISP. F.A.U. ADDRESS. SPACE HTR, . AIR COND.� CITY TEL. NO. CLOTHES WASH.—/_DISHWASH. LICENSE N0. CLASS. FAN OTHER 1.00 IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 - 1 1.00 LICENSED A5 REQUIRED BY LOS ANGELES COUNTY AND STATE OF d CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO 1 - 1O 3.00 RESIDE IN, THE ABOVE DESCRI D RESIDENTIAL PROPERTY. V SIGNATURE I=10 — 50 5.00 OF PERM O 11 50 — 100 10.00 ~ DISTRICT NO. CLASS PROefSSED BY iU 100 - 500 15.00 Q ( h SIGN, GASSIGN AND ONE CIRCUIT 5.00 NOTES: z TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 SERVI CENOTOVER 600 VOLTS OR 200 AMP 3.00 SERVICE OVER 600 VOLTS OR 200 AMP 10.00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP.POWER POLE TEMP SERVICE,POLE,&APPURTENANCES 5.00 TEMP LIGHT OR RECEPT. SYSTEM 3.00 UNDERSLAB WORK ROUGH CONDIUT WIRING FIXTURES POWER AUTHORIZED PERMIT FEE (SUB TOTAL) UTILITY CO. NOTIFIED -2eJrrr/3 '�f,��r�„r� PLAN CHECK FEE ��// , L r o�+J PERMIT ISSUING FEE 3.00 v INAr/- TOTAL FEE PLAN CHECK VALIDATION CK. M.00 PERMIT VALIDATION CK. M.O. <CASH nlal2- 1•i d o N rt 1.8 1 173 JUN 21 2 D 6.5 0~ �'- SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 1 C 1� 1TC� Rkl!RS'COMPENSATION DECLARATION- 76A663 6G 10/81 APPLICATION FOR ELECTRICAL PERMIT I h m that I have a certificate of consent to self 'fnsur errifcote of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a rrdrtified copy thereof(Sec. 3800, Lab. C.) Policy No, Company FOR APPLICANT TO FILL IN JOB — ❑ Certified co is hereby furnished. EACH NO. FEE ADDRESS 960-3 PY Y New Residential Bldgs..8 Pools _ ❑ 1 $2-Family, S Ft. $ = $ LOCALITY -7aMy LL- C/� Certified copy is filed with the county building inspec- Y. q• NEAREST tion department. Multi-family Sq. Ft. CROSS ST. Residential Swimming Pools OWNER OR Date Applicant , CERTIFICATE OF EXEMPTION FROM WORKERS' FIRM NAMEQ/y/f���� L SC�f(7Bv�' Outlets: RecLighf Sw._ ADDRESS / S D j �► CTG 1�/c COMPENSATION INSURANCE First 20 (This section need not be completed if the work involved by Total No. Additional CITY („—yep C' /'�� Tel. No. « j/$ the permit is for one hundred dollars($100)or less.) PIAN CHECK I certify that in the performance of the work for which this APPLICANT permit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. i Lighting Fixtures First 20 ADDRESS r f Total No. LJ Additional CITY Tel. No. Date S pplicant Fixed Appliances Not Over 3 HP PERMIT [+ NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT G Exemption, you should become subject to the Workers' Range_ Heater,_D.W. — ee- Compensation provisions of the Labor Code, you must forth- Oven —Dryer —W.M.— ADDRESS QJ with comply with such provisions or this permit shall be Top — FAU —W.H. — deemed revoked. CITY T' ty ce y, Tel. N � Hood _ Fan Other— LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. REG.NUMBER 9'� Class. —� (commencing with Section 7000)of Division 3 of the Business Power Apparatus&Large Appliances 1 DIISTRICT NO. �[V PROCES D BY >_,and Professions Code,and m license is in full force and effect. CL Size 8 Type HP, KW, KVA, or KVAR O License Number C �LLiic. Class Up Up to 1 Incl. FINAL V LZMA 5,6w te9—z.3 65 Over 1 to 10 Incl. DATE �._ VALIDATION 0 Contractor / Over 10 to 50 Incl. ❑ FINA I am exempt under Sec. i Over 50 to 100 Inc. BY in Over 100 to BAP.C. for this reason Services, Swbd., MCC&Panelboards !' Z Date: fj0 -200 Amp. Under 600 V if F �.0 201 - 1000 Am Under 600 V 2 9 7.7 A Signature p• Over 1000 Amp, or Over 600 V ❑ Exemption for Reg. Maint. Elect. # 0 0 0 0 0 2 SINGLE FAMILY Temp. Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I o - 51L50 I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits o 0 0 5 4 5 0= Law for the following reason (Section 7031.5, Business and 0 Professions Code): 9.2 3-8 5 ❑ I, as owner of the property, will do the work and the Misc. Conduits$Conductors structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)_ 7044, Business and Professions Code). 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 PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name it • PERMIT ISSUING FEE V Lender's Address �- I certify that I have read this application and state that the TOTAL FEE 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 Signature of Permittee Date