HomeMy Public PortalAbout9557 OLIVE ST_Electrical__ oee S-A Ia-aa APPUC.ATION FOR PEMW
IMPARTMENT OF BURDING AND SAFETY
COUNTY OF LOS. ANGELES
ELECTRIC
gm. J. FOXCHIEF ENGINEER u
z NAME r/b� DISTRICT NO. .GROUP ZONE PERMIT NO.
UUU ADDRESS�i��I PoC.LA.�V 7G7 e y9/
o'
READY FOR
CITY TEL.NO.6(i( -13 I-L- FIRST INSPECTION bAfE ISSUED
COUNTY
WI CERT NO. _l O 13 EXPIRES `��3 '- � i Y! /�/ '�•�^� CS
ACANT FILL IlNAYHLX ®iTTLHriED.: DRR ®1!T OnX; r
&F,
� JOB
DESQ.i ®}u"OF•,*OBK ADDRESS
r NUMBERjOF•.dUTLETS:OPI,CIRCUITB ° 'I:OCALITY is
LCCATION'BY ROOMS .••
NEAREST
LIGHT OUTLETS "' 1SW. 'PLUGS' I FIIir CROSS eT. ^
CIRCUIT A B I C I D I ,E G H W NAME
n / Z MAIL
?r. AD DRESS
O
CITY P.,� j `-
1I AM THE LEGAL ti-OSSESSOR OF THE ABOVE LOS
/ i / ANGELES COUNTYCERTIFICAT •F S•ALIFICATION..
cckp7 , 2
ELECTRICIAN.
J �ovs
M THr,"mm m OWNER OF THB PROPFyiri 1ESCRIBED
•�• � _
OWNER:
/ . 1 Cog � w8 ®1�s
3' _
/ Z
z
TOTAL
NO. OR OUTLETS I $ o APPROVALS
NO.OF FIXTURES E v DATE' INSPECTORS NAME
NO. OF MOTORS H.P. $ CONDUIT 4 v
NO. OF SIGNS TRANS. S i WIRING 'YV { �f
NOr.OF-Rd]y�1CiES:GR HEATERS ! $ d. `FIXTURES } r
MISCELLANEOUS---'- $ n I 'POWER y /w
PERMIT FEE + 2. `� $ �lr Y� UTILITY CO.NOTIFIED 0G/ -��.^ . ML�✓b~�{i V
��vrer Iry � s + `1 � !FINAL Ii�� f ZG> %. _ . _ (..,
0e S.A 10.41 23M /" MM
Tf'�4A'TA1►T Z9A�
DEPART11iE1�1'f OF BIIILDING ANE SAFELY i� La•�11llL� I'll ELECTRIC
GO OF LO ANGELES
7C F ENGINES R
NAM DISTRICT NOu GROUP 70111E PERMIT NO.
V ,�
'a
ADDRES �i
W Cl TEL.NO. ` RECEIVED Bx READY FOR DATE ISSUER
FIRST INSPECTION
JJ COUNTY // "
W CERT.NO. EXPIR /- ' ���
APPLICANT VMY OUTLINED POR.770N ONLY
DESCiREMON ®F ®RYA ADDRESS f F 7 /,..-
k
UMBER OF OUTLETS ON CIRCUITS LOCALITY
LOCATION BY ROOMS
NEAREST
LIGHT OUTLETS SW. PLUGS FIXT CROSS ST.
A B C D E P. G H IY NAME
z MAIL
3 ADDRESS
CITY TEL.NO
I AM
ABOVE LOS
COUNT]( CERTIF GAL POSSO IT F CATION.v
9 AM THE 1EEGAY: y/DWNER OF THE PROP EBCRIBED
ABOVE
OWNER.
CO$REC�IONS
:I
z
R.
O
OTAL O 6 �
NO. OF OUTLETS t APPROVALS
NO. OF FIXTURES DATE INSPIXITOR'S NAME
NO. OF MOTORS H.P.• CONDUIT
NO. OF SIGNS 'TRANS. WIRING
NO. OF RANGES OR HEATERS ffi FIXTURES
MISCELLANEOUS POWER
PERMIT FEE ` UTILITY CO.NOTIFIED
TOTAL FEB
_ 76ASSS DBS SA II-50 APPLICATION FOR PERMIT
- DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES ELECTRIC 1
WILLIAM J. FOX, CHIEF ENGINER
E
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMIT/NO.
ELECTRICIAN J_ 141.31
ADDRESS
RECEIVED BY READY FOR DATE ISSUED
FIRST INSPECTION
CITY TEL. NO.
G - a -�
COUNTY LICENSE NO. EXPIRES BUILDING
PERMIT FEkEf —ADDRESS
NUMBER EACH FEE LOCALITY
LIGHT OUTLETS NEAREST
RECEPTACLES CROSS ST.
WALL SWITCHES �9 OWNER
TOTAL OUTLETS SCIS (/
MAIL
ELEC. RANGES 25 'ADDRESS
ELEC. HEATERS 25 CITY
TEL. NO.
FIXTURES 5
M ISC. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
NUMBER OF LIGHT CIRCUITS /a— AND. AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING.
MOTORS I CERTIFY THAT 1 POSSESS THE ABOVE VALID 10
NUMBER HORSINC. EACH POWER ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
FEE
NEW MVD. HP OVER OF THE RESIDENTIAL PROPER DESCRIBED ABOVE.
�
I/s a I.Ess $ .25 SIGNATURE OF �!
I/s 2 .50 PERMITT•E
2 5' 1.00 INSPECTION RECORD
5 1s 1.50
15 s0 2.50
SO 200 5,00____i
200 500 10.00 J
goo 1000 15.00 Z
OVER.1000 20.00
M. G. SET/FREQ. CHANGER-HP
WELDERS:AC-KVA O
GENERATORS-KW
TRANSFORMERS-KVA
TEMP. MOTORS (75%OF CRlc.)
MOVED MOTORS (75%OFORIG.)
M ISC.
SIGNS
NO. NO.TRANS. I I APPROVALS
NO. NO. LAMPS
FOR EACH PERMIT:
DATE INSPECTOR'S NAME
WIRING $1.00 CONDUIT
FIXTURES $1.00 WIRING.
SUPPLEMENTARY .50 FIXTURES
POWER
TOTAL FEE $ UTILITY.CO. NOTIFIED
FINAL �.��'•^d ``�' a'�
aLloo
.a woRKL+RSi GOMPENSATION DECLARATION d 76A663CE-60B 10/81 PPLICATION FOR' ELECTRICAL PERMIT
I CE-80B1
I hereby affirm that I have a certificate of consent to self insure, �/ ` >'
or a certificate of Workers'Compensation Insurance,or a certified l� n 2 U TY OF LOS ANGELES BUILDING AND SAFETY
.,
copy thereof(Sec.3800,Lab:�� ;;
Policy Nol, .a;ompany —t `o`QA- as FOR APPLICANT TO FILL INJOB ti
ElCertified copy Is hereby furnished. i + Ngw Residential Bldgs.&Pools EACH NO.+ FEE ADDRESS ta
LOCALITT—kCertified copy is filed with the county building inspection I I 1 &2-Family,Sq.Ft. $ _ $department. Multi-family Sq'.Ft. NEAREST--n. CROSS ST.
DatJti Applicant L e C' N Wiles l Residential Swimming Pools OWNER OR
FIRM NAME.�O r
CERTIFICATE OF.EXEMPTION FROM WORKERS' MAIL
(Outlets:Rec—Light_Sw..—
COMPENSATION INSURANCE ADDRESS
(This section need not be completed If the work involved by the First.20 Tel.N'
permit is for one hundred dollars($100)or less.) Total No. Additional I CI TVT l S
PLAN:CHECK. -
I certify that in the performance of the work for which this permit APPLICANT 1 V
is issued, I shall. not employ any person in any manner so as to ;I
become subject to the Workers'Compensation Laws: Lighting Fixtures First 20 :AD ESS
,
Additional
' Total No. CITY Tel.No.
Date.. Applicant
NOTICE TO APPLICANT: If, after making this Certificate of ;� Fixed Appliances Not Over 1 HP PERMIT
Exemption,you should become subject to theWorkers'Compensation Range_ Heater D.W. _ APPLICANT u -Q�
provisions of the Labor Code,you must forthwith comply,with such Oven _ Dryer_ WM._ ADDRESS ob
provisions or this permit shall be deemed revoked. ; Top _ FAU. _ W..H. — 1
LICENSED CONTRACTORS DECLARATION Hood — Fan Other_ 91TY ) i Tel.No.'331 W
;Ail
I hereby,affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. LICENSE OR
(commencing with Section 7000)of Division 3 of the Business and REG:NUMBER 3 2 v ZS _u)
Professions Code,and my license is'in full force and effect. I DISTRICT.NO.. NqEq�Y
Power Apparatus&Large Appliances y:
' + Size&Type HP,KW,KVA,or KVAR �lX1�•
.License Number3 �S- Lic.Class'•Q-- Up.to 1 Incl. FINAL71- � �+
f ��"' .`' - �- \ + �_Over 1 to 10 Incl. DATE.
Contraeto,,L- ��� Date u� p7 '��. n rOver 10 to 50 Incl. FIN- VALIDATION
❑ I am exempt under Sen: Over 50 to 100 Inc. _ I gYLLI
B..&P.C:for this reason f Over 100 +
Services,Swbd.,MCC&Panelboards + ® N
Z Date-0-200 Amp.•Under 600 V
Signature201 -,1000 Amp.Under 600 V
I l' Over 1.000 Amp.or Over 600'V I •Q .`
❑ Exemption for Reg.Maint.Elect.
SINGLE FAMILY Temp.Power Pole&Appurtenances-
HOME OWNER-BUILDER DECLARATION Sign with One Branch-Circuit 3
I hereby affirm that I am exempt from the Contractor's License Law Additional Sign Branch Circuits +
for the following reason(Section'7031.5,Business and Professions g
Code): i
Misc.Conduits&Conductors
❑• I,as owner of the property,will do.the work and the structure , , ,
is not intended or offered for sale (Section'7044, Business ; Other(See Complete Fee Schedule)
and Professions Code).. + i P
CONSTRUCTION LENDING AGENCY I [,
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 FEEX gn
Lender's Name • &).. 'Va
Lender's Address PERMIT ISSUING FEE
.
I certify that i have. read this application and state that the above , TOTAL.FEE �. ( TA
information is correct:I agree to compl it ail County ordinances'
a tate laws re ulating Electrical firing, and hereby authorize II
Jeriftbilvesp
• e r up the above-mentioned .I Cytp�/ne I \ `MM 1 ISEE RENEE FQR EX NAEVY LANGUAGE
of PNDt �Y �OLw9' C7safetyDlvialJoellding and