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Home My Public Portal About9566 OLIVE ST_Electrical__ 08 STO 12-43 2SM DEPARTMEOF BUILDING ANBD SAFETY �iCATION FOR Y�ERMIT NT - a COUNTY OF LOS ANGELES ELE=IC WM. J. FOX CHIEF ENGINEER S NAME DISTRICT NO. GROUP ZONE PERMIT NO. 0 ADDRESS 4P 3 ^/ �` 0.7 . CITY • TEL. �1 RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION WCOUNTY CERT NO. EXPIRES oZ-d/ APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY NN�L�YJOB �p DESCRIPTION OF WORK ADDRESS &Z/ a NUMBER OF OUTLETS ON CIRCUITS LOCALITY LOCATION BY ROOMS NEAREST LIGHT OUTLETS JSW. PLUGS FII'r CR088 T. 26 w=AA—Ak CIRCUIT A B O D E F G H 19 NAME v. Z MAIL. U 0 3 ADDRESS CITY TEL.NO. I AN THE LEGAL�+ a ANGELES COUNTY CERTIFICA POSSESSOROFOFau HE ICBOVE LOS TION.. 6� 0 0 �• I B ® B' LF=RICIAN. I AI AM THE LEGAL OWNER OF THE PRO DESCRIBED o In 9 6'� fOr OWNER. A CORREMONS r J � J Z O_ E TOTAL NO: OF OUTLETS r 7 .1E APPROVALS MO. OF FIXTURES E a DATE INSPECTOR'S NAME NO. OF MOTORS' H.P. ffi CONDUIT / NO. OF SIGNS TRANS. E WIRING NO. OF RANGES OR HEATERS 8 FIXTURES MISCELLANEOUS__ POWER PERMIT FEE 2 '7 # UTILITY CO.NOTIFIED TOTAL.FE6 J FINAL 0M 5-p 12-43 25M DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PEW= y— - COUNTY OF LOS ANGELES ELE=IC M. J. FOX CHIEF ENGINEER R NAME* DISTRICT NO. GROUP ZONE PERMIT NO. O ADDRESS �� '✓�. � > �� °` CITY TEL.NO. O ��O RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTIONCOUNTY / CERT.NO. EXPIRES I°�� L"Cj�✓`� (/ APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY JOB DESCRIPTION OF WORK —ADDRESS &Z®'ob' o NUMBER OF OUTLETS ON CIRCUITS LOCALITY LOCATION BY ROOMS NEAREST LIGHT OUTLETS SW. PLUGS F gT CROSS ST. CIRCUIT A B C D E FJr. H E NAMELi Z MAIL (Z I-- ADDRESS J7 CITYTEL.NO. 4_AP ANGAAM COUNTY CERPOSSESSOR OF THE IABT E LOS °i 00 I e �/ LECTRICIAN. , A ® n I AM TkM LEGAL OWNER OF T=PROP"DESCRIBED C ® 7 ABOVE ° 9(j OWNER. r CORRECTIONS Q Z IS • •D TOTAL p� NO. OF OUTLETS ffi Si APPROVALS NO. OF FIXTURES ffi DATE INSPECTOR'S NAME NO. OF MOTORS' H.P. $ CONDUIT / NO. OF SIGNS TRANS. ffi WIRING NO. OF RANGES OR HEATERS ffi FIXTURES MISCELLANEOUS S POWER PERMIT FEE h 71 11.7 S' ffi UTILITY CO.NOTIFIED TOTAL FEE J71;7 -NAL J• i 4 , WORKER'S COMPENSATION DECLARATION 2o.0 DPW(12.91) I herebyaffirr7,that Ihave acertificate of consent to self insure, APPLICATION FOR ELECTRICAL PERMIT Ll or a certiticake of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereofraec.'3900 Lab..C.) 01' NoA�I&ZA Z E.A Company /l/ FOR APPLICANT TO FILL IN JOB ADDRESS Certified copy is herebyfurnished. NO: EACH FEE New Residential Bldgs.&Pools 1 &2-Family,Sq.Ft. — $ $ LOC Certified copy is filed with the county building Inspection — NEAREST ,department. t ��//// ��//�� Multi-family Sq.Ft. CROSS ST. Date, A lican l /1f �.��G��G Residential Swimming Pools ASSESSOR vim— PP T MAP BOOK �.S!/D PAGE ��6 PARCEL O/.:? CERTIFICATE OF EXEMPTION FROM WORKERS' Sw. OWNER OR ues: e�Ligt FIRM NAM rtCOMPENSATION INSURANCE First 20 N MAIL (Thisperm section,need not be completed 0 the work Involved by the Total No. �/ � Additional -ADDRESS .1 'permit is for one hundred dollars($100)or less.) - - ' alo 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 PLAN CHECK ��' become subject to the Workers'Compensation Laws. Lighting Fixture First 20 APPLICANT w Total No. Additional Date Applicant 3 RESIDENTIAL APPLIANCES NOT OVER 3 HP.711537- ADD S / �N�• 19 NOTICE TO APPLICANT: If, after making this Certificate of CITYI*_VWA1K Tel. Exemption,you should.become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code,you must forthwith comply with such PERMI provisions or this permit shalt be deemed revoked. I Power Apparatus&Large Appliances APPLICANT LICENSED CONTRACTORS DECLARATION Size A Type HP,KW,.KVA,or KVAR ADDRESS I hereby affirm that-I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. All (commencing with Section 7000)of Division 3 of the Business and CITY Tel.No. Professions Code,andmy license is in full force and effect. Over 10 to 50 Incl. LICENSE OR Class �- Over 50 to 100 Incl. REO.NUMBER a Over 100 DISTRICT NO. O BED BY V License Numbs Lic.Class • Lg Services;Swbd. MCC&Panelboards 0-07Q Contractor Date ✓ lA�fJ 0-39 ` mp.Under B00 V DATE 0 ❑ I am exempt under Sec. 400-1000 Amp.Under 600 V _ 7 VALIDATION V Over 1000 Amp,or Over 600 V ` W B.&P.C,for this reason BRANCH CIRCUIT FEES OPAL a (n Date: 15A,or 20A,120V,Lighting.or Recept. Z 1 To 10 Branch Circuits- Signature 11 To 40 Branch Circuits El 41 Or More Branch Circuits -Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits •1 SINGLE FAMILY Temp.Power Pole&Appurtenances r g HOME OWNER=BUILDER DECLARATION Ace I os I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit ^' for the following reason(Section 7031.5, Business and Professions Additional Sign Branch Circuits 3„•(},0 207.6.0' Code): ❑ Misc.Conduits&Conductors 1 ITEMS I,as owner of the property,will do the work and the structure � is TOTAL .._0a� d'�F0 not Intended or offered for sale(Section 7044, Business Other(See Complete.Fee Schedule) and Professions Code). , "HECK}. 207.611 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the i"HANGE .130 performance of the work for which this permit is issued(Sec. 3097, PERMIT FEE (Sub-Total) f/ Civ.C.) PLAN CHECKING FEE 10/ % Lender's Name PERMIT ISSUING FEE to d 1963 3 AM11QW7 Lender's Address I certify that I have read this application and under penalty of purjury state TOTAL FEE (p that the above Information is correct. I agree to comply with all County ordinances kind State laws regulating Electrical wiring,and hereby authorize representatives of this County to enter upon the a mentioned property forporion purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE F i%=EV D E WORKER'S COMPENSATION DECLARATION 200019 DPW(12.91) 76A663 APPLICATION FOR ELECTRICAL PERMIT � I.hereby.affirm that I have a certificate of consent to self insure, 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.) Policy N / Company FOR APPLICANT TO FILL IN JOB ADDRESS ❑ Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE LO AW $ $Ft Sq. . — Certified copy is filed with the county building Inspection 1&2-Family, — NEAREST epart ent�rr� Multi family Sq.Ft. CROSS ST. Date Applicant Residential Swimming Pools ASSESSOR 4 MAP'BOOK I PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER OR if0011, COMPENSATION INSURANCE Outlets:Re/-d—Light Sw. D /O FIRM NAM � (This section need not be completed if the work Involved by the First io MAIL ( l permit is for one hundred dollars(8100)or less.] Total No Additional ADDRESS !� I certify that in the performance of the work for which this permit CITY T.I.No is issued, I shall not employ any person.in any manner so as to PLAN o ECK become subject to the Workers'Compensation Laws.. Lighting Fixtures tl First 20 v APPLICANT Total No.. J Additional ADDRESS 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. ��/� provisions of the Labor Code?you must forthwith comply with such P PLIIITANf ' provisions or this permit shall be deemed revoked. • Power Apparatus&Large Appliances LICENSED CONTRACTORS.DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS V.1 6 Wj% 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 CITYC(fy��(� Professions Code;and my license is in full force and effect. Over 10 to 50 Incl. LICENSE oR . � Over 50 to 100 Incl. REG.NUMBER �/ � Class. O / Over 100 DISTRICT NO. P 0 SED BY V License Number Lic.CI -28ervices,Swbd.,MCC&Panelboards I Q Contra 0-399 Amp.Under 600 V DATE O 400-1000 Amp.Undei 600 V VALIDATION W I am exempt under Sec. I Over 1000 Amp.or Over 600 V FINAL d i B.&P.C.for this reason BRANCH CIRCUIT FEES BY Z Date: 15A,or 20A,120V,Lighting or Recept. — 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits ❑ j41 Or More Branch Circuits , Exemption for Reg'.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits SINGLE FAMILY Temp.Power Pole&Appurtenances lil=(s �v HOME OWNER-BUILDER.DECLARATION Si'n with One Branch Circuit +—s :O �' I hereby affirm that I am exempt from the Contractor's License Law g , 3`,L(,;r L=1.010 'for the following reason(Section 7031:5, Business and Professions Additional Sign Branch Circuits Code): 1 1 1 1r..M'= ❑ Misc.Conduits&Conductors I,as owner of the property,will do the work and the structure Tj 1—1 Ai 39,m IDID Is not Intended or offered for sale(Section.70.44, Business Other(See Complete.Fee Schedule) and Professions Code). , CHECK W. a 1.4 CONSTRUCTION LENDING AGENCY CHANGE .09 I hereby affirm that there is a constructlon lending agency for the performance of the work for which this permit isissued(Sec. 3097, PERMIT FEE (Sub-Total) Civ.C.) I- ( �3111��' j ( 1/19/94 PLAN CHECKING FEE' ' Lender's Name =� ; 8�__ PERMIT ISSUING FEE `�574 1 PM Lender's Address _ 0 I certify that 1 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 I represent v this County to ter uporyihe b mentioned property for ins e �C;� SEE REVERSE FOR EXPLANATORY LANGUAGE . SIG A E OF PERMITTEE DA.