HomeMy Public PortalAbout9622 OLIVE ST_Electrical__ COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Department of County Engineer
DIVISION OF BUILDING & SAFETY ��
WILLIAM J. FOX, County Engineer
FOR APPLICANT TO FILL IN f DISTRICT NO. GROUP I ZONE PERMIT NO.
e.1 —08
ELECTRICIAN
RECEIVED BY READY FOR DATE IBBU D
ADDRESS /1671* f�'."/�����' G�r' t® ) FIRST INSPECTION !
CITY /I t- ld Al TEL.NO.
COUNTY LICENSE NO. / f EXPIRES (0-30—, BUILDING
PERMIT FEES ADDREBB % (�/ Is—tyti' 1 '!,•'� „r
FEE ,��— C
NUMBER EACH LOCALITY `.-Z:�ii� LM.
LIGHT OUTLETS NEAREST '� f
RECEPTACLES
CROSS ST. S,I �dyt17 .� f
WALL SWITCHES 'rIf
t'q''� •3 "
OWNER
TOTAL OUTLETS BD B Y� MAIL
ELEC. RANGER 25 ADDREHS
ELEC. HEATERS 25 CITY TEL. NO.
FIXTURES S
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
MIBC. APPLICATION AND STATE THAT THE ABOVE IB CORRECT
NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING.
MOTORS 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
NEW MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
I/2 a LEBB B .25 SIGNATURE OF �}
I/2 2 .50 PERMITTEE L ----
2 s 1.00 INSPECTION RECORD
5 1B 1.50
15 SO 2.50
5O 200 5.00
200 500 IO.00 J
BOB 1000 15.00 Q
Z
OVER 1000 20.00 CI
M.G. BET/FREQ. CHANGER-HP
_ WELDERS:AC-KVA O
GENERATORS - KW _
TRANSFORMERB - KVA _
TEMP. MOTORS (75% OF CRIB.)
MOVED MOTORS (75% OF ORII1.)
MISC.
SIGNS
NO. NO.TRANS.
APPROVALS
NO. NO.LAMPS
FOR EACH PERMIT: DATE INSPECTOR'S NAME
WIRING $1.00 CONDUIT
FIXTURES $1.00 WIRING 6 C rK14 .g
SUPPLEMENTARY .50 FIXTURES
POWER
TOTAL FEE III �-� _UTILITY CO.NOTIFIED 0- A.)
FINAL kurI b) 'L fer re,
TBA663 DBS#5A 4-52
*6` WOBKER.S'COMPENSATION DECLARATION 76A663 10/81
�, ja APPLICATION FOR ELECTRICAL PERMIT
,"I hel�by�affirm that I have a certificate of ci7nsdnl'to'self insure, CE-Bose
!or &certificate of Workers' Compensation Insurance,or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY
+
bcebv tFAeregf(Sec.380Q,Lab.•,C.) y y�
Pollic. No� �mpany - t^U6�U J FOR APPLICANT TO FILL IN JOB
"Certified copy is 19 hereby furnished. EACH NO. FEE ADDRESS
New Residential Bldgs.&Pools
❑ '7 h n , LOCALITY
Certified copy is filed with the county building inspection2-Family,Sq. $ — $ PG G T
1 &
depar ment Multi-family Sq.Ft. — NEAREST ,r�
Date .6 Q Applicaaae"�/�� Residential Swimming Pools CROSS R Z G��'it/.y G �.(yJ
FIRM NAME��l 5 t /�L
CERTIFICATE OF EXEMPTION FROM WORKERS' � MAIL r�
COMPENSATION INSURANCE Outlets:Rec� Light Sw. .1%10 /G D�.ADDRESS &2-/i!' 04/V1
(This section need not be completed if the work involved by t9e JJ� First 20 O -
permit is for one hundred dollars($100)or less.) Total No. �U Additional -60 / PLAANN CCHECK CIHECK Tel.No hJ'_
I certify that in the performance of the work for which.this permit
to an APPLICANT
is issued, I shall not employ y y person in any manner so as'to
become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS
Additional
Total No. CITY Tel.No.
Date Applicant
NOTICE TO APPLICANT:.If, after making this Certificate Appliances Not Over 1 HPate of PERMIT �Na�
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 do
provisions or this permit shall be deemed revoked. Top — FAU W.H. _
LICENSED CONTRACTORS DECLARATION Hood —,Fan jgtf Other_ CITY Tel.NSoo &L99M
I hereby affirm that I am licensed under provisions of Chapter'9 Disp. — Room Air Cond. _ LICENSE OR 4t^�
(commencing with Section 7000)of Division 3 of the Business and REG.N1IMBER�X'J Z Class' ,�
Professions Code,and my license is in full force and effect. DISTRICT NO. PROCESSED BY
Power Apparatus&Large Appliances
ttom�.. Size&Type HP,KW,KVA,or KVAR ,' g
License Number r� Lic.Class 13 Up to 1 Incl. FINAL U
, �rSl'[ EmS Date' Over 1 to 10 Incl. DATE ,//..,3pr VALIDATION O0
Contracto Over 10 to 50 Incl.
FINAL f" I-
❑ I am exempt under Sec. Over 50 to 100 Inc. BY �j W
B.&P.C.for this reason Over 100 p,
Services,Swbd.,MCC&Panelboards
Z
Date: 0-200 Amp.Under 600 V es
Signature 201 - 1000 Amp.Under 600 V
❑ Exemption for Reg.Maint.Elect. Over 1000 Amp.or Over 600 V
SINGLE FAMILY Temp.Power Pole&Appurtenances
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit
I hereby affirm that I am exempt from the Contractor's License Law
for the following reason(Section 7031.5,Business and Professions Additional Sign Branch Circuits } %A a r
�M
Code): T
33 f i o to
El 1,
Conduits&Conductors
I,as owner of the property,will do the work and the structure 1'-*"
is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) _ i ITEMS:,
and Professions Code). ® TOT AL 77 o 70
CONSTRUCTION LENDING AGENCY ® ���; �{r?�(
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) 13 00 CHANGE .1313
Civ.C.).
PLAN CHECKING FEE
Lender's Name fL`(�Q - i l I � 8/91-1
PERMIT ISSUING FEE
Lender's Address 3 t70i AM 9:30,
1 certify that I have read this application and state that the above TOTAL FEE
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
pro rty for inspection pu oses. SEE REVERSE FOR EXPLANATORY LANGUAGE
SIgnaturRe;PrAittea D e ,