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Home My Public Portal About9624 OLIVE ST_Electrical__ APPLICATION FOR ELECTRIC PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING /1 r % BUILDING AND.SAFETY DIVISION ADDRESS r �/ /� JOHN A. LAMBIE. COUNTY ENGINEER CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY FOR APPLICANT TO F1L6 IN NEARESTL PEMW CROSS ST. ITEM NUMBER I EACH FEE OWNER OUTLEd MAIL LIGHTS RECEPT. SW. Y $ .10 ADDRESS' LIGHTING FIXTURES .10 Q CITY TEL.NO. ELEC.RANGES CLO.DRYERS ELECTRICIAN d WATER HEATERS .50 ADDRESS l L S ELEM SPACE HTRSj DISHWASHERS CITY aS TEL.NO. GARBAGE DISPOSERS f AUTO.- STATE WASHERS STA.COOKING UNITS 1 .23 LICENSE NO. MOTORS: OVER INC. H.P. DISTRIC NO. I GROUP I ZONE PR CESSED BY o— V2 i2 .21; p .50 INSPECTION RECORD 2— s 1.00 5— t5 1.50 is— so 2.50 50-200 5.00 SIGNS: NO.TRANS. NO.LAMPS SERVICE 0-600Vi.00 0 b SERVICE OVER 600V 5.00 MISC. WIRING PERMIT 1.00 ( 0 O ` FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT 50 0-vr(- YI: s. TOTAL FEE S b p I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'SSIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT ELECTRICAL WIRING. r I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR WIRING LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT I AM T LEG OWNER OF THE ABOVE DESCRIBED RESIDEN ROP iRTY. POWER SIGNATURE• UTILITY CO.NOTIFIED P� OF PERMI FINA 7a ATION ARTHUR C.VEIT, CK MO CASH SUPERVISING ELECTRICAL ENGINEER �n;)6 71 7rn CCT 29 2 A 7,60 WORKERS'COMPENSATION DECLARATION 8066mllo 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self i CECE- insure, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES / , ,. BUILDING AND SAFETY or a c�fied lc�opy therof.(Sec,tj 3800, Lab C.) �¢ ❑o y !r- :N / 3 Company �"3vC/ FOR APPLICANT TO FILL IN JOB 1- C rtified copy is hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE ADDRESS 1a Z „ ��i( £ — Certified copy is filed with the county building inspec- 1 8 2-Family, Sq. Ft. g $ LOCALITY Pi de C l tion de Multi-family S Ft. — NEAR artment. EST P Residential Swimming Pools CRO SS ST. �e_ �. Date. �3 Applicant!#/ LGf.G"C, OWNER OR L FIRM NAME 1lT CERTIFICATE OF EXEMPTION FROM WORKERS' � $ MAIL Outlets: Rec Light Sw. COMPENSATION INSURANCE I First 20 i � d ADDRESS 9624k £%, ouge- (This section need not be completed if the work involved by Total No. '5I Additional CITY 6 GLS Tel. NoAA li:59 the permit is for one hundred dollars($100)or less.) that in the erformance of the work for which this PLAN CHECK I certify P APPLICANT permit is issued, I shall not employ any person in any manner l so as to become subject to the Workers'Compensation Laws. ( Lighting Fixtures First 20 ADDRESS Total No. 8 Additional Date applicant CITY Tel. No. NOTICE TO APPLICANT: If, after makingthis Certificate of Fixed Appliances Not Over 1 HP PERMIT p.�GAatA lG Exemption, you should become subjRange Heater_D.W. APPLICANT ect to the Workers' �.� 9 Compensation provisions of the Labor Code, you must forth- Oven _Dryer —W.M.— ADDRESS with -comply with such provisions or this permit shall be 4 Top _ FAU —W.H. deemed revoked. CITY �t�� eA Tel. IVo. S7 LICENSED CONTRACTORS DECLARATION Hood _ Fan _Other_ LICENSE OR 1 hereby affirm that I am licensed under provisions of Chapter 9 Dis p' _ Room Air Cond. � REG.NUMBER 37,5W g(F Class. G"GQ (commencing with Section 7000)of Division 3.of the BusinessDISTRI.CT�NO. Piz B and Professions Code,and my license is in full force and effect. Power Apparatus&Large Appliance's fj y. / Size&Type HP, KW, KVA, or KVAR- 15-1 06 0 License Number 3�0 W Lic. Class 41:2-10 Up to 1 Incl. FINAL V r�� Over 1 to 10 Incl. DATE /� , o` VALIDATION IN Contractor '�"A � , Date Over 10 to 50 Incl. FINAL f Ci 0 ❑ I am exempt under Sec: Over 50 to 100 Inc: BY I&I BAP.C. for this reason Over 100 �" r y Services, Swbd., MCC&Panelboards Date: 0 -200 Amp. Under 600 V 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 Additional Sign Branch Circuits Law for the following reason (Section 7031.5;. Business and _p Professions Code): ❑ I, as owner of the property, will do the work and the Misc. Conduits&Conductors -`'o 0 0 0 0 structure is not intended or offered for sale (Section Other(See Completes Fee Schedule)_ o 4 Q 7044,.Business and.Professions Code). CONSTRUCTION LENDING AGENCY Ova ° 9, 0 0_ 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.) O —g'.� (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE 0 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 a -mention property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE b�/a Signa-tur9of Permittee Date