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Home My Public Portal About9649 OLIVE ST_Electrical__ IaABBf, APPLICATION FOR ELECTRIC PERMIT 1 �� BB.BA f f•BS DMSION OF BUILDING AND SAFETY Depfafinent of County Engineer BUILDING ` County of LosAngeles ADDRESS JOHN A.LAMB1E.COUNTY ENGINEER - CASSATT D.GRIFFIN.SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST ' F - PERM FEES CROSS 8T. NUMBE OWNER LIGHT OUTLETS MAIL RECEPTACLES ADDRESS WALL SWITCHES FEE CITY Q T O. TOTAL OUTLETS @ 5¢ $ O ELECTRICIAN ELEC.RANGES 28 ADDRESS ELEC.HEATERS 25 jj KW EA CITY / TEL.NO` - AT FIXTURES 5 LI9CENSE NO. / / G/ - MOTORS DISTRICT NO. GROUP I ZONE I READY FOR INSPECTION NUMBER HORSEPOWER FEE NEW MVD. HP OVER INC. EACH r e LESS $ .25 INSPECTION RECORD Yz 2 .50 2 5 1.00 5 is 1.50 15 SO 2.50 50 200 5.00 MISC. NO.SIGNS NO.'TRANS. NO.SIGNS NO.LAMPS FOR EACH PERMIT: WIRING $1.00 FIXTURES $1.00 SUPPLEMENTARY .50 APPROVALS TOTAL FEE $ DATE INSPECTOR'S SIGNATURE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ` AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT EWITH LECTRIL clWAITY IRI ORDINANCES AND STATE LAWS REGULATINGrWIRINGI HEREB CERTY THAT I AROPERLY GiSTERED AND/OR S LICENSED S REGU1 ED BY LO GE S U AND STAT OF CALIFORNI OR TH T I AM I OW OYEDESCRIBED PRO TC.SIGNAT CO.NOTIFIED OF P MITTE FINAL LLs,,— pp, a v �p�� ---, Y.. CYw+�- IOHN A.'LAMBI 'COUNTY ENGINEER ATION ARTHUR C.VEIT,CHIEF ELECT.INSPECTOR CK NO CASH 8 7 9 76A668 APPLICATION FOR .�L'E�C°T°RIC PERMIT 1 DBS-SA 12.54, ' R 1 DIVISION OF WELDING AND SAFETY Deportment of County Engineer- County of.Los Angeles BUILDING WM.J. FOX, COUNTY ENGINEER i ADDRESS ()649 Olive St CASSATT D.GRIFFIN.SUPT OF.BUILDING FOR APPLICANT TO-FILL IN LOCALITY_ TP.tTI jP. City. PERNII'I' FEES NEAREST - CROSS.ST.. FEE. NUMBER EACH LIGHT OUTLETS ?� OWNER Q nrj G'` nn S t TL t,1.•727. Oo RECEPTACLES -2MAIL WALL SWITCHES 5 :ADDRESS 9419-•R sema.a.d - - . TOTAL OUTLETS 24 5E. 51 20 CITY Rosemead .TEL. NO. ELEC. RANGES X 25. 25 ELECTRICIAN4f-yo ;,gin• '1--�C ELEC.HEATERS 25 ADDRESS 21232`1).qr i P)c; live KW EA _:CITY Tilj�c�'r� "��nG1 TEL ND W� 99 FIXTURES r/ 5 35 ;LICENSE NO. NUMBER OF LIGHT'CIRCUITS . 11 1 ' DISTRICT NO. GROUP I ZONEREADY FOR INSPECTION NUMBER OF RECEPTACLE CIRCUITS s I. .•�� I MOTORS NUMBER HORSEPOWER FEE INSPECT-ION RECORD NEW MVD. HP OVER INC. EACH YL&LESS .$ - ,25 `7 5. - - 16 2. .50 2 5 1.00 uF 5 X15 I.50 15 50. 2.50 ' SO 200 5.00 MISC. NO'.SIGNS NO.TRANS, NO.SIGNS NO. LAMPS. " FOR EACH PERMIT: WIRING S1 00 FIXTURES S1.00 SUPPLEMENTARY 50 APPROVALS TOTAL.FEE $4 5 ATE-1 INSPECTOR'S SIGNATURE 1 HEREBY ACKNOWLEDGE THAT i HAVE READ THIS APPLICATION CONDUIT AND STATE THAT THE ABOVE IS.CORRECT AND AGREE TO COMPLY ,. WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING. WIRING -ELECTRICAL WIRING. 1 HEREBY CERTIFY' THAT 1 A PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY 0 'ANGELES COU TY AND STATE OF POWER CALIFORNIA OR T 1 •A E LEGAL OW R BOVE DESCRIBED RESID N ALP ERT i SIGNATURE UTILITYCO.NOTIFIED -I t:.0 Qi -.✓ OF PERMITTE F .pFINuA71L1 f1 u WILLIAM J.FO oUNTY ENGINEER ll((++ •i++4AIOa�VL '`J ,rJ 5 N alL�O BY ak DEPUTY ?GASB$-CEBOB-II-WAPPLICATION FOR ELECTRIC PERMIT 1 COUNTY OF LOS =GEM DEPARTXlENT OF COUNTY ENGINEER BUILDING/ BUMDING AND SAFETY DIVISION ADDRESS rrOffiI A.L IB.CD�ttqy inr 'r C1 AIT A G8IFFIII.Ssp-t d$.W&g LOCALITY / NEAREST '^"� R FOR APPLICANT TO FILL IN CRO ss ST. PERMIT FEES / E ITEM HUM139RI EACH FEE OWNER OUTLETS: $ $ MAIL LIGHTS RECEPT. SW. .10 ADDRESS i LIGHTING FIXTURES .10 CITY TEL.NO. ELEC.RANGES CLO.DRYERS _ ELECTRICIANA 7 WATER HEATERS •50 ADDRESS ELEC.SPACE HTRS. DISHWASHERS -s�j,[/ GARBAGE DISPOSERS AUTO.- CITY) / J TEL.N / /tl(O t WASHERS SSA.COOKING UNITS ,25 STATE LICENSE NO. Io v MOTORS: OVER INC. H.P. 0— V. ,25 DI NO. ' GROUPF-BON271 READY POR INSPECTION Ma— 2 .50 2 — s 1.00 / pp INSPECTION RECORD a — is 1.50 Is — s0 2.80 50— 200 5.00 SIGNS: NO.TRANS. NO.LAMPS SERVICE 0-000V 1.00 ® . SERVICE OVER BOOV 5.00 MISC. 4 WIRING PERMIT 1.00 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT 50 TOTAL FEE S2 APPROVALS 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR S a LICENSED AS REQUIRED BY G ES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT I THE OWNER OF THE ABOVE POWER. DESCRIBED RESIDENTIAL Q SIGNATURE UTILITY CO.NOTIFIED OF PERMITTEEs c� FINAL ATION ARTHUR C.VETT, CK MO CASH .SUPERVISING.ELECTRICAL rameIA16BBt c3 0 4 3 u; JUL 2 1 2 A ,Q Q WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) �. I hereby affirm that I have a certificate of consent to self insure, APPLICATION FOR. ELECTRICAL PERMIT. �J oro 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 No.JZM02- Company S Lf EV--A� FOR APPLICANT TO FILL IN JOB Certified co Is hereby furnished. NO. EACH FEE ADDRESS �j o L L v rn -S4- Certified Y New Residential Bldgs.&Pools LOCALITY El Certified &2-Family,Sq.Ft. — $ $ Certified copy is filed with the county building inspection department. Multi-family Sq.Ft. NEAREST ST. �j Residential Swimming Pools ASSESSOR Date y�r G Applicant MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMP FROM WORKERS' Outlets:Rec._Light Sw. FOIRMNEROR NAME COMPENSATIO SURANCE (This section need not be completed if the work Involved by the First 20 MAIL permit Is for one hundred dollars($100)or less.) Total No. Additional ADDRESS I certify that in the performance of the work for which this permit CITY Tel.No. is issued, I shall not employ any person in any manner so as to PLAN CHECK become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANT Total No. Additional ADDRESS Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: If, after making this Certificate of CITY Tel.No. Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code, you must forthwith comply with such PERMIT provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances APPLICANT LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. (commencing with Section 7000)of Division 3 of the Business and CITY Tel.No. Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. } LICENSE - `? Class. Over 50 t0 100 Incl. REG.NUMBER a r'y l� �z Over 100 DISTRICT NO. P Q License Number ✓ 6 Z ` � Lic.Class `J � V P' l, ('L p/� Services,Swbd.,MCC&Panelboards �� '' (fy ,r"_r� � Contractor ^� S��—C/NS`Date — !I� 0-399 Amp.Under 600 V DATE1 ZTEhi$ O El I am exempt under Sec. 400-1000 Amp.Under 600 V LIDATIO V Over 1000 Amp,or Over 600 V FINAL T�M- �-�� w B.&P.C.for this reason BRANCH CIRCUIT FEES BY CHECK 61.50 V) Date: 15A,or 20 120V,Lighting or Recept. Z Signature s 1 To 10 Branch Circuits CHANGE °00 11 To 40 Branch Circuits F-141 Or More Branch Circuits Exemption for Reg.Maint.Elect. 15A,20A,208V To 2nV Lighting Br.Circuits �Q�1 ,tf,r 5/96 SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Temp.Power Pole&Appurtenances 5731 1 A�°lii"29 1 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 Code): ❑ I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors is not intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule) 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 (Sec. 3097, PERMIT FEE (Sub-Total) Civ.C.) PLAN CHECKING FEE Lender's Name ` PERMIT ISSUING FEE �7 Lender's Address I certify that I have read this application and under penalty of purjury state TOTAL FEE (y ( aL a that the 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 SIG17 URE OF PERMITTEE DATE