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Home My Public Portal About9665 OLIVE ST_Electrical__ 76AB53 DBB 5A 3-50 - '� APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES ELECTMC 1 WILLIAM J. FOX, CHIEF ENGINEER DISTRICTGROUP ZONE PERMIT NO. FOR APPLICANT TO FILL IN No. A ELECTRICIAN n RECEIVED BY READY FOR DATE ISBUED ADDRESS FIRST INSPECTION / CITY vylfe fDr / � TEL NO. o/A ly COUNTY LICENSE NO. EXPIRES 3d _ BUILDING /� 1 , PERMIT FEES ol ADDRESS N'� 4 d� V Z NUMBER EACH FEE LOCALITY LIGHT OUTLETS /[/) NEAREST RECEPTACLES CROSS ST. WALL SWITCHES ?OWNER . TOTAL 'OUTLETS So .MAIL ELEC. RANGES 85 ADDRESS ELEC. HEATERS 25 CITY TEL. No. FIXTURES 5 7 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS MISC. APPLICATION AND STATE THAT THE A813VE IS CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS , AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT 1 POSSESS TME ABOVE VALID LOB NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER NEW Mvo. o R .-f INC. EACH J , ' OF THE REBIDENTIAL RCP TY DESCR BED,ABOVE. w t %2 a LESS $ .25 .1�•�� SIGNATURE C n I 2 .sO PERMITTE ` 2 s 1.00 INSPECTION RECORD 15 So 2.50 s S so 200 5.00 200 5013 10.00 1 } W 8 'S 9 0J C Q 500 1 1000 15.00 Z OVER 1000. 20.00 � �' f _ [7 M.G. SET/FREM. CHANGER-HP WELDERS:AC-KVA 13 GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS 175% BF CRIB.) MOVED MOTORS 176% of CRIB. MIS:. SIGNS NO. NO.TRANS. APPROVALS _ NO. NO.LAMPS FOR EACH PERMIT: DATE INSPECTORS NAME WIRING $1.00 r� CONDUIT FIXTURES $1.00 . A JP, WIRING SUPPLEMENTARY .50 FIXTURES :::MOWER TOTAL FEE UTILITY Co.NOTIFIED I A I j"A' FINAL WORKERS'COMPENSATION DECLARATION I 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self � CE-806G insure, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES 'BUILDING AND SAFETY or a certified copy thereof (Sec.3800, Lab. C.) Policy No. Company ' FOR APPLICANT TO FILL IN j JOB ADDRESSJ - A•.� EACH NO. FEE Certified copy`is hereby furnished. New Residential Bldgs. & Pools 1 &2-Family S Ft. $ — $ LOCALITY Certified copy is filed with the county building inspec- Y+ q• tion department. Multi-family Sq. Ft. — NEAREST Residential Swimming Pools CROSS ST. Date Applicant i F OWNER OR k FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' ' �+ MAIL COMPENSATION INSURANCE Outlets: RecLight1 First 20 {Sw. r r ADDRESS ' �" `' .��' (This section need not be completed if the work involved by Total No.�.�'1- F— Additional :;1 V: d~,a CITY Tel. No. the permit is for one hundred dollars($100)or less.) I certify that in the,performance of the work for which this APPLICANTK permit is issued, I shall not employ any person in any manner t-•° so as to become subject to the Workers'Compensation.Laws. Lighting Fixtures First 20 ADDRESS I' Total No. Additional Date 'Applicant I CITY Tel.No. NOTICE TO APPLICANT: If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT -Exemption, you should become subject to the Workers' Range_ Heater_D.W. APPLICANT ;'• Compensation provisions of the Labor Code, you must forth- Oven —Dryer —W.M.— ADDRESS with comply with such provisions or this permit shall be Top — FAU —W.H. — deemed revoked. CITY Tel. ko. LICENSED CONTRACTORS DECLARATION Hood _ Fan _Other_ Disp. — Room Air Cond. LICENSE OR REG. NUMBER ;. / Class.;V' - f I I hereby affirm that.1 am.licensed under provisions of Chapter 9 - .� (commencing with Section 7000)of Division 3 of the Business I DISTRICT NO. ` PROCESSED BY p, Power Apparatus&Large Appliances and Professions Code,and my license is in full force and effect. ; O Size&Type HP, KW, KVA, or KVAR License Number Lic. Class I Up to 1 Incl. FINAL Lu Over 1 to 10 Incl. DATE VALIDATION U. Contractor Date Over 10 to 50 Incl. ' FINAL >_ a I am exempt'under Sec. Over 50 to 100 Inc. BY Q Over 100 B.&P.C. for this reason O 1 Servicesa R, WbcL.,..AACC&Pcknelboards M. d Date: 0'-200 Amp. Under 60 ► W Signature `1dT1„1000.Arrmp-Under 600'V ~ Over 1000 Amp. or Over 600 V Exemption for Reg. Maint. Elect. SINGLE FAMILY Temp. Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit t' I hereby affirm that I am exempt from the.Contractor's License -0'o Law for the following reason (Section 7031.5, Business and Professions Code): 1a'p'• l I, as owner of the property, will do the work and the + Misc. Conduits&Conductors •r ;'•,(: •�Ol structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ i oi( o, 7044, Business and Professions Code). rryy r siM 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 PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address ' I certify that I have read this application and state that the TOTAL FEE "��y RGA' above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and s hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. i SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date i WORKERS'COMPENSATION DECLARA'TI.ON:� wr"' i• •7..6A6$3 1.0/81•' r 7 r + f ; APPLICATION OR E�LECTII-ICAL PERMIT I. hereby affirm that, I. have a certificate of cdhsenthto .self ^'�' Ce 806G.,a �' insure, or.'a certificate of Workets'Compensation(nsurance, ! COUNTY OF'LOS ANGELES AND'SAFETY or a certified copy thereof(Sec. 3800,.Lagi C.) 1. Policy No. ., Company FOR APPLICANT TO FILL IN ADDRESS' /f9tL S� Certified:co:py.is:herebY furnished: New Residential'Bldgs.'&-.Popls EACH. ,'.NO.:' FEE _ 8 2=Famil S Ft. $ — $ LOCALITY " L -, •. Certified"copy, is filed with the county building inspec- 1 y, q'' — NEAREST . tion department. Multi-family Sq. Ft. T ` I, Residential Swimming'Pool's CROSS ST. /►q ,Date Applicant y OWNER OR FIRM NAME Afle 1�IYI s 10 CERTIFICATE OF EXEMPTION:FROM WORKERS' 6 y MAIL .: Outlets: RecLightSw._ COMPENSATION INSURANCE ADDRESS' � s / First.20 l. Jl� (This section need not'be completed-if the work involved by Additional CITY.'. Tel. No; the permit is for one hundred dollars($100)or less.) Total No. L� C!� $25 PLAN CHECK 1 certify that in the performance of the work.for which this APPLICANT 'permit is issued, I shall not employ any person in any manner $ � a so as to become subject•io'the Workers'Co mpensation..Laws.•. Lighting'Fiictures IF.irst 2U ADDRESS' Additional (�� Total No. CITY P:. Tel-.'No. Date `�?�� licant fes'" �'� ' �.: ... P.p Fixed Appliances of N� Over i.'HP PERMIT NOTICE TO APPLICANT: If, after making.,this .Certificate of ' APPLICANT.. 'Exemption, you' :Would become'.subject to the Wotkers' Ran.ge;_ Redter_D.W.'_ Compens6tion provisions of-the'Labor Code, you must forth- Oven —Dryer =W-.M.— 'ADDRES§ with complywith such provisions or this'Permit"shall. be Top _ FAU W.H. — ks dZJCITY el. IVo 3.3 eemed revoked. Hood _ Fan _.Other_ " LICENSED CONTRACTORS DECLARATION. ' : . 'LICENSE R I;hereby affirm that I.am licensed.under provision's of Chapter 9 ' _ Disp. _ Room Air,Cond. REG.NUMBER Class. —� (commencing with Section 7000)of.Division•3:of the-Business DISTRICT NO., :PROCESS 'By. and Professions Code,and my license is in full force and effect. Power-Apparatus&Large Appliances n � Size A Type-HP, KW, KVA,'or KVAR' L'icen'se Number Lic..Class ! Up to 1.Incl. FINAL'' /� �• Over_1 to 10 Incl. DATE 'L% ►O VALIDATION Contractor., Date Over 10 to 50 Incl. ' I am,exempt under Sec. Over50 t6.100 Inc. BY B.&P.C. for this reason Over 100' z Servi -AA elboards te: 6 -200 Amp:U'nder.600 Siangture 2 -. V ;- - Over 1000 Amp..or Over 600 V Exern.ption for,'.Reg„Maint..Elect. SINGLE FAMILY Temp. Power Pole•&Appurtenances �'. HOME OWNER-BUILDER DECLARATIONSign with One Branch Circuit �' I.hereby affirm.that lam exempt from the Contractor's License ; e o�o o o.2 Law for the following reason.(Section 7031.5, -Business.and Additional Sign Branch Circuits Professions Code):• ;i ( o o �j(� Q(j I, as owner of the prop6r.ty, will.do`the work and the Misc. Condujts&Conductors ; structure is not intended or offered for:sale'(Section Other(See Complefe Fee Schedule)_ 7044, Business and Professions Code). ► �,•_fa CONSTRUCTION LENDING AGENCY I hereby affirm.that there is a%construction lending agency for i. the performance of the work for which this,permit is issued PERMIT FEE • (Sub-Total) , (Sec. 3097, Civ. C.): . PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE' 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 j ordinances and State-laws regulating Electrical wiring, and hereby authorize representatives of this County to enter upon , / the above-mentione roperty for inspection purposes• SEE REVERSE:FOR EXPLANATORY LANGUAGE r Sure of Permittee Date' a ,