HomeMy Public PortalAbout9930 OLIVE ST_Electrical__ 76A663-CE8061-68 APPLICATIO OR ELECT ICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION 3D
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDINGj7C
Y
FOR APPLICANT TO FILL IN I_Z) �, 1A �J 46. (/[J /- ,I !!
NO. EACH FEE
RECEPT. $ S OWNER M
r MAIL
_ oo��
LIGHT 1 TOTAL FIRST 20 .20 o ADDRESS .7JI U I_I e0 , UE
SWITCH-L OVER 20 .10 CITY ®TEL. N0.2 - ��-
PLAN-CHECK
LIGHTING TOTAL FIRST 20 .20 10 APPLICANT
FIXTURES ---J—r OVER 20 .10 ADDRESS
RANGE—DRYER—WTR.HTR.— CITY TEL. NO.
STA.COOK—DISP._F.A.U._ CONTRACTOR JJ'
SPACE HTR. AIR COND. ADDRESS 5-06
CLOTHES WASH._DISHWASH._ CITY TEL. NO.
FAN—OTHER 1.00 LICENSE IJO. "7J CLAS13
S. O
MOTORS,TRANSFORMERS RATING
IND. HEATERS, ETC. HP. KW. KVA. I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
SIZE & TYPE OVER TO AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAVAS REGULATING
ELECTRICAL WIRING.
0 - 1 1.00
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
1 - 10 3.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM TH LEGAL OWNER OF, AND INTEND TO
S —QLD 10 - 50 5.00 RESIDE IN, THE ABOVE SCRIBED RESIDENTIAL PR TY.
I ♦ p
50 - 100 10.00 OF PERMIRTTEE V
Od
ISa 100 - 500 15.00 ]TEMP.
O
DIST ICT NO. G UP ONE P OC SSED Bi
SIGN,GAS SIGN AND ONE CIRCUIT 3.00
TUBE, OR
DIT
MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES: LI -Knn C O N r r;A//�V l� Z
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 ✓r u�'�f(�U� ��S^eE'T/!1 Al
SERVICE OVER 600 VOLTS OR 200 AMP 5.00 Nd Lil) F- (J t:L F.• �,
TEMP RVICE POLE, &APP TENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE
D
POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT _/9
PERMIT FEE (SUB TOTAL) WIRING �,�� t X All Jlf
.r
FIXTURES
PLAN CHECK FEE (50% PERMIT FEE)
POWER AUTHORIZED 33
PERMIT ISSUING FEE 2.00 2- CJo UTILITY CO.NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1.00, FINAL
TOTAL FEE JOSEPH C. ROOHAN
SUPERVISING ELEC ICAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
uto5 - S2 X16 2 D 32.80M
EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE/IEL/
4
Wnf�KERS'.at I have
a certificate
of TIONcorse 76-663 10/81 APPLICATION FOR ELECTRICAL PERMIT
• e�eb�y af�irm that I have a certificate of consent to self CE-B06G �j
insure, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY II JI
or a certifi to ther (Sec. 3800, L b. C.)
Pal' y No. Companyi✓1� FOR APPLICANT TO FILL IN I JOB /�
Certified copy is hereby furnished. New Residential Bldgs. 8.Pools
EACH NO. FEE I ADDRESS �3C./
❑ Certified copy is filed with the county building inspec- ; 1 &2-Family, Sq. Ft. $ — $ i LOCALITY el
�IER
�ICATE
I Multi-family Sq. Ft. — NEAREST
DateApplicant Residential Swimming Pools
CROSS ST.
OWNER OR
FIRM NAME fT � IPI
EXEMPTION FROM WORKERS' s! MAIL
Outlets:.Ree Light Sw,_. v�_1A1 7j-
COMPENSATION
INSURANCE I i ADDRESSd/
(This section need not be completed if the work involved by First ti
the permit is for one hundred dollars($100)or less.) Total No. Additional CIT �./�/� Tel. No.10-7-79Z
I certify that in the performance of the work for which this { PLAN CHECK
APPLICANT
permit is issued, I shall not employ any person in.any manner
so as to become subject to the Workers'Compensation Laws. Lighting.Fixtures First 20' 75 ADDRESS
Total No. Additional j17 CITY Tel. No.
Date Applicant Fixed Appliances Not Over 1 HP PERMIT
NOTICE TO APPLICANT: If, after making this 'Certificateof I APPLICANT S"&* a,
Exemption, you should become subject to the. Workers.' Range_ Heater_D.W. _
Compensation provisions of the Labor Code, you must forth- Oven _Dryer _W.M. ADDRESS LO �t
with comply.with such provisions or this'permit shall be I Top _ FAU —W.H. — �
deemed revoked. C .CITY 4 ' T
Z A
�✓1J
LICEHood _ Fan _Other_ fJ�'NSED CONTRACTORS DECLARATION LICENSE OR 177Disp: _ Room Air Cond. '-��
1 hereby affirm that I am licensed under provisions of Chapter 9 , REG. NUMBER
(commencing with Section 7000).of Division 3 of the Business DISTRICT NO. PROC BY Power Apparatus Apparatus 8 Large Appliances
ye-�
and Professions Code,and m license is in full force and effect. /}
Size&Type HP, KW, KVA, or WAR'
License Number L/` .�Lie. Class 6V/D Up to 1 Incl. FINAL
/�p�' ��/lJ�sr Over I to 10 Incl. DATE Z` VALID ON
Contract b[3 1!!✓ �`Z �'
❑ Over 10 to 50 Incl. FIN W
I am exempt under Sec. Over 50 to.100 Inc. �
I �— Over 1.00
B.BP.C. for this reason ; Z
Services,Swbd., MCC 8 Panelboards,
Date: ) 0 -200 Amp. Under 600 V ►
Signature.i 201 - 1000 Amp. Under 600 V 3 4% (-b
I Over 1000.Amp. or Over 600 V
❑ Exemption for Reg. Maint. Elect. W 4 5 7 7
SINGLE FAMILY ( Temp. Power Pole 8 Appurtenances l.f'$� 0 0 0 0 0
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit !s 0,10575
I hereby affirm that.I am exempt from,the Contractor's License i Additional Sign Branch Circuits 0 0 1 Q 5 `7 5=
Law for the following reason (Section 703'1.5, Business and + 1
Professions Code): j 0502_' 86
❑ l,'os owner of the property, will do the work and the I Misc. Conduits8 Conductors
structure is not intended or offered for sale (Section I Other(See Complete Fee Schedule)_
7044, Business and Professions Code). J
CONSTRUCTION LENDING AGENCY I
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' ame
PERMIT'ISSUING FEE
Lend 's Address '
I ce ify that I have read this application-,and state that.the TOTAL FEE Y751�.
a e information is correct. I agree to comply with all County I jl
or inances and St, a laws egulating Electrical wiring, and
by authorize, pre, n fives of this County to enter upon
' e ve- ned rty for inspection purposes. { SEE REVERSE FOR EXPLANATORY LANGUAGE
g ��G'�17 j •
Si nature of Mi tee Date I