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Home My Public Portal About5027 PAL MAL AVE_Electrical__ 7Ci1,Li r C_ [ �yy. {� 76A663-C€BQ�i 1:1.70 APPLICATION VOR ELECTRICAL PERMIT LI COUNTY-OF LOS ANGELES ry DEPARTMENT OF COUNTY ENGINEER BU REISS G �� I r BUILDING AND SAFETY DIVISION COLEMAN W. JENKINS. SUPERINTENDENT OF BUILDING LOCALITY I 02 NEAREST FOR APPLICANT TO FILL IN CROSS ST. OUTLETS NO. EACH FEE OWNER C�it _ ,RECEPT. S MAIL 7 LIGHT � TOTAL FIRST 20 25 ADDRESS /� b 0 CITY /-,6 TEL. N0. SWITCH__L_ OVER 20 10 PLAN CHECK LIGHTING TOTAL .f0 FIRST 20 25 APPLICANT FIXTURES OVER 20 ADDRESS APPLIANCES CITY TEL. NO. RANGE DRYER_WTR. HTR. PERMIT APPLICANT STA. COOK DISP. F.A.U. ADDRESS.1' a,,3 irLs �� eL [F) ACE HTR. AIR GOND. CITY E'% v Lv� (- ? .& TEL. NOy/, / OTHES WASH. DISHWASH. LICENSE N0. C'1� 'Z__ CLASS. N OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY OTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO l I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR '� 0 - 1 100 tj C) LICENSED AS REQUIRED 8Y LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO } . O 1 - 10 300 RESIDE IN, THE ABOV DESCRIL1RESIDENTIAL PROPERTY. O SIGNATURE b' 0 U 10 - 50 5.00 OF PERMITTEE d SO - 100 1000ADISTRICT NO CLASS q PROC SED BY 0 100 - 500 15.00 5, d g Irro SIGN, GAS SIGN AND ONE CIRCUIT 5.00 NOTES: to TUBE, OR ? MARQUEE ADDITIONAL CIRCUITS 1.00 SERVICE NOTOVER 600 VOLTS OR 200 AMP 3.00 ' SERVICE OVER 600 VOLTS OR 200 AMP 10.00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP.POWER POLE TEMP SERVICE,POLE,&APPURTENANCES 5.00 UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM 3.00 ROUGH CONDIUT WIRING FIXTURE'S POWER AUTHORIZED PERMIT FEE (SUB TOTAL) UTILITY CO. NOTIFIED PLAN CHECK FEE PERMIT ISSUING FEE 3.00 FINAL o 3• [ti L v JOS9PIq C. ROONAN TOTAL FEE '(� SUPERVISING EL CAL ENGINEER, PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M,O. CASH I-rl. t 2 n 4 91-4 NLS 1 2 D 4.0 0cQ - SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE DDS 5--Ay -A 12-44 DEPARTI�ENTF eF BUTMIUG ATM SA-FETY COUNTY OF LOS All.GEMES J. rO—X., C.KF KNGINEUR NAME �6 °.an.isyl WrADY FOR cl'ry TM.IINIDI. FIR�;T INS'PEC'11014 r—oF Gid",im-i-"y APPLICANT FILL "!J',rq'lr,TNEl'T3 POR T-i"DYN' JOB VUYmLM OF OUTLETS ON CIPCUITS L-—01c LOCATION BEY ROOMIS -- LAI \00- LGH'TOU LEG, S'vi. N.AYS" :EDc I V c vc rr r A B C D E F.- C4 "i ly NAM� MAIL ADDR 5;.S __ p P C a_ ° ,—CITY"" 1 AM Tfqr-- LEGAL POSSE OR OF THE AMOVF LCX.-' AV.B-"E:0- CCUNTY Crfll !CATZ OF Q!J: Ll7icATIOM.. 'Mr DEscal.'BE:n I AW� Ce"R"RE CT I W"i'S '77 —It Vllk tj Ck gi j]'At7 ALS NO OUTLETS NO. OF FIXTURES, NO. OF MOTOrS H.P. h0. OF SIGNS TRANe, NO. OF RANGES OR H.C-'A—,M? FIXTUPFFS NUSCELLAN70 PERMIT FEE t low e UTlLlTYC0.NOT9rzu:, -r,)TAL 717r FINAL DRE 5-A 2-46 ' DEPARTMENT-OF BUILDING AND SAFLITY;:: APPLICATION FOR PERNIIT COUNTY OF LOS .ANGELES ELECTRIC . WM. J. F.OX CHIEF ENGINEER a NAME DISTRICT NO. GROUP ZONE JFFERMIT NO. L U ADDRESS /al /� RECEIVED BY READY FOR DATE ISSUED CITYJOTEL.NO.1Q - FIRST INSPECTION W CERT.NO.UN EXPIRE APPLICANT FILL.IN Y OUTLINED PORTTION ONLY DESCRIPTION OF WORK JOB DRESS NUMBER OF OUTLETS ON CIRCUITS LOCALI LOCATION BY ROOMS NEAREST LIGHT,OUTLETS lsw. PLUGS FAIT CROSS ST. CIRCUIT A B C D E F G H_ m NAME ' Z. MAIL All3 ADDRESS O CITY TEL.NO. '1. AM THE LEGAL POSSES80 T ROVE LOS ANG COUNTY CERTIFI T Q /CATION.. ELECTRICIAN. AI AM BOVE THE LEGAL OWNER OF THB PROPERTY DESCRIBED ofy OWNER. CORRECTIONS lit - 1 Oee T 7— Z E • O 4 • rNA UTLETS $ Ass - APPROVALS , IXTURES O�' J DATE INSPECTOR'S NAME MOTORS H.P. S CONDUIT SIGNS -TRANS. WIRING RANGES OARS $ FIXTURES •1 ANEOUS B POWER �•F.EE $ UTILITYCO.NOTIFIED•+��vt sts � _._ ✓__'_- EE O 'FINAL r �r �(� �� WORKERS'COMPENSATION DECLARATIONt 10/81 I hereby aiflrm that I have a certificate of consent to self insure, APPLICATION FOR ELECTRICAL PERMIT peas. certificate of Workers'Compensation Insurance, or a certified COUNTY OF LOS ANGELES '' BUILDING AND SAFETY copy thereof(Sec.3800..Lab.C.) Policy No. Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished. Ne w.Residential Bldgs.&Pools EACH NO. FEE ADDRESS 1 &2-Family,S Ft. $ — $ LOCALITY Certified copy is filed with the county building inspection y' q• NEAREST J department. Multi-family Sq.Ft. Residential Swimming.Pools CROSS FIRMER Daae Applicant O tt FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' OL tlets:Rec—L.Light—Sw._ MAIL COMPENSATION INSURANCE. ADDRESS c11'jll/h (This section need not be completed If the work Involved by the First 20 permit Is for one hundred dollars($100)or less.) Total No. Additional CITY Tel.No. I certify that in the performance of the work for which this.permit -PLAN CHECK is issued, I shall not employ a APPLICANT LT - p y nY 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 Fli ed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making. this Certificate of , 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._ JADDRESS ,provisions or this permitshall be deemed revoked. Top — FAU _. W.H. — LICENSED CONTRACTORS DECLARATION Hood — Fan Other_ I hereby affirm that I am licensed under provisions of Chapter 9DLICE SE O.R (commencing with Section 7000)of Division 3 of the Business and isp. Room Air Cond. IREG.NUMBER e �Jr Class j0 Professions Code,and my license is in full force and effect. 'DISTRICT No PRO ED B Po r Apparatus&Large Appliances i y� Size&Type HP,KW,KVA,or KVAR 1921 Q License Number ST Lic.Glass ��/ Up to 1 Incl. FINAL V Contractor Date ` Z Over 1 to 10 Incl. DAT VALIDATION 0 Over 10 to 50 Incl. FINAL ❑ I a exempt under Sec. Over 50 to 100 Inc. BY B.BP.C.for this reason Over 100Ll D. Se ice &Panelboards Q ® Z Data: 260 Am Under 600 V v eJ Signature 201' mp.,Under 600 V ❑ Exemption for Reg.Maint.Elect. Over 1000 Amp.or Over 600 V SINGLE FAMILY Temp.Power Pole&Appurtenances ;3 7 3t.90 HOME OWNER-BUILDERDECLARATION. Sin with One Branch Circuit I hereby affirm that I am exempt from the Contractor's 'License Law for the following reason(Section 703.1.5,Business and Professions itional Sign Branch Circuits 1 ITEMS Code):. I TOTAL 36.90 Mf¢c.Conduits 8 Conductors El —+ rl I,as owner of the property,will do the-work and the structure CHECK 36.9L id not intended'or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) _ and Professions Code). i CHANGE • .00 I CONSTRUCTION LENDING AGENCY I ;I I hereby affirm.that there.is a construction lending agency for the performance,of the work for which this permit is issued(Sec.3097, PEIMIT FEE (Sub Total) I ��Q —��I 7� fg� Civ.W.., I i 1000 1 AM 71234 PL W CHECKING FEE Lender's Name PE 3MIT ISSUING FEE Lender's Address I certify.that I have read this application and state that the above AL FEE ) infon is correct.I agree to comply with all County ordinances Sta laws regulating EI o4rical wiring, and hereby authorize prese atives his enter u n the above-mentioned j proper for i n u s. SEE REVERSE FOR EXPLANATORY LANGUAGE I` Signature of Permittee Date ,