HomeMy Public PortalAbout5338 PARMERTON AVE_Electrical__ 76A6E3-CE6061-67 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER eu1LDING E E
BUILDING AND SAFETY DIVISION AODREss
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS, SUPERINTENDENT OF BUILDING LOCALITY — C
NEAREST
FOR APPLICANT TO FILL IN I [ROBS BT
No EACH FEE
RECEPT OTUOTLETS FIRST 20 s 20 S OWNER LIGHTMAIL
—SWITCH
Rn V
SWITCH ADD L to ADDESS R
OVER 20
TOTAL FIRST 20 20 CITY EMUE C-/:Q/TEL NO 7 Q r
LIGHTING FIXTURES
FIXTURES ADD L 10 CONTRACTOR W
OVER 20
RANGES DRYERS WTR HTRR 100 ADDRESS
BARB DISP ETA COOK
CITY TEL NO
DIENWAEH AUTO WASH STATE
SPACE HTRE STA APDL p0 LICENSE NO
MOTORS OVER NOT OVER H P DISFICT ISO GROUP ZONE PR9C ED BY
0 t t DO S . Off 4- Gs
1 B 1 150 INSPECTION RECORD
a 8 200
8 18 z so
18 80 O
so 100 500 1.1
l
SIGNS No TRANS ! GC
NO LAMPS Q
SERVICE O 600Y NOT OVER 200A 100
SERVICED 600V OVER 200A 12 O 200 If rB� G N
7 Z
SERVICE OVER BOOV 500
OTHER (EEE COMPLETE FEE SCHEDULE)
PERMIT ISSUING FEE 2001 .Z "
SUPPLEMENTARY PERMIT 188U[NO FEE 100 APPROVALS DATE INSPECTOw 0 MIGNATURIE
TOTAL FEE jr— T-
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION UNDERSLAB WORK
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ROUGH CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING WIRING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED A OIOR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNT ANO BT E OF
CALIFORNIA OR THAT 1 AM THE LEGAL WNEp OF NO INT B TO POWER
RESIDEIH THE DEDCRIB pCS EN IA PERTY �1
SIGNATURE UTILITY CO NOTIFIED 1 L —tot
OF PERMITT
FINAL
VALMO 14 1 JOSEPH C RO ELECTRICAL
(`lC� JOSEPH
C R OHAN IGL ENGINEBR
CK MO AGH
Ac, 1 2 0 5 0cT 16 2 D 5.5 0— v
` WS COMPENSATION DECLARATION CE
8636G (2 801 APPLICATION FOR ELECTRICAL PERMIT•
76 6 i
I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY
insure or a certificate of Workers Compensation Insurance or
a certified copy thereof(Sec 3800 Lab C)
Policy No CompanFOR APPLICANT TO FILL IN JOB
y ADD RE
• New Residential Bldgs &Pools EACH NOFFEECertified copy is hereby furnished 1 & 2 Famdy,Sq Ft S — LOCALIT
Multi family Sq Ft r — ARE T
Certified copy is filed with the county budding inspection CROSS ST
department Residential Swimming Pools OWNER OR /
FIRM
Date ApplicantOutlets Ret_Light_Sw _ MAIL
First 20
CERTII ICATL or EXEMPTION I ROM WORKERS Total No Additional CITY I Tal No
COMPENSATION INSURANCE }
LAN CHECK 1
(This sechonLneed not be completed if the work involved 1 ' APPLICANT p
by the permit Is for one hundred dollars, (S 100) or less) Lighting Fixtures First 20 ADDRESS U
Total No Additional
1 certify that in the performance of the,work for which this s Fixed Appliances Not Over 1 HP CITY Tel No ' Q
permit is issued 1 shall not employ any person in any manner PERMIT U
so as to become subject to the Workers Compensation Laws Range_ Heater_DIN _ APPLICANT W
Oven _ Dryer_W M _ " AO_DRESS N
Date Applicant Top _ FAU _WH _i Z
I / Hood — Fan _Other_ CITY Tel No
NOTICE TO APPLICANT If after making this Certificate of Disp _ Room Air Cond_ LICENSE OR
Exemption you should become subject to the Workers REG NUMBER Class
Compensation provisions of the Labor Code you must forthPower Apparatus& Large Appliances DISTRICT NO PROCESSED BY
with comply with such provisions or this permit shall be
deemed revoked Size&Type HP KW KVA or KVAR
Up to 1 Incl
FINAL
LICENSED CONTRACTORS DECLARATION Over 1 to 10 Incl DATE p Z VALIDATION
Over 10 to 50 Incl i�s — `
1 hereby affirm that I am licensed under provisions of Chapter •Over 50 to 100 Inc FINAL
(commencing with Section 7000)of Division 3 of the Busi Over 100 BY
III, and Professions Code and my liee4c is in full force and
effect Services _
License Number Lm Class 0 200 Amp Under 600 V `
201 1000 Amp Under 600 V
Contractor Date Over 1000 Amp or Over 600 V
HOME OWNER BUILDER DECLARATION Temp Power Pole&Appurtenances 1
'
1 hereby affirm that I em exempt from the Contractors Sign with One Branch Circuit - s
Additional Sign Branch Circuits ^
License Law for the following reason (Section 7031 5 Bust
ness and Professions Code) - �4 9,b 8 A
❑ Misc Conduits& Conductors•
1 as owner of the property will do the work and the Other (See Complete Fee Schedule)— # • • • a a 2
structure is not intended or offered for sale (Section ,
7044 Business and Professions Code) 2 •to 2,3 Jr O '
CONSTRUCTION LLNDING AGENCY
1 hereby affirm that there is a construction lending agency J • • • 2 S r?3
for the performance of the work for which this permit is PERMIT FEE (Sub Total) i
issued (Sec 3097 Civ C )
Lender s Name PLAN CHECKING FEE (One Fourth Permit Fee) O 7� 1 5—8 2
Lender's Address PERMIT ISSUING FEE '
r
I certify that I hese read this application and state that the TOTAL FEE
above information is correct I agree to comply with all County r _
ordinances and State laws uldung Electrical wiring and
here j;Luthor¢e representee of this Co to enter upon t I r
U,
ova m oned pr y for mspecti p rpo s `
I. SEE REVERSE I OR EXPLANATORY LANGUAGE
Sign ure of Permi tee r e ✓ L/ r