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HomeMy Public PortalAbout5444 PARMERTON AVE_Electrical__ ')anee5 CESOB 10 az APPLICATION FOR E ECTRICAL PERMIT COUNTY OF LOS ANGELES - DEPARTMENT OF COUNTY ENGINEER BUILDING ♦y v BUILDING AND SAFETY DIVISION ADDRESS 7 JOHN A LAMBIE COUNTY ENGINEER WILLIAM A JENSEN SUP T OF BUILDING L TY r I EfA REST FOR APPLIC - SS sT'� Recon TOTAL No EACH ME / I OUTLE S r�ST 20 $ $ - OWNER uaxT / 20 M ILY AOG `` ARESS 9NITCN / OV" Z� ID , TOTAL CITY TEL NO . LIGHTING � rIRBr 20 20 FIx TU RES Qven 20 1 10 ELECTRICIAN .� O^ RArvaee clo Dave ,,U V?R NTRS 100 ADDRESS �+ � ARG DIBP If BTA COOK „ 2 /1 y �/}� CITY t C6 TEL NO O �D�TV DlSrvwwBM nuTo wwBN STATE / O SPACE HTRG - BTA APP (W HP MAX ) 50 LICENSE NO (j' MOTORS, OVER NOT OVER HP DISTRI� N 1.GRO P Z NE PROCESSED BY O 1 100 1 5 150 INSPECTION RECORD B S 200 S 15 250 is e0 500 — O 60 100 a 00 LLVr! /D• d SIGNS NO TRANS YI NO LAMPS Z / I " T SERVICE BOOV NOT OVER 200A 100 SERVICE O 600V OVER 200 A 200 SERVICE OVER 600V 500 MISC PERMIT ISSUING FEE 200 SUPPLEMENTARY PERMIT ISSUING FEE 100MFI�URES , TOTAL FEE 6 I HEREBY ACKNOW LEDGE THAT I HAVE READ THIS APPLICATIONDATE INFECTOR S ONATUR[ ANO STATE THAT THE ABOVE IS CORRECT AND AOREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING 1 I HEREBY CERTIFY THAT I AM PROPERLY RCOISTHRHD AND/OR LICENSED AS REQUIRED BY LOB ANGELES COUNTY AND STATE OP CALIFORNIA OR THAT I AM THE LEGAL OWNER Or E ABOVE DESCRIBED RESIDun ROM 5 GNATOF PERURE 4 UTILITY CO NOTIFIED \ FINAL I0- _6 LIDATION ARTHUR C VErr C MO CASH SUPERVISING ELE ICAL ENGINEER L (D4776�2 OCT13 2 0 4.00- Q 5 DEPARTMENT OF BUILDING AND SAFETY APPLiCATiON FOR PERMTr COUNTY OF LOS ANGELES ELECTRIC M J OX CHIEF ENGINE6 Q NAME r DIST CT NO. GROUP ZO/NJ/E PE/yRMIITT NO. U ADDRESS w�/�',A�1. CITY � / L.TEL NO`N J 4 J H ®BV READY FOR DATE 186UHD q�1 � ,rr ^ FIRST INSPECTION W CERT NO h 4 tS SM 1 EXPIRES qr -'o- APPLICANT APPLICANT FILL IN HEAVILY OUTLINED/PORTION,ONLY JOB DESCRIPTION OF WORK ADDRESS T �� v NUMBER OF OUTLETS ON CIRCUITS LOCALITY LOCATION BY ROOMS NEAREST LIGHT OUTLETS SW PLUGS lmXT CROSS BT CIRCUIT A B C D E F G JH C NAME /. +3 AD KESS 0 1 r clrY TEL NO 1 AM THE LEGALOPOSSESSOR OF THE ABOV LOB ANGP,.I.EB COUNTY P"TIFIC F.�OF� IFICATIO� !. L C cnxcux I AM THE LEGAL OWNER OF THE PROP DESCRIBED ABOVE OWNER CORRECTIONS J 07 Q 2 I7 Q' rToTAL NO OF OUTLETS C s APPROVAIS NO OF FIXTURES / V S SIDAk INSPEC�TrOR S NAME NO OF MOTORS H P S CONDUIT U (/ .NO OF SIGNS TRANS /f WIRING NO OF RANGER OR HEATERS v FIXTURES MISCELLANEOUS S POWER PERMIT FEE S UTILITYCO NOTPIED • TOTAL FINAL, WORKERS COMPENSATION DECLARATION 63 10,6I APPLICATION FOR ELECTRICAL PERMIT I hereby aff_i n?that I have a certificateCE 8te of consent to self CE 06G 1 insure oorb cerlifirple of Workers Compensation Insurance COUNTY OF LOS ANGELES BUILDING AND SAFETY or a cerhtied copy thereof (Sec 3800 L,-o/bsb C ) Policy No 10a �f67Company �'""/e ���e/ FOR APPLICANT TO FILL IN JOBper/ Certified copy is hereby furmshed New Residential Bldgs 8 Pools EACH NO FEE ADDRESS 3 17 .F"ll�meA' n © $ = S LOCALITY TEPY) Certified copy is fled with the county'6Zddmg mspec_ 18 2 Family $q Ft hon department / Multi-family Sq Ft NEAREST CROSS ST 10-0-'0 Residential Swimming Pools Dole Applicant Residential y ! / FIRM NAME A#& L CERTIFICATE OF EXEMPTION/FROM WORKERS Outlets Rec 3 U ht 3 Sw / MAIL COMPENSATION INSURANCE g ADDRESS �7 vY 5�ojx neR (This section need not be completed if the work i volved by first 20 the permit is for one hundred dollars ($I00)or less ) Total No Additional CITY ]�E In riwe Tel No certify that in the performance` the work for which PLAN CHECK APPLICANT « permit is issued shall not employ any person m any mannerner so as to become subject to the Workers Compensation Laws Lighting Fixtures First 20 / ADDRESS ' Total No 3 Additional Dote cant t CITY Tel No /f AppL NOTICE TO APPLICANT If after making this Certificate of F1 xed Appliances Not Over I HP PERMIT ( Exemption you should become subject to the Workers Range_ Heater_D W APPLICANT LO Compensation provisions of the Labor Code you must forth- Oven _ Dryer _ W M — i ADDRESS '{/ ,�Pi/7!/�/sC C with comply with such provisions or this permit shall be Top — FAU —W H deemed revoked t Hood Fan _Other_ CITY ZLZX4 Tel No LICENSED CONTRACTOR _ S DECLARATION Dirsp _ Room Air Cond LICENSE OR Class I hereby affirm that I am licensed under provisions of Chapter 9 REG NUMBER (commencing with Section 7000) of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NO r, PROLE D BY and Professions C�,.4"�'�1'g is in full force and effect C�(/ d _ L Size 8 Type HP KW KVA or KVAR U s�(J O License N2 h4 c Class Up to 1 Incl FINAL V DATE /f, /O -Z_�9 Over l to 10 Incl zZ — V (DATION 0 Contractor Date❑ Over 10 to 50 Incl G V FINAL am exempt under Sec Over 50 l0 100 Inc BY d B 8P C for this reason Over leg _ :28043A W Services, Swbd MCC 8 Panelboords Date 0 200 Amp Under 600 V Signature L 201 - 1000 Amp Under 600 V ❑ Exemption for Reg Main1 Elect X0Over ( 0 Amp or Over 600 V ) • - 19.50 SINGLE FAMILY -:!Temp Power Pole 8 Appurtenances • 1 9,5 0 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ( t 8 7 1 hereby affirm that I am exempt from the Contractor s License Additional Sign Branch Circuits0 0'Z Low for the following reason (Section 7031 5 Business and Professions Code) ❑ I as owner of the property will do the work and the Misc Conduits 8 Conductors structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)— ► 7044 Business 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 PERMIT FEE (Sub Total) (Sec 3097 Civ C ) PLAN CHECKING FEE Lender s Name PERMIT ISSUING FEE _ Lender s Address tl I certify that I have read this application and state that the TOTAL FEE 5 1 aboveinform on is correct I agree to comply with all County - ordinance a State laws regulating Electrical wiring and hereby F orae representatives of this.Gounty to enter upon thea ve mentioned prop rty for inspection purposes, V �/J/I l /D n� SEE REVERSE FOR EXPLANATORY LANGUAGE _ rSignalure of PiPerm,tteeeee (�,��«'�/ Date G