HomeMy Public PortalAbout5502 PARMERTON AVE_Electrical__ 7&A663 CE 806(1) /78) L111�r--~
APPLICATION,FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN JQpB }}��-� ,s
New,Re4 deniial Bldgs&-Poo1s5- '- - EACH NO ---FEE - ADDRESS pJOW_ /n` *AN--.
�s 1 &2 Family Sq Fr b 025 = S t LOCALgY L�_
Multi fa'mily,Sq Fr - ' 02 = - �- NEAREST �'
- y - •-
_ Residential$w,mming Pools 2500 CROSS ST_ OWNER R- i-- + ,yL-r•
AFI ,NAME [Lb U'^' r~ r '/✓.-. u r-.--
Outlets Rec_Lg Et -f SW _ _ ` ADDRESS-' -'
First 20 SO
.,.Total No -:Additional 30 CIT4Y+T_ t INa �'•�j`
PLAN CHECK'
APPLICANT=,S -
Lig hTing Fixtures First 20 50 "'ADDRESS
' Total No `�-Addlnonol 30
- - - '- -- - -' -' -- - -'
CITY ,-�•. ^,la,.,o-p.L� psRTel No
Fixed,Applionces Not Over 1 HP -., _ ^''t PERMIT-y� : i--r---- `- - -^-r-- --
7R., WPLICANT •R ' - '"F -
Range_Heater_D W _ - ' ' ADDRESS
Oven—Dryer—W M— - -
Top —FAU _ W H _ _ _ CITYy __o„
• Hood_Fon _Ocher LICENSE OR _-
_ Disp _Room Arc Cond _ 2 50 _ _ _ _ REG NUMBER _ _ Class
t I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICA
Power Apparatus&Large Appliances TION AND STATE THAT-THE ABOVE 15 CORRECT AND AGREE TO
Size 8 Type HP KW KVA or KVAR COMPLY WITH ALL-COUNTY ORDINANCES-AND STATE'LAWS
'�C
REGULATING ELECTRICAL WIRING
-PP to 1 Incl_ _ r2 50 - -- I HEREBY CERTIFY THAPI AM PROPERLY REGISTERED AND/OR -V
Over 1 to 10 Incl 5 00 LICENSED AS RE-OUIRE BY LOS ANGELES COUNTY AND STATE OF pp
Over 10 to 50 Ind - 12 50 CALIFORNIA OR TH I AM THE-L_EGAI OWNER OF THE ABOVE -0
Over 50 to 100 Inc
25 00 - DESCRIBED RESOEN L P Y
- -` -" Over 100 - 4000- __ _ SER MTIE
_
r SIG NATUR_
_Z
Services /00 12 50
- DISTRICT NO '"� - Y'- P SED BY
0
0 2G0 Amp Und 600 V
-201-1000 Amp Under 600V- 2500 - - - - -Over 1000 Amp or Over 600 V 5000 _ Z '
O $6945A
Temp Power Pole&Appurtenances 1- 1000 - -- - < i1 1 ..
Sign with One Branch Circuit _ 1000 " # •� 4 • '• 2 '
Addtnonol Sign Branch Circuits !, ' I ,"2 00 INSPECTION >
°T INFORMATION 'M M
M,sc Condwts&Conductors 1 '1000 '
ON REVERSE
Other(See Complete Fee Schedule)_ G- - r 2,o,• 1915,011
p SIDE.
t. . . 1`9,'5 0,5'
0 1 �-7 9, .'
PERMIT FEE }� fS4.b Total)
PLAN CHECKING FEE [One Fourrh'Pem1m_Fee) O
PERMIT ISSUING FEE - _ E7 00
TOTAL FEE e 1 >
INSPECTION FINALED r a
dare ,o�ghq Y o Qv®z
WOP{(ERS COMPENSATION DECLARATION . 78A893 ,D,B, APPLICATION, FOR ELECTRICAL PERMIT
hereby affirm that have a certihcate of consent to self insure 808GGr It ,
or a certificate of'Workers Compensation Insurance,or a certified ,COUNTY, OF LOS ANGELES 1 - BUILDING'AND SAFETY, �X +
copy thereof(Sac 3800 Lab C) '
P01K.y No Company FOR APPLICANT TO FILL IN y,' JOB' p ,�)
❑ Certified copy+s hereby,furnished '_EACH NO FEE ADDRESS '�S°Z- /Qrw err-on' 4vf _
,¢ ,_ - New Residential Bldgs 8 Pools
' ❑ Certified copy is^tiled with the'%county buildup mspectwn 1 & 2-Family Sq"Ft $ — $ LOCALITY 1a
NEAREST ]�
department Multi-family Sq Ft CROSS ST 'TDQ 1 n Q
Data Applicant ` ' ` Resdentol Swimming Pools ,OWNER OR, J e(f(+,r
•1 FIRM NAME
i -rCERTIFICATE,OF EXEMPTION FROM WORKERS h•, Outlets Recy�• ' " °
COMPENSATION INSURANCE: y First 20 - � ADDRESS 5So2 rP�rm•ertan U2 „ =
^(Th18 section need not be completed it the,work involved by the t •• CITY 'C rel`No alj q-S6T� '
permit ie for ono hundred dollars ($,100) or less) .^ Total No Additional - - l�
I certify,that in the,perlormance of the work for which this permit ri, iPLAN CHECK A r
L L t -,-" 1 ( APPLICANT, S- ✓
Is b sewed stall not employ Work arty person marry manna"so es to, r
, 'become sublect,to the Workers Compensatxxl Laws ° Lighting Fixtures��yy First 20- { - ADDRESS ,- - ` _ I
. ^ Total No % Additional ti P•, CITY �•� Tel No
,Date +- Applicant
• NOTICE TO APPLICANT If aftei make p Fixed Appliances Not Over 1 HP, a)
rig•the CAperi a of _ .4
Exemption you should become sublect to the Workers ComperlsetIcn p, ,^ Range-- Heater— D W APPLICANT , i,U n Q
proYisu&n of the Labor Code you must forthwith comdY with such Oven Dryer _ W M • XI DRESS
.a wnsions or ths'perme shall be deemed rewketl r ,Tp_oF WH r. CITY ^ _ _ ,
LICENSED CONTRACTORS DECLARATION ,, _ O - 'Tel No •'
Held —'Fan,,� Other
_
' I hereby?afhrm that I am licensed under provisions of•Chapter B ` /1 _ '
(commenarp with Section 7000) of Division 3 of the Business end Disp Room Air Cond REG CENSE BER
Professions Code and my license is in lull foice'and effectr DISTRICT NO PROCESSED BY
r- Power Apparatus 8 Lenge Appliances _ - p _. y
Size& Type HP KW KVA for KVAR
Lcense Number Lc Class I _ Up to-1 Incl '.�' ' + FINAL
NAL - - -
• ' Over 1 IIriclLI
r DATE 1 ,
'Contractor Date - - to 10VADATION «. O
Over 10 to 50 Incl 1-
❑,-I am exempt under Soc Over 50 to 100 Inc BY v U
I Wer 100 , _ - T, r ax- •'�....wee � ,
IS for the reason
-- - - • Date
-Services Swbd MCC 8 Panelboerds-+ ► - / . - Z .
10- 200 Amp Urger 600 V
Signature ` `� 201 -{1000 Amp Under 600
'� - -- _ Over'1000 Amp or Over 600 V , ..
Exempixm far Reg Maart Elect u• r
- SINGLE FAMILY ' '^-' Temp Power Pole 8 SApp utterances _ '7
HOME OWNER-BUILDER DECLARATION "i- ' , r s
cense
I hereby affirm that I am exempt from the Contractors LiLaw Sign with One french Cvcud i r ✓ A��T• ,"• �.
Additional Sign Branch Circuits T 'f •'
'"for the following reason(Section 7031 5 Business and Professions R- --- _ - - '
*�n • 3j03 7 E0.00
r Mise Conduits&Conductors, - + ' - ` r, 1 ITEMS ,°+�"-'
I as owner of the property will do the work and the structure + "4 '• ti
/ \ is not intended or offered for sale (Section 7044 Business Oth .er,(See Complete Fee'Sohedule) , Y .. + 0
and Professions Code) ^' , C(yr.gl« '1 'UUVVAUrUY
+ +'- fIG�r1
CONSTRUCTION LENDING AGENCY
-ti I hereby affirm that there is a conshuctron•lending agency,for the I , ,� „ r , ' , .:CHANGE } ,r• 1•�N
rt Crtnaroe of the work for which this permit s issued(Sec 3007 ., PERMIT FEE i' „• (Sub-Totai)w' , „d F r • r l �i• ti - + •�+.',.�r f
Cnv ' - PLAN CHECKING FEEc
Lenders Name A" r 1100D0-0001' 7/13/9 i-
,ar' , ' 1• ' + I + PERMIT,ISSUING FEE• +«idii T, n'� cl
Lenders Address
I certify that I haw read thin application and state that the above TOTAL FEE
information is correct I
agree to comply with all County ordinances I
and State laws regulating Electrical'wining and hereby authonze
representatives of this County to enter upon the above-nrenironed` "- - ` '•{^ "'"rn ` ^ :$ S ` ` - « "+'�- 't';'^ ' A,
property for inspecaorL purposes _r SEE REVERSE FOR EXPLANATORY LANGUAGE ,✓ ri_ 1 I `�'' -•,.,.
7-13- 9'S J
S nor ne of Permittee + • _`
� Date