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HomeMy Public PortalAbout5544 PERSIMMON AVE_Electrical__ IA663-CROOB 10-60 APPLICATION FOR ELECTRICA .PERMIT ` COUNTY OF LOS ANGELES DEPARMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS. JOHN A. LAMBIE, COUNTY ENGINEER y WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL"IN cRoss sT. PERMIT•FEES OWNER. ®' I T E M NUMBER EACH FEE MAIL ti `. OUTLET $, $ ADDRES LIGHTS RECEPT . SW.' .1O CITL. N LIGHTING FIXTURES 10 D ELEC.RANGES CLO.DRYERS f - ELECTRICIAN - WAj98 HEA Tx R N .50 ADDRESS. ELEC.SPACE FRRS. ISHW 'OHERS CITY TEL NO. GARBAGE DISPOSERS AUTO:- STATE WASHERS STA.COOKING UNITS ,25 LICENSE NO. MOTORS: OVER INC. H.P. DI ICT GROUP ZONE PZ0990SED BY f 0— 1/a .25 2 :SO. INSPECTION RECORD, 2— 5 ' 1.00 r 5— 15 1.50 c�. Is-- 50 2.50 5ad 0' O rip./ ��t ,r— 200 5.00 T' i NO TRANS. SIGNS: .NO.LAMPS SERVICE 0-600V 1,00 z SERVICE OVER 600V 5.00 M ISC. WIRING PERMIT 1,00 FIXTURE PERMIT 1.00 O® SUPPLEMENTARY PERMIT ,S0 TOTAL FEE $ 1HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP LICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES ANC STATE LAWN REGULATING ELECTRICAL WIRING. WIRING' I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED. AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR T T I AM THE LEGAL OWNER OF 'THE ABOVE / r DESCRIBED RE TIAL PROPER POWER ' SIGNATU UTILITY CO.NOTIFIED" L� _Cef �tA OF PERMI LIDATION ARtHUR C: VEIT . C Mo CASH SUPERVISING ELECTRICAL ENGINEER Lj,o-774 3 -8 Y 2 D -4.8,0 Fry CHTY �eae.cseo.a.eo :. ,APPLOCATION FOR ELECTRICAL �PERMIT . COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BU '3'N BUILDING AND SAFETY DIVISION_ ADDRES d JOHN A.LAMBIE,COUNTER ENGINEER WILLIAM A.JENIS.EN. SUPT OF BUILDING l.00N.ITY� FOR APPLICANT TO FILL IN NEAREST CR038 8 _ PERMIT FEES OWNER - I ITEM NUMBER EACH FEE MAIL C OUTL $ ADDRESS - "LIGHT R6CEPT. 8W: .f0 LIGHTING FIXTURES AO CITY TEL. 'ELEC.*AHGEB CLO.DRYERS .ELECTRICIAN WATER HEATERS .50 ARDRESS ELEC.SPACE-HTRS.;DISHWASHERS CITY TEL.NO: GARBAGE DISPOSERS AUTO, � STATE WASHERS STA.COOIONG UNITS ,2$ LICENSE NO. ' MOTORS: OVER INC. H:P. DISTRICT GROUP ZONE PR CE D O — A — 2 .s0 INS ECTION RECORD 2 — s 1. 1.00 .1. 1.50 V 15 so ° rs `-) OG 2.50 3 �. � �. rleb� .tri, p so — zoo 4 S.00 Jr r.Z Lu SIGNS: NO.TRANS. - r H NO.LAMPS - Z SERVICE.C; 1.00. SERVICE OVER GOOV $.00 MISC. WIRING PERMIT 1.00. FIXTURE PERMIT .1.00 SUPPLEMENTARY PERMI ,S0 TOTAL FEE Z S I HEREBY ACKNOWLEDGE'THAT I HAVE READ THIS APPLICATION APPROVALS DATE .INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND 'AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING f •. ..e fir•''.� I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ,y LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES )�✓% ' "f'�„:� a,l� CALIFORNi T I AM THE LEGAL OWNER OF THE ABOVEr'- .DESCRIBE TIAL PROP POWER SiGNATUR UTILITY CO. NOTIFIED OF PERMI FINAL. VALIDATI AFftjjkUFiC.VETT. {' CK MO CASH SUPERVIsiNG.ELECTRICAL ENGINEER #�ci 8 3 1.,3• i 8 .2 D 2.60 76A663.C.ESDR 1-6/ APPLICATION FOR ELECTRICAL ERMIT 70 COUNTY OF LOS ANGELES DEPARTMENT OF.COUNTY ENGINEER BUILDING yy BUILDING AND SAFETY DIVISION ADDRESS cJ 'COLEMAN W. JENKINS SUPERINTENDENT OF BUILDING LOCALITY NEAREST G� FOR APPLICANT TO FILL IN CROSS ST. OUTLETS NO. EACH FEE OWNER S S RECEPT._ MAIL LIGHT TOTALh FIRST 20 25 ADDRESS OVER 20 CITY TEL. NO. fdZ SWITCH_ .10 PLAN CHECK LIGHTING TOTAL FIRST 20 .25 APPLICANT FIXTURES OVER 20 ADDRESS •10 APPLIANCES CITY TEL. NO. PERMIT RANGE DRYER_WTR. HTR. - APPLICANT STA. COOK DISP. F.A.U. ADDRESS SPACE HTR. AIR COND. CITY TEL. NO. CLOTHES WASH. DISHWASH. LICENSE NO. L CLASS. FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW.KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO ` I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 - 1 100 0-6 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF, AND INTEND TO a 1 - 1O 3.00 RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. O SIGNATUREr ` U 10 — 50 5.00 OF PERMITTEE IY 50 — 100 10.00 DISTRICTNO. CLASS ZON PR CE D I- 1 100 — 500 15.00 e© a SIGN, GAS SIGN AND ONE CIRCUIT 5.00 NOTES: ? z TUBE, OR AloMARQUEE ADDITIONAL CIRCUITS 1.00 SERVI CENOTOVER 600 VOLTS OR 200 AMP 3.00 �� ' � `a " fes"�- r•'a— APPROVALS DATE INSPECTOR'S SIGNATURE SERVICEOVER 600 VOLTS OR 200 AMP 10.00 TEMP.POWER POLE TEM PSERVICE,POLE,&APPURTENANCES 5.00 TEMP LIGHT OR RECEPT. SYSTEM 3.00 UNDERSLAB WORK ROUGH CONDIUT + ` WIRING- FIXTURO a" PERMIT FEE (SUB TOTAL) 'f POWER AUTHORIZED Ue UTILITY CO. NOTIFIED ! PLAN CHECK FEE FINAL PERMIT ISSUING FEE 3.00 QG F JOSEPH C. ROOHAN' TOTAL FEE SUPERVISING EL CAL ENGINEER, PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH - 6 �-.s '7.� 15 2 T 5_:0 4 SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE D.e.e.BA asM Bare io-47 AIMCATION FOR PERIM . DEPAR ��Tl�1TN' oF F�f OF u �AN� ANDELES SAFM ELL F .'FOX CHIEF E INKIER i IC NAME�XA_ .lf°rv9iG�. D18TR1 GROUP ZONE. PERMIT 1►!O. U ADDRESSe/A.Za-1144&.111, 6 Z_/42�.G1•L.l/1• /� 6�+`�/� w I CiT1fi h��:l L>f+1�+�.GY.L:�.+t //TEL NO. L2'��S f E V� FIRST INSPECTION'FORREADY DA LSSU C CENT!No. EXPIRES F' APPLICANTTWILL IN IICAVILY OUTLINED PORTION ONLY JOB IBEIOIoi OF W®IdIC !ADDRESS c .r .�'W - ��.t NUMBER OF OUTLETS ON CIRCUITS LOCALITY LOCATION BY ROOMS �111EAREST LIGHT OUTLETS SW.I PLUGS Filtr CROSS ST. CIRCUPP gA 113 C D E 'F G H ll W NAME . . , C��or /�f�f.Fiila:�✓��t . � . 3 ' ADDREMAIL 68-1.1 rl '' 1 Ap�M�.�THE- LEGAL IR SESSOA OF THE ABOVE LOS ANGFII.ES COUl1ITlG CERTIF18 T) rRA_FI . ICU IK CoA E THE&-Mw .OWNER OF THB.pgOP�RTY�DESCRIBED r OWNER. ORREMONS Q' TOTAL i i -NO. OF OUTLETS' ffi ls�+/ '• APPIIOVAI:S NO. OF FIXTURES DATEIf[P �f INSPECTOR'S"NAME NO. OR MOTORS H.P. ffi CONDUIT / w NO. OF SIGNS TRANS. ffi 'WIRING NO. OF RANGES OR HEATERS ffi :5 S FIXTURES- t MISCELLANEOUS ffi POWER PERMIT FEE ffi /! 4, 'UTILITY CO.NOTIFIED �rA A V `% .-4— .TOTAL FEE ® '7' �� FINAL WORKERS'COMPENSATIONDECLARATION f E-806G (2-80) APPLICATION FOR ELECTRICAL PERMIT �06 I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELESBUILDING AND SAFETY insure,or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) FOR APPLICANT TO FILL IN JOB ADDRESSS'S4 SJ #1GJkJ AU4 Policy No. Company New Residential Bldgs.&Pools EACH NO. FEE Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ — $ LOCALITYe-m C . Multi-family Sq. Ft. NEAREST Certified copy is filed with coup y building.inspection Residential Swimming Pools CROSS ST department. OWNER OR , �+ /gam 4 L \ FIRM NAME � L KC C� Dateo— y Applicant Outlets: Rec.-�L t Sw.2U ADDRESS !JC First 0 CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY Tel No. COMPENSATION INSURANCE PLAN CHECK a APPLICANT (This section need not be completed if the work involved U by the permit is for one hundred dollars ($100) or less.) Lighting Fixtures First 20 ADDRESS cc Total No. Additional O I certify that in the performance of the work for which this CITY Tel No. I— ermit is issued, I shall not employ an person in any manner Fixed Appliances Not Over 1 HP V P P Y Y P PERMIT � d W so as to become subject to the Workers'Compensation Laws. Range_Heater D.W._ APPLICANT 1401 1 ( p, Oven _ Dryer_W.M. N _ ADDRES rJ.— ,��� � � Date Applicant Top _ FAU _W.H.,_ — Hood _ Fan _Other_ CITY (it . Tel NOTICE TO APPLICANT: If, after making this Certificate of Disp. —Room Air Cond. LICENSE OR �� se Exemption, you should become subject to the Workers' REG.N UMBE R3 997;? Class Compensation provisions of the Labor Code, you must forth- Power Apparatus&Large Appliances DISTRICT NO. PROCESS D BY with comply with such provisions or this permit shall be Size&Type HP,KW,KVA,or KVAR Q deemed revoked. 3 Up to 1 Inch - FINAL --+ 11 LICENSED CONTRACTORS DECLARATION Over 1 to 10 Incl. DATE ` .- '�' VALIDATION Over 10 to 50 Incl. I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL / 9 (commencing with Section 7000)of Division 3 of the Busi- Over 100 BY ness and Professions Code,and my license is in full force and effect. Services LicenseLic.Class 0-200 Amp.Under 600 V R �/ Number L 201-1000 Amp.Under 600 V h actio`D'S OM(7 ft Date �'g Over 1000'Amp,or Over 600 V HOME OWNER-BUILDER DECLARATION Temp.Power Pole&Appurtenances I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits f, �_ 1 i, ness and Professions Code): Misc.Conduits&Conductors 0 o a o o ❑ I, as owner of the property, will do the work and the I Other(See Complete Fee Schedule)— structure is not intended or offered for sale (Section " o 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 PERMIT FEE (Sub-Total) issued(Sec.3097,Civ.C.). C Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) Lender's Address PERMIT ISSUING FEE d O I certify that I have read this application and state that the TOTAL FEE l above information is correct.I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby a thorize representatives of this County to enter upon the o menti o ed property for inspection purposes. SEE•REVERSE FOR EXPLANATORY LANGUAGE Signature of KrMittee Date WORKERS'COMPENSATION DECLARATION C� 06G 10/81 APPLICATION FOR ELECTRICAL PERMIT i hereby affirm thaf•I. have a certificate of consent to self ;,sure, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY ,or a certified co y thereof (Sec. 3800, ob. C.) Policy No��limpanyN 'r FOR APPLICANT TO FILL IN' JOB /�J'!/79/Y10�tJ Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO.— FEE. ADDRESS 7 Certified copy is filed with the.county building inspec- 1 &2-Family, Sq. Ft. $ — $ LOCALITY ehf le 0;-/ tion department. Multi-family Sq. Ft. — NEAREST ' 1 �/�,.�5 Residential Swimming Pools OWNERCROSS O �� �+ Date Applicant OWNER OR / � FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL {{ Outlets: Rec Light Sw._ COMPENSATION INSURANCE 'I' ADDRESS �yy a 44" COMPENSATION Or This section need not be completed if the work involved b First 20 ( P Y Total No. Additional CITY Tei. Noyy�-� the permit is for one hundred dollars(;100)or less:) I certifythat in the performance of the work for which this PLAN CHECK P .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 ADDRESS TAdditional Total No. CITY Tel. No. ' Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, offer making this Cerfificate of APPLICANT /VIVO!2 � C 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 /� � '�%�% / with comply with such provisions or this permit shall be Top _ FAU —W.H. —. deemed revoked. Hood _ Fan _Other_ CITY Tel. No. �� a Cdr� YS�a�! LICENSED CONTRACTORS DECLARATION LICENSE OR 7 I hereby affirm that I am licensed under provisions of Chapter 9 Disp: _ Room Air Cond. REG.NUMBER Class. C (commencing with Section 7000)of Division 3 of the Business DISTRICT NO. PROC BY and Professions Code,and m license is in full force and effect. Power Apparatus&Large Appliances ��"" 1710373-5- /6�-j� C, sJ� Size&Type HP, KW, KVA, or KVAR- 51 `77 �� JJ at License Number Lic. Class Up to 1 Incl. FINALC Jam✓ T Over 1 to 10 Incl. DAT V. IDATION � Contractor Date Date 7`�` � AV 0 Over 10 to 50 Incl. I am exempt under Sec. Over 50 to 100 Inc. BY BY � B.&P.C. for this reason Over 100 46 Services, Swbd., MCC&Panelboards Z Date: 0 -200 Amp. Under 600 V Signature 201 -1000 Amp. Under 600 V Over 1000 Amp. or Over 600 V ❑ Exemption for Reg.:Maint. Elect. -32464A SINGLE FAMILY Temp. Power Pole&Appurtenances # o. 0 0 0 0 2 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ­ 2550 I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits " Low for the following reason (Section 7031.5, Business and O= Professions Code): + Misc. Conduits&Conductors o o o 2 5,5 c5 I, as owner of the property, will.do the work and the structure is not intended or offered for saie (Section Other(See Complete Fee Schedule)_ , 0 7.1 6 s.8'5 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY 6 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued PERMITFEE (Sub-Total.) (Sec. 3097, Civ. C.). PLAN CHECKING FEE + Lender's Name PERMIT ISSUING FEE Lender's Address r I certify that.I'have read this application and state that the TOTAL FEE t,p above:information is correct. I agree to comply with all.County ordinances and State laws regulating Electrical wiring, and.l' hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. SEE,REVERSE FOR.EXPLANATORY LANGUAGE , Signature of Permittee Date WORKERS'COMPENSATION DECLARATION 78-863 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby affirmrm tlAt I-have•a certificate of consent to self insure, CE-806G or a certiflcate 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. New Residential Bldgs.&Pools EACH NO. FEE ADDRESS s-q` t JZ 1 & 2-Family,Sq.Ft. $ _ $ LOCALITY t e iJlfl Certified copy is filed with the county building inspection NEAREST department. Multi-family Sq.Ft. CROSS ST. Date — Applicant Residential Swimming Pools OWNER OR FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' A ` MAIL _ / ��n Outlets:Rec —Light Sw. / `- COMPENSATION INSURANCE ADDRESS (This section need not be completed if the work involved by the Q First 20 permit is for one hundred dollars($100)or less.) Total No. u Additional PLAN CHEC CITY Tel.No. I certify that in the performance of the work for which this permit -APPLICANT K 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 ADDRESS Total No. .7 Additional CITY Tel.No. Date Applicant Fixed 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 r provisions of the Labor Code,you must forthwith comply with such Oven _ Dryer_ W.M._ ADDRESS provisions or this permit shall be deemed revoked. Top _ FAU _ W.H. _ LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other_ CITY Tel.No. I hereby affirm that I. am licensed under provisions of Chapter 9 Disp: _ Room Air Cond. LICENSE , _ Cless. (commencing with Section 7000)of Division 3 of the Business and REG.NUMBB ER Professions Code,and my license is in full force and effect. Power Apparatus&Large Appliances DISTRICT NO. ` r/ PROCESSED Size&Type HP,KW,KVA,or KVAR U Qy License Number Lic.Class Up to 1 Incl. FINAL 0 Over 1 to 10 Incl. DATE V IA DATION O Contractor Date Over 10 to 50 Incl. ❑ IN I am exempt under Sec. Over 50 to 100 Inc. BY AL 7 8 % A W B.&P.C.for this reason Over 100 p. Services,Swbd.,MCC&Panelboards ® ;t o 0 0 0 0 2 Date: 0-200 Amp.Under 600 V J 0 0 21.75�'/5 Signature 201 - 1000 Amp.Under 600 V E] Over 1000 Amp.or Over 600 V Exemption for Reg.Maint.Elect. ° ' ' r �• 55 SINGLE FAMILY Temp.Power Pole&Appurtenances 9' 8-6 7 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law Additional Sign Branch Circuits for the following reason(Section 7031.5,Business and Professions Code): Misc.Conduits&Conductors ElI,.as owner of the property,will do the work and the structure Other(See Complete Fee Schedule) is not intended or offered for sale (Section 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the Z. performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total) Civ.C.). PLAN CHECKING FEE Lender's Name !1 PERMIT ISSUING FEE V Lender's Address I certify that I have read this application and state that the above TOTAL FEE information is correct.I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize representatives of this County to enter upon the above-mentioned property f inspection p y oses. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date