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Home My Public Portal About5927 PRIMROSE AVE_Electrical__ OeSDEPARTMENT OF BUILDING AND SAFETY' APPLICATION:'FOR PERNIIT COUNTY OF LOS ANGELES 'ELECTRIC WM. J. FOX CHIEF ENGINEER _z NAME ;; DISTRICT-NO. GROUP ZONE PERMIT NO.• U ADDRESS h } 1' r f RECEIV..ED..13Y READY;FOR DATE ISSUED l� CITY EL.NO: . FIRST'1NSPECTION CERT.NO. EXPIRES APPLICANT FILL IN HEAVILY OUTLINED PORTIO_ N ONLY DESCRIPTION OF WORK ADDRESS NUMBER OF OUTLETS ON'CIRCUITS' LOCALITY ap LOCATION BY ROOMS NEAREST LIGHT OUTLETS SW. PLUGS.::'.FniT CROSS ST. �/.t... CIRCUIT A I B G D E F. G ar, V ADDRESS. � . CITY TEL.NO. ;THE• LEGAL POSSESSOR.OF THE ABOVE LOS. ANGELES COUNTY CERTIFICATE. OF QUALIFICATION.. .. ELECTRICIAN. . .i... .,...,. _ I AN THE�E6A1.OWNER O THE PROPERTY/DESCRIBED ' ABOVB ..+�. 7�Q OWNER. CORRECTIONS !F!! s Orr,- _ r `$ miff ' lipw TOTAL +: . . . APPROVALS .'NO. OF OUTLETS : . �;k'. :$.... .m.�- NO: OF:FIXTURES-. tl $ffiva� ioo,. DATE INSPECTOR'WNAME NO.',OF-MOTORS H.P., $' CONDUIT ' rs� IiIO..OF SIGNS.. TRANS.:.... .>. •.,..>..': ': .;'$ WIRING NO..OF RAIi1GES bit:HEATERS- ffi FIXTURES MISCELLANECUB POWER PERMITFEE yr .a t�...., :. ffi. #•' '�'�+1 `- 'UTILITYCO.NOTIFIED /us I fl �:'lG ..ff�•''�� 'TOTAL FEE + ; .'�...::...` l :_ sf FINAL. 005 .5-A 6�45 DEPARTMENT OF BUILDING AND SAFETY Aero riur ry r ani r COUNTY OF LOS ANGELES ELECTRIC M. J. FOX CHIEF ENGINEER 2 N , DISTRICT NO. GROUP ZONE PERMIT NO. Q AME U ADDRESS CITY TEL.NO �� REC'EYED BY READY FOR FIRST INSPECTION ��ISSUED CERT.NO-10-14 EXPIRES APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY DESCRIPTION OF WORD ADDRESS NUMBER OF OUTLETS ON CIRCUITS LOCALITY LOCATION BY ROOMS NEAREST LIGHT OUTLETS SW. PLUGS Fl7LT CROSS ST. w CIRCUIT A B C D I E F Jr. I H W NAME` st r 1�- Z MAIL 3 ADDRESS O CITY TEL.NO. 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANG€L= COUNTY CE IYA F QUALIFICATION.. ELE=RICIAN. AI AM BO STM LEGAL OWNER OF.THE PROPERTY DESCRIBED tQ 7� OWNER. �COgBREMONS f �.�. l J Q Z_ L7 R O FTCMALETS ffi APPROVALS RES ffi DATE INSPECTOR'S NAME NO. OF MOTORS H.P. ffi CONDUIT NO. OF SIGNS TRANS. ffi WIRING NO. OF RANGES OR HEATERS ffi FIXTURES MISCELLANEOUS ffi POWER PERMIT FEE ffi 00 UTILITY CO.NOTIFIED TOTAL FINALI-s' - 1� I WOaKER'S COMPENSATION DECLAft RATION 1IM0019 DPW(12- 1) APPLICATION FOR ELECTRICAL PERMIT •1 hereby affirm that I have a certificate of consent to self insure, ,7 or a certificate of Worker's Compensation Insurance, or a certified COUNTY OF OS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV.' copy thereof(Sec.•3800 Lab.C.) Policy No.• Company FOR APPLICANT TO FILL IN JOB Z7 �j`/ � � • ADDRESS Certified copy is her@by furnished. New Residential Bldgs.&Pools NO. EACH FEE. LOCALITY -Family,Sq.Ft. — $ $ , Certified copy is filed with the1&2-F .county building inspection NEAREST- CROSS department Multi-family Sq..Ft. CROSS ST. /W r��R'U,NA�• Date Applicant Residential Swimming Pools ASSESSOR MAP BOOK PAGE I PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec._Light Sw. OWNER OR P�lz lc/C Glrom COMPENSATION INSURANCE FIRM NAME (This section need not be coFirst 20 MAILmpleted If the work Involved.by the Total No. Additional, ADDRESS e,/�--.1 N permit Is for one hundred dollars($100)or less.) I cerfify that in the performance of the work for which this permit CITYTel.No. is issued, I shall not employ any person In any manner so as to PLAN CHECK become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANT Total No. Additional ' ADDRESS Date Applicant RESIDENTIAL APPLIANCES NOT-OVER 3 HP. NOTICE TO APPLICANT: If, aftef making this Certificate of CITYTel.No. Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP.. provisions of the Labor Code, you must forthwith comply with such PERMIT Power Apparatus&,Large Appliances APPLICANT provisions or this permit shall be deemed revoked. I - LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. (commencing.with.Section 7000)of Division 3•of the Business and CITY Tel.No. Professions Code,.and my license is in full force.and effect. Over 10 to 50 Incl. } LICENSE OR Class. Over 50 to 100 Incl, REG..NUMBER IL Over 100 DISTRICT NO. PROD SED.BY License Number Lic.Class. A��Contractor Date DATE F WI am exampt under Sec. VALIDATION Over 1000 Amp:or Over 600'V' FINAL d. B.&P.C..for this reason BRANCH CIRCUIT FEES By co Z Date: 15A,or 20A,120V,Lighting or Recept. _ 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits 41 Or More Branch Circuits Exemption for Reg.Maint Elect. 15A,.20A,208V To 277V.Lighting Br.Circuits ,y SINGLE FAMILY Temp.Power Pole&Appurtenances r HOME OWNER-BUILDER DECLARATION Sign with One.Branch Circuit s eB' JL I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits 3307 61.55 Code): d C Conduits& onuctors 1 i !TES tt� A I,as owner of:the property,will do the work and the structure Misc. i Is not.intended or offered for sale (Section 7044, Business Other(See.Complete Fee Schedule) , ) TAL 61.65 and Professions Code). iq CONSTRUCTION LENDING AGENCY CHECK V J.65 I hereby affirm that there is a construction lending agency for the CHANGE e00 performance of the.work for which this permit is issued(Sec. 3097, PERMIT FEE (Sub-Total) Civ.C.) PLAN CHECKING FEE 0000-0001 4/15/93 Lender's Name •— - PERMIT ISSUING FEE �d 922331 AM11:23 Lender's Address I certify that I have read this application and under penalty of purl ury state TOTAL FEE that the above Information is correct. I agree to comply with all County ordinances and.State laws regulating Electrical wiring,and hereby authorize repres tives of this County to enter upon the above-mentioned property for i� ecti X. , SEE REVERSE FOR EXPLANATORY LANGUAGE DATE WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) 176A663 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that.I have a certificate of consent to self insure, or a ce'rtifioate&Worker's Compensation Insurance, or a certified ! COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec.3600 Lab.C.) Policy No. Company FOR APPLICANT TO FILL IN JOB ADDRESS Certified copy is hereby furnished. New Residential Bldgs.&Pools NO, EACH FEE _ 9 _ $ $ LOCALITY ❑ Certified copy is filed with the county building inspection 1 &2-Family,Sq.Ft. NEAREST Jr department. Multi-family Sq.Ft. CROSS ST. Date . Applicant Residential Swimming Pools ASS MAP SSpK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec._Light Sw. FIRM NAME COMPENSATION INSURANCE First 20 MAIL (This section need-not be completed If the work Involved by the ` permit 16 for one hundred dollars($100)or less.) Total No. Additional ADDRESS A I certify that in the performance of the work for which this permit CITY el.No.�fi Z is issued, I shall not employ any person in any manner so as to PLAN CHECK become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 L APPLICANT S d� 3 f Total No. Additional ADDRESS Date Applican RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: If, after making this Certif.ica of CITY TeI.No. Exemption,.you should become subject to Comp ation OTHER APPLIANCES.NOT'OVER 3 HP.. provisions of the Labor Code,you must forthwith comp ith such power Apparatus&Large Appliances P ZLI&NT L� C,- provisions or this permit.shall be deemed revoked. LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. (commencing with Section'7000)of Division 3 of the Business and CITY L e /�, odaf� TeI.No: >3 � ' L, Professions Code,and mOver 10 to50 Incl. y license is in full force and effect. LICENSE OR . s I/n O Ciaes.,G—iv d Over 50 to 100 Incl. REG.NUMBER i License Number • LIC.Class. Over 100 DISTRICT NO. P. C SED BY Services,Swbd.,MCC&2gnyelbo ds "e l Contractor.�G �� Date 0-399 Amp. nTJ der V �6 DATE O ❑ 400-'1000 Amp..Under 600 V VALIDATION V I am exempt under Sec. UJ Over 1000 Amp.or Over 600 V FINAL d B.&P.C.for this reasonBRANCH CIRCUIT FEES BY Z Date: 15A,or 20A,120V,Lighting.or Recept. 1 T 10 Branch Circuits Signature 11 To 40 Branch Circuits ❑ 41.Or More Branch Circuits Exemption,for Reg.Maint.Elect. 15A,RDA,208V To:277V Lighting Br.Circuits 2 SINGLE FAMILY Temp.Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATIONR%4 j n•aa I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit for the following reason(Section 7031.5, Business and-Professions Additional-Sign Branch Circuits 'r p , Code) : _ ❑ Misc.Conduits&Conductors 1 I EN3 I,as owner of the property,will do the work and the structure _ Is not Intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule) , TOTAL 61.65 and.Professions Code). CHECK 61.65 CONSTRUCTION LENDING AGENCY 000 I hereby affirm that there is a construction lending agency for the CHANGEperformance of the work.for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total) Civ:C.) ' PLAN CHECKING FEE 5/ 6193 Lender's Name PERMIT ISSUING FEE 95&1 1 AN11:26 Lender's Address I certify that I have read this application and under penalty of purjury state TOTAL FEE f that the above 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 ter upon the above-mentioned property for Insp rpose _ SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE OF PERMITTEE DATE