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Home My Public Portal About6109 PRIMROSE AVE_Electrical__ 7SASS9 DBS SA 11-50 APPLICATION FOR PERMIT DEPARTMENT OF BUII.DING AND SAFETY �� COUNTY OF LOS ANGELES . WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRICIAN R. F. Walton Ir 1 2-.TqZ - RECEIVED BY READY FOR DATE ISSUED ADDRESS 5134 No Acacia S'to FIRST INSPECTION CITY San Gab, TEL, NO. AT 68583 �'/6 COUNTY LICENSE NIVA EXPIRES BUILDING ADDRES3 6109 Primrose Ave. PERMIT FEES NUMBER EACH FEE LOCALITY Temple City LIGHT OUTLETS 15 NEAREST RECEPTACLES 24 CROSS ST. WALL SWITCHES 19 OWNER Meeker TOTAL OUTLETS 58 Sc $ 2 190 MAIL ELEC. RANGES P9 ADDRESS ELEC. HEATERS 1 25 25 CITY TEL. NO. FIXTURES 15 S 75 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER FEE OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. NEW MVD. HP OVER INC. EACH 1/2 s LESS $ .25 SIGNATURE OF 1/2 2 .50 PERMITTEE TTS 2 5 1.00 INSPECTION RECORD S 1s 1.50 1s 50 2.50 , b so 200 S.00 -fly, C.A1TPnI/ 200 500 10.00 Soo 1000 15.00 Z OVER 1000 20.00 a M. G. SET/FREQ. CHANGER-HP R' WELDERS'AC-KVA O GENERATORS-KW TRANSFORMERS-KVA TEMP. MOTORS (75%OF ORIG.) MOVED MOTORS (75%OFORIG.) MISC. SIGNS NO. NO.TRANS. I I APPROVALS NO. NO. LAMPS DATE INSPECTOR'S NAME FOR EACH PERMIT: WIRING $1.00 00 CONDUIT —Qt /n(�j�/o vW FIXTURES $1.00 1 00 WIRING SUPPLEMENTARY .50 FIXTURES C 6I 15 POWER TOTAL FEE $ UTILITY CO. NOTIFIED ® FINAL `V ,1 1 ;ffi WORKER'S COMPENSATION DECLARATION 20-.0019DPW(12-91) APPLICATION FOR ELECTRICAL PER-MIT +� I hereby affirm that I have aicertificate of consent to'self insure, or a certificate of Worker's Compensation Insurance,.or a certified COUNTY OF LOS ANGELES DEPT.OF'PUBLIC WORKS BUILDING AND SAFETY DIV. Copy thereof(Sec.3800 Lab.C.). Policy No. Company FOR APPLICANT TO FILL IN ADDRESS 04❑ Certified co is hereb furnished. - NO. EACH FEE �' PY Y New Residential Bldgs.&Pools LOCALITI�'� 1&2-Family,Sq.Ft: — $ �,. Certified copy is filed with the county building inspection _ NEAREST department. I Multi-family Sq.Ft. ORo9S ST. Date Applicant. Residential Swimming Pools MAPBOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS', Outlets:Rec. Light Sw. O NNERM NR OR COMPENSATION INSURANCE APO O U First 20 MAIL AME (This-section need not be completed if the work Involved by the Total No. Additional ADDRESS permit is for one hundred dollars($100)or less.) I certify that in the performance of the work for which this permit CITY Tel:No. is issued,I shall not employ any person in any manner so as to PLAN CHECK become subject to the Workers'Compe tion Laws. Lighting Fixtures First 20 APPLICANT Total No. Additional ADDRESS Date_1-1 ApplicRESIDENTIAL APPLIANCES NOT OVER.3 HP. NOTICE TO APPLICANT: If, after.making this Certificate.of CITY Tel.No: Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. PERMIT provisions of the Labor Code,you.must forthwith comply with such APPLICANT provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances LICENSED CONTRACTORS DECLARATION Size&Type VP,KW,KVA,or KVAR t ADDRESS I-hereby affirm that I am licensed under provisions of Chapter 9 O (commencing with Section 7000)of Division 3 of the Business and Over 3 to 10 InclOver 10 to.50 Incl.. CITY �-/t T.I.No.� ({,1 77 Professions Code,and my license is in full force and effect. LICENSE / b Cess.Over'50 to 100 Incl. NUMBER Over 100 DISTRICT NO. � O ULicense Number Lic.ClassSAqEL -f- Services,Swbd.,MCC&Panelboards } dv Contractor is o� 0-399 Amp.Under 600 V DATE 0 ❑ 400.1000 Amp.Under 600 V r VUJI ALIDATION V I.am.exempt under Sec. Over 1000 Amp.or-Over 600 V FINAL IL B.&P,C.for this reason -BRANCH CIRCUIT-FEES BY Z Date: f— --�y� 15A,-or 20A,120V,Lighting or Recept. 1 To 10 Branch Circuits f Signal 11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits '�r ,'' e Exemption'for Reg.Mairit.Elect. _75A,20A,.208V To 277V Lighting Br.Circuits / f rU:[.-Ir SINGLE:FAMILY Temp.Power Pole&Appurtenances 4.3.7 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit i T".�Is' I hereby affirm that I am exempt from the Contractor's License Law 1 a I E S for the following reason(Section 7031.5, Business and Professions Additional Sign Branch Circuits Code): TOTAL x-23 a 75 ❑. I,asowner of the property,will do the work and the structure Misc.Conduits&'Conductors CHECK 48.75 is not intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule) , t and Professions Code). CHANGE: e.0 1 CONSTRUCTION LENDING AGENCY I hereby affirm that there.is a construction lending agency for the ^ 130120-000I"I � � Gf ' 4 performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total) : Civ.C.) 4661 d i e 48. PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE � D Lender's Address Q I certify that I have read this application and under penalty of Purim state TOTAL FEE U 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 enter upon the above-mentioned property fo ape on purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE OF PERMITTEE DATE WORKERS'COMPENSATIONDEC•LARATIOIV CE-8P6 APPLICATION FOR ELECTRICAL PERMIT CE-806G'(2-80) ' I hereby affirm that I have it 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. Company FOR APPLICANT TO FILL IN ,{OB ® New Residential Bldgs.&Pools EACH NO.I FEEADDRESS. 0 Certified copy is hereby furnished. 1.•Iii 2-Family.Sq. Ft. $ — $ LOCALITY ❑ ' Multi-family Sq. Ft. _ NEAREST { Certified copy is filed with the county building inspection CROSS ST department. Residential Swimming Pools OWNER OR n FIRM NAME 1. e. Date Applicant Outlets: FIRM SW. �� Q ADDRESS /® �,,( G First 2 CERTIFICATE OF EXEMPTION FROM WORKERS' ' Total No.02A Additional, CITY Tel No. , COMPENSATION INSURANCE • PLAN CHECK' 0- (This section need not be completed if the work involved �� „ APPLICANT V Lighting Fixtu as First 20' by the permit is for one hundred•dollars ($100) or less.) g ADDRESS IM No. Additional I certify that in the performance of'the work.for which this Fixed Appliances.Not Over 1 HP CITY Tel No. O permit is issued, I shall not employ any person in any manner PERMIT �^ W so as to become subject to the Workers'Compensation Laws. Range_Heater D.W._ APPLICANT Oven Dryer_/W.M. ADDRESS 6 I Date Applicant Top _FAU _Mi.. 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 forth- Power Apparatus&Large Appliances DISTRICT NO. PR D BY with comply with such provisions or' this permit shall .be K Size&Type HP,KW, VA,or KVAR deemed revoked. Up to 1 Incl. FINAL Over 1 to 10 Incl. DATE- LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl. r� g VALIDATION I hereby affirm that I am licensed under provisions of Chapter Over 50 to 106 Inc. FINAL 9 .(commencing with Section 7000 B Y ,)of Division 3 of the Busi- Over 100 :mess and Professions.Code,and fny,license is in full force and effect. Services 0-200 Amp.Under 600 V License Number Lic.Class 201-1000 Amp:Under 600 V Contractor Date 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 ness and Professions Code): Misc.Conduits&Conductors . I, as owner of the property, will do the work and the Other(See Complete Fee Schedule)— ructure is not intended or offered for sale (Section 7044,Business and Professions Code). _'2 7 6.6 a CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency o o a o o 2 for the performance of the work for which this permit is PERMIT FEE (Sub-Total) issued(Sec.3097,Civ.C.). Lender's Name2 ° - 3810 • PLAN CHECKING FEE (One-Fourth Permit Feel Lender's Address PERMIT ISSUING FEE ° ( 023-8C I certify that I•have read this application and state that the TOTAL FEE 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 enter upon th bove-men *0 ed pr ty for inspection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date , = \YORKERS'COMPENSATION DECLARATION ` 76A663 10/81 he ebur aifirrtlntiv�li l have a certificate of consent to self CE•1306G APPLICATION FOR ELECTRICAL PERMIT • insure,r-•°ep certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY orcera led copy thereof(Sec. 3800, Lab. C,) Policy No. Company FOR APPLICANT'TO FILL IN JOB Certified co is hereby furnished. I EACH NO. FEE ADDRESS copy y I New Residential Bldgs. &Pools 4V -IJ7 Certified copy is filed with the county building,insp'ec- 1 &2-Family, Sq. Ft. y'3 $ — $ LOCALITY tion department. Multi-family Sq. Ft. — NEAREST �( CROSS ST. Date//�'� 1 t/ Applicant Residential Swimming Pools OWNER OR ,py FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec 1 Light�Sw:�, MAIL IV COMPENSATION INSURANCE . ` ADDRESS (This section need not be completed if_the work involved by f�'es�'' First 20.. the permit is for one hundred dollars($100)or less.) Total No. Additional CITY Tel. No. PLAN CHECK I certify that in the performance of the work for which this APPLICANT permit is issued, I shall not employ any person in any manlier so as to become subject the Workers'Compensation Lalvs. Lighting Fixtures First 20 ADDRESS Total No. ?9 Additional Dat ' nppl!cant . •• CITY Tel. No. Fixed Appliances Not Over 1 H NOTICE TO APPLICANT: If,. after making this Certif' of. ..P ERMy� Exemption, you should become subject to the ers' Range_ Heater—D.W. — APPLICC ANT 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 _ FA..0 —W.H. — deemed revoked. Hood CITY ��, Tel. No. C/,'ALICENSED CONTRACTORS DECLARATION _ Fan _Other_ . _ Room Air Cond. LIC SE OR I hereby affirm that I am licensed under provisions of ChapterDisp 9 REG. NUMBER (:-- � - Class. 1-"`9 (commencing with Section 7000) of Division 3 of the,Business DISTRICT NO. PROMEY n- Power Apparatus 8 Large Appliances and Professions Code,and my license is in full force and effect. �^ /� V r.•, /'� Size&Type HP, KW, KVA, or KVAR' %� Z61Z Lic. Class FINAL FINAL License Number Up to 1 Incl. Ar-P�,e C � Over 1 to 10 Incl. . DATE VALID11011111 Contractor ate D W ❑ Over 10 to 50 Incl. FIN I am exempt under Secy Over 50 to 100 Inc. BP .Ily �- t Over 100 Z B.&P.C. for this reason _ Services, Swbd., MCC&Ponelboards � y Date: 0 -200 Amp. Under 600 V Signature Cut' s' 201 - 1000 Amp. Under 6011 ❑ Over 1000 Amp. or Over 600 V a 3'2 247 A Exemption for Reg. Ma.int. Elect. SINGLE FAMILY Temp. Power Pole&Appurtenances #-000002 `. HOME OWNER-BUILDER DECLARATION Sign-with One Branch Circuit ( 0 0 2 Q O I hereby affirm that I am exempt from the Contractor's License Additional Sign Brandi Circuits Law for the following reason (Section 7031.5, Business and o 0 0 2 Q v Professions Code): I, as owner of the property, .will do the work and the Misc. Conduits&Conductors 1 (121 -85 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 \ I certify that I have read this application and state that the. TOTAL FEE 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 enter upon thi�7/Zp tioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE 1 Signature Of �51 e ��