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Home My Public Portal About6251 PRIMROSE AVE_Electrical__ L f f 76AS63 D13B BA 11-50 `y` APPLICATION FOR PERMIT r DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES ELECTRIC 1. WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMIT NO. ELECTRICIAN Walton 4!!( 1 —/o RECEIVED BY READY FOR DATE ISSUED ADDRESS 5134 NAcaoia St. FIRST INSPECTION CITY San Gabe TEL. No. AT 68583 ��) yo, —/6-.!r COUNTY LICENSE NO. 1104 EXPIRES BUILDING PERMIT FEES ADDRESS 6251 Primrose NUMBER I EACH FEE LOCALITY Temple City LIGHT OUTLETS 14 NEAREST RECEPTACLES 23 CROSS ST. WALL SWITCHES 19 OWNER Meeker TOTAL OUTLETS 56 Sc 170 MAIL ELEC. RANGES 85ADDRESS ELEC. HEATERS 25CITY TEL. NO. FIXTURES 4 5 1 HEREBY ACKNOWLEDGE THAT 1 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 HORSEPOWERANGELES COUNTY LICENSE, OR .I AM THE LEGAL OWNER FEE NEW MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. W4 1/2fi LESS S . 25 SIGNPERMITTEE- 5 ERMITTE 1/2 2 .50 E SO '5 1.00 INSPECTION RECORD 5 1s 1.30 1s 50 2.50 50 200 5.00 200 Soo 10.00 A Soo 1000 15.00 Z OVER 1000 20.00 M. G. SET/FREQ. CHANGER-HP Q' 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 FOR EACH PERMIT: DATE INSPECTOR'S NAME CONDUIT v WIRING $1.001 3. oo— FIXTURES $1.00 1100 WIRING �Y1 SUPPLEMENTARY .50 FIXTURES 3(/ 1.1 6100 POWER -` TOTAL FEE $ UTILITY CO. NOTIFIED I _ t. A�, *+► 1 ® FINAL w 'WORKER'S COMPENSATION DECLARATION 20.0019 DPW 9/89 I hereby affirm that I have a certificate of consent to self Insure, 76ASM APPLICATION FOR ELECTRICAL PERMIT or a cdMficate 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 RLL IN JOB'• ADDRESS �GJ ❑ Certified copy is hereby.furnished. New Residential Bldgs.&Pools EACH NO. FEE _ LOCALITY ❑ depafied rtmentPy Is filed with the county building inspection Multi2famailylggSgF�Ft. $ — $ NEARS ST. NEAREST . Date Applicant Residential Swimming Podia ASSESSOR MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec. .LigSw.7- OWNER 0 h COMPENSATION INSURANCE - Q p� (This.section.need not.be.completed If the work Involved by.the Flrst 20 FIRM MAIL permit Is for one hundred•dollars($1.00)or less.) f Total No2L C_ Additional i ADDREss6 2s- I certify that in the perfofmance'of the work for which this permit Cl Tel.N..5aq9 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: 9, Additional ADDRESS Date �� Appli 14.OR 20A,120V BRANCH CIRCUITS. NO.TI E T.: APPLICANT: If, er making 'this Certificate of CITY Tel.No. Exemption,you should become subject to the Workers'Compensation 1.T0 10 INCLUSIVE EACH provisions of the Labor Code.,you must forthwith comply with such .11 TO 40'INCLUSIVE EACH PERMIT APPLICANT provisions or this permit shall be deemed revoked. 41 OR MORE BRANCH CIRCUITS EACH >_ LICENSED CONTRACTORS DECLARATION 15 OR 20A208V TO 277V LIGHTING EACH ADDRESS d , I hereby affirm that i am licensed under provisions of Chapter 9 Q (commencing with Section 7000)of Division 3 of the Business and CITY Tel.No. V Professions Code,and my license is in full force and effect. RESIDENTIAL APPLIANCES UP TO aHP LICENSE OR Q Class. Power Apparatus&Large Appliances. REG.NUMBER O License Number Lic.Class Size&Type HP,KW,KVA,or KVAR DISTRICT NO. p PWSS BY U Up to a Incl. �U . a Over 3 to 10 Incl. FINAL C13Contractor Date DATE Over 10 to 50 Incl. //��f ' Z ❑ I'am exempt under Sec. Over 50 to 100 Incl. 1 v VALIDATION B.&P.C.for this reason Over 100 FINAL Services,Swbd.,MCC&Panelboards Date.* 0 bmp.Under 600 V Signature 201-1000 Amp.Under 600 V ❑ Exemption foi'Reg.Maim.Elect. Over 1000 Amp.or Over 600 V SINGLE FAMILY Temp.Power Pole&Appurtenances HOMEOWNER-BUILDER DECLARATION 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 Code): I,as-owner of the property,will do the work and the structure Misc.Conduits&Conductors Is not intended or offered for sale,(Section 7044, Business Other(See Complete Fee Schedule) t_ �„4'�0=:-. 35 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 pernilt is Issued(Sec.3097, PERMIT FEE (Sub-Total) Civ:C.) PLAN CHECKING FEE ) —a3 ji!> I Lender's Name PERMIT ISSUING FEEo2M. i AN ` 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 for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE OF APPLICANT OR AGENT DATE - WORKER'S COMPENSATION DECLARATION 20.0019DPW 9/89 76As63 APPLICATION FOR ELECTRICAL PERMIT I hereby affllm that I have a certificate of consent to self insure, gr..,a certificalip-of WoNer's Compensation Insurance,or a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. c py-thereof(Sec.3800 Lab.C.) /c o r No. VZ Company � � � I FOR APPLICANT TO FILL IN JOB �w ❑ Certifled copy is hereby furnished. New Residential Bldgs.&Pools EACH NO.. . FEE ADDRESS Certified copy is flied with the county'buiiding inspection 1&2-Family,Sq.Ft. $ — $ department. n nn Multi-family Sq.Ft. CROSS ST. Date' ,-/—/&—/&� Applicant At 116 Residential Swimming Pools ,r s MAP SSOR / PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec._Light Sw. OWNIRM NAME COMPENSATION INSURANCE First 20 (This section need•not.be.completed if the work Involved by the MAIL permit Is for one hundred dollars($100)or less.) Total-No:,. Additional ADDRESS /� fU I certify that in the performance of the work for which this permit CITY� Tel.No. G 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 15 OR20A,120V BRANCH CIRCUITS NOTICE TO APPLICANT-:. If, after making this Certificate of CITY Tel.No. Exemption,you should become subject to the Workers'Compensation 1 TO 10 INCLUSIVE EACH, provisions of the Labor Code, you must forthwith comply with such AI TO 40:INCLUSIVE EACH PERMIT rovislons'or this permit shall be deemed revoked. APPLICANT yr ,e, P 41 OR MORE BRANCH CIRCUITS EACH �.. LICENSED CONTRACTORS DECLARATION ADDRESS/0/ , d I hereby affirm that I am licensed under provisions of Chapter 9 15 OR.20A,208V TO 277V LIGHTING EACH O (commencing with Section 7000)of Division 3 of the Business and CITY Tel.No._4—yl—IHO V Professions Code,and my license is in full force and effect. RESIDENTIAL APPLIANCES UP TO 3HP LICENSE OR �— _ Power Apparatus&Large 3, cles6•Cof ? /� pp rg Appliances REO.NUMBER License Number 9 3) Lic.Class C2_v Size&Type;HP,KW,KVA,or KVAR DISTRICT NO. PROCESSED BY O `�`t ,(� /� (0,144 // ///��f Up to,3 Incl. a Contraclor0 /�/-- t!''cif' 4 pate Over 3 to 10 Incl. FINAL E co ❑ Over 10 to 50 Incl. Z I am exempt under Sec. .- Over 50 to 100 Incl. VALIDATION Over 100 B.&P.C.for this reason FINAL BY• Services,Swbd.,MCC&Penelboards Date: 0-200 Amp.•Under 600 V Signature '201-1000 Amp.;Under 600 V El Over 1006 Amp.or Over 600 V Exemption for Reg.Maint.Elect. SINGLE FAMILY Temp.Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION ' I hereb.y affirm that i am exempt from the Contractor's License Law Sign with One Branch Circuit �_ y., E.; - for the following reason(Section 7031.5, Business and Professions Additional Sign:Branch Circuits Code): 1 "Er..r. ❑ I,as owner of the property,will do the work and the structure Misc .Conduits&Conductors r." + 3is not Intended or offered for sale(Section 7044, Business Other eeplate F e Schedule) and Professions Code , r•r'� `F '')? 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(Sec. 3097, PERMIT TEE -(Sub-Total) Civ,.C.) r-n -'I i ; i PLAN CHECKING FEE. =3 i'� = ��_ 1 }'' Lender's Name 7-SQ ty� PERMIT ISSUING FEE ` Lender's Address TOTAL FEE 3 I certify that I have read this application and'state that the above Information Is correct. I.agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize represent ves of:this County to enter upon the above-mentioned prop Inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE OF.,PPL" AGENT DATE I I WORKERS'COMPENSATION DECLARATION 20.0019 DPW 3/87 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self CE insure, or a certificate of Workers'Compensation Insurancd, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certified copy thereof (Sec. 3800, Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB ❑ / 7 Certified copy is hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE ADDRESS461-c</ r Certified co is filed with the count building inspec- 1 &2-Family, S Ft. $ — $ LOCALITY PY � Y 9 � P Y. q• tion department. Multi-family Sq. Ft. — NEAREST Date Applicant Residential Swimming Pools CROSSOWNEST. G�N� FIRM NAM G31S1� Vf�1 ��`r/'/ CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: w._Rec Li ht SMAIL COMPENSATION INSURANCE g I ADDRESS (This section need not be completed if the work involved byTotal No. Additional Tel. No.First 20 CITY -9l �. the permit is for one hundred dollars($100)or less.) I PLAN CHECK I certify that in the performance of the work for which this I APPLICANT permit is issued, I shall not employ any person in any mann6r so as to be ome subject to the ers'Compensation Law(. Lighting Fixtures First 20 ADDRESS GAdditional Date �3 Tota! No. CITY Te!. Applic NOTICE TO APPLICANT: If, ma er king this Certific of Fixed Appliances Not Over 1 HP PERMIT Exemption, you should become subject to the Workers' Range— Heater—D.W. — APPLICATION 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. CITY Tel. No. LICENSED CONTRACTORS DECLARATION Hood — Fan —Other_ Disp. _ Room Air Cond. LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 REG. NUMBER Class. (commencing with Section 7000)of Division 3 of the Busine§s Power Apparatus&Large Appliances DISTRICT NO. PROCED BY >- and Professions Code,and my license is in full force and effect. D_ I Size&Type HP, KW, KVA, or KVAR (V 0 License Number Lic. Class ! Up to 1 Inc!. FINAL U Contractor Date i Over 1 to 10 Incl. DATE N ! V D ION 0O ❑ I Over 10 to 50 Incl. FINAL I am exempt under Sec. Over 50 to 100 Inc. BY U Over 100 LU B.&P.C. for this reason I D_ Date: Service wbd. MCC&Panelboards � 1 , Z -200 Amp. U� n _oder 600 (/ Z Signature 20~1 100 Amp. Under 600 Vf ❑ Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V Jr 9.3 A SINGLE FAMILY Temp. Power Pole&Appurtenances G HOME OWNER-BUILDER DECLARATION , I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit # o o o 0 o 2 Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits ( o 02550 Professions Code): I, as owner of the property, will do the work and the it-01Misc. Conduits&Conductors structure is not intended or offered for sale(Section 7044, Other(See Complete Fee Schedule)_ , 09. 02-88 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 t� TOTAL FEE e J/1 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 0e above-mentioned propert for inspection p poses. r SEE REVERSE FOR EXPLANATORY LANGUAGE -fit c Signature of Permittee Date � /®'