HomeMy Public PortalAbout6043 RENO AVE_Electrical__ APPLICATI-ON FOR ELECTRIC PERMIT � 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING G 0 i Imo'
BUILDING AND SAFETY DIVISION ADDRESS T'
JOHN A. LAMBIE, COUNTY ENGINEER yI
CASSATT D. GRIFFIN,SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL•,IN CROSS s.
PERMT FEES
Y ITEM NUMBER I EACH FEE OWNER
IL
OUTLET /� $ .IO $ ® ADDRESS ,
i LIGHTS RECEPT. SW. �, � �)�
LIGHTING FIXTURES 10 O CITY 8/u VrEL.jgO. •,Asa
ELEC.RANGES CLO.DRYERS ELECTRICIAN
WATER HEATERS .SO ADDR SS Fe,,
ELEM SPACE HTRS. DISHWASHERS CITY X111/q� TEL.NO. /
GARBAGE DISPOSERS AUTO.-
STATE / Q
WASHERS STA.COOKING UNITS .25 LICENSE NO.
MOTORS: OVER INC. H.P. DISTRICT NO. I GRO P E P D B
O— I/a .25 J
- 2 .50 INSPECn- V ORD
.2— 8 1.00
a— i8 I 1.50
I5— 50 2.80 �.
50.--20C 0.00
SIGNS: NO.TRANS.
NO.LAMPS
SERVICE O-SOOV 1.00
SERVICE OVER 600V 5.00
MISC.
WIRING PERMIT 1.00 %
FIXTURE PERMIT i.00
SUPPLEMENTARY PERMIT .50
TOTAL FEE $
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND.AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT
ELECTRICAL WIRING.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR WIRING c� J �7•.
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OR FIXTURES �.G.
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOV$
DESCRIBED RESIDENTI P OP '�Y. rr�'_-� POWER
SIGNATURE / ,N;a�,- ij'�' UTILITY CO.NOTIFIED <0
OF PERMITTE ni [!c �I
FINAL
)P ATON Lk SUPERVISING EE
C
MO CASH ELECTRICAL.ENGINEER
CK
LI'_ �40 .90 ; R17 2A 4.60
WORKERS'COMPENSATION DECLARATION CEABo6G tD/St APPLICATION FOR ELE6TRICAL PERMIT
I hereby affirm that I have a certificate or consent to self Insure,
or a certificate of Workers' CompeffSati6d"hr 9irance, or a certified I COUNTY OF LOS ANGELES BUILDING AND SAFETY
copy thereof(Sec.3800.Lab.C.) I I
Policy No. Company FOR APPLICANT TO FILL IN SOB �� ve •
❑ EACH NO. FEE ADDRESS •
Certified copy is hereby furnished. New Residential Bldgs.&Pools
Certified copy is filed with the county building inspection 1 &2-Family,Sq.Ft. $ _ $ LOCALITY
department. Multi-family Sq.Ft. NEAREST
Residential Swimming Pools CROSS ST. �-ew 1v Or
Date Applicant OWNER ORZ
FIRM NAME •
CERTIFICATE OF EXEMPTION FROM WORKERS' Out�ets:Rec—Light—Sw.— MAIL
COMPENSATION INSURANCE ADDRESS /V• P/✓B d!
(This section need not be completed if the work involved by the First 20
Total No. Additional CITY Tel.No.
permit is for one hundred dollars($100)or less.)
I certify that in the performance of the work for which this permit PLAN HECK
APPLICANT
is issued, I shall not employ any person in any manner so as to I
become subject to the.Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS S
Total No. Additional CITY Tel.No.
Date Applicant Fixed Appliances Not Over 1 HP PERMIT
NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT
Exemption,you should become subject to the Workers'Compensation Range_ Heater_ D.W. _
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. _
CITY Tel.No.
LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other_
I hereby affirm that I am licensed under provisions of Chapter 9LICENSE OR
Disp. — Room Air Cond. REG.NUMBER Class.
(commencing with Section 7000)of Division 3 of the Business and.
Professions Code,and my license is in full force and effect. Power Apparatus&Large Appliances DISTRICT NO �/ PR SSED
016,
Size&Type HP,KW,KVA,or KVAR
1 5 (SJ( pU
License Number. Lic.Class Up to 1 Incl. FINAL
i
Over 1 to 10 Incl. DATE� /A( ) VALIDATION 0
Contractor Data Over 10 to 50 Incl. I
FB NAL
❑ I am exempt under Sec. Over 50 to 100 Inc. LSA
B.&P.C.for this reason
Over 100
Date
Services,Swbd.,MCC&Panelboards ® Z
0-200 Amp.Under 600 V
i
Signature 201 - 1000 Amp.Under 600 V I
❑ Over 1000 Amp.or Over 600 V
Exemption for Reg.Maint.Elect.
SINGLE FAMILY Temp.Power Pole&Appurtenances .17
HOME OWNER-BUILDER DECLARATIONSigrAdditional Sign Branch Circuits " e4
i with One Branch Circuit ,
1 hereby affirm that I am exempt from the Contractor's License Law ( : '( a
for the following reason(Section 7031.5,Business and Professions ,-
Code): I 3307 31.00
❑ Misc.Conduits&Conductors ITEMS
I,as owner of the property,will do the work and the structure JO
is not intended or offered for sale (Section 7044, Business Othgr(See Complete Fee Schedule) _
and Professions Code). ® TOTAL 3 1 m 00
CONSTRUCTION LENDING AGENCY 4HEt K 31.01,
1 hereby affirm that there is a construction lending agency for the
performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub Total) CHANGE a i�
Civ.C.).
PLAN CHECKING FEE � I
Lender's Name 0000-01101 7/18/90
Lender's Address
PERMIT ISSUING FEE I
1878 1 AM 7-0 59
1 certify that I have read this application and state that the above TOTAL FEE tJ
Information is correct.I agree to comply with all County ordinances
and State laws regulating Electrical wiring, and hereby authorize
representatives of this Coun upon the above-mentioned
propert r inspection p SEE REVERSE FOR EXPLANATORY LANGUAGE
ig a e o t "Date