HomeMy Public PortalAbout6228 RENO AVE_Electrical__ 6.3-CE606 10/72 'APPL.ICATIO'N. OR EkEVRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER 'OB.
BUILDING AND SAFETY DIVISION ADDRESS.
LOCALITY L f+
04
NEAREST J
FOR APPLICANT TO FILL IN CROSSST... Lb A.4 Q. Q 6
OUTLETS N0. EACH FEE OWNER OR.
$ $ CT-
FIRM NAME C.tJeJ jai) W.VE
RECEPT._ MAIL
FIRST 20 25 ADDRESS /U O.
LIGHT TOTAL
CITYf'� C TEL. N0.
SWITCH_ OVER 20 .10 PLAN CHECK
LIGHTING TOTALI FIRST 20 25• APPLICANT
OVER 20 ADDRESS _ �/
FIXTURES _ •10 -
RESIDENTAP IANCES CITY TEL. N0.
PERMIT,
RANGE DRY: WTR. HTR.- APPLICANT' J /(.
STA. COOK DISP. F.A.U. ADDRESS =274, e 05Q
SPACE HTR. AIR.COND.� CITY TEL. NO.
CLOTHES WASH. DISHWASH. LICENSE OR. DES d r CLASS.
REG. NUMBER
.FAN OTHER 4 �. 1.00 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS 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 - 11..00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND. ST TE
CALIFORNIA OR THAI I AM THE LEGAL OWNER
1 - 10 3.00
DESCRIBED RESIDE NTIAL PROP R Y.
PERMITEE
10 - 50 &GO SIGNATURE • �
O
50 - 100 I0A0 DISTRICT N0. P D BY v
W
100 - S00 15.00 1
t Z
SIGN, GAS =SIGN ONE CIRCUIT 5.00 APPROVALS. DATE iNSPEC SIGNATURE
TUBE, OR
MARQUEE. ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE
SERVICENOTOVER.600VOLTS OR200AMP 3.00 UNDERSLAB WORK
SERVICEOVER 600 VOLTS OR 200AMP 10.00 ROUGH CONDUIT
LEERCE,POLE,&APPURTENANCES 5.00 WIRING 9-10 � p?.�
OR R.ECEPT. SYSTEM 3.00 FIXTURES
POWER AUTHORIZED
UTILITY CO. NOTIFIED
FINAL ��� jA !A i,f.�^..�f1✓
(SUB TOTAL) NOTES:
FEE
UING FEE 3.00
E
PLAN CHECK VALIDATION CK. M.O. CASH. PERMIT VALIDATION CK. M.O. CASH
1
9 2 L"Z'MAR 22 2' 8.0 0 A'uR
SEE BACK OF APPLICATION FOR.COMPLETE SCHEDULE
WORKERS'COMP76AG63ENSATION DECLARATION
�a ' 'CE-806G (2-90) APF IC;ATION, FOR •ELECTRICAL PERMIT '
I hereby affirm that I'have a certificate of consent to self COUNTY OF LOS ANGELES L 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 ' 'JOB
New Residential Bldgs.&.Pools EACH N.O. FEE ADDRESS ,y��.
F1 Certified copy is hereby furnished. 1 '&2-Family.Sq. Ft. —_ $ LOCALITY f +
Certified copy is filed with the county'buildingp Multi-family Sq. Ft.
WE
inspection CROSS ST
department; Residential Swimming Pools OWNER OR
i.FIRM-NAM
Date Applicant Outlets: Recf Light Sw, MAIL p .�J
j "First 20 Q ADDRESS �01 O 7511
CERTIFICATE OF EXEMPTION:FROM WORKERS'
Total Additionalyo. CI
Tel No
5-ya
CQMPENSATION INSURANCE. PLAN CH=K
� t • - a
(This section• need not be completed if the work involved 7—
APPLICANT
by the permit is for. one 'hundred dollars.•($1.00) .or less.) Lighting Fixtures First 20 ADDRESS 0
Additional
Total No. v� �
92
I certify that in the .performance of the.work for which this CITY Tel No. O
Fixed Appliances Not Over 1 HP ,
permit is issued. I'shall not employ any person in any manner PERMIT
so _,
so as to become subjebt to the Workers'Compensation Laws. Range._Heater D.W.,T_ APPLICAN Cox
,& W
Oven _.Dr V0_.W.M._ ADDRESS ((AA
.Dat sFf ?ipplicant� , ayjt„ Top _ FAU _W.H.._ Z
-Hood _ Fan, _Other_ CITY ' •Tel No. _
Otion, you should: become subject to
Certificate of Disp. _Room Air Cond-_ LICENSE OR
NOTICE TO APPLICANT: If, after making this " �'� 003 .
NTI
Exemption, the Workers' REG.NUMBER Class
Compensation provisions of the Labor Code,you must forth- -Power'Apparatus A.Large Appliances DISTRICT NO. PROCESSED BY
with comply with .such provisions or this permit-shall be
,deemed revoked. ; • Size&Type HP,KW,KVA,or'KVAR �
Up to 1 Incl. ®�
FINAL
i Over 1 to 10 Incl. DATE
LICENSED CONTRACTORS DECLARATIONq Over 10 to 50 Incl.. VALI DAT
I.hereby affirm,that I.am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL
BY ,
9 (commencing.With Section 7000)•of Division Sof.the Busi; I
Ovei.1'00
nets and•Professibns,.Code,.and my license is.in full force and
effect. Services
o► /q0-200 Amp.•Under'600 V
License Number ! / Lic.Class /
III ../� � 201-1000 Amp.Under 600 V � C.7 L(,0 A
1'
ContractorB/ LA:d.LYate / �.�� Over 1000 Amp.or Over 600 V c o 0 0.'
HOMEOWNER-BUILDER:Dg.ECLARATION• Temp.Power Pole&Appurtenances 1„ 02700
I hereby Sign with One Branch Circuit
i • y 'affirm that'I am exempt from the'Contractor's Aiiditional'Sign Branch Circuits 0 kb n ?r
;License Law for the followingreason (Section 7031.5, Busi- I
ness and Professions Code): J r (1;;—3 3
Misc.Conduits&Conductors
d, as owner of the property, will do the work and the. .; Other(See Coinplete.•Fee Schedule)—
structure is not intended or offeredfor sale (Section
7044.,Business and Professions Code).
CONSTRUCTION LENDING AGENCY 7-
hereby affirm that there is a construction lending agency
for the performance .of the work for which this permit is PERMIT FEE (Sub-Total) /G
;,,Issued(Sec. 3097,Civ.C.).
Lender's Name
- PLAN CHECKING FEE (One-Fourth:Permit Fee)
sender's Address PERMIT ISSUING FEE f
certify that I have read this application.and state that the TOTAL FEE
,bove information is correct.I agree to comply with all County
lydinances and. State laws. regulating Electrical wiring,,And
iereby authorize.representatives.of this County to enteF.Upon
he above-mentioned property for inspection purposes. SEVREVERSE FOR EXPLANATORY.LANGUAGE
Sign re of Permittee — Date !f