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Home My Public Portal About5022 RIO HONDO AVE_Electrical__ • 7.6A883 DBS SA 11-50 APPLICATION FOR PERMIT - DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES ELECTRIC Z WILLIAM J. FOX. CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMIT NO. ELECTRICIAN R F - /.?f F3.2-/Z RECEIVED BY READY FOR DATE ISSUED c// ADDRESS 5131 Ne Agagia St U� fJciC/C� FIRST INSPECTION CITY San Gabe TEL. No. AT 65583 .. COUNTY LICENSE NO. 1104 EXPIRES BUILDING PERMIT FEES 5022 Rio Hondo Aged Temple e Cit ' NUMBFEE ER EACH LOCALITY emP Y LIGHT OUTLETS 10 NEAREST. RECEPTACLES 19 CROSS ST. WALL SWITCHES 18 OWNER Turner Homes TOTAL OUTLETS 47 sc ffi 2 35 MAIL ELEC. RANGES 25 ADDRESS ELEC. HEATERS 25 CITY TEL. NO. FIXTURES 10 S. 50 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 1 CERTIFY THAT I POSSESS THE' ABOVE VALID LOS NUMBER HORSEPOWER ANGELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER FEE NEW MVD. HP OVER INC. EACH OF THE RESIDENTIAL PRO ESCRISED ABOVE. I/2 a LEss ffi .25 25 SIGNATURE OF I 1A I/2 2 .50 PERMITTEE 2 s 1.00 INSPECTION RECORD 5 15 1 1.50 1S 50 2.50 SO 200 5.00 200 500 10.00 ..I 500 1000 15.00 Z OVER 1000 20.00 3 M. G. SET/FREQ. CHANGER-HP (r WELDERS:AC-KVA 0 GENERATORS-KW TRANSFORMERS-KVA TEMP. MOTORS (75%OF ORIG.) MOVED MOTORS (75%OF ORIG.) MISC. SIGNS IVO. NO.TRANS. I I APPROVALS NO. NO. LAMPS FOR EACH PERMIT: DATE INSPECTOR'S NAME I ' WIRING $1.00 I lo CONDUIT FIXTURES. ffi1.00 WIRING �� Fi?:t�r.. •�^ /'2 SUPPLEMENTARYFIXTURES.50 , 5 10 POWER TOTAL FEE ffi UTILITY CO. NOTIFIED ® FINAL G r YS . WORKERS'COMPENSATION DECLARATION zo-oalvDPW Va7 APPLICATION FOR ELECTRICAL PERMIT I� ' I hen6_/ offirn- that I have a certificate of consent to self CE g06� I I '• insure, or a cerfiflcate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Li or a certified copy thereof (Sec. 3800, Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB RS� r C Certified copy is hereby furnished. New Residential Bldgs. ADDRESS & Pools EACH NO. FEE Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. $ _ $ LOCALITY tion department. Multi-family Sq. Ft. CROSS NEARESTtion L Residential Swimming Pools OWNER OR Date Applicant FIRM NAME Q ZA ,�A CERTIFICATE OF EXEMPTION FROM WORKERS' I 2 COMPENSATION INSURANCE Outlets: Rec�Light Sw._ ADDRESS J (This section need not be completed If the work involved by First Z CITY Tel. No) ry the permit is for one hundred dollars($100)or less.) Total No. Additional J PLAN CHECK I certify that in the performance of the work for which this APPLICANT permit is issued, I shall not employ any person in any manner Lighting Fixtures First 20 ADDRESS so as to become subject to the Workers'Com en tion La Additional d Total No.� CITY Te Date 9 Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO AP (CANT: If, after makin this Certificate of APPLICATION Exemption, you should become subject to the Workers' Range— Heater—D.W. — Compensation provisions of the Labor Code, you must forth- Oven — Dryer —W.M.— ADDRESS with comply with such provisions or this permit shall be Top — FAU —W.H. — deemed revoked. Hood — Fan —Other— CITY Tel. No. LICENSED CONTRACTORS DECLARATION LICENSE OR Disp. — Room Air Cond. — REG. NUMBER Class. I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO PROCESSED Y d and Professions Code,and my license is in full force and effect. Size&Type HP, KW, KVA, or KVAR , O License Number Lic. Class Up to 1 Incl. FINALU Over 1 to 10 Incl. DATE / VA ION D- Contractor Date Over 10 to 50 Incl. U ❑ FINAL I am exempt under Sec. Over 50 to 100 Inc. gY 1, B.&P.C. for this reason Over 100 l y d Date: J Z Services, Swbd., MCC 8 Panelboards � Z 0-200 Amp. Under 600 V u�L,r� ) 1 0$ (,A Signature 201 - 1000 Amp. Under 600 V Exemption for Reg. Maint. Elect. #� o 0 0 0 0 'Z Over 1000 Amp. or Over 600 V SINGLE FAMILY Temp. Power Pole&Appurtenances o - 3525 HOME OWNER-BUILDER DECLARATION r 5 I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit o 0 0 3 5 c 5 c Law for the following reason (Section 7031.5, Business and I Additional Sign Branch Circuits Professions Code): i 1,L7-'c8 XI, as owner of the property, will do the work and the Misc. Conduits&Conductors structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ 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 jaws regulating Electrical wiring, and hereby authorize representatives of this County to enter upon the above Itned proviorty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE 4 1 ®s ignatur o m rittee ,ate COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF 'BUILDING & SAFETY WILLIAM J. FOX, County Engineer FOR APPLICANT TUI-I IN DISTRICT NO. 1IR13UP I ZONE PERMIT NO. . A - 'J O ELECTRlCIA.' Jl Ip X71/� Y y: . n RECEIVED BY READY FOR DATE ISSUED ADDRESS 6 I D -. /%/ I� /1 _ FIRST INSPECTION /J �_J CITY !� %�:% TEL NO. rd;0 v, ClJ!/®�-'�7. COUNTY LICENSE NO.�' EXPIRES BUILDING j PERMIT FEES ADO REBB ,5 e 0 t.'el V4, JV NUMBA ER'EACH FEE LCCLITY e L'�_"' LIGHT OUTLETS J NEAREST I D.�� RE09PTACLEB r CROBB ST. WALL SWITCHES OWNER �, Q- 1 1VC IY TOTAL OUTLETS Y— SO 10 `LDMAIL �a �a ELEC. RANGES 85 ADDRESS :.L_. D � f y 0 « Q ss J� ELEC. HEATERS as Y CITY 1p P ��TEL. N0. FIXTURES 13 !S l EREBY -KNOWLEDGE THAT 1 HAVE READ THIS I A MIS-. APPLICATION AND STATE THAT THE ABOVE IB CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWIJ,REGULATING ELECTRICAL WIRING. MOTORS 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL -OWNER NEW MVD._ HP OVER INC. EACH OF THE RESIDENT! L PROPERTY DEBC 1®ED ABOVE. Ya m LESS .28SIGNATURE OF / - %s Z .6D PERMITTE a B 1.00 INSPECTION RECORD 5 16 1.50 i6 60 2.SO 60 ZOO 5.00 ZOO 600 10.0a J _ 500 1000 15.00 Z OVER 1000 20.00 _ p M.O. BET/FREQ. CHAMBER-HP WELDERS:AC-KVA O GENERATORS-- KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF ORIS-) MOVED MOTORS (75% OF ORIG.) M ISC. SIGNS NO. NO.TRANS. 5 NO. NO:LAMPS APPROVALS FOR EACH PERMIT: DATE 1N9PECTOR'8 NAME WIRING $1.00 CONDUIT FIXTURES 101.00 d Q WIRING mit.+. se �.TyZp� cr• SUPPLEMENTARY .60 FIXTURES POWER TOTAL FEE UTILITY CO.NOTIFIED 2 .FINAL /f �a3L.i!_0 �P�J�5 76A663 DBS#5A 4-58