HomeMy Public PortalAbout10673 ROSEGLEN ST_Electrical__r
' COUNTY OF LOR ANGI Ln APPLICATION FOE PEED�T
Deparhm'F B ELECTRIC 1
.•
DIVISION OF BUII..DINC� 8c SAFETY
WILLIAM L FOX. a■[ty Enjisw
FO I LIN LL]IIffTRICT NO. GROUP ZZ^ONC mRN
vmrr om.
QLEG'fRICI /-t—I
[LVED READY FOR DATM jsmieD
ADDR[■■ �-I &ff6c, I !W` F1R■T IM■P[OTION /�
OILY O.
COUNTY Er6cmiiiiN IRI■ ■UILDIN■t
PERMIT FiM6
ADD
NUmmKqjKADH �[ IUA ITY
LIGHT DUTLET■ NGR[■T00,
R[O[PTAOL.E■ �!
WALL■WITOHC• OVVNIER
TOTAL OUTLMTN 613 MAIL
[LIG. RANGEN 95 ADDRE■M
[LED. HEATER■ 9i CITY TEL NO.
FIXTURES ■ 1 H[RE■Y A13KNCW — [ THAT 1 HAVE READ THIN
MIND_ APFLICATION AND ■TAT[ THAT TH[ A■OVE 12 CORRECT
MUMMER OF LIGHT CIRCUITS AND ACRE[ TO COMPLY WITH ALL COUNTY ORDINANCE■
NUMs[R OF R[DEFrAOL.E DIROUIT■ AND ■TATE LAWN REGULATING [L[CTRIOAL WIRINM.
MOTORS I CERTIFY THAT I FOMNE■M TH[ ABOVE VALID LOS
NUMMIER HORMEPOWIRFIE[ ANG[LEN OOUMTY ENMi. OR 1 A TH[ L1GAL OWNER
N[w MVO. Hr Ovcx IND. EAaH OF THE RE■ID[NTI NO D III I■tD ■
! .i0 P[RMI
7
_3Z 11111MATURic or .4
or
9 ■ 1'130 INSPECTION RECORD
5 1■ 1.■0
is ■O 9.60
60 1 ZDD ■.DO
100 6D0 —1 CLED J
6DD 1DOO IILOO
OVIR IOOO 9Q.00 0
Md. 0L`T/IrRKIjL 13HANSER-HF Q' '
WILD[Re1AO-KVA O
G[N[RATORN - KW
TRANNFORM[R■ - KVA
TEMP. M=R■ 76 or 01011I
movico MOTOR■ (73OF o1UKJ
MI
SIGNS
MO. NO.TRAM■.
APPROVALS
N
FDR EACH PERMIT] DATE INNP WE NAM[
WIRING 1.00 CONDUIT
FIXTUIII E■ Ei.cIO WIRING .S
RUPPIr[MIENTAIRY 1110 FIXTURE■
PQWER
TDTAL F[Q • UTILITY O0.NOTIFIED
FINAL -
7s4ae2 OM#■A ■-&X
1
76A663-CE806 F0/72
APPLICATION
FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING
^ � -� S
BUILDING AND SAFETY DIVISION URESS
LOCALITY LG
NEAREST
FOR APPLICANT TO FILL IN CR0533T.
OUTLETS NO. F[ OWNER OP
FIRM NAME
RECEPt:L b b MAIL
FIRST 20 ADDRESS
LIGHT TOT L ffi
C I TY T
SWITCH OVER 20 10 PLAN CHECK
FIRST 20 APPLICANT
LIGHTING TOTAL
F-0VER 20 ADDRESS
FIXTURES ,10
RESIDENTIAL APPLIANCES �VTY TEL. NO.
PERMIT � r
RANQE DRYER_WTR. HTR. ,APPLLCANT V, 1 t
STA. COOK DISP. F.A.U. ADDRESS
SPACE HTR. AIR COND. Cl Ty Q�MEL.
CLOTHES WASH. DISHWASH. RE6UM& CLASS.
FAN-Of HEft 1.00 1 HERESY ACKNOWLEDGE THAT I HAV[ READ THIS APPLICATION
AMD STATE THAT YHE ABOVE 13 CORRECT AND AGR[[ TO COMPLY
MOTppRS, TRANSFORMERS RATIN[ WITH ALL COU1tY OADINANCHS AN6 B.TATE LAWS REGULATIN9
INE. HEATERS, ETC. IIF. KW. RVA. ELECTRICAL WIRING.
SIZE & TYPE OVER TO
I HEREBY CERTIFY THAT I AM P}10P[RLY A4G UT[RED AND/6#
0 - 1 1.00 LIC[NBED AS R[OUIRED BY LOS ANY[LIES COUNTY AND STAT[ OF
CALIFORNIA OR THAT 1 AM THE LE rAL OWNER OF THE ABOVE y
1 - 70 3.010 DESCRIBED R E IAL PRO PBRTY. G..
PERMITEE
10 - 60 p.00 $IGNATURE GC
O
50 - 100 10A0 DISTRICT 1410. PROC 93ED BY
100 - 600 16.00 O Z
81". GAS SION AND ONE CIRCUIT &00 APPROVALS DAT[ SlECTCIWS SNRM.TUM
TUBE, OR
MARQUEE ADDI'TIONAL CIRCUITS 1D0 TEMP. POWER POLE
9ERVICENOT40VIER600VOLTSOR200AMP 3.00 UNDERSLAB WORK
8ERVICEOVER 600VOLTS OR200AMp IODO ROUGH CONDUIT 1
TEMP$ERVICE,POLE, &APPURTENANCES \iL00 WIR-1NG
TEMP LIGHT OR RECEPT. SYSTEM 3 FIXTURES `0�
POWER AUTHORIZED
UTILITY CO. NOTIFLED
I Al
FINAL o�
PERMIT FEE (SUB TOTAL) NOTES:
PLAN CHECK FEF-
PERMIT
EEPERMIT ISSUING FEE 3.00
TOTAL FEE
PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION Q CK. M.O. c
247x1311 2B 4.75
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
R that I have a cert pEte of consent
C6A� ,o��; APPLICATION. FOR ELECTRICAL PERMIT
I hereby affirm that I have a certtfitate of consent to self ��
rnsure, or a certtflcate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY
or a certified copy thereof (Sec_3800, Lab. C.)
Poilcy No. Company POR/1"UCANr TO KLI,IN JOB
Certified copy Is hereby furnished. New Residential BIdQs Q Pooh EACH NO. FEE ADDRBS
❑ Certified copy Is filed with the county building Inspec- 1 8 2-Famlly, Sq. Ft.� ; — s LOCALITY �M �:Z 7
tion department. Multi-family Sq. Ft.
Data Appllcant
Residential Swimming Pools. �OR ,
l�NAME O L_
CERTIFICATE OF EMPTION FROM WOkKERS' L
COMPENSATION INSURANCE Outlets: Rec�lflhT Sw. AWRE55 3 � IPN
I section recce not be cam IsMed Ff tis•vrork Irnrphred Flat 20 i
p b Total No Additional rA L,F,C Tel. Nb.3505
the permli Is for one hundred dollars(=100)or bss.)
I certify that 1n the performance of the work for which this N-
permit is Issued,1 shall not employ any person In arty mgnner
so as to become subject to the Workers'C6mpensatlon Laws. Lighting Fixtures First 20 AD[3RE55
Additional
:F 7Total No. CITY N T
Date ATpllcant Fixed Appll nces Not Over l HP PSZWT
NOTICE TO APPLICANT: if, after making this Certfflc of ��,P�(/ n�
5xemptton, you should become sublet- to'the W en' flange Heater_D.W. —
Corhpensatlon 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— CrFY Tel. No�� 3 3 y
LICENSED CONTRACTORS DEQLARATION
I hereby gfRrm that I amlicense¢under provisions of Chapter 9 Disp. _ -Room Air Cond. Ll/L Class. CSD
(commencing with Section 7000)of Division 3 of the BUtlness IDISTRICT NO. BY
and Profeslons Code,and my license Is in full force and effect. Power Apparatus 8 Large Appliances /l d
/�rr �/h� Sim 8 Type HP, KW, KVk or KVAR' (C! CL
License Number IG Classes Up to 1 Incl. FINAL
,,,�a.ss`
Over t to 10 Inc[. DATA V T10N 0
Contract Date Over i0 to 50 Incl. �j
❑
[ a exempt under Sec FI - W
Over 50 to 100 inc. BY
fL
wo
B.SP.C. for lhls reOson Over 100 ;F 2 6 9,1 A
Services, Swbd,, MCC 8 Panelboards' /
Date: 0 -200 Amp. Under 600 V ft.-o o 0 0 0 2
Signature 201 - 1000 Amp. Under 600 V o 0 2 9,.0 0
❑ Exemption for Reg. lylalnt. flect. Over 1000 Amp. or Over 600 V
o o o 2 q,0 0 i
SINGLE FAMILY
Temp. Power P.oLe 8 Appurtenances
HOME OWNER-BUIID%R DECLARATION1 3.-_85
I hereby affirm that I am exempt from the Contractors License Sign with One Bwnch Circuit Q
Law for the following reason (Section 7031.5, Business and Addltlonal 519n Branch Circuits
Professions Code): �.-
❑ 1, as o*ner of the proappeerty, will do the work and the Esc'Condults B-Condutton;
stl-ucture Is not intendgd or offered for sale (Section Other (See Complete Fee Schedule)— ►
7U4, Business and Professions Code).
CONSTRUCTION LENDING AGENCY
I hereby affirm that there Is o tonstruction lending agency for
the performance of the work for which this permit Is Issued PERMIT FEE (SUl;�-Total)
(Sec. 3097, Clv. C.).
PLAN CHECKING Ffif
Lender's Name
PERMIT ISSUING FEE
Lender's Address -
I certify that I have rood this application and state that the TOTAL FEE
above Irrfornwtion 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-mentlonedpro for pection pyrposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of PermIttee Date