The URL can be used to link to this page

Home My Public Portal About6230-6236 ROSEMEAD BLVD_Electrical__ . _5�•r-��- (u 75A563_CE806 ,,,TG . APPLICATION FOR ELECTRICAL PERKY COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING n BUILDING AND SAFETY DIVISION ADDRESS ,o COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST, or 7RECEPT.- TS NO. EACH FEE OWNER $ $ MAIL /� nFIRST 20 25 ADDRESS J/�.�TOTAL p��/1 CITY�� i TEL. NO.,2,,V,'52 7 SWITCH_ OVER 20 .10. PLAN CHECK FIRST 20P5 APPLICANT LIGHTING TOTAL OVER 20 ADDRESS FIXTURES .10 APPLIANCES CITY TEL. NO. PERMIT RANGE DRYER_WTR. HTR. APPLICANT STA. COOK DISP. F.A.U. ADDRESS /,�_ Id. SPACE HTR._ IR COND.� CITY TEL. N0. CLOTHES WASH. DISHWASH. LICENSE N0. ,612 6 CLASS. FAN OTHER 1.00 ro 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ObDINANCES AND STATE LAWS REGULATING IND. HEATERS,..ETC. HP. KW.KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR O — 1 1.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I A HE LEGAL OWNER OF, AND INTEND TO }. 1 — 10 3.00 RESIDE IN, THE AB E DESCRIBED RESIDENTIAL PROPERTY. O SIGNATURE U 10 - 50 5.00 OF PERMITTEE 50 - 100 10.000 OISTRICTNO. CLASS Lw ERZtjSSED BY 100 - 50Q 15.00EL e SIGN, GASSIGN AND ONE CIRCUIT 5.00 NOTES, H Z TUBE, OR - MARQUEE ADDITIONAL CIRCUITS 1.00 SERVICENOTOVER 600 VOLTS OR 200AMP 3.00 SERVICE OVER 600 VOLTS OR 200 AMP 10.00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP.POWER POLE TEMP SERVICE,POLE, &APPURTENANCES 5.00 UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM 3.00 ROUGH CONDIUT dr ay WIRING ow FIXTURES POWER AUTHORI7ED PERMIT FEE (SUB TOTAL) UTILITY CO. NOTIFIED PLAN CHECK FEE deg FINAL PERMIT ISSUING FEE 3.00 JOSE ROOHAN . TOTAL FEE SUPERVISI ELE' CAL ENGINEER. PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDAT N CK. M.O. CASH ,00wS �AU-0 5 3 4 3 A?R 6 2 7,00- SEE EE BACK OF APPLICATION FOR COMPLETE SCHEDULE 75A558 DBS 5A 3-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY ELECTRIC 1 - - COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRICIAN MIF/5-•o N � 1 6 < M 2-7 Z- FOR ADDRESS IO l0 \ r ` 0 w R ED BY FIRST INSPECTION DATE ISSUED 12, CITY J �y EL NO. Q 11� 2- / �!"' COUNTY LICENSE NO. .y EXPIRES $d�� A6dADDRESS MIL4 / �2 P PERMIT FEES - NUMBER EACH FEE LOCALITY nJ2 L40 / A LIGHT OUTLETS MEARES. RECEPTACLES CROSS 9T WALL SWITCHES .OWNER n r a7®Jv 1� /) l TOTAL'OUTLETS g so $ 1/ 0 ADDRESS ((� Cf �J I+ /I 6� l f�AL ELEC. RANGES 25 ELEC. HEATERS 25 Z CITY TEL. NO. FIXTURES 5 ' 5 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIN MISC. 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 LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT 1 POSBESB THE ABOVE VALID LOB NuNBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER NEW MVD. HP OVER IND. EACH OF THE RESIDENT PROPS ' DESCRIBED ABOVE. Ie A LEBB .2s A SIGNATURE OF , I/2 2 .SO PERMITTER � �4 �;)efA r, dsm- INSPECTION RE RD s 15 1.5D 1s so a.Bo n^+ 60 200 5.00 200 Sao 10.00 E J soo luau 15.00 Q OVER 1000 1 20.00 0 M.G. BET/FREq. CHANGER-HP X Q s'�_ �� E WELDERS:AC-KVA ® /� O GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75%OF DRIB.) MOVED MOTORS 175% DF DRI®a MISC. SIGNS NO. NO.TRANS. APPROVALS NO. NO.LAMPS DATE INSPECTORPS NAME FOR EACH PERMIT: WIRIND $1.00 CONDUIT FIXTURES $1.00 j MO WIRING 2.`2 Z (XI IAA SUPPLEMENTARY .50 FIXTURES / G. POWER TOTAL FEE ly®� UTILITY CO.NuTirig 7 - / fir, FINAL �WORvERS'COMPENSATION DECLARATION 26AW DPW 3/87 APPLICATION FOR ELECTRICAL PERMIT I here affirm that I have a certificate of consent to self O -80613 insure, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES . �, -DEPT. OF PUBLIC WORKS or a certified copy thereof(Sec. 3800, Lab. C.) a� .Policy No.00 $ Company 9minDhe 14, FuDFOR APPLICANT TO FILL IN ! ADDRESS 30 M.-Certified copy is hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE ' rCertified copy is filed with the ou Ing in Pec- 1 &2-Family, Sq. Ft. $ — $' LOCALITY "'� ti tion department. — NEAREST P Multi-family Sq. Ft. f� pp •Residential SwimmingPools � CROSS ST. �N�vGi' Pi Date 'Z8 O� Applica t OWNER ORRS� � FIRM NAME.fQ`( �-� CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light. Sw._ MAIL COMPENSATION INSURANCE ADDRESS . 4 2A (This section need not be completed if the work involved by First 20 CITYTel. N PLAN CHECK the permit is for one hundred dollars($100)or less.) Total No. Additional i °+� . I certify that in the performance of the work for which this APPLICANT permit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation LawsLighting Fixtures First 20 ADDRESS Additional Date Applicant I Total No. CITY Tel. No. NOTICE. TO,APPLICANT: If; after making this Certificate o Fixed Appliances Not Over 1 HP ( PERMIT �• Exemption, you should become subject to the Workers Range— Heater—D.W. — j APPLICATION 'l'L. LAI W_ C; Compensation provisions of the Labor Code, you must forth Oven — Dryer —W.M.— ADDRESS (1a to,, y,W h . with comply with such provisions or this permit shall bq Top — FAU —W.H. — deemed revoked. Hood — Fan "—Other— ! CITY Tel. No. Sc'7LOW LICENSED CONTRACTORS DECLARATION t, LICENSE OR Disp. — Room Air Cond. — Class. 1 hereby affirm that I am licensed under provisions of Chapter 9 REG. NUMBER d (commencing,with Section 7000)of Division 3 of the Business Power Apparatus&Large Appliances DISTRICT NO. PROCES. D BY and Professions Code,and my license is in full force and effect: t1 v Size&Type HP, KW, KVA, or KVAR � O License Number J ��9 Lic. Class Up to 1. Incl. FINAL U INTEL LJs1.1pP�IRK� CA��'i- �j Over 1 to 10 Incl. 7 DATE V ION Contractor ---I Date 7 '"$a' I O ❑ Over 10 to 50 Incl. FINAIIE I am exempt under Sec. Over 50 to 100 Inc. BYW U , B.&P.C. for this reason Over 100 :I d i Date: Services, Swbd.., MCC.&Panelboards ® Z 0-200 Amp. Under 600 V Signature ! 201 - 1000 Amp. Under 600 V ❑ Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 VI � I SINGLE FAMILY Temp. Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION ! I hereby affirm that I am exempt from the Contractor's LicensSign with One Branch Circuite Law for the following,reason (Section 7031'.5, Business an Additional Sign Branch Circuits Q 3 Q,l .A Professions Code): 1 # 0 0.0 0 0 2 ❑ I, as owner of the property, will do the work and the Misc. Conduits&Conductors structure is not intended 6 offered for sale(Section 7044, Other(See Complete Fee Schedule)_ ` ® ;( - 2550 Business and Professions Code). j 0 0 0 2 5 5 CONSTRUCTION LENDING AGENCY 00 I hereby affirm that there is a construction lending agency fo the performance of the work for which this permit is issued. PERMIT FEE _ (Sub-Total) 7' 88 (Sec. 3097, Civ. C.). 11.... rr,, Lender's Name I&L Wl;;. =_ QA PLAN CHECKING FEE I+I� T PERMIT ISSUING FEE Lender's Address VA(tEV tw>g &AAM TOTAL FEE I certify that I have read .his a� pplic�ation and state that the above information is correct..I agree to comply with all Coun ordinances and State laws regulating Electrical wiring, aril hereby authorize re resentatives of this County to enter upon r erty f inspection purposes. i SEE REVERSE FOR EXPLANATORY LANGUAGE pp--p � ®s Signat of Perm ttee. WORKERS'COMPENSATION DECLARATION 10/81 CE-806 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self CE-8066 -.insurer]at'a•certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY J1 or a certified copy thereof(Sec. 3800, Lab. C.'). FOR APPLICANT TO FILL IN JOB O�3 p viSC m 6 ��V� Policy No. Co.rtipany � � EACH NO.. FEE ADDRE Certified copy is hereby'furnished• New Residential Bldgs. &Pools �' ❑ Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. $ _ $ LOCALIT �'m C C f tion department. Multi-family Sq. Ft. 'NEAREST Residential Swimming Pools CROSS . ,,/ WNER OR Date Applicant FFIIRM NAME*DC F, , Od-J �'�`/1K 0 CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Ree Light Sw._ ADDRESS IL /1 3 1 COMPENSATION.INSURANCE First 20' (This section need not be completed if the work involved by ,I Total No. Additional CIT 2I.A D 1'/r} j/00 ,Tel. No the permit is for one hundred dollars($100)or less.) PLAN CHECK 444ce— q1 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 so as to become subject to the Worker'Com ensatio La s. Lighting Fixtures First 20 ADDRESS Total No. Additional CITY Tel.,No. XDate _ AApplicant / Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after Makin9 this Certi icate of J� APPLICANT Exemption, you should become subject to the Workers' , Range_ Heater_D.W. Compensation provisions of the Labor Code,•.yo.0 must forth- Oven —Dryer —W.M.— ADDRESS (S . with comply with such provisions or this permit shall be I Top _ FAU —W.H. —Oth Hood Fan _Other— r deemed revoked. I Hoo _ CITY , e L( Tel. No� _ LICENSED CONTRACTORS DECLARATION J LICENSE OR ,�¢ I hereby affirm that I am licensed under provisions of Chapter 9 ADisp. Room Air Cond.REG.NUMBER /� 8 CI° (commencing with Section 7000)of Division 3 of the Business DISTRICT NO, P SED BY and Professions Code,and my license is in full force and effect. Power Apparatus&Large Appliances. !� d r i Size&Type HP, KW,:KVA, or KVAR' �J License Number Lic. Class—_ Up to 1 Incl. FINAL RR 09 Over 1 to 10 Incl. DATE VALIDATION Contractor Date FIN SSSUUU � Over 10 to 50 Incl. ❑. I am exempt under Sec. I Over 50 to 100 Inc. BY // rU IL BAP.C. for this reason I Over 100 ; vvvv ,I Services Swbd:, MCC&Parielboards ate: 0 -200 Amp. Under 600 V X Signature I 201 -1000 Amp. Under 600 V ite❑ I Over 1000 Amp. or Over 600 V Exemption for Reg. Maint. Elect. SINGLE FAMILY i Temp. Power Pole&Appurtenances HOMEOWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm,that I am exempt from the Contractor's License Additional Sign Branch Circuits Law for the following reason (Section 7031.5, Business and Professions Code): ❑ I, as owner of the property, will do the work and the Misc. Conduits&Conductors structure is not intended or offered for sale (Section I Other Pee Comple a Fee Sch d1Lle)- 7044; Business and Professions Code). 6 0 „3 A CONSTRUCTION LENDING AGENCY ' I hereby affirm thaf there is a constructio.n.,lending agency for # 0 0 0 0 0 2 the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) .Q. (Sec. 3097, Civ. C.). I ° 0 3 Q 5 0 PLAN CHECKING FEE Q Lender's Name 0 0 0 3 4 5 0 5 PERMIT ISSUING FEE • Lender's Address \ 1 1..24"86 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 laws regulating Electrical wiring, and hereby authorize representatives of this County to enter upon , the m Wlonprparty for ' action purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE X �6 Signat of Permittee Date 1 W_.&W ikERS'COMPENSATION DECLP�,RATIOy .� 7eA683 10/81 APPLICATION FOR ELECTRICAL PERMIT i + �• CE-808G Q firm that I have a certificate of,xonsent to self insure, ` �_ . �'j { Pr a certificate of Workers' Conipens9tion.Insurtince, or a certified COUNTY OF LO$ANGELES BUILDING AND SAFETY copy thereof(Sec.3800.Lab.C.) 'C'� 3 j �i(�} Policy No. Company FOR APPLICANT TO-FILL IN JOB ❑ Certified copy is hereby furnished. EACH NO. FEE ADDRESS New Residential Bldgs.&Pools ❑ 1 &2-Family,Sq.Ft. $ _ $ LOCALITY Certified copy is filed with the county building inspection NEAREST department. Multi-family Sq.Ft. CROSS ST. Date Applicant / ea ential Swimming Pools OWNER OR y FIRM NAME 7. C IFICATE OF EXEMPTIQaAy @ RKERS' Outlets:Rec—Light_Sw. MAIL COMPENSATION INSURANCE ADDRESS (This section need not be completed-if the work Involved by the First'20' Total Additional CITY Tel. Tol Nb. nal permit is for one hundred dollars'($100)or less.) , ` I•certify that in the performance of the work for which this permit APPLAN PLICANTK is issued; I shall not.employ any person in any manner so as to become subject to the Workers"Compensation Laws. Lighting Fixtures F.irst.20 ADDRESS Additional ' - Total No. 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._. l 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 (commencing with Section 70.00)of Division 3 of the.Business and. Disp. — Room Air Cond. REG.NUMBER Class.G" Professions Code,and my.license is in full force and effect. DISTRICT NO. PROCESSED BY Power Apparatus&Large Appliances, .r a, Size&Type HP,KW,KVA;or KVAR J U Q License Numb 7 Lic.Class� Up to 1 Incl. FINAL v -Azz_^ Over 1.to 10 Incl. DAA yAUDATION O Contractor Date ` Over 10 to 50 Incl. �. I am•exe un er.Se Over.50 to 100 Inc. OW.. BAP.C.for this reason Over 100 N Services,.Swbd.,MCC&Panelboards , Z Date... 0-200 Amp.Under 600 V Signature 201-1000Amp'.Urider 600 V ❑ Over 1000 Amp.or Over.600 V Exemption for Reg.Maint.Elect. SINGLE FAMILY Temp.Power Pole&Appurtenances 2 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I'am exempt from the Contractor's License Law Additional Sign Branch Circuits AGGToa for the•following reason(Section 7031.5,:Business and:Professions ; Code): 3307 381050 Misc..Conduits&Conductors ITEMS ❑ I,as owner of the property,will do the work and the structure is not,intended or offered for.sale (Section 7044, Business Other(See Complete Fee Schedule) and Professions Code). TOTAL • 381 o 50 CONSTRUCTION LENDING AGENCY CHECK, 381050 1 hereby affirm that there is a construction lending agency for the CHANE performance of the work for which this permit is issued.(Sec.3097,,. PERMIT FEE (Sub Total) D . Civ.C.). PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE �/) 0000-0001 - 512/89 C/ 'Lender's Addressa 3253 1 AN 9°o32, 1 certify that I.have read this application and state that the above ,. TOTAL FEE (/ Q 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 pro inspection p rposes; SEE REVERSE FOR EXPLANATORY LANGUAGE ld � Signature of rmitt .