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HomeMy Public PortalAbout6266 ROSEMEAD BLVD_Electrical__ DB 5-A 12-43 25M C•M�/O�N• FOR PEWW IIlEPA1tTlCO y Y DY.y11OL1./'Yl�\pO�(�FL1�L�+ SAY L'1 1 ELECTRIC�Iv�i� COUNTY OF LOQ Hl\'17E�J WM. J. FOX CHIEF ENGINEER Z DISTRICT NO.. GROUP ZONE PERMIT NO. Q NAME!" L �� ��,�ET ��EL. CO .{ U ADDRESS /00/ J O . IV 7'H v� 1 �/ � � �+�I U CITY leC/�'p/!9 TEL.NO,#r �� REGEO BY READY FOR DATE ISSUED 1 FIRST INSPECTION' J COUNTY o W CERT.NO. $ EXPIRES APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY - JOB DESCRIPTION OF WORK ADDRESS 4r:S' A. p EM E'I9 L� NUMBER OF OUTLETS ON CIRCUITS LOCALITY ✓ .L Err/a/y LOCATION BY ROOMS NEAREST e' LIGHT OUTLETS SW. PLUGS FIXT, CROSS ST t .4 gol�6 Q i/Y CIRCUIT A B C I D I E F G H m NAME r EY L GRCC� 3 MAIL ADDRESS SIYO, t0Sj'1f��� CITY r L,r6 f, r TEL.NO. AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTfIFICAT F QUALIFICATION., 1 AM THE"GAL OWNER OF THE PROPERTY DESCRIBED Ile ABOVE OWNER. ' CORRECTIONS J - Q Z . L7 !Y O TOTAL Ly•J Y NO. OF OUTLETS :2-3 $ /,J- APPROVALS �I NO. OF FIXTURES /I. E n DATE INSPECTOR'S NAME NO. OF MOTORS H.P. $ CONDUIT Cj{ �1d�v414,11 NO. OF SIGNS TRANS. E WIRING v `fav NO. OF RANGES OR HEATERS $ FIXTURES L SCELLANEOUS $ POWER RMIT FEE �-�r $ UTILITY CO.NOTIFIEDTAL FEE 3 V d a 1 FINAL 348 Sr,G IM SWM 7647 � APPLICATION FOR -P51ia SP.dYBENII OF TyII9DiN^ AND SA1Lp �1/ECp.$�WJL� I/!� COUNTY OF LOS ANGELES . HAA�@ll,,, W-M..-J. FOX. CHIEF E INE t DISTRICT NO. GROUP ZONE PERMIT NO. NAME /s/�L� .�'/�L'/ ADDR SS � CITY TEL.NO. REC6IYED BY FIRSREADY INSPECTION DATE ISSUED J COUNTY ® 7 W CERT.NO. 7 EXPIRES APPLICANT FILL IN HEAVILY OUTLINED PORTION ONV JOB DESCRIPTION OF WORK —ADDRESS NUMBER OF OUTLETS ON CIRCUITS LOCALITY I LOCATION BY ROOMS a NEAREST / o w` ®� - LIGHT OUTLETS SW. PLUGS FACT C 'V CIRCUIT A B C D E IT IG IH 1 rc• NAME 1141loV 04E Zr MAIL S I ADDRESS J �// O _ CITY r TEL.No. 1 AM THELEGAL POSE SO OF THE ABOVE LOS ANGR�m COUNTY CERTIFI' OF QUALIFY TION.. ELECTRICIAN. I AFI TM LEGAL OWN THE PROPERTY DESCRIBED ABOVB ' OWNER. g NQ b LrJ a z D TOTAL g NO. OF OUTLETS 9 $ APPROVALS NO. OF FIXTURES $ DATE INSPECTOR'S NAME NO. OF MOTORS H.P. $ CONDUIT NO. OF SIGNS TRANS. $ WIRING ' NO. OF RANGES OR HEATERS $ FIXTURES MISCELLANEOUS $ POWER i PERMIT FEE $ UTILITY CO.NOTIFIED TOTAL FEE f !$ FINAL �Y Io, V V DOS 6-A 1-46 - APPUCATION FOR PERMIT DEPARftE-N'I", OF BUILDING AND SAFETY ' COUNTY OF LOS ANGELES ELECTRIC IC M. J. FOX CHIEF ENGINEER Q NAME G; �}'�" ��' co, DISTRICT NO. GROUP ZONE PERMIT NO. U ADDRESS 4V, � y U CITY ��(�� TEL.N p 'yyg0 RECEIVED BY READY FOR DATE ISSUED j FIRST W COUNTY fes„) CERT.NO. � EXPIRES �9APPLICANT FILL IN HEAVILY OUTLINEDPORTIONONLY t�yp� /� DESCRI TIO OF WORK JOB ADDRESS 4 `.�e� F/ Q� f6!T PA AM NUMBER OF OUTLETS ON CIRCUITS LOCALITY�➢♦ 6 a LOCATION BY ROOMS NEAREST dd {{��gq // �! �,g LIGHT OUTLETS SW. PLUGS F13iT CROSS ST. N�r �CJ",Q FL,`AI ,0i6T 9t! CIRCUIT A, 113 C D E F G H NAME /j Z MAIL p�A / 3 ADDRES*S�� �`T� f ,0,, �dS���AA CITY //j, c'• TEL.NO. 1 AM THE LEGAL POSSESSOR OF THE -ABOVE LOS ANGOLES COUNTY CERTJIF.ICATE OF ALIFI TION.. lldti Z's ��� aen. KZEC' TRICIAN. I AM THE E,EGAL OWNER OF THE PROPERTY DESCRIBED ABOVE OWNER. COR.I;EMONS J Q _Z CJ tY o p TOTAL NO. OF OUTLETS $ � APPROVALS NO. OF FIXTURES $ �� DATE INSPECTOR'S NAME NO. OF MOTORS H.P. $ CONDUIT WIRING NO. OF RANGES OR HEATERS $ FIXTURES MISCELLANEOUS $ POWER A PERMIT FEE $ UTILITY CO.NOTIFIED r .1 y� TOTAL FEE T b FINA b \ DS S-A 12-43-25M ���CAT�®1!T FOR PES DEPARTMENT OF BUILDING A-NO SAFETY COUNTY O LOS ANGELES ELECTRIC CTRIC I 11 WM. J._ OX CHIEF ENGINEER z R _ DISTRICT NO. GROUP /eZONE PERMIT . NAME ADDRESShf-L RECEIVED BREADY FOR D CITY A -'� TEL.NO. J FIRST INSPECTION � ��� �� ' COUNTY CERT.NO. z EXPIRES � ,Pt 4frl' APPLICANT;' FILL Ir4 HigAVILY OUTLINED PORTION ONLY JOB DESCRIPTION OF WORD DDRESS ,p .j� / S �. b NUMBER OF OUTLETS ON CIRCUITS LOCALITY LOCATION BY ROOMS NEAREST J� LIGHT OUTLETS SW. PLUGS FIXT CROSS ST. B r' f�/ 0 p� CIRCUIT A B C I D I E F G H Ir NAME ZMAIL a a ADDRESS f� O CITY TEL.NO. / 1 AM THE LEGAL POSSESIMPR OF THE ABOVE LOS ANGELES COUNTY CERTIFICA QF QU' IFICATION.. / ELECTRICIAN. I AM THE LEGAL OWNER I• THE PROPERTY DESCRIBED ABOVE OWNER. CORRECTIONS Q _Z [7 !Y O a� a, TOTAL a NO. OF OUTLETS $ APPROVALS NO. OF FIXTURES $ (�S DATE INSPECTOR'S NAME NO. OF MOTORS H.P. $ CONDUIT NO. OF SIGNS TRANS. $ WIRING �i NO. OF RANGES OR HEATERS $ FIXTURES r MISCELLANEOUS $ POWER PERMIT FEE $ UTILITY CO.NOTIFIER TOTAL FEE 0 - ® FINAL ��/ �� �.1 �• OB 5-A 7-38' 25M - - - DEPARTMENT OF BUILDING AND SAFETYAPPLICATION�FvO�R+ PERMIT COUNTY-OF .LOS.ANGELES ELEC CTRIC - ,.NATURE O iINSTALLA ON DISTRICT No. GROUP TYP - •PERMIT NO.- 2- WIRING-, SERVICEFIXTURES - O � _ READY- FOR REC IVED DA BSUED RANGE HEATER, I i POWER FIRST,INSPECTION ®�V� SIGNS - I MISCELLANEOUS • �� /- 'APPLICANT ILL IN,g A I Y O(JTLINED Z' � JOB _ Q• 'NAME ADDRESS • C ,, ADDRESS LOCALITY '�� �A - NEAR '•W CITY TEL No' CROSS 6T W •STATE _ COUNTY �{ - - .. LICENSE No - REG.`No. NAM,• - _ - - _ - _ DESCRIPTION-OF WORK z MAIL / V -ADDRESS IK lt) �• -eJ t.� - . NUMBER OF OUTLETS,ON CIRCUITS ' LOCATION BY ROOMS _ D I CITY A - TEL Nl., _ LIGHT-.OUTLETS- BW. PLUGS SIX,'. CORRECTIONS 'CIRCUIT I A I B IC_ I D I'E LIVING' ROOM DINING- ROOM I "1 71 1 . BRFST. RM. I i I l G> �:�r r - BATH - ENT. HALL _ II 'I; HALL Nil-.'- I I I .1 t I. _ FRONT-PORCHI I 1• -2LI• "1w-0 q ' - Z OUTSIDE' I I I I 1 I I I i I - -" • KI�C>;,E�,e..- I I ' L�..I' I'- I .I. .,I I • -I� _ , • _ ' . _ - . . - ,` 0 SEPV. PCH. - BDRM:NO` � CLOSET, BDRM. No. ' .I I °4 I CLOSET' I' I I' APPROVALS. DATE INSPECTOR'S NAME I . CONDUIT- 71 WIRING TOTAL I I P'I I I L . I�I ' ' FIXTURES NO. OF OUTLETSI `POWER $ NO. OF FIXTURES. g' UTILITY CO. NOTIFIED NO. OF MOTORS H. P. $• FINAL a - 1 AM THE LEGAL OWNER OF*jTHE ABOVE LOS ANGELES NO OF SIGNS - TRANS. $' COUNTY REGISTRATION NUMBER.] , r NO. OF RANGES OR HEATERS $ L ' {*,ELECTRICIAN., --i'MISCELLANEOUS $ 1 AM THE LEGAL OWNER OF THE PROPERTY-DESCRIBED ABOVE. PERMIT FEE _ TOTAL FEE $ OWNER. I 76A663 DBS SA 7-51 APPLICATION FOR PERMIT " DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT N GROUP I ZONE PERMIT NO. ELECTRICIAN Idcl ELEI.TRiC COWA a I ��� _ OWA-NY RECEIVED READY FO DATE ISSUED EleetriCa( Cent�aCfo.� FIRSTINSP TI❑ ADDRESS f �` CITY 45 SANTA ,Qi4,Aq / -57 ' COUNTY LICENSE iFEXPMESDO. 7-7ADDRESHG PERMIT FEES �e FEE LOCALITY NUMBER EACH LIGHT OUTLETS NEAREST CROSS ST. RECEPTACLES _ WALL SWITCHES OWNER~ig TOTAL OUTLETS 5c $ �� MAIL ELEC. RANGES 25 ADDRESS ELEC. HEATERS 25 CITY TEL. NO. FIXTURES _ S /® I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS ..3U AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWERFEE ANGELES COUN LICENSE, OR I AM THE LEGAL OWNER NEw MVD. HP OVER INC. EACH OF THE REBID TI L OPERTY DiMCRIBED ABOVE. %2 6 LESS $ .25 SIGNATURE O Z, V2 2 .50 PERMITTEE _ 2 s 1.00 7INSPECTIbN RECORD 5 15 1.50 _ is 50 2.50 50 200 5.00 200 500 10.00 J 500 1 000 15.00 Q Z OVER 1000 20.00 E3 M.G. SET/FREQ. CHANGER-HP WELDERS:AC-KVA O GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF ORIG.) MOVED MOTORS (75% OF ORIG.) _ MISC. SIGNS NO. NO.TRANS. APPROVALS NO. NO. LAMPS DATE INSPECTOR'S NAME FOR EACH PERMIT: CONDUIT WIRING $1,00 ®® FIXTURES $1,00 ®� WIRING y � SUPPLEMENTARY .50 FIXTURES ® POWER TOTAL FEE UTILITY CO. NOTIFIED FINAL 6"-"lO,`� �_✓„� ��" L/ ' 76AS63 D9S SA 25M SETS 11-48 ' APPLICATION FOR PERMIT i DEPARTMENT OF BUILDING AND SAFETY ELECTRIC �����'� � 1 COUNTY OF LOS ANGELES WILLIAM J. FOX. CHIEF ENGINEER DISTRICT NO. GRO P ZO PERMIT NO. FOR APPLICANT TO FILL IN ELECTRICIAN Electrical Products Cor . RECEIV C;lF&Y READY FOR /DATE ISSUED ADDRESS 1100 N.Maln St. FIRST INSPECTION CITY L A —12 p TEL. NO.CA 1-6141 BUILD LICENSE NO. 6-B EXPIRES —3-0 Q ADD EISS 654 North Rosemead Blvd. DESCRIPTION OF WORK I FEES LOCALITY Temple City NUMBER OUTLETS EACH CROSS LIGHTS Sc $ STREET Longden Ave. RECEPTACLES s OWNER M. T. Heydel FIXTURES s WALL SWITCHES 5 I MAIL ADDRESS 654 North Rosemead Blvd. ELEC. RANGES 25 ELEC. HEATERS 25 CITY Temple CitylCal TEL. NO. MISC. I CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER OF CIRCUITS INSTALLED: ANGELE UNTY LICENSE. LIGHTS RECEPTACLE4 MOTORS 10 ECTRI CIAN. NUM13ER HORSEPOWER FEE NEW MVD. HP OVER INC. EACH 1 AM THE LEGAL OWNER OF THE RESIDENTIAL PROP- 1/2 & LESS $ .25 ERTY DESCRIBED ABOVE. %2 2 .50 2 5 1.00 OWNER. s is 1.5D INSPECTION RECORD 1 is so 2.S01 I I s0 1 200 5.001 200 SOO 10.130 Boo I 1000 15.00 J Q OVER 1000 20.00 Z M.Q. BET/FREQ. CHANGER-HP I n WELDERS: AC-KVA 0 GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (7S% Or ORIG.) MOVED MOTORS (75% Or ORIG.) MISC. I SIGNS ��11 TYPE: Doub1.,le Face 1 NO.TRANS. 1. 00 TYPE: Neon NO. LAMPS APPROVALS PERMIT FEE DATE INSPECTOR'S NAME FOR ISSUING PERMIT: 1. 00 CONDUIT WITHOUT FIXTURES $1= I WIRING WITH FIXTURES 1.25 FIXTURES SUPPLEMENTARY .50 - POWER TOTAL FEE $ 2. OO UTILITY CO. NOTIFIED _ FINAL TEMPLECR AI Y reeves-CEeae4-eo APPLICATION FOR ELECTWCAL PERMIT � COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING ✓ BUILDING AND SAFETY DIVISION ADDRESS JOHN A.LAMBIE, COUNTY ENGINEER WILLIAM A.JENSEN, SUP'TOF BUILDING LOCALITY v r FOR APPLICANT TO FILL IN CROSSS T PERMIT FEES OWNER 1 T E M NUMBER EACH FEE MAIL OUTLETS. $ $ ADDRESS LIGHTS RECEPT. SW. .10 LIGHTING FIXTURES t0 CI T NO ELEC. RANGES CLO. DRYERS ELECTRICIAN d WATER HEATERS .50 ADDRESS OQF7 c ELEC.SPACE HTRS. DISHWASHERS CITY TEL.4falO GARBAGE DISPOSERS AUTO.. STATE t WASHERS STA. COOKING UNITS .25 LICENSE NO. MOTORS: OVER INC. H.P. DISTRT ZO— NE P SSED BY O 1/2 C ; INSPECTION RECORD y, - 2 so r 2 — 5 1.00 _ 5 181.50 .w3'�" Kn OU 15 — 50 2.50 w O so — 200 5.00 V L+ W SIGNS: NO TRANS. - N NO .LAMPS Z SERVICE 0-600V 1.00 a SERVICE OVER 600V 5.00 ` MISC. WIRING PERMIT 1.00 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .50 TOTAL FEE $ 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATINSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT ELECTRICAL WIRING. , WIRING I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR L'FSCRIBED CENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES ALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE RESIDENTIAL PROPERTY. a POWER IGNATURE UTILITY CO. NOTIFIED F PERMITTE VALIDAT ARTHUR C.VETT. CK NO CASH SUPERVISING ELECTRICAL ENGINEER L;t_ 9 OCT :D 2 D . - ,� 78A883_CE608.9_57 APPLICATION FOR ELECTRIC PERMIT �. COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING t BUILDING AND SAFETY DIVISION ADDRESS JOHN A.LAMBIE,COUNTY ENGINEER e CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY NEAREST y FOR APPLICANT TO FILL IN CROSS ST 0% PERMIT FEES J !� I T E M NUMBER1 EACH FEE OWNER MAIL OLIGHTS TS RECEPT SW $ 10 /C7 ADDRESS I -S O LIGHTING FIXTURES 100 CITY r/ TEL NO ELEC RANGES CLO DRYERS ELECTRICIAN WATER HEATERS - 50 ADDRESS ELEC SPACE HTRS DISHWASHERS JJ w //JJ�� GARBAGE DISPOSERS AUTO- CITY R TEL N V& / WASHERS STA COOKING UNITS 25 STATE LICENSE NO b 7 7 a MOTORS. OVER INC H P 0 +/2 25 DISTRICTN0. GROUP 33�PNE' READY FOR INSPECTION +/2 2 50 INSPECTION RECORD 2 — 5 100 5 - 15 150 [�9 � 6 / /� 15 - 50 250 J \ -itill /� �°` 50- 200 500 SIGNS- NO TRANS p,J' _ Ik NO LAMPS / C 1-1 11-/?/, ,D SERVICE 0-600V loo QQ SERVICE OVER 600V Boo MISC WIRING PERMIT 1.00 FIXTURE PERMIT 1.00 (� SUPPLEMENTARY PERMIT 50 TOTAL FEE . g v APPROVALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT �J.Id . WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. - WIRING I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE POWER DESCRIBED RESIDENTIAL PROPERTY. a' SIGNATURE UTILITY CO NOTIFIED 7..�� dfb � A�1PifU OF PERM ITTE ` + / d V vv N/vI'�'r FINAL TION ARTHUR C.1/EIT, CK afo CASH SUPERVISING ELECTRICAL ENGINEER 1 1 71 9 USJ1Ad 1 A ; 4-5-0, utlD�EPARTMENT OF RIDING AND SAF'L-ff) APPLICATION FOR PERMIT' COUNTY OF LOS ANGELES �, ELECTRIC IC WM.-J. OX CHIEF NG IGEER �I a NAME �/ DISTRICT NO. GROUP" ZONE P�fER�MtIT/ NO. V ADDRE CITY / TEL.NO. v / RECEIVED BY READY FOR DATE ISSUED /�{ M FIRST INSPECTION dy ,1 7 ,.1 COUNTY .�y /C///'�!{' ` W CERT.NO. mC EXPIRES APP CANT FIM.IN HEAVILY OUTLINED PORTION ONLY /,, ,g - DESCRIPTION OF WORK A DRESS �� & &Te Age o9b NUMBER OF OUTLETS ON CIRCUITS LOCALITY _ 4G7' LOCATION-BY ROOMS NEAREST - LIGHT OUTLETS JSW. PLUGS F1IiT CROSS ST. //J tfI .d E CIRCUIT A B C I D I E F G H 0: NAME 2 MAIL Q� /�/Y Q , s.• 3 ADDRESS �s 2 o �p CITY � 6:- � TEL.NO. I ' AM THE LEGAL PO SOR�OF THE ABOVE LOS ANGF3LEB COUNTY CERT1 1 T6 OF qU lFtCAVION.. i ECTRICIAN. I AM THS LeEGALow OF TH6 PROPZRTY DESCRIBED ABOVE1*4 4 OWNER. v CORRECTIONS J ar Z_ L7 d' a TOTAL 3 �J NO. OF OUTLETS $ APPROVALS NO. OF FIXTURES $ @ DATE INSPECTOR'S NAME NO. OF MOTORS H.P. $ CONDUIT ? NO. OF SIGNS TRANS. $ WIRING A/ NO. OF RANGES OR HEATERS $ FIXTURES MISCELLANEOUS - a#�- $ POWER / PERMIT FEE UTILITY CO.NOTIFIED TOTAL FEE FINAL Y e CE-806 WORKERS'COMPENSATION DECLARATION 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self CE-806G ^� insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof4S 3800,0,, Lob. C.) Policy Nd6gedomo Company J� � FOR APPLICANT TO FILL IN JOB EACH EACH NO. FEE ADDRESS 6-,2,&1,, n Certified copy is hereby furnished. New Residential Bldgs. &Pools ------- LOCALITY �, — Certified copy is filed with the county building inspec- 1 & 2-Family, Sq Ft. $ $ � R tion department. Multi-family Sq. Ft. NEAREST CROSS ST. Residential Swimming Pools OWNER T. �–r— Date Applicant FIRM NAME ` �3�ft _ CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw._ MAIL COMPENSATION INSURANCE ADDRESS First 20 (This section need not be completed if the work involved by Total No. Additional CITY Tel. No. the permit is for one hundred dollars ($100)or less.) 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 so as to become subject to the Workers'Compensation Laws, Lighting Fixtures First 20 ADDRESS Total No. Additional CITY Tel. No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of =CANTSCD 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 CJ with comply with such provisions or this permit shall be Top _ FAU —W.H. — deemed revoked. CITYTel. No Hood _ Fan _ Other— `3 lee LICENSED CONTRACTORS DECLARATION LICENSE OR � I hereby affirm that I am licensed under provisions of Chapter 9 Disp. _ Room Air Cond. REG. NUMBER q'� 1 �l Class. }. (commencing with Section 7000) of Division 3 of the Business DISTRICT NO. PRO S BY 0- Power Apparatus& Large Appliances. and Professions Code,and my license is in full force and effect. �)�/ U Size & Type HP, KW, KVA, or KVAR 4 V(1 License Number Lic. Class t� Up to 1 Incl. FINAL p Over 1 to 10 Incl. DATE F�- Contractor Date VA (DATION W DOver 10 to 50 Incl. FIN L I am exempt under Sec. Over 50 to 100 Inc. BY Over 100 B.&P.C. for this reason Date: Services, Swbd., MCC& Panelboards 0 -200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V El Over 1000 Amp. or Over 600 V Exemption for Reg. Maint. Elect. SINGLE FAMILY Temp. Power Pole&Appurtenances ;2347.9A HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit # o o.o 0 0 '� I hereby affirm that'(am.exempt from the Contractor's License Additional Sign Branch Circuits I -o2 5 0 Law for the following reason (Section 7031.5, Business and o 2 5.5 0= Professions Code): 0o v I - I, as owner of the property, will do the work and the Misc. Conduits&Conductors 1. 1 5 S 5 structure is not intended or offered for safe (Section Other (See,Complete Fee Schedule)_ , 7044, 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 FEEt]1 . 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 ve-mentione property for inspection p rposes. SEE REVERSE FOR EXPLANATORY LANGUAGE L a Signature of Permittee ate WORKERS'COMPENSATION DECLARATION CE-806 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self CE-806G jnsure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec. 3800, Lab. C.) Policy No. 6'4697 Company 4710e F;I~10 FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS 62 Gig Al, osifmg,1� Certified copy is filed with the co ty b g ' pec- 1 & 2-Family, Sq. Ft. $ — $ LOCALITY Q`f-,'lld� �t7' tion depart ent. Multi-family Sq. Ft. — NEAREST / Residential Swimming Pools CROSS ST. �N��OAl Date �1 30 b -Applicant a g OWNER OR /� FIRM.NAME TDi✓ �s CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw.._ •�y Z / MAIL ./ COMPENSATION INSURANCE First 20 ADDRESS (This section need not be completed if the work involved by Total No. Additional CITY''jZp,ee 7' Tel. No.$ g mgtj/� V the permit is for one hundred dollars ($100)or less.) PLAN CHECK I certify that in the performance of the work for which this APPLICANT permit is issued, I shall not employ any person in any manner so as to become subject to theW rkers'Compensation Laws. Lighting Fixtures First 20 ADDRESS Total No. Additional gg CITY Tel. No. Date is t/� Fixed Appliances Not Over I HP PERMIT l NOTICE TO APPLICA If, of making this Certificate of APPLICANT /`dLw✓$ 610-7w-le— ✓/ 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 -717W S/ with comply with such provisions or this permit shall be Top _ FAU —W.H.' — deemed revoked. CITY G�/4r L Tel, o�'� LICENSED CONTRACTORS DECLARATION Hood _ Fan _Other_ Disp. Room Air Cond. LICENSE M .y• Class. _ I,hereby affirm that I am licensed under provisions of Chapter 9 REG. NUMBER 3771K570 6'S'� e J y (commencing with Section 7000) of Division 3 of the Business DISTRICT NO. PROC S D BY Power Apparatus& Large Appliances and Professions Code,and my license is in full force and effect. IS-169 D Q 0 7 �;© Size &Type HP, KW, KVA, or KVAR (� License Number .3 q Lic. Class 42'JD _ Up to 1 Incl. 'OO FINAL Q� /��i/�is �Lf TQ ' f2, 3Q 9� Over 1 to 10 Incl. ® DATE 1-16 Contractor. ese 6 VALIDATION W ❑ Over 10 to 50 Incl. FINAL I am exempt under Sec. Over 50 to 100 Inc. BY �^ B.&P.C. for this reason Over 100 z Services, Swbd., MCC& Panelboards Date: Services, -200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V /117 Over 1000 Amp. or Over 600 V ❑ Exemption for Reg. Maint. Elect. SINGLE FAMILY Temp. Power Pole&Appurtenances HOME OWNER-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 031.5, Business and Professions Code): ❑ 1, as owner of the pro rt ill o the work and the Misc. Conduits &Conductors structureis not inten or,of d for sale (Section Other (See.Complete Fee Schedule)_ , 9.3 3,0'A 7044, Business and Profess}ons C de). CONSTRUCTION LENDING AGENCY 0 0 0,0.6 2 I hereby affirm that there is a construction lending agency for 1 006200 the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). 0 0 PLAN CHECKING FEE ° 6200u Lender's Name .12 3 0 $ O ire Lender's Address PERMIT ISSUING FEE 1 certify that I have read thi application and state that the TOTAL FEE 6� above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authors repr entatives of this County to enter upon the bove-r�ierttlon pro a for inspection p rpose . U SEE REVERSE FOR EXPLANATORY LANGUAGE 3O 8 Si nature of rmittee Date