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HomeMy Public PortalAbout6273 ROSEMEAD BLVD_Electrical__ DBS SA 2SM SETS 1-48 a MPgyGCnmV ON FOR PERWr VNTY OF LOS ANGELES ELECTRIC 'WM, J FOX. lE N E a NAME l q��" ��j�/ DISTRICTNO. GROUP ZONE PERMIT/MO. ADDRESS � A 0 M > rf A E�JBY� ILS 1 q�pQ. � 1 r W~ RAtN�@}� TEL.NO.�S{ !/ y6gi RECEIVED BY FIRST INSPECTION READY FOR DATE ISSUED CITY ' a COUNTY., CERT.NO. moi' PPWIRES APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY JOB DESCRIPTION OF WOE. ADDRESS p m / }�� � NUMBER OF OUTLETS ON CIRCUITS LOCALITY " f,M P 41 LOCATION BY ROOMS NEAREST` / A LIGHT OUTLETS SW. PLUGS FIXT C OSS ST. R B Al 0 ey CERCUrr A 3 C D E F G H 0: NAME N V l e Iw /.I U V 3 z MAIL p p y p� ADDRESS Q'c II?E B rG _ O CITY TEL.NO. S 210 a 6la / -1 AM THE LEGAL Pct SESSOR OF THE AF30VE LOS ANGELES COUNTY CE 1 ! T� CF QU !FI TION.. kt s FavQl�s /v� A / _ ELECTRICIAN. I- A (fl I AN THE LEG OVA ER OF THE PROPERTY DESCRIBED ABOVE . 4J �{I +.1IC11I OWNER. F � k- - / f C01MECTIONS J - Q Z_ jo -23• -� NO. OF OUTLETS y $ G APPROVALS /I NO. OF FIXTURES � � $ to 0 DATE SPECTOR'S NAME NO. OF MOTORS 4 H.P. OSJ <'es I� $ 7 CONDUIT NO. OF SIGNS TRANS. $ WIRING ENO. OIFNGES OR HEATERS $ FIXTURES :F,�' 4S $ POWERE $ _Z2_15UTILITY CO.NOTIFIED Bn S 62. INA L` ��i .`Lv ���:T✓° y 26A666-CESOO 4-60 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION ADDRESS JOHN A.LAMBIE, COUNTY ENGINEER f� WILLIAM A.JENSEN, SUP•TOF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. (J`v- PERMIT FEES OWNER C e C a I T E M NUMBER EACH FEE MAIL OUTLETS: $ $ ADDRESS LIGHTS RECEPT. SW. .10 LIGHTING FIXTURES 10 CITYTEL.NO, ELEC. RANGES CLO. DRYERS ELECTRICIAN ,!T 2 l(le I - a 13 c_lC / WATER HEATERS .50 ADDRESS ?��/i `J C 4'— ELEC.SPACE HTRS. DISHWASHERS CITY /ll C ,/��77 LI.S1.fEL.NO >2,P,5 ✓ GARBAGE DISPOSERS AUTO.. STATE cc� LICENSE NO. V 6 WASHERS STA.COOKING UNITS .25 MOTORS: OVER INC. H.P. DIST R CT NO. GROUP ZONE PR ESSED BY O — %2 .25 I ag 'i, — 2 .50 INSPECTION RECORD 2 — 5 1.00 o. 5 — 15 1.50 O V 15 — 50 2.50 O SO — 200 5.00 n• ~ • '1 J �' 'l'J l/� /t "-/ W SIGNS: NO TRANS. a NO. LAMPS ''� • ��'�~' Z_ SERVICE 0.600Y/'+� 1.00 ✓ SERVI E OVER 600V 5.00 MIS (RING PERMIT FIX PERMIT 1.00 SUPPLEM ENTARY—PE—WIT SO TOTAL FEE 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'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 LICENSED AS REQUIRED BY OS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT 1 THE LEGAL WNER OF THE ABOVE DESCRIBED REST(DENTIA OPERTY. �e POWER SIGNATUREOF PERMIT ` `� UTILITY CO. NOTIFIED FINAL Za'2 VALIDATION ARTHUR C.VETT. CK MO cps SUPERVISING ELECTRICAL ENGINEER �.�I.i o 7 -� OCT L, 2 A 1 .7 5 City of Temple City 71A883-CE8061/7a APPLICATION FOR ELECTRICAL PERMIT u 4 LOS.-ANGELES I DEPARTMENT OF COUNTY ENGINEER BUILDING 6273 N. Rosemead BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER LOCALITY COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING ti FOR APPLICANT TO FILL IN NEAREST Lon do CROSS ST, Long dog NO, EACHI FEE $ $ OWNER Texaco RECEPT.� MAIL LIGHT TOTAL FIRST 20 20 ADDRESS CITY TEL. N0, SWITCH_ OVER 20 10 PLAN CHECK 1 LIGHTING TOTAL FIRST 20 20 APPLICANT FIXTURES OVE .f0 R 20 ADDRESS J APPLIANCES CITY TEL. NO. PERMIT RANGE DRYER_WTR, HTR. APPLICANT Vic Stein Elec. Inc. STA. COOK DISP, F.A.U. ADDRESS 312 S. Melrose SPACE HTR. AIR COND. CITY Placentia, EL. N0. 928-214 CLOTHES WASH. DISHWASH. LICENSE N0. 2195596/ CLASS Clo i FAN OTHER 1.00 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 ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO / y� I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 1 0 - 1 1.00 eLL LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO 1 - 10 3.00 RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. >' D� SIGNATURE O 10 - 50 5.00 OF PERMITTEE V 50 - 100 10.00 DISTRICTNO. CLASS GROUP ZONE PROCE SED_ BY O 100 - S00 15.00 �'� V UJI SIGN, GAS SIGN AND ONE CIRCUIT 3.00 NOTES: ' `riy N TUBE, OR � �_ Q MARQUEE ADDITIONAL CIRCUITS 1.00 .C.(1�\ — SERVICENOTOVER 600VOLTS OR200AMP 2.00 Rsa; u APPROVALS (DATE INSPECTOR'S SIGNATURE SERVICEOVER600VOLTS OR200AMP 5.00 TEMP.POWER POLE TEMP SERVICE, POLE, &APPURTENANCES 3.00 UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM 3.00 ROUGH CONDIUT WIRING FIXTURES PERMIT FEE (SUB TOTAL) POWER AUTHORIZED PLAN CHECK FEE (50% PER FEE) UTILITY CO. NOTIFIED PERMIT ISSUING FEE 2.00 FINAL SUPPLEMENTARY PERMIT ISSUING FEE 1.00 JOS PH C. ROOHAN TOTAL FEECy�',I SUPERVISING ELECTRICAL ENGINEER. PLAN CHECK VALIDATION CK. M.0.3 CASH PERMIT VALIDATION CK. M.O. CASH x27 2Q 3.001' SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 76AB632CE806 1/70 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEERBUILDING BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER LOCALITY COLEMAN W. JENKINS, SUPERINTENDENT.OR BUfLDING NEAREST FOR APPLICA.NT TO'FILL IN CROSS OUTLETS NO. EACH FEE OWNER $ RECEPT. s MAIL �R TOTAL A LIGHT FIRST 20 �` �j .� OC> A ADDRESS e OVER 20 j —11 SWITCH ,..5 .10 CITY TEL. NO. V PLAN CHECK LIGHTING FIRST 20 APPLICANT TOTAL Q �� OVER 20 ADDRESS FIXTURES .10 APPLIANCES CITY TEL. NO. PERMIT RANGE DRYER_WTR. HTR. 1* APPLICANT 1G4'V A-1 STA. COOK DISP. F.A.U. ADDRESS SPACE HTR. AIR COND. CITY TEL. N0. 2117pr CLOTHES WASH. DISHWASH. LICENSE NO.C`Q /7 CLASS. &f� FAN. ® OTHER 1.00I HEREBI" ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION 00 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 6 TYPE OVER TO y� I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 3 0 - 1 1.00 �/a LICENSED AS REQUIRED BY LOS ANGEL S COUNTY AND STATE OF CALIFORNIA OR THAT I AM-TH A NCE OF, AND INTEND TO 10 3.00 RESIDE IN, THE ABOV CRI , ESIDENT I AL PROPERTY. w d SIGNATURE 10 — 50 5.00 OF PERMITT 0- 50 — 100 10.00 y DISTRICT NO. LASS GROUP ZONE PRO E Y O 100 — 500 15.002 _ V SIGN; GAS �./� W SIGN AND ONE CIRCUIT J"b NOTES: h TUBE, OR V) MARQUEE ADDITIONAL CIRCUITS 1.00 z SERVICENOTOVER600VOLTS OR200AMP 0� APPROVALS DATE INSPECTOR'S SIGNATURE SERVI CEOVER 600 VOLTS OR 200 AMP O6 TEMP.POWER POLE �,i�� �-71 TEMP SERVICE, POLE, &APPURTENANCES � 6& UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM 3.00 �7 ROUGH CONDIUT --7J WIRING r�l r, / O�'�✓✓�`, PERMIT FEE (SUB TOTAL) FIXTURES , POWER AUTHORIZED PLAN CHECK FEE (50% PERMIT FEE) M UTILITY CO. NOTIFIED PERMIT ISSUING FEE 3.00 i, FINAL SUPPLEMENTARY PERMIT ISSUING FEE 1.00 , JOGEPH C7. ROOHAN TOTAL FEE �cJ� SUPERVISING ELECTRICAL ENGINEER. PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION <n- M.o. CASH SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 76A663=0E8061/70 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER ADDRESS o BUILDING AND SAFETY DIVISION � JOHN A. LAMBIE, COUNTY ENGINEER LOCALITY �,df'f Ge MY/ COLE W. JENKINS, SUPERINTENDENT OF BUILDING NEAREST LUe yea A:2' 4 . i FOR APPLICANT TO FILL IN CROSS ST. OUTLETS NO, EACH FEE OWNER $ $ RECEPT._ MAIL LIGHT TOTAL FIRST 20 20. ADDRESS c�� _ SWITCH OVER 20 10 CITY TEL. NO. PLAN CHECK LIGHTING TOTAL FIRST 20 20 APPLICANT FIXTURES OVER 20 .10 ADDRESS APPLIANCES CITY TEL. N0, PERMIT LSI RANGE DRYER_WTR. HTR._ APPLICANT STA. COOK DISP. F.A.U. ADDRESS SPACE HTR. AIR COND. CITY TEL. N0. Q CLOTHES WASH. DISHWASH. LICENSE N0. CLASS. FAN OTHER 1.00 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 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 — 1 100 LICENSED AS RE0U IRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL �IDEII�IAAI, NTEND TO 1 — 10 3.00 RESIDE IN, THE A E DESCRIBEDROPERTY. SIGNATURE d 10 - 50 5.00 OF PERMITTE V 50 - 100 10.00 DISTRICTNO. CLAS GROUP ZONE PRO SED BY W 100 - 500 15.00 �f^ �Q� / �-' 2. 0 V SIGN, GAS SIGN AND ONE CIRCUIT #5 ©G NOTES: d TUBE, OR h MARQUEE ADDITIONAL CIRCUITS 1.00 z SERVI CENOTOVER 600 VOLTS OR 200 AMP 2.00 APPROVALS DATE INSPECTOR'S SIGNATURE SERVI CEOVER 600 VOLTS OR 200 AMP 5.00 TEMP.POWER POLE TEMP SERVICE,POLE, &APPURTENANCES 3.00 UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM 3.00 \ ROUGH CONDIUT -71 WIRING PERMIT FEE (SUB TO FIXTURES PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED UTILITY CO. NOTIFIED PERMIT ISSUING FEE 00 3 ©O FINAL �D SUPPLEMENTARY PERMIT ISSUING FEE 1.00 JOSEPH C. ROO WKN " TOTAL FEE SUPERVISING ELECTRICAL ENGINEER.ILA PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIO Y CK. M.O. CASH S87gN AUG.10 2 D 8.00 SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE ��.__`�-'_.�.----yam'• _- 76A663CE-806(6/78) APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN, New Residential Bldgs.&Pools EACH NO. FEE ADDRESS 72 1 &2-Family,Sq. Ft. $ .025 — $ LOCALITY Multi-family Sq. Ft. .02 — NEAREST CROSS ST. Residential Swimming Pools 25.00 OWNER OR �9 FIRM NAME A 04 co Outlets: RecLight I Sw. MAIL 67 First 20 .50 ADDRESS Total No. Additional .30 CITY- Tel. No. PLAN CHECK APPLICANT Lighting Fixtures First 20 .50 Q ADDRESS Additional .30 Toto) No. CITY Tel. No. Fixed Appliances Not Over 1 HP PERMIT APPLICANT Range_Heater_D.W. _ ADDRESS� Oven—Dryer—W.M.— Top _FAU — W.H._ CITY ' . Tel. No. Hood_Fan _Other_ LICESE OR / J Disp.—Room Air Cond. L 2'50 R GNNUMBER _ Class.5 42 Com'/40 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA- Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO Size&Type HP, KW, KVA,or KVAR COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS _ REGULATING ELECTRICAL WIRING. Up to 1 Incl. 2.50 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR Over 1 to 10 Incl. 5.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF Over 10 to 50 Incl. 12.50 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE Over 50 to 100 Inc. 25.00_ DESCRIBED RESIDENT I ROP TY. 40.00 PERMITEE 7, Over 100 SIGNATURE 2$1 Services DISTRICT NO. P CES BY 0-200 Amp. Under 600 V 12.50 ,r. v 201-1000 Amp. Under 600 V 25.00 V Over 1000 Amp.or Over 600 V 50.00 Z Temp. Power Pole&Appurtenances 10.00 a/� Sign with One Branch Circuit 10.00 D I Additional Sian Branch Circuits 2.00 INSPECTION INFORMATION Misc.Conduits&Conductors 10.00 ON REVERSE z Other(See Complete Fee Schedule) SIDE v 9 11009 A q. j Z4 d o 0 0 0 2 PERMIT FEE (Sub-Total) Z g 4 00 PLAN CHECKING FEE (One-Fourth Permit Fee) Z o o 0 2 7 0 01J PERMIT ISSUING FEE $7.00 —7 Q27-;-78 TOTAL FEE > INSPECTION FINALED m W date: 7- .^ By (,KERS!.Ce)MPENSATION DEC ARATION 76A663 10/81 t�hX f'i4n hhat I helve a certificate of consent to self CE-806G APPLICATION FOR ELECTRICAL PERMIT insureq,:or a certificauB of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or 6 certified copy thereof (Sec. 3800, Lab. C. Policy No. Company FOR APPLICANT TO FILL IN ADDRESS ❑ / / ' �✓% / Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE S — Certified copy is filed with the county building inspec- 1 & 2-Family, q• Ft. $ $ LOCALITY tion department. Multi-family Sq. Ft. — 'NEAREST CROSS ST. Residential Swimming Pools OWNER OR r Date Applicant FIRM NAME Z CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec�LightSw. MAIL COMPENSATION INSURANCE First 20• ADDRESS (This section need not be completed if the work involved by Total No.�YL Additional & 0 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 Lamanner so as to become subject to the Worker ompLaws. Lighting Fixtures First 20 ADDRESS Additional /e Total No. �/�— CITY Tel. No. Date-=5 O. K➢Applicant MR44 °` Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, Apr ing this Certificate of APPLICANT 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 I hereby affirm that I am licensed under provisions of Chapter 9 Disp. _ Room Air Cond. REG. NUMBER Class. C-10 (commencing with Section 7000) of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT N0. PRO D BY and Professions Code,and my li ense is in full force and effect. J /f /`' /� Size & Type HP, KW, KVA, or KVAR' V License Numbberr f DLic. Class( `—/J�l(t/✓ Up to 1 Incl. FINAL Contractor % i/ 1/7-; C_ Date ts]'.1t/• D Over 1 to 10 Incl. DATE � —a VALI ION Over 10 to 50 Incl. U FINAL I am exempt under Sec. Over 50 to 100 Inc. BY r B.&P.C. for this reason Over 100 Date: Services, Swbd., MCC & Ponelboards ► .fit -° f� s 2 0 1,2 A 0 -200 Amp. Under 600 V Signature1 - 10 m Under 600 V # 0 0 o 0 0 2 ❑ Over IU Amp. or Over 600 V Exemption for Reg. Maint. Elect. 1 0 1 1 &50 SINGLE FAMILY Temp. Power Pole &Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit o 0 1 .1 &5 0 v 1 hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits Q 5 1 0-85 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 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 FEE a'sa above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby,authorizer resentatives of this County to enter upon the a�ve-mentio edtproperty for inspection_,purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE \S ature of Permittee Date WORKERS' COMPENSATION DECLARATION 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I MCE-806G 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 '�thereof (Sec. 3800, L b. C.) `Policy No.��� '�i)1/0 Company FOR APPLICANT TO FILL IN JOB 17�TCTI`L Certified copy is hereby furnished. EACH NO. FEE ADDRESS O i„vQ New Residential Bldgs. & Pools ❑ LOCALITY Certified copy is filed with the county building inspec- 1, & 2-Family, Sq. Ft. $ — $ �e tion departtmm�ent, )n/ Multi-family Sq. Ft. — NEAREST 3"SCRtQ r'! (Y'� Residential Swimming Pools CROSS ST. o� Date Applicant�-' OWNER OR / Am FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw._ MAIL COMPENSATION INSURANCE ADDRESS O /7► (This section need not be completed if the work involved by First 20 � the permit is for one hundred dollars($100)or less.) Total No. Additional CITY Tel. No. I certify that in the performance of the work for which this PLAN CHECKAPPLICANT 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 Date Applicant CITY Tel. No. NOTICE TO APPLICANT: If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT � Exemption, you should become subject to the Workers' Range_ Heater_D.W. _ APPLICANT LAN4N,D 2 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 I. No. LICENSED CONTRACTORS DECLARATION DisP� _ Room Air Cond. LICENSE OR b I hereby affirm that I am licensed under provisions of Chapter 9 REG. NUMBER 3 Class.,g (commencing with Section 7000) of Division 3 of the Business DISTRICT NO PROCE ED D_ and Professions Code,and my license is in full force and effect. Power Apparatus 8 Large Appliances �^L r, U 39,\ Size &Type HP, KW, KVA, or KVAR' J v License Number (� Lic. Class Up to 1 Inc(. FINAL / n= �t r '�" ' Over 1 to 10 Incl. DATE ` -- / _ VALID ION Contractor'�f�' L Date Over 10 to 50 Incl. ( S� ❑ FINAL W I am exempt under Sec. Over 50 to 100 Inc. B B.&P.C. for this reason Over 100 Z Services, Swbd., MCC & Panelboards 4 2 5 5 A Date: 0 -200 Amp. Under.• 00 V.. Signature 201 - 1000 Amp. Under 600 V #,o 0 0 0 02 ❑ Over 1000 Amp. or Over 600 V I1 Exemption for Reg. Maint. Elect. -,c, 2550 SINGLE FAMILY Temp. Power Pole & Appurtenances . 'o 0 0 _ . 2550 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 O 3 9 8 b 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 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 FEE S 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 ove-mention prop ty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date WORK 76A663 Airco thobIl MPENa cerci DECLARATION CE-806 toisl APPLICATION FOR ELECTRICAL PERMIT I hereby af4irm tha�'wwe a certificate of consent to self CE-806G 7� insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY lu' or a certified copy thereof (Sec. 3800, Lab. C.) once Policy No. /l Company.✓/–lz/ v ,U FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS S Ft. $ LOCALITY — $ Certified copy is filed with the county building inspec- 1 & 2-Family, q tion department. Multi-family Sq. Ft. NEAREST r Residential Swimming PoolsOWNER OR T. Date Applicant FIRM NAMEEZIIV ..r lei CERTIFICATE OF EXEMPTION FROM WORKERS' MAIL Outlets: RecLight Sw. COMPENSATION INSURANCE First 20 1S b ADDRESS (This section need not be completed if the work involved by Total No. Additional CITY Tel. N 5 yd the permit is for one hundred dollars ($100)or less.) PLAN CHECK I certify that in the performance of the work for which this APPLICANT permit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS Total No. Additional CITY Tel. No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT Exemption, you should become subject to the Workers' Range_ Heater—D.W. As Compensation provisions of the Labor Code, you must forth- Oven — Dryer — W.M.— ADDRESS © �� with comply with.such provisions or this permit shall be Top _ FAU —W.H: — h deemed revoked. Fan CITY '�(� Tel. No.. LICENSED CONTRACTORS DECLARATION Hood'_ _Other_ LICENSE OR Disp. _ Room Air Cond. REG. NUMBER /O Class. I hereby affirm that I am licensed under provisions of Chapter 9 � 'G t/ (commencing with Section 7000) of Division 3 of the Business li A Apparatus& Large Appliances DISTRICT NO. PR SED BY 0}. and Professions Code,and my license is in full force and effect. Power AppO Size&Type HP, KW, KVA, or KVAR5.V U License Number Lic. Class L Up to 1 Incl. FINAL �= Over 1 to 10 Incl. DATE�7 �ALIDATION Contractor Date G Over 10 to 50 Incl. FINA W I am exempt under Sec. Over 50 to 100 Inc. BY 1% Over 100 fn B.&P.C. for this reason Z Date: Services, Swbd., MCC& Ponelboards ► 0 -200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V ❑ Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY Temp. Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch.Circuit I hereby affirm that I am exempt from the Contractor's License additional Sign Branch Circuits 3 7 7,$ A Law for the following reason (Section 7031.5, Business and Professions Code): # o o 9 o o 2 Misc. Conduits& Conductors I, as owner of the property, will do the work and the e ^ structure is not intended or offered for sale (Section Other (See.Complete Fee Schedule)_ ( a 331 V 0 7044, Business and Professions Code). 0 0 op3 3 Q Q v CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for O 1.0 8:86 the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). Lender's Name /�L� PLAN CHECKING FEE 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 laws regulating Electrical wiring, and hereby authorize representatives of this County to enter upon the above-menti ed propert for nspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date WORKERS' COMPENSATION DECLARATION 10/81 APPLICATION FOR ELECTRICAL PERMIT I bereby`� CE-806G 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 thereof (Sec. 3800, Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB �1�7 Certified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE ADDRESS 6v /3 &S m Qz L� 7 e• ❑ 1 & 2-Family, S Ft. $ — $ LOCALITY Certified copy is filed with the county building inspec- Y, 9 tion department. Multi-family Sq. Ft. — —'NEAREST L O^115 C)'coo Date - �!/A� Applica ""— Residential Swimming Pools CROSS OWNER T. 170 I_ArJ1*rJ OWNER OR FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw._ MAIL 13Z-f 3 T>oYG &O p C>COMPENSATION INSURANCE ADDRESS First 20 (This section need not be completed if the work involved by Total No. Additional CITY [�p�/f)tJ[� Tel. N 818)0-4a-7 78 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 AA 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' 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 I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. REG. NUMBER Class. (commencing with Section 7000) of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO. PRO D BY and Professions Code,and my license is in full force and effect. /J Size & Type HP, KW, KVA, or KVAR' �[ License Number /D 3Lr( Lic. Class 6 U to 1 Incl. FINAL' Q) + Over 1 to 10 Incl. DATED` VALI TION Contract,ef- ✓418 -1V K //�Date Z 0 ❑ Over 10 To 50 Incl. FINA 1 am exempt under Sec. Over 50 to 100 Inc. BY LU B.&P.C. for this reason Over 100 Date: Services, Swbd., MCC& Ponelboards 0 -200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V ❑ Over 1000 Amp. or Over 600 V :2 1 9 5 8 A Exemption for Reg. Maint. Elect. # o a o o a t SINGLE FAMILY Temp. Power Pole &Appurtenances ( o a 2 S rJ 0 HOME OWNER-BUILDER DECLARATION = Sign with One Branch Circuit o 0 0 2 5 0 I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits O 5 0 1 —85 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 Other (See Complete Fee Schedule)_ D 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 Lender's Address PERMIT ISSUING FEE U � r I certify that I have read this application and state that the TOTAL FEE J 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 above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE � -_ ;Z o Permittee Date WORKERS'COMPENSATION DECLARATION to/Si APPLICATION FOR ELECTRICAL PERMIT I herCE-806G affirm that I have a certificate of consent to self CE-8o6G insure; or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec. 3800, Lob. C.)dG Policy No15'iy, 0��' ompany FOR APPLICANT TO FILL IN JOB �s Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS �, �� 7� 1 & 2-Family, q. LOCALITY Certified copy is filed with t eco my buildin in p y, S Ft. $ — $ tioUdop ment. Multi-family Sq. Ft. — NEAREST / Residential Swimming Pools CROSS ST. Dateb Applicant OWNER OR S FIRM NAME CERTIFICATE OF EXEMPTION FR�_" M WORKER Outlets: Rec Light Sw._ MAIL COMPENSATION INSURANCE (_ First 20 ADDRESS (This section need not be completed if the work involved by Total No. CITY Tel. No. 2 the permit is for one hundred dollars ($100)or less.) Additional I certify that in the performance of the work for which this PLAN CHECK `` 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 Additional CITY Tel. N " Total No. �t1 ,3 Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT APPLICANT 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 I.hereby affirm that I am licensed under provisions of Chapter 9 Dis p' Room Air Cond. REG. NUMBER Class. (commencing with Section 7000) of Division 3 of the Business DISTRICT NO. PRO BY and Professions Code,and my license is in full force and effect. Power Apparatus & Large Appliances `� (L Size&Type HP, KW, KVA, or KVAR , v y V License Number l20 Lic. Class Up to 1 Incl. FINAL � �� ^y��� p Over 1 to 10 Incl. . DATE�j / VALI ATION Contractor) m _ ' kk , Date fj ❑ Over 10 to 50 Incl. FIN W I am exempt under Sec. Over 50 to 100 Inc. BIY fiL Over 100 B.&P.C. for this reason z Date: Services, Swbd., MCC& Ponelboords 0 -200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V 9 3 9 a 6 A ❑ Over 1000 Amp. or Over 600 V # 0 0 0 0 0 2 Exemption for Reg. Maint. Elect. � ­ 2550SINGLE FAMILY Temp. Power Pole& Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ° ° ° 2 Jr 5 0 C5I 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 0 Z 05-186 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 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 FEE S S above information is correct. I agree to comply with all County ordinances and State I ws regulating Electrical wiring, and he eb authori repr ntatives of this CountKri ente upon I� ve-me one r perty for inspection ose . a SEE REVERSE FOR EXPLANATORY LANGUAGE b not re of Permit Date