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Home My Public Portal About4903 RYLAND AVE_Electrical__ 1 •WARK$ES.COMP*>•JSATION DECLARATION 05.806 APPLICATI®N FOR ELECTRICAL PERMIT '�" ,. r ;6,.t � CE-806G (2.80) I hereby affirm that I have a%rtificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY insure,.or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,.Lab.C.) Policy No. OB R Company FOR APPLICANT TO FILL IN gDDRESS `� 7 I New Residential Bldgs.&Pools EACH NO. FEE 0 _ . lM Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ — $ LOCALITY / Multi-family Sq. Ft. — NEAREST El Certified copy is filed with the county building inspection Residential Swimming Pools CROSS ST d department. OWNER OR FIRM NAME (Q A I Date Applicant Outlets: Rec, r)Light•�_Sw.." d MAIL �, First 2� ADDRESS (, CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY Tel No. COMPENSATION INSURANCE PLAN CHECK (This section need'not be completed if the work involved 5'v APPLICANT U •by, the permit is for one hundred dollars ($100) or less.) Lighting Fixtures First 20 ADDRESS Total No. Additional ` O I certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No. (— permit is issued, I shall not employ any person in any manner PERMIT, W so as to become subject to the Workers'Compensation Laws. Range_HeaterD.W._ APPLICANT d Oven _ Dryer_W.M._ ADDRESS. to trate Applicant' Top _ FAU _W.H. Hood — Fan _Other_ CITY o. NOTICE TO APPLICANT: If, after making this Certificate.of Disp. _Room Air CoridILICENSE OR Exemption, you should become subject to the Workers' REG.NUMBE Class. Compensation provisions of the Labor Codp, you must forth- Power Apparatus&Large Appliances DISTRICT NO. PRO E D BY with comply with such provisions or this permit shall be deemed revoked. Size&Type HP,KW,KVA,or KVAR Up to 1 Incl. FINAL 01 Incl: DATE y� LICENSED CONTRACTORS DECLARATION Over 10 to 5 Over 1 to 10 Incl.. ��` G�' VALIDATION nclI hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. BY AL 9 (commencing with Section 7000)of Division 3 of the Busi- Over 100 ness and Professions.Code, and my license is in full force and effect. Services License Number Lic.Class 0-200 Amp.Under 600 V 201-1000 Amp.Under 600 V 0 3 . n Pi Contractor Date Over 1000 Amp.or Over 600 V 0 0 0 a 0 2: HOME OWNER-BUILDER DECLARATION Temp.Power Pole&Appurtenances 'I hereby affirm that I am, exempt.from the Contractor's. Sign with One Branch Circuit 2-° 0 1 4,50 License Law'for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits Hess and Professions Code): Misc.Conduits&Conductors I, as owner of the property, will do the work and the Other(See Complete Fee Schedule)— structure is not intended or offered for sale (Section 7044,Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that thereis a construction lending agency for the performance of the work for which this permit is PERMIT FEE (Sub-Total) issued(Sec.3097,Civ.C.).. Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) Lender's Address PERMIT ISSUING FEE I certify that I have read this application and state that the TOTAL FEE above information is correct.1 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 \ lia- 13 IN06 6.1 Signat of Permittee Date J WORKER S'COMPENSATIONDECLARATION CE-806G (2-80) APPLICATION FOR ELECTRICAL PERMIT CE-806 I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY insure,or a certificate of Workers.'Compensation Insurance,or a certified,copy thereof(Sec.3800,Lab.C:) FOR APPLICANT TO FILL IN SOB y Policy No. Company ADDRESS ✓ 'New Residential Bldgs.&Pools EACH NO. FEE 3 LAS✓j Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ $ LOCALITY �� C NEAREST //JJ Certified copy is filed with the county building inspection Residential Swimming Multi-family Sq. Ft. Pools CROSS ST L LJ 4a- 1- SA a department. OWNER OR FIRM NAME f\ /,. !�rug Date Applicant Outlets: Rec.—Light— Sw.— MAIL First 20 ADDRESS CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY Tel No.y Z' 1/VY } COMPENSATION INSURANCE PLAN CHECK p. (This section need not be completed if the work involved APPLICANT p by, the permit is for one hundred dollars ($100) or less.) Lighting Fixtures First 20 ADDRESS V Total No. Additional lr I certify that in.the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No. O permit is issued, I shall not employ any person in any manner PERMIT () so as to become subject to the Workers'Compensation Laws. Range_Heater D.W. _ APPLICANT WC.' Oven _ Dryer_W.M._ ADDRESS �� N Top _ FAU _W.H.,— Z Date Applicant Hood _ Fan _Other— CITY ' NOTICE TO APPLICANT: If, after making this Certificate of Disp. —Room Air Cond.— ' I LICENSE OR Exemption, you should become subject to the Workers' REG.NUMBER Class Compensation provisions of the Labor Code,you must forth- Power Apparatus&Large Appliances DISTRICT NO. ' PRO SSE BY with comply with such provisions or this permit shall be Size&Type HP,KW,KVA,or KVAR deemed revoked. / Q Up to 1 Incl. FINAL opl– LICENSED CONTRACTORS DECLARATION Over 1 to 10 Incl. DATE Over 10 to 50,Incl. VALIDATION I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL 9 (commencing with Section 7000)of Division 3 of the Busi- Over 100 BY ness and Professions.Code, and my license is in full force and effect. Services , d License Number Lic.Class 0-200 Am p.�Under 201-1000 Amp.Under•600 V Contractor Date Over 1000 Amp.or Over 600 V HOME OWNER-BUILDER DECLARATION Temp.Power Pole&Appurtenances I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit License Law for the following reason'(Section 7031.5, Busi- Additional Sign Branch Circuits 1 J 8 4 A ness and Professions Code): Misc.Conduits&Conductors #+ o o a o 0 2 I, as bwner of the property, will do the work and the Other(See Complete Fee Schedule)— structure is not intended 'br offered for sale (Section o o 9.50 7044,Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency c n o 1 r J() for the performance of the work for which this permit is PERMIT FEE (Sub-Total) I (�_fl issued(Sec.3097,Civ.C.). Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) Lender's Address PERMIT ISSUING FEE 2 Vel 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 authoize representatives of this County to enter upon l the'sbove-Jm ti a pro for inspection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE Si ture of Permittee Date ERS'COMPENSATIONDECLARATION-a CE-806G (2-80) APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self i COUNTY OF LOS ANGELES BUILDING AND SAFETY insure,or a certificate of Workers'Compensation Insurance,or a certified,copy thereof(Sec.380�0,/1Lab.C.)r1n'�1 Policy N —La(Icompany v AX0 M-0 FOR APPLICANT TO FILL IN gDDRESS �3 ��f7r—�� New Residential Bldgs.&Pools EACH NO. FEE' ED Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ —' $ LOCALIT C___r— Multi-family Sq. Ft. NEAREST Certified copy is filed with the county building inspection CROSS ST d�ep�rt�ment. r�it,f , y� Residential Swimming Pools Q Datil -- AppIicaittAn'Com =� v FIRM NAME /��. Outlets: Rec.._Light—First MAIL First 20 • ADDRESS CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY Tel No. COMPENSATION INSURANCE PLAN CHECK d (This section need not be completed if the work involved APPLICANT V Fixtures First 20 Lighting by the ,permit is for one hundred dollars ($100) or less.) LigAdditional ADDRESS Total No. I certify that in the performance of the work for which thisFixed Appliances Not Over 1 HP CITY Tel No. Q permit is issued, I shall riot employ any person in any manner PERMIT ��t t3 so as to become subject to the Workers'Compensation Laws. Range_HeaterD.W. _ APPLICANT C l-WWCXK9 5W Oven _ Dryer_W.M._ ADDRESS d� � � a N Date.Applicant Top _FAU _W.H.._ Z Hood Fan _Other_ CITY �� DispTel No.F� _7 NOTICE TO APPLICANT: If, after making this Certificate of . _Room Air Cond,_ LICEN EOR �o Exemption, you should become subject to the Workers' REG.NUMBER Classen 12 Compensation provisions of the Labor Code.,you must forth- Power Apparatus& Large Appliances DISTRICT NO. P S e with comply with such provisions or this p shall be _/ � i deemed revoked. Size&T pe HP,KV11,KVA,or KVAR `_/ �� Up to 1 Incl. FINAL. Over 1 to 10 Inch DATE LICENSED CONTRACTORS DECLA TION Over 10 to 50 Incl. .d VALIDATION I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINA'C BY 9 (commencing with Section 7000)of Division 3 of the Busi- Over�100 ness and Professions Code, and my license-is in full force and effect. C;?rC`�f*Cap Services License Numb �_ Lic.Class C3 6,Ca- q Amp.Under 600 V 201-1000 Amp.Under 600 V Contractor Date 2 Y Over 1000 Amp.or Over 600 V HOME OWNER-BUILDER DECL ATION Temp.Power Pole&Appurtenances I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits ness and Professions Code): ;2'2 1.5.4 A Misc.Conduits&Conductors o o,0 0 0 2 I, as owner of the property, will do the work and the Other(See Complete Fee Schedule)— structure is not intended or offered for sale (Section 7044,Business and Professions Code). 2 V o 11L50 CONSTRUCTION LENDING AGENCY I hereby affirm that there isr a construction lending agencyo 0 0 1. Q.X for .the performanceof the work for which this permit is PERMIT FEE (Sub-Total) issued(Sec.3097,Civ.C.). ( 202-81 Lender's Name PLAN CHECKING FEE (One-Fourth.Permit Fee) Lender's Address PERMIT ISSUING FEE I certify that I have read this application and.state that the TOTAL FEE A mation is correct.I agree to comply with all County and State laws regu ting Electrical wiring, and horize represe tive f this County to enter upon mentioried arty inspectio purpose . SEE'REVERSE FOR EXPLANATORY LANGUAGE uc ( 2 gnatur f Permittee ate 76A868 DBS SA 11-60 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES ELECTRIC LE CTR I C 1 WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRICIAN ADDRESS ,�� / RECE/Iy(VE�DBY READYFOR FIRST INSPECTION CITY TEL. NO ,6, 0 �j `� COUNTY LICENSE6NO. EXPIRES , pDDREIN 1 V PERMIT S FEE 1 NUMBER EACH LOCALITY LIGHT OUTLETS _ NEAREST CROSS ST. RECEPTACLES , `1 WALL SWITCHES o� OWN E R / 4- r�] e"✓tlo _ TOTAL OUTLETS Sc $ �'1 MAIL ELEC. RANGES 25 ADDRESS ELEC. HEATERS 25 CITY TEL. NO. FIXTURES 5 1 HEREBY ACKNOWLECGE THAT I 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 HORSEPOWERFEE I ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER NEW MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. 1/2 a LESS $ .25 SIGNATURE OF 1 1/z 2 SO PERMITTE Y 2 5 1.00 INSPECTION`RECORD 5 15 1.50 15 50 2.50 50 200 5.00 200 500 10.00 J Soo 1000 ls.0o Z OVER 1000 20.00 M. G. SET/FREQ. CHANGER-HP 0' WELDERS:AC-KVA 0 GENERATORS-KW TRANSFORMERS-KVA TEMP. MOTORS (75%OFORIC. MOVED MOTORS (75%OFOR16.) MISC. SIGNS NO. NO.TRANS. I I APPROVALS NO. NO. LAMPS DATE/ INSPECTOR'S NAME FOR EACH PERMIT: WIRING $1.00 CONDUIT pp FIXTURES $1.00 WIRING SUPPLEMENTARY .50 FIXTURES POWER i TOTAL FEE UTILITY CO. NOTIFIED '�'T ® (/ FINAL x�