The URL can be used to link to this page

Home My Public Portal About4919 RYLAND AVE_Electrical__ 76ASSS DBS SA 11-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY ELECTRIC COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMIT NO. ELECTRICIAN RECEIVED BY READY FOR DATE ISSUED ADDRESS JJZ FIRST INSPECTION /� CITY �yrpesy TEL. NO. le4l � .�" ��S�� COUNT LICENSE NO. EXPIRES BUILDING ed& /- PERMIT IfWS ADDRESS FEE NUMBER EACH LOCALITY LIGHT OUTLETS NEAREST CROSS ST Q/ RECEPTACLES WALL SWITCHES OWNER TOTAL OUTLETS Sc $ MAIL {/ ELEC. RANGES 2S ADDRESS % ELEC. HEATERS 25 CITY TEL. NO. G FIXTURES 5 I HEREBY ACKNOWLEDGE 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 1 NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWERANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER FEE NEW MVD. HP OVER INC. EACH E RESIDENTIAL OF THE PR DESCRIBED ABOVE. I � I/2&LESS $ .25 SIGNATURE OF PPERTY • __ I/a 2 .SO PERMITTEE--/r/- v 2 S 1.00 INSPECTI• N RECORD 5 15 1.50 1s so 2.50 So 200 5.00 200 500 10.00 J Soo 1000 15.00 Z OVER 1000 20.00 M. G. SET/FREQ. CHANGER-HP WELDERS:AC-KVA 0 GENERATORS-KW TRANSFORMERS-KVA TEMP. MOTORS (75%OF ORIG.) MOVED MOTORS (75%OFORIG.) misc. SIGNS NO. NO.TRANS. I I APPROVALS NO. NO. LAMPS DATE INSPECTOR'S NAME FOR EACH PERMIT: WIRING 1.00 CONDUIT $ —/� FIXTURES $1.00 WIRING 1&46 SUPPLEMENTARY .50 FIXTURES POWER TOTAL FEE $ UTILITY CO. NOTIFIED A _ d7 ® FINAL WORKERS'COMPENSATION DECLARATION20 19 DPW 3/87 APPLICATION FOR MkTRIC AL PERM I hereby affirm that I have a certificate of consent to self cE O insure, or-*certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS certified copy thereof(Sec. 3800, Lab.,C.) Policy No. Company j FOR APPLICANT TO FILL IN JOB s ` /. ❑Certified copy is hereby furnished. Naw Residential Bidgs. 8 Pools EACH NO. FEE ADDRESS Iv1 Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. $ — $ LOCALITY — NE Date Applicant AREST OSS tion department. Multi-family Sq. Ft. Residential Swimming Pools I OWNER OR FIRM NAME YtJ CERTIFICATE OF EXEMPTION FROM WORKERS' Cutlets: Rec Light Sw._ MAIL pyo COMPENSATION INSURANCE ADDRESS a fe This section need not be completed If the work involved- First ti CIT Tel. No. ( P Y Total No. Additional C� .'x`7.;16 the permit is for one hundred dollars($100)or less.) PLAN CHECK I certify that in the performance of the work for which this 1 APPLICANT permit is issued, I shall not employ any person in any manner g Li htin Fixtures First 20 ADDRESS so as to become subject to the Workers'Compensation,Laws. Additional Date Applicant Total No. I CITY Tel. No. NOTICE TO APPLICANT: If, after making this Certificate of Fixed Appliances Not Over 1 HP I PERMIT Exemption, you should become subject to the Workers' Range— Heater—D.W. — APPLICATION 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— I CITY Tel. No. LICENSED CONTRACTORS DECLARATION LICENSE OR ' Disp. — Room Air Cond. — LICENSE I hereby affirm that I am licensed under provisions.of Chapter 9 REG. NUMBER (commencing with Section 7000)of Division 3 of the Business P wer Apparatus&Large Appliances DISTRICT PROIT ED B O} and Professions Code,and my license is in full force and effect. Size&Type HP, KW, KVA, or KVAR U License Number Lic. Class Up to 1-Incl. FINAL Over 1 to 10 Incl. DATE 4 VALIDATION Contractor Date Over 10 to 50 Incl. U ❑ FINAL I am exempt under Sec. Over 50 to 100 Inc. BY LU EL B.BP.C. for this reason Over 100 S` rvices, Swbd.,MCC&Panelboards i Z Date: 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 I n SINGLE FAMILY Tmp. Power Pole&Appurtenances j HOME OWNER-BUILDER DECLARATION ACCT-T I.hereby affirm that I am-exempt from the Contractor's License S5 gn with One Branch Circuit Law for the following reason (Section.7031.5, Business and dditional Sign Branch Circuits LLt` � 31oL0 Professions Code): I ITEMS-2 I, as owner of the property, will do the work and the Misc. Conduits&Conductors F - structure is not intended or offered for sale(Section 7044, Other(See Complete Fee Schedule)_ }'l�ljt;ty 3 1 o(30 Business and Professions Code). �� 3.1.00 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for I CHANGE e0-l3 the performance of.the work for which.thik'permit is issued PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). Lender's Name P N CHECKING FEE a10100_011101 3/ 6/90 7TAL MIT ISSUING FEEL y(j +; Lender's Address �'� 46 1 certify that I have read this application and state that the FEE �U above information is cprrect. I agree to comply with all County ordinances and State laws regulating Electrical'wiring, cirid hereby authorize representatives of this County to enter upon the above-mention property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE 0 es Signature bf Permilttee ate �e j WORKERS'COMPENSATION DECLARATION 7MM3 DPW 3/87 A®®® ICA`jj�ION FOR ELECTRICAL PERMIT O I hereby affirm that I have a certificate of consent to self ,ce-�D moi® 9-9� 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.) j Policy No, Company FOR APPLICANT TO FILL IN j JOB 1--erYifed copy is hereby furnished. New Residential Bldgs. &Pools. EACH NO. FEE I ADDRESS V a Certified co is filed with the count building inspec- 1 &2-Family, S Ft. $ — $ ! LOCALITY PY � Y 9 � P Y' q' j tion department. Multi-family Sq. Ft. NEAREST Residential Swimming Pools j CROSS ST. O Date Applicant OWNER OR IRNAME CERTIFICATE OF EXEMPTION FROM WORKERS' I ADD FM Outlets: Rec Light Sw._ r�r ` COMPENSATION INSURANCE First 20 I ADDRESS (This section need not be completed if the work involved by Total No. Additional CIN Tel. No. the permit is for one hundred dollars($100)or less.) I PIAN CHECK 1 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 Additional I Total No. 1 CITY Tel. No. Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of j Fixed Appliances Not Over 1 HP PERMIT � APPLICATION 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 j LICENSE OR Disp. — Room Air Cond. M. NUMBER Class. I hereby affirm that I am licensed under provisions of Chapter 9 i (commencing with Section 7000)of Division 3 of the Business Power Apparatus&Large Appliances DISTRICT NO. P ED BY and Professions Code,and my license is in full force and effect. a Size&Type HP, KW, KVA, or KVAR O License Number Lic. Class Up to 1 Incl. FINAL —�� U Over 1 to 10 Incl. ATE ! DVALIDATION Er Contractor Date' Over 10 to 50 Incl. j F" -FINAL I am exempt under Sec. Over 50 to 100 Inc. BY U W 100 I B.&P.C.for this reason Over (L Serv' MCS.&Pan (boards ' U)Z Date: I .0-200 Amp. Under 600 V '" ,• ; _ Signature 201 - 1000 Amp. n er 600 V ! ;r Exemption for Reg...Maint. Elect. Over 1000 Amp. or Over 600 V �.�-Ci7 SINGLE FAMILY I HOME OWNER-BUILDER DECLARATION t Temp. Power Pole&Appurtenances 1_1 EMS I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuity-13 3156 6 00 Law for the following reason (Section 7031.5, Business and ,I Additional Sign Branch Circuits Professions Code): Misc. Conduits&Conductors I - �I �, as owner of the property, will do-the work and the Other See Complete Fee Schedule)— Business chedule ='L•� structure is not intended or offered for sale(Section 7044, 0 ( P )— Business and Professions Code). CONSTRUCTION LENDING AGENCY I I (jisEj%�—i til i 61 17/9 r 7 1 hereby affirm that there is a construction lending agency for 1 75 n, - n=-i-: the performance of the work for which this permit is issued I PERMIT FEE (Sub-Total) �3 -'�C' t I�(` °=f" (Sec. 3097, Civ. C.). f i / 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 LJ 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 abov .mentioned pr erty for inspection pu'rypos, SEE REVERSE FOR EXPLANATORY LANGUAGE Signature ermit a Date ' ®s