HomeMy Public PortalAbout5435 RYLAND AVE_Electrical__ 76AE6'�`DVB9 6A -s, APPLICATION FOR PERMIT
�> &,ARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES ELECTRIC i
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO..
- 1 c s'4�4
ELECTRICIAN '
� RECEIVED BY READY FOR DATE ISSUED
ADDRESS ,`° „0 _ FIRST INSPECTION
CITY TEL NO. I I6•�
COUNTY LICENSE NO. EXPIRES BUILD' 13
PERMIT FEES ADDRESS
FEE LOCALITY �►yAi �,. '
-_ NUMBER EACH
LIGHT OUTLETS NEAREST o
F
RECEPTACLES CROSS ST.
WALL SWITCHES OWNER t,vp if. J&rMwoza
TOTAL OUTLETS , 513 $ 70 MAIL
ELEC. RANGES 25 ADDRESS
ELEC. HEATERS p 25 ZS CITY a TEL. NO. s ��
FIXTURES �f //_ 5 /S' 1 HEREBY CKNOWLEDG THAT I HAVE READ
. THIS
M19C. -, r7 �—r
APPLICATION AND STATE THAT THE ABOVE 19 CORRECT
NUMBER OF LIGHT CIRCUITS _ AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS D AND STATE LAWS REGULATING ELECTRICAL WIRING.
MOTORS I CERTIFY THAT I POSSESS THE ABOVE VALID LOB
NUMBER HORSEPOWERFEE ANGELES COUNTY LICENSE. OR I AM THE LEGAL OWNER
'
NEW MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DEpCFIIBgD ABOVE.
�4a Ff �' %2 6 LE66 $ .28 J SIGNATURE OF , ���
%2 2 .513
PERMITTEES+'!+- 9"4lt_A�
2 5 1.130 j $- � INSPECTIOW RECORD
_ s is 1.513
15 so 2.50
s0 200 5.00 i 7'-Ll�c s T! J' o Ire o C
200 Soo 10.013 IFA .D6rb Si p'FA-`6r J
500 1000 15.00 Z
OVER 1000 20.00 I7
M.G. SET/FREQ. CHANGER-HP I
WELDERS:AC-KVA O
GENERATORS - KW
TRANSFORMERS - KVA
TEMP. MOTORS (75% or CRIB.)
MOVED MOTORS 475% OF DRIB.)
MISC.
SIGNS
NO. NO.TRANS
APPROVALS
NO. N13.LAMPS
FOR EACH PERMIT: DATE INSPECTOR'S NAME
WIRING $1.00 CONDUIT
FIXTURES $1.00 0 d WIRING [. �
SUPPLEMENTARY' .513 FIXTURES ,
POWER ��• /�'Yr �f/JiG7 p 491✓
TOTAL FEE $ d�. °J UTILITY CO.NOTIFIED0'
FINAL_
:f
WOrm that
COMPENSATION DECLARATION 20-0019 DPW 3/87 APPLICATION FOR ELECTRICAL PERMIT
".I Ftereby"affirm that I have a certificate of consent to self � �E�a
insure, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS
dr a•cet`,ified copy thereof(Sec. 3800, Lab. C.) i
• Policy Nb.• ' Company FOR APPLICANT TO FILL IN JOB
❑CeAified1copy is hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE ADDRESS
54
Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. LOCALITY a
-tion department. Multi-family Sq. Ft. -- NEAREST
Date Applicant Residential.Swimming Pools CROSS ST.
OWNER OR
FIRM NAME
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec MAIL
COMPENSATION INSURANCE Light Sw._First 20 ADDRESS
(This section need not be completed If the work involved by I Total No. Additional CITY Tel. No.
the permit is for one hundred dollars(:900)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
Additional
Dote 1 ' � 52&JApplicant � + Total No. CITY Tel. No.
NOTICE TO APPLI( NT: 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. — 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. CIN
Hood Fan —Other_
LICENSED CONTRACTORS DECLARATION LICENSE OR
Disp. — Room Air Cond. — REG.NUMBER Class.
I.hereby affirm that I am licensed under provisions of Chapter 9
(commencing with Section 7000)of Division 3 of the Business Power Apparatus&Large Appliances DISTRICT NO. PROQ?SSED BY a
and Professions Code,and my license is in full force and effect. G
Size&Type HP, KW, KVA, or KVAR . .0 U �,�y pt_-.--„ �. O
License Number Lic. Class CAP- Up to 1 Incl. I
FINAL T 2 U
Over 1 to 10 Incl. J ® �j VALIDATION It
Contractor Date 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 (/ / N
Date: Services, Swbd., MCC&Ponelboards 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 V
SINGLE FAMILY Temp. Power Pole&Appurtenances 2
HOME OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit st;t i,T
Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits r. r.
Professions Code): 131'.7 1t 7 a-6F
t 113.0
E] 1, as owner of the property, will do the work and the Misc. Conduits 8 Conductors j 1 11
structure is not intended or offered for sale(Section 7044, Other(See Complete Fee Schedule)_ lI AL �+ rte-
Business and Professions Code). ( 'HECK
CONSTRUCTION LENDING AGENCY s- '169%65
I hereby affirm that there is a construction lending agency for I, 'CHANGE
the performance of the work for which this permit is issued ,PERMIT FEE (Sub-Total)
(Sec. 3097, Civ. C.). -
PLAN CHECKING FEEj+ ns
Lender's Name 1113,120-13-101)1 12,1211'. J
PERMIT ISSUING FEE 2j ] {a C,a°40
Lender's Address ;tts L
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 ove-mentione perty for inspection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE .I
Signature of Permitte - Do