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HomeMy Public PortalAbout6323 SALTER AVE_Electrical__ • WORKER'S COMPENSATION DECLARATION 2(>0o19DPW I APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self Insure, 78A683 or a certificate of Worker's Compensation Insurance,or a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy ther4of(Sec.3800 Lab.C.) Policy No!Za ✓.15 Company-d-ge FOR APPLICANT TO FILL IN JOB ADDRESS �"� ❑ Certified copy is hereby furnished. EACH NO. FEE LOCALITY New Residential Bldgs.&Pools Certified copy is filed with the county building Inspection 1&2-Family,Sq.Ft. $ _ $ 11 CJ 11 department. �__ Multi-family Sq.Ft. NEAREST CROSS ST. t.. 1c o Date Applicant 12)3"l OF Residential Swimming Pools MASE SSOR CEL CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER OR COMPENSATION INSURANCE PAG PAR � Outlets:Rec.�Light Sw. �d. FIRM NAME r _ Ba13 (This section need not be completed if the work Involved by the First 20 MAIL permit is for one hundred dollars($100)or less.) Total No. Additional 42 V1 ADDRESS _ I certify that in the performance of the work for which this permit CITY L• Tel.No.OZ& 7 is issued, I shall not employ any person in any manner so as to 70 PLAN CHECK become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANT NT Total No. Additional ADDRESS Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of 15 OR 20A,120V BRANCH CIRCUITS ! A06? '7/ CITY Tel.No. Exemption,you should become subject to the Workers'Compensation 1 TO 10IINCLUSIVE EACH provisions of the Labor Code,you must forthwith comply with such 11 TO 40 INCLUSIVE EACH PERMIT APPLICANT 41 OR MORE BRANCH CIRCUITS EACH provisions or this permit shall be deemed.revoked. LICENSED CONTRACTORS DECLARATION ADDRESS o I hereby affirm that I am licensed under provisions of Chapter 9 15 OR 20A,208V TO 277V LIGHTING EACH (commencing with Section 7000)of Division 3 of the Business and { CITY T.I.No,r:P Gi-1 _ <27 U Professions Code,and my license is in full force and effect. RESIDENTIAL APPLIANCES UP TO 3HP LICENSE OR p f 6� GCl�ass. a:Power Apparatus&Large Appliances REO.NUMBER O License Number Lic.ClassL-L- Size&Type HP,KW,KVA,or KVAR DISTRICT No. �! P SED BY U Up to 3 Incl.// W • d.- Over 3 to 10 Incl. FINAL CD Contractor Data Over 10 to 50 Incl. DATE ❑ I am exempt under Sec. VALIDATION Z_Over 50 to 100 Incl. ZZ�7� Over 100 FINAL B.&P.C.for this reason ', BY Services,Swbd.,MCC&Panelboards Dom" 0-200 Amp.Under 600 V Signature 201-1000 Amp.Under 600 V ❑ Over 1600 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 Law for the following reason Section 7031.5, Business and Professions Additional Sin Branch Circuits ' Code): ❑ 1,as owner of the property,will do the work and the structure Misc.Conduits&Conductors - Is not intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule) ® .a=.L, and Professions Code). CONSTRUCTION LENDING AGENCY I I, I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total) Civ.C'.) ! _ PLAN CHECKING FEE .,c -7/ Lendees•Name PERMIT ISSUING FEE -•-- _ - Lender's Address I certify that I have read this application and state that the above TOTAL FEE information is correct. I agree to comply with all County ordinances I and State laws regulating Electrical wiring,and hereby authorize i representatives of this County to enter upon the above-mentioned property f jDspetTbn p ,SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE AppLIcA TE 7BA663 DBS.5A 7-5I APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY ELECTRIC 14 COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. �f j!XRP. y ELECTRICIAN RE IVED BY READY FOR DATE ISSUED ADDRE88 9*V; ;:,C-Ayes 279,/1/ FIRST INSPECTION CITY TEL.NO.Q% q COUNTY LICENSE NO. EXPIRES BUILDING PERMIT FEES ADDRESS 6/La NUMBER EACH FEE LOCALITY ��/iq/20P/ G LIGHT OUTLETS CROBBIT ST. ✓✓a Mme, Dtrr N C9 RECEPTACLES WALL SWITCHES OWNER �yy/, � . A�`�(J� AI TOTAL OUTLETS 5C III _ MAIL ELEC. RANGES 25 ADDRESS / ELEC. HEATERS 25 CITY I jrJpG¢ TEL. NR&n ee FIXTURES 5 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS MISC. / APPLICATION AND STATE THAT THE ABOVE 18 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 1 POSSESS THE ABOVE VALID LOB NUMBER HORSEPOWERFEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER NEW MVD. HP OVER I INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. 11 %2 6 IEBB 5 .25 SIGNATURE or-77.7 %2 2 .50 PERMITTEES 2 5 1'130 INSPECTION RECORD 5 15 1.50 15 513 2.50 50 200 5.00 200 500 10.00 J 500 1000 15.00 Q X OVER 1000 20.00 M.G. SET/FREQ. CHANGER-HP WELDERS:AC-KVA O GENERATORS - KW TRANSFORMERS - KVA _ TEMP. MOTORS (75% or CRIB.) MOVED MOTORS (75% OF DRIG.) MISC. SIGNS NO. NO.TRANS. APPROVALS NO. NO.LAMPS FOR EACH PERMIT: DATE INBPECTORP9 NAME WIRING $1.00 —CONDUIT � FIXTURES 61.0WIRING 0 � - SUPPLEMENTARY .50 FIXTURES POWER TOTAL FEE s UTILITY CO.NOTIFIED FINAL 76ABae_CE60e_11-10APPLICATION FOR"E•LECTRIC PERMIT' 1 COUNTY OF•LOS )MELES- . DEPARTW= OF'COUNTY ENGINEER 'BUILDING BUILDING AND SAFETY DIVISION ADDRESS No �JYArWMNCo�nn�q • 'LOCALITY Mx-,G .NEAREST FOR APPLICANT TO FILL IH CROSS O 'PERMIT,FEES• ITEM NUMBER EACH' FEE 'OWNER - MAIL OUTLETS: $' O ADDRESS /� yy _ LIGHTS RECEPT. SW.' .10 V NO 17' LIGHTING FIXTURES .10 CITY TEL.NO. ELEC.RANGER +CLO.DRYERB ,, •. •,; .ELECTRICIAN _ e'.!:.'L - WATER H E A T E R S •15O''+ • ADDRESS 1 ELEC,SPACE HTRB. DISHWASHERS - GARBAGE DISPOSERS AUTO._ CITY - TEL...NO. ' STATE WASHERS STA.COOKING UNITS LICENSE NO.. MOTORS: OVER INC. H.P. O- +%a 2S „DIS. Rf�C NO. GR P ZO E READY FOR INSPECTION,, I/2— 2` ,.150 a IN 2- -s. 1.00 INSPECTION RECORD Is-- 'so ,2.80 ++ 150— 200 15.00 /q , SIGNS: NO.,TRANB. A. •�,i .� !a!i'IfI �J 1�Ii{'1 � F9 NO.-LAMPS - .. .. ••„ + .,T ..``. ... SERVICE O-GOON SERVICE OVER GOOV Boo MISC. -44 P III WIRING PERMIT 1.00. `� r ?�l '.l w Rp-;I, FIXTURE PERMIT .1.00• ? G p SUPPLEMENTARY PERMIT 150' TOTAL FEE g O 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 WITH ALL COUNTY ORDINANCES •AND STATE LAWS. REGULATING ELECTRICAL WIRING. WIRING I HEREBY CERTIFY THAT I AM PROPERLY"REGISTERED' AND/O.R,' FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY. AMP STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE POWER - ,DESCRIBED RESIDENTIAL;PROPERTY. _ SIGNATURE `�/� UTILITY CO.NOTIFIED. OF PERMITTEE FINAL VAIMATI ARTHUR C. IT. SUPERVISiN6 ELECRRICAL'EN6INEER •' .CK Mo . -,[EQ.4 5'2 0 OR, SEP' 5 } '2 A 4.00 . M 7Ea66HZ*CE:B'O6 10/72 APPLICATIO FO ELECTR CAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER loe lf .. JBUILDING,AND SAFETY DIVISION ADDRESS. LOCALITYr'� L Gp NEAREST FOR APPLICANT TO FILL IN CROSS ST. �® eAl FRECEPT.— TS N0, EACH FEE FIRM NAME /� /• $ $ MAIL TOTALFIRST 20 25 ADDRESS OVER 20 CITY ��' TEL. N0� -086 10 PLAN CHECK FIRST 20 .25 APPLICANT LIGHTING TOTAL OVER 20 ADDRESS F I XTU RES .10 RESIDENTIAL APPLIANCES CITY TEL. N0. PERMIT RANGEZDRYER._WTR. HTR. APPLICANT STA. COOK DISP. F.A.U. ADDRESS SPACE HTR. AIR COND. CITY CLOTHES WASH. DISHWASH. LICENSE OR REG. NUMBER CLASS, FAN OTHER 1.00 • /� 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION v AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING WITH ALL COUNTY.. ORDINANCES AND STATE LAWS REGULATING INO. HEATERS, ETC. HP. KW.KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 - 1 1.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. C 1 - 10 3.00 PERMITEE 01v 10 - 50 5.00 SIGNATURE CD 50 - 100 10.00 DISTRICT NO. ROCES BY v W 100 - 500 15.005 0 R =SIGN SIGN, GAS AND ONE CIRCUIT 5.00 APPROVALS C� DATE INSPEC 'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE SERVICE NOT OV ER 600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK SERVICEOVER 600 VOLTS OR200AMP 10.00 ROUGH CONDUIT TEMP SERVICE,POLE,&APPURTENANCES 5.00 WIRING TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED +1/_ Ls FINAL if—f -.7n r PERMIT FEE (SUB TOTAL) NOTES: PLAN CHECK FEE PERMIT ISSUING FEE 3.00 3.0 '0 TOTAL FEE -'09 4 PLAN CHECK VALIDATION CK. M..O. CASH PERMIT VALIDATION C M.O. CASH LAC.o G a b 473 KAR 2 0 2 D 7.0 0cu - SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 76A663-CE60610/72 APPLICATION FOR ELECTRICAL PERMIT i COUNTY OF LOS ANGELES y` DEPARTMENT OF COUNTY ENGINEER JOB BUILDING ,� BUILDING AND SAFETY DIVISION ADDRESS fG LOCALITY FOR APPLICANT TO FILL IN CROSSS T. OUTLETS N0. EACH I FEE OWNER OR FIRM NAME U E'2T T. � p 7' RECEP ._ $ 5 LIGHADDRESS S�L / ��/�' ^/�((,� LIGHT TOTAL FIRST 20 2S / CITY fe L� TEL. N0.217Z`0 SWITCH —4p— OVER 20 ip PLAN CHECK LIGHTING TOTAL FIRST 20 25 APPLICANT .�/ OVER 20 ADDRESS FIXTURES d� •10 RESIDENTIAL APPLIANCES CITY TEL. N0. PERMIT RANGE DRYER_WTR. HTR. APPLICANT STA. COOK DISP. F.A.U. ADDRESS SPACE HTR. AIR COND. CITY TEL. NO. CLOTHES WASH. DISHWASH. LICENSE OR REG. NUMBER CLASS. FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING ' WITH ALL COUNTY ORDINA NCES 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 REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAI I AM THE LEGAL OWNER OF THE ABOVE r 1 - tO 3.00 DESCRIED RESIDENTIAL PROPERTY.��J y� p- PT ,/� Chi 10 - 50 5.00 SIGNAIGNATURR E � O 50 - 100 10.00 v DISTRICT N0. g PROCESSED BY � 100 - 500 15.00 v03 z SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTOR'SSIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE SERVI CENOT OVER 600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK SERVI CE OVER 600 VOLTS OR 200 AMP 10.00 ROUGH CONDUIT TEMP SERVICE,POLE,&APPURTENANCES 5.00 WIRING / .7 I TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL PERMIT FEE (SUB TOTAL) NOTES: PLAN CHECK FEE PERMIT ISSUING FEE 3.00 (/d TOTAL FEE X'b PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALID TI N CK. M.O. CASH 9 6 3 SEP .17 2 ©✓ 5.5 0 ,&,% SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 76•p663-CEB06 10,72 - APPLICATION F R ELEC • 6CAL PERMUT u COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER FJAODDRE BUILDING AND SAFETY DIVISION TY T FOR APPLICANT TO FILL IN STOUTLETS ..NO.. EACH FEE RME /r� / �� RECEPT. $ $ ADDRESS (%J PL0 6,4L—/ G LIGHT�sy T TAL FIRST 20 25 CITY TEL. NO. SWITCH_ OVER 20 f0 PLAN CHECK LIGHTING TOTAL FIRST 20 25 APPLICANT c OVER 20 ADDRESS FIXTURES : •10 RESIDENTIAL APPLIANCES CITY TEL. N0, ' PERMIT RANGE' DRYER_WTR. HTR. APPLICANT STA. CO01C DISP. F.A.U. ADDRESS SPACE HTR, AIR COND. CITY TEL. NO. CLOTHES WASH. DISHW.ASH. LICENSE OR REG. NUMBER CLASS. FAN/OTHER 1.0010 0 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 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 — 1 1..00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAI1 AM THE LEGAL OWNER OF THE ABOVE I — 10 3.00 DESCRIBED RESIDE IAL PROPERTY. 10 - 50 lee CD S00 PERMITEE C.2 SIGNATURE. CD 50 — I DO t0.00 DISTRICT NO. PRO SSED v 100 — 500 15.00 ^ Qty \ Z 16c 40 SIGN, GAS SIGN AND ONE CIRCUIT '5.00 APPROVALS DATE INSPECTOR'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE SERVI CENOT OVER 600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK SERVICE OVER 600VOLTS OR.200AMP 1.OAO ROUGH CONDUIT LRE E,POLE,&APPURTENANCES :5:00 WIRING �� v OR RECEPT. SYSTEM 3.00 FIXTURES POWER AUTHORIZED. UTILITY CO. NOTIFIED FINAL (SUB TOTAL) NOTES:FEEING FEE 3.00 E PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH 4 4 9-ACT 23 . :2. 0 7.0 0 d98 SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE