The URL can be used to link to this page

Home My Public Portal About5451 SANTA ANITA AVE_Electrical__ WORKERS'COMPENSATION DECLARATION +�76A663 10/81 ®®® C�+ �® p l� ®® PERMIT I hereby affirm that I have a cerIlficate of consent to self CE-806G �■ ®'��'6m��1®®� ®� ELECTRICAL ® ��LYhI� insure, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES / C BUILDING AND SAFETY or a certified copy thereof(Sec. 3800, Lab. C.) Policy No. Company 1 FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished. New Residential Bldgs. &Pools . EACH NO. FEE ADDRESS 5q s S,4 A oR V ❑ 1 &2-Family, S Ft. $ — $ LOCALITY I Certified copy is filed with the county building inspec- Y� q• tion department. I Multi-family Sq. Ft. 'NEAREST ff Residential Swimming Pools CROSS ST. Date Applicant OWNER OR FIRM NAMEKlrd CERTIFICATE OF EXEMPTION FROM WORKERS' ��yy p D MAIL COMPENSATION INSURANCE Outlets: Rec�_LighY_�Firs 20 ADDRESS6" i Al fa 0 If (This section need not be completed if the work involved by Total No.-IsAdditional D CITY Tel. No _ 5 the permit is for one hundred dollars($1100)or less.) I certifythat in the performance of the work for which this PLAN CHEC P S permit is issued, I.shall not employ any,person in any manner APPLICANT so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS Additional Total No. 1,97k., CITY Tel. No. Date pplicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO PPLICANT: If, after making this Cqslficate of APPLICANT Exemption, you should become subject to t. a Workers' Range_ Heater—D.W. Compensation provisions of the Labor Code, you must forth- jl Oven —Dryer —W.M.— ADDRESS Vie, �. tis �_ Loq fJ with comply with such provisions or this permit shall be a Top _ FAU —W..H. — deemed revoked. CITY JV/a&N. Tel. f(,7it -2P LICENSED CONTRACTORS DECLARATION Hood _ Fan _Other_ LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. Room Air Cond. REG.NUMBER!2/0'_M3- Class. C (commencing with Section 7000)of Division 3 of the Business VI Power Apparatus&Large Appliances DISTRICT NO. PROC ED BY - and Professions Code,and my license is in full force and effect. �F ' Size&Type HP, KW, KVA, or KVAR rx V License Number 46 Uc.Class 1 Up to 1 Incl. FINAL f Over 1 to 10IncL DATE VALIDATION 0 i� Contracto Over 10 to 50 Incl. FINAL ElPE - C J- a-a. I am exem tun er Sec. Over 50 to 100 Inc. BY BAP.C. for this reason Over 100 Date: Services;Swbd.,MCC 8 Panelboards ell 0 -200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V ❑ Over 1000 Amp. or Over 600 V "? A Exemption for Reg. Maint. Elect. SINGLE FAMILY ' HOME OWNER-BUILDER DECLARATION Temp. Power Pole 8 Appurtenances , o ° o ° 2 Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits i ° ° 57.00 Law for the following reason (Section 7031.5, Business and Professions Code): 5 7 x 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)_ it 1)-83 7044, Business and Professions Code). 6 1 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 U Lender's Address I certify that I have read this application and state that the TOTAL FEE S s a 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 &thve-menti ned property fort ection purp ses. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permi tee Da '1I' ' ` COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer ELECTRIC DIVISION OF BUILDING & SAFETY WILLIAM J. FOX, County Engineer FOR APPLICANT TO FILL IN DISTRICT NO. rsROUP ZONE PERMIT NO. _ELECTRICIAN RECEIVED BY READY FOR DATE ISSUED E ADDRESS _ FIRST INSPECTION CITY____ TEL.. NO. COUNTY LICENSE NO. EXPIRES BUILDING PERMIT FEES aDDREas FEE NUMBER EACH LOCALITY LIGHT OUTLETS NEAREST c CROfl9 ST.. RECEPTACLES WALL SWITCHES _ TOTAL OUTLETS .-- 5c $ MAIL _- ----`_— — ELEC. RANGES 25 ADDRESS ELEC. HEATERS 25 CITY TEL NO. FIXTURES 5 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS misc. APPLICATION AND STATE THAT THE ABOVE 19 CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER NEW MVD. HP AVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. ',/2 S LESS $ .25 SIGNATURE OF 1/2 2 .51 PERMITTEE 2 5 1.00 �. _ INSPECTION RECORD _ 5 15 1.51 — _7 s 50 2.51 A-: c a f _ 50 201 5.00 200 500 10.00 500 1000 15.00 Q Z OVER 1000 20.00 M.G. SET/FREQ. CHANGER-HP WELDERS: AC-KVA D GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF ORIG.) MOVED MOTORS (75% OF ORIG.) MISC. — -- SIGNS NO. NO.TRANS. APPROVALS NO. NO. LAMPS FOR EACH PERMIT: ____ ._ DATE INSPECTOR'S NAME _WIRING $1.00 CONDUIT - _ FIXTURES _ $1.00 J WIRING SUPPLEMENTARY .50 -�— FIXTURES _ POWER _ TOTAL FEE 3 4 UTILITY CO.NOTIFIED FINAL 76A663 D05#5A 2-53 76A663 DBS BA 11-50 APPLICATION FOR PERMT DEPARTMENT OF BUILDING AND SAFETY ELECTRIC 1 COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRI GROUP ZONE PERMIT NO. FAD CTRICIAN r L/ EIVED BY READY FOR DATE ISSUED ES �, FIRST INSPECTION �� TEL. NO LJ ' i'�'�TY LICENSE NO.PERMIT FEES EXPIRE r ADDREING SS � `4� FEE ,-Y NUMBER EACH LOCALITY j� v v 1 LIGHT OUTLETS CNEARE ROSS T BT. RECEPTACLES CROSS s-- WALL SWITCHES �}, OWNER TOTAL OUTLETS Sc S ri"l r L MAIL � ELEC. RANGES 2S ADDRESS r 2ELEC. HEATERS 25 CI �rr� '`r� TEL. NO. .' FIXTURES S MISC. I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS � 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 1 POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER FEE I ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER OF THE RESIDENT4LPRORTY DESCRIBED ABOVE. NEW MVD. NP OVER INC. EACNQ LESS S .26 SIGNATURE OF , �/2 250PERMITTE 2 s 1.00 I SPECTION RECORD s 1s 1.50 is so 2.50 so 200 5,00 200 soo 10.00 J Soo 1000 15.00 Z OVER 1000 20.00 z_ M. G. SET/FREQ. CHANGER-HP a WELDERS:AC-KVA 0 GENERATORS-KW TRANSFORMERS-KVA TEMP. MOTORS (7S%OFORIG.) MOVED MOTORS (7S%OFORIG.) MISC. SIGNS NO. NO.TRANS. I I APPROVALS NO. NO. LAMPS FOR EACH PERMIT: DATE INSPEootCTOR'S NAME WIRING 61.00 CONDUIT I g, 1 FIXTURES $1.00 WIRING ✓P / K",!,1.,'-Tv'� SUPPLEMENTARY .50 FIXTURES POWER i TOTAL FEE S � UTILITY CO. NOTIFIED ® FINAL /GAGGS.CESOG.7.88 APPLICATION FOR ELECTRIC PERMIT BUILDING AND SAFETY DMSION Deportment of County Engineer BUILDING County of Los Angeles ADDRESS JOHN A.LAMBIE. COUNTY ENGINEER CASSATT D.GRIFFIN.SUPT OF BUILDING LOCALITY FFOR APPLICANT TO FILL IN CR SS ST . PERMT FEES NUMBER OWNER LIGHT OUTLETS MAIL ADDRESS RECEPTACLES , WALL SWITCHES FEE CITY TEL.NO. TOTAL OUTLETS 0 5¢ $ ELECTRICIAN ELEC.RANGES 25 ADDRESS a oma'✓}.c ELEC. HEATERS 25 CITY ,p TEL.N0.4V KW EA ATE FIXTURES S LICENSE NO. MOTORS DISTR�T NO. G OI,1EZON READY FOR I�NS�PEC�TIQJN ' NUMBER HORSEPOWER FEE `L) .,� I • NEW MVD. HP OVER INC. EACH >�&LEGS $ .25 INSPECTION-RECORD Yz 2 ' .50 2 5 1.00 S Is 1.50 15 '02,11 50 200 5.00 M ISC. NO.SIGNS NO.TRANS. NO.SIGNS NO.LAMPS FOR EACH PERMIT: WIRING PERMIT $1.00 FIXTURE PERMIT $1.00 SUPPLEMENTARY .501 APPROVALS TOTAL FEE $. J Z DATE INSPECTORS SIGNATURE 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ T.H1S APPLICATION CONDUIT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY � WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING / ' Pic a aG2R ELECTRICAL WIRING. ° I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF POWER. CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE / r DESCRIBED RESIDENTIA OP Y c UTILITY CO.NOTIFIED / "- SIGNATURE 7+ r.fir OF PERMITTEE FINAL J -J / 1 a : JOHN A.LAMBIE. VALIDATION ARTHUR C.VETT. ..OUNTY ENGINEERCK NO . `CASH SUPERVISING ELECTRICAL ENGINEER UC 3 8 3 9 JAN 2 2 1.2 5 10 76AG619:CEBOi 3'69 APPLICATION FOR LECTRIC� PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALI:TY�/� C �J FOR APPLICANT TO FILL IN NEAREST CROSS ST.�J//��NG NO. EACH FEE $ $ OWNER Qo RECEIPT._ MAIL LIGHT TADDREOTAL FIRST 20 20 T , SWITCH OVER 20 ip CITY �� TEL.N �p PLA CHECK LIGHTING TOTAL FIRST 20 ,20 APPLICANT. FIXTURES } OVER 20 ,10 ADDRESS RANGE_DRYER_WTR. HTR. CITY TEL.NO. STA. COOK_DISP._F.A.U. CONTRACTOR SPACE HTR. AIR COND. ADDRESS CLOTHES WASH._DISHWASH.� CITY 4 TEL.N FAN_OTHER 1.00 Qd LICENSE NO. CLASS. MOTORS,TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION IND. HEATERS, ETC. HP. KW. KVA. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. 0 - 1 1.00 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSEDASREQUIRED BY LOS ANGELES COUNTY AND STATE OF I - 10 3.00 CALIFORNIA OR THAT 1 AM THELEGAL OWNER OFA AND INTEND TO CL RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL OPERTY. C 10 — 50 5.00 L SIGNATURE ad so — 100 10A0 OF PERMITTEE C F- 100 - SOO 15.00 DISTRICT NO. GROU ZONE PR C SEED BY U TUBE,A SIGN AND ONE CIRCUIT 3.00 �V z MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES: - SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 SERVICE OVER 600 VOLTS OR 200 AMP 5.00 TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP. POWER POLE UNDERSLAB WORK ROUGH CONDUIT WIRING PERMIT FEE (SUB TOTAL) FIXTURES PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED 14, PERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL TOTAL FEE JOSEPH C. ROOHAN SUPERVISING ELECTRICAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION eK M.O. CASH cc ,AN 8 3 P- 7&R-2 JAN 12 2 D 3.0 0- SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE �" � I)e- 6-Vly i6A608.°E80610.99 APPLICATION FOR ELECTRIC PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER .y WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY v FOR APPLICANT TO FILL IN NEAREST. +6' I PERMIT FEES CROSS OWNER _ ITEM NUMBER EACH FEE MAIL s LLIGHTSOUTLET ECEPT. SW. $ $ �J ADDRES �/.� LIGHTING FIXTURES .10 �-� CITY `' TEL.NO. ` ELEC.RANGES CLO.DRYERS ELECTRICIAN e /Z i. �p WATER HEATERS .50 ADDRESS I- I- B V � i ELEC.SPACE HTRS. DISHWASHERS CITY 4114v �L �� GARBAGE DISPOSERS AUTO.- STATE v �- WASHERS STA.COOKING UNITS .25 _ LICENSE NO. MOTORS: OVER INC. H.P. DISTRICT NO. 1GROUP11 ZONE SSED B O— +/g .25 +iz— z 5o INSPECTION RECORD 2— 5 1.00 a— 15 1.50 is— BO 2.50 50-200 5.00 SIGNS: NO.TRANS. NO.LAMPS SERVICEO-600V �Yi'�I� ! 1.00 SERVICE OVER SOOV 5.00 MISC. WIRING PERMIT 1.00 FIXTURE PERMIT 1.00 B SUPPLEMENTARY PERMIT 50 TOTAL FEE S 1 HEREBY ACKNOWLEDGE THAT 1 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 e / ELECTRICAL WIRING. I HEREBY CERTIFY THAT 1 AM FROPERLY REGISTERED AND/OR WIRING �T ��',' LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES- CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. POWER SIGNATURE UTILITY CO.NOTIFIED .4 I OFPERMITTE FINA .� 0 - A�.y,,, tHLJR C. bp CK MO SU ERVISING EEECTRICAL ENGfNEER CK MO ^/CA�{BH L 1 i� ( `Y J V 4.k fr V WORKERS'COMPENSATION DECLARATION CE-8M 10/81 APPLICATION PPLIC 6k TION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self ICE-BO6G ^ �rP'1 �V ,1�r , insure, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES / BUILDING AND SAFETY a or certified copy thereof(Sec. 3800, Lab. C.) ♦ C Policy No. Company FOR APPLICANT TO FILL IN JOB ADDRESS J S N Certified copy is hereby furnished. Au r New Residential Bldgs. &Pools . EACH NO. FEE .r ❑ 1 8 2-Family, S Ft. $ = S LOCALITY I Certified copy is filed with the county building inspec- Y, q' NEAREST tion department. Multi-family Sq. Ft. Residential Swimming Pools CROSS ST. Date Applicant OWNER OR .{ FIRM NAME !' VS tw-& C"' CERTIFICATE OF EXEMPTION FROM WORKERS' ��0� � MAIL Outlets: Rec��LighY�Sw rr t COMPENSATION INSURANCE � � ADDRESS$ $ 'Ffl �U If This section need not be completed if the work involved b First 20 S ( P y D CITY EC C Tel. No Total No.9 Additional _ S the permit is for one hundred dollars($100)or less.) ,i I certifythatthe performance of the work for which this PLAN CHET in e P I APPLICANT permit is issued, I shall not employ any person in any mannerIS' so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS Additional Total No.— CITY Tel. No. Date pplicant �e Fixed Appliances Not Over 1 HP PERMIT NOTICE TO PPLICANT: If, after making this Cgy1 icWe of APPLICANT e ri Exemption, you should become subject to We' Workers' Range_ Heater_D.W. — Compensation provisions of the Labor Code, you must forth- !i Oven —Dryer —W.M.— ADDRESS Hood Fan _Other— V �.� �. �c s �_ f� With comply with such provisions or this permit shall be 'i Top _ FAU —W.H. — / deemed revoked. CITY (W44C Tel. _ LICENSED CONTRACTORS DECLARATION Dis _ Room Air Cond. — LICENSE OR p' ` L�l 1 hereby affirm that I am licensed under provisions.of Chapter 9 REG. NUMBER �� Class f (commencing with Section 7000)of Division 3 of the Business ' DISTRICT NO. PROC ED BY and Professions Code,and my license is in full force and effect. J' Power Apparatus 8 Large Appliances � /t I Size&Type HP, KW, KVA, or KVAR• J sUe V License Number e — Lic. Class i Up to 1 Incl. FINALDATE y !� Contractor — e �7 Over 1 to 10 Incl. Gt- Ll VALIDATION ❑ ! Over 10 to 50 Incl. FINAL I am exempt un er Sec. I Over 50 to 100 Inc. BY �c @• LU B.&P.C. for this reason Over 100 U) Date: Services, Swbd.,.MCC&Ponelboards ' ® � /a 0 -200 Amp. Under 600 V Signature i 201 -1000 Amp. Under 600 V ❑ Over 1000 Amp. or Over 600 V Exemption for Reg. Maint. Elect. r 5 23 A SINGLE FAMILY I Temp. Power Pole&Appurtenances a ° a c o L HOME OWNER-BUILDER DECLARATION l Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits ° ° 5 7 Q Law for the following reason (Section 7031.5, Business and Professions Code): q ° ° F 7 r1 rN ❑ I, as owner of the property, will do the work and the M.sc. Conduits&Conductors r' . structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)_ ® 0 F—C? 3 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 j PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE eo Lender's Address I certify that I have read this application and state that the I TOTAL FEE s a above information is correct. I agree to comply with all County i. ordinonces and State laws regulating Electrical wiring, and hereby authorize representatives of this County to enter upon �Ihoe-mentl ned property for i action purp ses. ' SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Perm.tee Da 4