HomeMy Public PortalAbout5454 SULTANA AVE_Electrical__ APPLICATION FOR ELECTRIC PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
SUILDING AND SAFETY DIVISION ADDR68H
JOHN A LAMBIE. COUNTY ENGINKKRlot
CASSATT D GRIFFIN,Suri OF MWILDINY LOCALITY
FOR APPLICANT TO FILL IN NEAREST
PEEMIT FEES CROSSST
I T[M NUMa[R [OCH F[[ OWNER
OU MAIL
uOXTI R[C[K eV! 10 Q ADDRE83
LIGHTING FIXTURES 10 CITY TEL NO
CLO DRYQtI ELECTRICIAN
WALIR H[AT[R8 50 ADDRESS
[ [C IFACa XTRD IINWAIIHe O CITY TEL NO
STATE
OARMO[DITTOS AUTO- !1
WASHERS ITA COOKIHO UNIT[ YD Jo.1 LICENSEEO
MOTORS OV[R INC X P CJ P
o— V, 25 3 —�
V.— Y so INSPECTION RECORD
2— 5 100
a— is too
to— 50 250
a0—200 000
SIGNS NO 7RAM5
NO LAMPII
SERVICE O.000V 1 00
SERVICE OVER GOOV boo
t
MISC
WIRING PERMIT too
FIXTURE PERMIT 100
SUPPLEMENTARY PERMIT 50
TOTAL FEE i
1 HBiEIIY ACIWOWLEDO[ THAT 1 HAV[ R[Ap TH18 IG ION APPROVALS DAT[ IMIP[CIOR[IIOMATUR[
AND ITAT[ THAT TH[ Aa m CORR[CT AND AOR[[ TO COMELY
WITH ALL COUNTY OROINANC[a Alm STAT[ LAWS REOULATWo CONDUIT LZ
[L[CTRICAL WWNG
I H[R[IIY C[RTIFY THAT 1 AM PROF y R[DIIIIERZO AMD/OR WIRING
LICENSED AII N[OUIRm MY L ANO[LEI COUNTY AMD WAT[ OF FIXTURES
CALIFOIWU OR THAT I X[ LE ! TX2 Ya
D[ Iaw R[IIm POWER
SIGNATURE UTILITYCO NOTIFIED Z 3
OFPERMIT'. .
FINAL
®T VALIDATION ARTHURC V91T,
Mo amm UPERV181NG E1dCTRICAL ENGINEER
I JC0 7 1 4 6 -, NOV 9 2 A 7.7 Q n
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TEMPLE CRTY
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vwI3 "" APPLICATION FOR ELECTRICAL PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE.COUNTY ENGINKIM
WILLIAM A JENSEN SUPTOF BUILDING LOCALITY Y1
FOR APPLICANTTO FILL IN ' NEAREST.CROSS ST-
/✓
PERMIT FEES
OWNER
ITEM NUYBER EACH P[a MAIL A ��
OUTLSTHI 3 i t Q ADDRESS
LIGHTS RRCBPr Bw fo T
LIGHTING FIXTURES 10 T lJ Q
ELEC RANGES Cl" DRYRRB ELECTRICIAN
WATER HEATERS QO ADDRESS
ELEC SPACE M DISNwASNBRB CITY TEL NO `
GARBAGE DISPOSmS AUTO. STATE p yy
WASHEnB BTA COOKING UNITS 23
LICENSE NO
MOTORS OVER INC N P DIST ICT G P Z P D
0 — Va 25 WE
Ya — 2 Qp INSPECTION RECORD
2 — Q 100 y
E — IQ / Q0 O
V
1Q — QO 250 Dt
OF
SO — 200 p pp U
W
SIGNS NO Lune q
NO uxPB IZ_�
SERVICED SOOV 100
SERVICE OVER BOOV goo
MIBC
WIRING PERMIT 1 00
FIXTURE PERMIT too
SUPPLEMENTARY PERMIT Qp
TOTAL FEE t
1 HEREBY ACKNOWLRDOC THAT 1 HAVE BRAD THIS APPLICATIONLWI
PPROVALS CAL IMBPECTO 'S SIGMATURE
AND STATE THAT THE ABOVE IB CORRECT AND AORaE TO COMPLY
WITH ALL COUNTY ORDINANCRB AND GAT[ LAWS RKOUTATINGIT
ELECTRICAL WIRING G71/610
1 HEREBY CERTIFY THAT I AM PRCP[RLY RE01871A D AND/OR
LICEMBCD AS REQUIRED BY LOS ANGELES COUNTY AND GATE OFES
CALIFORNIA OR THAT 1 W LEGAL OWNER THE ABOVE
DEBCRIB=Ru1D[NT SIGNATURE / 'INAYCO NOTIFIED
OF PERMITTEIL
VALIDATION SU URC VETT,
CX MO SUPERVISING ELECTRICAL ENGINEER
uI;o75aa �— Itnr24 2 D 1 .30p �R
�i`is �uLr�
WORKER S COMPENSATION DECLARATION 776AW669 DPW(12 B„ APPLICATION FOR ELECTRICAL PERMIT 11
I hereby affirm that I have a certificate of consent to self Insure
or a certificate of Worker s Compensation Insurance or a certified COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV
copy thereof(Sec 3800 Lab C)
Policy No Company FOR A"UL NT TO RLL IN
❑ Certified copy Is hereby furnished New Residential Bldgs d Pods NO EACH FEE 7 V
❑ Certified copy Is hled with the county building Inspection
1 8 2 Family Sq Ft
$ $ LOCALITY
department Mulh family Sq Ft NCROSS
Residential Swimming Poole ASSES
I ApPIICent MAP BOOK AGE PARCEL
CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Roc —Light S. OWNER OR �1/ p
COMPENSATION INSURANCE FIRM NAME V6
First 20 'MAIL
(This aeotlon need not be completed If the work Involved by the Total No Pzltlrtlonel
permit Is for one hundred dollen(5700)or leu)
I certify that In the performance of thew r winch Is permit CI �. U Ta No
IS Issued I shall not Bmpl Dy any porn In ny m or so as to PLAN CHECK
become eublect to the kers Comp set Laws Lghting Fixtures First 20 APPLICANT
Total No Additional ADDRESS
Date cRESIDENTIAL APPUANCES NOT OVER 3 HP
NO71 E O APPLICANT If aft making this IIII to o/ CITY Tel No
Exemption,you should become sub t to the Workers ompensation OTHER APPLIANCES NOT OVER 3 HP
promatons of the Labor Code you must forthwith comply with such PER&ItT
provisions or this'permit shall be deemed revoked Power Apparatus 8 Large Appliances APPLICANT
LICENSED CONTRACTORS DECLARATION Size 8 Type HP KW KVA or KVAR ADDRES (
I hereby affirm that I am licensed under provisions of Chapter B Over 3 to 10 Inc] q�
(commencing with Section 7000)of Division 3 of the Business and CRY c Tel No "G
Professions Code and my license is In lull force and effect Over 10 to 50 Ind }
LICEN LIMB Cys — f1 a
Over 50 to 100 Incl qE0 NUMBE [/ O
� ��6,`�/2/� // �j Over 100 016"CT NO P ED BY
LIcenee NumbeiCv+✓7�LIc Close�� ! 0
Serwces wwbbd wMC 8 P el de / �� p„J �'e Md�iLG�LC! Q
/� FINAL O
ContractA ``WW'i' I DATE F_
400 1000 Amp Under 600 V C�
❑ VALIDATION
I aexempt under Sec ✓
m LU
Over 1000 Amp or Over 600 V FINAL d
B dP C fa this reason BY Tit
BRANCH CIRCUIT FEES
Date 15A or 20A 120V Lightning or Receipt z
1 To 10 Branch Circuits
Signature 11 To 40 Brand)Circuits
41 Or More Branch Circuits i
❑ Exempbon for Reg I Elect 15A 21A 208V To 277V Lghbng Br Cmdo 2
SINGLE FAMILY Temp Power Poled Appurtenances ACCT.:
HOME OWNER BUILDER DECLARATION Sign with One Branch Circuit
I hereby affirm that I em exempt from the Contractor a License Law J770J 3 66,60
for the following reason (Section 7031 5 Business and Professions Additional Sign Branch Circuits
Code) 1 ITEMS
❑' I ao owner of the property will do the work and the structure Miac Conduits d Conductor TOTAL 66 . 60
Is not Intended or offered for sale (Section 7044 Business Other(See Complete Fee Schedule) ,
end Professions Code) CASH 66.60
CONSTRUCTION LENDING AGENCY CHANGE •00
I hereby affirm that there Is a construction lending agency for the
performance of the work for which this permit is Issued (Sec 3087 PERMIT FEE (Sub Total)
CIV Of 0000—M 7/29/96
PLAN CHECKING FEE
Lender a Name 770J 1 AM 9'57
PERMIT ISSUING FEE
Lenders Address
I certify that 1 have need this application and under penalty of purlury state TOTAL FEE
that the above information M torted I agree to comply with all County
ordinancesand atelawsregulahng Elecbicalwinng andharehyaulhonze
repreeentet this kenter upon Ne above-menbanedpr
forIns urposeSEE REVERSE FOR EXPLANATORY LANGUAGE
RE OF PERMITTEE /I DATY