HomeMy Public PortalAbout5509 SULTANA AVE_Electrical__ +�� o�M " �• APPLICATION FOR PERMIT
DEPARTMENT OF1G AND SAFETY ELECTRIC 1
COIINTY OFF LOS LOS ANGELES
WILLIAM J. FOX. CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT O. OROLJP ZONE _PERMIT NO.
ELECTRICIAN 2&
RECEIVED BY READY FOR DAT[ ISSUED
ADDR[BB�-+ ter-
P4_4'1jfA A4 Aid n,� 4 U d FIRST INSPECTION
CITY A T[L NO
COUNTY LICENSE NO r EXPIRES BUILDING
1 PERMIT FEE ADDRESS SS6
4F[[
Q
NUMBER OUTLETS EACH LOCALITY
LIGHT 6C S NECRrr
CROBB nT
RECEPTACLES 6 O
_ rlxru REB a OWNER
�Jd WALL SWITCHES S MAIL
El O. RANGES as ADORESs
Z L� [LEO HEATERS 26 CITY TEL NO
71 (
so
HUMBER Or CIR1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
1 CUITS INSTALL EDi
TDTA APPLICATION AND STAT[ THAT THE ABOVE IB CORRECT
LIGHTS [ [ AND ABR[[ TO COMPLY WIT" ALL COUNTY ORDINANCES
MOTORS AND STATE LAWS REGULATING ELECTRICAL WIRING
MUNe[RHORSEPOWER Fee I CERTIFY THAT 1 POSBEBB THE ABOVE VALID LOB
N[w Nw MP DV[R INC EACH ANGELS COUNTY LICENSE. OR I AM THE LEGAL OWNER
• uu a6 Or THE REBIDEMTIA [RTY DESCRIBED AsOV
1 a SO BIGMATURE OF
a n , GD
PERMITTE
S is 1 s0 MSPECTIOW&COO
16 SO 2150
n0 200 n GO
200 sm SO 00
s7D IDDD 1500
Q
OVER 1270 2000 Z
M G RET/FRM CHANGER-HP
W[LOER81 A0-KVA R
GENERATORS - ISW D
TRANBFORMERB - KVA
TEMP MOTORS (76 or DRIG)
MOVED MOTORS (76 or DRIDJ
B
BIONS
TYPE. MO.TRANS
NO MPB APPROVALS
FOR EACH PERMITS DAT[ INSPECTOR'S NAM[
WIRING mi.clo 0 CONDUIT
FIXTURES $IGO WIRING
SUPPLEMENTARY6 riKTUREB
tL POWER
TOTAL FEE s 7 r S ' UrILITY CO NOTIFIED in
FINAL I
ION
WORKERS have
a certificate
of cLAFIATI o 78,83 ,pia, APPLICATION FOR ELECTRICAL PERMIT {1
I hereby affirm that I have a Certificate of consent to sett insure
cE-spe0 u
or a certificate of Workers Compensation Insurance or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY
copy thereof (Sec 3800 Lab C)
Policy NO Company FOR APPLICAWITO FILL IN JDB
❑ Carried copy is herebyfurnished EACH NO FEE
New Residential Bldgs 8 Pauls �
❑ Garbled copy is filed with the county building inspection 1 8 2-FamJy So Ft $ _ $ LOCALITY
department Multi-family So Ft NEAREST
CROSS ST
Date Applicant Residential Swimming Pods ' QYNER OR
FIRM NAME
CERTIFICATE OF EXEMPTION FROM WORKERSMAL
COMPENSATION INSURANCE Outlets Rec—Light Sw ADDRESS
(This section need not be completed of the work involved by the First 20
permit is fa one hundred dollars($100)or Was)
Total No Additional CITY Tel No
1 certify that in the performance of the work for which the permit PIJAN CHECK
,s issued I shall net employ any person in arty manner so as to A1TtiucnNT
becane subject to the Workers Compensation Laws Lighting Fixtures First 20 ADDRESS
���_q A Total No Additional CITY Tel No
DaL! Applaent-—"- -—_� Fixed Appiances Not Over 1 HP
NOTICE TO APPLICANT If after making the Certificate of PERMO
Exemption you should become subject to the Vi Compensation Range_ Heater_ DW _ APPLICPITT
proms+on9 of the Labor Code you must forthwith comely with such Over, _ Dryer _ W M _ ADDRESS
provisions or this permit shall be deemed revoked Top — FAU _ WH
CI Tel No
LICENSED CONTRACTORS DECLARATION Hood Fan Other_
I hereby affirm that I am licensed under pmvis,ons of Chapter 9 Dep _ Room Air Cond LICENSE B Caas.
(commencing with Section 7000) of Division 3 of the Business and REO NUMBER
Professions Code and my(cense is in full force and effectDISTRICT NO ^ E 0 BV
Winer Apparatus It Large ApWumceS [V/
Size 8 Type HP KW KVA or KVAR
License Number Lic Clens Up to 1 Incl RNAL Kf
Over 1 to 10 Incl DATE VALIDATION
Contractor Date Over 10 to 50 Incl RNAL r 0
Elam exempt under Sac Over 50 to 100 Inc BY i
t W
BBPC for this reason Over 100 ( L N
Services Swbd MCC 8 PaneIWWs , Z
Data f,0-2 D AMD, UM67600 V > c"
Signature 201 - 1000 Amp Under 600 V
❑ Exemption for Over 1000 Amp or Over 600 V
Reg Maim Elect _
SINGLE FAMILY Temp Flower Pole S Appurtenances
HOME OWNER-BUILDER DECLARATIONSign with Or,e Branch Circuit
2
1 hereby affirm that I am exempt from the Contractors License Law Sign
for the following reason (Section 7031 5 Business and Professms Additional Sign Branch Circuits
Cade) =7 22.00
Misc Conduits 8 Conductors
I as owner of the property well do the wok and the Business
Other(See Complete Fee Schedule) 1 ITEM
h�
anet intended or offered fa sale (Section 7044 Bus,neas ► TOTAL 22.00
and Professions Code)
CONSTRUCTION LENDING AGENCY CHECK 22.GO
I hereby affirm that there ,s a constriction lending agency for the '`lr.`r�
performance d the work for which this permit is issued(Sac 3097 PERMIT FEE (Sub-Total) C .00
Civ C)
PLAN CHECKING FEE
Lender aName p —pQpl b/ 4/90
PERMIT ISSUING FEE .k�
Lenders Address lOEO 1 AN 7.332
1 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
and State laws regulating Electical wiring and hereby authorize
representatives of this County to enter upon the above-mentioned
property for inspection Purposes
1,..�CTply�'T SEE REVERSE FOR E%PLANATORY LANGUAGE
r Signe ure of Permifte pat T _