HomeMy Public PortalAbout5637 SULTANA AVE_Electrical__ COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Department OF of County Engineer ELECTRIC
DIVISION OF BUILDING & SAFETY I��J"i■r9 ��'/•ii[
WILLIAM l FOX County Enylne•r
FOR APPLICANT TO FILL IN DiBTRICT.,,N O. GROUP ZONE PERMIT NO
ELECTRICIAN P— /
R[ IVCD BY READY FOR DAT[ ISSUED
ADDRESS rIRBT INSPECTION
CITY ' TEL NO ��ii – / / /1-- 3
COUNTY LICENSEE�NNrO.r. �� Z EXPIRES -JO BUILDING
Pci+c>MI FEES ADDRESS
NUMBER EACH FEE LOCALITY
LIGHT OUTLETSNEAREST
RECEPTACLES CROSS ST
WALL SWITCHES Z OWNER J _
TOTAL OUTLETS Sc D MAIL
ELEC RANGER 25 ADDRESS _
ELEC HEATERS 25 CITY TEL NO
FIXTURES 5 17 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIU
MISC APPLICATION AND STATE THAT THE ABOVE IB CORRECT
NUMBER Or LIGHT CIRCUITV SS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS AND STAT[ LAWS REGULATING ELECTRICAL WIRING
MOTORS I CERTIFY THAT 1 POBBESB THE ABOVE VALID LOB
Mu.. HORSEPOWER FEE ANGELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER
NEW MVD HP 11 YER ISD Or THE RESIDENTIAL PROPERTY DEBCRIBED ABOVE
LE[r 2 25 SIGNATURE Or Q �p
2 BO PERMITTEE >��
_ 2 B 100 INSPECTION RECORD
5 15 1 so
_ is 50 250
_ BO 200 500
ZOO son lam J
BOO IGGO is DD Q
Z
OVER 1000 2000 0
M G BET/FREp CHANGER-HP
WELDERS AC-KVA O
GENERATORS
TRANSFORMERS - KVA
TEMP MOTORS (75% Or DRID)
MOVED-MOTORS (75q Or GRID) _
MISC I
91GNB
NO NO TRANS.
NO NO LAMPS APPROVALS
FOR EACH PERMIT DA INBPECTOR'B NAME
WIRING 6100 / CONDUIT
rIXTUR[B S1 00 Q D WIRING
UPP EMENTARY SO rIXTURES
Agn 1 POWER
TOTAL FEE ! J UTILITY CO NOTIFIED .- a
FINAL /
7GA892 DBS#5A 4-52
WORKERS COMPENSATION DECLARATION 18A803 10/91 ,aAPPLICATION FOR ELECTRICAL PERMIT {�
hereby ffirm that I have a certficate of consent to sell insure CE Boeo LJ
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 APPLICANT TO FILL IN JDB
ADDRESS" VU ����'/
❑ Cerhfrod copy is hereby furnished New Residential B - EACH NO FEE
fdgs & Pools r
❑ Certified copy is filed with the count builds " 1 8 2-Family Sq Ft $ — $ LOCAl1TY+„ L 6
y ng inspectiM NEAREST
department _ I Mult-fam ly Sq Ft CROSS ST
Date Applicant Residential Swimming Pools OWNER OR
* I FIRM NAME
CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Ree— Light 'Sw MAIL O /7
COMPENSATION INSURANCE ADDRESS C/
(This section need not be completed It the work involved by the First 20
perrmt is for one hundred dollars($100)or less) Total No Additional CITY L L E Z
I certify that In the performance of the work for Which this permit PLAN CK
is issued I shall not am lo an y APPLICANT ,
p y y person in an manner so as to _
tiecome subject to the Workers Compeosat ws Lghting Fixtures First 20 ADDRESS -
o Total No Additional
Date 2-/ 10 Apple 'CITY Tel No
NOTICE TO APPLICANT If after making this state of Fixed Appliances Not Over 1 HP PERMIT
Exemption you should become subject to the Workers Compensation Range_ Heater_ DW "M uC 1J L e
nrwc
provisoes of the Labor Code lyou must forthwith comply with such Oven _ Dryer = W M ADDRESS 3n/, 4
pro%nsions or this permit shall be deemed revoked , Top _ FAU WH
LICENSED CONTRACTORS DECLARATION INC►EC
Hood,— Fen Other_ CITY &S
1 hereby affirm that I am licensed under provisions of Chapter g UCENSE OR
(commencing with Section 7000) of Division 3 of the Business and aDisp —+Room As Cand REG NUMBER Clesy�`iy
Professions Code and my license a in full force and effect DISTRICT N O PROC ED BY
Power Apparatus 8 Large Appliances - y
License Number �� �� Lip C ��Q Size Type HP KW KVA or KVAR 7 8
Up to 1 Incl FINAL
Over 1 to 10 Ind DATE d'
Contract ��2- - - VALIDATION O
Over 10 to 50 Incl FINAL F-�
❑ am exempt under Sec Over 50 to 100 Inc _ BY W
B&PC for this reason Over 100 I N
Services Swbd MCC 8 Pa600 Vrds pip, / Z
Oats 0-200 Amp Under 600 V
Signature 201 - 1000 Amp Under 600 V"
❑ Over 1000 Amp or Over 600 V -
Exemption for Reg Maint Elect r
SINGLE FAMILY l Temp Power Pole& Appurtenances 71 r
HOME OWNER-BUILDER DECLARATION with Branch Circuit
Sign y -
I hereby affirm that I am exempt from the Contractors License Law Add with OneSigBranch Circuits .i
for the following reason (Section 7031 5 Business and Professons
Code)
r _ 3307
❑ I as owner of the property will do the work and the structure Misc Conduits & Conductors - i IT05
is not intended or offered for'sale (Section 7044 Business Other (See Complete Fee Schedule)
and Professions Code) TOTAL 31 - 00
CONSTRUCTION LENDING AGENCY CGK
I hereby affirm that there is a construction lending agency for the
performance of the work for which this permit is issued(Sac 3097 PERMIT FEE ' (Sub-Total) - r-HAWiE
Civ C)
PLAN_ CHECKING FEE
Lenders Name O0W—ODO1 8/22J90,
PERMIT ISSUING FEE
Lenders AddressO 2523 1 AM10:12,
certdy 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 Electrical wrong and hereby authorize
representatives of tWs County to enter upon the above-mentroned
prope$u,.
e 6n rp SEE REVERSE FOR EXPLANATORY LANGUAGE
a of Permitt Date