HomeMy Public PortalAbout5847 SULTANA AVE_Electrical__ 'ABBB.°EBoe,G•BG . APPLICATION FOR ELECTRICA PERMIT 1
COUNTY OF LOS ANGELES
DEPARMENT OF COUNTY ENGINEER ; 'BUILDING
BUILDING AND SAFETY DIVISION ; ADDRESS Sm� 7W Al.4
-
JOHN A. LAMBIE. COUNTY ENGINEER }
WILLIAM A.JENSEN.SUPT OF BUILDING LOCALITY
EAREST
FOR APPLICANT TO FILL IN 'Ross S.
PERMIT FEES �6�"WNER 41d fffg�=
1 T E M NUMBER EACH FEE WIAIL. -
OUTLETSs . III ADDRESS
LIGHTS RECEPT. SW. •10 CITY TEL.NO.
LIGHTING FIXTURES .10 I
ELEC.RANGES CLO.DRYERS L`
'ADDRESS
/ y/
WATER HEATERS .50 ADDRESS ` J�IZ"
ELEC.SPACE HTRS.DISHWASHERS
CITY TEL NO.
GARBAGE DISPOSERS AUTO.- - STATE'
WASHERS STA.COOKING UNITS . ,25 LICENSE NO. 6
MOTORS:.. OVER INC. H.P. DISRI TO. GR UP O .E ' PR ESSED BY
0— va .25 s
1/2— 2 :5o I INSPECTION R ORD
2— 5 1.00 I 0
5— is 1.50 V
a
10— 5o 2.190 O
50— .200 5.00
c.
SIGNS: .NO TRANS.NO.LAMPS
SERVICE 0-600V 1.00 I
SERVICE OVER 600V g,pp
M ISC.
WIRING PERMIT Loo
FIXTURE PERMIT 1.00
SUPPLEMENTARY PERMIT 50 j
TOTAL FEE
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION I •APPROVALS DATE INSPECTOR'S'SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
'
WITH ALL; COUNTY ORDINANCES AND STATE LAWS REGULATING G .
ELECTRICAL WIRING. IRING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS'ANGELES COUNTY AND.STATE OF IXTLIRES
CALIFORNIA OR THA 1 AM THE LEO OWNER OF THE ABOVE
DESCRIBED RESIDENT P PERTY. PLOWER U
SIGNATURE TILITY CO.NOTIFIED
OF PERMITTEEFINAL
IDATION a rHUR C.VEIT
Mo CASH SUPERVISING ELECTRICAL ENGINEER
WORKERS'COMPENSATION DECLARATION 6A603 APPLICATION FOR ELECTRICAL PERMIT
E 806G (2 80)
I hereby affirm that 1 have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY
insure,or a certificate of Workers'Compensation Insurance,or :
a certified copy thereof(Sec.3800,Lab.C.) I
��.� L FOR APPLICANT TO FILL IN JOB [4
Polic ompany_U,u, V ADDRESS '(7. /�Iti
• New Residential Bldgs.&Pools EACH NO. FEE
Certified copy is hereby furnished/._0 �/ 1 &2-Family,Sq. Ff. $ -- $ LOCALITY
I Multi-family Sq. Ft. NEAREST
El Certified.copy is filed wi eco building inspection CROSS ST IJ►-V►.
department. I Residential Swimming Pools OWNER OR �A
��������jj�� FIRM NAME c NO
Date //��/LAppl nt Outlets: Rec.—Light Sw. MAIL'
First 20 ADDRESS er
CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY ( Tel No .-z 6 }
COMPENSATION INSURANCE 4ff
PLAN CHECK 0-
A'PPLICANT O
(This section need not be completed if the work involved I 0
by the permit-is .for one hundred dollars ($100) or less.) Lighting Fixtures First 20 ADDRESS
Additional i
I certify that in the performance of the work for which this Total - CITY, Tel No.
Fixed Appplpl iances Not Over 1 HP.,,
permit is issued, I shall not employ any person in any,manner PERMIT W
so as,to become subject to the Workers'Compensation Laws. Range_Heater D.W._ APPLICANT L a
Oven _ Dryer_W.M._ ADDRESSN
to Applicant Top _FAU _W.H.._ 'r. U���1 AL,
Hood —Fan —Other CITY V1�1 c�.N y} Tel No.f�& 787 7
TICE TO APPLICANT: If, after making this Certificate of Disp. —'Room Air Cond— LICENSE O:R
mption, you should become subject to the Workers' REG.NUMBER:/u ?JClass — D
{
pensation provisions of the Labor Code,you must forth- Power Apparatus&Large Appliances DISTRIC . PRO Y
comply with. such provisions or this permit 'shall be i
ed revoked. Size&Type HP,KW,KVA,or KVA X �� ✓
Up to 1 incl. -
FINAL
LICENSED CONTRACTORS DECLARATION ; Over 1 to 10 Incl. DATE
Over 10 to 50 Incl. � 'j � � VALIDATION
by affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL
mmencing with Section 7000)of Division 3 df the Busi- Over 100 BY
►nd•Professions,Code,and my license-is in full force and
S rvices
&-/O 1 "'0-200 Amp.,Under 600 V /OVA 1.•�1''
e e Lic.Class d ' 201-1000 Amp.Under 600.V
site- 2�7�rT Over 1000 Amp.or Over 600 V
HOME OWNER-BUILDER DECLARATION + T dmp.Power Pole&Appurtenances
affirm that I am exempt from the Contractor's ( Sign with One Branch Circuit
aw for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits
ofessions Code):
Misc.Conduits&Conductors
owner of the property, will do the work and the Other(See Complete Fee Schedule)— 1 4 0 7 0.A
.tura is not intended or offered for sale (Section �
4,Business and Professions Code). i
CONSTRUCTION LENDING AGENCY # o o a o 0 2
affirm that there is a construction lending agency i 2 0 0.2.4,5 0
performance of the work for which this permit is
PERMIT FEE (Sub-Total) r2&50'o
ec.3097,Civ.C.). 0 0 0
Name PLAN CHECKING FEE (One-Fourth Permit Fee)
02, 17-81 7-81
Address PERMIT ISSUING FEE
thatI have read this application and state that the I TOTAL FEE
rmation is correct.I agree to comply with all County
d State laws regulating Electrical wiring, and
horiz presentatives of this County to.enter upon
nen tion property for inspection purposes. SE.E'REVERSE FOR EXPLANATORY LANGUAGE '
ermi Date. ,;