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HomeMy Public PortalAbout6035 SULTANA AVE_Electrical__ 76AS63-CESOS 12-SS APPLICATION FOR ELECTRIC PERM IT �. COUNTY OF LOS ANGELES / DEPARTMENT UILD NG AND SAFETY DIVISION ADDRESS C�to JOHN A.LAMBIE,COUNTY ENGINEER CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. PERM FEES OWNER S /3 ITEM NUMBER EACH FEE OUTLETS: / g.10 g MAIL LIGHTS RECEPT. SW. /le � ADDRESS LIGHTING FIXTURES .10 �® CITY � TEL.NO. ELEC.RANGES CLO.DRYERS ELECTRICIAN Sri G C WATER HEATERS .50 ADDRESS r ELEC.SPACE HTRS. DISHWASHERS- CITY �J�/.�- '/TEL.NO. / 6(� rJ GARBAGE DISPOSERS AUTO.- STATE f P l WASHERS STA.COOKING UNITS .25 LICENSE NO. MOTORS: OVER INC. H.P. DISTRICT O. GR ONE P E54SED 0— 1/2 1 •.25 14 1i:- 2 .50 INSPECTION RECO 2— 5 1.00 5— 15 1.50 is— 50 2.50 50-200 5.00 SIGNS: NO.TRANS. NO.LAMPS SERVICE 0-600V 1.00 O SERVICE OVER 600V 5.00 MISC. WIRING PERMIT 1.00 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .50 TOTAL FEE g APPROVALS 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP LICATION DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT ELECTRICAL WIRING. as t rF 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR WIRING LICENSEDAS REQUIRED BY LOS ANGELES COUNTY&D STATE OF FIXTURES CALIFORNIA OR THAT I AM THE LEGAL OWNER F THE ABOVE DESCRIBED RESIDE�LPROPERTY. POWER SIGNATURE -� UTILITY CO.NOTIFIED OF PERMITTEE �� FINAL OF ARTHUR C. VEIT.IUDATION NO CASH SUPERVISING ELECTRICAL ENGINEER 09'.. z Q, DEC 14 2 D 4.9 0 WORKERS'COMPENSAT..IONI)ECLARATION CE-806G (2.80) APPLICATION FOR• ELECTRICAL PERMIT ' r CE-806 I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES 7' BUILDING AND SAFETY insure,or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) Policy NO 0 io`mpanyPaclfic National FOR APPLICANT TO FILL IN JOB 0 New Residential Bldgs.&Pools EACH NO. FEE ADDRESS 6035 SULTANA AVE, cop is hereby furnished.Certified.co Ins. Co 1 &2-Family.Sq. Ft. $ — $ LOCALITY e T © Certified.co Multi-family Sq. Ft. NEAREST copy is.filed with the.c u buildi spection CROSS,ST department.• Residential Swimming Pools OWNER OR ti cmba FIRM NAME �� Date Applica Outlets: Rec,7Li.ght Sw. AIL ' First 2 ADDRESS CERTIFICATE'OF EXE PTION F ORKERS' -Total No. Additional CITY Tel No. COMPENSATION INSURANCE PLAN CL APPLICANTK O (This section need not be completed if the work involved 0 by the permit is for one hundred dollars ($1.00) or less.) Lighting Fixtures First Additional ADDRESS cc Total No. Addition I certify that in the performance of the work for which thisFixed Appliances Not Over 1:HP CITY Tel No. 1� permit is issued, I shall not employ any person in any manner PERMIT U.1 ' so as to become subject to the Workers'Compensation Laws. Range_Heater D.W. _ APPLICANT G & S ELECTRIC a Oven _ Dryer_W.M._ ADDRESS 531 S. Atlantic Blvd. z- Datd Applicant. Top • _ FAU _W.H... Hood — Fan. _Other_ CITY Monterey Parkel No•576-8180 NOTICE TO APPLICANT: If, after making this Certificate of Disp. _Room Air Cond.— LICENSE OR x:10 Exemption, you should become 'subject to the Workers' REG.NUMBER 24805.7 Class Compensation provisions of the Labor Code,you must forth- Power.Apparatus&Large Appliances DISTRICT NO. PROC SSEDRY with comply with such provisions or this permit shall be deemed revoked. Size&Type HP,KW,KVA,or KVAR D Up to 1 Incl: T FINAL X'– LICENSED CONTRACTORS DECLARATION Over-1 to 10.Incl. DATE. VALIDATION .Over 10 to 50 Incl. I hereby affirm that I'am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL BY 9 (commencing with'Section 7000).of Division 3 of the Busi- Over 100 ness. and Professions.Code,and my license is in full force and effect. Services License Number /2"0 5 7 Lic.Class C10 0-200 Amp.Under 600 V . - J . 201-1000 Amp.Under 600 V 97. Contractor Date Over 1000 Amp:or Over 600 V HOME OWNER-BUILDER DECLARATION Temp.Power Pole&Appurtenances I hereby affitm. ,that I am 'exempt from the Contractor's Sign with One Branch.Circuit 1 90 •A License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits � ness and Professions Code): ' .a o•o.•L'., Misc.Conduits&Conductors + E] I. as owner of'the property, will do the work and the Other(See Complete Fee Schedule)— �,''" 3 1.7 5 structure is not intended or offered for sale (Section 7044,Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there isl a construction lending agency. C c; 1 e,_ •-'M2, for.the performgnce of the work'for which this permit is PERMIT FEE (Sub-Total) issued(Sec.3097,Civ:C.). Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) Lender's Address PERMIT ISSUING FEE O SO I certify that I have read this.application and state that the TOTAL`FEE 3/ 7 above info ation is correct.I agree to comply with all County ordinance a State laws reg ting Electrical wiring, and. hereby a h i .representativ this County to enter upon the abov oned propert fo inspecti purposes. SEE'REV ERSE.FOR EXPLANATORY LANGUAGE ignature o V&te