HomeMy Public PortalAbout6049 SULTANA AVE_Electrical__ APPLICATION FOR ELECTRICAL PERMIT 'Q
COUNTY OF LOS ANGELES .
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS G
JOHN A.LAMBIE,COUNTY ENGINEER
WILLIAM A.JENSEN.SUPT OF BUILDING LOCALITY 74
FOR APPLICANT TO FILL IN NEAREST /
CROSS ST
PERMIT FEES
OWNER
I TIC M NUMBER EACH FEE MAIL
OL GHTST RECEPT. SW. S.10 $ 0 ADDRESS
LIGHTING FIXTURES .10 CITY TEL.NO ..
ELEC.RANGES CLO.DRYERS ELECTRICIAN
W A E EATER 8 .60 ADDRESS
LEC.SPACE HTRS DISHWASHERS CITY TEL.NO. Cf
RBAGE DISPOSS % AUTO.- STATE
WASHERS STA.COOKING UNITS
.215 D LICENSE NO.
MOTORS: OVER INC. H.P. DISTRICT�0. QRQup NE P OCESSED BY
.29
I.
!/a — 2 .50 z,4 INSPECTION RECORD
2 — s 1.00 }`
O.
5 — is1.50 V
Is — so 2.60 OC
i
NO — 200 5.00 O
bd
SIGNS: NO TRANS. U)
c NO.LAMPS '
Z
SERVICE 0.600V 1.00
SERVICE OVER 600V 5.00
j MISC.
` WIRING PERMIT 1.00 J—r_ L `�U
FIXTURE PERMIT 1.00 f cam] `/rI __ I.A
SUPPLEMENTARY PERMIT .50 ? ,'rggLl ffr
TOTAL FEE. Si3a �'Gj ft/<hee--rep,
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLIC ION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY 9
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT /Z���•-� l� f.�Iv�.
ELECTRICAL WIRING. WIRING
IHEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AM THE •EGAL O OF 81 ABOVE
DESCRIBED RESIDENTI 'ROPE POWER. 1 •�;
1 SIGNATURE �� f', UTILITY CO.NOTIFIED
OF PERMITTE Now ow.mimormw FINA
��k�.IDATI.ON ARTHUR C.VETT.
1 MO CASH SUPERVISING ELECTRICAL ENGINEER '
(`�✓[.[.s'z $ 1 c NOV ?l 2 D 8 A rJ
gel
WORKERS'COMPENSATION DECLARATION 176A663 10/81 APPLICATION FOR ELECTRICAL PERMIT
Kh--,,..by affirm that I have a certificate of consent to self CE-8MG
r a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY
tified copy thereof(Sec. 00, Lab
Policy NiCor pSn � FOR APPLICANT TO FILL.IN
'0B
Certified copy is herebyfurnished. New Residential Bldgs. &Pools EACH NO. FEE ADDRESS
1 &2-Famil S Ft. $ = S LOCALITY
Certified copy is filed with the county building inspect y% q' 'NEAREST
icon d portm t. Multi-family Sq. Ft. CROSS ST.
Date
Residential Swimming Pools OWNFIRMN (+ ./ER O pq c
pplicant I
CERTIF TE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw.� -MAR
COMPENSATION INSURANCE First 20 ADDRESS
(This section need not be completed if the work involved by1 Total No. Additional CITY Tel. r
the permit is for one hundred dollars($100)or less.) PLAN CHECK
I certify that in the performance of the work for which this 'I j APPLICANT
permit is issued, I shall not employ any person in any manner
so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS
Total No. f Additional CITY Tel-,;40.-
Date
el. o.Date ' Applicant Fixed Appliances Not.Over I HP' PERMIT
NOTICE TO APPLICANT: If, after making this Certificate of APPLICA
Exemption, you should become subject to the Workers' I Range_ Heater—D.W. —
Compensation provisions of the Labor Code, you must forth- i Oven _Dryer, M.— ADDRESS 7
with comply with such provisions or this permit shall beTop _ FAU =W.H. —
deemed revoked. I Hood _ Fan _Other_ CI Tel: IVo:
LICENSED CONTRACTORS DECLARATION LICENSE OR
I hereby affirm that 1 am licensed under provisions of Chapter-9 Disp. _ Room Air Cond. REG.NUMBER Class.
(commencing with Section 7000)of Division 3.of the Business DISTRICT NO. PROCESSED BY
and Professions Code,and my license is in full force and effect. Power Apparatus&Large Appliances r„p 0
Size&Type HP, KW, KVA, or KVAR' (�
License Number Lic. Class UP to'1 Incl. DATE
FINAL U
09
Over 1 to 10 jncl: 9ZL 01 ��� VALIDATION O
Contractor DateV
Over 10 to 50 Incl. FINAL �`
I.am exempt under Sec. I Over 50 to 100 Inc. BY 'l -C:7 qr�-vs.�•
B.&P.C. for this reason
Over 100 V
Services,Swbd„ MCC&..Panelboards ► �� .�L�-�"�c—
Pate: 0 -200 Amp. Under 600 V Tr 1W 7
Signature '201 : 1000 Amp. Under 600.V
❑ Over 1000 Amp. or Over 600 V
Exemption for Reg. Malnt. Elect: '
1
I SINGLE FAMILY Temp. Power Pole&Appurtenances
HOME OWNER-BUILDER DECLARATION ' Sign with One Branch Circuit
I hereby affirm that I am exempt from the Contractor's License Additional Sign Branch Circuits
Law for the following reason (Section 7031..5, Business and
Professions Code): 6 G p
Misc. Conduits&Conductors ,
I, as owner of the property, will do the work and the Other(See Complete Fee Schedule)_ 0 0 0 0 0
ffr
structure is not intended or offered for sale (Section
7044, Business and.Professions Code). I , 0 0 2 75 2 c
CONSTRUCTION LENDING AGENCY 0 0 0 23256
I hereby affirm that there is a construction lending agency for I
the performance of the work for which this permit is issued I PERMIT FEE (Sub-Total) �.'� -6_
(Sec. 3097, Civ, C.).
83
PLAN CHECKING FEE
Lender's Name
PERMIT ISSUING FEE
Lender's Address
I certify that I have read this application and state that the TOTAL FEE: .
above information is correct. I agree to comply with all County 11
ordinances and State laws regulating Electrical wiring, and
here µ ze repres tives of this County to enter upon
e above-me a property r tnspec` urposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
ignature Per. . tt Date
1