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Home My Public Portal About6245 SULTANA AVE_Electrical__ GA668-CE000 10-62 APPLICATION F R ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT UILD NG AND SAFETYDIVISIONENGINEER BUILDING DD Ess 4-119MS�. r��d /�rjo� �Cre+,Tr. JOHN A. LAMBIE. COUNTY ENGINEER WILLIAM A.JENSEN,SUP'T OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST.. LO RECEPT. 'a�' TOTAL NO. EACH FEE OUT FIRST ZO E.20 OWNER Qilp LIGHT / O'O swlrcll. //aFy MAIL ADD'L ADDRESS /V OVER 2O �� .10 3 (pio TOTAL 4 O0 CITY TEL.NO. LIGHTING FIRST TO .20 ✓ /' FIXTURES ADD'L 10 ELECTRICIAN 69 1 C OVER 2O RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS /0 72 X 40 4 GARB.DISP.Y STA.COOK CITY Cl /104TEL.NO. 4 Q DISHWASH. AUTO.-WASH. STATE 6 S-3SPACE HTRS.7 STA.APP.(y=H.P.MAX.j .50 LICENSE NO. A d MOTORS: OVER NOT OVER H.P. DISTRIC O. G OUP XNE I P MCESSEDBY O 1 1.00 ( //�" 1 s 1.50 INSPECTION RECORD s s 2.00 n.n 8 is 2.50 8 ac 1s 50 8.00 O so 100 5.00 9 o. SIGNS: NO.TRANS. f NO.LAMPS z SERVICE 0.60OV-Nor OVER 200A 1.00 VQ SERVICE 0.60OV-OVER 200 A. 2.00 SERVICE OVER 600V 5.00 . MISC. PERMIT ISSUING FEE 2.00 SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE $ IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLIC ION APPROVALS DATE INBPECTOR'881GNATURB AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND _STATE LAWS REGULATING ELECTRICAL WIRING. WIRING !r 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR ii LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES A; �v�/ 1� CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL RTY. POWER /J •, SIGNATURE UTILITY CO.NOTIFIED D'3 _ iP1!/L i" OF PERMITTEE S / J / FINAL /v` 5"/, > I�aC��LW�Yvt•� �LIDATION ARTHUR C. VEIT CK MO CASH SUPERVISING ELECTRICAL ENGINEER L&864 4t; AUG 8 _ 2 D_ _ 1 4.6 0~ � ' - l WORKER'S COMPENSATION DECLARATION 76A6s3 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to salt insure, or a certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy th re��'off(Sea 3BO(Ytab.C.) �i'i�P� Policy No.i3 2437 Company '5V_TM-• 170�-Q FOR APPLICANT TO FILL IN JOB � ADDRESS 2�t5 certified copy ia hereby furnished. `/.--m. 1V New Residential Bldgs.&Pools NO. EACH FEE LOCALITY — Certified copy is filed with the county1&2-Family,Sq.Ft. $ $ ilding inspection NEAREST �..�p department. Multi-family Sq.Ft. CROSS ST. VGF� Date Z Applican X esldential Swimming Pools ASSESSOR MAP BOOK PAGE PARCEL 4�CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec._Light Sw.. OR M NAME COMPENSATION INSURANCE (This section need not be completed If the work Involved by the First io ADDRESS permit Is for one hundred dollars($100)or less.) Total No. Additional �� I certify that in the performance of the work for which this permit CITY, Tel.No. ' Z4 is issued, I shall not employ any person in any manner so as toPLAN CHEC become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANT w rJF_ Date Applicant Total No. Additional ADDRESS 2_41 Lx,— � RESIDENTIAL APPLIANCES NOT OVER 3 HP. AV NOTICE TO APPLICANT: If, after making this Certificate of CITYA'�''�^Pt Tel.No Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code,you must forthwith comply with such PERMIT �. provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances APPLICANT LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS '7,,AJ kkw— I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. (commencing with Section 7000) of Division 3 of the Business and CITY Tel.No. <* Professions Code,and Jny license is in full force and effect. Over 10 to 50 Incl. Over 50 to 100 Incl. LICENSE Class >" REG.NUMBB ER d r'�+ ®1� Over 100 DISTRICT NO. P O SED BY v License Number i 3��Lic.Class 1 0 y� Q `�yy��','p�� rr g Services,Swbd.,MCC& an bo rd - G Contractor W�,t�"`( w Z .i 0-399 A� der� �� DATE F1 I am exempt under Sec. 400-1000 Amp.Under 600 V VALIDATION V Over 1000 Amp.or Over 600 V FINA W B.&P.C.for this reason BRANCH CIRCUIT FEES BY YffCL Date: 15A,or 20A,120V,Lighting or Recept. Z 1 To 10 Branch Circuits - Signature 11 To 40 Branch Circuits , ^rjj ` ❑ 41 Or More Branch Circuits Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits 1: SINGLE FAMILY Temp.Power Pole&Appurtenances r Q HOME OWNER-BUILDER DECLARATION ri:• !or I hereby affirm that I am exempt from the Contractor's License Law Sign with One Branch Circuit for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits 3130 iz+;ti Code): .s N., r_1 1,as owner of the property,will do the work and the structure Misc.Conduits&Conductors _ 1 I: is not intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule) ® I I ISL 61 -65 and Professions Code). /('.L� r: ,. r-. 4f1L1�\ i'io�f:• CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the CHANGE 'I]E performance of the work for which this permit is issued(Sec. 3097, PERMIT FEE (Sub-Total) Civ.C.) _ (��s �� PLAN CHECKING FEE 00010 3-t,00 6 (%5„ Lender's Name 1� - at PERMIT ISSUING FEE �� 0112 1 AM 2:44 Lender's Address I certify that I have read this application and under penalty of purjury state TOTAL FEE that the above Information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring,and hereby authorize representatives of this County to enter upon the above-mentioned property for inspect' purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE X 7- I A ER TTE AT WORKER'S COMPENSATION DECLARATION 720-0019 6A663 DPW(12-97) APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self insure, or a certificateof Work�r's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy tVreof,(See:,3600 F. C.) �r AA�[4� Policy No. Company �i+ El 1 N� FOR APPLICANT TO FILL IN JOB �7 C` ADDRESS G+ 5 Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE LOCALITY Certified copy is filed with the county b ilding inspe 1 &2-Family,Sq.Ft. _ $ $ NEAREST M •- de artment ulti-family Sq.Ft. — CROSS ST. QpW Date Applica esidential Swimming Pools ASSESSOR MAP BOOK PAGE PARCEL CERTI CAT'OF EXEMPTION FROM WORKERS' Outlets:Rec._Light Sw. OWNER OR COMPENSATION INSURANCE FIRM NAME First 20M Al (This section need not be completed if the work Involved by the Total No. Additional ADDRESS 4 /[ 5b Ft permit Is for one hundred dollars($100)or less.) I certify that in the performance of the work for which this permit CI c3 Tel.No. is issued, I shall not employ any person in any manner so as to PLAN CHECK become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 APPLICANT Total No. Additional ADDRESS 24 d9 LEE- &M Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP. n� NOTICE TO APPLICANT: If, after making this Certificate of CITY 1�A%0 Tel.N Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code, you must forthwith comply with such APPLI ANT L&JQMJC r-_ IC ' provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS-241!2LJU—= I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. (commencing with Section 7000)of Division 3 of the Business and CITYTel.No. Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. A-Qr_AQA >_LICENSE OR Class. Over 50 to 100 Incl. REG.NUMBER a. O CCCS d Over 100 DISTRICT NO. PROC SED BY License Number )/ Lie.Class C n V ,,� .��..� �c r� Services,Swbd.,MCC&Panelboardsi Contracto,�jir I�t�e 4 3 0-399 Amp.Under 600 V DATE O El I am exempt under Sec. 400-1000 Amp.Under 600 V W Over 1000 Amp.or Over 600 V FINAL VALIDATION fl. B.&P.C.for this reasonBY BRANCH CIRCUIT FEES vv Date: 15A,or 20A,120V,Lighting or Recept. Z Signature 1 To 10 Branch Circuits 11 To 40 Branch Circuits F-141 Or More Branch Circuits Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits I Y SINGLE FAMILY Temp.Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ACC j°v I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits ��.I?�, i)� Code): # ITEMS ❑ I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors _OT ,r-;, is not intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule) t IJ I A�. a 1-I' and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the ' CHANGE °1'113 performance of the work for which this permit is Issued(Sec. 3097, PERMIT FEE (Sub-Total) Civ.C.) ��/� PLAN CHECKING FEE 0000-00011A�l2 f-�f_ Lender's Name o�� y� PERMIT ISSUING FEE a 13430 f AN 7°° .tib Lender's Address I certify that I have read this application and under penalty of purjury state TOTAL FEE that the above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring,and hereby authorize representatives of this County to enter upon th above-mentioned rope for inspect i urpo es. SEE REVERSE FOR EXPLANATORY LANGUAGE Y� 7 G F PERMITTEEATE