HomeMy Public PortalAbout6326 SULTANA AVE_Electrical__ 8A689_CE806-B.B7 APPLICATION F'.O R E LE CT R I C P E R M.I t
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDREss -�
JOHN A.LAMBIE,COUNTY ENGINEER
CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY s
FOR APPLICANT TO FILL INcRoss ST.
PERNBT FMS
OW
ITEM NUMBER NER EACH RSB -
OUTLETS: $ $ MAIL
LIGHTS RECEPT. SW. .10 ADDRESS.
LIGHTING FIXTURES .10CITY / - ! i
STEL.NO:'
ELEC.RANGES CLO.DRYERS - ELECTRICIAN ��_•• �.�. _
WATER HEATERS .SO '�� (+J �•
ELEC.SPACE HTRS. DISHWASHERS
ADDRES/S'✓ �,/ ry
GARBAGE DISPOSERS -AUTO.-
't-
CITY �.t� 'L' TSL.NO.`'"�i1 �4 /
STATE �•
WASHERS STA.COOKING UNITS_ .28 LICENSE NO.
MOTORS: OVER INC. H.P.
D S RICN GR ZON� READY FOR INSP80TION
0— 1/a .28
1/2— 2
DWEC1TION RECORD
2 — 8 1.00
is — 18 1.80
1S — s0 2.80
50— .200 8.00
SIGNS: NO.TRANS.
NO.LAMPS
SERVICE.0-600V 1.00
SERVICE OVER 600V 8.00
MISC.
WIRING PERMIT .1.00
FIXTURE PERMIT 1.00
SUPPLEMENTARY PERMIT .80
TOTAL FEE (o APPROVALS
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION DATE INSPECTOR'SSIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
I HEREBY CERTIFY THAT. I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I.AN THE GALA-W ER OF THE ABOVE POWER.
DESCRIBED RESIDENT-IAA ROPE TY.
SIGNATURE :f�\ :v / 'V` UTILITY CO.NOTIFIED
OFPERM -
FINAL
–-- MATION ARTHUR C.VETT.
NQ CASH SUPERYiS1NG ELECTRICAL ENGINEER
DEC
TION
Worm that
I have a cerci cafe of corse 20.0t)19DPW 3/87 APPLOC ° MN FOR EdC�C UC AL PERNT
.� I hereby affirm that I have a certificate of consent to self CE"aoM6G
i re, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS
or,V.de,(tffied copy thereof(Sec. 3800, Lab..C.)
Policy No Company I FOR APPLICANT TO FILL IN JOB
Certified copy is hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE ADDRESS 227 L GI e .
0 Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. $ — $ LOCALITY ��
tion department. Multi-family Sq. Ft. — NEAREST ,
Residential Swimming Pools CROSS ST. l)If7 O,S"a
OWNER OR
Date Applicant a FIRM.NAME 0 v
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec !1 Light�Sw. ?v AMALDDRESS 2
COMPENSATION INSURANCE SGS
First 20 'M
(This section need not be completed if the work involved by Total No., Additional a— CITY �. RICL Tel. No. _a .
the permit is for one hundred dollars($100)or less.) PLAN CHECK
I certify that in the performance of the work for which this 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
Additional
Date Applicant Total No. �O CITY Tel. No.
NOTICE TO APPLICANT: If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT
Exemption, you should become subject to the Workers' Range— Heater—D.W. — APPLICATION
Compensation provisions of the Labor Code, you must forth- Oven — Dryer W.M.— ADDRESS 44-1
with comply with such provisions or this permit shall be Top — FAU �W.H. —
deemed revoked. Hood — Fandtof Other— CITY Tel. No.
LICENSED CONTRACTORS DECLARATION LICENSE OR
Disp. _ Room Air Cond. REG.NUMBER Class.
I hereby affirm that I.am licensed under provisions of Chapter 9
(commencing with Section 7000)of Division 3 of the Business Power Apparatus&Large Appliances DISTRICT NO.— =:La
>_
and Professions Code,and my license is in full force and effect. d U� O
Size&Type HP KW*, K,,V,AA or KVAR
License Number Lic. Class 3Wi"4 k'd- Up to 1 In--c7:"j Z. FINA . V
Contractor Date Over 1 to 10 Incl. r DATE 2� VALIDATION 0
❑ Over 10 to 50 Incl. FIN U
I am exempt under Sec. Over 50 to 100 Inc. BYzw��kj LU
B.&P.C. for this reason Over 100 a.
Date:
Services, Swbd., MCC&Panelboards � > Z
0-200 Amp. Under 600 V
Signature 201 - 1000 Amp. Under 600 V Id
Over 1000 Amp. or Over 600 V -.. a
Exemption for Reg. Maint. Elect. ;��,•, ,s
SINGLE FAMILY Tem Power Pole 8 Appurtenances �._ - ^.
HOME OWNER-BUILDER DECLARATION p' pp �4_a�L•
I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit
Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits
Professions Code): _ :rfi 243 o 20
Conduits&Conductors
I, as owner of the property, will do the work and the Misc. - •• . ,;,7�oa:.l_
structure is not intended or offered for sale(Section 7044, Other(See Complete Fee Schedule)_ _
Business and Professions Code).
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency forf�i
the performance of the work for which this permit is issued PERMIT FEE (Sub-Total)
(Sec. 3097, Civ. C.).
PLAN CHECKING FEE
Lender's Name
PERMIT ISSUING FEE
Lender's Address TOTAL FEE 3
I certify that I have read this application and state 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
theabove-m ntione,^,d prop/perty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Permittee Date
,