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Home My Public Portal About6345 SULTANA AVE_Electrical__ 75A668_CES0612-58-APPLICATION FOR ELECTRIC PERMIT •��' -� '--��. COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING �� 1 BUILDING AND SAFETY DIVISION ADDRESS JOHN A.LAMBIE,COUNTY ENGINEER CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST PERMIT FEES OWNER ITEM NUMBER EACH FEE OUTLETS: 5 g MAIL LIGHTS RECEPT. SW.: .10 ADDRESS LIGHTING FIXTURES .10 CITY TEL. ELEC.RANGES CLO.DRYERS // r ELECTRICIAN r WATER HEATERS .50 D ADDRE ELEC.SPACE HTRS. DISHWASHERS CITY TEL.NO. GARBAGE DISPOSERS AUTO.- STATE- WASHERS STA.COOKING UNITS .25 1 LICENSE NO. MOTORS: OVER INC. H.P. DISTRIC O. 1 G P I ZONE P CESSE BY 0.— '/a .25 2/2— 2 .50 INSPECTION RECORD 2— 5 1.00 5— 15 1.50 15— 50 2.50 50 200 5.00 SIGNS: NO.TRANS. / rn / 23- NO.LAMPS "C-Ir kv—p _�, ` !hl"' SERVICE 0-60OV 1.00 l a OC/�wl r A47- SERVICE OVER 600V 5.00 F �� .7- M - MISC. L Y /� D r' lot T'' � • WIRING PERMIT 1.00 L p FIXTURE PERMIT 1.00 /fall✓/moi /�`J�Yf� SUPPLEMENTARY PERMIT .50 TOTAL FEE APPROVALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION 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. WIRING ` I I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR CE LINSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT' I AM THE EGAL NER OF THE ABOVE DESCRIBED RESIDENT PER POWER ! SIGNATURE UTILITY CO.NOTIFIED !� OF PERMITT FINAL �FXIMDATION ARTHU C. VETT. CK MG CASH SUPERVISING ELECTRICAL ENGINEER 1tr069741A i`iAy25 2A 2.50 �° WORKERS'COMPENSATION DECLARATION 76A683 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have•a certificate of cogsent to self insure, CLE-806G o;ii'certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec.3800,Lab.C.) Policy No. Company FOR APPLICANT TO FILL IN JOB 6-:5446 S /��i!� /l`�"r`E ❑ EACH NO. FEE ADDRESS L/ ,V Y Y 'lr CG Certified copy is hereby furnished. New Residential Bldgs.&Pools $ _ $ T /Vf�L� elry Certi1 &2-Family,Sq.Ft. LOCALITY II,,,, �1Zr department ed copy is filed with the county building inspection Multi-family Sq.Ft. CROS ST. /'Y�� y �/ Date Applicant , Residential Swimming Pools OWNER OR CERTIFICATE OF EXEMPTION FROM WORKERS' Outliets:Rec—Light�' f� FMAIL IRM NAME /�/�POL0° o�LGG` l 0 _ COMPENSATION INSURANCE ADDRESS 03//S03//S o 1*177-AIA Y4 V,1r1V� (This section need not be completed If the work Involved by the I Firstt 2 20 permit is for one hundred dollars($100)or less.) Total No. � Additional CITY HECK �� Tel.No�&/� � 1 certify that in the performance of the work for which this permit APPC LI CANETCK is issued, I shall not employ any person in any manner so as to become subject to the Workers'Com ation Laws. Lighting Fixtures First 20 11 ADDRESS 1 Total No._� Additional CITY Tel.No. Date a"'r' Applicant �1 Appliances Not Over 1 HP PERMIT t NOTICE TO A PLICANT: If, aft aking this Certificate of APPLICANTA/7 �i6w1+`; �f� 0• Q0d ��e Exemption,you should become subje to the Workers'Compensation Range_ Heater D.W. _ provisions of the Labor Code,you must forthwith comply with such Oven _ Dryer W.M. ADDRESS provisions or this permit shall be deemed revoked. Top _ FAU W.H. _ &S LICENSED CONTRACTORS DECLARATION Hood — Fan Other r��l/ CITY ��„�//�[ Tel.No. I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. REG NUMBER LICENSE OR Class. (commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. power Apparatus&Large Appliances DISTRICT NO. PRO ESE BY Size&Type HP,KW,KVA,or KVAR ( � 0 License Number Lic.Class Up to 1 Incl. FINAL V Over 1 to 10 Incl. DATE IIZ Contractor Date VALIDATION Over 10 to 50 Incl. FINAL V ❑ I am exempt under Sec. Over 50 to 100 Inc. BY W I Over 100 �- BAP.C.for this reasonI fn Services,Swbd.,MCC&Panelboards ® Z Date: I 0-200 Amp.Under 600 Vovvv Signature 201 - 1000 Amp.Under 600 V ❑ Exemption for Reg.Maint.Elect. Over 1000 Amp.or Over 600 V n SINGLE FAMILY Temp.Power Pole&Appurtenances ` HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ACCTAF v I hereby affirm that I am exempt from the Contractor's License Law Additional Sin Branch Circuits -� "'� for the following reason(Section 7031.5,Business and Professions g 33177 b5 o DEVI Code): 1 ITEMS ❑ Misc.Conduits&Conductors I,as owner of the property,will do the work and the structure Other(See Complete Fee Schedule) _ ' TOTAL , �� is not intended or offered for sale (Section 7044, Business ® o and Professions Code). CHECK 65.00 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the CHANGE Or ,� e performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub Total) Civ.C.). PLAN CHECKING FEE , 0000_0001 7/20/9(7 Lender's Name PERMIT ISSUING FEE 1943 1 Art 7=14 Lender's Address I certify that I have read this application and state that the above TOTAL FEE 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 j proforfor i tion�urpo-� a. ' I SEE REVERSE FOR EXPLANATORY LANGUAGE S' tura of Permittee �e� WORKERS'COMPENSATION DECLARATION �CE-S 613 (2-80) APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self I COUNTY OF LOS ANGELESBUILDING AND SAFETY insure,or a certificate of Workers'Cimppensation Ins nce,or 80 C:�% . FOR APPLICANT TO FILL IN JOB P1, y No. Compa EACH NO. FEE ADDRESS New Residential Bldgs.&Pools Certified copy is heSeby furnished. 1 &2-Family,Sq. Ft. $ —' $ LOCALITY oe Certified co g inspection Multi-family Sq. Ft. — NEAREST 42 6--py is filed with the county buildin Residential Swimming CROSS ST department. g Pools ff B c OWNER OR Date Applicant gQ otr L/I��- �i FIRM NAME Z_ Outlets: Rec// Lighti sw2 [� gDDRESS -15 0/ ! CERTIFICATE OF EXEMPTION FROM WORKERS' Total No.L Additional CITY COMPENSATION INSURANCE PLAN CHECK d (This section need not be completed if the work involved APPLICANT L V Lighting Fixtu es First 20 �� by the permit is for one hundred dollars ($100) of less.) Total No. Additional ADDRESS969:r=6 u2g2cuo cc I certify that in the performance of the wbrk for which this CITY Tel No. Q permit is issued, I shall not employ any person in any manner Fixed Appliances Not Over 1 HP PERMIT V so as to become subject to the Workers'Compensation Laws. Range_Heater D.W. _ APPLICANT ,f Z LU Ovpn = AU Dryer .H. O. = ADDRESS -- � � � c Date Applicant Hood _ Fan jt Other CITY _ p £, el No. r N r�, ek NOTICE TO APPLICANT: If, after making this Certificate of Disp.. _Room Air Cond.— r�fJ / LICEN EOR Exemption, you should become subject to the Workers' REG.NUMBER Class Compensation provisions of the Labor Code,you must forth- Power Apparatus&Large Appliances DISTRICT NO. E BY with comply with such provisions or this permit shall be Size&Type HP,KW,KVA,or KVAR � 00 deemed revoked. Up to 1 Incl. FINAL L/ Over 1 to 10 Incl. DATE LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl. VALIDATION I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL #i 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 vvv effect. Services License Number Lic.Class- CCJJJ(((,/f 0-200 Amp.Under 600 V 1 �l.�/ �'r'J 201-1000 Amp.Under 600 V Contractor/ ArCPCL Z Data Over 1000 Amp.or Over 600 V HON bW'NER-BUILDER DECLARATION Temp.Power Pole&Appurtenances s I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit License Law for the following reason (Section 7031.5, Busi- Additional Sign Branch Circuits ness and Professions Code): ti Misc.Conduits&Conductors I, as owner of the property, will do the work and the Other(See Complete Fee Schedule)— + •+ +: structure is not intended or offered for sale (Section 7044,Business and Professions Code). + n .• t �, CONSTRUCTION LENDING AGENCY ereby affirm that there is a construction lending agency the performance of the work for which this permit is PERMIT FEE (Sub-Total) 3d(Sec.3097,Civ.C.).. der's Name PLAN CHECKING FEE (One-Fourth Permit Fee) der's Address PERMIT ISSUING FEE •tify that I have read this application and state that the TOTAL FEE e information is correct.I agree to comply with all County ►ances and State laws regulating Electrical wiring, and )y authorize representatives of this County to enter upon bove-mention pi pe y for i action purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE ignatu o mittee fDatef I