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Home My Public Portal About9641 VAL ST_Electrical__ vvAw DBesA llr° APPLICATION FOR PERMIT DEPARTMENT OFNG AND SAFETY ELECTRIC i COIINTY OFF LOS LOS ANGELES WILLIAM J. FOX. CHIEr ENSINEER FOR APPLICANT TO FILL IN DISTRICyNO. OROIJP ZONE PERMIT NO. S/ ELECTRICIAN ! 11 R[C[IVCD BY READY FOq OAT[ ISSUED t� Z 6 �� FIRST IN�CTI CITY TEL..NO DN _POUMTY LICENSE NO O EXPIRES BUILDING PERMIT FEES ADDRESS t/J r[[ LOCALITY 6 / NUMBER OUTLETS EACH LIGHT Sc NEAREST CROSS BT RECEPTACLES B /2 I IF rIXTURKS B 6 OWNER / r WALL 13WITCHEB 6 MAIL E.LrP RANGES 25 ADDREOB ELEC HEATERS 25 CITY TEL NO HISC 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS NUMBER OF CIRCUITS INSTALLED TCTAI APPLICATION AND STAT[ THAT THE ABOVE IS CORRECT LIGHTS RECEPTACLES AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES MOTORS AND STATE LAWS REGULATING ELECTRICAL WIRING NUMBER HORSEPOWER rtE I CERTIFY THAT I POSSESS THE ABOVE VALID LOS NEw Mw HP RV[R INC E.WH ANGELES COUNTY LICENB[, OR 1 AM THE LEGAL OWNER A L"Ill • ZS OF THE RESIDENTIA.I. PROPERTY DESC SED ABOVE I 7 SO SIGNATURE \�( 1 S 100 PERM B is 1513 INSPECTION RECORD is Bo s Bo SO ZOO Sao 200 600 1000 SDO IDOa 1500 J OVER 1000 1D 00 Z M 0 SET/rREQ CHANGER-HP G WELDERS.AO-KVA R GENERATORS - KW G TRANSFORMERS - KVA TEMP MOTORS (75 OF DRIB) MOVED MOTORS (76 or DRIG) MIRC SIGNS TYPE N6 TRANS MPS APPROVALS ►OR EACH PERMITI DATE1NSPECTOR16 NAM[ WIRING 91,G0 O D CONDUIT — Jr FIXTURES III1 DG e-)t1WIRING SUPPLEMENTARY O FIXTURES �� W POWER TOTAL FEE G UTILITY CO NOTInto rINAL 1 7&MW CIE-BE16(11 78) APPLICATI FOR EL AL PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO PILL IN ADDRESS �� L 1/aL New Residential Bldgs &Pools - EACH NO - FEE DD L—V - - - - -- 1 &2 Family Scl Ft S 025 - S LOCALITY , - e-h4pi 6 GITY Multi Gr;,ly Sg Fr 02 - NEA ST 8 r�rc'ELA Residential Swimming Pools 2500 CROSSWNER R -- -- - Outlets Rec� ',LghtL#-sw FIRM NA sAr,.1UE�- hAA61-u7AiJ First 20 50 ADDR55 '{b VAL Total No •Additional 30 CITY Ur -( 1180 Tel No .4.¢6-4,715 - — PLAN CHECK APPLICANT Lighting Fixtures First 20 50 ADDRESS Total No 4-- Additional 30 CITY_ Tel No Fixed Appliances Not Over l HPRMI �llDIJ�. - ---- - - Range_Hearer_D W APPLICANT Oven_Dryer W M ADDRESS -SAm ---- - - - - Top _FAU —WH _ CITY _ _ _ Tel No a - Rood_Fan -V-Other_ LICENSE OR Dnp Room Air Cond-_ 2 50 REG NUMBER Class _ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO Sae&Type HP KW KVA or OAR COMPLY WITH ALL'COUNTY-ORDINANCES AND STATE LAWS - 2 50 REGULATING ELECTRICAL WIRING O Up to 1 Incl 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 'V Over 1 to 10 Ind 500 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF W Over 10 to 50 Incl 12 50 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE O 25 00 DESCRIBED RE510 TIAL PROPERTY - Over 5010 100 Inc Over 100 4000 - PERMITEE - - O SIGNATURE y, ServicesV/ny�a.�,i-+'ayUrAV/� - DISTRICT N P BY 0 Amp er V 12 50 201 1000 Amp Under 600 V 2500 Over 1000 Amp or Over 600 V 5000 Z Temp Power Pole&Appurtenances 10 00 w Sign with One Branch Circuit _ 1000 po Additional Sign Branch Circuits s 200 _ INSPECTION > 0 0o INFORAAATION '� X0 8 4,8 A Misc Conduits&Conductors REVERSE Other(See Complete Fee Schedule)_ SIDE _ 3 # • • • • • 2 �j 2 • • 4620 • • • 46205 PERMIT FEE ISA Total) 0 PLAN CHECKING FEE (One Fourth Permit Feel 620-80 F PERMIT ISSUING FEE s, t $700 TOTAL FEE �pS t� > INSPECTION FINALED dote „/ A -r- By �� ®s DEC TION WORKERS Ihave COMPENSATION cafe of corse 7� I0r81 APPLICATION FOR ELECTRICAL PERMIT I hereby offnm that 1 have a certificate o5 consent to self a� insure or a certificate of Workers Compensation Insurance COUNTY OF LOS ANGELES BUILDING AND SAFETY or a ce ifiCgd copy Che�af (Sec 38M Lob � C ) aIcy N J093 I13 tampon;[-r Y�'RIWT '�Y FOR APPLICANT TO FILL IN �oB �/ Certified copy is hereby furnished New Residential Bldgs 8 Pools EACH NO FEE ADORES$ 4! G VA1_ S T IYJ Certified copy is filed with the county budding mspec 1 d 2 Family, Sq Ft s — LQXAUTY -rt tion deport Multi Multi family Scl Ft NEAREST Date�f_J V E4-Applicant Residential Swimming Pools i - C R TO" 'G (A NLUD CERTIFICATE OF EXEMPTIO Outlets Rec FROM WORKERS 1 wLight_ZSw FIRM NAMEOR ILIACOMPENSATION INSURANCE ADDRESS (This stolon need not be completed If the work Inn olved by - First 20 \ the pormit Is for one hundred dollars ($100)or less) Total No Additional CITY Tel No PLAN CHECY, I comfy that issued,the performance a the work for which this ICANT L IL I11 permit rserneI shall not employ any person m any n Laws ,_3 '� 1 so as to become subject to the Workers Compensators Laws Lighting Fixtures First 20 ADDRESSiii)L/7Y�/ Total No S _ Additional CITY AM(�pl-p I IQ Tel No LRI Dote Applicant aft fixed Appbgnces Not Over 1 HP PERMIT NOTICE TO APPLICANT If after making this Certificate of APPLICANT Exemption you should become subject to the Worker Range_ Heater_D W Compensation provisions of the Labor Code you must forth Oven _ Dryer .— W M _ ADDRESS with comply with such provisions or this permit shall be _ deemed revoked Hood _ Fan _Other_ CITY Tel No LICENSED CONTRACTORS DECLARATION Dlsp _ Room Air Cored LICENSE OR 6_`�� Clan I hereby affirm that I am licensed under provisions of Chapter 9 REG NUMBER (commencing with Section 7000)of Division 3 of the Business power Apparatus 8 Large Appliance DISTRICT NO D BY dQ and Professions Code and my license is in full force and effect //(/ U Size 8 Type HP KW KVA, VAR V o License Number��L,c Clain UP to 1 FINAL O DATE i -A4 Ov to l0 incl V IDATION F- Contractor Dateor 10 to 50 Incl FI itf ❑ I am exempt under Sec Over 50 to 100 Inc BY a B 8P C for this reason Over 100 CnZ Date Services Swbd MCC&Pa rds 0 -200 Amp U V Signature 201 - 1000 Under MVV ❑ Exemption for Reg Mamt Elect Over 1 Amp or Over 600 V h 61L U A /01 SINGLE FAMILY Temp Power Pole 8 Appurtenances # a • is • • 2 HOME OWNER BUILDER DECLARATION Sign with OneBranch Branch Circuits Branch Circuit I hereby effort that I exempt from the Btw s License Law for the followingg r reason (Section 703131 5,5, Business andd Additional Si Professions Code) ❑ 1 4±8 b Q S I os owner of the property will do the work and the Mnc Conduits 6 Conductors structure is not intended or offered for sole (Section Other(See Complete Fee Schedule)_ ► 7044 Business and Professions Code) CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) (Sec 3097 Civ C ) 'A Y / a. - PLAN CHECKING FEE Lander s Nome �V 7 PERMIT ISSUING FEE Lander s Address I certify that I have read this application and state that the TOTAL FEE q90"2 above mformahon is correct I agree to comply with all County ordinances and State laws regulating Electrical wiring and here y a 11 orize rept sentohve of this County to enter upon the ov - e roperty for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Sign ores of Permittee —�Dote -