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HomeMy Public PortalAbout9206 WEDGEWOOD ST_Electrical__ DBS 5-A 12-44 i• , DEPARTMENT OF -BUMI)ING AND SAFETY' APPLiCt�TI011T FOR PERMIT. : .COUNTY OF LOS MGELES 'S" ELECTRIC WM..J. FOX CHIEF ENGINEER 1 Z /� { DISTRICT NO. GROUP 'ZONE PERMIT NO. NAME U 7 57S ADDRESS t ME:Fslft U 'RECEIVED BY READY FOR DATE 188UED W COUNTY ,� 4� TEL.NO. 1 J d /C FIRST INSPECTION CERT.NO. Id' / EXPIRES APPLICANT FILL: IIEAV LY OUTLINED PORTION ONLY„JOB ' DESCRIPTION.OF WORD 'ADDRESS Af 6 ,0f/ fr NUMBER OF OUTLETS ON CIRCUITS LOCALITY LOCATION BY ROOMS ` NEAREST ski• LIGHT OUTLETS SW. PLUGS FWT CROSS ST. CIRCUIT A, B C D E yF G H m .NAME _/p, 1 AD RMAIL E58 E) q /"zr TJJ�e.'�c6�iP' ryq 1 CITY TEL.NO. I AM THE I EGAI. .POSSESSOR OF THE ABOVE LOS • '. ANGELES,COUNTY CERT I 16 OF. UALIFICATION.'. Adam; ' ELECTR IAN. I AM 7HE LEGAL OWNER OF THR PROPERTY D CRIBED .. OWNER. CORRECTIOmB' J Z TOTAL ®y b� •NO.OF OUTLETS S. APPROVALS. I NO. OF FIXTURES DATE- INSPECTOR'S NAME NO: OF MOTORS' H.P. ffi CONDUIT 1 A ti NO. OF SIGNS TRANS. ffi WIRING �� , i✓�/�` NO. OF RANGES OR HEATERS ffi rFIXTURES. MISCELLANEOUS ffi POWER a PERMIT FEE ffi � UTILITY CO.NOTIFIED WORKERS'COMPENSATION DECLARATION CE-808G'-803 10/81r CAPPLICATION FOR ELECTRICAL PERMIT I hereby affirm that i have a certificate of consent to self insure; �� or a certificate of Workers' Compensation Insurance, or a certified CdbNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec.3800,Lab.C.) Policy NO. Company FOR APPLICANT TO FILL IN I JOB ❑ EACH N0. FEE ADDRESS Ir IF Certified copy is hereby furnished. New Residential Bldgs.&Pools LOCALITY ❑ Certified copy is filed with the county building inspection 1 &2-Family,Sq.Ft. $ _ $ department. Multi-family Sq.Ft. NEAREST • CROSS 3T. Date Applicant Residential Swimming Pools OWNER OR FlRM NAME. ur CERTIFICATE OF EXEMPTION FROM WORKERS' 1' MAIL Outlets:Rec_Light_Sw.— COMPENSATION INSURANCE r y ADDRESS (This section need not be completed If the work involved by the t First 20 permit is for one hundred dollars($100)or less.). I Total No. Additional CITY `� Tel.No. I certify that in the performance of the work for which this permit + PLAN CHECK J is issued, I.shall not employ any person,in any manner so as to APPLICANT become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS; i Additional Total No. I CITY Tel.No. Date Applicant f Fixed Appliances Not Over 1 HP 7 PERMIT NOTICE TO APPLICANT: If, after making this Certificate of i Exemption,you should become subject to the Workers'Compensation I Range_ Heater_ D.W. _ APPLICANT 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. LICENSED CONTRACTORS DECLARATION • 'Hood _ Fan _ Other_ CITY V T.I.No. I hereby affirm that I am licensed under provisions of Chapter 9 Disp. —. Room Air Cond. LICENSE OR Class (commencing with Section 7000)of Division 3 of the Business and II REG..NUMBER i Professions Code,and my license is.in full force and effect. I power Apparatus&.Large Appliances y DISTRICT N P ES j Size&Type HP,KW,KVA,or KVAR. (� Q License Number Lic.-Clads Up to 1 Incl. FINAL. V I Over 1 to•10 Inc[. DATE O Contractor Date .• VALIDATION Over 10 to 50 Incl. FINAL 0 o❑ I am exempt under S(c. ;I Over 50 to 100 Inc. BY . W BAP.C.for this reason i Over 100. VAO Services,Swbd:,MCC&Panelboards Date: j� 0-200 Amp.Under 600 V ® d Signature 11' 201 - 1000 Amp.Under 600 V f Over 1000 Amp.or Over 600 V i ❑ 'Exemption for Reg.Maint.Elect: SINGLE FAMILY1; Temp.Power Pole&Appurtenances 2 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 7 3 I hereby affirm that I am exempt from the Contractor's License Law ACOT.a for the following reason(Section 7031.5,Business and Professions; Additional Sign Branch Circuits i Code): 3307 33.00 El 1, Conduits&Conductors 1 ITEMS I,as owner of the property,will do the work and the structure Other(See Complete Fee Schedule) _ is not:intended or offered for sale (Section 7044, Business ® _ �3 and Professions Code). 1 S TOTAL �` s 00 CONSTRUCTION LENDING AGENCY CASH X3.00 I hereby.affirm that there is a construction lending agency for the'r I, " 'HAN .0L1 performance of the work for which this permit is.issued(Sec.3097,•,• ,PERMIT FEE (Sub Total) Civ.C.). PLAN CHECKING FEE Lender's Name I ! 0000-0001 10/19/90 PERMIT ISSUING FEE Lender's Address 3408 1 ACI 81-1, 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 property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE I � ?-( ,q � 1 111d6ature of ftrmiftee Date •� ;� _ �.,nw.�-_.,, 3 ttUVORKERS'COAAPENSATION DECLARATION 76-61'0/81 APPLICATION FOR ELECTRICAL PERMIT f�ereby affirm that CE-80606G I have a certificate of consent to'self insure, , or a certificate of Workers' Compensation Insurance, or a certified I COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec.3800,Lab.C.) Policy No. Company FOR APPLICANT TO FILL IN JOB ❑ Certified copy is hereby furnished. I EACH NO. FEE ADORES �Q New Residential Bldgs.8'Pools ❑ 1 1£2-Famil — LOCALITY 'Certified copy is filed with the county building inspection � y,.Sq.Ft. $ —Is f department. Multi-family Sq.Ft. NEARESTCROSS ST. Date Applicant Residential Swimming Pools. OWNER OR ! FIRM NAME LW11,0 k, CERTIFICATE OF EXEMPTION FROM WORKERS' OutletsRec—Light_Sw.— MAIL VLN (This section need not be completed if the work Involved by the First 20 � permit Is for one hundred dollars($100)or less.) Total No. Additional CITY � Tel.No. I certify that in the.performance of the work for which this permit PLLANLICANT 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 �r�,„ � Additional - `�Dat 2 Applicant Oma"" �' mss' �' Tot/l No.. CITY; Tel,No: Fixed Appliances Not Over 1 HP NOTICE O APPLICANT: If, after making this,Certificate of PERMIT Exemption,you should become subject to.the Workers'Compensation Range_ Heater D.W. APPLICANT provisions of the Labor'Code,you,must forthwith comply with such Ove _ .Dryer_ W.M._ ADDRESS . provisions.or this permit shall be deemed revoked. Top: FAU W.H. LICENSED CONTRACTORS DECLARATION Hood —. Fan Other_ CITY Tel.No. I hereby affirm that I am licensed under-provisions of Chapter 9 LICENSE OR (commencing with Section 7000)of Division 3 of the Business and Disp.. Room Air Cond. REG.NUMBER Class. Professions Code,and my license.is in full force and effect. Power l DISTRICT fdC. PROCESSED BY �pparatus&Large Appliances Siz &'Type HP,KW,KVA,or KVAR J O License Number Lie.Class ' Up to,1 Incl. FINAL II -Over'1 to 10 Incl. DATE EI 0 Contractor Date IDAT N G Over 1.0 to 50 Incl. FINAL � / ❑ ' I am exempt under Sec. �� Over 50 to 100 Inc. gY ✓ Over'100 N B.BP.C.for this reason rvice Ses,Swbd.,MCC&Panelboards Z ,j Date: QQI 200 Amp.Under 600 V © r' Signature 201 - 1000 Amp.Under 600 V ❑ Over 1000 Amp.or Over 600 V Il ; Exemption for Reg.M.aint.Elect. SINGLE FAMILY Temp. ,I r Pole&Appurtenances � HOME OWNER-BUILDER DECLARATION Sign wjh One Branch Circuit ; d I hereby affirm.that I am.exempt from the Contractor's License Law d II ACCTA f�aehe following reason(Section 7031.5,Business and Professions Additio.�all Sign Branch Circuits 07 fJaV )) 25.50Misc.GPnduits A Conductors 1 I fs` I,as owner of the property,will do the work and the.structure See Complete Fee Schedule) _ �y•� is not.intended or offered for sale (Section 7044, Business Other(I poloIj T,�lAL20 5.5 end Professions Code). CONSTRUCTION LENDING AGENCY I CAM 25050 I.hereby affirm that.there is a.construction lending agency for the I ' O nOD performance of the work foe-which this permit is issued(Sec.3097, PERMIT FEE (Sub Total) , Civ.C.). I PLAN aHECKING FEE , M-MI 7/24/89 • Lender's'Name �� ' • PERMIT ISSUING FEE 4644 1 Ria, Lender's Address- ;l. 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 repressritatives of this County to enter upon the above-mentioned I , property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date •, • WORKERS'COMPENSATION DECLARATION 78-883 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a'certifjcate�of consent to"s"insure, • CE-806G yor a-certificate'of Workers' Compensation Insurance or a eeriified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec.319%.Lab.C.)" •, ° Policy No. Company , FOR APPLICANT TO FILL IN JOB ❑ Certified copy is hereby furnished. EACH NO. FEE ADDRESS New Residential Bldgs.&Pools ❑ 1 &2-Family,Sq.Ft. $ — $ LOCALITY Certified copy is filed with the county building inspection I NEAREST department. Multi-family Sq.Ft. CROSS ST. Date Applicant Residential Swimming Pools OWNER OR FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' ' MAIL Outlets:Rec Light Sw. r COMPENSATION INSURANCE ADDRESS D4 (This section need not be completed if the work Involved by the -0 First 20 CITY '� Tel. permit is for one hundred dollars($100)or less.) Total No. Additional I certifyy that in the performance of the work for which this permit APPLICANT K OOF 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 at Total No._�� CITY Tel.No. ' Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT Exemption,you should become subject 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. _ CITY, Tel.No. LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other_ I,hereby affirm that I am licensed under provisions of Chapter 9 LICENSE OR Disp. - Room Air Cond. REG.NUMBER 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 l r./ P SED B Size&Type HP,KW,KVA,or KVAR Q License Number Lic.Class Up to 1 Incl, .FINAL U BY Over 1 to. 10 Incl. DATE , 0 Contractor Date G VALIDATION ElOver 10 to 50 Incl. FINAL I am exempt under Sec. Over 50 to 100 Inc: i2BAP.C.for this reason Over 100 Services,Swbd.,MCC&Panelboards ® Z Date: 0-200 Amp.Under 600 V Signature 201 - 1000 Amp.Under 600 V ❑ Over 1000 Amp.or Over 600 V Exemption for Reg.M.aint.Elect. SINGLE FAMILY Temp.Power Pole&Appurtenances ry HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit zd 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 ACCTeg�. Code): �, -• 337.70 El I, Conduits&Conductors 3301 I,as owner of the property,will do the work and the structure 1 !TEMS is not intended or.offered for sale (Section 7044, Business Other(See Complete Fee Schedule) _ and Professions Code). ® TO T AL :37.70 CONSTRUCTION LENDING AGENCY CHECK 37,70 I hereby affirm that there is a.construction lending agency for the performance of the work for which this permit is issued'(Sec.3097, PERMIT FEE (Sub:Total) CHANGE .00 Civ.C.). , PLAN CHECKING FEE Lender's Name3 Q 0000-0+001 7/ 5/90 ' PERMIT ISSUING FEE _ Lender's Address 16619 1 AM. 7:5t) 1 certify that I•have read this application and state that the above TOTAL FEE 23 , 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 abpve-mentioned I property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Si a ure of Pe mittee Date ;, WORKERS'COMPENSATION DECLARATION 78Aa63 10/91 APPLICATION FOR ELECTRICAL PERMIT 11,hereby'affirm that I have a certiflcate'of'consent to"self insure, 6r a &rtificat'� of Workers'.Compansatlon Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec.3800;L-ab.C.) Policy No. Company FOR APPLICANT TO FILL IN JOB ❑ Certified copy is hereby furnished. New Residential Bldgs.& IIsP ^� EACH NO. FEE ADDRESS 1 &2-Family,Sq.Ft. 0 $ — $ LOCALITY ❑ Certified copy is filed with the county building inspection I — NEAREST department. Multi-family Sq.Ft, Residential Swimming Pools OWNCROSER ST, Date Applicant OOWNER oR . FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' + Outlets:Rec—Light_Sw.— MAILs Y 1410 ob U COMPENSATION.INSURANCE (This section need not be completed if the work Involved by the i First 20 Total..No. Additional CITY Tel. permit.is for one hundred dollars($100)or less.)• PLAN CHECK I certify that in the performance of the work for which this permit i APPLICANT is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS Additional ,l Total No. 'CITY Tel.No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT Exemption,you should become subject to the Workers'Compensation Range_ Heater D.W. _ provisions of the Labor Code,you must forthwith comply with such Oven _ Dryer_ W.M._ ADDRESS provisions or this permit shall be deemed revoked." Top _ FAU _ W.H. _ LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other_ CITY Tel.No: I hereby affirm that I am licensed under provisions of Chapter 9 LICENSE OR Disp. — Room Air Gond. REG:NUMBER CIS$• (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. PROE Size&Type HP,KW,KVA,or KVAR. ©� Q License Number Lic.Class Up to 1 Incl. FINAL �•+ Allis Over 1 to 10 Incl. 7-1-14 1/DATE VALIDATION Day Contractor ._ Date Over 10 to 50 Incl. FINAL 13, ❑ I am exempt under Sec. Over 5.0 to 900 Inc. BY ... — B.&P.C.for this reason Over 100 n- � N Services,Swbd.,MCC&Panelboards ® Z Date: 0-200 Amp.Under 600 V i.Signature 201 - 1000 Amp.Under 600 V ❑ Over 1000 Amp.or Over 600 V Exemption for Reg.Maint.Elect. SINGLE FAMILY Temp.Power Pole&Appurtenances 2 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law ACCT o g for the following reason(Section 7031.5,Business and Professions Additional Sign Branch Circuits Code): 3307 143.030 El 1, Conduits&Conductors I,as owner of the property,will do the.work and the structure I ITEMS is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule)_ and Professions Code). ® TOTAL 143 o 00 CONSTRUCTION LENDING AGENCY CHECK 1435.al I hereby.affirm that there is a construction lending agency for the performance.of the work for which this permit is issued(Sec.3087, PERMIT FEE (Sub Total) CHANGE 'GO Civ.C.). PLAN CHECKING FEE Lender's Name i 0000-0001 7/ 5/911 PERMIT ISSUING FEE • Lender's Address 1664 1 AM 795 1 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 property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Si .a ure.of PermIttee UDate