HomeMy Public PortalAbout5318 WELLAND AVE_Electrical__ 76A663 CE-806 NF6/78 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES BUILDINOAND SAFETY
FOR APPLICANT TO FILL IN JOB
New Residential Bldgs.&Pools EACH NO. FEE ADDRESS . 5318 Welland
1 &2-Family,Sq� -Ft.' $1 — $ LOCALITY Temple CitV
Multi-family Sq.Ft. — NEAREST
Residential Swimming Pools. CROSS ST. Freer
OWNER OR
FIRM NAME lvbfarlaud
Outlets:Rec - Light Sw. MAIL
First 20 ADDRESS - 5318 Welland
Total No. Additional CITYTem 1 Cit Tel.No-579—o642
PLAN CHECK
APPLICANT
Lighting Fixtures First 20 ADDRESS
Total No. Additional
CITY Tel.No.
Fixed Appliances D.W.ces Not Over 1 HP PERMIT
Range_Heater_
APPLICANT Morales Electric
_
Oven—Dryer=W.M. ADDRESS 88-43 Ni:i.ssion Drive
Top._FAU —W.H._ CITY Rosemead Tel.No-280-_426-0
Hood_Fan —Other LICENSE OR
Disp._Room Air Cond. REG.NUMBER 2279 62 Classcjo
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA.
Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO
Size$.Type HP,KW,KVA,.or KVAR COMPLY WITH ALL .COUNTY ORDINANCES AND STATE LAWS
REGULATING ELECTRICAL WIRING.
�1—== Up to 1 Incl. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
Over 1 to 10 Incl. �� LICENSED AS REQUIRED BY LOS ANGELES LINTY AND STATE OF.
CALIFORNIA OR THAT I.AM.TH LEG ER OF THE ABOVE
Over 10 to 50 Incl. DESCRIBED RESIDENTIAL PROPER
Over 50 to 100 Inc.
PERMITEE ,.
Over 100 SIGNATURE
Services DISTRICT NO. ESSE Y g
0-200.Amp.Under 600 V � p8
201.1000 Amp. Under 6.00 V
Over 1000 Amp.or Over 600 V
Temp.Power Pole&Appurtenances •./�-�"7 3S JOG 7
Sign with One.Branch Circuit j}
Additional Sign Branch Circuits INSPECTION
MINFORMATION
ON Conduits&Conductors Yi
ON REVERSE s
Other(See.Complete Fee Schedulel SIDE u
g �j588.9A
d
# 0 0 0 0 0 2
PERMIT FEE (Sub-Totall 2 o o 2&5 0
PLAN CHECKING FEE (One-Fourth Permit Feel O
PERMIT ISSUING FEE 7 )0 p 0a02-79
TOTAL FEE 24.5 >
F
INSPECTION FINALLEED
date: d�I�/ BY IL ®s
78A88H-CE8087-88 A►PPLICA►TION FOR ELECTRIC PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS ,QJ
JOHN A. LAMBIE, COUNTY ENGINEER �•
CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY
FGARBAGE
OR APPLICANT TO FILL IN NEAREST
✓
P MWr FEES CROSS ST.
I T E M NUMBER EACH FEE OWNS •
$ $ MAIL
RECEPT. SW. ` .10 ADDRESS
G. FIXTURES. 1 . .10 � CITY TEL. NO.
GES CLO. DRYERS ELECTRICIAN "aP�
T_6 R HEATERS .50 ADDRESS
CE.HTRS. DISHWASHERS
CITY TEL. NO: O�
DISPOSERS AUTO.- STATESTA. COOKING UNITS .2S LICENSE NO.: OVER INC. H.P. DISTNT NO. GROUP z NE =,E!SE�BY
O— V2 .25
va— 2 so. M=CnON RECORD'
2— 5 1.00
5— Is 1.50
IS— So° 2.50 d �
SO-200 5.00
SIGNS: NO. TRANS. )0' cl 1-?e_'r GI GG L "7.5",
NO. LAMPS
SERVICE 0-600V I.00 q1
SERVICE OVER 600V 5.00
MISC. `/.J /Gr G-`". G^' / [./� /`�o% -•(!1i
�• i
WIRING PERMIT 1.00
00
FIXTURE PERMIT i 1.00 1O
SUPPLEMENTARY PERMIT .50
TOTAL FEE $ APPROVAL
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY OROINANCES_AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF { FIXTURES 7 'mac
CALIFORNIA OR THAT I AM THE LEG OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. POWER '
SIGNATURE ''-UTILITY CO.NOTIFIED '7
OF PERMITTEE FINA •
/ KSON ARTHUR C. VETT,
Mo OABH SUPERVISING ELETRiCAL ERGINEER
� Co6 9 3 1 Wly ?2 . 2 A •9.90
vl.� -
WORKERS'COMPENSATIONDECLARYTION E-B76AG63 APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I have a certificate of consent to self I COUNTY OF LOS ANGELES /) BUILDING AND SAFETY
insure,or a certificate of Workers'Compensation Insurance,or l (� ,
a certified copy thereof(Sec.3900,Lab.C.) ( e.
Mpg
Policy No. Company FOR APPLICANT TO FILL IN 2
New Residential Bldgs.&Pools EACH NO. FEE ADDRESS J
❑ Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ — $ LOCALITY N
❑ Certified co is filed with the count building inspection Sq. Ft. NEAREST
copy y gins action CROSS ST
department. Residential Swimming Pools
Date Applicant FIRM NAMEbl"VV\s? C
1 Outlets: Rec ti t w. f ADDRESS �/ t° 1 � At C—
First 200—
CERTIFICATE OF EXEMPTION FROM WORKERS' Total No. Additional CITY ���� Tel No.
-06 y
COMPENSATION INSURANCE
PLAN CHECK CL
(This section need not be completed if the work involved PPLICANT 0
by. the permit is for one hundred dollars ($100) or less.) Lighting Fixtures First 20 ADDRESS
Additiorial
Total No. 0
I certify that in the,performance of the work for which this CITY Tel No.
ermit is issued, I shall not em Fixed Appliances Not Over 1 HP H
p employ y an y person in any manner PERMIT 0
so as to become subject to the Workers'Compensation Laws. Range_Heater D.W._ APPLICANT O.
Oven Dryer_W.M._ ADDRESS CO)Top _ FAU W.H. Z
Date Applicant CITY
Hood _ Fan Other_
NOTICE TO APPLICANT: If, after making this Certificate of Disp. _Room Air Cond— ICENSE OR
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. PR ES BY
with comply with such provisions or this permit shall be
deemed revoked. Size&Type HP,KW,KVA,or KVAR
Up to 1 Incl.
FINAL
LICENSED CONTRACTORS DECLARATION Over 1 to 10 Incl. DATE VALIDATION
Over 10 to 50 Incl.
.I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL
B,Y
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
effect. Services
License Number n Lic.Class 0-200 Amp:Under 600 V
201-1000 Amp.Under 600 V bt r
Contractor Date Over 1000 Amp.or Over 600 V
HOME OWNER-BUILDER DECLARATION Temp.Power Pole&Appurtenances
Sign with One Branch Circuit
I hereby affirm that I am exempt from the Contractor's Additional Sign Branch Circuits
License Law for the following reason (Section 7031.5, Busi- r'3 LI 6
ness and Professions Code): . .
Misc.Conduits&Conductors
[a,,, as owner of the property, will do the work and the Other(See Complete Fee Schedule)— jt o 0 0 0 0
structure is not intended or offered for sale (Section 2 o o 1 9.30
7044,Business and Professions Code). _
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency ° ° ° 1 J` c=.
for the ,performance of the work for which this permit is PERMIT FEE (Sub-Total) i �r 2
issued(Sec.3097,Civ.C.).
Lender's Name PLAN CHECKING FEE (Oris-Fourth Permit Fee)
Lender's Address PERMIT ISSUING FEE
I certify that I have read this application and state that the TOTAL FEE
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 inspe tion purposes. ,
SEE'REVERSE FOR EXPLANATORY LANGUAGE
nature of Permittee Date