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Home My Public Portal About4943 WILLMONTE AVE_Electrical__ 76A663 DBS SA 11-50 APPLICATION FOR PERMIT - ° DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES .ELECTRIC l WILLIAM J. FOX. CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMIT NO. M I r 3lyzI ELECTRICIAN .�Ad3: ��/ �i � 11, . RECEIVED B READY FOR D TE ISSUED ADDRESS , r- B M,l� r! FIRST INSPECTION CITY -1-Yyam J TEL. NO. � COUNTY LICENSE NO. EXPIRES BUILDING ,• (a �! f ��•`�� - ys PERMIT FEES ADDRESS NUMBER IkACH FEE LOCALITY 40 / LIGHT OUTLETS _ NEAREST / (�� RECEPTACLES CROSS ST. - WALL SWITCHES --NOWNER < All- TOTAL OUTLETS Sc $ ELEC. RANGES 25 ADDRESS d/9 elk ®B AM. 1� � � •r (� ELEC. HEATERS 25 CITY �� 7 a FJ p_ f P TEL. NO. FIXTURES 5 1 HEREBY ACKNOWLED THAT 1 HAVE READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER FEE NEW MVD. HP OVEINC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. R 1/2&LESS $ .25 SIGNATURE OF 1/2 2 .50 PERMITTE 2 s 1.00 INSPECTION RECORD 5 1s 1.50 15 SO 2.50 SO 200 5.00 200 500 10.00 500 1000 15.00 Z OVER 1000 20.00 M. G. SET/FREQ. CHANGER-HP a WELDERS- AC-KVA 0 GENERATORS-KW TRANSFORMERS-KVA TEMP. MOTORS ('75%OF ORIG.) MOVED MOTORS (7S%OFORIG.) MISC. SIGNS NO. NO.TRANS. I I APPROVALS NO. NO. LAMPS DAXf INSPECTOR'S NAME FOR EACH PERMIT- CONDUIT WIRING $1.00 Fo yJj-x v' `3 'Z 7•`ate FIXTURES $1.00 /,� f�Co WIRING SUPPLEMENTARY .50 FIXTURES POWER TOTAL FEE $ pl ® UTILITY CO. NOTIFIED ® FINAL r64668 CE .806R 10./77 APPLICATION FOR ELECTRICAL PERMIT ,r: COUNTY OF:LOS•ANGELES DEPARTMENT OF COUNTY ENGINEER' gpDR i OJ1N Srd/w BUILDING AND SAFETY DIVISION. FOR APPLICANT TO FILL IN LOCA TY 11 T' �° New Residential Bldgs.&Pools EACH FE 7 , CROSS T. t 1 &,2-Family,S Ft. $ 025 — $ � q•. OWNe Multi•fomily Sq.Ft.. . •02 — FIRM NA E UA'r17'440 G Residential Swimming Pools 25.00 MAIL ' -AD-DR .51 Y 7 Qry �rr� Outlets:Rec Light—Sw. CIT Tel,No-21217 First 20 •50 PL N CHECK Total No. Additional .30 A .PLICANT f. DRESS Lighting Fixtures First 20 i50 C Y Tel.No. Additional .30 iPE IT Total No. AP ICANT k- Fixed Appliances Not.Over'l HP ADD Range—Heater_D;W._ CITY Tel.No. Oven_Dryer_ W.M.—LICENSE OR p y Top —FAU —W.H. REG.NUMBER 5 Class.- JE Ho od._Fan _Other- 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND`STATDisp. _ Room Air.Cond. 2'50 THAT THE ABOVE IS CORRECT AND AGREE'TO•COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. Power Apparatus&Large Appliances Size&Type HP,KW;KVA,or KVAR I.'HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND%OR LICENSED A2.50 REQUIRED•BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA,OR THAT 1'A Up t0'1 Ind. • .THE LEGAL OWNER OF THE ABOVE DESCRIBED:RESIDENTIALPROPERTY. p. Over 1 to.10 Incl. 5.00 Over 10 to 50 Incl. 12.50 PERMITTEE c Over 50 to 10.0 Inc. 25.00 SIGNATURE �. u:1 Over 100 40:00 EWERAUTHORIZED T NO. �t Q PRO ED y Services 0-200 Amp.Under 600 V 12.50 f ". / INSP..ECTOR'S 201.1000 Amp.Under 600 V 25.00 PPROVALS DATE SIGNATURE Over 1000 Amp.or Over 600'V 50.00 . WER POLE Temp.Power Pole&Appurtenances 10.00 LAB WORK Sign with One Branch Circuit 10.00. CONDUIT 2.00 Additional Sign Branch:Circuits Misc.Conduits&Conductors 10.00 Other(See Complete Fee Schedule) UTHORIZED O.NOTIFIED PERMIT FEE (Sub-Totall.' NOTES PLAN CHECKING FEE (One-Fourth Permit Feer PERMIT ISSUING FEE -$7.00 TOTAL FEE PLAN CHECK VALIDATION CK. M:O. CASH PERMIT A ADJOd CK, M.O. CASH 975 (D An SEE•BACK O AW PPLICATION FOR COMPLETE SCHEDULE M D.B.C^25M SETS 10-47 r I ANIMATION FOR PERMT ,II9I:,PARTMENT OF BDII.DINQs ANS� SA 'I'! il.s��ELECTRIC - ' • COUNTY OF LOS ANGELES J. FOX CHIEF ENGINEER NAME , DISTRICT NO. GROUP ZONE PERMIT NO. U z- r-- -� �z 91 ADDRESS CITY TEL.NO. RECEIVED BY READY FOR FIRST INSPECTION EXPIDATE ISSUED COUNTY �r / CERT.NO. [tE3 APPLICANT ML IN HEAVILY OUTLINEI)PORTION ONLYJOB p DESCRIPTION OF WORD ADDRESS P, NUMBER OF OUTLETS ON CIRCUITS LOCALITY o LOCATION BY ROOMS r NEAREST LIGHT OUTLETS SW. PLUGS RniT CROSS ST. CIRCUIT A B C D E F • Ga H NAME y Id / Z ADDRESS �'O y e9 3 CITYTEL.NO. 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANG€r...EB COUNTY CERTIFICATE OF QUALIFICATION.. ELECTRICIAN. �1 OAME THE LWAL OWNER OF THE PROPKRTY DESCRIBED CORREC�.'IONS J Q Z L7 O RN ' OUTLETS ffi APPROVALS RE ffi 5 DATE INSPECTOR'S NAME RS H.P. �� $ CONDUIT TRANS. ffi WIRING G -�— NO. OF 0ADMOS OR HEATERS ffi S FIXTURES IB EL ffi POWER PERMIT FE $ Z UTILITYCO.NOTIFIED , TOTAL FEE Q FINAL U 9 / rre ' 11V4RKER'S COMPENSATION.DECLARATION 20.0019 DPW(12-91) ®R ELECTRICAL PERMIT tmereby affirm that) have a certificate of consent to self insure,; 76A663APPLICATION nor a certificate o1 worker's Compensation Insurance, or•a certified .COUNTY OF LOS ANGELES DEPT.OF PUBLIC,WORKS BUILDING AND SAFETY DIV. copy thereof.(Sec.3800 Lab.+C.) Policy No. Company FOR APPLICANT TO FILL IN ADDRESS Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE '� LOCALITY r f a CI-4 I�n ❑ 1 &2-Family,Sq.Ft. _ $ $ department.Certified copy is filed with the county building inspection Muld-family Sq.Ft. d CROSS ST. j Date Applicant Residential Swimming Pools ASSESSOR MAP BOOK AGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' � OWNER OR - + COMPENSATION INSURANCE Outlets:Rec. Light Sw. FIRM NAME J First 20 MAIL 4ry t (This sectiori need not be completed if the work Involved by the Total No.�[.[ Additional ADDRESS 6 permit is for one hundred dollars($100)or less.) — I certify that in the performance of the work for which this permit li CITY el.No. I ssuad, I shall not employ any person•in any manner so as to I, PLAN CHECK oma subject to the Workers'Compensatiqn Laws. Lighting Fixtures First 20 APPLICANT 1 . Total No.. Additional a •., (,� ADDRESS Date +% L Applicant �f �«---- RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: If, after making this Certificate of j; CITY Tel.No. Exemption,you should become subject to the Workers'Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code, you must forthwith comply with such , PERMITA� provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. (commencing with Section 7000) of Division 3 of the Business and CITY Tel.No. Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. ` LICENSEClass. d Over 50 t0 100 Incl, REQ NUMBER Over 100 DISTRICT NO. PR B O License Number Lie.Class Services,Swbd.,MCC&Panelboards �(� Contractor Date 0-399 Amp.Under 600 V FINAL DATE a El 400-1000 Amp.Under 600 V I V I am exempt under Sec. Over 1000 Amp.or Over 600 VFINAL _ • VALIDATION W FI AL d B.&P:C.for this reason BRANCH CIRCUIT FEES Z Date: 15A,or 20A,120V,Lighting or Recept. �' 1 To 10 Branch Circuits 4 Signature 11 To 40 Branch Circuits ❑ 41 Or More Branch Circuits Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits SINGLE FAMILYr Temp.Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit Fit S.• u s 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 -7 '? E..7 San J'[ Code): F1 1,as owner of the property,will do the work and the structure Misc.Conduits&Conductors t�(q+_ I is not intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule) +'51 =60 and Professions Code). FF r ft _qq 1_ CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the .{AN113E AID performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (S -Total) Civ.C.) PLAN CHECKING FEE 9.}1}3 Lender's Name PERMIT ISSUING FEE s./4U F All 84,R Lender's Address TOTAL FEE I certify that I have read this application and under penalty of purjury state that the above information is correct. I agree to comply with all County I ordinances and State laws regulating Electrical wiring,and hereby authorize representatives of this County to enter upon the above-mentioned property for inspe .Ion p rposes. SEE REVERSE FOR EXPLANATOR LANGUAGE SIGNATURE OF PERMITTEE DATE