Loading...
HomeMy WebLinkAbout1155 SOUTH DIAMOND BAR BLVD (96) __. .....� - - _ .-.._,- ...�.ay..vYd?'.'%�ka:y"-ySv.a.}'Wfi!'�°"ti=R'w—�«.�,._::-.��.r �'-�-' � .:.n..ra ..:.'--'� . _ . .,..: . �:... V .- wi9Plr I - WORKERS'COMPENSATION DECLARATION 7sass3 icie7 pppLICATInN�FOR ELECTRICAL PERMIT�A ��' I here6y affirm thai I hzve a certificate of censent o sef insure, CEaesG .. � or z certificate of Workers'Compensation Insurance,or'a certifi`ed� � - - � � �C0�1f�`���OF LOS ANGELES QUILDING AND SAFETY ��� copY ihereof(Sec.3it00y.Lab.C.1 �--� (��� 7p � . . . - . . .._....;....�._.....,..,.,..,,. . ...._ ., . PolicY No.���l��i ComPa�v �T�-7'3i� !-W�T.,ll�i..�: ...,....-:�,.,._ . .. . . FOR APPLICANT TO FILL IN�� ��"' " JOB { ,p� � Certiiied copy is herzD�furnisheq. � � � EACH N0. FEE Aooaess� ��"j � ��9C�iYAtJnC3,,,'�-Y7(7- Y , Nevf Residential 6!d�s.&Poo:s , . � 7&2-Famil S R. $ — $ LOCALITY Certified cooy is ii:eC with the counh� buildin� inspecticn �'� Q� department. �- ; •� Muiti-famlly Sq.FL — �EARF'^T CRO55 5f. � : ��� Dat2��Aoplican} elJv' Residential5wimmingPools OWNEROR � -� ' � FIRM NA^AE ���- ,C7 . � CERTIFICATE OF EXEMPTION FROM RKERS � AIL � �� ���"' O�atlets:Rec Llght_Sv+.— COMPENSATIONINSURANGE � �tl /+�DRESS V�E. -�'C� iJ(?�Y` � � (This sectiort neetl not be com leted if the work irnolvetl b the Firs}2C . p Y Total No. Additional CITV i� � �� Tel.No. �� ,�'�� permit is for one hundred dollars($100)or less.) I certif that in;hc er`ormance of the work for which this ermit P�AN GHECK ✓ p p APPLICAlT is issuetl,I shali not empby any person in any manner so as to ��-. �- ---- -.-..�. become subjec[to tne Wakers Campensaiion LzJus. Lighting Fixtures First 20 ADDRESS - Additionzl . . -..- .-.....--� .. ..:..•:-,. ' - Total No. CITV Tel.No. Date App!icznt NOTIGE TC APPLICANT: li. afier making inis Certific2te oi Fixed Appliances Not Over 1 HP peRMii � '�" ""�'����-����� ExemFtion,you sho�ld become subjer,t to the N/orkers Compensztion Range_ Heater_ D.�V. _ AaPLICAN' ''V1 �' ' � provisions ef the Lzbo�Code,you must fortirmith eomply with sucn Oven_ Dryer_ 4V.M._ ADDRE55 � provisions or inis permif snall be deemeC reyoketl. Top — FAU _ Nl.H._ CITY Tel.No. p LICENSEp CONTRACTORS pECLARATION. Hood_ Fan _ Other_ I - �- !' I� I hereby affirm Ihat I aro licensed untl�r provisions of��Cfi2pter 9 uCENSECft /� (� �y - Icommencinc with Section 7000)of Division 3 of the Business and DiSo. — RoOm Air Gond. , REG.NUMBEF y..��t?'� Clals. Professions Code,and my:icsnse is in full force and effect. Po•s�er Apparatus&L2rge Appliances �^.ISTRICT NO. PROCESSED BY ('a� � Size&Type HP.KW.KVk,or KVAR � License Number Lia Ci2ss ! Up to 1 Incl. plA EL � �'7 i�p�' Over 7!0 1C Incl. � ��o`�1 VALIDATION � Contrector � j Date ( ^O. Over 10 to 50_Incl. i FlNAL O ❑ I am exem unCer Sec. Over 50 to 100 Inc B`! ��� �� W BdP.C.for this reason � Over 100 p„ . . . _......... r`76{Fn�{{ N Services,Swbd..Iv1CC&Panel6oards , Z � , _,__,Date: ,._,,,._. _ ❑-2p0 Amp.Under 600 V ^ Signature _,_ � .'.,_�., 20Y-1000 Amp.UnCer 600 V fF", ' " '2 ❑ � Ove!1000 Amp.or Over 600 V Exemotion ror Reg.Maint.Elect. � ' °7�,�l i SINGLE FAMILV � Temp.Povrer Pole&Appurtenances I � c c i 1,7��� HOPAE O`�VNER-BUILDER DECLARATION Sign with One 8ranch Circuit I here6y zffirm that I am ezempt from Cne Contracto�s License Law� Add�tional Sign BranCh Circui� � �'� �'��8 7 for the foiloa�ing reason(Saction 7031,b,8usiness ano Professions Codel: � �� �Nisa ConAuits&Conductors I,as ou�ner of ihe proFerty,wi!I do ihs work and ihe structure Other(See Complete Fee Schedulej_ is not intentled or ofiered.for sale(Sectlon 7044,Business ► and Pmfessions Codel. GONSTRUCTION LENDIPdG AGENCY - ��� - ..-..__.. .. .. . I here6y afiirm that therc is a construction lending agency for the . ... . __. performance of the work for ivhich this permit is issued(Sec.3097, pERMIT FEE � lSub-To[al) � Civ.C.1. PLAN CHECKWG,FEE, Lentler's Name . .......... ���� PERAAIT ISSUING FEE _ [ _._ Lenders Address .� I certify that I have read this application and s[ate that the a6ove TOTAL FEE f information Is correct.I agree to comply with all County ordin2nces - - .�.. -......... . .........,., ..„..,.:,.._� ,..,,;;.,..,�-...,�„.�.. •�...„.. and Stat2 la�as recu!zting Electricc�l winng: and hereby authorize � � �- �� � re resontatives of fhis Counh�to enter upon the above-mentioned�-- � -` '� � � � - ' for inspection qurno3es. SEE REVERSE FOR E%PLANATORY LANGUAGE �� � � Signature Permitte� Date __. _ _. ,�.,,� �-�..r�..�:--�-----�-. - , _... �. _ ,c: , .. . s ..s ,,:. � , . ..,..... -. ,. . _ �. ................�m. � . �_ - �-r S = c, _ ��_ - _.-_ - - "�,?e'"�'�F*�� !���n-7E�'- +'�-,�'r .. - . . . .._..___.._ _.. � . __.. __..L- ,� �_..__..,.._.._! . { .,�' E_ flC.Tt_ �I '..:r'v.;:t . n! .< hF,^«.�.,f C .l- .._ ;{.,(?�:t �... ... . _ „._:._....�_" � ". _.._..�-.__..._ � "=': 'c� tl .ci; _,._ ... .,r,,:.. � '��.�.._�..�:nn �.__ , � ' _-6._b. . _._.,_. .�_..._'_.,. . ._'. " . ra'2ss:J�s c, a .'!�^ } c'^ ,..:Y.,... _a l,3".`% . ... . . . _ , . -____ . �j._._.__,_.«...__ :4ClSf'...':�ai£C'• Y:J.'Ll S'��..�Si� "E'C�� i~S C i.3,� . . 1 . ti n� I�- ' _ �_. . . . _ . :_. . . _ ...� - - --�'-�-/`--'� '---I .. ,a �s n s � c . ._ r - r er _ - � i ir� . : ��?�c�/�/ .�•.�� ' _ : ;� �n n t-a -.r.s�r�- iz r r ., . �. . __ _. ..T. .._. . �.'.�._' _'__ __i ' ._ . . � �� . �zF,S . . . _ F, �,.r.ui �. ^ � .z. C, 7 .,•, , . _ . ., . ' c�:t'.:i'7't,•, �:�V.C ., . : 1�t?...,...n. . ..S..;C^:i '..� . .. _. .,� ..�.._:..,.._.__._ , ... � - .� ,_....w , �..._..�....__..._._._"...'"...."_w"'_"_,,._._..._.,_""'.,.., . ;. ,. � .. .._ . . ..... ,.' . ..., .• , A.' �Qt ��. : r i ' _ _' .... ..,. ^�'2i , .t.. . �u -- cY..=C.�fil. ?i!� . ... .�. � ' ... .__ , __..._._.....___.�_.�_.�..__"_.__.._- , 1 . ,. ......._ . .... , . ^�,�_,�.�"�:.] � i ' a . e.x n,.n � - fo. �,r�:,i 2 v ! , ��...:�__..---.T_....�_,____.._._.._-_._..�__._.- .,�.�..., o i,,.-�.,,,s,.ec� .e ,,....:, ,. . ,�.. :;y -._.._._�_-_� . . . . � �.��.. . ..,, z.--«.,< : .: .,mo � :.ic+ _ �,`:::� �p;. . .. . . . .� � - -v d - . � : .�. .,.,„ ,..,.,, � '.., � 6_._._...__._�.._....'___..�_._�.__._�.�_.._..__.__...,._..�......__.: -_�:ms'-�!i;.;r�:;��c;=., �...,.�.,. ..�,. - , . , ,. . .. .. . ... ,..., .. ... . . . -- .. ..r;-. .. . . . . , . . . s.-� :�.:e . . . ..�J� r..-., , ,_ . . . - .1.4�SSv �:]Ci. ,`'1�2f:•_ , . r , . . . ' ' � �..�._. ...� . o - -, . . . .. _. . _ . ,._.._.�_.:_....�,�_.:i:_....�..w �;;.�':. .5... .. „?, . .. ... _ ....'ft� �_�._" .- ... _" "'_. ._ .. . .,..___..a.....�_v �_...... ..._,_�. .�... . . ':;C:t v�(,_' _ . v,<:�.A'' :'c'I' .^l.:.n,.i ..�.__.,.... ._._..._._�...�..._.._��.�__�.<._�..._....�.:...._..._�..�_....�._..._�..._ �. ,�W.:.:�_..�.m�.�.�•_�.�...,.n..,�a�a:..a._....-�. .,�' ...�.;e:.__�.... .. ._- � , .. . , -.-.�..�� ,.,,e�..,-� ...-., �,- .,..... �.��-,_..- .,-,... -. . ,-. . . . . . . :., � :� .. _ . .. . < . :... .: . . , . . . _ . . -:�e._�'. ` -a� �--�„ier S.�.c-,;;rr.n ,-a. _ __..._�:.,:.__..-:.:...�_..�_�.....:_..._____...___...___._.,.._._.�..._._.____._._______�._....�.._._..:.,._...�.�,...,u,._�,y,�:_�.._;,:,s+�_.c�_.--.< -«wxx- � -' - �. . t� ,�..;o .e�_�...e.. ,�..::v �. 5. .,'� .. . ... , _. . ,.._ . , . ._ . . ... .. . . ., . .��f .� _l 'Ry� a ��,,,,�-,S � ..._.-._ ... _._._. ._._.,.—.__�_.�.._�._...�.._.��....-.__.._. ..�.._�_ _.... ..�.�����s:� . . _.,...._ „u.,._..a. . . .. . _... ..,_...+ . . wcw.o-z... . .. _. .. . ' . . 3�._._..-L�..-..s_. .�._. .-:_ - �.., ,....�,._.,. . ' ,. .,-:..a.>.. ..-w:»w.-.,,,.,� :..._,-, �w..�: . . . : ..__�. ...._�"�."__....,__.__'�--�...�_.�..._...._��....�:._._,_...._.�:..�.._.:.�r_.�=._._.'_".�Y.�.=�.s..�.'_..�.,:x.... -_"'=_...:_.._.�:....w. "'7-.,.:i . ._ ._._. _ . .. . -(�: . .. . � .' �.�____,...:....:.�...:..�..,....�...e...,.i.,__�.,�, ._,.. .,.. ....._. ,,.. ' '_... _ � ... .. ..... . '-"-_�_�.� ...... . �_ .�. _.._.. .....,_ ..._. . ., . . � .._.w....._..._.�_...'_"__ . . .. �.,�. .. .. ....:. ....._���. .... . . _ y .. . � - - � ". . . , . .,. . . .____.___._W.�._.___..._....._._.._.___,____._�..._...�,�._.___�.:a....,�..:;._::._._�� .__�,.....�.,.-��-�.t:.,_ww...�c..-......._..... .............. -:._<<.. ...._ ,..... .: .. ._ . .�.., . . . . .... . . , . ._._ , .......,.._... ._ .. , . ..._.. _._.._ ..'-_-._"-' '__.__.._._..___..�..__._..._.__..w_..__�.�......._.,_,.._.......�....__....:..�.��-�:..,_��:��.__ -- . _ . ,.w.-n-:,_.L....,. .,::.,,w... _� .. ..s�__,... .. .,..__ .�,._ � .,-o_....._......-`-'-.._-'_'--_._._._...._.�.__.�__...�..__�-�..r.� �-- -� ._.-..-.:. -,_� _-..�:..:��_.�..>. .�.:....a... �.w;.:....�«.»:�.v-..�._�+�w.n.vx...=ix]au. .. ...-e.. . ,..-.... .._._.."._"_'.____._._.�__,.....,._..____�.�_.�__..__...____..._.....�..._._......�_..W,...�._,.,_..�._,.,-:.r..�_:_...._._.v:..,:+�:.z...rr.•+.*�u�cxus+aifvUial"�ni.et�_��-.....�,w�.,.a.,.rma�.,�.�x+w..,.:...�.r..e.....,w�„+..:..r,.�..:...:.. . ... . xw...-.,.. _. . ___.._..'_"_.__�.._�__."___......�___..�_. .�__._...:.._....�.___...__ . .... .. .<.ea..e..n�....._.,u....rn..:.�..,-axe._�.�.au.o....�.�........a...r....m........ , .. . .,�_..__. ..�_...�._.._�.�...._:_,..._.::.:_. ..._.:_.��t,__:.8.,,.:.�....':.,. .:._ „ „ . . ' _ _'______'_—__.�_�..—._.:._�.�..._..�.s�_.._.�"'..._-'.._..�_"".-._..__.-._._,...c,:._.<:....i.a_.. ...�-,...i,'�.�.�rF....>�.�e.i..,v.,.;. . .. . r..,...,a.. , ,- ._.__._.__.�..._.__..�_.___."""...__"..__....___.....�..._....._._....._..__::e.._...___x......_.._.._._._�:. ��-��_....�]ay'n'<��a«..,...k.a'..,.m>..�...�...:.....r.�:... . ...�.....�...... `_"_'"_` -_"'-".. .,_ _.._.__.....-__...___..__........�..�.�._ �1:...�z,.s .. .. .._:.�.:..e.�__�_...._..:.f.s.s.%.��z.kL ss.+��ne�'-xs , _...:... .. ._..... . .. .. . ......_..,-.... .... . . ..�-_,.._'_ ___"_.�_�...........�___�,___...._...�_�._.......,_._..._..+.....�....:f.:.�_-�„„_�._.,....�_...�.�......__.�.:._�,.:...�:.�...»_.�..:-. � �iti�'u.+t�.....w.,^_.•�al.�4..mA:e..�W:-.m'41al..aSu1�r]MW:ISMwiNN�+ia�t»-FkxW�m.umtotai.�xuai'k.yxwrra.i.+. .. _.,._�._.__...___.'__'.__"_'".__.___.-._.....�..__.�_....._._..__..._.__�_._...___.___..._�,......._.,_._�_..:..__.._._._.�..,.=__.._ ._..._:..,..:.•_,�,_u...:...:G>'L:::..�wr�s::W'-Sr...sG>':.:H.�L...t.�P..rr�u.4w..w. .G.a. .,..aa. ...�u . . _-'..____. '__.__.-..._� .._.,__..._..____._�___..._.�_._.____...__..:_._..c .Lv< �rvu.xhA[!Rr:3�a�ks�u RSd•_..'....].3.Ee.'....__ . . ... ,. ..,.4..�.,-. �... . . c,.. 7 �.. . . ....i .